A worldwide network of research and training centers will build institutional and community capacity to prevent and control chronic diseases, such as cardiovascular, lung diseases, and diabetes, announced the National Heart, Lung, and Blood Institute (NHLBI), one of the National Institutes of Health (NIH). The NHLBI is awarding 10 contracts totaling more than $34 million in this effort. The NHLBI joins with Minneapolis-based UnitedHealth Group's existing Chronic Disease Initiative (UnitedHealth CDI) in establishing the "UnitedHealth and NHLBI Collaborating Centers of Excellence" (COEs) network.

Each COE is led by a research institution in a low- or middle-income developing country paired with at least one partner academic institution in a developed country to enhance research and training opportunities. A signed Statement of Joint Commitment between the NHLBI and UnitedHealth Group, one of the world's largest health and well-being companies, underscores their collaborative efforts to address chronic disease globally.

A comment on the program, "Combating Chronic Disease in Developing Countries — Partners in Progress," by NHLBI Director Elizabeth G. Nabel, M.D., Simon Stevens, president, Global Health, at UnitedHealth Group, and Richard Smith, M.D., director of UnitedHealth CDI, will be published online in The Lancet June 11, and in the June 13 print edition.

The NHLBI will fund six centers in Bangladesh, China, Guatemala, India (Bangalore and New Delhi), and South Africa. These centers are also receiving funding from United Health Group's CDI. The NHLBI is funding three additional centers in Argentina, Kenya and Peru; and United Health CDI funds two centers located at the U.S.-Mexico border and in Tunisia.

"Scientific discovery knows no boundaries — and neither do chronic diseases, which are increasingly affecting the young and the elderly, the rich and the poor, and every ethnic group in every nation," said Nabel.

According to the World Health Organization, chronic diseases — primarily cardiovascular diseases, chronic lung diseases, some cancers, and type 2 diabetes — account for more than half of deaths worldwide, of which 80 percent occur in low- and middle-income countries. Furthermore, each year more than 35 million people worldwide die from chronic noncommunicable diseases.

"Unless we make chronic disease prevention a worldwide priority, the personal, social, economic, and political consequences will reverberate throughout the globe," said Simon Stevens. "The time has come to increase resources to counter the pandemic of chronic disease sweeping through low- and middle-income countries."

"By developing infrastructures for research and training, the centers will apply their considerable expertise to enhance local capacity to conduct population-based or clinical research to monitor, prevent, or control chronic cardiovascular and lung diseases," said Cristina Rabadán-Diehl, Ph.D., M.P.H., program director, NHLBI Division of Cardiovascular Diseases and director of the NHLBI Centers of Excellence Global Health Program. "We look forward to long-term sustainability of this seed investment — and improved global health."

The centers will conduct research tailored to their local or regional needs to reduce the burden of chronic diseases, including heart disease, heart failure, stroke, diabetes, and chronic obstructive pulmonary disease (COPD). Related risk factors such as high blood pressure, high blood cholesterol, obesity, and environmental exposures that contribute to COPD will also be emphasized. Center collaboration with existing health care systems in their communities or regions will be key to building and strengthening sustainable programs.

Each center will foster the training and mentoring of emerging scientists, physicians and other health professionals, and/or community health workers in collaboration with their partner institutions. Each NHLBI-funded center is also a Fogarty International Clinical Research Fellow or Scholar site. The Fogarty International Center is dedicated to advancing the mission of the NIH by supporting and facilitating global health research and training activities.

"As part of the NHLBI's expanding commitment to providing global leadership through research, training, and education, we have also commissioned a report from the Institute of Medicine on the global epidemic of cardiovascular disease in developing countries, are establishing a global health office, and plan to join with other government agencies to create the Global Alliance for Chronic Disease," said Nabel.

The NHLBI is awarding five-year contracts totaling almost $26 million to the following Centers of Excellence and the developed nation partner. In addition, the NHLBI is awarding a six-year $8.8 million contract to Westat of Rockville, Md., to serve as the administrative coordinating center for the NHLBI COEs.

• South American Center for Cardiovascular Health (SACECH), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
  Partner: Tulane University School of Public Health and Tropical Medicine (SPHTM), New Orleans, La., USA
• International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh*
  Partner: Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Md., USA
• The George Institute, Beijing, China*
  Partner: Duke Global Health Institute, Durham, N.C., USA
• Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala*
  Partners: Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Md., USA; RAND Corporation, Santa Monica, Calif., USA; Harvard School of Public Health, Boston, Mass., USA
• St. John's Research Institute, Bangalore, Karnataka, India*
  Partner: Population Health Research Institute (PHRI), Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
• Public Health Foundation of India, New Delhi, India*
  Partner: Emory University, Atlanta, Ga., USA
• Moi University, School of Medicine, Eldoret, Kenya
  Partner: Duke University Medical Center, Durham, N.C., USA
• Universidad Peruana Cayetano Heredia, Lima, Peru
  Partner: Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Md., USA
• University of Cape Town, Cape Town, South Africa*
  Partner: Harvard Medical School, Brigham and Women's Hospital, Boston, Mass., USA

*COE also funded by UnitedHealth CDI.

In addition to the above COEs that are supported in part by the UnitedHealth CDI as indicated, UnitedHealth is also funding:

• University Hospital Farhat Hached, Sousse, Tunisia
  Partner: Department of Chronic Disease Prevention and Health Promotion, National Public Health Institute of Helsinki, KTL, Finland
• Pan American Health Organization U.S.- Mexico Border Office, El Paso, TX, USA
  Partners: University of Texas, El Paso, TX, USA; The University of Arizona, MEZ School of Public Health, Tucson, Ariz., USA; Whittier Institute of Diabetes, San Diego, Calif., USA

Information on all of the UnitedHealth and the NHLBI Collaborating Centers of Excellence can be found on the NHLBI Global Health InitiativeWebsite, www.globalhealth.nhlbi.nih.gov (to go live at 6:30 p.m. EDT on June 10).

Information on the UnitedHealth Group can be found at www.unitedhealthgroup.com.

To interview an NHLBI spokesperson, contact the NHLBI Communications Office at 301-496-4236 or at nhlbi_news@nhlbi.nih.gov. To interview a UnitedHealth spokesperson, contact Marti Jones at 952-931-5490 or at martha_jones@uhc.com. For a list of in-country media contacts, see http://www.nhlbi.nih.gov/about/globalhealth/media-room/index.htm (live at 6:30 p.m. EDT on June 10)

Part of the National Institutes of Health, the National Heart, Lung, and Blood Institute (NHLBI) plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics. NHLBI press releases and other materials are available online at www.nhlbi.nih.gov.