India's NCD burden is increasing at an alarming rate, now including, eg, >50 million diabetics. This demanding burden can be lessened by research and prevention programs both create awareness and provide effective and efficient strategies for action. This proposal targets this burden with an institution and individual capacity building and training program developed under ICOHRTA by a collaboration between UAB and the Madras Diabetes Research Foundation (MDRF) in Chennai. The highly successful training model that evolved goes beyond degree training to institutional capacity building and enhancing individual research capability broadly across career stages and paths with a major focus on activities within India. It addresses NCD broadly with an International Training Seminar held in India and designed to provide awareness and skills for delegates from, and enhancing the capacity of, an array of medical colleges and health sector institutes and agencies. The seminar includes annually >100 delegates and >20 faculty, a mixture of a US team and a selection of highly respected Indian scientists and educators. Also proposed are continuing the Intensive Sessions with a focus on 10 specific research projects per year, a series of in-house workshops at 2+ institutions per year designed to build institute capacity and enhance dissertation projects and a seminar series, some during the proposed twice-monthly video conferences and some during visits to the institutions. Another proposed component is to continue the short-term training in the US, for 4/year for pre-determined highly focused training. This overall strategy has proven highly productive in producing PhDs, with 18 completed since 2002 and 24 currently underway with the added benefit that all these persons remain in India except a post-doc in the US. Important new initiatives will expand the breadth and depth of the ongoing program and include creating a Community Medicine Faculty Forum;a focus on Developing Common NCD Definitions and Data Collection Procedures;a Train the Trainers Program, designed to make existing procedures and methods plus those a result of the Forum and common methods activities above readily available via a webpage;a process for adding new collaborating institutions, at least one per year;a process for creating new courses at MDRF and continuing and expanding a Genomics Training Program. These proposed activities will continue to influence the extent and nature of NCD research at the participating institutions and beyond to India, beyond their already considerable impact. Trainees now hold important positions in the health sector in India. Further MDRF and the trainees have developed a most laudable scientific project and publication record during the collaboration. The course and the nature of the activities will be guided by the existing Internal Advisory Committee and the Training Advisory Committee to be created. PUBLIC HEALTH RELEVANCE: Cardiovascular disease and diabetes, eg, have become major health problems in India and other developing countries, with the prevalence of diabetes having gone from 2.1% in 1970 to more than 15% now so that there are some 30-50 million diabetics in the country. Non communicable disease relevant clinical research capacity building and training are thus a critical component of efforts to stem this tide.