A pioneering collaboration led by the National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre (BRC) is helping to tackle one of Nepal’s most pressing public health challenges: poor lung health driven by pollution, smoking, and indoor biomass fuels.
Working in partnership with clinicians and engineers in Nepal, Nottingham-based respiratory experts are contributing to a growing body of research aimed at improving outcomes in a country where respiratory disease remains a significant burden – particularly in rural communities.
Air pollution and rural risk factors driving disease
While Nepal is often associated with the clean air of the Himalayas, the reality is starkly different in many urban and rural settings. The World Health Organisation has identified air pollution in Nepal as a critical environmental and public health concern.
In Kathmandu, factors such as tobacco use and emissions from traffic and industry are key drivers of lung disease. However, with more than 80% of the population living in rural areas, a different risk profile dominates outside the capital.
Here, the widespread use of traditional indoor cooking stoves – fuelled by biomass and used in poorly ventilated homes – exposes households to harmful pollutants, significantly increasing the risk of chronic respiratory conditions.
Two-way exchange strengthens clinical and research capacity
The Nottingham-led initiative has centred on a two-way exchange programme involving Dhulikhel Hospital and Kathmandu University’s Department of Mechanical Engineering. The collaboration is designed not only to generate new evidence but also to build sustainable research and clinical capacity within Nepal.
During the most recent phase of the programme in March, Dr Binaya KC, Associate Professor and Head of Mechanical Engineering at Kathmandu University, played a key role in advancing a large-scale genetic study. This work is creating a new research cohort of 5,000 individuals – set to become the first of its kind in Nepal.
Once completed, the cohort will provide critical insights into how genetic factors influence lung function and susceptibility to respiratory disease in the Nepali population – an area that has previously been under-researched.
Addressing global inequalities in respiratory health
The collaboration reflects a broader shift in focus for UK-based academic health science centres, which are increasingly addressing global health inequalities alongside domestic priorities.
Professor Ian Hall, Director of the NIHR Nottingham BRC and lead on the Nepal lung health project, highlighted the importance of this international approach:
“When the University Medical School based at Nottingham University Hospitals was established, its original purpose was to mainly improve health for the local population. However, over the years, we have increasingly focused on global health issues.
“The largest burden of diseases such as COPD (Chronic Obstructive Pulmonary Disease) – a chronic respiratory disease – won’t be in Nottingham, it will be in low-income countries like Nepal, where public health interventions have not reduced the exposure to the extent they have done in the UK.
“Not only has our joint research helped to design health services within Nepal, but our active exchange programme has helped build capacity and exchange views and expertise.”
Implications for the UK health sector
For UK healthcare leaders and policymakers, this programme underscores several key themes:
- Global health partnerships matter: Collaborative initiatives can deliver mutual benefit, improving outcomes abroad while informing UK practice.
- Prevention-led approaches are critical: Addressing environmental drivers such as air pollution and indoor smoke exposure remains central to reducing respiratory disease burden.
- Data and genomics are unlocking new insights: Large-scale cohort studies are enabling more targeted, population-specific interventions.
The Nottingham–Nepal partnership demonstrates how UK expertise can play a vital role in tackling global respiratory health challenges – while also strengthening research, innovation, and clinical practice across borders.
Image credit: iStock
