Greater collaboration is needed among stakeholders to ensure all countries have the capacity to respond effectively to disease outbreaks.
That was the consensus of a June meeting of global health leaders who met at the Rockefeller Foundation’s Bellagio Center in Italy to develop a roadmap for building global field epidemiology capacity.
The Task Force for Global Health convened the meeting with key partners including representatives from the Centers for Disease Control and Prevention (CDC), field epidemiology training programs (FETPs), organizations that provide global and regional support to the FETPs, the business community, and major foundations.
FETPs are now the backbone for disease surveillance and response in more than 100 countries. Modeled after the CDC’s Epidemic Intelligence Service in the United States, these programs train frontline health workers in how to detect and respond to disease outbreaks. FETPs also collect, analyze, and interpret public health data and turn it into action.
The Bellagio group recognized that FETPs began as a modest grant program for a few countries that has since evolved into a complex, multi-partner global enterprise involving many stakeholders with a range of priorities. The group discussed that current approaches to the management of this enterprise are relatively informal and overlapping, with no single group mandated to make strategic decisions for this global undertaking. This presents challenges to modernizing the FETP curriculum, assuring adequate funding, and fostering the institutionalization of self-sustaining FETPs in every country.
“We agreed that some sort of collectively empowered group is needed to strategically manage the global FETP enterprise,” said Patrick O’Carroll, MD, MPH, head of The Task Force’s health systems strengthening sector. “This body may take the form of a coordinating committee or a secretariat.”
The group agreed that every country in the world should have adequate field epidemiologic capacity to protect and promote the health of its own population, as well as the ability to support other countries to prevent the spread of infectious diseases. There was also consensus that research is urgently needed to develop a practical, evidence-based approach to help countries determine the level of field epidemiology capacity that they need to protect their populations.
“Every country needs to know how many trained field epidemiologists they need, at various levels of epidemiology training,” said O’Carroll. “This will help countries advocate for funding and articulate the value of having sufficient capacity.”
TEPHINET, a program at The Task Force, has played an important role in improving program quality, by aligning FETPs with common standards through an accreditation program. To date, TEPHINET has accredited eight FETPs. The Bellagio group agreed that the program accreditation process should continue and ideally accelerate. The group also suggested that an analogous program to credential individual FETP graduates should be considered in order that FETP graduates can respond international disease outbreaks.
Meeting participants are now working to prepare a report of the meeting outcomes to share with stakeholders. A final report will be released publicly this fall, and a follow-up meeting to develop concrete plans is planned.
“The group at Bellagio did a terrific job developing a roadmap for the next phase of field epidemiology capacity development,” said O’Carroll. “We now have an inspiring vision for this global effort, a concrete set of recommendations to move us toward that vision, and a proposed process for strategically managing our collective efforts. Now it’s up to all of us to put this roadmap into action.”
Martyn Kirk, PhD, professor of applied epidemiology at the Australian National University and former director of the Australian FETP, said the meeting helped provide new strategic direction to the global FETP enterprise. “The meeting was critical to fully developing the potential of FETPs around the world to prevent diseases that threaten global health security, such as Ebola and Middle East Respiratory Syndrome.”
The Task Force for Global Health owes its origins to a Bellagio meeting. In 1984, Dr. Bill Foege brought together the world’s leading health and development agencies at Bellagio where they formed The Task Force for Child Survival with the single goal of raising childhood immunization rates worldwide.
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