ARUA Center of Excellence for Non-Communicable Diseases - Mini-Grants 2020-2021

Introduction and Purpose UK Research and Innovation (UKRI) through the Global Challenges Research Fund has awarded the University of Nairobi on behalf of the ARUA Center of Excellence for Non-Communicable Diseases (ACE-NCD) a capacity building grant. Part of the funds is to provide mini-grants in support of scoping studies and pilot studies that lead to strengthening research collaboration among researchers in the ACE-NCD universities, and strengthen proposals submitted by ACE-NCD teams to conduct cutting-edge research that addresses one of the thematic areas listed below. Under this call activities must be undertaken and funds must be spent before March 31, 2021. ACE NCD Universities are the Makerere University, University of Ghana, University of Ibadan, University of Nairobi, and University of the Witwatersrand. Example activities include focused research workshops to develop sustainable strategies and partnerships for future activities, with clearly identified outcomes; preliminary data collection, analysis or research-focused proof of concept. It is expected that the outcomes of mini-grant activities will inform more substantive funded research into and impact on addressing NCDs in Africa. Strategic Priorities and Criteria Funding is available to support projects that are within the ACE-NCD thematic areas: Prevention – Much of the increase in NCDs in SSA is due to rapid unplanned urbanization, deteriorating environments, population ageing, and lifestyle changes such as decreasing physical activity, obesity, tobacco use, and increasing consumption of alcohol and unhealthy foods. Our approach to prevention of NCDs is modelled after the WHO three-pronged approach that includes epidemiological surveillance, primary prevention, and secondary prevention targeted at preventing complications and improving the quality of life through medical, psychosocial and/or economic interventions. Interdisciplinary research shall interrogate the root causes and propose innovative interventions that make efficient use of existing resources. Multi-morbidity - There is a high prevalence of NCDs multi- morbidity, ‘the coexistence of more than one chronic non-communicable disease in an individual at any one point’. However its aetiology, mechanisms and pathophysiology is poorly understood, with little data available. NCD health seeking behaviour is symptom driven, thus asymptomatic disease conditions receive very little attention, both at individual level and amongst health systems planners because the need is masked. There is a need to conduct research to understand the social determinants, the magnitude of the problem, characterize it, define pathways of progression of the disease conditions, detect coexistence of and interactions between NCDs and infectious diseases. Mechanics of Disease - In order to manage and prevent NCD multi-morbidity in a rational manner, it is necessary to understand the natural history of the contributing diseases and to define the mechanistic underpinnings of how these diseases interact in Sub-Saharan Africa (SSA). Potential mechanistic studies include identification of the key interactions exacerbating the multi-morbid state, mapping of pathways and development of multi-morbid disease models. Epidemiological data can then be used to test these models. Bio-banking/biomarkers – Africa has, hitherto, been under-represented in the bio-banking revolution with the few available biobanks serving mainly as conduits of samples to the developed countries. Models of Care – There has been inadequate efforts in development of prevention, management and control of NCD care models acceptable to the community and policymakers specific to SSA. Management of chronic conditions is a challenge for healthcare delivery systems globally but especially so in low resource settings. Possible projects could include data mining of existing data sets, DHIS2, hospital data and women who have attended ANC (>90%), and/or key informant interviews with government (implementing arm such as county/district health authorities), community and industry to identify possible models of care. Big Data – There is inadequate data and trend analysis for the risk factors in nearly all African countries, especially among the target population of adolescents and youth. Developing effective risk-factor interventions for the target population requires current information on both the drivers and the trends particularly of sub-age groups. Even where the data is available, there are substantial variations in how the indicators weere collected, and samples drawn across populations. This makes comparison across and learning between different communities and countries very difficult. Large data sets shall form the basis of data-driven research that facilitates evidence-based decision and policy making. Example projects could include investigating avenues for building consensus, at least across ARUA countries on the selection, definition and measurement of a core set of cross-culturally, comparable and appropriate indicators.