Our Research

The LMICs face dual, intertwined challenges of a rapidly growing burden of NCDs and the existential threat of global environmental change. In addition, health systems in LMICs face specific challenges in delivering high-quality, equitable services for NCDs prevention and care, especially for marginalised populations most impacted by environmental change.

With a focus on Bangladesh, India, and Indonesia, which are highly impacted by the dual challenges of NCDs and environmental change, our program will address crucial knowledge gaps through our research teams

We are a four-country multi-institutional collaboration started in October 2022 to generate the best actionable evidence to combat the dual challenges of global environmental change and non-communicable diseases (NCDs).

Hosted by The George Institute India, in partnership with Imperial College London, the NIHR Global Health Research Centre for Non-Communicable Diseases and Environmental Change aims to be a recognised centre of excellence on non-communicable diseases (NCDs) and global environmental change in low and middle-income countries (LMICs), offering world-leading research, training and policy advice for health equity.

Addressing Non-Communicable Diseases (NCDs), particularly in countries with limited resources, is a global health priority endorsed by Goal 3.4 of the Sustainable Development Goals (SDG). Similarly, safeguarding the environment is a crucial aspect of sustainable development. The WHO Global Strategy on Health, Environment, and Climate Change emphasizes the urgent need, potential, and framework for promoting actions that yield dual benefits. These actions aim to enhance health system resilience to address the prevention and care requirements of populations most affected by rapid environmental changes.

Despite the urgent need for action, there is a shortage of evidence regarding effective and economical strategies to tackle both these challenges in countries with limited resources. The NIHR Global Health Research Centre on NCDs and Environmental Change is a collaborative effort involving four institutions based in low- and middle- income countries (LMICs) across Bangladesh, India, and Indonesia. In each of these countries, comprehensive interventions will be designed and assessed at the intersection of environmental factors and NCDs, within both multiple sectors and primary healthcare. These efforts will employ rigorous implementation science methods.

While distinct priorities have been identified for each country, we actively encourage and consider the integration of successful elements developed in one country into the approaches of others. Furthermore, a supplementary research theme focuses on comprehending and enhancing Comprehensive Environmental Interventions (CEI) for maximum impact.

Our Focus Areas

SMARThealth” (Systematic Medical Appraisal, Referral, and Treatment), an innovative primary healthcare approach with mobile technology support, already operational in India and Indonesia (Figure 2). Similarly, COBRA-BPS, involving government community health workers, physician training, and care coordination, is enhancing primary healthcare across Bangladesh, Pakistan, and Sri Lanka. These strategies have demonstrated their efficacy in enhancing guideline-based preventative healthcare for NCDs. Building on these successes, we envisage an extension of these PHC strategies to tackle environmental hazards and a broader spectrum of health conditions. This expansion aims to cater to vulnerable communities experiencing environmental shifts while operating within fragile healthcare systems.

  • Leveraging food aid for NCD prevention in India
  • Coastal water salinity and hypertension in Bangladesh
  • Plastics burning and air pollution in Indonesia

Through our research programme, we aim to empower communities, local populations, and primary healthcare professionals who actively contribute to the design, implementation, and evaluation of interventions.

Another critical facet of our approach is Research Capacity Strengthening (RCS). We are crafting a robust RCS framework that is custom-tailored to bolster capacities at the individual, institutional, and network levels. In line with this, we are establishing a global research consortium focused on addressing emerging threats arising from the nexus of NCDs and environmental change. We are committed to providing interdisciplinary research training that promotes gender equity for PhD students, postdoctoral fellows, and emerging research leaders.

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Through our research programme, we place a strong emphasis on Community Engagement and Involvement (CEl) as a pivotal aspect of the evidence-to-policy process within each research focus area. Our engaged communities provide invaluable perspectives, lived experiences, insights, and ideas at all stages of our research.

The insights gleaned from these evaluations will inform the development of optimal strategies to drive future CEI efforts across research, advocacy, and policy realms within the region. These initiatives will also support and nurture the next generation of community activists, fostering a strong bond between health and environmental community engagement.

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