CALL FOR CONCEPT NOTES

PROMOTING HEALTHY DIETS: A KEY STRATEGY FOR NONCOMMUNICABLE DISEASE PREVENTION IN LOW- AND MIDDLE-INCOME COUNTRIES The International Development Research Centre is pleased to announce a call for Concept Notes concerning the promotion of healthy diets as a key strategy for the prevention of non-communicable diseases (NCDs) in low- and middleincome countries. The key objective of this Call is to support research led by low- and middleincome countries (LMICs) researchers designed to influence the adoption and implementation of effective policies and programs for the promotion of healthy diets in those countries.

Key Thematic Areas:

Research on policies, population-wide programs and community-based interventions that aim to reduce the availability and consumption of unhealthy food products (high in fat, sugar and salt) or increase the availability and affordability of healthy foods such as fruits and vegetables. The production of evidence syntheses or situation analyses to inform policy dialogues and the adoption and implementation of key interventions to address unhealthy diets as a key NCD risk factor. Please note that three major cross-cutting issues are central to the NCDP program: equity, intersectoral action and commercial Influence on public healthrelated policy.

Key Eligibility Criteria:

The principal applicant must be a citizen or permanent resident of a low- or middle-income country (LMIC) and with a primary work affiliation in a LMIC institution.

Deadline for Submission: September 23, 2011 Value and Duration: Grants ranging from CA$20,000 to CA$300,000 over a maximum of 36 months.

1 Non-communicable Disease Prevention (NCDP) Program | IDRC CRDI

Table of Contents 1. Information on IDRC and program area ............................................................................. 3 2. Background, rationale and key objectives of the Call ........................................................ 3 3. Thematic focus and priority research considerations.......................................................... 5 3.1 3.2 Promoting healthy diets ......................................................................................... 5 Evidence syntheses and policy dialogues ............................................................. 8

4. Funding scope and duration ................................................................................................ 8 5. Eligibility criteria ................................................................................................................ 9 6. Evaluation criteria ............................................................................................................... 9 7. Selection process ............................................................................................................... 10 8. Format and requirements .................................................................................................. 11 9. Submission process and contact for further information .................................................. 12 10. Country clearance requirements ..................................................................................... 13 11. IDRC standard grant conditions...................................................................................... 13 12. Communication of results ............................................................................................... 13 13. Permission for use and disclosure of information........................................................... 13 Appendix A Allowable Costs/Budget Guidelines ............................................................. 14 References ............................................................................................................................. 16

1. Information on IDRC and program area

The International Development Research Centre (IDRC) is a Crown corporation created in 1970 by the Parliament of Canada. Now in its fifth decade, IDRC builds the capacity of people and institutions in low- and middle-income countries (LMICs) to undertake the research that they identify as most urgent. It works with researchers as they confront the challenges of the 21st century within their own countries and contribute to global advances in their fields. IDRC supports research in four broad areas, making knowledge a tool for improving lives across the developing world. Agriculture and the environment Global health policy Social and economic policy Science and innovation IDRC builds on decades of work on gender issues, international relations and global governance, and the role of information and communication technologies in development, and integrates these dimensions into all research themes. In June 2011, IDRC launched the Non-communicable Disease Prevention program (NCDP). This new program housed within the program area Global Health Policy builds on the lessons learned from the program Research for International Tobacco Control and expands IDRCs support for tobacco control research. The goal of the NCDP program is to generate new knowledge to inform the adoption and effective implementation of healthy public policies, population-wide programs and community-based interventions that address the major modifiable risk factors for noncommunicable diseases (NCDs) tobacco use, unhealthy diet, alcohol misuse and physical inactivity. Finding the most cost-effective package of interventions in low-resource settings remains a critical issue for LMIC governments and international donors. Current evidence suggests that primary preventioni through the development of healthy public policies offers the greatest potential for improvement and a number of best buys need the attention of researchers and policymakers involved in global health and development initiatives. This is the niche of the NCDP program. This program will fund intervention research projects that address one or several NCD risk factors in order to reduce the burden of NCDs and improve overall population health in LMICs.

2. Background, rationale and key objectives of the Call

NCDs, especially cardiovascular diseases, diabetes, cancer and chronic obstructive respiratory diseases, are the leading causes of death and disability around the world and will be responsible for more than 75% of all deaths in 2030.1 Of the 33 million people who died from NCDs in 2008 (58% of all deaths worldwide), half were under 70 years of age and half were women. Approximately 80% of all NCD-related deaths occurred in LMICs2,
i

Primary prevention strategies intend to avoid the development of disease.

indicating that the burden is not limited to high-income countries. NCDs are already the major cause of death in lower-middle- and upper-middle-income countries, and will also become the leading cause of death in low-income countries by 2015 3. The same is true for mortality among those of working age. NCDs also account for 46% of the disease burden in LMICs as measured in disability-adjusted life years. 4 The increasing global crisis in NCDs is a barrier to development goals including poverty reduction, health equity, economic stability, and human security. 5 NCDs are recognized as factors in almost every Millennium Development Goal (MDG). NCDs and their risk factors and determinants are closely related to poverty and mutually reinforce each other 6. Propoor initiatives, like the MDGs, will have limited impact if they do not address the full set of threats including NCDs that trap poor households in cycles of debt and illness 7. The main risk factors for NCDs for individuals are well known and are similar in all countries. Tobacco use, foods high in saturated and trans fats, salt, and sugar, physical inactivity and the harmful use of alcohol cause more than two-thirds of all new cases of NCDs. Cost-effective interventions exist to prevent NCDs, with the implementation of tobacco control interventions being acknowledged as the most urgent and immediate priority. 5 However, the adoption and effective implementation of NCD interventions remains limited in developing countries, with the lack of local evidence about their effectiveness and costeffectiveness often being one of the barriers to policy action. The NCDP program seeks to address this gap. The key objective of this Call is to support LMIC-led research that will generate new knowledge about policies and programs that promote healthy diets as a key strategy for reducing the NCD burden and improving overall population health in LMICs.8 The NCDP program seeks to be responsive to country-specific research needs. Ultimately, research proposals will need to demonstrate how the knowledge generated could be used to influence policy direction at a particular stage of policy development.ii For example, dietrelated policies may have been adopted at the national level but may never have been effectively implemented and evaluated; the NCDP would support research to address those gaps. Alternatively, research may be needed to support the framing of an NCD issue as a priority on the governments policy agenda. The implementation and evaluation of targeted programs and community-based interventions (e.g. as demonstration projects) can sometimes play that role and provide local evidence on which to base future policy. Please note that the NCDP program is solution-oriented and will not fund nation-wide NCD risk factor surveillance studies. However, projects that integrate risk factor measurements as part of a study about the implementation and effects of a specific population health intervention would be eligible for funding.

ii

Some models describe the policy cycle as comprising five stages: agenda setting; policy formulation; policy adoption; policy implementation and policy evaluation.

3. Thematic focus and priority research considerations

Through this Call, the NCDP program will fund projects that aim 1) to inform the adoption and effective implementation of population health interventions that promote healthy diets for the prevention of NCDs and 2) to evaluate the impacts of already adopted diet-related population health interventions. For the purpose of this Call, population health interventions are categorized as being either policy interventions, such as regulation, legislation and taxes, or community-based interventions that have the potential to be scaled-up. More specifically, through this Call for Concept Notes, the NCDP program seeks to support: Research on interventions that aim to reduce the availability and consumption of unhealthy food products (high in fat, sugar and salt) or increase the availability and affordability of healthy foods such as fruits and vegetables. The production of evidence syntheses or situation analyses to inform policy dialogues and the adoption and implementation of key interventions to address unhealthy diets as a key NCD risk factor. Additional details about the priority research considerations are provided below.

3.1

Promoting healthy diets

The elevated consumption of energy-dense, nutrient-poor foods that are high in fat, sugar and salt is fueling the global obesity epidemic and is associated with rising rates of diabetes, hypertension, cardiovascular diseases and several cancers in LMICs.9, 10 There is now also increasing evidence that poor nutrition during pregnancy and during early childhood are predisposing factors to developing NCDs later in life.11 Reducing dietary sodium (salt) intake: The consumption of too much sodium (salt) causes up to 30% of all cases of hypertension12 and is an important risk factor for cardiovascular diseases high blood pressure causing approximately over half of all strokes and ischaemic heart disease deaths globally.13 In addition, a high sodium diet may have other harmful effects, for example by increasing the risk of renal disease and stomach cancer.14 The World Health Organization and the Food and Agriculture Organization of the United Nations (FAO) recommend the consumption of less than 5g of sodium chloride (or 2g of sodium) per day as a population nutrient intake goal, while ensuring that the salt is iodized.14 In many LMICs, salt intake is above 10g per person per day.15, 16 Reducing fat and sugar intake: Foods that are high in saturated and trans fats, cholesterol, and sugar also elevate the risk of stroke and heart disease and several other NCDs.14 The consumption of trans fats and sugar is linked to obesity, diabetes and some cancers. For trans fats alone, studies estimate that between 72,000 and 228,000 deaths in the US alone could be prevented each year by eliminating trans fats.17 The World Health Organization recommends 1) to limit the daily intake of free sugar, 2) to limit the energy intake from total fats and 3) to shift fat consumption away from saturated fats to unsaturated fats and towards the elimination of trans fatty acids.14

Increasing the availability and affordability of healthy foods: The consumption of fruits and vegetables is a good proxy for a healthy diet. High intake of fruits and vegetables is a protective factor against heart disease and several cancers.18 Several food guides and dietary recommendations, including for fruits and vegetables daily intake, have been developed at the country level or by international organizations. However, healthy foods are not necessarily available and affordable across different communities and to the poorest. What is needediii: Several diet-related interventions have proven to be cost-effective in specific settings and micro-simulation studies have concluded that price interventions and regulation can produce the largest health gains in the shortest timeframe.19 There is a need for more evidence from LMICs to stimulate policy adoption on a wide scale. The NCDP program will fund projects that seek to address research gaps related to the use of population-wide approaches to reduce the consumption of unhealthy foods. Questions and issues to be considered include, but are not restricted to: Using policy instruments: What are, or would be, the effects of food-related fiscal policies on consumption patterns across different population groups and, ultimately, on obesity and NCD rates? o What are, or would be, the effects of taxes on unhealthy products (e.g. sugar-sweetened beverages, foods high in fat, salt and sugar) on dietary patterns and, ultimately, on population health outcomes? o What are, or would be, the effects of a targeted subsidy on intake of fruits and vegetables across different population groups?

What are, or would be, the effects of different types of marketing regulation (advertising bans, product sales restrictions, sales promotions regulation) on the consumption of unhealthy foods in adults and children? What are the effects of food labeling regulation on dietary patterns across different population groups? What agricultural and trade policy levers exist to o alter unhealthy eating patterns at the population level? What are, or would be, their effects across different population groups? o increase the availability and affordability of fruits and vegetables? Population-wide programs and community-based interventions: Are population-wide programs and community-based interventions effective and cost-effective

iii

Research projects that include dietary intake measurements (e.g. urine excretion and dietary records) will be eligible as long as their overall purpose is to inform policy development through the generation of cost-effectiveness evidence about potential interventions at the population or community levels.

to reduce the consumption of foods that are high in fat, sugar and/or salt (e.g. salt added during cooking or at the table, use of hydrogenated oil, etc.)? to increase the adequate daily intake of fruits and vegetables? to reduce the prevalence of intermediate NCD risk factors (obesity/overweight, raised blood pressure, high blood lipids, glucose intolerance) at the population level?

o o

How can evidence from small-scale programs or projects be best used and communicated to inform policy formulation and adoption? Additional cross-cutting research considerations: Three major cross-cutting issues are central to the NCDP program and are described below: Equity: All projects should examine the impact of NCD-related interventions on different social groups particularly the poor and marginalized. Equity will be an important focus for the program and this will build on the gender exploration initiated by the Research for International Tobacco Control program. As NCDs disproportionately affect the poor, this is a natural entry point for work on all risk factors. Working across government sectors for NCD prevention: The NCD epidemic cannot be tackled by the health sector alone. The lack of capacity for working across sectors is currently an important barrier to the uptake and implementation of NCD-related policies. There is a need for policy research to examine the factors that enable and constrain the use of a Health in All Policies approach in government, e.g. what coordination and accountability mechanisms are most effective to generate a sustainable intersectoral response. We invite research teams to generate evidence through case studies about the most effective coordination and accountability mechanisms to bring together different sectors of government (health, agriculture, finance, etc.) and, when relevant and appropriate, other stakeholders to tackle the NCD epidemic. Commercial influence: There is a critical need for more research on the barriers posed by commercial influence on the development of NCD-related policies (that concern not only the Ministry of Health but also other sectors, like agriculture, trade, finance, etc). Industry opposition, as shown by the Research for International Tobacco Control program, can be a major barrier to the successful implementation of healthy public policies. Yet, limited research has been done in LMICs on these issues. For the purpose of this Call, questions and issues to be considered include, but are not restricted to: Equity: What are the differential impacts of diet-related policies, population-wide programs and community-based interventions that aim at promoting healthy diets? What are the key contextual factors and intervention features influencing results (e.g. culturally-sensitive interventions)?

Working across government sectors: What are the key factors that drive policy decisions when different government sectors are involved? What are the factors that enable and constrain the use of a Health in All Policies approach in government, e.g. what coordination and accountability mechanisms are most effective to generate a sustainable intersectoral response for tackling unhealthy diets? Commercial influence: What are the advantages, disadvantages and impacts of using a regulatory approach versus voluntary approach for food reformulation and labeling? What mechanisms/policies are effective to minimize undue commercial influence over the development of diet-related public policies? What mechanisms/policies are effective to ensure that collaboration with the food industry, when pursued, is geared towards the achievement of public health goals?

3.2

Evidence syntheses and policy dialogues

Projects that do not include primary data collection could also be supported through this Call. The production of evidence briefs for policy-making based on the best global and local evidence available, followed by policy dialogues with key stakeholders, can be influential to inform the adoption and effective implementation of diet-related-related policies

4. Funding scope and duration

A number of eligible research teams with high-quality Concept Notes will be invited to prepare a full-scale application by January 16 2012. Each successful team at the fullapplication stage will receive a research grant of up to CA$ 300 000 over a maximum of 3 years. Although CA $300 000 is the maximum budget allowable per grant under this competition, in many instances a smaller budget may be deemed more appropriate. The appropriateness of the budget for the proposed project will play a significant role in the merit review and selection processes. Final budgets awarded for each project will be determined by IDRC based on the review process and, if necessary, negotiation with the applicant institution. Project budgets must be submitted according to standard IDRC budget categories, details of which will be provided to applicants. The number of Concept Notes selected will be determined based on quality of proposals received and the cumulative cost of each proposal. Excellent or very good quality concept notes that cannot be selected in September 2011 due to budget limitation will be eligible for reconsideration in 2012. A total budget of CA$1 million is available during this fiscal year to be allocated to the selected projects. The IDRCs obligations herein are subject to sufficient funds being made available to the IDRC by the Parliament of Canada.

5. Eligibility criteria
In accordance with the IDRC Act, all parts of the developing regions of the world can in principle qualify for IDRC support. IDRC funds research in the locations that best suit the corporate and program objectives approved by the Board of Governors. The primary considerations in selecting projects will be the scientific merit of the research proposal and its potential for development impact, including capacity building. However, the selection of projects may also be influenced by operational considerations, i.e. Canadian law, knowledge of research settings, ability to monitor research activities, conditions that may make it difficult, costly, dangerous or onerous for IDRC to carry out the objects of the Centre or exercise proper stewardship of the Centres resources. Applicant organizations are considered to be those that have legal corporate registration in an eligible country. IDRC enters into agreement with legal entities only. This particular Call is not targeted to specific countries or regions. The specific eligibility criteria are: The principal applicant must be a citizen or permanent resident of a low- or middleincome country, and with a primary work affiliation in a LMIC institution. The recipient institution must be a recognized legal entity that is capable of entering into contractual arrangements and assuming legal and financial obligations. The Applicant(s) must demonstrate that they work in an environment that supports research through administration of funds, provision of space and equipment, etc. The majority of the grant funds must be administered by one or by up to three LMIC institutions. Researchers from high-income countries are eligible as co-investigators or collaborators. Only Concept Notes that meet the eligibility criteria above will be considered. IDRC reserves the right to cancel the process at any time without prior notice and/or at its discretion to award all or none of the awards under this process.

6. Evaluation criteria
The eligible Concept Notes will be evaluated based on the following criteria: Relevance and Potential Impact Clear links between the proposed activities and at least one of thematic areas covered by this Call;

Value-added of the research project to existing initiatives and/or its potential influence on other projects or related research collaborations on the same topic(s); Likelihood that the project will have a positive and substantive impact on NCD policies; Quality, feasibility and appropriateness of the proposed strategies for translating research into action. Team composition and partners The mix of experience, skills and networks of the proposed team members and partners in relation to the proposed research project. Decision-makersiv may be listed as co-applicants or collaborators; The track record of team members in conducting NCD research and/or research experience on NCD-related policies; Demonstrated organizational capacity to administer grants of this nature (in human and financial terms). Scientific Merit Clarity of the research objectives/questions; Appropriateness of proposed methods (quantitative, qualitative, or mixed methods approaches when appropriate); Overall feasibility of the project (with considerations given to the tentative project schedule and budget).

The following is the breakdown of the weighting of the criteria: Relevance and potential Impact 40% Team composition and partners 20% Scientific merit 40%

7. Selection process
This Call is the first step of the selection process for the funding of a proposal. All Concept Notes will be reviewed and short-listed by IDRC program staff according to the criteria outlined in Section 6.

iv

An individual who makes decisions about, or influences, health policies or practices (definition used by the Canadian Institutes for Health Research).

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Selected teams will be asked to submit full research proposals for review and funding consideration. Full proposals will then be reviewed by an internal committee according to review and selection criteria which will be provided to short-listed teams. The selection process is outlined below: 1) Concept Notes received no later than September 23, 2011. 2) Incomplete or late applications are eliminated. 3) Full review of Concept Notes: An internal IDRC team conducts the review based on the review criteria outlined in the Call for Concept Notes. 4) Short-listed applicants are invited to develop their concept notes into full proposals. Full proposals will need to be submitted before January 16, 2012. 5) IDRC conducts an institutional and risk assessment of each application invited to develop a proposal. This step assesses the potential risk of material loss of IDRC funds due to weaknesses in the capacity of an applicant institution to manage or report on the financial aspects of project activities; or through economic and political conditions relating to the institution's operating environment. From this flows the need for IDRC to review three broad areas in its assessment of what measures should be applied to minimize such risk: the materiality of the investment, the management capacity of the applicant institution, and the wider environment within which the organization operates. 6) Full review of proposals: IDRC staff review all proposals based on the evaluation criteria communicated to the selected teams at the Concept Note stage.

7) Final Decision (March 2012): Memorandum of Grants Conditions are sent to all applicants that submitted a proposal graded as a priority for funding and whose institution is eligible to receiving a grant from IDRC following the institutional assessment.

8. Format and requirements

The Concept Note should be concise and presented in single-spaced, Arial point 12-font text, with a maximum length of up to 5 pages (not including annexes). Cover Page The Concept Note must have a cover page that includes the following: Brief project title; Name and location of organization/institution that will administer the project funds; Total amount of funding requested in local currency or Canadian dollars (maximum of CA$300,000 over three years).

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Concept Note The Concept Note must include the following items: Title Research problem and justification Objectives Methodology Gender and equity considerations Dissemination strategy and anticipated outcomes and impact Preliminary schedule Tentative budget Annexes Full CV of the principal investigator and co-investigators (no more than 5 pages but no page restrictions on peer-reviewed articles and presentations) Signed letters of support from relevant stakeholders (e.g. Ministry of Health) Specify other supporting funds and in-kind contributions o Information on the complementary sources of funding being envisaged and to clarify the complementary aspects of the research work.

The tentative budget should state the total amount of funds requested over the total duration of the grant. Please note that the following expenses are eligible as per IDRC guidelines (see Appendix A for more details): Projected expenses per budget category (as per IDRC eligible expenses): o Personnel o Consultants o Evaluation o Equipment o International travel o Research expenses (include funds provided to any third-party organizations) o Indirect project costs o Financial contribution by other donors o Estimates of local contribution to project

9. Submission process and contact for further information

Concept Notes must be submitted by no later than September 23, 2011. Concept Notes can be submitted in either English or French. Concept Notes received after the deadline WILL NOT be eligible for funding during this fiscal year. Concept Notes should be submitted electronically to ncdp@idrc.ca.

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Electronic submissions must be sent in PDF or Microsoft Word format. Other formats will not be accepted. Contact for further Information Robert Geneau, PhD Senior Program Specialist IDRC Tel: 613-696-2618 Fax: 613-563-0815 Email: ncdp@idrc.ca

10. Country clearance requirements

IDRC has conducted general agreements for scientific and technical cooperation with a number of governments. These agreements establish the framework for IDRC cooperation with that country by defining the rights and obligations of both IDRC and the government. As such, the applicant institution may be required to obtain country approval in accordance with these agreements prior to receiving funding from IDRC.

11. IDRC standard grant conditions

Any selected proponents shall be required to sign the Centres standard grant agreement, as amended by IDRC from time to time. For a sample of the Centres general terms and conditions, please refer to the following link: http://publicwebsite.idrc.ca/EN/Funding/Guides_and_Forms/Pages/default.aspx

12. Communication of results

Short listed applicants are expected to be announced by October 7, 2011.

13. Permission for use and disclosure of information

By way of submitting an application under this Call for competitive grants, the applicant consents to the disclosure of the documents submitted by the applicant to the reviewers involved in the selection process, both within IDRC and externally. The applicant further consents to the disclosure of the name of the applicant, the name of the lead researcher and the name of the proposed project, in any announcement of selected proposals.

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Appendix A Allowable Costs/Budget Guidelines

Personnel You can include all remuneration, allowances, honoraria and benefits that are paid to project staff and advisors hired for your specific project. Project advisors are people hired for long periods (more than one year) and paid on a regular basis. IDRC may pay the replacement cost (release time for academics) of principal researchers based on their time commitment to the project, their research role and the policy of your institution. In such cases, IDRC will only cover the payroll cost of the replacement (usually a lower cost than the person being replaced). Consultants All expenses related to acquiring the services of a consultant for a specific activity within your project can be included in this category. Costs may include fees, travel, accommodation, living expenses and support services hired directly by the consultant and billed to your project. You should indicate the total cost for each consultant as a single lump sum and use a note to give a breakdown of the costs. Evaluation You should include here all costs related to systematic evaluation that assess either progress toward achieving project objectives or the quality and effects of IDRC-funded activities. You can include here costs for consultant fees, travel expenses and the dissemination of evaluation findings. In projects where evaluation is the primary objective, costs can also include research expenses, training and salaries and benefits for personnel directly involved in the evaluation. Equipment Within this category you can include all equipment that has a useful life of more than one year and costs more than CA$1,000. Costs may include the basic purchase price, freight costs and other costs associated with purchasing the equipment. However, IDRC does not pay import duties, sales tax or insurance on equipment after it is delivered to you: these costs are considered the responsibility of recipients. Canadian recipients which purchase equipment using IDRC funds must remit that equipment to a developing country partner at the latest upon completion of the project work which falls under the IDRC grant. International travel This category includes costs for ground transportation, accommodation, meals, airfare, departure taxes and other expenses related to international travel by project staff. You must use your institution's own travel-management processes to handle travel, but the class of travel must follow IDRC policy as stipulated in the attachments to your grant agreement. Training Under this category you should include all expenses related to registration, tuition fees, living allowances, research and training expenses and travel costs to undertake the training. These costs should be reported under four categories: PhD degree; Master's degree;

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Short Course (e.g., a diploma or certificate); and Other (e.g., postdoctoral fellowship or sabbatical).

Please note that you should include under "research expenses," on-the-job training for project staff that is directly related to the implementation of research activities. Research expenses All costs related to carrying out the research and disseminating the research findings should be recorded as research expenses. These costs may include such items as payments to people who gather data or provide casual labour, the maintenance and operation of project vehicles, consumable goods and non-capital equipment, computer services, in-country travel, reference materials, rent paid for land or premises used in a research project, conference registration, dissemination costs, equipment rentals for seminars and conferences and printing. Indirect costs Here you should include administrative costs not directly related to the research. Indirect costs exclude overhead which are disallowed. Indirect expenses can only include: salaries and benefits of personnel which support and administer the project, such as secretaries, clerks and accountants; stationery and other office supplies; telecommunication cost (unless the nature of the project has warranted a specific budget line item for that purpose see Attachment C of your grant agreement); and computer equipment used for the administration or accounting of the grant disbursements.

You must keep track of your indirect cost charges in order to satisfy the requirements of any possible audit. Where your institution has a policy of recovering its indirect costs through the application of a percentage, it shall be able to satisfy IDRC or its auditors that the levy is fair and reasonable. Under no circumstances will the Centre consider indirect costs over 13% of the recipientadministered grant value excluding the amount awarded toward the procurement of equipment which will be vested in your institution and excluding the amount of the indirect costs themselves.

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References
1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006; 3(11): e442. 2. Alwan A, Maclean DR, Riley LM, d'Espaignet ET, Mathers CD, Stevens GA, et al. Monitoring and surveillance of chronic non-communicable diseases: progress and capacity in high-burden countries. Lancet. 2010; 376(9755): 1861-8. 3. The World Bank. Public policy and the challenge of chronic noncommunicable diseases. Washington: The World Bank; 2007. 4. Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007; 370(9603): 1929-38. 5. Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, et al. Priority actions for the non-communicable disease crisis. Lancet. 2011. 6. United Nations Economic and Social Council. Ministerial Declaration- 2009 HighLevel Segment: Implementing the international agreed goals and commitments in regard to global public health. Geneva: United Nations Economic and Social Council; 2009. 7. Stuckler D, Basu S, McKee M. Drivers of inequality in Millenium Development Goal progress: A statistical analysis. PLOS Medicine. 2010; 7(3): e1000241.doi:10.1371/journal.pmed. 8. Institute of Medicine. Promoting cardiovascular health in the developing world: A critical challenge to achieve global health. Washington: Institute of Medicine; 2010. 9. The double burden of malnutrition. Case studies from six developing countries. FAO Food Nutr Pap. 2006; 84: 1-334. 10. Miranda JJ, Kinra S, Casas JP, Davey Smith G, Ebrahim S. Non-communicable diseases in low- and middle-income countries: context, determinants and health policy. Trop Med Int Health. 2008; 13(10): 1225-34. 11. Stein AD, Thompson AM, Waters A. Childhood growth and chronic disease: evidence from countries undergoing the nutrition transition. Matern Child Nutr. 2005; 1(3): 177-84. 12. Campbell NR, Legowski B, Legetic B. Mobilising the Americas for dietary salt reduction. Lancet. 2011; 377(9768): 793-5. 13. Lawes CM, Vander Hoorn S, Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet. 2008; 371(9623): 1513-8. 14. World Health Organisation. Global strategy on diet, physical activity and health. Geneva: World Health Organization; 2004. 15. Mohan S, Campbell NR. Salt and high blood pressure. Clin Sci (Lond). 2009; 117(1): 1-11. 16. Earland J, Campbell J, Srivastava A. Dietary habits and health status of AfricanCaribbean adults. J Hum Nutr Diet. 2010; 23(3): 264-71. 17. Willett WC. Trans fatty acids and cardiovascular disease-epidemiological data. Atheroscler Suppl. 2006; 7(2): 5-8. 18. Khan NA, McAlister FA, Rabkin SW, Padwal R, Feldman RD, Campbell NR, et al. The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part II - Therapy. The Canadian journal of cardiology. 2006; 22(7): 583-93.

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19. Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D. Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. Lancet. England: 2010 Elsevier Ltd; 2010. p. 1775-84.

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