Past Breakthrough Grant Cycles

Problem Statement: With over 2.8 million incident cases and over 300,000 deaths from TB each year,1 TB control is a top priority for India.  To tackle the epidemic, systematic screening among high-risk groups is essential, however the current program misses a key high-risk group: individuals who recently completed TB treatment. An analysis of India’s 2019-2021 TB prevalence survey found that 27% of the TB cases detected were recurrent.

Intervention: Clinics across India have been capturing patient-level data about the diagnosis, treatment and prevention of TB using the online portal Nikshay, which serves as backbone for India’s TB surveillance system and informs programmatic decisions. Researchers from the School of Medicine at JHU and the Koita Center for Digital Health at Indian Institute of Technology Bombay are trying to leverage Nikshay data and apply novel analytical methods to assess the effectiveness and impact of post-treatment TB screening, while also paving the way for future research using Nikshay.

Impact: Through their work, the JHU – KCDH team aims to emulate a trial to estimate the effect of post-treatment TB screening on detection of recurrence. It is expected that systematically screening patients for recurrent TB after treatment completion could play a critical role in finding the missing millions, leading to improvements in clinical outcomes and reductions in transmission.

Principal Investigator and Researchers at JHU: Dr. Emily A. Kendall, Associate Professor of Medicine, Division of Infectious Diseases at Johns Hopkins University, & Dr. Jonathan E. Golub, Professor of Medicine, Epidemiology, and International Health at Johns Hopkins University

Principal Investigator and Researchers in India: Dr. Mithun K. Mitra, Professor of Physics at the Indian Institute of Technology Bombay (IIT-Bombay), Faculty at the Koita Centre for Digital Health (KCDH).

Problem Statement: Breast cancer is the most common form of malignancy among women worldwide. According to the global cancer report, the number of incident cases in 2020 alone was 2.3 million, representing 11% of all cancer cases.The breast cancer rate in India has been steadily rising over several decades and is now the most common form of cancer across all states in the country. According to Globcan report, the estimated number of new cases is 178,000 (14% of all cancer cases), and deaths are 90,000 (10% of all cancer deaths) for the year 2020 in India

Intervention: While it is understood that screening strategies need to move towards a risk-based approach rather than a broad age-based recommendation, no breast cancer risk prediction model has been developed or validated to date, specifically for the Indian population. In this project we propose to develop a collaboration across Johns Hopkins, IIT Mumbai and the Tata Memorial Hospital (TMH) to develop the first breast cancer risk prediction tool for the population of Indian women.

Impact: The development of the first breast cancer risk prediction tool for the Indian population will invigorate future research in multiple directions, including validation of the tool in additional studies, incorporating genetic and other biomarkers and use of AI-technology for the development of more advance models in the future.

Principal Investigator and Researchers at JHU: Dr. Nilanjan Chatterjee, PhD, Bloomberg Distinguished Professor, Johns Hopkins Bloomberg School of Public Health at Johns Hopkins University

Principal Investigator and Researchers in India: Dr. Saket Choudhary, Assistant Professor, Koita Centre for Digital Health, Indian Institute of Technology Bombay

Problem Statement: India is one of the most climate-vulnerable countries, facing significant challenges due to rising temperatures, erratic monsoons, and increasing frequency of extreme weather events such as floods, droughts, and cyclones. These climatic shifts have profound impacts on agriculture, water resources, public health, biodiversity, and the overall economy

Intervention: Collaborating with the Regional Centre for Biotechnology of the Department of Biotechnology in the Indian Ministry of Science and Technology, a Research Team from Johns Hopkins University is conducting interviews of Indian and US scientists, policy experts, and government officials to identify areas of collaboration, potential areas where collaboration is already underway and could use additional support and provide an assessment of which areas may be more fruitful in the near-term. The intent of the project will be to identify policy actions that will deepen US and Indian ties to collaboratively address some of the most serious issues facing both nations.

Impact: India’s efforts towards addressing climate change requires a holistic, multistakeholder approach that engages all segments of society. This collaboration can foster sustainable development, protect vulnerable communities, and position India as a global leader in climate resilience and innovation.

Principal Investigator and Researchers at JHU: Gigi Gronvall, PhD, Associate Professor, Department of Environmental Health and Engineering; Senior Scholar at the Center for Health Security, Johns Hopkins Bloomberg School of Public Health

Supporting Partner in India: Regional Centre for Biotechnology of the Department of Biotechnology in the Indian Ministry of Science and Technology, Government of India

Problem Statement: HIV/AIDS remains a significant public health concern in India, with approximately 2.4 million people living with HIV (PLHIV), according to the National AIDS Control Organization (NACO). While the country has made considerable progress in controlling the epidemic over the past few decades, several challenges persist, particularly in terms of prevention, treatment access, and addressing social stigma. The NACO in India oversees the distribution of antiretroviral therapy (ART) to approximately 1.5 million people living with HIV through about 700 public sector ART centers,. India, with its large and diverse population, faces unique challenges in managing ART supply. Geographic disparities, migration, logistical challenges, and non-real-time tracking of ART stocks complicate demand forecasting. These factors underscore the need for a robust and adaptable forecasting method that can handle the complexities of the Indian context.

Intervention: A collaborative project between Johns Hopkins University, Ashoka University, and NACO aims to develop a machine learning (ML) based model to enhance ART demand forecasting in India. The initiative, leveraging a multidisciplinary team’s expertise, seeks to create an ML model capable of learning complex patterns from extensive historical data and a range of influencing factors to produce more accurate and robust forecasts compared to traditional methods. The project aims to develop an adaptable ML model to predict the annual demand for each ART drug in India, validate the ML model using historical data from 2017-2020, and design a user-friendly interface for healthcare administrators.

Impact: This project will contribute to improving the accuracy of ART demand forecasting in India, thereby enhancing the effectiveness of HIV/AIDS treatment and management. The project will also demonstrate the potential of machine learning in addressing complex health challenges and provide a foundation for further research and development in this area.

Principal Investigator and Researchers at JHU: Dr. Steven J. Clipman, Assistant Professor Division of Infectious Diseases at the Johns Hopkins University School of Medicine.

Principal Investigator and Researchers in India: Dr. Debayan Gupta, Assistant Professor of Computer Science at Ashoka University

Problem Statement: The widespread adoption of Electronic Health Records (EHR) in India through initiative such as Ayushman Bharat Digital Mission and ABHA ID marks a pivotal moment in the country’s healthcare evolution. With its vast and diverse population, India’s healthcare system faces unique challenges, such as access disparities, uneven quality of care, and high demand for medical services. The integration of EHR systems offers not only solutions to these challenges but also creates a wealth of data that can benefit medical research and innovation on a global scale.

Intervention: Researchers from Johns Hopkins University and Ashoka University are using natural language processing (NLP) and large language models (LLM) to extract symptoms, comorbidities, clinical findings, diagnoses, and medications from clinical notes to develop Common data models (CDM) such as the Observational Medical Outcomes Partnership (OMOP) model. Such CDMs allow investigators to perform reproducible research using structured data across healthcare systems.

Impact: This pilot project will demonstrate among the first applications of modern NLP and LLM tools to the task of extracting clinical features from EHR datasets in India. The resulting OMOP CDM instance will be among the first of its kind in India. The researchers will also use the findings from this study to assess the link between febrile illness and prescription of antibiotics in India.

Principal Investigator and Researchers at JHU: Dr. Matthew Robinson, Assistant Professor Division of Infectious Diseases at the Johns Hopkins University School of Medicine.

Principal Investigator and Researchers in India: Dr. Rintu Kutum, Faculty Fellow of Computer Science at Ashoka University

Problem Statement: Several researches have placed the South Asian ethnicity to have a predisposition and increased risk towards non-communicable diseases often termed as lifestyle diseases. The most common among these are Type II Diabetes and diseases of the heart and cardiovascular system. This burden is significantly rising in the younger population in younger and apparently healthier populations. While several studies have explored the biological predictors for such conditions there is a paucity of such data for the South Asian population primarily India which is home to one-seventh the global population. Issues such as rapid urbanisation and increasing environmental pollution further exacerbate the issue.

Innovative/Intervention: In partnership with Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, The Johns Hopkins Medical Institute (JHMI) is leveraging artificial intelligence and machine learning to identify the risk factors for critical conditions such as myocardial infarctions, stroke and congestive heart failure as well as diabetes related issues of the eyes and kidneys.

Potential Impact: So far, the project has screened over 250 patients in India using an AI algorithm to determine their risk factors which range from demographic factors, dietary habits, lack of exercise, genetics, disorders of lipid mechanisms, substance abuse and obesity. The algorithm will be refined, and an operational model will be developed by 2025. The identification of these risk factors will pave the way for actionable targets to mitigate the effects of the biomarkers.

Principal Investigator and Researchers from JHU: Prasanna Santhanam, Rexford Ahima – Division of Endocrinology, Diabetes and Metabolism, DOM, Johns Hopkins University School of Medicine, Baltimore, MD (Principal Investigator) & Martin Lindquist – Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Co-Investigator of the study.

Principal Investigator in India: Anoop Misra – Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chairman, National Diabetes, Obesity and Cholesterol Foundation (N-DOC).

Problem Statement: Pregnancy and early childhood are two critical periods for mother and child. Altered growth within the first few years of life increases future risk of obesity and other chronic disease among newborns. Further, addressing modifiable risks during pregnancy can also improve all health outcomes . Metabolomics, which is an approach of studying biomarkers to predict diseases is now also being employed in improving maternal and child health. Metabolomics in pregnancy represents the overall physiologic status of the mother and encompasses molecules in cells, tissues, organs, and biological fluids.

Intervention: The Bloomberg School of Public at Johns Hopkins University together with the Public Health Foundation of India are geared towards increasing the understanding of child non-communicable disease risk, including cardiovascular disease and obesity through exploration of the maternal metabolome.

Potential Impact: The study is to a larger extent exploratory in nature, however the researchers through the results of their previous studies have hypothesised that maternal metabolites that have an adverse effect on children primarily revolve around lipids and saturated fatty acids which in turn are affected by maternal diet during pregnancy. This modifiable risk factor could then become a target for maternal health interventions once the sufficient evidence is generated through the study.

Principal Investigator and Researchers at JHU: Sara Benjamin-Neelon, PhD, JD, MPH, RD Professor Johns Hopkins Bloomberg School of Public Health & Noel Mueller, PhD Associate Professor Johns Hopkins Bloomberg School of Public Health

Principal Investigator and Researchers in India: Giridhara Babu, MBBS Professor and Head Public Health Foundation of India & Debarati Mukherjee, PhD Additional Professor Indian Institute of Public Health – Bengaluru

Problem Statement: Tuberculosis (TB) and mental health are closely linked, and addressing both is crucial for improving patient outcomes and overall public health. Integrating mental health support into TB care is essential for improving both mental and physical health outcomes. A holistic approach to TB management—one that recognizes the psychological impact of the disease—can lead to better treatment adherence, reduced stigma, and overall improved quality of life for patients. This is especially relevant for a country such as India which currently has a third of the global burden of TB.

Intervention: Investigators from Johns Hopkins University’s School of Medicine in collaboration with D.Y Patil Medical College and Research Center are undertaking efforts to enhance TB treatment programs by expanding access to mental health services in India with an integration approach that is informed and led by patients living with these conditions.

Impact: Through in-depth interactions with TB survivors and non-psychotic mental health conditions (such as depression, anxiety, post-traumatic stress); the researchers aim to identify key characteristics of a peer-led TB-Mental Health integration model for India. The resulting model will demonstrate effectiveness, cost-effectiveness, acceptability, feasibility, and sustainability for use by India’s TB programs at national, state and local levels.

Principal Investigator and Researchers at JHU: Christopher Kemp, PhD, MPH, Assistant Scientist at JHU and Branch Co-Director with the Center for AIDS Research Implementation Science Core & Nishi Suryavanshi, PhD, MSc, Behavioral Scientist and Deputy Director of Johns Hopkins Center for Infectious Diseases in India

Principal Investigator and Researchers in India: Arjun Kakrani, Director of Academic Collaborations & Professor of Clinical Eminence, D.Y. Patil Medical College, Hospital and Research Centre