Building Non-Communicable Eye Disease Research Capacity in India

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ABSTRACT India is home to over 17% of the world’s population and to 25% of those who are blind or visually impaired worldwide. Blindness and vision impairment are the fourth leading cause of years lived with disability in India and are the number one cause in those age 70 and older, a segment of the Indian population that is rapidly growing. Over 90% of vision loss in India is due to non-communicable disease, the majority of which is avoidable. Poor vision is associated with wide-reaching consequences, including an increased risk of falls, dementia, depression, disability, loss of independence, longer and more frequent hospitalizations, and increased mortality. Despite the large and growing burden of non-communicable eye disease, particularly among older adults, the shortage of research expertise in India to characterize the epidemic and understand its causes and consequences is a critical barrier to intervening effectively and reducing its population health impact. Therefore, the focus of this training program is on building clinical-epidemiological research capacity, with an emphasis on lifecourse analyses applied to the study of non-communicable eye disease (NCED) in older adults. Given the aging of the Indian population and the disproportionate impact of NCED on older Indians, it is critical to train Indian vision researchers in the research principles and methods that will enable them to effectively address this critical need. Moreover, we currently lack knowledge from a lifecourse perspective to understand the effects of early- and mid-life exposures on late-life vision and vision-related disability in India. Research specific to the Indian context is vital to determine key risk factors and disability consequences of NCED, and to develop effective contextualized interventions. The proposed research capacity building program will draw upon the exceptional institutional environments at the Aravind Eye Care System (AECS) in India and at the University of Michigan (UM), including the NIH-funded UM Claude D. Pepper Older Americans Independence Center and Clinical and Translational Science Award. The UM and AECS have a long-standing history of collaboration and educational exchanges. Based on the results of a needs assessment survey, doctoral- and masters-level training tracks have been designed to meet the needs of early- and mid-career AECS faculty who aspire to careers in clinical-epidemiological research. The aims of this program include: 1) to provide comprehensive graduate-level training in the conduct of clinical and epidemiologic research for trainees from AECS who will be equipped to take a leading role in NCED and sensory aging research in India; 2) to develop the mentoring and research education skills of AECS faculty; and 3) to establish research training opportunities at AECS that are offered to a broad regional audience. All training activities will be transitioned to AECS by the end of the 5-year grant period. Both partner institutions are dedicated to the success of this training program and to its strong potential to address the growing epidemic of NCED and visual disability among India’s rapidly aging population.