September 17, 2015

 

by Mary Bayham In September 2014, investigators from several leading U.S. academic institutions came together to discuss the current landscape of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs). From this meeting, the collaborators were able to identify themes of successful global collaborations, discuss career development opportunities for global NCD research, examine funding sources and how to leverage them, and the role of U.S. agencies and academic institutions in fostering development in global NCD research. Along with his colleagues, Doug HeimburgerM.D., professor of Medicine and VIGH associate director for education and training published a commentary comprising the group’s recommendations in the Health Affairs Blog, The Atlanta Declaration: a 21st Century Vision for US-Based Global Noncommunicable Disease Research as well as an article in the Annals of Internal Medicine.

The group concluded that the current landscape of research and development in global NCDs is failing in several areas.  The United States is not committing enough resources to NCDs, which account for 66% of all deaths worldwide. The economic impact of NCDs is significant; it is estimated that global productivity will suffer a $47 trillion loss by 2030.

Dr. Heimburger and colleagues identified several recommendations to facilitate a paradigm-shift in emphasis on Global NCDs. First, funding agencies, governments, and foundations should re-prioritize to a longer-term vision through which achievements can be made and sustained. Improvements in NCDs are not immediately realized, making it appear to be a less attractive global health investment to many funders. Second, learn from frontrunners like Google, who has been a leader of excellence by investing in macro- and micro-economic development in Africa by providing internet connectivity. Other entities, such as the UnitedHealth Chronic Disease Initiative, invested in research and development and have established infrastructure through which young scientists in LMICs are provided with opportunities to build their own experience and academic credibility. A successful method for building research capacity is “twinning” initiatives, in which an institution from a developing country is paired with one from a developed country. These partnerships provide tangible benefits to both institutions. Finally, a reconsideration of the metrics used for valuation of research would shift priorities to action versus just publication. Specifically, the authors recommend a shift in the “publish or perish” paradigm from using easily-quantifiable metrics (number of publications or grants received) to focusing on the impact of one’s research on human health. Academic leaders can be leaders in individualizing evaluations and considering the importance of teamwork and innovative forms of action.

In order to combat the rising epidemic of global NCDs, the authors recommend that action must be taken by funding agencies, governments, and academic institutions. Representatives of several NIH institutes participated in the meeting, with good effect. “We are gratified that at least two NIH institutes (the National Institute of Diabetes and Digestive and Kidney Diseases and the National Cancer Institute) issued Requests for Applications for NCD research relevant to LMICs as a direct result of the symposium.  We hope there will be much to come from multiple sectors, as that is required to begin addressing this mounting but less heralded epidemic," Heimburger said.

See other papers from the symposium here: