Lung disease and tuberculosis together account for three of the top five causes of death worldwide, and this research unit will develop and test integrated approaches to tackle them across Africa. The problem is that communicable diseases like TB and non-communicable lung conditions—such as those caused by air pollution and tobacco smoke, which kill 13 million people globally each year—are converging in low- and middle-income countries. Health systems designed for one set of diseases struggle to handle both at once. This unit brings together clinicians, social scientists, health economists, and policy experts to develop interventions that work in these complex settings. If successful, the research could produce policy-ready findings that reshape how respiratory care is delivered across African health systems. The unit will also train five PhD students and five post-doctoral scientists from partner countries, building long-term research capacity. The aim is to reduce premature deaths from non-communicable lung disease, TB, and air pollution, while supporting progress toward Universal Health Coverage.
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STRATEGIC AIM To improve the health of children and adults in Africa through multi-disciplinary applied health research on lung health and TB. HOW THIS WORK WILL BUILD ON LSTM STRATEGY LSTM's vision is to save lives in resource poor countries through research, education and capacity strengthening. The work the Unit will conduct and co-ordinate has the LSTM mission at its core: to reduce the burden of sickness and mortality in disease endemic countries through the delivery of effective and affordable interventions which improve human health for the poorest communities. LSTM's track record of successful development of scientific advances and their translation into evidence-based policies and practices is underpinned by collaborative multi-disciplinary work in over 70 countries. Our International Multidisciplinary Programme to Address Lung health and TB in Africa (IMPALA) will add value to high-level LSTM strategy and benefit from a thriving, internationally-excellent global health research environment. WHY LSTM IS WELL PLACED TO MAKE THIS APPLICATION LSTM is uniquely positioned with a critical mass of internationally excellent clinical and applied health scientists with expertise in lung health and TB in the tropics. There is considerable momentum within applied global health research at LSTM - e.g. LSTM has made several senior academic appointments over the last 5 years to provide global health research leadership in this area. CAHRD was established in 2012 to create a global network of individuals, disciplines and organisations to facilitate both applied global health research and the development and evaluation of interventions to transform health systems and improve health for people in LMICs. CAHRD is led by LSTM in collaboration and partnership with individuals and organisations from over 20 LMICs. This application will leverage these various investments and substantially scale-up our capacity to deliver impact through world-leading multi-disciplinary applied global health research. EXISTING LSTM PARTNERSHIPS AND STRATEGIES Existing collaborations and partnerships have been included in this proposal where they have synergies with the overall theme of lung health and TB. The Unit will generate new applied health research findings that are policy- and practice-ready on the closely interlinked themes of non-communicable respiratory disease, TB, acute presentations of respiratory disease, and air pollution and tobacco-related disease through multi-disciplinary (clinical, applied social science, health systems, health economics, modelling, policy, delivery and impact) work. It will invest strategically in building capacity and capability through 5 PhD studentships for African students, adding value to our existing LSTM-led MRC funded Doctoral Training Programme in Global Health, as well as in 5 post-doctoral scientists based in LMIC partner organisations or at LSTM. Strengthening LMIC partner research infrastructure and individuals’ skills at all levels will help ensure future sustainability of investments in capacity and capability. PROPOSED PROGRAMME OF RESEARCH Non-communicable lung diseases, TB and acute presentations of lung disease account for 3 of the top 5 causes of death worldwide, disproportionately affecting the world's poorest people. The inhalation of polluted air, including tobacco smoke, causes 13 million deaths globally a year. The co-existing burdens of communicable and non-communicable lung disease bring special challenges to health systems adapting to epidemiological and socioeconomic transitions in LMICs. We will develop and evaluate integrated, multi-disciplinary approaches in intervention development, evaluation and implementation research to meet these challenges, and address the SDGs for health including reducing premature mortality from non-communicable diseases (NCD), TB and air pollution. Our outputs will also help achieve the goals of Universal Health Coverage. STRATEGIC RESEARCH
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