Africa Research Universities Alliance, Centre of Excellence for Non-Communicable Diseases

Context. The rise in non-communicable diseases (NCDs) threatens to roll back the progress that has been made in health and development of Africa. Globally, the World Health Organisation (WHO) estimates that in 2008, there were 36 million deaths from NCDs, projected to rise to 50 million by 2050. In 2008, these deaths were mainly from cardiovascular diseases (48%), cancers (21%), chronic respiratory diseases (12%) and diabetes (3.5%), with 80% of all the deaths occurring in low- and middle-income countries. In Sub-Saharan Africa, WHO estimates that 23% of all deaths are from NCDs, and projected to grow to 27% by 2020. What is however not clear, due to lack of data from the continent, is the distribution of among the key NCDs. The rise in NCDs in Africa places a tremendous social and economic burden on communities through increased absenteeism, job loss, unaffordable medical costs, increased responsibilities from family members for care-giving, or complete loss of income from death of the breadwinner. The loss of income (partial or complete) pushes low income households further into the poverty trap. On a broader scale, the combined effect of decreased labour outputs, lower return on human capital investments, increased healthcare costs, and loss of economic activity, leads to increasing inequalities not only within populations, but between countries. The four common NCDs - cardiovascular diseases, cancers, chronic respiratory diseases and diabetes - have four shared behavioural risk factors: tobacco use, unhealthy diet, physical inactivity and harmful alcohol use. These are in conjunction with other conditions including mental disorders, disabilities (including blindness and deafness), violence and injuries. To achieve a reduction in the levels of NCDs, there must be a concerted effort to bring about behaviour change through evidence-based approaches by conducting localised research and training.

Aims and Objectives. The ARUA Centre of Excellence on NCDs (ACE-NCDs) provides a platform for the creation of a long-term strategic network of researchers in African Universities through a hub and spoke model to strengthen intra-African collaboration, and collaboration between the network and the rest of the world. The ACE-NCD will build on the strengths of the core university members, University of Nairobi (Kenya and the Hub), University of Ghana, University of Ibadan (Nigeria), Makerere University (Uganda) and the University of the Witwatersrand (S. Africa). At its inception, the ACE-NCD has also partnered with the University of Leicester and University of Glasgow who shall support its development. In addition, the ACE-NCD will bring on board relevant stakeholders involved in prevention, control and management of NCDs within their regions including medical research institutions, relevant professionals, policy-makers, civil society to ensure co-design and co-production of high impact research output that shall be support policy-making, interventions, and commercialisable intellectual property. Continental and regional teams will be supported to develop grant proposals around the ACE-NCD thematic areas, thus ensuring sustainability and growth of ACE-NCD beyond the current grant.

Potential Application and Benefits. ACE-NCDs seeks to build capacity in holistic NCD research through training of Masters and PhD students (while ensuring co-supervision across member universities), targetted short courses in need-identified areas, staff and student exchanges, among other interventions. Dissemination of research output will be through journal and conference articles and book chapters targeting researchers and practitioners, policy-briefs, workshops and seminars aimed at policy-makers, stakeholders and civil society. The envisioned outcome as a result of this capacity building funding is a vibrant, sustainable ACE-NCD at the forefront of NCD research, capacity-building and policymaking support in Africa.

The beneficiaries to this research are two fold. In the first instance are the students who will receive their Masters and PhDs as part of the training and mobility programme. On completion of their studies they will have a significant impact on the continental research output on NCDs and as practitioners will play a key role in deepening the understanding on NCDs and thus be at the forefront in the development of strategies for prevention, early detection and control. The doctoral graduates will increase the small pool of highly trained staff to support the university systems in their respective countries for the training of the next generation of undergraduate and postgraduates in all disciplines that address NCDs. To ensure these expected beneficiaries exploit the opportunities from ACE-NCD, the research team will establish a robust and vibrant training programme with timely, broad dissemination of information and active recruitment to get a broad representation of students into the NCD programmes at their respective institutions. The centre will purposely ensure that under-represented groups and gender is a key consideration in the recruitment strategies employed. Further the Centre will work to ensure that students and faculty from the less research intensive African Universities participate in the capacity building programmes and support mentorship of both the faculty and students from these universities. This collaboration will be enhanced through continuous grant applications to ensure continuity, and where applicable, some of the capacity building courses will be offered on commercial basis beyond the 36 months period.

In the second instance, it is expected that the data collected, analysed and stored in the data and information repository will facilitate secondary studies that shall provide a better understanding of the drivers, prevalence, interventions, success and failed interventions for NCD care and management on the continent. In addition, the data and information will enable evidence-based decision and policy-making, increasing the chances for their success. The ultimate beneficiary impacted by the activities of the ACE-NCD shall be all citizens on the continent who are at risk of suffering from NCDs or who already do and can benefit from earlier, more accurate, affordable diagnosis, management and care. To ensure these expected beneficiaries are impacted, the ACE-NCD data and information repository shall be set up within the first year of the project, and begin to be populated from year 2 both from past studies, and from new data gathered as a result of the work of the ACE-NCD. In addition, highlights of the work done shall be widely publicised in the Centre online newsletter as well as through workshops, seminars and symposia.