Final Report Summary - GACD (Global Alliance for Chronic Diseases)
The Global Alliance for Chronic Diseases (GACD) brings together leading health research funding agencies of key countries to coordinate research activities addressing on a global scale the prevention and treatment of chronic, non-communicable diseases such as cardiovascular diseases, diabetes, respiratory diseases, cancer and mental health. The first coordinated research programme of the GACD focuses on hypertension prevention and control in low- and middle-income countries. The specific objectives of the GACD Secretariat were the following: 1) Coordinate among the GACD members the next chronic disease research programme, 2) coordinate among GACD members and participating research teams the joint activities of the GACD Hypertension Programme and 3) implement the communications strategy.
The funding covered the period between 01 January 2013 and 31 March 2014.
Project Context and Objectives:
On behalf of its member agencies, the Secretariat of the Global Alliance for Chronic Diseases (GACD) seeks to identify common approaches to develop the evidence base needed to guide policy and identify best practices for fighting chronic diseases, thereby contributing to a sustainable and significant reduction of illness, disability and premature death around the world. The GACD is the first collaboration of international research funding agencies, which aims to coordinate research activities that will address, on a global scale, the prevention and treatment of chronic non-communicable diseases with a particular focus on the needs of low- and middle-income countries (LMICs) and vulnerable populations in developed countries, with targeted support for researchers in and from these communities.
The creation of the GACD brings to fruition a global commitment to urgently increase the resources and focus on chronic non-communicable diseases, which constitute the major burdens of illness and disability in almost all countries of the world. The conditions cause the greatest global share of death and disability, accounting for around 60% of all deaths worldwide. Some 80% of chronic disease deaths occur in low- and middle-income countries. They account for 44% of premature deaths worldwide. The number of deaths from these diseases is double the number of all deaths from infectious diseases (including HIV/AIDS, tuberculosis and malaria), maternal and perinatal conditions, and nutritional deficiencies combined.
The first coordinated research programme of the Global Alliance for Chronic Diseases focuses on “Hypertension Prevention and Control in Low and Middle Income Countries (LMICs)”. Hypertension is a major contributor to the growing global pandemic of cardiovascular disease and stroke. Poor control rates for hypertension and a lack of strategies to maintain normal blood pressure, particularly in LMICs, reflect the challenges of effective and affordable implementation in health care and other systems. The programme emphasises implementation science and focuses on high blood pressure prevention, management and control applicable to populations in LMICs and to Aboriginal communities within Canada and Australia. It builds on previous research that has examined the efficacy and effectiveness of approaches to prevent and control high blood pressure. This programme seeks to improve the implementation of existing approaches to prevention and control rather than to develop new treatments. Prevention is a critical component of all hypertension control programmes.
Following on from this work, the specific objectives of the GACD Secretariat were the following:
1. Coordinate among the GACD members the next GACD chronic disease research programme and the process for the subsequent call for applications.
2. Coordinate among the GACD members and participating research teams the joint activities of the GACD Hypertension Programme research teams.
3. Implement the communications strategy on social media, website and other outreach instruments to increase awareness of the GACD’s work and chronic diseases in general.
These objectives address the great need within the area of health research to increase the focus on chronic diseases, which account for the majority of all deaths worldwide, but receive a disproportionately low amount of public funding and attention.
Project Results:
The overall results of the project at the end of the reporting period, which is also the end of the funding period relate to all three work packages. Firstly, the second GACD joint call for applications has been agreed to by all member agencies, which includes jointly developed and agreed assessment criteria and coordinated timelines. This will enable all members to award research funding under the joint umbrella of the GACD Diabetes Programme and enable the funded teams to collaborate and share their knowledge in the area of diabetes research. Secondly, the funded teams of the GACD Hypertension Programme have continued their collaboration and knowledge sharing in the programme’s second year, working together in a number of working groups and getting together in the second annual meeting, which took place in Cape Town. The meeting enabled interaction amongst the researchers and fostered successful engagement with policymakers. Lastly, the GACD has continued to grow its public profile and increased awareness of its activities. This is evident in the rise in followers on all media platforms and the on-going interest in the GACD’s communications outputs.
The knowledge that has been generated from the activities of the GACD relate to experiences with regard to collaboration between GACD members and between researchers. Some of this knowledge may benefit the members, researchers and similar initiatives and the exploitation of these results is described below.
The GACD can serve as a model for collaboration. As the GACD increases in membership and in the number of funded research programmes, it holds much promise as a model for funding bodies to work together in pursuit of a common goal, which no single agency can tackle alone. While the challenges are many and progress is slow at times, the GACD stakeholders have learned that the investment in working through such challenges will pay off in dividends down the line, in terms of lessons learned which enhance our ability to work together with each call, and in terms of the ability of the GACD to have direct influence not only on policymaking at the national level but guidelines development at the global level. By working with each other, the GACD has gained experiences in successfully crossing geographical and cultural boundaries in order to achieve common goals. This extends, for example, to the GACD’s governance structures and leadership, its model of encouraging equal partnerships between high-income and low- and middle-income countries and the learnings from coordinating joint review processes.
In addition, as member agencies become more familiar with the ways in which each other work, additional ideas are generated on ways to collaborate beyond the scope of the GACD. In this way the GACD has a larger impact beyond its mission of addressing chronic, non-communicable diseases in the developing world and generates knowledge that may be applicable to other disease areas or even other topic areas.
The GACD is also producing results through facilitating the collaboration between researchers on the Hypertension Programme. While this is still on-going, at this stage much of it relates to the processes of working together, for example with regard to how the programme was set up and how collaboration can be fostered or with regard to how data standardisation can be achieved amongst a diverse group of research projects. Once the funded teams have further advanced their research projects, they will be able to produce some comparative studies. The working groups of the Hypertension Programme are coordinating the submission of joint papers on these topics.
The GACD has also generated knowledge with regard to programme evaluation. The secretariat set up an evaluation committee consisting of various GACD stakeholders as well as two external collaborators, which jointly considered options for an evaluation of the GACD, developed a logic model and carried out interviews with researchers and funding agency representatives. This generated insights into how an evaluation of an international and collaborative alliance such as the GACD may be implemented and insights into how the stakeholders can be engaged in this process. This will be further analysed and is due to be submitted for publication by members of the evaluation committee. Furthermore, the qualitative interviews with researchers and funding agency members shed a light on the participants’ experiences and will inform the future development of GACD research programmes.
Potential Impact:
Tackling chronic diseases is not a task that can be shouldered by a government on its own. The huge burden of disease warrants a collective approach in order to find evidence-based solutions that help prevent, manage and treat chronic diseases across different countries. By coordinating chronic disease research funding of some of the largest public health research funders, the GACD expects to have a fundamental impact on the future orientation of public health research policy and its implementation. The decision-making on the second GACD research programme was a crucial step towards a more focused research funding effort. The GACD and its member agencies will continue to benefit from the lessons learned from the coordination of the first and second joint call for applications. In addition, in managing the Hypertension Programme the GACD aims to build a strong community of researchers, strengthening capacity in implementation research on hypertension and providing a basis for evidence-informed recommendations for national and international policymakers. In the long term, this will lead to evidence-based policy and practice which will address the burden of chronic diseases and benefit patients around the world.
Dissemination and exploitation of results
The GACD disseminates general information on chronic diseases as well as information on its activities including the research programmes. Its main avenue for this dissemination is through its website, which was launched in October 2012. The GACD complements this with the publication of an annual report which is distributed amongst academics, policymakers and the general public. In addition, the GACD is using social media channels to reach out to the general public to mainstream dialogue on chronic diseases, their prevention and mitigation. As the Alliance is based at a higher education institution, there is also significant contact with students and young researchers. This provides an opportunity for reaching out to the next generation of leaders who will be responsible for conducting biomedical research as well as for translating research results into policy and practice. It is therefore crucial to make them aware of the great need to increase the focus on chronic disease prevention and control in order to motivate young people to participate in this important endeavour. The GACD has regularly hosts student interns and intends to continue providing this opportunity in the future. Furthermore, the GACD has organised public events at its host institution University College London and the Executive Director regularly attends relevant conferences to present the GACD’s work. In addition, the GACD partners with other organisations that are active in the chronic disease realm. For example, there is regular interaction with partner organisations and other London based higher education institutions and efforts are made to share knowledge and best practices as well as to collaborate in spreading information about research into chronic diseases.
The secretariat intends to continue its dissemination and exploitation activities. Learnings from the coordination processes and overall project activities will be shared through articles in academic and non-academic publications, written by GACD staff or members as appropriate or published by external parties with the support of the GACD. Member agencies will apply outcomes of the knowledge sharing and collaboration by improving and adapting their own processes. Furthermore, similar initiatives may be able to exploit the generated knowledge, for example with regard to joint peer review processes and co-funding by adopting similar approaches, which will be actively encouraged by the GACD.
List of Websites:
Global Alliance for Chronic Diseases
UCL Institute for Global Health
30 Guilford Street
London WC1N 1EH
United Kingdom
www.gacd.org