International research network aims to counter the triple threat to health

The Global Diet and Activity Research Network (GDAR) has launched an ambitious four-year research programme funded by the NIHR Global Health Research initiative. The programme is looking at how the ‘syndemic’ of urbanisation and climate change is influencing diet and physical activity and their related non-communicable diseases. A syndemic, from ‘synergistic epidemic’, is a situation where simultaneous epidemics and risks interact to intensify the burden of disease.  

GDAR is a research network across seven countries on three continents. It is working in Cameroon, South Africa, Kenya and Jamaica, as well as collaborating with UN-Habitat, and Universities in Brazil, Nigeria and the UK.

The GDAR Network is building on its recently completed first phase of research, which explored how policy, community and commercial systems shape diet and physical activity environments and behaviours in cities in low- and middle-income countries. This latest phase of research – named GDAR Spaces in recognition of the importance of physical, economic and cultural spaces in shaping our health – has a particular focus on how climate change and rapid urbanisation interact with the built and food environment.

Dr Tolullah Oni, Joint Lead for GDAR and Clinical Senior Research Associate at the MRC Epidemiology Unit, University of Cambridge said:

“We’re all now very familiar with epidemics and pandemics. The concept of a syndemic describes the co-occurrence of interacting epidemics and risks. Indeed, the COVID-19 has been described as a syndemic because of the ways it interacts with non-communicable disease. In our research, mass urbanisation, rapid climate change, and epidemics of poor diet and physical inactivity are interacting to form another such syndemic. These forces are driving up the incidence of non-communicable diseases such as obesity, diabetes, heart disease and cancer. To tackle this threat, we need to devise interventions that consider all the interacting forces at play.”

This syndemic approach aims to develop interventions that will work by reducing the exposure of urban populations to these hazards, as well as reducing the vulnerability of the wider built and food environments to these hazards.

Prof Alafia Samuels, Joint Lead for GDAR and Honorary Professor at the George Alleyne Chronic Disease Research Centre, University of the West Indies, said:

“Although non-communicable diseases (NCDs) are still sometimes thought of as ‘diseases of affluence’, they are more common in low- and middle-income than high-income countries. Here they also mostly affect people of working age, meaning that resulting death or disability can leave families destitute, particular when access to healthcare is limited. And it is the poor in low- and middle-income cities that are most affected by the hazards of climate instability, urbanisation and spaces that don’t support good diets and active lives.”

Across a number of evolving work packages, the GDAR Network will be exploring the following four core research objectives:

  1. Measuring syndemic hazard exposure. Identifying and characterising exposure to syndemic hazards in Johannesburg and Cape Town, South Africa; Yaoundé, Cameroon; and Kingston, Jamaica.
  2. Assessing adaptability to syndemic hazards. Understanding the capacity of community, policy and commercial institutions to adapt to syndemic hazards in Cameroon, Kenya, Jamaica and South Africa.
  3. Evaluating diet and physical activity related responses to COVID-19. Evaluating the role of Covid-19-mitigation actions by policy and community actors in shaping the food and built environment in Africa and the Caribbean.
  4. Co-designing built and food environment interventions. Working in Yaoundé and Cape Town, we will design, implement and test interventions that promote healthy diets and physical activity, particularly with adolescents.

Contributions of non-academic stakeholders will guide activities throughout the research process including the co-design of syndemic interventions. This will help to identify the policy and community actions and characteristics that can support future interventions. The goal is to find solutions that are affordable and created in partnership with local communities.


Through a research focus on how physical, policy and social environments influence diet and physical activity, the Global Diet and Activity Research Network (GDAR) is working to prevent non-communicable diseases such as type 2 diabetes, heart disease, and cancers, in low- and middle-income countries.

GDAR is funded through the NIHR Global Health Research initiative. The NIHR Global Health Research initiative builds on existing expertise within the UK and the wider global health research community to commission and support internationally outstanding applied health research which addresses issues affecting the poorest and most vulnerable people in low- and middle-income countries using Official Development Assistance (ODA) funding.

The GDAR Network is a collaboration of researchers from universities and agencies in seven countries on three continents: