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The Non-Communicable Diseases Group was created in late 2018 following a long-recognised need to strengthen ITM’s expertise in understanding and addressing the spreading NCD (such as obesity, diabetes, cardiovascular diseases, and cancers) epidemics in low-resource settings, areas traditionally burdened with infectious diseases. The overall motivation of the group is to understand the socioeconomical, behavioral and metabolic risks driving the onset of cardiometabolic diseases and cancer, and therefore our focus is on prevention. The group uses epidemiological methods and advanced modelling to address these research questions, and aims to enable evidence-based, population-specific public health strategies that are efficient and sustainable.

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Objectives

NCDs remain the main cause of premature death and disability globally. However, while NCD-related death rates are declining in most HIC, the mortality due to NCDs in LMIC is increasing at an alarming rate, especially among the youngest and poorest strata. Rapid globalisation, population aging, unplanned urbanisation, and widespread unhealthy lifestyles are the root causes of NCDs in LMIC, that in addition to traditional infectious disease challenges, constitute a double burden of disease that requires complementary approaches. Though there is evidence on the most effective strategies to tackle NCDs in HICs, more research is needed to characterise the differential drivers of NCDs in LMIC. This includes the contextualisation of NCD prevention and care in already burdened systems, inequities in daily life conditions and underlying socioeconomic, political, environmental and cultural factors. In alignment with WHO’s prioritized actions for NCDs, we will investigate the best approaches to achieve the reduction of modifiable risk factors (malnutrition in all forms, physical inactivity, alcohol, tobacco, and obesity), as well as the control and management of conditions such as diabetes and hypertension to curb the burden (morbidity, mortality, trends, and costs) of NCDs in the context of LMIC. The NCDs group will integrate a multi-disciplinary team of researchers aiming to identify effective and equitable public health strategies that can reduce the burden of NCD specifically in LMIC as well as among vulnerable populations in HIC. Our research overarches all levels of prevention and, initially using available observational data and surveillance analysis and modelling, will focus on four specific objectives:

• Specific objective 1: Burden of NCDs: characterize and quantify burden of individual NCDs in specific population strata and assess individual, socio-economic, environmental, and geographical determinants and assess risks, and synergies with infectious diseases.
• Specific objective 2: Early prevention: identify, evaluate and implement population-based interventions with maximal cost-effective potential to reduce NCDs in specific, vulnerable populations.
• Specific objective 3: Secondary prevention and control: identify, evaluate, and implement population-based strategies to reduce progression of diagnosed NCDs; including adherence to treatment, and behavioral interventions to prevent or delay progression.
• Specific objective 4: Healthy aging: identify drivers of healthy aging and develop programs that strengthen prevention, increase early detection, and ensure sustainable care of chronic NCDs.

Education activities

The NCDs group participates in teaching across the ITM’s academic offering. Also, the team runs the ITM’s short course (3-weeks) on NCDs, as part the MPH and as a stand-alone course. The course is divided in 3 modules dedicated to burden, risk factors and prevention, and control and is oriented to quantitative aspects.