Strengthening

the public health workforce

The public health workforce is vast and diverse, including nurses in clinics giving routine childhood vaccines, field epidemiologists investigating cholera outbreaks, data scientists analyzing causes of childhood deaths, pharmacists testing for influenza and many others whose work saves and improves lives each day. Here we feature some of the ways The Task Force strengthens the public health workforce.

The Task Force manages a global network that links field epidemiologists worldwide, helping them detect and respond to acute public health threats, including outbreaks, natural disasters and humanitarian crises. This program, Training Programs in Public Health Interventions and Network (TEPHINET), develops, connects, and mobilizes a global field epidemiology workforce to strengthen public health systems and advance health security. There are 81 Field Epidemiology Training Programs (FETPs) across 165 countries and territories, some of which include laboratory, veterinary (FELTP and FETP-V) and non-communicable disease tracks, which are trained, equipped and supported to ensure that every country has the capacity to protect and promote the health of its population.

To date, TEPHINET member programs have trained more than 22,000 public health professionals across the world, contributing to a global workforce that is advancing health security. These field epidemiologists have investigated more than 14,000 outbreaks, ranging from global concerns like the COVID-19 pandemic to localized events like a salmonella outbreak at a wedding in Kazakhstan or the first incursion of Japanese encephalitis virus in New South Wales, Australia.

The Public Health Informatics Institute (PHII), is playing a key role in the U.S. Data Modernization Initiative, funded by the U.S. Centers for Disease Control and Prevention (CDC), by supporting health agencies to strengthen the public health infrastructure and address gaps highlighted in the COVID response. In FY23, PHII helped train representatives from nearly 100 state, local, tribal, territorial and federal health agencies on modernizing public health infrastructure. Globally, PHII is working with partners in seven countries in Africa and Asia to document and analyze data on causes of death for children under five to inform programs and policies that reduce preventable deaths.

One highly successful Task Force initiative leverages both the public and private sector—involving the CDC, ministries of health, corporate partners and others—to create sustainable respiratory virus vaccination programs in low- and middle-income countries. This program, the Partnership for International Vaccine Initiatives (PIVI), has helped partners identify risk groups including health workers and helped partners in 27 countries build vaccination programs and deliver more than 5 million vaccines. A related program specifically focused on helping countries deliver COVID vaccines, with 83 percent of partners reporting increased capacity to deliver vaccines after being trained.

The Task Force’s Focus Area for Compassion and Ethics (FACE) strives to bring ethics and compassion to the center of global health practice by raising awareness, generating evidence, providing support and strengthening capacity. In this fiscal year, FACE designed a Task Force-

wide inquiry into ways programs contribute to fairness and equity in global health partnerships and practice. In its collaboration with WHO, FACE completed 3-years of Global Health Compassion Rounds webinars and launched a new initiative on compassion and Primary Health Care. FACE also drove a media campaign on the centrality of compassion in the Sustainable Development Goals, published a seminal review on the Epidemiology of Compassion and commissioned a measurement toolbox for compassion in healthcare settings. FACE also launched several exciting new projects in India, Uganda, and Kenya focused on enhancing the presence of compassion within local organizations and systems. 

In FETP, It’s All About People

When Magda Duarte was getting ready to post job vacancies for the 20th cohort of Brazil’s Field Epidemiology Training Program (FETP), she and her team noticed that the FETP cohorts were not representative of the diversity of Brazil that she witnessed during her work travels  to Brazil’s 27 states. She noticed that other sectors in Brazil were incorporating diversity, equity, and inclusion in their workplace strategies, but the FETP in Brazil was not. Duarte and her team decided to work with Brazil’s Ministry of Health to start brainstorming creative ways to create an inclusive FETP cohort starting with the selection process of the FETP cohorts.

Since 2022, Madga Duarte has led Brazil’s Field Epidemiology Training Program (FETP) also known as Training Program in Epidemiology Applied to Services of the Single Health System (abbreviated as EpiSUS). Duarte has been working in public health since 2016 with a specialty in data analysis and information systems in surveillance. From managing FETP training at three levels – elementary, intermediate and advanced, to advocating for the Brazil FETP program in her country and abroad, Duarte is a tireless champion for field epidemiology training. 

“Every single year, when we were selecting people for the Advanced Tier, we saw that we were selecting the same profile. We don’t have a lot of data on this. Historically, we did not collect data on race, gender, and sexual orientation. We started collecting this data as the first step to understand who we are working with and studying with us. We confirmed that we work a lot with women. We had a recent cohort that started and ended only with women. From the teachers, to the tutors, to the students, only women.”

Duarte reflects on the immense support she received from other women who helped her grow into the ever evolving work in field epidemiology.

“It was a woman who put me in this position that I am now and I am really proud of it. I always take the opportunity to open new positions for women and highlight the work of the amazing women that work here. Everywhere I go, I say I am a woman in leadership, but I have a lot of other women leaders who support me to give you this information and content. Value us because we are working hard to make FETP in Brazil.”

As Duarte and her team want to empower women in FETP, they also want to make FETP a safe space for other historically marginalized people in Brazil. 

“In the selection process for the 20th Advanced FETP Cohort in Brazil, we had an affirmative strategy that embraces diversity, equity and inclusion by reserving vacancies for indigenous, black and transgender applicants” said Duarte. “We also intend to strengthen field epidemiology in other Portuguese-speaking countries by offering slots for those that do not have Advanced Tier.”

“When we finish a cohort and we see the difference of that person when he or she got into that program and when they leave the program. They are so different. They can look for health issues. They can lead something and answer some responses to health events. They can transform public policies positively.”

“We are here because of people. We are making public policy for people, for our people, the Brazilian people. I think we can make an impact on people’s lives in many ways. We are here teaching people how to epidemiology and surveillance so that they can go back to their states and make it better every day. We are responding to health emergencies and trying to mitgate the bad events. We don’t want any new cases or death. The FETP works for people. Not just for public policy.”

The Importance of FETP Accreditation
Among Duarte’s many responsibilities, she was also managing Brazil EpiSUS’s application for reaccreditation. Duarte and her team were determined to have their next cohort reflect the diversity of Brazil. Although the accreditation process is long and requires a lot of documentation, Duarte understands the importance of accreditation.

“It is so important to understand what we are doing, what we are not doing, where we want to be in five years, and what is the importance of FETP in our country. As we were walking through this [reaccreditation] process, we realized that we were lacking in publicizing our activities. We now have videos, news, department weekly reports, etc. We started publicizing more. This is an outcome of our reaccreditation.”

The reaccreditation process was supported by The Task Force’s TEPHINET program. Reaccreditation is an opportunity for field epidemiology training programs (FETPs) to align with common standards that support quality training and increased recognition of their value in supporting country public health priorities.

Increasing Diversity, Equity, and Inclusion in FETP
In 2023, the theme of World Field Epidemiology Day (WFED) 2023 was announced as “Increasing Diversity, Equity, and Inclusion in Field Epidemiology” and people from all over the global network of FETPs shared their stories of creating a inclusive workplaces for FETPs and Brazil proudly shared their story of how they are dedicated to make Brazil FETP a workplace where everyone can thrive.

Duarte is always willing to share what she has learned from leading an FETP and how she wants to empower people from all backgrounds to know that there is a place for everyone in the global FETP network.

“When you work in FETP, you start realizing that people make the public policies happen,” said Duarte. “People who want to learn. People who want to teach. People who are suffering through something and we can make recommendations so we can change their lives. We can stop the spread of a virus. We can recommend changing a water source so they don’t get sick anymore. It’s all about people here. It doesn’t matter their position or who they are or what they did. We work a lot in prisons since they have many outbreaks. You have the right, a human right to water, to food, to health.”

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