Interlinked burdens: Understanding the diabetes-depression syndemic in continental Africa (360G-Wellcome-332984_Z_25_Z)

Type 2 diabetes (T2D) and depression are major global health challenges that often co-occur, leading to worse outcomes and increasing health system burdens. In Africa, both conditions are rising rapidly, yet their interplay remains poorly understood - particularly among African-ancestry populations, who are underrepresented in biomedical research and often present with distinct disease phenotypes. This fellowship aims to uncover shared biological and psychosocial mechanisms linking T2D and depression in African settings, generating foundational insights to inform future interventions. Building on my leadership in studies such as the Generation Malawi Birth Cohort and DepGen Africa, I will use rich, harmonised data from Malawi and other African countries to explore interactions between biological systems, social environments, and lived experiences. The programme comprises three work packages: (1) identify shared metabolic and inflammatory signatures using large-scale metabolomics; (2) investigate causal pathways through genetic analyses, including Mendelian randomisation; and (3) apply qualitative methods to understand how individuals experience comorbidity and navigate care. This interdisciplinary, discovery-focused research will advance our understanding of a critical but understudied public health challenge. Through a tailored training and mentorship programme, it will also support my development as a leading African scientist at the intersection of physical and mental health.