Goal: To help provide context-specific solutions to control the epidemic of chronic diseases in low- and middle-income countries, and to advance understanding of disease by leveraging the striking heterogeneity of environmental, lifestyle and genetic exposures in these populations.
Achievements: We have established a portfolio of studies in various emerging economies, with a particular focus on settings with rapidly increasing rates of cardiometabolic conditions (eg, heart disease and diabetes). They include BELIEVE (a 25,000-participant household survey in Bangladesh), MAVERIK (a 5000-participant case-control study of myocardial infarction in Malaysia), and PROMIS (a 40,000-participant case-control study of myocardial infarction in Pakistan). Initial findings have highlighted the important interplay of universal risk factors (eg, blood lipids) and local factors (eg, consanguinity, toxic metal exposure).
Future plans: As part of a £8 million capacity-building effort funded by Research Councils UK, we are establishing a 100,000-person cohort in Bangladesh in urban, rural and slum contexts, using this study as a framework to develop and evaluate interventions that help control the complex set of risk factors for chronic disease.