South Asians are nearly twice as likely to develop type 2 diabetes and cardiovascular disease as other populations, yet the region lacks the evidence base needed to design effective healthcare interventions. This research unit will build surveillance systems—health observatories and disease registers—across Bangladesh, India, Pakistan and Sri Lanka to track disease burden, risk factors, and quality of care. The team will then test low-cost, scalable strategies for prevention, early detection, and management, using technologies such as mobile health platforms and community-based screening. If successful, the work could shift national health programmes from reactive treatment to proactive prevention, reducing the 17.5 million annual deaths from cardiovascular disease globally and the economic strain that pushes families into poverty. The project also strengthens local research capacity through training programmes, exchange schemes, and tenured lecturer positions, ensuring that knowledge generated in South Asia stays in South Asia. This is applied implementation science: it aims to close the gap between what is known to work and what is actually delivered in resource-poor health systems.
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Strategic objectives and positioning Imperial College London identifies improving global health and wellbeing as one of four key strategic objectives.(1) Transformational global health research for T2D and CVD is delivered through the School of Public Health, the Wellcome Centre for Global Health Research, the WHO Collaborating Centre for NCD Surveillance and Epidemiology, the WHO Collaborating Centre for Public Health Education and Training, the Institute of Global Health Innovation, the Clinical Trials Unit and Imperial College Business School. Our inter-disciplinary team (9 Chairs, >30 researchers) harnesses expertise in translational research for prevention and control of T2D and CVD in national and global settings, including South Asia. Imperial further commits 2 tenured Lecturer positions, educational funding for LMIC researchers (stipends for MPH courses, an exchange program, and an international workshop), and space within the School of Public Health. Institutional partnerships and strategies We take advantage of partnerships with clinical institutions, academic centres of excellence, non-governmental and governmental organisations in Bangladesh, India, Pakistan and Sri Lanka (Letters of Support [LoS], Diagrams 1-3). We are aligned to national programmes for prevention and control of T2D and CVD,(2-5) and leverage ongoing investments by partners in all 4 countries. We will strengthen Centres of Excellence in Translational Research, establish Translational Research Networks (Diagram 2), and support programmes for high quality training in each country, to build sustainable capacity and capability. Stakeholders are committed to contributing resources to projects (eg Corporate Social Responsibility, see FICCI LoS). Proposed programme of research -Scientific strategy We will develop acceptable, equitable, efficient, scalable and sustainable approaches to prevention and control of T2D and CVD in South Asia, taking advantage of low-cost innovative technologies, to enhance the efficiency, effectiveness and equity of health systems. Our goal is to translate knowledge into practice and policy, to reverse the current epidemics of T2D and CVD, and improve health and welfare in South Asia. We focus on T2D and CVD based on the high burden of these related diseases on the Indian subcontinent.(6-8) The similarities between South Asian countries will facilitate South-South learning, rapid dissemination, early implementation and wide impact. -Global health agenda CVD and T2D are leading, inter-linked global health challenges: 422M people live with T2D, while CVD caused 17.5M deaths in 2012 (31% of global mortality).(9, 10) T2D and CVD pose enormous economic burdens on individuals, families and healthcare systems,(11-13) and contribute to poverty, inequality and social instability (Diagram 4). Our proposal is targeted to reversing the global epidemic of these diseases, and contributing to the UN Sustainable Development Goals, and WHO Global Action Plan for Prevention and Control of NCDs (Diagram 5).(14,15) The burden of T2D and CVD are especially high in South Asia,(6-8) the most populous and densely populated region of the world (1.73 billion people in 2015, 25% of world population, 3% of land area). There remains little evidence base to inform healthcare interventions for T2D and CVD in these resource-poor environments. This knowledge gap contributes to the continued, rapid increase in the burden of T2D and CVD, and to widening global health inequality. -Aims and objectives (Diagrams 6-10) i. Surveillance: strengthen surveillance systems to provide robust data on the burden of T2D, CVD and their risk factors (health observatories), and on quality of care (disease registers) in South Asia. Thus, quantify needs, inform priorities, and impact of healthcare interventions. ii. Strategies for prevention and control: prioritise strategies for prevention, early detection and management of T2D and CVD, taking accou
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