NIHR Global Health Research Centres 1: NIHR Global Health Research Centre for Non-communicable Diseases and Environmental Change A UK and low-and-middle-income-country (LMIC) partnership to create a centre of excellence on non-communicable diseases (NCDs) and global environmental change in Bangladesh, India and Indonesia offering world-leading research, training and policy advice for health equity. LMICs face dual, intertwined challenges of a rapidly growing burden of NCDs and the existential threat of global environmental change. In addition, health systems in LMICs face specific challenges in delivering high-quality, equitable services for NCDs prevention and care, especially for marginalised populations most impacted by environmental change. Despite an increasingly recognised imperative for action, there is a paucity of evidence on cost-effective interventions to address major challenges emerging at the nexus of NCDs and environmental change. Our Centre will focus on three countries highly impacted by the dual challenges of NCDs and environmental change. Partner institutions are the George Institute in New Delhi, India, Imperial College London, International Centre for Diarrhoeal Disease Research, Bangladesh in Dhaka, Sri Ramachandra Institute of Higher Education & Research in Chennai and University of Brawijaya in Malang. This project will start in October 2022 and runs for five years ending in September 2027. We will address crucial knowledge gaps through three integrated research themes: 1. Strengthening primary health care and essential public health services for NCD prevention and management in communities affected by rapid environmental change; 2. Developing and evaluating multi-sectoral interventions that have dual benefits in reducing the burden of NCDs and hazardous environmental exposures at the population level; 3. Strengthening engagement of communities in the generation and use of evidence and advocacy for health and environment policy change. All interventions will have a focus on reducing inequities in addition to cost-effectively improving health outcomes. An example of the integrated research program relates to the burning of plastic wastes in Indonesia. In the same communities, dual benefit interventions (e.g. reduced burning within the context of improved waste management strategies) and an innovative technology-based primary health care model will focus on the prevention of exposure to environmental hazards, while also promoting screening for and management of airpollution related NCDs, such as chronic obstructive pulmonary disease. Common systems to collect data for both implementation and evaluation of such complementary interventions will be deployed. Throughout the research lifecycle, our Centre will emphasise systematic and meaningful engagement of community members and policymakers – including through co-design and evaluation of interventions. In addition to delivering high-quality impactful research, we will focus also on research capacity strengthening and will deliver several training and development opportunities targeting three critical career periods: pre-doctoral, early post-doctoral and transitioning to senior leadership. Recruitment into these training opportunities and posts will be based on gender parity and we will monitor and report diversity in career progression for all staff and students across academic career levels. We will strengthen research capability at institution, network and ecosystems levels to enable LMIC-led production and use of highquality evidence at the nexus of NCDs and environmental change. Our aim is to be a recognised centre of excellence on NCDs and global environmental change in LMICs, co-producing world leading implementation research with local communities, strengthening research capability, advocacy, and policy for health equity. Objectives To establish a common data platform across all three countries that can comprehensively capture community environmental risks, behavioural risk factors and disease management To expand existing PHC strengthening strategies (COBRA-BPS in Bangladesh, SMARThealth in India and Indonesia;) to incorporate environmental risks and a broader range of disease conditions using a community co-design approach To develop, implement and evaluate multi-sectoral interventions in each country which address key dual threats to NCDs and the environment (water salinity, air pollution, poor dietary diversity) To understand the nature of Community Engagement and Involvement (CEI) in the evidence to policy process in each of our focus countries and identify opportunities for enhancement To evaluate the process for CEI in co-production and collaborative engagement activities undertaken within our Research Programme and to understand how and how well the CEI activities have been implemented under these themes To strengthen Research Capability in four domains identified in our framework, covering individuals, institutions, networks and ecosystems