Strengthening research capacity in LMICs to address the global NCD burden

Figures & data

Figure 1. Awards by Country of Focus

Figure 2. Research Topics of Funded Awards, 2001–2017.Grants can focus on more than one research area, and thus a grant can be counted in more than one NCD category

Table 1. Examples of Research Outputs

Clinical Protocols
Forty-six percent of projects surveyed reported creating a clinical protocol to be used in an LMIC context, including:
– protocols for clinical trials of anti-cancer therapy in breast cancer patients
– provincial protocols for a) the assessment of first episode psychosis and prodromal status, and b) the assessment of untreated psychosis and reduction of untreated psychosis
– a WHO Mental Health Gap Action Program-based protocol for use by health providers
– a research protocol for the management of sickle cell disease
– protocols for air sampling and analyses in Mongolia
– adapted protocols for primary care physicians in Ukraine treating patients with addiction
– protocol for clinical use of dental prostheses for periodic uptake of fluoride
Patient Registries/Databases
Forty-two percent of projects surveyed implemented new patient registries or databases, collecting information ranging from stroke incidence in Peru to biospecimens in China to alcohol addiction in Poland. In Nigeria, grantees developed a Food Frequency Questionnaire that aggregates dietary intake over time and a validation tool through which they can assess the collected data.
Analytic Tools
A grantee group in Thailand made a software application to assist in the analysis of large national health data sets for diabetes studies. Another team designed a data analysis platform for genetic studies that can be used to identify genotype-phenotype relations in genome-wide association studies.

Case Study: Research Training and Partnerships in Mental Health

Mental health is a key gap in NCD research and research capacity in many LMICs. FIC Program grantees from the University of Pittsburgh sought to address this gap by leveraging their co-funded National Institute of Mental Health (NIMH) award to develop a program that provides psychiatric research training to investigators in Egypt and India [12]. Through this grant, forty-one trainees were enabled for three months or more to study novel and effective interventions for schizophrenia and other topics including mental functioning, hepatitis C, and mental health-related stigma. Trainees have also partnered with U.S. and LMIC investigators to develop collaborative grant applications for multi-site research studies, further extending the reach of their work. Program funding allowed these researchers to be trained at their home institutions and focus on addressing local mental health concerns. Such a robust project demonstrates the power of collaboration, both among the researchers themselves as well as between NIH Institutes. FIC and NIMH have worked together closely to synergize their approaches to capacity building related to NCDs to help ensure that the best scientific outcomes are developed.

Case Study: Clinical, Operational, Health Services, and Prevention Research in India

Over the past decade, FIC-supported grantees from the University of Alabama at Birmingham led a program in India that has trained a cadre of local investigators in clinical, operational, health services, and prevention science research focused on NCDs [13]. In collaboration with Chennai’s Madras Diabetes Research Foundation (MDRF), the program has provided short-term training sessions to an estimated 750 researchers, enabling them to understand the impact of NCDs in India and develop methods to address them. Trainees are taught research methodologies, data management, sample handling systems, basic science and other research skills through a variety intensive training workshops, video conferences, and special courses. The program also created the Indian NCD Network, a formal entity that provides clinical research training on diabetes research and prevention, a major health concern in India. MDRF has evolved into one of the leading diabetes and clinical care institutions in South Asia, and FIC’s training program has helped identify promising young investigators for leadership roles. The program has brought national awareness the problem of NCDs in India, and helped provide the evidence and regional research capacity needed to address it.

Table 2. Examples of Policy and Practice Impact

South America
In the Jujuy Province of Argentina, grantees trained primary care health agents on early identification, referral and follow-up of individuals with psychosis, a plan later implemented by the Ministry of Health. The region has since seen a twofold increase in the number of psychologists and psychiatrists in the ministry services. The grantees also participated in an WHO-sponsored meeting to establish a strategic plan and research agenda for national mental health reform in Peru.
East Asia
Program fellows conducted empirical work that informed the drafting of China’s first national mental health law in 2013. A FIC-grant principle investigator was a co-author of the law, and continues to provide information to mental health specialists across the country about the provisions of the law and study the effectiveness of its implementation process. The grantees were recognized in 2012 by the Shanghai Municipal Government’s prestigious Magnolia Silver Award for their dedication to mental health services research, policy advice, and capacity building efforts in the country.
Middle East
FIC-funded U.S. researchers worked alongside Egyptian counterparts to conduct multi-country studies on the highly addictive and abused opioid Tramadol. The evidence collected has informed the WHO and governments of Egypt and the United Arab Emirates about the treatment needs of Tramadol users, resulting in the approval of addiction medications in these countries.

Zeitvogel K. Focus on NCDs: energizing psychiatric research in Egypt, India. Global Health Matters. 2017;16:7.

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Confronting South Asia’s diabetes epidemic [Internet]. Bethesda, MD. Fogarty International Center; 2020 [cited 2020 Oct 15]. Available from: https://www.fic.nih.gov/News/Examples/Pages/india-diabetes.aspx

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