Grant: Foundation Grant

GOALS: Generate direct epidemiological evidence required to fill large data gaps in understanding causes of death (COD) in low and middle-income countries (LMICs) and quantify risk factors for premature mortality globally. This knowledge will improve use of health resources and public understanding of avoidable mortality. OBJECTIVES: #1 Enable rapid collection of high-quality COD information to influence disease control priorities in 5 LMICs/1.5 billion people. This grant will deepen our prior study in India to investigate unexpected disease patterns documented in 2001-13, enable similar studies in Ethiopia, Bangladesh, Mozambique and Sierra Leone, support innovations, train researchers, and link statistics to health policy and control programs. #2 Investigate changing mortality from smoking and other risk factors to influence control programs and individual understanding of risk in 10 countries/2.3 billion people. We will conduct retrospective and prospective studies on ~120 million living/dead persons. We document changing tobacco hazards, especially in LMICs. We also investigate changing hazards from smoking and the age, sex and SES-specific benefits of tobacco cessation in clinically relevant subgroups (e.g. diabetic or hypertensive). Later, we investigate other classic and emerging risk factors. Our request is consistent with CIHR's Research Roadmap, the principles of CIHR Governing Council and Government of Canada plans to expand its global health footprint. This grant will enable us to achieve our research goals, attain high impact, attract more funding, and ensure Canadian leadership in global health. SIGNIFICANCE: By 2024, we provide direct evidence on COD in 5 LMICs; develop innovative methods for COD studies; expand our understanding of risk factors in 10 countries/2.3 billion people; spur ~10 countries to adopt our methods; increase our publication impact; and expand our global influence on health policy and individual awareness of risk.