Afghanistan and Pakistan are facing a surge in heart disease, diabetes, and common mental disorders, yet their health systems remain focused on infectious diseases and maternal care. This research centre will develop and test affordable, scalable ways to prevent and treat these non-communicable diseases (NCDs) together—giving mental health equal priority with physical health for the first time in these settings. The problem is stark: there is almost no local data on what works, how much it costs, or how to scale up effective treatments. Conflict has drained resources and left a severe shortage of trained researchers. Without action, premature deaths, disabilities, and economic losses will accelerate. If successful, the centre will embed proven interventions—using community health workers, private clinics, and workplaces—into existing health platforms. It will also evaluate policies already in place and model new ones. Crucially, the project will train 30 early-career researchers and 70 support staff, build institutional capacity for research governance, and create academic career paths. The long-term goal is to transform local institutions into regional NCD knowledge hubs, producing evidence that can shape health policy across both countries.
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The rapid rise in NCD-related morbidity and mortality represent a critical challenge in Afghanistan and Pakistan. With policies and systems traditionally geared towards communicable and maternal/neonatal disorders, and resources depleted due to regional conflicts, the NCD-related threat remains largely neglected. Empirical evidence on the (cost-)effectiveness of interventions addressing NCDs is scarce. Likewise, there is inadequate data to inform and evaluate policies. Our understanding of how to scale-up efficacious/effective prevention and treatment strategies is also poor. This evidence gap may widen due a dearth of trained researchers and institutional capacities. Our aim is to prevent premature deaths, disabilities, and economic loss due to cardiovascular diseases, diabetes and common mental disorders in Afghanistan and Pakistan. Our strategy to strengthen research capacity will be embedded within our research plan to develop and evaluate individual- and population-level interventions to address afore-mentioned NCDs. Uniquely, we will give mental health parity alongside physical health. Our research strategy is based on local needs, knowledge gaps, value-of-information analysis, and stakeholder-identified priorities. While a suite of planned studies will be ready at the inception, further studies will be prioritised through a formal process. We will select interventions that are likely to be affordable, scalable, and efficacious and are recommended by the WHO best-buys , Disease Control Priorities-3 and relevant Lancet Commissions. We will deliver these using sustainable platforms cognisant of the diverse and dynamic health systems in Afghanistan and Pakistan. These platforms will utilise community healthcare workers, non-state actors, private providers, and workplaces in preventing, screening, and treating NCDs. Furthermore, we will evaluate intersectoral policies that have been implemented already, and model others that are still under consideration. Our capacity strengthening strategy focuses on promoting gender equity, mentorship, academic leadership, and allied health professionals. We will train 30 early-career researchers (Masters=8, PhDs=16, Postdocs=6) and 70 research and support staff (certification courses). To maximise experiential learning and diversify supervision, our trainees will be embedded in our research thematic teams. By creating academic positions and open-ended contracts and supporting post-docs in securing fellowships, extramural funds, and promotions, we will help streamline academic career paths. Institutions will become good at research governance, grant management, mentoring academics and engaging with communities and policymakers. The Centre will establish a sustainable partnership between national experts in cardiovascular diseases, diabetes, mental health and health systems, world leaders in health economics and trial-based evaluations, national and regional policymakers, and communities. We will use a variety of dissemination channels to make our findings accessible to relevant audiences. By co-producing high-quality competitive and scalable research, creating a diverse group of world class academic leaders in NCD, and helping institutions in transforming to regional NCD knowledge hubs, our Centre will bring significant health, societal and economic benefits to Afghanistan and Pakistan.
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