Strengthening capacity for policy-relevant life course epidemiological research in Ghana - Project Summary/Abstract Forty-one million people die every year from non-communicable diseases (NCDs), accounting for 71% of all global deaths. Premature deaths, defined as deaths occurring in persons aged 30-69 years, disproportionately impact low- and middle- income countries (LMICs) like Ghana. There is an urgent need to develop a sustainable pipeline of interdisciplinary African physician scientists (MD, MD/MS, MD/PhD) and postdoctoral investigators (PhD) dedicated to developing and implementing evidence-based interventions to address the growing NCD burden in Ghana and other West African countries. Our D43 takes a life course approach and is centered on the principle that environmental exposures drive development of chronic disease and transitions from health to disease begin in early life. Once risk factors develop, environmental exposures may accelerate progression to disease and death. We propose to leverage four extant, well- characterized cohorts (GRAPHS, PRISMA, KHP, and KHDSS) with extensive exposure repositories to provide mentored research opportunities to examine how environmental exposures: i) set in motion aberrant developmental trajectories; ii) accelerate progression to disease once risk factors are established; and iii) are associated with mortality. Ghanaian trainees will be enrolled in three tracks – PhD training, Master degree training, and short-term workshops. Training will be led by the Kintampo Health Research Centre, one of three Government of Ghana research centers and a part of Ghana’s Ministry of Health therefore providing a direct linkage from research to policy. KHRC will be joined by the University of Ghana’s School of Public Health, a premier Master and PhD degree-granting institution in Ghana and where coursework will occur, and Columbia University and the Icahn School of Medicine at Mount Sinai. Additionally, we will develop seminar series and a grant writing workshop and provide grant administration support to build research infrastructure in Ghana and support professional advancement of D43 trainees.