Global Alliance for Chronic Diseases: prevention and treatment of type 2 diabetes

Specific challenge: In the past twenty years the global death rate from diabetes has doubled and the World Health Organisation (WHO) is predicting that this will increase by two thirds by 2030. It is currently estimated that 347 million people worldwide suffer from diabetes with more than 80% from low-and middle-income countries. Of those suffering from diabetes, type 2 comprises 90% of this population around the world. Halting the rise in prevalence of diabetes has been identified as one of the 9 WHO non communicable diseases global voluntary targets to be met by Member States by 2025

With the burden of this chronic non-communicable disease ever-increasing the Global Alliance for Chronic Diseases (GACD) partnership, of which the Commission is a member, has agreed to launch a call for proposals on the prevention and treatment of type 2 diabetes, with a focus on implementation and intervention research in low- and middle-income countries and in vulnerable populations in high income countries.

Scope: Proposals must focus on type 2 diabetes. Proposals should generate new knowledge on interventions and their implementation for the prevention and treatment of type 2 diabetes in low and middle income countries, and in vulnerable populations in high income countries. Proposals must focus on existing approaches to prevention and control of type 2 diabetes rather than development of new treatments. Proposals may address prevention or treatment of specific complications of type 2 diabetes.

Proposals may focus on a wide range of prevention and/or treatment strategies. This may include programmes addressing (one of or combinations of):

• Changes to lifestyle and behaviour resulting from the provision of an environment that supports and promotes better health. This may include community-wide approaches, or other strategies targeting individuals at high risk. For example, population prevention strategies designed to address unhealthy diets and physical inactivity as risk factors for diabetes;
• Structural interventions or policies designed to promote improved health outcomes. For example, evaluating the contribution of public policies to diabetes prevention efforts, or monitoring the potential effects of such policies if adopted and implemented;
• Delivery of relevant health care and health interventions;
• Approaches to implementing accessibility of or adherence to, pharmaceutical, nutritional or other promising or proven interventions.

Proposals should focus on implementation research, to examine what works, for whom and under what contextual circumstances, and how interventions can be adapted and scaled up in ways that are accessible and equitable. Proposals may address prevention or treatment of specific complications of type 2 diabetes. Proposals may also focus on gestational diabetes. Proposals may focus on specific societal groups but a clear justification should be provided as to why the group has been chosen and how the choice will assist the funders in delivering their aim to address health inequities at a local and/or global level. Proposal should focus on implementation research into interventions for prevention and treatment of type 2 diabetes that are applicable in low resource settings. However, in some settings, proposals may incorporate work to establish baseline data on prevalence of diabetes and its risk factors to evaluate the impact of the intervention. Proposals may include these aspects if they do not duplicate existing evidence available. 

All proposals should:

• Focus on research into implementation of prevention and/or treatment strategies derived from existing knowledge and research.
• Develop an improved understanding of the key barriers and facilitators at local and national levels that affect the prevention and treatment of type 2 diabetes.
• Include an assessment of equity and gender gaps in diabetes prevention and treatment.
• Demonstrate a sound understanding of the local health system context.
• Provide evidence of a health economics dimension such as cost effectiveness of the proposed intervention and its scalability.
• Describe a clear proposed pathway to embedding the intervention into policy and practice after the study which addresses how:
• Local and/or national policy makers will be engaged both at the start of the project as well as the end.
• The project outcomes/evidence will be utilised for the scaling up of the intervention on a local, national and international level.
• Future scaled-up implementations will fit within the local social, cultural and economic context.
• Identify obstacles such as inequities and equity gaps including gender that will be taken into account in the design of an implementation strategy.
• Be proposed by a multidisciplinary project team, including local researchers as co-investigators where applicable.
• Include local stakeholders such as patient groups or community groups.
• Proposals shall not include:
• Replication of effectiveness studies and clinical trials testing the efficacy or effectiveness of new or established pharmacological agents (or combination of agents) which have wider effects than those relating to type 2 diabetes.
• Aetiological or mechanistic studies of type 2 diabetes.
• Phase I or Phase IIa trials.

The Commission considers that proposals requesting a contribution from the EU of between EUR 1 to 3 million would allow this specific challenge to be addressed appropriately. Nonetheless, this does not preclude submission and selection of proposals requesting other amounts

Expected impact:

• Reducing health inequalities and inequities, including gender, in the prevention and treatment of type 2 diabetes in both a local and global context.
• Pursuing knowledge translation and exchange approaches that are designed to maximize the public health benefits of research findings within different health contexts.
• Providing evidence to inform local health service providers, policy and decision makers on the effective scaling up of the interventions at the local, national and regional levels. For example, applicants could address affordability for users and the financial implications for implementing organisations and funders or might assess scalability to various socio-political contexts.
• Contribute to the Global Alliance for Chronic Diseases.
• Appropriate leveraging of existing programmes and platforms (e.g. research, data, and delivery platforms).
• Contribute to the WHO Global Action Plan on NCDs (2013-2020) as proposals will demonstrate alignment with international and/or national commitments to halt the rise in prevalence of type 2 diabetes.
• Contribute to the United Nations Millennium Development Goals.

The GACD aims to develop a network of researchers that can enhance cumulative learning across individual projects, and work towards understanding how socio-economic, cultural, geopolitical and policy contexts have influenced results and how findings might be adapted and applied in different settings. The funded researchers should meet annually to discuss their research and share information and data in order to develop approaches to standardise data collection, and wherever feasible to use these standardised approaches in their respective projects

Type of action: Research and innovation actions