Global Alliance for Chronic Diseases. Prevention and treatment of lung diseases

Topic description

Scope:

Specific challenge: The Global Alliance for Chronic Diseases will focus its 2015 call for implementation science proposals on lung diseases.

With the burden of this chronic non-communicable disease ever-increasing, the Global Alliance for Chronic Diseases (GACD[1]), of which the Commission is a member, has agreed to launch a call for proposals on the prevention and treatment of lung diseases, with a focus on intervention research in low- and middle-income countries (LMIC) and/or in vulnerable populations in high income countries (HIC).

Controlling tobacco consumption and reducing harmful environmental exposures (indoor and outdoor exposures) are among the most important interventions in lung disease[2].

Smoking and other forms of tobacco consumption are considered the single most important cause of preventable morbidity and premature mortality worldwide[3]. Tobacco addiction causes about 5.4 million people death each year, and if resolute and urgent action is not taken by 2030 the epidemic will cause between 8 and 10 million deaths each year, of which over 80% occur in low- and middle-income countries (LMIC). Smoking is a major cause of inequality in health between gender, socioeconomic groups and age categories. With nicotine being highly addictive, it is important to prevent young people from taking up tobacco use. 70% of the smokers start before the age of 18 and 94% before the age of 25 years.

The precise health risk that environment exposure poses to lung diseases is not well established because of the difficulty to assess the prevalence linked to the amount of exposure. Risk assessment is further complicated by socioeconomic, age and genetic factors.

Scope: Proposals must focus on lung diseases and they must have an implementation science focus. They must address what works, for whom, under what contextual circumstances and are the intervention(s) adaptable and scalable in ways that are accessible and equitable. Proposals should generate new knowledge on interventions and their implementation for the prevention and treatment of lung diseases in LMIC, and/or in vulnerable populations in HIC[4]. Proposals must focus on existing approaches to prevention and control of lung diseases or develop treatments at lower costs. They should demonstrate a sound understanding of the local health system context as well as the global cross-sectorial context.

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 lung diseases.
• 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.

• Include local stakeholders such as patient groups or community groups.

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

• Structural interventions or policies designed to promote improved health outcomes. For example, evaluating the contribution of public policies to lung diseases prevention efforts, or monitoring the potential effects of such policies if adopted and implemented;
• Approaches to implementing accessibility of or adherence to, pharmaceutical, or other promising or proven interventions;
• Study the feasibility and effectiveness of low-cost and integrated prevention and management approaches of lung diseases;
• Study populations exposed to tobacco products[5], in particular assessing the behaviour of populations consuming those products that may contribute to: (i) developing addiction, (ii) shifting normative attitudes to smoking and tobacco control, and (iii) establishing overall impact of those tobacco products at both individual and population levels;
• Study populations exposed to electronic cigarettes[6], in particular assessing (i) the behaviour of populations consuming these products that may result in developing addiction to nicotine; (ii) the overall public health impact of electronic cigarettes over long term and address questions to what extent these products are an initiation product to/cessation product from nicotine addiction and tobacco consumption.
• Assess current policy for prevention (e.g. design/presentation, fiscal, tax and information policy related to tobacco) as well as options to support smoking cessation (including pharmacotherapy, electronic cigarettes, intervention financing mechanisms), taking into account the context in which they are implemented. Research on new low cost formulations of proven effective therapies will also be supported;
• Optimize tobacco cessation interventions, identify the most cost-effective interventions for resource-constrained settings and integrate smoking cessation into health systems;
• Evaluate the impact of interventions for reducing environmental exposure and mitigating their effects in indoor and outdoor air pollution;
• Investigate the interaction between the individual and the environment to better define at-risk populations and identify biomarkers for lung diseases associated with environmental exposure;
• Propose intervention(s) to modify indoor and outdoor exposures and assess the subsequent health outcome.

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.

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:

• To demonstrate the link between the intervention(s) and health outcome in lung diseases;
• To reduce health inequalities and inequities, including gender, in the prevention and treatment of lung diseases in both a local and global context;
• To pursue knowledge translation and exchange approaches that are designed to maximize the public health benefits of research findings within different health contexts;
• To provide 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;
• Appropriate leveraging of existing programmes and platforms (e.g. research, data, and delivery platforms);
• To improve quality controls and safety (including toxicity profile) of tobacco products and electronic cigarettes;
• To develop the necessary knowledge basis for further coordination of regulatory aspects related to tobacco products and electronic cigarettes;
• To characterise behavioural group specificity in successful intervention(s) in order to tailor preventive and control interventions;
• To develop lower cost therapeutic option for smoking cessation that are cost effective in LMIC;
• To contribute to the United Nations Millennium Development Goals[7].

Type of action: Research and innovation actions

[1]     http://www.gacd.org/

[2]     The World Health Report 2002—Reducing Risks, Promoting Healthy Life (http://www.who.int/whr/2002/en/)

[3]     WHO, Priority Medicine for Europe and the World 2013 Update (http://www.who.int/medicines/areas/priority_medicines/MasterDocJune28_FINAL_Web.pdf)

[4]     The applicant needs to explain why the proposed population under investigation in HIC is vulnerable

[5]     Cigarettes, slim cigarettes, water pipes, smokeless tobacco, novel tobacco products.

[6]     As defined in Article 2(16) of the Tobacco Products Directive 2014/40/EU of the European Parliament and of the Council of 3 April 2014, 'electronic cigarette' means a product that can be used for consumption of nicotine-containing vapour via a mouth piece, or any component of that product, including a cartridge, a tank and the device without cartridge or tank. Electronic cigarettes can be disposable or refillable by means of a refill container and a tank, or rechargeable with single use cartridges

[7]     http://www.un.org/millenniumgoals/bkgd.shtml