global alliance for chronic diseases · on the first anniversary of the establishment of the global...

www.gacd.org ANNUAL REPORT 2012

GLOBAL ALLIANCE FOR CHRONIC DISEASES

INTRODUCTION

03

INTRODUCTION

The Global Alliancefor Chronic Diseases(GACD) is a unique

collaboration ofmajor research

funding agencies thatseek to address theprevention, controland treatment of

chronic non-communicable

diseases (NCDs) inlow- and middle-

income countries andmarginalised

populations of moredeveloped countries.

The Alliance brings together national and international funding agenciesrepresenting more than 80 percent of all public research funding in the world:

Australia’s National Health and Medical Research Council

Canadian Institutes of Health Research

Chinese Academy of Medical Sciences

The U.K.’s Medical Research Council

The U.S.’s National Institutes of Health

Indian Council of Medical Research

South Africa’s Medical Research Council

The European Commission’s Health Directorate at the Research &Innovation Directorate General

Our mission

The GACD’s goal is to ease the burden of chronic non-communicable diseases in low-and middle-income countries, by systematically building the evidence base for soundpolicymaking, as guided by global experts on NCDs.

We do this by:

1 Coordination - building increasing levels of research collaboration across the member agencies.

2 Awareness – raising understanding of global NCDs and conducting outreach beyond the foundingmembers.

3 Capacity-building – facilitating platforms for global chronic non-communicable diseases research.

GACD members, ambassadors and researchers at Ottawa meeting in December 2012

GACD ANNUAL REPORT 2012

02

Often referred to as “lifestyle” diseases, most chronic non- communicablediseases (NCDs) are largely preventable. Yet a fraction of global health fundingis focused on NCDs despite their increasing burden on already burdenednations, limiting economic development and improvements in quality of life forbillions. On the heels of the UN High-level Meeting on NCDs, the Global Alliancefor Chronic Diseases (GACD) is attempting to provide the evidence which willenable international donors and governments to bridge this gap by leveragingresearch funding to address NCDs globally. Our member research fundingagencies support research which provides evidence that is changing globalhealth policy in low- and middle-income countries today. In my travels this year as Chair of the GACD, I have been encouraged by the creative andenergetic research partnerships across the globe, with true commitment tochanging the NCD landscape. I am delighted to introduce you to our ground-breaking hypertension research projects and the personalities that make up our Global Alliance for Chronic Diseases.Our focus now is to support governments to reach the new health goal, highlighted by the World Health Assembly: to reduce mortality from NCDs by 25% by 2025. Our commitment to this is strengthened by our combined energy,resources and expertise to generate the evidence base to meet that goal.

Susan B Shurin, M.D.Chair, GACD

A MESSAGE FROM OUR EXECUTIVE DIRECTOROn the first anniversary of the establishment of the Global Alliance for Chronic Diseases (GACD) Secretariat, I’d like tooffer some reflections on a year that has been dynamic, challenging and inspiring. Throughout 2012 the GACDnavigated through the growing pains of a startup international alliance, bringing together large national researchorganisations in measured, thoughtful steps. This has resulted in a sharp, robust and lean team tackling some of thebiggest challenges we face in global NCD research.

Each of the three defining moments of 2012 has been key to the successes we have achieved thus far. In June 2012, Dr.Francis Collins announced the fifteen research teams as the first-ever grantees of the GACD Hypertension Programme.This watershed moment reflected countless hours of hard work by the member agencies to break out of national silos andfocus on the areas of collaboration. The second moment was the re-launch of www.gacd.org, putting GACD on thevirtual map and laying the groundwork for all virtual, global collaborations under the GACD. Finally, the 1st Joint TechnicalSteering Committee Meeting in Ottawa in December 2012 was the culmination of the entire year’s efforts to coordinate15 research teams from around the world. This annual meeting paved the way for joint publications and new professionalrelationships to develop, which will contribute to the global NCD research community for many years to come.

The hard work is far from over. In fact, this is just the beginning, as we apply all the essential lessons learnedthroughout the year to future joint research programmes and activities both in person and online. In the process weaim to increase the quality and quantity of research in the field of global NCDs. The future is full of challenges buttogether, we have the ability to turn them into opportunities, building concrete evidence to change global healthpolicy in low- and middle-income countries through all GACD research programmes to come.

Celina Gorre, Executive Director, GACD

A MESSAGE FROM OUR CHAIR

Left to right; Abdallah Daar, past Chair, CelinaGorre, Executive Director, Susan Shurin M.D.Current Chair, Dr. Xuetao Cao Chair-elect.

GACD HISTORY

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GACD HISTORY

The Global Alliancefor Chronic Diseasestakes its origin in theGrand ChallengesPartnership, which

was first announced in 2007.

This partnership was inspired by an article published in Nature involving a panelof fifty global experts who identified twenty global Grand Challenges in chronicNCDs and highlighted a set of priorities to address the burden of cardiovasculardiseases, type 2 diabetes, chronic respiratory diseases and certain cancers.These under-resourced and preventable conditions cause the greatest share ofdeath and disability. They account for 60 percent of all deaths worldwide, 80percent of which are in low- and middle-income countries.

The GACD is unique in its research partnership model, between low- andmiddle-income and high-income countries, putting lifestyle diseases at theheart of the global health debate.

NOVEMBER 2007

DECEMBER 2012

JUNE 2009

NOVEMBER 2009

OCTOBER 2010

JUNE 2011

NOVEMBER 2011

JANUARY 2012

JUNE 2012First Joint Technical SteeringCommittee meeting for allinternational GACDresearchers held in Ottawa.Working groups andknowledge sharingplatforms established.

15 Hypertension projectawards announced byDr Francis Collins atlaunch event of GACDSecretariat at UCL.

Celina Gorre appointed asfirst Executive Director ofthe GACD. Secretariatestablished within UCLInstitute for Global Health.

Dr Susan Shurin elected asnew Chair and Dr Xuetao Caoas her planned successor, atthe meeting of the GACD inCanberra, Australia.

UCL announced ashost for the GACDInternationalSecretariat.

Call for applications forHypertension Programmeannounced at GACDand Board meeting inBeijing, China.

GACD agrees three initialpriority areas for research atinaugural scientific summitin New Delhi, the first ofwhich is hypertension.

Announcement of GrandChallenges GlobalPartnership inspired byarticle published in Nature.

Global Alliance for ChronicDiseases officially launched inSeattle, United States. Dr AbdallahDaar serves as its first Chair.


04

THE GACD ADDED VALUE

Connecting chronicdiseases researchcommunities by

creating global linksbetween low, middle-

and high-incomecountries.

1 Facilitating virtual working groupson hypertension research.

2 Bringing together the globalGACD research community in theannual Joint Technical SteeringCommittee meetings.

3 Managing social media spacesby maintaining an active networkof researchers with the GACDProfessional forum on LinkedIn,highlighting news, events andinformation on Facebook,inspiring real-time discussions onTwitter and NCD multi mediastories on www.gacd.org

4 Collaborating with our host, theUCL Institute for Global Health,and engaging with theacademic community of auniversity that is ranked 4th in the2012 QS World University Rankings.

5 Engaging with policymakers –organising tailored talks andtraining sessions for researchers,policymakers, ambassadors,ministers and the widerinternational developmentcommunity.

What our researchers say:

“Coming from a middle-income country wherescience is not too highlyregarded, the GACD hastaught me very importantlessons. My backpack is nowfull of ideas and new thingsto offer and I will start toapproach talking to policymakers in a different way.”

Adolfo RubinsteinGACD Principal Investigator, Argentina.

“It was a huge learning curve for me to learn howother countries are doingthings, how to join researchand policy. It gave mehuge peace of mind when Ilearnt about other countriesthat have similar battles.Academics like politicianscan stimulate debate.”

Sarah GumedeDeputy Director, Mpumalanga Departmentof Health, Nelspruit, South Africa.

Dr. Derek Yach, Executive Director Vitality Institute, former VP Global Health, PEPSICO.

YEAR IN REVIEW - 2012

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Two new staff memberswere appointed within theGACD InternationalSecretariat to support theAlliance with theadministrative,programmatic andcommunication aspectsof the Secretariat’sactivities.

The GACD Secretariatwas officially launchedwith a public event atUCL, which was markedby a lecture from FrancisCollins. The launchcoincided with theannouncement of theGACD first joint fundingeffort into hypertension.

A Board andManagement Committeemeeting were also held inLondon.

The EuropeanCommission’s HealthDirectorate at theResearch & InnovationDirectorate General joinsas a new Alliancemember.

All HypertensionProgramme researchteams participated in thefirst Joint TechnicalSteering Committeeconference call, whichintroduced theresearchers to each otherand laid out the agendafor their joint work.

Australia’s National Healthand Medical ResearchCouncil hosted areception for newly-awarded researchers ofthe GACD HypertensionProgramme at theInternational Society forHypertension conferencein Sydney.

The new GACD websiteand logo was launched.www.gacd.org is thehome for GACDmultimedia content andnews, whilst showcasingthe GACD’s coordinatedresearch activities aroundthe world.

Celina Gorre spoke on theInnovative Partnerships forGlobal Health Researchas well as decision-makingfor shifting demographicsand disease burden atthe CanadianConference on GlobalHealth in Ottawa.

The GACD ScientificAdvisory Task Force issuedtheir recommendations onthe GACD’s research focusareas. Members were Dr TimEvans, Prof Judith Whitworth,Prof Mark Hanson, ProfBongani Mayosi, Prof LouiseGunning-Schepers and ProfNikhil Tandon.

Celina Gorre spoke at aconference on obesity inmothers and children atthe London School ofHygiene and TropicalMedicine.

At the GACD BoardMeeting in London, it wasagreed that the focus ofthe next GACD fundingcall will be diabetes.

GACD hypertensionprogarmme research teamsmet for the first time todiscuss their join activities. Thisevent was generously hostedby the Canadian Institutes ofHealth research (CIHR) inOttawa. Researchers werejoined by ambassadors andpolicy makers.

We held a panel debateat the UK Houses ofParliament “NCD timebomb – whose problem isit anyway? Learning fromHIV and searching forleadership.”

www.gacd.org

SEPTEMBER OCTOBER NOVEMBER DECEMBERJUNE


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YEAR IN REVIEW - 2012

The GACD InternationalSecretariat wasestablished at its hostinstitution, the UCL Institutefor Global Health, andCelina Gorre wasappointed at its firstExecutive Director.

GACD Chairperson, DrSusan Shurin, spoke about‘The Global Alliance forChronic Diseases: AModel for InternationalCooperation’ at‘Diabesity – A World-WideChallenge’ in Brussels.

A strategy meeting washeld in London with keyGACD and UCLexecutives to build therelationship between theGACD and its hostinstitution.

The GACD ExecutiveDirector, Celina Gorre,presented at the ChronicNon-communicableDiseases and DisordersResearch TrainingNetworking Meeting at theNational Institutes of Healthin Washington DC.

Celina Gorre presented atthe launch of the Centrefor Global NCDs at theLondon School of Hygieneand Tropical Medicine.

The GACD International Secretariatbecame a working team in June 2012.Throughout the year we ran events tohighlight current debate around non-communicable diseases, working inalliance with our board partners andresearchers across the globe. Throughthe development of our website inOctober, we are starting to see a hugethirst for knowledge sharing aroundNCDs. We culminated our first year witha busy month in December, when wehosted a debate at the Houses ofParliament. Shortly afterwards we heldthe first conference for GACD globalhypertension teams in Ottawa. Wewere kindly hosted by the CanadianInstitutes of Health Research.

JANUARY FEBRUARY MARCH APRIL2012

GACD HYPERTENSION PROGRAMME

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The objectives of the GACDHypertension Programme are toidentify commonalities acrossresearch studies, to shareknowledge, and adaptsuccessful approaches within aculturally relevant and practicalcontext.

GACD Hypertension ProgrammeWorking Groups

We have 4 Working Groups tofacilitate joint activities of thefifteen research teams and identifycommon approaches and metrics.

The Working Groups are organisedinto the following areas

I Baseline prevalence data anddata sharing

II Evaluation and reporting

III Cluster randomised controlledtrials, including issues of consent

IV Identifying barriers tohypertension control

Specifically, the Programme aims to:

1 Improve health gains whilst reducing health disparities in LMICs as wellas amongst Aboriginal populations in higher income countries.

2 Focus on research topics where the need for evidence to informpolicy, programmes, and practice is most urgent.

3 Pursue knowledge translation and exchange approaches that aredesigned to maximize the public health benefits of research findings.

4 Identify common approaches for implementation, integration, andthe scaling-up within different health service delivery systems.

5 Develop common protocols for implementation science with theseinitiatives developed and refined, including protocols for systemsanalysis.

6 Develop a strengthened capacity for implementation research inchronic disease.

7 Develop a prototype for the international peer review ofimplementation research on chronic diseases in LMICs.

Our map on the following pages shows all funded hypertension researchteams and their study locations.


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GACD HYPERTENSION PROGRAMME

The GACD BoardMeeting in Delhi in

2009 highlighted threegrowing challenges

impacting the healthof communities

worldwide: indoor airpollution, tobacco,and hypertension.

Hypertension is associated with higher rates of stroke, heart attacks anddiabetes, particularly in the developing world. Despite the abundance ofrobust evidence that lowering blood pressure reduces the likelihood ofdeveloping cardiovascular disease, rates continue to rise. The GACDdecided to launch its first joint research programme on hypertension, to fillthe knowledge gaps on prevention, control and treatment, with high-qualityresearch, especially in low- and middle-income countries and marginalisedpopulations in high-income countries.

Hypertension is one of the most common chronic conditions worldwide. 1 in 3 people around the world today are affected by raised blood pressure(WHO World Health Statistics 2012 Report).

The GACD Hypertension Programme is the first initiative of its kind, with theworld’s largest funders of medical and health research coming together tofund NCD research. With a collective investment of over US$23 million, fifteenstudies are being funded around the world involving researchers fromnineteen countries. Each research project is conducted through apartnership between investigators from institutions in high-income and low-and middle- income countries. The aim is to build upon current research withan emphasis on implementation science.

GACD research project in rural Kenya

HYPERTENSION PROGRAMME LOCATIONS

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INDIAA Smartphone-basedclinical decision supportsystem for primary healthcare workers in rural India.Funding Organisation:

National Health and MedicalResearch Council, Australia

US$897,234

‘Our studies in rural India have found that 1 in 4adults have hypertension.’Dr D Praveen, The George Institute India

INDIARandomised ControlledTrial of early use of asimplified treatmentregimen incorporating ahalf-dose, three-in-oneblood pressure loweringpill vs. usual care forimproving hypertensioncontrol in India.Funding Organisation:


US$1,029,660

INDIADeveloping a national saltreduction program forIndiaFunding Organisation:


US$880,045

INDIAImproving the control ofhypertension in rural India:Overcoming the barriersto diagnosis and effectivetreatmentFunding Organisation:


US$997,105

SOUTH AFRICA,UGANDAAND RWANDAUtilizing HIV/AIDSinfrastructure as agateway to chronic careof hypertension in AfricaFunding Organisations:

Canadian Institutes of HealthResearch , GrandChallenges Canada,Canadian Stroke Network,International DevelopmentResearch Centre

US$1,887,409

GHANATask Shifting and BloodPressure Control inGhana: A Cluster-Randomized TrialFunding Organisations:

National Institute ofHealth/National Heart,Lung, and Blood Institute ,United States

US$2,117,296

FIJI AND SAMOACost effectiveness of saltreduction interventions inPacific IslandsFunding Organisation:

National Health and MedicalResearch Council Australia

US$1,008,474

‘Approximately 40% of9.7 million Pacific Islandcitizens including Fiji andSamoa have beendiagnosed with a non-communicable diseasenotably cardiovasculardisease, diabetes andhypertension.’WHO Bulletin 2010

KENYAOptimizing linkage andretention to hypertensioncare in rural KenyaFunding Organisations:

National Institutes ofHealth/National Heart, Lung,and Blood Institute, UnitedStates of America

US$2,104,519

SOUTH AFRICATreating hypertension inrural South Africa:Strengtheningcommunity-basedoutreach services forintegrated chronic careFunding Organisation:

Medical Research Council,UK

US$1,408,457

Globally, the NCD burden will increase by 17% in the next ten years and in Africa by 27%.WHO World Global Report on Non Communicable Diseases 2010

CHINAA school-basededucation programme toreduce salt intake inchildren and their familiesFunding Organisation:

Medical Research Council,UK

US$1,187,014

‘In 2010 NCDsaccounted for 83% ofall deaths in China.’WHO

HYPERTENSION PROGRAMMELOCATIONS


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COLOMBIA ANDMALAYSIADeveloping an innovativestrategy for hypertensiondetection, treatment andcontrol in two middleincome countries(Hypertension OutcomesPrevention andEvaluation: HOPE-4)Funding Organisations:

Canadian Institutes of HealthResearch, Grand ChallengesCanada, InternationalDevelopment ResearchCentre, Canadian StrokeNetwork

US$1,431,012

‘NCDs are estimated toaccount forapproximately 66% of alldeaths in Columbia.”WHO NCD Country ProfileColumbia 2011

‘In a 2009 report, the highestrate of untreatedhypertension in Canada isamongst Aboriginalcommunities in the northernregions at 29.2%. This iscompared to 12.7% in theoverall Canadian population.DREAM-GLOBAL

‘Approximately 60% ofdeaths are attributed tohypertension and othercardiovascular conditions.’ WHO Peru NCD Country Profile 2011

PERULaunching a saltsubstitute to reduceblood pressure at thepopulation level in PeruFunding Organisations:

National Institute ofHealth/National Heart,Lung, and Blood Institute ,United States

$2,029,249

ARGENTINAComprehensiveApproach forHypertension Preventionand Control in ArgentinaFunding Organisations:

National Institute ofHealth/National Heart, Lung,and Blood Institute, UnitedStates

US$2,083,675

‘Coronary heart diseasewas the number 1 causeof death in Argentina.’ WHO Global status report on non-communicable diseases 2010

‘Nigeria is Africa’s most populouscountry and the strain onhealthcare resources has becomemost apparent with the increase in hypertension incidence.’ WHO World Global Report on NonCommunicable Diseases 2010

NIGERIATailored Hospital-basedRisk Reduction to ImpedeVascular Events afterStroke (THRIVES). Funding Organisations:

National Institutes of Health(NIH)/National Institute ofNeurological Disorders andStroke, United States

US$2,216,772

CANADA ANDTANZANIADREAM-GLOBAL:Diagnosing hypertension -Engaging Action andManagement in GettingLower BP in Aboriginaland LMIC.Funding Organisations:

Canadian Institutes ofHealth Research, GrandChallenges Canada,International DevelopmentResearch Centre

US$1,915,265

FACTS AND FIGURES

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FACTS AND FIGURES

Hypertension research funding

The total amount of research funding for Hypertension Programme is US$23,193,186(exchange rates as of 4 June 2012)

Research funding for studies focussing on salt reduction is US$5,104,782

Research funding for studies using mobile communication technology is US$9,021,199

3675 visitsto our website since October 2012 (between 1 Oct and 31 Jan)

Increase of 34.7%

Web traffic and statisticsFunding by continent

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FINANCIAL STATEMENT 2012

30.54%

31.33%

38.13%

20.4%

36.2%

43.4%

10.5%

11.1%

33.4% 45.0%

Projected Expenditure 2013

Income 2012

Total Member Contributions US$400,000

Expenditure 2012 (As of 15 January 2013)

Permanent and Temporary Staff US$167,882

Travel US$41,287

Operational costs (including communications, office equipment, expenses) US$124,653

Overheads US$39,161

Total Expenditure US$372,983

Budgeted Expenditure by Objective

Objective #1: Coordination – To build increasing levels of researchcollaboration across the member agencies.

Objective #2: Awareness – To raise understanding of global NCDs andconducting outreach beyond the founding members.

Objective #3: Capacity-building – To facilitate platforms for global chronicnon-communicable diseases research.

In 2012, the GACD International Secretariat was established at the UCLInstitute for Global Health in London. In this inaugural year, the Secretariatfocussed on three key priorities: building staff and infrastructure at its hostinstitution, creating an online presence, and forming the GACD HypertensionProgramme. In 2013, with the Secretariat well-established, the GACD candedicate more of its resources to capacity-building, including thedevelopment of the next GACD research programme.

The GACD Secretariat has put the following measures in place to make thebest use of its resources:

• Scheduling of Board meetings in conjunction with other internationalresearch meetings to save travel costs and lessen its environmentalfootprint.

• Organising the vast majority of GACD meetings virtually. For example, the Management Committee met only twice in 2012, but held more than 8 teleconference meetings.

• Making use of the infrastructure offered by its host institution UCL toredesign the GACD website, host public events, and guide finance and human resources policies and procedures.

• Engaging an external auditor to validate the Secretariat’s financial systems.

Actual Expenditure 2012

Objective #1: Coordination

Objective #2: Awareness

Objective #3: Capacity-building

Expenditure 2012

Permanent and temporary staff

Travel

Operational costs (includingcommunications, office equipment,expenses, overheads)

Overheads

15

The GACD members fund innovativeresearch that will change NCD global health

policy around the world.

Additional photography: Kenya images courtesy of Rajesh Vedanthan, Ampath Kenya & Tom Kelly, IGH, UCL.


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GACD PEOPLE

The Board has theultimate authorityover the Alliance’svision, values and

overall governanceframework. The Boardworks in collaboration

with UCLrepresentatives to

develop andimplement GACD

policies.

GACD Board

• Susan Shurin, National Heart,Lung, and Blood Institute,National Institutes of Health,United States (Current Chair)

• Xuetao Cao, Chinese Academyof Medical Sciences, China(Chair Elect)

• Abdallah Daar (Previous Chair)

• Warwick Anderson, NationalHealth and Medical ResearchCouncil, Australia

• Alain Beaudet, CanadianInstitutes of Health Research,Canada

• Ruxandra Draghia-Akli, HealthDirectorate at the Research &Innovation DG of the EuropeanCommission (Designate: KarimBerkouk)

• Salim S. Abdool Karim, MedicalResearch Council, South Africa

• Vishwan Mohan Katoch, IndianCouncil of Medial Research, India

• John Savill, Medical ResearchCouncil, United Kingdom(Designate: Wendy Ewart)

• Anthony Costello, UniversityCollege London (Host InstitutionRepresentative)

• Anne Johnson, University CollegeLondon (Host InstitutionRepresentative)

In addition, the World HealthOrganization (WHO) has an observerstatus on the GACD Board.

GACD Management Committee

The Management Committee isresponsible for the oversight,management and coordination ofthe portfolio of research awardsmade under the umbrella of theAlliance. Current ManagementCommittee members are:

• Muhammad Ali Dhansay,Medical Research Council, SouthAfrica

• Nancy Edwards, CanadianInstitutes of Health Research,Canada

• Jill Jones, Medical ResearchCouncil, United Kingdom

• Clive Morris, National Health andMedical Research Council,Australia

• Cristina Rabadán-Diehl, NationalHeart, Lung, and Blood Institute,National Institutes of Health,United States

GACD International Secretariat

The Secretariat serves as theadministrative hub for the GACDmember agencies, funded researchteams and host institution, andrepresents the Alliance externally.Current staff members are:

• Celina Gorre, Executive Director

• Rosie Bartlett, CommunicationsManager

• Dorothea Kanthack, SeniorProgramme Officer

• Eshe Jackson-Nyakasikana,Programme Officer

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