Research Themes

Non-communicable diseases (NCDs) are rapidly increasing and are now responsible for 64% of deaths and disabilities globally. In Pakistan and Afghanistan, they account for almost a million deaths every year.

There is an urgent need for new interventions that are effective and can be delivered at scale in low-resource, conflict-affected settings. The five-year £7.6m Centre provides new opportunities to develop, test and embed evidence-based treatments that address NCDs.

The Centre will deliver on four research themes, based on local needs, knowledge gaps, value-of-information analysis, and stakeholder-identified priorities.

For each theme, established consensus development methods will be used to select candidate interventions.

Theme A: Population-level interventions

NCD-related behavioural risk factors pose substantial challenges in Pakistan, acknowledged in a recent Government brief “Intersectoral policies for Pakistan to Reduce Health Risk”, and in the Country Cooperation Strategy for WHO and Pakistan 2020–2025.

The brief listed 29 “highest priority” intersectoral policies that serve as a reference for this theme, in addition to the conclusions of a Government-commissioned Technical Working group that included Centre’s team representatives.
Afghanistan is at an earlier stage of the demographic transition than Pakistan, but is increasingly adding NCD risk factors to the ongoing burden of communicable diseases. The ongoing humanitarian crisis situation calls for more rather than less action for health, including for NCDs, which typically do not receive the attention they deserve in such circumstances, particularly for preventive NCD policies.

We aim to support the governments and relevant international agencies/donors by producing evidence to inform the prioritisation of population-level policies from among tight (and uncertain) resource envelopes.

Theme B: Addressing the mental health treatment gap

In Afghanistan and Pakistan, common mental disorders (depression and anxiety) are responsible for 0.7m and 3.1m disability-adjusted life years lost, respectively.

Yet >90% of cases go untreated. To address this, we focus on post-conflict settings and chronic physical disease populations, in which common mental disorders (CMDs) are particularly prevalent, and where implementation of effective interventions, delivered by non-specialist workers, has huge potential to alleviate distress, improve health and save costs.

Theme C: Preventing diabetes

Pakistan ranks 4th in the world for the number of people with type-2 diabetes (diabetes) in 2019 (19m), 2030 (26m) and 2045 (36m).

The Centre will deliver a set of studies involving patients, families and communities in diabetes prevention.

In Pakistan:

  1.  Assess (cost-)effectiveness of a community mobilisation intervention in preventing diabetes
  2.  Assess feasibility of a family-based intervention to prevent and manage diabetes

In Afghanistan, we will assess the feasibility of the above approaches

Theme D: Reducing cardiovascular disease risk

A steep rise in CVD burden in LMICs calls for an urgent need for strengthening health systems and multi-sectoral collaborations.

Building on our previous work on hypertension, and medications access, community-based CVD cohorts, and school- based approaches for childhood obesity, in Pakistan, we aim to:

  1. Study the implementation of an evidence-based community-based hypertension control intervention
  2. Co-create and evaluate the (cost-)effectiveness of a workplace-based programme for reducing CVD risk
  3. Assess the feasibility of school-based interventions for addressing childhood obesity