The 20 Grand Challenges — Oxford Health Alliance

Below are the 20 Grand Challenges in Chronic Non-Communicable Diseases.

Raise the political priority of non-communicable disease;
Promote healthy lifestyle and consumption choices through effective education and public engagement;
Package compelling and valid information to foster widespread, sustained and accurate media coverage and thereby improve awareness of economic, social and public health impacts.

Research needed to address goals

Study how to engage governments in partnerships for disease prevention;
Develop research activities for health that bridge government departments (e.g. transport, civic planning, health, education and environment);
Identify the reasons for low awareness and advocacy of chronic disease in societies;
Study how to create public forums that sustainably raise awareness of CNCD issues.

Study and address the impact of government spending and taxation on health;
Develop and implement local, national and international policies and trade agreements, including regulatory restraints, to discourage the consumption of alcohol, tobacco and unhealthy foods;
Study and address the impacts of poor health on economic output and productivity.

Research needed to address goals

Evaluate the health impacts of agricultural policy interventions;
Study the health and economic impacts of comprehensive community-based interventions;
Create general population metrics and outcome indicators for policy and program surveillance;
Quantify impact of CNCDs on domestic economies;
Study the international ramifications of change of food and tobacco consumption;
Probe motivations behind domestic expenditures, and how these affect lifestyle choices;
Investigate the impact and effectiveness of food labelling legislation.

Deploy universally measures proven to reduce tobacco use and boost resources to implement the WHO Framework Convention on Tobacco Control;
Increase the availability and consumption of healthy food;
Promote lifelong physical activity;
Better understand environmental and cultural factors that change behaviour.

Research needed to address goals

Do prospective cohort studies to identify risk factors, the magnitude of their effects, and factors that reduce risk of CNCDs;
Evaluate foetal and early life influences on chronic disease risk;
Find and evaluate new or combined medical preparations to prevent cardiovascular disease and diabetes, or reduce their morbidities;
Evaluate behavioural modifications to reduce risks;
Establish metrics, and relationships between metrics, which are culturally and ethnically specific;
Investigate cultural and ethnic variation in risk factors to refine behavioural interventions;
Quantify personal risk related to phenotypes, genotypes and multiplicative risks;
Study the interaction of environment and genes in risk factors and in outcomes;
Develop new biomarkers and diagnostics for risk and for early disease detection.

Make business a key partner in promoting health and preventing disease;
Develop and monitor codes of responsible conduct with the food, beverage and restaurant industries;
Empower community resources such as voluntary and faith-based organisations.

Research needed to address goals

Study marketing techniques and marketing data derived from commercial companies regarding behaviour modification;
Investigate mechanisms for consumers and the public to influence food industry positively;
Research the impact of taste, flavour, packaging, labelling and advertising on choice and health;
Create and evaluate community-based strategies to promote healthy living;
Identify modes of effective public/private partnerships that support health;
Develop better understanding of nutrient benefit in foods.

Study and address how poverty increases risk factors;
Study and address the links between the built environment, urbanisation and chronic non-communicable disease.

Research needed to address goals

Investigate the biological basis of health risks related to poverty;
Examine the influence of poverty on the adoption of high risk behaviour;
Identify negative effects of economic growth on health;
Study how to work with planners, architects and city representatives to enhance the environment for healthier living.

Allocate resources within health systems based on burden of disease;
Move health professional training and practice towards prevention;
Increase number and skills of professionals who prevent, treat and manage chronic non-communicable diseases, especially in developing countries;
Build health systems that integrate screening and prevention within health delivery.

Research needed to address goals

Develop strategies to integrate health system management of communicable and non-communicable disease;
Form collaborations to find best practices in delivering affordable and equitable health care;
Study how to provide more structured knowledge for health promotion;
Develop strategies to ensure that medical training and curricula focus on chronic non-communicable diseases;
Develop and provide culturally specific and nationally appropriate resources for training of health-care workers;
Study how best to ensure that disadvantaged communities have adequate resource allocations in health care and in preventative practice;
Optimise use of electronic health records for predicting disease and measuring the effect of health interventions;
Study how best to develop and establish real-time surveillance tools;
Discover and develop tools for screening and stratifying populations according to risk;
Increase access to medications to prevent complications of chronic non-communicable disease.

The Oxford Health Alliance | www.oxha.org