Translational Research Capacity Building Initiative to address Cardiovascular Diseases in Nepal Cardiovascular diseases (CVDs) are the leading causes of premature death in the world with more than 80% of all CVD-related deaths occurring in low-and middle-income countries. In Nepal, CVD and their risk factors have increased alarmingly over the past decades. Although there are proven measures for prevention and appropriate management of CVD, the challenges of implementing known interventions are severely limited by gaps in: a) epidemiological understanding of CVD and its risk factors; b) national level policies and strategies to address them; c) health systems infrastructure to provide education and treatment; d) community and patient-level support at the local level; and e) human resources to lead and implement agendas when they are developed. To address these gaps, this proposed project plans to build national capacity in Nepal to lead transnational research in cardiovascular disease (CVD) by creating and training a multi-sectorial, multi- disciplinary team; building partnership with the US and regional institutions; systematically assessing national needs; and developing an actionable translational research plan.
Specific aims are to: 1) Create a multi- sectorial, multidisciplinary collaborative team to lead the translational research capacity building initiative to prevent and manage CVD in Nepal; 2) Assess national level infrastructure and capacity to implement evidence based CVD prevention and management interventions and its risk factors in Nepal; 3) Identify and prioritize health issues for cardiovascular disease in Nepal; 4) Prepare a comprehensive actionable translational research plan for management of CVD in Nepal. We will consolidate existing partnerships with US Universities (University of Washington, University of Wisconsin, Faculties from Harvard University) and build new partnerships with regional institutions (Public Health Foundation of India, Sun-Yat-Sen University in China) to support these efforts. We will apply mixed methods (qualitative and quantitative) to assess the existing capacity, needs, opportunities and challenges among the governmental and non-governmental sectors to implement evidence-based interventions for prevention and management of CVD. We will conduct secondary data analysis on epidemiology of CVD by using data sources from national surveys, hospital-based data and published and unpublished research to identify the epidemiology of CVD in the context of region, gender, ethnicity, and income groups of Nepal. We will initiate efforts to ascertain MI and stroke via a pilot registry. By the end of the project, we will have developed a critical mass of human resources in Nepal, collaborating with national and international partners to conduct translational research in CVD. We will have defined clearly identified prioritized needs and a well-defined implementation research plan to address one or more major CVD risk factors and outcomes. The team will thus form a ?Center of Excellence for Translational Research in Cardiovascular Diseases?, which will also serve as a model for other resource-constrained settings around the world.
Although there are proven measures for prevention and appropriate management of cardiovascular diseases, the implementation of known interventions in real world setting are challenging especially in low-income countries such as Nepal. Translational research provides a means to apply the critical components of implementing proven interventions in these settings. Dhulikhel Hospital Kathmandu University Hospital, Nepal, will lead work to create a multi-sectorial, multidisciplinary collaborative team to develop translational research capacity building initiatives to prevent and manage CVD in Nepal. By the end of the project, we will have developed a critical mass of human resources in Nepal, collaborating with national and international partners, to conduct translational research in CVD. We will have defined clearly identified prioritized needs and a well- defined translational research plan to address one or more major CVD risk factors and outcomes.