Public Health Foundation of India awarded £10 Million Grant for Research into Multiple Long-Term Conditions in India and Nepal

Experts from the Public Health Foundation of India and University of Leicester have been awarded a prestigious grant of nearly 10 million by the National Institute for Health and Care Research, UK to help improve the health outcomes and re-orient health systems to effectively address multiple long-term conditions (MLTCs) or multimorbidity in India and Nepal.

Launch of the NIHR Global Health Research Centre for Multiple Long-Term Conditions. Chief Guest Prof. VK Paul, Member, NITI Aayog

The Public Health Foundation of India and University of Leicester will collaborate with the All India Institute of Medical Science (AIIMS), Jodhpur, Health Related Information Dissemination Amongst Youth (HRIDAY), Delhi, and Kathmandu Medical College (KMC), Kathmandu, thanks to the National Institute of Health and Care Research (NIHR) Global Health Research Centre for grant.

During the first stage of the research implementation, the researchers will review existing evidence, generate new data as required and talk to people living with these conditions to identify the best care approach for people with multimorbidity in both countries.

In addition, using the concepts of 'co-design and community engagement/involvement' they will conduct studies to assess what type of integrated, technology-enabled, patient-centred, high impact, equitable health system intervention designs could most benefit individuals with two or more long-term conditions, which are increasingly impacting population health in both countries.

As part of the project, 17 places on master's degrees, 19 PhDs as well as 14 post-doctoral placements will be available in Leicester, Birmingham or Brunel, covering applied health research, implementation science, medical statistics, quality and safety in healthcare, health data science and diabetes. In addition, Public Health Foundation of India and University of Leicester with other co-applicant institutions will deliver short courses to approximately 400 participants. These will be across a range of topics, including epidemiology, biostatistics, behavioural sciences, implementation science, health economics, qualitative methods, health systems research, community and patient engagement, leadership and management as well as other areas depending on identified needs.

In the long-term, the Centre will work with Indian and Nepal governments to improve the health outcomes of those with MLTCs, as well as create a self-sustaining Centre for improving management of MLTCs not only in these countries but also in other LMICs which face similar problem. The learnings and findings from the Centre's activities will be disseminated globally.

The Centre, through research, capacity building and community engagement and involvement will build evidence base on what works, how and why in the Indian and Nepal contexts while simultaneously addressing the current gaps in care for patients with MLTCs. Through co-design, a simple, cost-effective, scalable and sustainable context-relevant interventions for the prevention, diagnosis and treatment of MLTCs will be tested in real-world settings and the learning incorporated to improve the intervention. Through "community champions", feedback from the community at large will be gathered to make the intervention truly contextual.

The NIHR Global Health Research Centre for Multiple Long-Term Conditions scheme funds high-quality applied health research and training in areas of unmet need. The grant is for the direct and primary benefit of people in low and middle income countries but also will have lessons for the UK and other high income countries.

The five-year project will be launched on December 2, 2022.

Professor Faith Osier, President of the International Union of Immunological Societies and Chair of the NIHR Global Health Research Centres Funding Committee, said, "These new Centres are truly ground-breaking - it's the first time we've seen anything like this level of investment in non-communicable disease research in low and middle income countries. The potential for this truly equitable partnership working between researchers in LMICs and in the UK is immense and we're so excited to see the advances that the next five years will bring."

Professor Kamlesh Khunti CBE, Director of NIHR Applied Research Collaboration (ARC) East Midlands and the Real World Evidence Unit and Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester, and Co-Lead of the award said, "It is an honour to be awarded this international grant as it allows us to make a difference globally. Research into this area is crucial as people in India are living longer with long-term conditions so it is vital to provide them with the right care, at the right time. To achieve this, healthcare workers need to be trained to deliver high-quality care which is of good value and based on evidence."

Professor Prabhakaran Dorairaj, the LMIC/India Lead of the proposed NIHR Centre and Distinguished Professor of Public Health at the Public Health Foundation of India, said, "We are very excited to secure this centre grant. This collaboration will help us in furthering our decade-old work on task shifting and using frugal digital technologies to redesign health systems for improving the health of population health in India and Nepal. Given the burgeoning chronic disease burden and multimorbidity, the research and capacity building to be undertaken by the proposed centre is timely and will have far reaching implications for India, Nepal and other LMICs facing similar health challenges."

Prof Sailesh Mohan, Director, Centre for Chronic Conditions and Injuries, PHFI, "This Centre will enable creation of a critical mass of researchers in India and Nepal, who will conduct high quality research addressing various facets of Multimorbidity with goal of improving the lives of people living with it."

On launch of the Centre, Prof. Sanjay Zodpey, President, PHFI, "PHFI has worked to establish a robust evidence for research for India in key areas of public health. With the growing burden of non-communicable diseases in our country, through the NIHR Global Health Research Centre for Multiple Long-Term Conditions, we aim to build capacity and evidence for the need for comprehensive management of multiple conditions which can enable our health systems to be agile to meet the needs of our population at various levels."

Prof. K. Srinath Reddy, "Founder (Past) President and Distinguished Professor of Public Health, PHFI said, "Co-existence of multiple chronic health ailments is becoming increasingly common as life expectancy increases. This is a problem not only for older age groups but also evident in younger age groups where changes in living habits and environmental conditions are increasing susceptibility for multiple diseases. Health systems which employ disease specific programmes are ill equipped to deal with co-existent conditions which require chronic, continuous care. Such care is best provided through integrated delivery teams at the level of primary healthcare. Capacity for providing such care through efficient, equitable and empathetic health systems is an urgent requirement. This project will aim to build needs based capacity for addressing the challenges of multimorbidity."

The Chief Guest for the launch Prof VK Paul Member, NITI Aayog, Government of India said, "With increase in life expectancy India is witnessing a rising burden of non-communicable diseases and many a time the NCDs co-occur in the same patient. Given this unique challenge of managing different conditions in the same patient/person, innovative research like the one being proposed under the Centre is warranted to improve MLTC care and population health in India."

PHFI

The Public Health Foundation of India (PHFI) is a not for profit public - private initiative working towards a healthier India. A national consultation, convened by the Union Ministry of Health and Family Welfare in September 2004, recommended a foundation, which could rapidly advance public health education, training, research and advocacy. PHFI is a response to the limited public health institutional capacity and was established to strengthen training, research and policy through interdisciplinary and health system connected education and training, policy and programme relevant research, evidence based & equity promoting policy development, affordable health technologies, people empowering health promotion & advocacy for prioritised health causes in the area of Public Health in India. The setting up of PHFI in 2006 was enabled by the Government of India and the Foundation (registered as a Society) is managed by an empowered governing board comprising senior government officials, eminent Indian and international academic and scientific leaders, civil society representatives and corporate leaders. The Foundation is headquartered in New Delhi and its constituent Indian Institutes of Public Health (IIPH) set up by PHFI have a presence in Hyderabad, Delhi NCR, Gandhinagar, Bhubaneswar, Bengaluru and Shillong. www.phfi.org.

University of Leicester

University of Leicester was founded as Leicester, Leicestershire and Rutland University College in 1921. In academic year 2021/22 the University celebrated 100 years since the first students started. It has been consistently ranked in top 100 universities in the UK and in Europe. The University's mission statement is - "Diverse in our make-up and united in our ambition we change lives through education and research." The vision is to provide inspiring education and research working in partnership with communities to become a truly inclusive university.

Leicester is ranked in the top 25 universities in the Times Higher Education REF Research Power rankings. The Power ranking takes into account both the quality of research and the number of research-active staff who made REF returns. Research power is important because it gives a strong indication of a combination of world-class research, international impact, critical mass and sustainability.

Founded in 2012, the Leicester Diabetes Centre is a unique, collaborative partnership between the NHS and the University of Leicester. LDC has strong links with local population and is led by two of the top ten world diabetes experts - Prof Melanie Davies CBE and Prof Kamlesh Khunti CBE. LDC has a talented and diverse team of over 150 researchers, clinicians and educationalists working together on an innovative research portfolio of successful academic and commercial trials.

National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

• Funding high quality, timely research that benefits the NHS, public health and social care;

• Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;

• Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;

• Attracting, training and supporting the best researchers to tackle complex health and social care challenges;

• Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;

• Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries. NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.