PHFI receives £10 Million grant to address multimorbidity in India and Nepal

New Delhi: 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 health outcomes and re-orient health systems to effectively address multiple long-term conditions (MLTCs) or multimorbidity in India and Nepal.  

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 a grant.

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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 that 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."

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