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Sustaining Health

Pilot funding for cross-disciplinary research connecting environment, nutrition and health.
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Humanity faces profound questions about how our planet can sustain nine billion people by 2050. With the trend of urbanisation, the majority of the world’s population now lives in cities. There is a global nutrition crisis, with dual problems of under nutrition and obesity. Meanwhile, environmental and population changes have major implications for issues including food and nutrition security, access to clean water and sanitation, and natural disasters. In meeting these challenges and delivering culturally, socially and economically appropriate solutions, research has a critical role to play.

The Sustaining Health initiative seeks to invest in pilot research projects investigating novel aspects of this broad area. Proposals should be designed to open up new research avenues, ultimately leading to work that will have a significant impact on human health. As general guidance, awards are of the order of £250,000, exceptionally up to £500,000.

Aims of the awards

Pilot projects may address any aspect of the interplay between health, environment and nutrition but key is a focus on health. Projects are not required to cover issues related to both environment and nutrition.

We expect these awards to stimulate collaborations and build capacity for interdisciplinary research.

We believe that high-quality research in this area requires the development of new interdisciplinary and cross-sector partnerships, particularly between biomedical (including public health) researchers and those working in social, economic, environmental, climate, engineering, agricultural, development and computer sciences.

Our scoping work has highlighted two sub-themes that we have a particular interest in:

The health impacts of climate change mitigation and adaptation measures

Climate change threatens the health of populations worldwide. What is less widely understood is how climate change mitigation and adaptation measures could have more immediate and potentially large impacts on population health. Such measures can offer an opportunity not only to reduce the risks of climate change and climate variability but also, if well-chosen and implemented, to provide the co-benefit of delivering improvements in health. Equally, some measures could have negative impacts on human health. We are interested in projects that propose to investigate topics in this area.

These could include:

• Using existing longitudinal and geospatial data on population health and environmental factors to investigate how climate variability will affect the health of the most vulnerable populations.

• Investigating the potential for technological and institutional innovations to ease threats to health from climate variability.

• Designing social environments for resilience to climate variability.

• Improved vulnerability and adaptation assessments that focus on particularly vulnerable populations and encompass complex causal pathway linkages.

How to feed 9 billion

Demand for food will rise over the coming decades as the world population rises towards 9 billion by 2050. At the same time, growing affluence means that ever more people are eating resource-intensive diets rich in meat and dairy products. In addition, changes in temperature, precipitation patterns, extreme weather and water scarcity driven by changes in the global climate system pose a significant risk to global and local food supply chains. To meet rising global demand for food, yield increases alone may not be enough. We are interested in projects that propose to investigate topics in this area.

These could include:

• Developing nutrition and agricultural economics tools to evaluate options for changing dietary choices whilst incorporating an understanding of the immediate impacts and downstream consequences on health, water use and climate change.

• Improving nutrition and health through novel crop-based agriculture while reducing impact on the environment.

• Efficacy and effectiveness trials to assess nutritional and health effects in local contexts.

Projects outside of these sub-themes, but relevant to the Sustaining Health area in other ways, are also welcomed.


The Wellcome Trust Strategic Plan includes a specific challenge in the broad area of 'connecting environment, nutrition and health'. includes a specific challenge in the broad area of 'connecting environment, nutrition and health'. This embraces the research themes of behaviour change, global nutrition, health impacts of climate change, and ecological public health.

Public health is seriously threatened by a lack of access to nutritious food, clean water and sanitation, by poor air quality, and by environmental (including climate) change. These interlinked dangers are developing in parallel with dietary choices and lifestyles that are contributing to an unprecedented burden of obesity and chronic diseases.

In light of this, and building on the Wellcome Trust Strategic Plan’s challenge in the broad area of 'connecting environment, nutrition and health', we have launched this Sustaining Health awards scheme. We want to support work, embracing the research themes of behaviour change, global nutrition, health impacts of climate change, and ecological public health, that will yield deeper insights into the issues at stake and develop strategies to mitigate the risks to human health.

This call aims to stimulate the formation of creative partnerships that bring together the diversity of competences required to tackle these complex problems and inform the global response through multidisciplinary research.

Funded projects

Round 1: Funded Projects

Palm Oil: Sustainability, Health and Economics (POSHE)
Bhavani Shankar (SOAS) & Richard Smith (LSHTM)

Palm oil, a ubiquitous food ingredient, has brought economic benefit to Asia, but has been linked with negative health (cardiovascular disease risk) and environmental (deforestation and greenhouse gas emission) outcomes. Potential health and environmental benefits flowing from careful policy development to alter edible oil consumption profiles in the region are substantial, but need to be balanced against economic impacts.

This research will break new ground in terms of (i) investigating health, economic as well as environmental aspects of palm oil at an economy/population-wide scale, and (ii) integrating health as well as environmental aspects with a whole-economy macroeconomic model. This interdisciplinary pilot project set in Thailand will (i) examine interconnections between economic, health and environmental dimensions of palm oil production and consumption, and (ii) identify and simulate the impacts of a set of policy-relevant scenarios. The modelling approach involves integration of data and combination of macroeconomic and health models with an environmental module. Policies will be simulated, and economic, health and environmental impacts estimated. Trade-offs and synergies will be examined, and policy recommendations made.

Sustainable Healthy Urban Environments (SHUE)
Paul Wilkinson (LSHTM)

More than half the global population now live in urban environments and that proportion is set to grow especially in low-/middle-income settings and in cities with a population of less than one million. The environments and governance of those urban environments will play an important role in influencing the exposures and health-related behaviours of their populations. Cities also have a demand for resources beyond current limits of sustainability.

The changes needed to help reduce these local and global environmental impacts offer opportunities for improving population health by reducing current unhealthy exposures and behaviours which also contribute to patterns of unsustainable living.However, as yet, there is only patchy empirical evidence on the degree to which city characteristics are associated with variations in health-related exposures, behaviours and outcomes as well as greenhouse gas (GHG) emissions.

The Sustainable Healthy Urban Environments (SHUE) project aims to build up a detailed database of a globally-distributed selected sample of cities and their populations with the aim of identifying the inter-relationship between city characteristics, their use of energy and other resources, and health-related behaviours and exposures. From comparative analyses combined with health modelling, it will assess the potential impact on health of realistic options for more sustainable strategies in such areas as transport policy and infrastructure, aiming to identify examples and principles to promote health and sustainability that can be more widely applied. The resulting database will be an open access resource for the research community and can be expanded over time.

The project is a collaboration between researchers at the London School of Hygiene & Tropical Medicine, the Institute of Public Health, Federal University of Bahia, The Complex Built Environment Systems Group at University College London, and The Environmental Research Institute (TERI), Delhi.

Spatial, social and environmental determinants of malnutrition in Africa: a pilot in Kenya
Jay Berkley (KEMRI-Wellcome Trust Research Programme & University of Oxford)

This project aims to understand the changing nutritional landscape across sub-Saharan Africa in order to develop targeted and effective interventions. The group will apply well-established methods developed for infectious diseases such as malaria to understanding and visualising the burden, spatial distribution and determinants of over- and under-nutrition in sub-Saharan Africa. The project will provide: i) a new understanding of malnutrition, reflecting diverse ecologies and determinants on the continent; ii) maps that clearly characterise the current burden and distribution of malnutrition; iii) predictions of future trends (e.g. with increasing urbanisation, climate change or interventions); and iv) tools to directly guide strategies to improve health, and for advocacy.

The pilot phase will be in Kenya. We will combine data from national surveys with remote sensing data, and data from targeted, small area, high-resolution surveys in an urban slum, a coastal rural zone and an arid land zone. The outputs of the pilot will include a continuous national map of nutritional status in children and women, and an understanding of the heterogeneity of prevalence and determinants of malnutrition. Through the pilot, a set of tools will be identified that can be used visualise the nutrition landscape on a continental scale.

Health and environmental implications of low-carbon, climate-change resilient diets in India’
Alan Dangour (LSHTM)

The food system is a major contributor to global greenhouse-gas emissions. This project will forge an interdisciplinary team to collate and analyse existing data on agriculture, diet, food-related GHG emissions, water footprints and health in India, in order to define healthy, low-carbon, climate-change resilient and context-relevant diets. It will provide a suite of agricultural and dietary options to guide national policy decisions, and make linked datasets available to the wider research community. This project will enhance the field by providing a method to determine the overall suitability of particular foods and dietary patterns, taking into account nutritional content, acceptability, health outcomes, GHG emissions, water footprint and climate-change resilience. The project will provide dietary solutions for specific socio-demographic sectors of the Indian population, and for different geographical regions, increasing the direct policy relevance of the work. Finally, this work will make a linked dataset available to the wider research community to significantly strengthen research into healthy and sustainable diets in poor countries.

This is a collaborative project between the London School of Hygiene & Tropical Medicine, the University of Aberdeen and the Public Health Foundation of India.

Environmental and nutritional interventions for improving cardiovascular health in rural China
Professor Majid Ezzati (Imperial College London)

Cardiovascular diseases (CVDs) and chronic obstructive pulmonary disease (COPD) are the leading causes of death in China’s aging population. Elevated blood pressure and its nutritional determinants are important risk factors for CVDs in China, as is household air pollution (HAP) from biomass and coal burning, which is a risk factor for elevated blood pressure, CVDs, and COPD. Exposure to these risks varies geographically within China. Therefore, there is a real need for data on risk factor exposures and their health effects, and for developing interventions that reduce exposures, at the regional level.

In this pilot study, we will establish a multi-disciplinary collaboration and integrate methods and data from health, engineering, environmental, quantitative and social sciences to identify locally-relevant environmental and nutritional CVD risk factors in three Chinese regions, and to develop interventions that can effectively reduce exposure to these risks. The objectives of our study are: (1) to measure the geographical and seasonal differences in blood pressure and other markers of cardiovascular function and health, and their environmental and nutritional risk factors; (2) to identify novel biological markers for exposure to HAP and nutritional risks and for the mechanisms and pathways of their hazardous effects on CVDs; and (3) to develop region-specific effective interventions that reduce HAP and improve nutrition for a subsequent intervention study.

Application process


We welcome proposals from a broad range of disciplines and we particularly encourage applications from cross-sector collaborations, involving academic organisations, industry/business, non-governmental organisations and/or government agencies based in the UK and overseas.

Participating organisations may be located in any country, and the principal investigator may be employed in any sector.

All applications will require clear arrangements for leadership and management of the project, whether this involves a single institution or a consortium.


Not-for-profit research institutions in the UK that are able to sign up to Wellcome Trust Grant Conditions are eligible to apply; this includes those funded by the Medical Research Council, Cancer Research UK or the Biotechnology and Biological Sciences Research Council.


Commercial companies are eligible to apply, either as principal applicants or as collaborators. We fund commercial companies to meet our charitable objectives through programme-related investment (PRI). For further details, please see our policy on PRI [PDF 38KB]. Companies will normally be expected to sign up to specific terms relating to the scheme.

To register an expression of interest you should complete a concept note [Word 79KB] and send it to sustaininghealth@wellcome.ac.uk before the deadline of 5pm GMT, 25 July 2014. We encourage you to discuss the suitability of your proposal with us before you submit your concept note. We also strongly encourage submission ahead of the 5pm GMT, 25 July deadline as we aim to review concept notes as we receive them.

If we decide to invite a preliminary application, we will email you a preliminary application form by the 20 August 2014. From this stage onwards, the process is by invitation only. Uninvited applications will not be considered.

Preliminary applications will be reviewed and shortlisted by the Sustaining Health Committee.

Following triage shortlisted applicants will be invited to submit a full application and will be subject to international peer review and due diligence. Applicants shortlisted to submit a full application will also be expected to make a presentation on their proposal to the Sustaining Health Committee.

Assessment criteria

Applications will be assessed using the following criteria:

  • importance and relevance of proposed research questions, both in the proposed pilot and in the long term
  • the applicants and co-applicants and their ability to deliver high-quality research
  • collaborative nature of proposed project and demonstrable ability to bring together multiple disciplines
  • potential to build multidisciplinary research capacity
  • regional and national and international context of the application (as appropriate)
  • plans for data management and sharing
  • potential for attracting additional, longer-term support.

Application advice

Wellcome Trust staff are happy to advise you during the preparation of a proposal.

If it is adequately justified, modest equipment purchase and maintenance costs may be included in an application. Building or refurbishment expenditure will not normally be considered.

Applications may not include requests for academic institutional overheads.

Find out more about allowed costs and disallowed costs.

The most common application queries are addressed by our FAQs.

What’s included?

Support may be requested for all research costs that are attributable to the project, including, for example:

  • salary costs for research staff
  • consumables and small equipment
  • collaborative travel
  • conferences and meetings
  • office support and communication costs.


Deadline for concept notes: 25 July 2014
Invites to submit preliminary applications will be sent by 20 August 2014
Deadline for preliminary applications: 26 September
Invites to submit full application sent during week commencing 10 November 2014
Deadline for full applications: 14 February 2015
Funding Committee: 7-8 May 2015


Enquiries should be sent to: sustaininghealth@wellcome.ac.uk.

Forms and Guidance

Concept note [Word 79KB]
Frequently asked questions

Wellcome Trust, Gibbs Building, 215 Euston Road, London NW1 2BE, UK T:+44 (0)20 7611 8888