Strategic Plan

Transcription

1 Strategic Pla

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3 Foreword Dear frieds ad colleagues, We are delighted to share our Strategic Pla, the result of extesive iteral collaboratio ad exteral cosultatio, which will set the course for icddr,b for the ext three years. Our ew strategic focus aligs our research with the most pressig global public health challeges today, icludig the ogoig threats of ifectious disease as well as cotiued improvemets eeded i materal ad child health ad utritio, ad health systems. It also embraces the eed for expasio of our research focus to the emergig threats of o-commuicable diseases ad climate chage, which may developig coutries are facig. Our strategic pla is dyamic, providig a foudatio to achieve broader objectives by developig a greater iteratioal focus, promotig the growth of South-South collaboratios ad icreasig egagemet with the private sector. We are proud of beig the leadig cetre of public health research excellece ad iovatio i the global South. We believe that this Strategic Pla will help us to cotiue to be at the forefrot of world class sciece that is made i Bagladesh. We look forward to workig with you as collaborators ad parters i the future. Kid regards Professor Joh Clemes Executive Director, icddr,b icddr,b Strategic Pla

4 5 About icddr,b Bagladesh ad beyod Shapig the future Cotets 8 Goal 1 - Implemet a focused research strategy 9 Key research themes 10 Reducig materal ad eoatal mortality 12 Prevetig ad treatig materal ad childhood malutritio 14 Cotrollig eteric ad respiratory ifectios 16 Detectig ad cotrollig emergig ad re-emergig ifectios 18 Achievig uiversal health coverage 20 Research iitiatives 20 Examiig the health cosequeces of climate chage 21 Prevetig ad treatig o-commuicable diseases 22 Goal 2 - Icrease the visibility ad impact of our research evidece 24 Goal 3 - Ivest i our research platforms 26 Goal 4 - Ivest i our people 27 Goal 5 - Improve orgaisatioal efficiecy ad cost-effectiveess 30 Goal 6 - Esure fiacial sustaiability 32 Moitorig ad evaluatio 32 Fudig the strategic pla Our visio A world i which more people ca survive ad ejoy healthy lives Our missio To solve public health problems through iovative scietific research Our values Excellece We are sigle mided i our pursuit of scietific rigour ad operatioal efficiecy Itegrity We are a resposible ad accoutable orgaisatio, committed to the highest stadards of behaviour Iclusiveess We work together collaboratively across the orgaisatio ad with our parters

5 About icddr,b icddr,b has a log ad distiguished history. Istrumetal i the developmet of oral rehydratio therapy, our research i this area has bee credited with savig millios of lives worldwide. From a early focus o cholera ad diarrhoeal disease, our scope has expaded to ecompass most of the cotemporary health challeges facig developig coutries. Several factors have bee cetral to our success. Beig embedded withi a developig coutry, we are itimately familiar with health ad health systems challeges i such settigs. We uderstad the socio-ecoomic ad cultural determiats of health, as well as local health priorities, ad we develop ad evaluate itervetios appropriate to local settigs. I additio, by emphasisig rigorous testig ad scalability, we geerate evidece that is ot just of relevace i Bagladesh, but also improves the health ad wellbeig of people livig i comparable low- ad middleicome coutries. We have a commitmet to traslatig research ito policy ad practice, ad vast experiece dissemiatig ad traslatig our scietific evidece for use by policy-makers, programme maagers ad the scietific commuity. Our researchers collectively comprise oe of the largest ad strogest commuities of scietific expertise i the developig world. They are extesively etworked with leadig research istitutios i North America, Europe ad Australasia. Uderpiig our research is a uique ifrastructure that eables us to udertake a full spectrum of research spaig populatio-based studies ad demographic surveillace, large-scale cliical trials, hospital-based cliical studies ad laboratory research utilisig the very latest techologies. As well as beig a major facility for cliical research, icddr,b s Dhaka Hospital is a beaco of health care excellece, treatig more tha 140,000 patiets each year ad settig the stadard for treatig ifectious disease ad malutritio, amog other coditios, i low-resource settigs. Our Matlab Health ad Demographic Surveillace Site, the logest cotiuously ruig surveillace site i the developig world, is a model of how logitudial data ca be used to track ad iform developmet policies ad programmes to have maximum impact. Bagladesh ad beyod We work i close collaboratio with the Govermet of Bagladesh, geeratig evidece to iform policy developmet ad implemetatio, ad evaluatig health service delivery. I its 40-year history, Bagladesh has udergoe little short of a health revolutio, achievig sigificat reductios i child ad materal mortality, reachig Milleium Developmet Goals (MDGs) 4 ad 5 despite limited fiacial resources. It is predicted to be o course for achievig middle-icome coutry status by Eve so, there remais cosiderable scope to improve health. Just as icddr,b has cotributed to Bagladesh s past successes, we aim to deliver the evidece that will uderpi further improvemets i the health ad wellbeig of the people of Bagladesh, ad other populatios across the global South where the burdes of premature death ad disability remai persistetly high. Shapig the future With a illustrious past, our cotemporary challege is to pursue a clear set of strategic goals that will improve the quality of our research, eable us to achieve maximum impact ad esure that we are orgaisatioally able to deliver our ambitious aims over the log term. Our ew strategy focuses our research o areas of umet health eed where we have existig stregths. We are also moderisig our orgaisatio to esure it is fit for purpose, meets iteratioal stadards of operatio ad provides a strog platform o which to execute our strategic goals. We take a three year perspective with this dyamic pla, which will be regularly moitored ad updated give the eed for our research to remai relevat ad resposive to global health agedas such as the Sustaiable Developmet Goals ad major disease elimiatio iitiatives. icddr,b Strategic Pla

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7 Strategic goals We aim to be the leadig cetre of public health research excellece ad iovatio i the global South Goal 1 Goal 2 Goal 3 Goal 4 Goal 5 Goal 6 Implemet a focused research strategy We will focus our research o areas of umet eed, developig research programmes of excellece with a strog emphasis o relevacy i the global South. Icrease the visibility ad impact of our research evidece We will build skills ad parterships to esure that our research evidece has impact o atioal ad iteratioal policies, programmes ad practices for improved health. Ivest i our research platforms We will develop our research ifrastructure for populatiobased, cliical ad laboratory-based research to esure it is aliged to our research objectives, iteratioally competitive ad fiacially sustaiable. Ivest i our people We will build the skills ad competecies of scietific ad other staff, with a special focus o developig local research capacity, particularly at the mid-career level, ad supportig female researchers. Improve orgaisatioal efficiecy ad cost-effectiveess We will moderise our orgaisatio s operatios to esure maximum efficiecy ad cost-effectiveess. Esure fiacial sustaiability As well as carefully cotrollig expediture, we will revise our fudraisig strategy ad idetify additioal opportuities for icome geeratio.

8 GOAL Implemetig a focused research strategy We will focus our research o areas of umet eed, developig research programmes of excellece with a strog emphasis o relevacy i the global South. Sice the orgaisatio was established i 1960, our research focus has broadeed from cholera ad diarrhoeal diseases to ecompass may other health challeges facig people livig i poverty. While still addressig a rage of health issues, we are implemetig a focused research strategy that builds o our locatio ad prove stregths, ad eables us to cocetrate our resources o some of the most pressig ad itractable health cocers of the global South. We are egaged with the Govermet of Bagladesh as well as actively sharig our evidece ad experiece with other low- ad middle-icome coutries to esure that our research beefits people i greatest eed. Our research priorities are orgaised aroud five public health goals: Reducig materal ad eoatal mortality Prevetig ad treatig materal ad childhood malutritio Cotrollig eteric ad respiratory ifectios Detectig ad cotrollig emergig ad re-emergig ifectious diseases Achievig uiversal health coverage While these five themes will form the focus of our research, we will also establish ad ivest i two research iitiatives i areas highly relevat to Bagladesh ad other low-icome coutries: Examiig health cosequeces of climate chage Prevetig ad treatig o-commuicable diseases Withi each research priority, research will be coducted across the cotiuum of: Discovery research that defies the ature ad causes of the problem; Developmet research that develops solutios or a respose to a problem; ad Delivery research focusig o implemetatio, scale-up ad/or sustaiability of itervetios i public health or health care practice. While cotiuig to coduct research i Bagladesh, we are developig more collaboratio with research istitutios i the global South, leadig ad participatig i research studies i South Asia ad other low-icome coutries. We are also reviewig ad updatig our scietific goverace ad research admiistratio systems, icludig research ethics oversight, ad will regularly covee our iteratioal Scietific Advisory Group to guide the delivery of worldclass research ad its dissemiatio ad traslatio ito policy ad practice. 8

9 KEY RESEARCH THEMES Reducig materal ad eoatal mortality We will discover, develop ad evaluate ew or improved itervetios to prevet ad treat obstetric complicatios, adverse birth outcomes ad life-threateig eoatal coditios. Prevetig ad treatig materal ad childhood malutritio We will study biological ad o-biological mechaisms uderpiig materal ad childhood malutritio, develop iovative itervetios to prevet ad treat these coditios ad evaluate ew itervetios for efficacy, feasibility ad scalability. Cotrollig eteric ad respiratory ifectios We will geerate a better uderstadig of key diseasecausig orgaisms ad host immue resposes, ad develop ad evaluate low-cost potetially scalable prevetive ad therapeutic itervetios. Detectig ad cotrollig emergig ad re-emergig ifectios We will work with parters i Bagladesh ad iteratioally to detect, characterise ad respod to emergig ad re-emergig ifectious disease threats. Achievig uiversal health coverage We will evaluate gaps i access, delivery, quality, fiacig, policy ad goverace i the health sector i Bagladesh, ad test itervetios to remedy deficiecies. RESEARCH iitiatives Examiig the health cosequeces of climate chage We will evaluate the impacts of climate chage ad migratio patters o populatio health i Bagladesh ad ways i which populatios ca adapt. Prevetig ad treatig o-commuicable diseases We will assess the burde of chroic diseases i Bagladesh, documet curret care practices ad health-seekig behaviours ad evaluate ew itervetios relevat to lowicome coutries to improve health outcomes ad health care, with a focus o cardiovascular diseases ad diabetes.

10 Key Research Themes Reducig materal ad eoatal mortality The global cotext Every two miutes a woma somewhere i the world dies from a pregacyrelated complicatio, ad 70% of these deaths are caused by five prevetable coditios: post-partum haemorrhage, eclampsia or pre-eclampsia, puerperal sepsis, complicatios from usafe abortio ad obstructed labour. Each year, 2.8 millio eoates die globally, mostly from preterm birth, birth asphyxia or severe ifectios, while 2.6 millio babies are stillbor. We will discover, develop ad evaluate ew or improved itervetios to prevet ad treat obstetric complicatios, adverse birth outcomes ad life-threateig eoatal coditios. Neoatal health ad materal health are iextricably liked. Improvig wome s health ad the quality of care durig ad immediately after birth could substatially lower materal ad eoatal mortality, icludig stillbirth. The situatio i Bagladesh Although Bagladesh has achieved remarkable progress towards MDG targets, mortality rates amog mothers ad childre remai high. A dramatic declie i deaths amog childre uder 5 years of age mostly reflects reduced posteoatal mortality. Mortality amog ewbors has ot declied as rapidly, ad accouts for almost 60% of all deaths uder 5 years of age. The mai causes of eoatal deaths are severe ifectio, birth asphyxia, prematurity/low birth weight ad acute respiratory ifectio. About 70% of wome i Bagladesh still deliver at home without a skilled birth attedat. Effective itervetios durig pregacy ad birth are ofte missig ad the quality of available services is geerally poor. Overall the health system remais weak, lackig skilled birth attedats, resources ad appropriate policy support. Our track record We have a log history of developig materal ad child health itervetios, ad esurig they are adopted ito policy ad practice i Bagladesh ad globally. Several of our iovatios have bee scaled, icludig a commuity health worker-based family plaig programme. Our fidigs o the atiseptic chlorhexidie to prevet umbilical cord ifectios have iflueced atioal ad global policy-makig. We actively participate i the developmet of atioal policy, ad cotiue to seek opportuities to apply the learig gaied i Bagladesh i other low-icome coutries. 10

11 Research Goals Evaluate the biological pathways leadig to preterm birth Defie causes of serious eoatal ifectios Assess existig ad ew biomarkers for the early detectio of pre-eclampsia/ eclampsia, ad improved itervetios for the maagemet of these coditios Evaluate at scale the feasibility, acceptability ad impact o post-partum haemorrhage of a expaded birthig kit cosistig of misoprostol ad a birthig mat to moitor haemorrhage, for domestic, regioal ad global applicatio Evaluate approaches to delay first pregacies amog married adolescets ad to scale up o-surgical mestrual regulatio Evaluate measures to improve health systems i Bagladesh for care of pre-eclampsia/ eclampsia, post-partum haemorrhage, eoatal sepsis, preterm birth ad birth asphyxia. icddr,b Strategic Pla

12 KEY Research Themes Prevetig ad treatig materal ad childhood malutritio The global cotext Two billio people i the world suffer from malutritio. Some 45% of deaths of childre uder five years or age are attributable to uder-utritio. Malutritio is a uderlyig cause of death of 2.6 millio childre each year a third of child deaths globally. More tha 165 millio childre uder-five worldwide are affected by stutig. I some coutries as may as half of all adolescet girls ad wome of child-bearig age are stuted, icreasig the risk of poor foetal growth ad low birth weight amog their childre. We will study biological ad obiological mechaisms uderpiig materal ad childhood malutritio, develop iovative itervetios to prevet ad treat these coditios ad evaluate ew itervetios for efficacy, feasibility ad scalability. The situatio i Bagladesh I Bagladesh, more tha half the populatio suffers from malutritio. Severe acute malutritio affects 600,000 childre, while close to 2 millio childre have moderate acute malutritio. Stutig affects 40% of childre uder-five, while a quarter of wome are uderweight ad aroud 15% have short stature, which icreases the risk of difficult childbirth ad low birth weight ifats. Half of all wome suffer from aaemia, mostly utritioal i origi. Malutritio is estimated to cost Bagladesh more tha US$1b every year i lost productivity. Our track record We have worked extesively with iteratioal parters to uderstad the causes ad implicatios of malutritio ad to develop ew products to prevet ad treat malutritio, icludig ready-to-use foods developed from locally available igrediets. We have published ifluetial work o abormalities i the gut microbiota of childre with severe acute malutritio, ad are ow ivestigatig how these abormalities ca be reversed. We have iflueced the global utritio research ageda through our egagemet with the WHO ad the New York Academy of Scieces. I Bagladesh, we led the developmet of the Natioal Nutritio Policy ad reviewed the utritio backgroud paper that will iform the coutry s seveth Five Year Pla. 12

13 Research Goals Measure the burde ad costs of materal ad childhood malutritio i Bagladesh to facilitate targetig of itervetios ad policy decisios regardig resource allocatio for measures to cotrol these coditios Assess the biological ad o-biological determiats of childhood stutig ad severe acute malutritio to discover ew prevetative ad therapeutic itervetios Evaluate the role of materal malutritio as a determiat of birth weight ad subsequet childhood utritioal status to guide the developmet of ew materal supplemetatio strategies Develop ad test through cliical ad field trials, ready to use therapeutic (RUTF) ad supplemetary foods (RUSF), prepared with locally available igrediets, for the treatmet of severe ad moderate childhood malutritio, respectively Coduct cliical trials of ew itervetios to prevet ad treat childhood stutig Coduct trials of ew itervetios to prevet ad treat materal malutritio i pregat ad opregat wome Coduct implemetatio research evaluatig the scalability, acceptability ad cost-effectiveess of RUTF ad RUSF for the treatmet of severe ad moderate childhood malutritio Evaluate programmatic costraits to effective itervetios to improve materal malutritio icddr,b Strategic Pla

14 Key Research Themes Cotrollig eteric ad respiratory ifectios The global cotext Globally, eteric diseases (diseases affectig the gut) ad respiratory ifectios are the leadig causes of mortality, morbidity, malutritio ad impaired growth ad cogitive developmet i childre, as well as i older age groups. I 2010, there were a estimated 1.7 billio episodes of diarrhoea ad 120 millio episodes of peumoia i childre less tha five years of age, collectively causig more tha 2 millio deaths. Two-thirds of fatalities were of childre uder two years of age. We will geerate a better uderstadig of key diseasecausig orgaisms ad host immue resposes, ad develop ad evaluate low-cost potetially scalable prevetive ad therapeutic itervetios. The situatio i Bagladesh Despite some improvemets i the cotrol of ifectious disease, Bagladesh remais oe of te coutries with the highest burde of peumoia, tuberculosis ad diarrhoea-related deaths ad illess, collectively resposible for early oe of every five deaths overall. The burde of commo ifectious diseases has a profoud impact o the health ad ecoomic coditios of Bagladesh s populatio. While existig itervetios eed to be delivered effectively to more people at risk, there is also a eed to develop ew itervetios, based o our evolvig uderstadig of pathoge biology ad evolutio ad host pathoge iteractios. Our track record Our outstadig laboratory, cliical ad populatio-based research capabilities have eabled us to make major cotributios to the uderstadig of ifectious disease epidemiology, immuology ad microbial pathogeesis. We are iteratioally recogised for the quality of our research i cholera ad other diarrhoeal diseases, icludig pioeerig molecular-geetic studies of the cholera pathoge Vibrio cholerae. We have a log history of developig effective itervetios to prevet ad treat diarrhoeal diseases ad respiratory illesses. We developed ad proved the value of oral rehydratio solutio for treatmet of paediatric diarrhoea, ad later showed the positive impact of zic supplemetatio of oral rehydratio solutio. Studies o several key vaccies, icludig cholera, rotavirus, peumococcal, Hib ad iflueza, have geerated evidece that has iflueced global health policy, icludig WHO recommedatios, ad Bagladesh s atioal immuisatio programme. 14

15 Research Goals Idetify ew vaccie atiges to provide leads for developmet of improved vaccies Determie the molecular mechaisms goverig the evirometal ecology ad pathogeesis of bacterial eteric pathoges to provide leads for ew prevetative ad therapeutic itervetios Better characterise disease burde ad huma susceptibility for improved targetig of itervetios Develop ad evaluate improved diagostics to facilitate detectio ad treatmet Study mechaisms of emergece of ew pathogeic strais ad their evolutio Evaluate ew vaccies for pathoges of public health importace Elucidate the immue resposes resposible for mediatig immue protectio agaist key eteric pathoges, ad mechaisms to ehace protectio via improved vaccies Evaluate ew therapeutics to improve therapeutic outcomes Develop ad evaluate o-vaccie prevetive itervetios icddr,b Strategic Pla

16 Key Research Themes Detectig ad cotrollig emergig ad re-emergig ifectios The global cotext Detectio ad cotrol of some ifectious diseases are importat ot because they represet a cosistetly high burde, but because of the risk they pose to susceptible populatios, icludig resurgece of elimiated ifectious diseases. History records the devastatig impact of emergig ifectios ad drug-resistat ifectious agets, ad the emphasis ow is o early detectio ad cotrol. With routie itercotietal travel, the cross-border dissemiatio of ovel ifectious diseases ca be alarmigly rapid. We will work with parters i Bagladesh ad iteratioally to detect, characterise ad respod to emergig ad reemergig ifectious disease threats. The situatio i Bagladesh Bagladesh provides opportuities to study emergig ifectios ad their trasmissio withi aimal populatios, from aimals to humas ad from perso to perso. As well as helpig to cotrol ifectios locally, such work has a vital role to play i idetifyig ad cotaiig emergig ad re-emergig ifectios, icludig drug-resistat agets that pose a regioal ad global public health threat. Degue is commo i Dhaka ad a emergig risk i rural areas. Nipah virus causes yearly outbreaks of ecephalitis i Bagladesh, with more tha 75% case fatality. Avia iflueza is edemic i Bagladeshi poultry, but has thus far caused oly mild illess i humas. Yearly outbreaks of athrax occur i rumiats such as cattle, with some huma ifectios. Behavioural chage itervetios to prevet cross-species trasmissio are ofte hampered by local poverty ad food isecurity. Multidrug-resistat tuberculosis (MDR-TB) is commo i Bagladesh, ad the ifrastructure to treat MDR-TB is limited. Global spread of atibiotic-resistat bacteria ad malaria, some origiatig from South Asia, has caused iteratioal cocer ad Bagladesh is see as oe of the crossroads betwee Asia ad Africa for their spread. Our track record We have a log-stadig collaboratio with the US Ceters for Disease Cotrol ad Prevetio, which has eabled us to build platforms to track ifectios, through hospital-based surveillace ad populatio-based surveys. Our laboratory capacity, icludig a BSL-3 laboratory for dagerous pathoges, allows us to study emergig ifectios ad atimicrobial-resistat pathoges. We are also parterig with USAID s Emergig Pademic Threats programme, ad routiely respod to ifectious disease outbreaks i partership with the Istitute of Epidemiology, Disease Cotrol ad Research (IEDCR), ad i collaboratio with the local Oe Health iitiative. As a member of the Asia Pacific Malaria Elimiatio Network, we are cotributig to the elimiatio of malaria i the Asia Pacific Regio by

17 Research Goals Characterise the disease burde ad risk factors, ad idetify hot-spots for ecological spillover from aimals to humas to permit ratioal targetig of itervetios Test ew vaccies ad behavioural itervetios as prevetative itervetios Evaluate ew cliical treatmets for huma disease Coduct implemetatio research o the sustaiable scale up ad acceptability of ew prevetative ad therapeutic itervetios icddr,b Strategic Pla

18 Key Research Themes Achievig uiversal health coverage We will evaluate gaps i access, delivery, quality, fiacig, policy ad goverace i the health sector i Bagladesh, ad test itervetios to remedy deficiecies. The global cotext Developig coutries have made cosiderable gais i materal health, child survival ad utritio ad maagemet of commuicable diseases. Eve so, iequities persist betwee ad withi coutries, ad threate to grow i a era of global epidemiologic ad demographic trasitios, urbaisatio ad climate chage. To esure equitable ad sustaiable improvemets i health, poverty ad weak health systems must be addressed. We will work with parters i Bagladesh ad iteratioally to detect, characterise ad respod to emergig ad reemergig ifectious disease threats. The situatio i Bagladesh Several factors cotribute to the lack of uiversal health coverage i Bagladesh. With oly 0.5 doctors ad 0.2 urses per 1000 people, i cotrast to the WHO recommedatio of 1 doctor ad 3 urses per 1000 populatio, the coutry s huma resources for health are at crisis levels. Ueve distributio of the health workforce, ad issues of retetio ad overwork, will require iovatios i capacity buildig, icetives ad task shiftig. The lack of effective regulatory systems also cotributes to poor quality services ad a large iformal sector caterig to the poorest i society. Fially, high out-of-pocket health care expeditures create fiacial barriers for those least able to afford the cost of health care. Our track record icddr,b is committed to the priciple that all people, irrespective of their social ad ecoomic positio, should have access to affordable, acceptable, high quality ad resposive health care. The coceptual framework for our work is provided by the six buildig blocks of health systems idetified by the WHO: service delivery, the health workforce, iformatio systems, medical products, fiacig ad leadership ad goverace. We have particular expertise i areas such as urba health, health care fiacig mechaisms, geder-related issues ad iovative use of ew techologies. Our field site i Chakaria i south east Bagladesh allows us to test itervetios ad moitor equity idicators over time. We actively egage with policy makers ad implemeters i Bagladesh at atioal ad grassroots levels, promotig uiversal health coverage ad ecouragig the use of evidece to iform decisio-makig ad to stregthe health systems. The Research Policy Commuicatio Cell established withi the govermet s Directorate Geeral of Health Services, with our support, provides a formal meas to chael evidece to policy. 18

19 Research Goals Assess curret gaps i service availability, service utilisatio by people of differet socioecoomic groups ad livig i margialised commuities, resource availability, healthcare cost ad fiacig, policy, ad goverace for achievig uiversal health coverage (UHC) Test ew approaches to icrease access to care, improve quality of services, reduce fiacial barriers i accessig services ad provide evidece base for policies ad programmes Develop a roadmap to UHC with defied stages of progress ad a moitorig framework to assess progress, icludig developmet of methods ad idetifyig idicators Establish a learig platform for UHC icddr,b Strategic Pla

20 Research INITIATIVES Examiig the health cosequeces of climate chage We will evaluate the impacts of climate chage ad migratio patters o populatio health i Bagladesh ad ways i which populatios ca adapt. Average global temperatures are projected to rise by several degrees durig this cetury, accompaied by more itese raifall ad sea level rise. Bagladesh is highly vulerable to climate chage. It is likely to experiece floods i the wet seaso, potetially balaced by droughts i the dry seaso as eighbourig coutries limit cross-border fresh water supply. It is also likely to face more extreme weather evets. There are cocers that rates of vector-bore diseases such as malaria, degue fever, kala-azar ad Japaese ecephalitis virus ifectios could icrease with climate chage. Cholera outbreaks may also become more frequet as sea surface ad river temperatures rise. Health may also be affected i other ways. Heat stress is already occurrig i urba areas, while risig saliity levels i coastal districts are likely to reduce crop productio ad exacerbate coditios such as hypertesio. Large-scale populatio displacemets are highly likely. We have a log history of research o the liks betwee climate ad spread of ifectious diseases, ad i recet years we have bee buildig our expertise i evirometal sciece. Our social scietists are participatig i a major iteratioal iterdiscipliary project examiig impacts i vulerable areas. Drawig o our log experiece i health ad populatio research i Bagladesh, we are well placed to shape ad iform discussios o the appropriate respose to climate chage, while also esurig that discussios are relevat to other coutries facig similar challeges. Research Goals Evaluate the effects of climate chage o populatio health Assess the effects of climate chages o populatio migratio patters Develop predictive models for how climate chage will affect populatio health ad migratio patters i the future Develop ad evaluate adaptatio strategies to climate chage for vulerable populatios i Bagladesh ad similar low-icome coutries Sythesise o-goig work o climate chage i Bagladesh 20

21 Research INITIATIVES Prevetig ad treatig o-commuicable diseases We will assess the burde of chroic diseases i Bagladesh, documet curret care practices ad health-seekig behaviours ad evaluate ew itervetios relevat to low-icome coutries to improve health outcomes ad health care, with a focus o cardiovascular diseases ad diabetes. No-commuicable diseases (NCDs) are major killers worldwide, causig 36 millio deaths every year, icludig 29 millio i low- ad middle-icome coutries. NCDs also pose a huge threat to developmet ad ecoomic growth. The burde of NCDs is o the rise due to populatio ageig ad a icrease i uhealthy lifestyles, ad they will cost health systems globally a estimated US$30 trillio by I South Asia, NCDs accout for aroud half of aual mortality ad burde of disease. All major risk factors for NCDs are widespread i Bagladesh, icludig tobacco use, iadequate itake of fruit ad vegetables, low physical activity, obesity ad high blood pressure. I respose to this growig threat, Bagladesh has developed a atioal strategy for Surveillace ad Prevetio of No-commuicable Diseases, ad a dedicated uit has bee established withi the Miistry of Health ad Family Welfare, with ew service delivery optios beig piloted. NCDs are a relatively ew area of icddr,b work. We have explored the shift from commuicable to o-commuicable diseases usig Matlab surveillace data, ad have developed research competecy i cardiovascular ad respiratory diseases, diabetes, idoor air pollutio, smokig ad other chroic diseases ad risk factors. Future work will have a particular focus o cardiovascular diseases ad diabetes. Research Goals Assess the icidece, prevalece ad risk factors for diabetes ad cardiovascular diseases to support developmet ad ratioal targetig of itervetios Characterise health care utilisatio patters for diabetes ad cardiovascular diseases to idetify barriers to care Ehace tools ad systems of surveillace to permit trackig of temporal ad spatial treds of risk factors ad disease Coduct commuity-based trials for prevetio ad cotrol of hypertesio ad diabetes relevat to low-icome coutries settigs icddr,b Strategic Pla

22 GOAL Icrease the visibility ad impact of our research evidece We will build skills ad parterships to esure that our research evidece has impact o atioal ad iteratioal policies, programmes ad practices for improved health. We are committed to esurig the research we geerate reaches those who ca utilise it, whether they are policy makers, implemetig agecies, fellow researchers or doors. We already have a track record of publishig i high quality ad high impact jourals, ifluecig policy both i Bagladesh ad at a global level, ad sharig our evidece ad experiece through traiig coducted i Dhaka ad abroad. With a emphasis o improvig the time take for researchers to publish their results, we will cotiue to support our researchers to publish i appropriate high impact scietific jourals. To improve the impact of our research, we will stregthe our relatioships with policy makers ad other research users, ad actively egage them i priority-settig ad research desig. We will esure that our research fidigs ad prove itervetios are effectively dissemiated, usig a rage of cotemporary commuicatio tools. Through such activities, we will promote uptake of our research evidece, ad demostrate to doors ad others the value of ivestmet i research. We also aim to commuicate to potetial parters policy makers, advocacy groups ad implemeters the opportuities offered by collaboratio with us, ad of coductig research i Bagladesh. We have a well-established traiig programme, ruig courses for health professioals from Bagladesh, the regio ad further afield. We will review ad re-develop our portfolio of traiig activities to maximise their cotributio to skill ad kowledge developmet of global South researchers ad health professioals. As a foudig member of the WHO Global Outbreak Alert ad Respose Network (GOARN), we will cotiue to respod to requests for our techical assistace i maagig outbreaks of diarrhoeal disease worldwide. Specific Goals Dissemiate research fidigs through a rage of scietific ad other maistream commuicatio chaels Active egagemet with policy makers, practitioers ad advocacy groups Deliver a portfolio of traiig activities reflectig our kowledge ad expertise ad aliged to our research priorities 22

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24 GOAL Ivest i our research platforms We will develop our research ifrastructure for populatio-based, cliical ad laboratory-based research to esure it is aliged to our research objectives, iteratioally competitive ad fiacially sustaiable. Field sites have bee itegral to our research, supportig large-scale cliical trials i urba ad rural settigs ad a cotext i which to evaluate itervetios. We ru seve sites coverig populatios from 19,000 to 600,000 people each. The Matlab field site 50 km south of Dhaka is the logest cotiuously ruig demographic surveillace system i the developig world, ad a global public health resource. Coverig 220,000 people, Matlab is the model for our other field sites, as well as for the iteratioal INDEPTH etwork of health ad demographic surveillace sites. We will cotiue to leverage these well-established sites to address critical atioal ad global public health issues, ad to esure our researchers have access to populatio cohorts of the appropriate size ad type. Our two hospitals ad oe treatmet cetre, which provide care free of cost to patiets, are cetral to our cliical research ad to surveillace. They treat more tha 200,000 patiets each year, ad the Govermet of Bagladesh, bilateral doors ad civil society ackowledge the importace of their humaitaria role to the poorest i society. We believe it is essetial that we cotiue to provide high-quality evidece-based cliical care to the populatios amog whom we work ad to showcase what ca be achieved cliically i a low-resource settig. We will cotiue to ivest i our cliical services, while also lookig to icrease our portfolio of cliical research ad to secure additioal icome streams to fud cliical care. The comprehesive ature of our laboratories, which iclude facilities for workig with highly pathogeic orgaisms, the calibre of our laboratory staff ad our ability to brig moder molecular sciece to the study of huma disease all distiguish us from may other istitutios i the regio. As advaces i techological capabilities cotiue to trasform research, it is critical that our researchers have i-house access to advaced techological platforms. As well as maximisig the use of our existig equipmet, we are committed to ivestig i laboratory resources that meet the ambitio of our research. 24

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26 GOAL Ivest i our people We will build the skills ad competecies of scietific ad other staff, with a special focus o developig local research capacity, particularly at the mid-career level, ad supportig female researchers. Our people, ad their kowledge, skills ad commitmet, are essetial to achievig our research goals. Our highly skilled multidiscipliary scietific staff is recogised as a distictive asset. As well as our ow researchers, we are committed to urturig the ext geeratio of public health leaders from the global South. Importat priorities for the ext three years iclude recruitig, retaiig ad developig mid-level scietists, ad supportig the career developmet of female researchers. We will also create a successio pla for seior scietific leadership. I additio, we will recruit seior admiistrative staff with the experiece ad leadership qualities ecessary to deliver ad sustai chage. A high-performace eviromet that ecourages learig ad supports career progressio is key to our ability to carry out high-quality research ad promote the use of research evidece. Across all fuctios, the overarchig focus will be o buildig the capacity ad competece of all employees. Specific Goals Recruit ad reward the best talet Recruit ad reward the best talet Develop ad urture our emergig talet Develop ad urture our emergig talet Reward superior performace Reward superior performace Drive geder ad diversity equality Drive geder ad diversity equality Egage ad recogise our employees Egage ad recogise our employees 26

27 GOAL Improve orgaisatioal efficiecy ad cost-effectiveess We will moderise our orgaisatio s operatios to esure maximum efficiecy ad cost-effectiveess. Effective ad efficiet busiess systems uderpi our ability to compete for iteratioal fuds ad deliver high quality research. As oe of the regio s leadig research cetres, it is essetial that we operate to the highest possible stadards, with oversight appropriate for a iteratioal research orgaisatio. I particular we eed to esure that our policies, structures ad procedures are compatible with a icreased emphasis o accoutability ad trasparecy. Champioed by a stregtheed leadership team, we are implemetig a programme to moderise i-house busiess processes, systems ad practices. We have reviewed ad bechmarked support services agaist iteratioal stadards ad idetified opportuities for streamliig ad improved use of techology to achieve cost savigs. We have lauched a recruitmet drive to esure that key leadership positios are filled by staff with the ecessary competecies ad experiece to drive forward this orgaisatioal chage programme. Specific Goals Recruit ad reward the best talet Revise our busiess processes Develop ad urture our emergig talet Implemet a chage maagemet pla to Reward facilitate superior delivery performace of the strategic pla with associated key performace idicators (KPIs) Drive to geder implemet ad the diversity strategic equality pla Egage Restructure ad recogise the orgaisatio our employees Evaluate the adequacy ad effectiveess of risk maagemet, cotrol ad goverace icddr,b Strategic Pla

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29 We will build the skills ad competecies of scietific ad other staff, with a special focus o developig local research capacity, particularly at the mid-career level, ad supportig female researchers. icddr,b Strategic Pla

30 GOAL Esure fiacial sustaiability As well as carefully cotrollig expediture, we will stregthe our fudraisig strategy ad idetify additioal opportuities for icome geeratio. Despite a icreasigly competitive global fudig eviromet, we have a strog track record of attractig fudig, obtaiig a wide rage of research ad implemetatio grats. The pricipal challege is to sustai ad icrease the pipelie of fudig to cover our humaitaria services, as well as to support our focused research ageda. I additio, it will be ecessary to alig all grats to the research strategy, esure total cost recovery ad support researchers to budget correctly for all i-house services ad ifrastructure costs. We have idetified three key icome streams, each requirig ivestmet ad a strategy to esure optimum success: research fudig, humaitaria fudraisig ad icome geeratio from services. Uderpiig these efforts to icrease icome are the o-goig measures to cotrol expediture ad ehace busiess efficiecy. Specific Goals Recruit ad reward the best talet Reduce overhead reductio ad esure cost Develop recovery ad urture our emergig talet Reward Icrease superior research performace fudig Drive Ehace geder fudraisig ad diversity fuctio equality Egage ad recogise our employees 30

31 Moitorig ad evaluatio Moitorig ad evaluatio of the implemetatio of this strategic pla falls uder the scope of Goal 5. It will ivolve (1) developig ad esurig adherece to a detailed, time-boud implemetatio pla, ad (2) developig a revised set of idicators acceptable to our Core Doors ad Board of Trustees to esure that the pla is deliverig the aticipated results. Iteral oversight will be stregtheed further i order to detect fraud ad prevet its occurrece. Vigorous iteral audit reviews will deter fiacial impropriety ad esure value for moey. I additio, uder Goal 6, specific moitorig ad reportig requiremets will be established usig stadard fiacial mothly ad quarterly reports for grat holders, seior maagemet ad the Board of Trustees. Effective modificatio of the iteral grat admiistratio system ad the chart of accouts will also be completed to automate reportig. These tools will facilitate budgetary cotrol ad assist corrective actio to be take. The Seior Leadership Team will provide day-to-day oversight ad be accoutable to the Board of Trustees. Furthermore, a aual review commissioed by the Core Door group provides a idepedet assessmet of our performace, which will complemet our ow moitorig ad evaluatio. Fudig the strategic pla The research curretly itemised i the Strategic Pla Research Priorities is covered by grats already secured. Additioal proposed projects will alig with these research priorities, ad will have full cost recovery icorporated ito their fudig applicatios. The activities i Goals 2-6 will be fuded by urestricted/core fuds. The proportio of fuds directed to the delivery of each goal will be determied ad agreed aually. As ivestmets i improvig efficiecy ad effectiveess across the orgaisatio deliver reductios i operatioal cost, the cost savigs will be directed to ivestmets beefitig our research ad humaitaria provisios. The operatioal plas for each of the goals will be accompaied by detailed budgets approved by our Board of Trustees. icddr,b Strategic Pla

32 Recogisig our core doors: Photo credits icddr,b icddr,b is committed to ethical developmet photography ad, wheever reasoable ad practical, obtais permissio from photo subjects Photographs by Shumo Ahmed, Shahidul Alam ad GM Akash 68, Shaheed Tajuddi Ahmed Sarai, Mohakhali, Dhaka 1212, Bagladesh Phoe: +(880 2) Website: Facebook Likedi