Active Public Health & Healthcare

Non-Communicable Diseases

In plain English

AI plain-English summary

Diabetes in sub-Saharan Africa strikes lean people, not just the obese, and mental illness often accompanies chronic infections like HIV. Researchers are now working to understand why non-communicable diseases (NCDs) take these different forms in Africa, and to find treatments that actually work there. This matters because solutions imported from wealthy countries may fail in Africa, where local factors—genetic susceptibility, past malnutrition, and chronic infections—shape how NCDs develop. Without targeted research, millions of people could receive ineffective or harmful care. The team will first characterise diabetes in lean Africans, determining whether it stems from a small pancreas (due to early malnutrition or infection) or from insulin that does not work properly. They will then test whether standard diabetes drugs, designed for obese patients, are effective in this population. Separately, building on evidence linking HIV and depression in young people, they will design a psychological intervention delivered by lay health workers and test whether it improves mental health outcomes. Finally, they will study how to improve healthcare access and quality of life for people living with both infections and NCDs, a combination that causes severe disability. If successful, this research could reshape how diabetes and depression are diagnosed and treated across sub-Saharan Africa, replacing imported guidelines with evidence-based, locally effective care.

View original technical description
Non-communicable diseases (NCDs) pose a threat to sub-Saharan Africa (SSA), but there is little research to address this challenge. We have shown that NCD manifest differently in SSA. For example, mental illness is often seen with chronic infections (eg HIV). Similarly, type 2 diabetes occurs in lean individuals Africa, unlike in the West where it associates with obesity. Solutions from elsewhere may therefore not be necessarily effective in SSA. The unique NCD presentations are likely shaped by local factors, such as genetic susceptibility and other exposures, including infections and malnutrition. We aim to do rigorous research to uncover the fundamental underlying mechanisms, and to find best ways to prevent and treat these disorders in Africa. We will carefully characterise diabetes to see if it is caused either by lack of insulin (eg because the pancreas is small from previous malnutrition or infection) or because the insulin produced is not working well. We will test if drugs used to treat diabetes in the obese work in thin Africans. Building on our studies that have strongly linked HIV and depression, particularly in young people, we will design and test psychological intervention(s), delivered by lay health workers, to manage depression in young people living with HIV. As combination of infection and NCDs can cause huge disability, we will study how to improve the quality of life of people with disabilities, including through better access to healthcare.

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Researchers

Moffat Nyirenda (Principal Investigator)

Related Research

Grants with similar aims, by meaning.

Understanding non-communicable diseases (NCD) and the role of infection in Africa: building a partnership to generate big data
Epidemiology of metabolic risk factors in Uganda
Chronic Disease in Sub-Saharan Africa: a critical history of an 'epidemiological transition'.
Evaluation of Interventions and Diagnostics of Neglected Tropical Diseases in sub-Saharan Africa
NIHR Global Health Research Group on prevention and management of non-communicable diseases and HIV-infection in Africa, Liverpool School of Tropical Medicine

Original classification

Intramural

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