In a groundbreaking article published in the prestigious Nature Medicine journal, experts from
various parts of the world collaborated to address evidence gaps for non-communicable
diseases (NCDs) in children and adolescents. Notable experts, including Dr Zulfiqar Bhutta and
Dr Jai Das from the Institute for Global Health and Development at Aga Khan University (IGHD-
AKU) in Pakistan, partnered with Dr Rehana Salam from the University of Sydney in Australia,
Laura Lewis-Watts from the Hospital for Sick Children (SickKids) in Canada, Maryam Hameed
Khan, currently pursuing her Master of Public Health at Johns Hopkins University in the United
States, and Syed Saqlain Ali Meerza from IGHD-AKU. Dr Rehana Salam played a lead role in
the study, conducting the research, while Dr Bhutta conceptualized, designed the study and
secured financing.
The research, titled “An evidence gap map of interventions for noncommunicable diseases and
risk factors among children and adolescents,” sheds light on the significant burden these
diseases place on young lives and carry on in adulthood. These diseases include obesity,
mental health conditions, type 1 diabetes, cancers, cardiovascular and chronic respiratory
diseases, and substance misuse, which collectively contribute to 41% of disability-adjusted life
years related to NCDs among children and adolescents worldwide. Dr Rehana Salam adds,
“Our research underscores the imperative of addressing the evidence gaps for non-
communicable diseases in children and adolescents. By focusing on LMICs and collaborating
across borders, we aim to pave the way for impactful interventions that can shape the health
outcomes of the next generation.”
Dr Jai Das, Assistant Director at IGHD, emphasizes, “Childhood and adolescence provide a
window of opportunity for targeting and improving behaviours and risk factors which can then
lead to better health and hence productivity in adulthood.” Shockingly, the evidence on risk
factors and interventions for this age group is alarmingly scarce and particularly in low- and
middle-income countries (LMICs), where approximately 70% of premature deaths result from
health-related behaviours that originate in childhood and adolescence.
The study found that the treatment interventions on biomarkers and adverse events for NCDs
appear to be well evidenced, while interventions for mental health conditions appear to be
moderately evidenced, and interventions for obesity and substance misuse appear to be
moderate to very low. There is a need to prioritize action to integrate NCD actions with the child
health and survival agenda, extending from early childhood to adolescence. The study also
suggests that future studies should focus on evaluating the effectiveness of digital and
community-based delivery platforms, especially for preventing these conditions and focusing on
marginalized and at-risk populations.
“This is the first of a series of Gap Maps conceptualized and initiated by our multi-country
research group, focusing on what needs to be done to bridge the evidence divide that many
LMICs face in addressing priority non-communicable diseases in children and adolescents, as
only 3.8% studies were conducted in LMICs. We trust that these findings will stimulate action
and implementation research in many countries confronting myriad challenges in the post-
pandemic world,” says Dr Zulfiqar Bhutta, a Distinguished University Professor at IGHD-AKU.
The findings resonate with global health goals, including the Sustainable Development Goals
(SDGs) that call for a reduction in premature mortality from NCDs by one-third through
prevention and management by 2030.
