Global Alliance for Chronic Disease to fight against chronic non-communicable diseases

Nov 17 2009

An alliance of institutions collectively managing an estimated 80 percent of all public health research funding worldwide today announced their first targets for concerted action in the fight against "chronic non-communicable diseases" (CNCDs).

Lowering hypertension (high blood pressure), and reducing tobacco use and the indoor pollution caused by crude cooking stoves in developing countries -- which together contribute to about 1 in 5 deaths each year -- were chosen as initial priorities for the unprecedented coordinated research program under the recently-formed Global Alliance for Chronic Disease.

The priorities were set earlier this month in New Delhi, India, at the Alliance's inaugural scientific summit. 

The Alliance was created last June to support clear and coordinated research funding priorities in the battle against CNCDs, namely:

·         Cardiovascular diseases (mainly heart disease and stroke)

·         Several cancers

·         Chronic respiratory conditions, and

·         Type 2 diabetes.

Three new members (the South African Medical Research Council, the Qatar Biomedical Research Institute, and the National Institute of Mental Health (NIMH) of the US National Institutes of Health) were welcomed by the Alliance's six charter members:

·         Australia National Health and Medical Research Council

·         Canadian Institutes of Health Research

·         Chinese Academy of Medical Sciences

·         Indian Council of Medical Research

·         U.K. Medical Research Council, and

·         U.S. National Institutes of Health, specifically its National Heart, Lung, and Blood Institute (NHLBI), the Fogarty International Center, now joined by NIMH (the three NIH members sharing one vote on the Alliance board).

Welcomed also were three new partner organizations:

• Pan American Health Organization, Chronic Disease Prevention and Control  Department
• World Heart Federation, and
• National Institute of Medical Research, Tanzania

According to the World Health Organization (WHO), which is represented on the Alliance Board by an official observer, 58 million deaths were recorded in 2006, some 60 percent of them caused by CNCDs -- twice as many deaths as the combined total of HIV/AIDS, tuberculosis, malaria, maternal and peri-natal conditions, and nutritional deficiencies.

The health impact and socio-economic cost of CNCDs is enormous and rising, upending efforts to combat poverty.

About 11.5 million deaths per year are attributed to hypertension, tobacco and indoor air pollution from cooking stoves, representing almost one-third of the 35 million deaths caused annually by CNCDs (please see appendix 1).

Alliance members also agreed in New Delhi to commission several scoping initiatives to prepare future joint research into obesity and diabetes, a process to be led by the Alliance's acting Executive Director, Prof. David Matthews of Oxford University.

The Alliance's multi-country, multi-disciplinary research will focus in particular on the needs of low and middle income countries, and on those of low income populations of more developed countries.

Collectively, Alliance members expect to invest tens of millions of dollars in their first coordinated research programmes over five years.

Members agreed that the research must, among other things:

·         Involve local policymakers from the outset, with a commitment to scale up successfully tested programs

·         Measure clinical outcomes - for example, a reduction in the incidence of stroke, not just a drop in the incidence of hypertension

·         Ensure that human and other resources are not diverted from local health care systems

·         Create a tool-kit to be used later to scale up and replicate successfully tested programs

·         Include a training / capacity building component.

Alliance members also agreed at their board meeting in New Delhi to fund a program to identify the world's "Grand Challenges in Mental Health" under the leadership of the US National Institute of Mental Health, in association with Alliance Board Chair Abdallah Daar of the McLaughlin Rotman Centre for Global Health, Toronto, and Vikram Patel, of the London School of Hygiene & Tropical Medicine and Sangath in Goa, India.

Though not traditionally listed among chronic non-communicable diseases, the Alliance expanded its mandate to include mental illnesses because of their link to CNCDs and the rising toll they take globally, including 1 million suicides annually, eating disorders and alcoholism leading to death by illness and injury. 

Some experts predict mental health problems will become the world's second leading cause of disease burden by the early 2020s.

Says Dr. Pamela Y. Collins, Associate Director for Special Populations and Director, Offices for Special Populations, Rural Mental Health Research and Global Mental Health at NIMH: "Our mission at the NIMH is to conduct and support research on mental disorders that will ultimately lead to prevention, recovery and cure.  We have an opportunity to engage the global mental health community around pressing research questions. We are excited to be working with the Alliance and look forward to developing the Grand Challenges in Global Mental Health."

It was agreed in New Delhi that Canada's International Development Research Centre will host the Alliance secretariat, subject to IDRC board approval.  IDRC will leverage its experience with the Global Health Research Initiative in the delivery of the goals and objectives of the GACD.  Ottawa-based IDRC was chosen from among six expressions of interest from around the world. 

And, at the invitation of the Chinese Academy of Medical Sciences, China will host the Alliance's next scientific and Board meeting in 2010.