Strengthening the public health workforce - The Task Force for Global Health

Educating the Community

Although the majority of the community members were familiar with how anthrax could impact humans, there was little understanding about anthrax in animals due to a lack of consistent, clear health information. Meat consumption practices were found to be high risk for anthrax. Community sensitization and health education sessions helped people to identify sick animals, report animal and suspected human cases, and understand how to take protective measures. Photo: Shaban Senyange - FETP Cohort 2021 talking to residents of Kerop Village, Kween District about the dangers of eating meat from an animal that has died suddenly. (September 2022) Photo credit: Shaban Senyange

Main Report

Force Multiplier

Global Health Force

Collective Force

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.

Inaccessible Mountain Pass Won't Stop Us

Vietnam intermediate FETP fellows participated in an investigation of a group project on the research “Factors associated with rabies post-exposure prophylaxis in high-burden districts — Central Highlands region, Vietnam, 2020–2022” in Muong Hoong commune, Dak Glei district, Kon Tum province on March 1, 2022. Here is a mountainous place inaccessible by means of transport. That's why we had to walk through the mountains to meet the locals who are mainly ethnic minorities. Photo credit: Giang Pham

Saving Communities Through Yellow Fever Vaccination

Step into the heart of Isiolo county, Kenya, where KFELTP, the national vaccine program, and the World Health Organization united for a mass vaccination campaign against yellow fever in November 2022. This photo captures a tender moment as Jedidah, a KFELTP resident, bonds with locals who share with her that yellow fever is known locally as "Kano Birelle" and their understanding of the infection risk posed by outdoor herding. As the head of the household responds to an electronic survey, his wife and son, along with their flocks, join in for a touching family moment. This snapshot demonstrates the power of vaccination in saving this pastoralist community from zoonotic diseases. Photo credit: Jedidah Kiprop Kenya FETP

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 helping 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 25 countries build vaccination programs and deliver more than 5 million vaccines. COVID-19 Vaccine Implementation Program (CoVIP), a related effort, helped countries deliver COVID vaccines, with 83 percent 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 the World Health Organization (WHO), FACE completed three 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.

During investigation of acute Watery Diarrhea (AWD) with dehydration, The Investigation team filled the questionnaires and collected samples from suspected cases and sources of water. Parwan province, Afghanistan. Photo credit: Momina Rahimi, Afghanistan FETP

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 incoming cohorts were not representative of the rich diversity she witnessed during her travels to Brazil’s 27 states. She also knew that other sectors in Brazil were incorporating diversity, equity, and inclusion in their workplace strategies, and she felt the epidemiology training sector was lagging. Duarte and her team worked with Brazil’s Ministry of Health to start devising creative ways to create an inclusive training cohort, starting with the selection process of who would participate.

Duarte has been working in public health since 2016 with a specialty in data analysis and information systems in surveillance. Duarte completed the frontline and advanced levels of FETP and holds a Bachelor of Science and a Master of Science degree in Collective Health from the University of Brasília. Since 2022, she has led Brazil’s Field Epidemiology Training Program (FETP), also known as the Training Program in Epidemiology Applied to Services of the Unified Health System ( EpiSUS). The Brazil FETP is a member of The Task Force’s Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET), a global network of FETPs in more than 165 countries and territories.

Responsible for FETP training at three levels – frontline, 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 year, when we were selecting applicants for the Advanced Tier, we noticed that we were selecting people with the same profile. We don’t have a lot of data on this because 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 who is studying with us.”

Duarte and her team want to ensure that every corner of Brazil is aware of FETPs, and therefore they are committed to making field epidemiology a safe space for 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 offerings.”

Duarte’s passion for working in FETP is rooted in her love of working with people in communities and being able to understand how she can work with her team to make communities in Brazil live happy and healthy lives.

“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 do 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 mitigate the bad events. We don’t want any new cases or deaths. The FETP works for people.”

Duarte presenting the results of EpiSUS at her department’s biannual planning meeting at PAHO’s Office. Photo credit: Gabriel Galli

Increasing Diversity, Equity, and Inclusion in FETP

In 2023, the theme of World Field Epidemiology Day (WFED) was “Increasing Diversity, Equity, and Inclusion in Field Epidemiology” and people from all over the global network of FETPs shared their stories of creating an inclusive workplace for FETPs. Brazil proudly shared its 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 from 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 do. We work a lot in prisons since they have many outbreaks. You have the right, a human right to water, to food, to health.”

The Importance of FETP Accreditation

In 2023, the Brazil FETP was re-accredited by TEPHINET with merit and distinction. The re-accreditation process was supported by The Task Force’s TEPHINET program. Accreditation 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.

Brazil’s recent re-accreditation and dedication to diversity, equity, and inclusion will create diverse FETPs and consequently culturally sensitive and diverse public health work forces equipped to deal with the wide range of needs and challenges throughout Brazil.

Magda Duarte is making great strides to ensure that FETPs in Brazil can connect back to all of the country’s diverse people, helping them to protect themselves, no matter who they are, no matter what they do and no matter where they live.