Updates from the Field… Strengthening Systems and Workforce Capacity Globally

Spring 2012, Issue 6

Director’s Message “ By leveraging the skills, energy, Inside this issue: and local knowledge of its Director’s Message residents and graduates, FETPs Dear Colleagues: • FETP Polio eradication initiatives ...... 1 are uniquely positioned to provide n December valuable service to the Global Highlights of investigations I2011, Dr. • N-STOP: Pakistan’s Fight against Polio ...... 2 Thomas Frieden, Polio Eradication Initiative, their fellow citizens, and all humanity. • Road to Haiti’s Recovery and establishing Director, Centers ” the First FETP Cohort in Haiti...... 3 for Disease World Health Organization to improve Partnership Matters Control and management of polio eradication Prevention (CDC) • t Is i time for FELTPs for the whole of Africa? programs in endemic countries. There The Dar es Salaam Agenda ...... activated CDC’s 4 have also been many discussions here • CDC Represents United States in Emergency at CDC about how our partner Field Consultative Working Group to Draft New Operations Training Programs (FETPs) PAHO Budget Policy...... 5 Center (EOC) to increase — Peter B. Bloland around the world have been involved in • CDC Launches FETP NCD track in Six support to the Global polio campaigns and we are Countries ...... 6 Polio Eradication Initiative. In January actively looking at how they could assist Graduate Corner 2012, India marked its first year free of even more with this effort. polio cases. Overall, polio incidence • South Africa-FELTP Graduate Reflects on her Residency in Haiti ...... worldwide has dropped more than 99% In this edition of our newsletter, we 7 since 1988, when global eradication efforts have a report from Pakistan, one of Training/Resources began. Despite this remarkable success, three countries with ongoing polio virus • Leveraging resources and strengthening recent progress has been slow and there transmission. Dr. Rana Jawad Asghar health systems through partnerships for have been some setbacks. On 21 January reports on a successful collaboration IDSR and IHR (2005) ...... 8 2012, the World Health Organization’s between Pakistan’s FETP and the polio • SMDP Launches 2012 Webinar Series ...... 9 Executive Board (WHO/EB), alarmed by the eradication effort. Pakistan has developed • Software Training in Bamako, Mali unexpected upsurge of cases in Nigeria, a national version of Stop Transmission ...... 10 Pakistan and Afghanistan in 2011, declared of Polio (N-STOP) teams that capitalize on the completion of polio eradication a FETP graduates and residents (fellows) What’s New?...... 11 “programmatic emergency for global to access difficult to reach places and Upcoming Conferences/Events public health.” people. In the past, STOP teams have • Upcoming Conference Events...... 12 relied heavily on external personnel In Nigeria and Pakistan the continued participating in three-month assignments circulation of two wild poliovirus to assist countries with acute flaccid (WPV) serotypes was accompanied by paralysis surveillance and planning and re-introduction, should look at this effort spread to other countries, despite the implementation of vaccination campaigns. as a high priority and investigate how to introduction of national emergency partner with the Initiative. This effort is an polio eradication plans. By activating By leveraging the skills, energy, and opportunity to contribute substantively to the EOC, Dr. Frieden made a very strong local knowledge of their residents and improving public health for generations statement regarding CDC’s commitment graduates, FETPs are uniquely positioned to come, a goal that is central to the to achieving polio eradication. Within to provide valuable service to the Global philosophy of FETPs. our Division of Public Health Systems Polio Eradication Initiative, their fellow and Workforce Development (DPHSWD), citizens, and all of humanity. FETPs in — Peter B. Bloland, D.V.M., M.P.V.M. programs are actively engaged in the the three last endemic countries (Nigeria, Director, Division of Public Health Systems effort. For example, the Sustainable Afghanistan, and Pakistan) as well as FETPs and Workforce Development Management Development Program in other countries where international U.S. Centers for Disease Control and (SMDP) is partnering with CDC’s travelers have brought polio virus back or Prevention Global Immunization Division and the those countries remaining at high risk of

Center for Division of Public Health Systems and Workforce Development

CS231171-A Updates from the Field...

Highlights of Investigations N-STOP: Pakistan’s Fight Against Polio

Submitted by Dr. Rana Jawad Asghar, Resident Advisor, Dr. Rana Muhammad Safdar and Dr. Poonam Mazher, Faculty, Pakistan Field Epidemiology and Laboratory Training Program

he eradication of polio in Pakistan is CDC (Atlanta, GA, USA) and supports an ongoing struggle. While Pakistan’s National Emergency Action Ttremendous progress has been made, Plan (NEAP). The program is being the program faces many challenges and supported by CDC’s Global ongoing poliovirus transmission in Pakistan Immunization Division and is poses a threat to other countries. In 2011, considered by GID to be a model for 1/3 of all global polio cases (197) were similar programs being planned in diagnosed in Pakistan, including 2 cases of other countries. type-3 virus, a strain on the verge of Stakeholders and partners identified elimination elsewhere in Asia. Dr. Mumtaz Ali Laghari (FELTP alumnus (2009-2011), FELTP- Approximately 1/3 of all districts in Pakistan 16 high-risk districts for the first NSTOP officer) vaccinating kids in camps for flood affected report polio cases. Persistent transmission deployment of N-STOP assignees persons in Hyderabad, Sindh. of poliovirus is evident from continuously beginning on April 4th 2011. N-STOP positive environmental samples. Oral teams were staffed with FELTP alumni poliovirus vaccine (OPV) is not reaching and residents as well as trainees of a enough children in high risk areas. Mass FELTP-organized “surveillance and displacement of populations and damaged outbreak response” training course. health infrastructure due to floods, Awareness of the local area and culture especially in the northern Sindh and helped N-STOP members rapidly southern Punjab, have complicated access secure local ownership and support of to some areas. the health management teams and the community. Team members helped Nonetheless, the Government of Pakistan develop district and union council (UC) (GoP), working in partnership with the plans, involving local political and Centers for Disease Control and Prevention religious leaders. Specific attention (CDC) and other international partners, was given to reaching nomadic remains determined to eliminate polio in populations and families that had Dr. Muhammad Dawood Kasi (FELTP alumnus (2008-2010), Pakistan. previously refused routine vaccination. FELTP-NSTOP officer) vaccinating/checking vaccination Members revitalized non-functional EPI coverage among children in Quetta Balochistan. In 2009 the national Expanded Programme centers and gained the commitment for Immunization (EPI)/GoP requested the and assistance of education departments, than 400 religious leaders to participate in Pakistan Field Epidemiology and female health workers, and community or endorse the national polio eradication Laboratory Training Program (FELTP) to volunteers. Access to insecure areas was campaign. N-STOP officers have also been conduct a vaccine coverage survey in the supported by security agencies. instrumental in revising microplans in 279 Districts of Multan and Muzaffargargh high risk UCs and establishing more than 70 where a cluster of polio cases was N-STOP officers overcame many District and Union Council Polio Eradication identified. After observing the challenges, including difficult terrain, poor Committees in keeping with NEAP methodological approach of the FELTP security, and an ongoing negative guidelines. residents (fellows), EPI and the World perception of OPV. N-STOP has helped Health Organization (WHO) invited the launch vaccination campaigns for high-risk These efforts have contributed to increases Pakistan FELTP to assist them in polio populations and, as of April 2011, has in vaccination coverage indicators in a eradication work throughout Pakistan. supported covering 53 new areas with substantial portion of Pakistan. Despite After a year of preparations, a national vaccination; 5,106 missed children and many challenges, the N-STOP campaign version of Stop Transmission of Polio 2,670 individuals who initially refused OPV continues to make steady progress towards (N-STOP) was launched in April 2011. due to religious or tribal reasons have been a ‘Polio Free Pakistan’. N-STOP is a collaborative initiative of the vaccinated. In addition, a standard NEAP Pakistan FELTP, EPI, WHO, United Nations implementation guidance document was For further information please contact: International Children’s Fund (UNICEF) and developed. N-STOP has motivated more Dr. Rana Jawad Asghar at [email protected] www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 2 Updates from the Field... Highlights of Investigations The Road to Haiti’s Recovery and Establishing the First FETP Cohort in Haiti Submitted by Dr. McKenzie André, DPHSWD

n January 2010, the world looked on as Haiti struggled to survive the aftermath Iof the devastating earthquake that shattered Haiti’s infrastructure and left hundreds of thousands of people homeless, and in need of urgent medical attention. Over 230,000 people died, over 300,000 were injured, and more than 2,000,000 were displaced. This situation created increased risk for infectious diseases from overcrowding and poor living conditions. CDC was among the first U.S. government agencies to provide Haiti with immediate assistance. HAITi-FELTP residents working in small groups on a case study. According to staff from the Health Systems is based on a three-tiered structure which Reconstruction Office, the lead program for targets different levels of government (local, CDC’s response efforts, it became clear that departmental, and national) for training in epidemiological support for the Ministère field epidemiology. The curriculum of each de la Santé Publique et de la Population level varies in the amount of time and depth (MSPP), the Haitian Ministry of Health, devoted to each subject area so that the was needed. Discussions to establish material corresponds to the participants’ a Field Epidemiology Training Program work functions. (FETP) began in June 2010. The rollout of the program was postponed due to the Since the program was established in the demands of responding to the cholera Dr. McKenzie André giving a lecture on Surveillance midst of a major crisis, the FETP decided and Public Health during the basic screening course. outbreak which occurred in the same to focus on the intermediate curriculum year. According to Dr. McKenzie André, which could be completed in between Research, “The MSPP is fully engaged (CDC, FETP), the response to the cholera 9 to 12 months. To identify promising and pleased with CDC’s support to Haiti outbreak further demonstrated the need candidates while also quickly providing in helping us to establish FETP as a for epidemiologic capacity development basic field epidemiology training, the basic program that will help build capacity within MSPP. In the coming months (post course within the tiered structure was as well as change the culture of MSPP cholera) the ability to collect and evaluate modified into a screening course to help by introducing epidemiology into the surveillance data as well as respond to select intermediate and advanced level community. This is the beginning of a possible outbreaks of disease would be candidates. Two candidates were identified Haitian owned epidemiology program.” paramount in helping MSPP respond to by the MSPP to attend the advanced 2-year future outbreaks. course in the Central America Program According to Haiti-FETP Resident that began in May 2011. Intermediate Advisor, Dr. Fabienne Laraque, “Future A little over a year after the devastating level training in Haiti officially began in plans include leveraging all the actors earthquake, CDC began screening November 2011 and includes 12 residents, and participants to provide mentors for candidates for the Haitian FETP which is including four physicians, five nurses and training; partnering with NGOs and local modeled after the pyramid structure of three statisticians. universities; and identification of basic the Central America FETP and based on epidemiology skills and competencies the CDC’s Intelligence Service According to Dr. Magloire, from the which address the immediate needs of program. The Central America program Directorate of Epidemiologie et Laboratory the MSPP.” www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 3 Updates from the Field... Partnership Matters Is it time for Field Epidemiology and Laboratory Training Programs for the whole of Africa? The Dar es Salaam Agenda for Action, December 2011 Submitted by: Hon. Hadji Mponda- Minister of Health Tanzania, Peter Mmbuji, Nasir Sani-Gwarzo, David Mukanga, Mufuta Tshimanga, Peter Nsubuga

good public requires a competent workforce to promote Apractical and appropriate public health interventions using sustainable local strategies. Africa therefore requires public health professionals who can develop feasible health strategies, enabling countries to progress towards achieving the health-related Millennium Development Goals. In December 2011, the Minister of Health and Social Welfare of Tanzania, Hon. Hadji Ministers and Representatives of Ministries of Health, CDC, and AFENET, after the Ministerial Round Table meeting. Mponda hosted nine ministries of health Seated (L-) Prof. Abdulsalam Nasidi- Nigeria, Dr. Richard Nduhuura- Uganda, Dr. Hadji Mponda- Tanzania, (Democratic Republic of the Congo, Hon. Kayanza Pinda- Tanzania Prime Minister, Hon. Yatta Lori Lugor- South Sudan, Dr. Henry Madzorera- Ethiopia, Ghana, Mozambique, Nigeria, Zimbabwe, and Dr. Dadi Jimma- Ethiopia.Standing (L-R) Dr. Peter Mmbuji- Program Director, Tanzania FELTP, Dr. Deo Mtasiwa- , Tanzania, Dr. Peter Bloland- CDC Atlanta, Dr. Justin Wane- Rwanda, Dr. Rwanda, South Sudan, Uganda, Tanzania, Appiah-Denkyira- Ghana, Dr. António Guilherme Mujovo - Mozambique, Prof. Mapatano Ali- DRC, Prof. Mufuta and Zimbabwe), represented by their Tshimanga- AFENET Chairman and Mr. David Mukanga- AFENET Executive Director Ministers or delegates at a Ministerial Roundtable meeting to discuss the future 2. African FELTPs, which are jointly hosted Services through CDC, the U.S. Agency for of Field Epidemiology and Laboratory by ministries of health and training International Development (USAID), the U.S. Training Programs (FELTPs) as a strategy to institutions, have existed for nearly two Department of Defense, the World Health strengthen public health systems in Africa. decades and have produced many public Organization, the Bill and Melinda Gates health leaders. Since 2004, the number Foundation, the Rockefeller Foundation, The Ministerial Roundtable was part of of programs has increased with some the Ellison Medical Foundation, and the events to mark the 5th Anniversary of combining field epidemiology with European Union. the African Field Epidemiology Network and veterinary (AFENET) which was held jointly with epidemiology training. The programs At the end of their deliberations, the the 4th AFENET Scientific Conference have a high graduate retention rate, with Ministerial Roundtable resolved and December 11-16, 2011 in Dar es Salaam, many graduates continuing to practice adopted the “Dar es Salaam Agenda Tanzania. The conference theme was public health in their home countries; and for Action of Public Health Systems “Field Epidemiology and Laboratory Strengthening for African Nations through Training Programs as a Platform for Public 3. AFENET has a five-year productive FELTPs” which states in part: Health Systems Strengthening”. The experience with FELTPs and seeks to 1. FELTP as a national strategy: All African conference was attended by more than sustain them in Africa and develop new nations shall adopt FELTP as a key 400 participants. Over 120 oral and poster ones. national strategy for health systems presentations by residents and graduates The Ministerial Roundtable resolved to strengthening and develop career paths of African FELTPs were made, interspersed adopt a five-year action plan for immediate for FELTP graduates to ensure effective with several keynote addresses by global implementation and support by their and efficient utilization of resources. public health experts. respective governments and partners. The Ministerial Roundtable noted the The delegates called for strengthening 2. Each country creates a budget line for following: collaboration through continued FELTPs: Health Ministers shall advocate for support, and expressed appreciation and ensure dedicated national funding 1. Africa lacks clinical care and a public for the contributions of partners in for these programs in their respective health preventive workforce and both developing FELTPs in Africa especially the national budgets, to ensure sustainability are critical in addressing communicable U.S. Department of Health and Human of FELTPs. and non-communicable diseases; Continued on page 10 www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 4 Updates from the Field... Partnership Matters CDC Represents United States in Consultative Working Group to Draft New PAHO Budget Policy

Submitted by Denisse Betancourt, DPHSWD

special working group with representation from the Pan AAmerican Health Organization (PAHO) member countries met in Washington, D.C., in February at the PAHO headquarters, to discuss and draft a new budget policy to guide the allocation of PAHO resources starting in 2014. Once finalized, the new policy will be presented for approval by all PAHO Member States during the Pan American Sanitary Conference in September 2012. PAHO Consultative Working Group PAHO’s current budget policy has been Front: (L-R) Ms. Patricia Cabrejo, Program Budget Specialist PBR/WDC,Dra. Milagro Clareth Vera Fereira, General in effect since 2006 and was extended Director for Management MOH (Venezuela),Ms. Denisse Betancourt, Centers for Disease Control & Prevention, through 2013 to allow time for the Budget Officer, Center for Global Health (United States),Mr. Arionaldo Bomfim Rosendo, Sub-Secretary of Planning Consultative Working Group to produce a and Budget Ministry of Health (Brasil),Dr. Rosina Salerno, Evaluation Advisor, Internal Oversight and Evaluation new policy, which is expected to respond Services PAHO (WDC),Sr. José Ignacio Dougnac Vera, Chief of Management & Planning (CHILE), Sr. Percy Minaya, to the needs and changing environment Regional Coordinator for Central America and Caribe, CDC – TEPHINET COAG (Peru) for technical cooperation in the Americas. Back: (L-R) Mr. Ian Stein, Advisor, Planning and Resource Coordination PAHO, Mr. Roman Sotela, Senior Advisor, Program Budget Management PAHO. Mr. Terron Gilchrist, Consultant/Advisor in the Ministry of Policy (Granada), According to Denisse Betancourt, Budget Mr. Ruben Suarez, Senior Advisor, Public Policies, Regulation, & Health Financing PAHO, and Dr. Oscar Jesus Alberto Officer for CDC’s Division of Public Health Mujica, Advisor, Social Epidemiology/PAHO Systems and Workforce Development and US Representative to the PAHO at the World Health Organization (WHO), Consultative Working Group, “The and with the development of the new Consultative Working Group is made up of PAHO Strategic Plan for 2014-2019.” The representatives of Brazil, Chile, Granada, rationale of the WHO Reform is responding Tell us what you think… effectively and efficiently to the needs of Peru, the United States, and Venezuela. Updates from the Field…Strengthening Member States requiring predictable and The working group was appointed Public Health Systems and Workforce sustainable financing for WHO. by PAHO’s Executive Committee in Capacity Globally is a quarterly September 2011 with a mandate to Recommendations on principles and newsletter produced by CDC’s Division analyze the current budget policy and also criteria to guide the development of a of Public Health Systems and Workforce to review trends in the budget policies revised budget policy developed at the Development. The newsletter aims of other intergovernmental agencies, first meeting will be presented in March to to inform residents and graduates of globally and regionally, to identify relevant PAHO’s Subcommittee on Program, Budget, Field Epidemiology Training Programs, good practices.” All PAHO Member States and Administration. The working group national and regional partners, and will have the opportunity to react to the will meet again in early April and initiate a the general public about news, events, group’s work and to offer input before the consultative process with PAHO Member training, and resources of interest. We document is finalized. States. The resulting proposed policy will welcome your feedback and would like you to take a few minutes to complete a According to Mr. Roman Sotela from the then be presented to the PAHO Executive Committee during its June 2012 meeting, survey. Please click the link: http://www. PAHO Budget Policy Consultative Working surveymonkey.com/s/GWSB6NB. Please Group, “The development of the new and eventually to the Pan American Sanitary Conference in September. send any additional comments and or PAHO budget policy should coincide suggestions to Ruth Cooke Gibbs at with, and respond to, the implementation For further information, please contact [email protected]. of financial and management reforms Denisse Bettancourt at [email protected]. www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 5 Updates from the Field...

Partnership Matters CDC Launches FETP NCD track in Six Countries Submitted by Bassam Jarrar, Deputy Director, DPHSWD

n 2010, under the leadership of Dr. Thomas Frieden, Director, Centers for IDisease Control and Prevention (CDC), CDC began to refocus its global health work to create better synergies between its programs and respond to pressing global needs. This effort included strengthening CDC’s global non-communicable disease (NCD) work and building capacity and systems needed to address the increasing burden of NCDs in low-and middle-income countries (LMIC). When asked about the importance NCDs Dr. Frieden responded, FETP residents and Ajloun governorate staff discuss implementation of the physical activity project. “NCDs are an urgent challenge for countries in every corner of the globe and at every Center for Chronic Disease Prevention producing a new generation of experts in stage in development. Besides being the and (NCCDPHP) began NCD epidemiology and prevention. right thing to do, CDC has allocated funds collaborating on an initiative to strengthen NCD training modules for the FETP are to support NCD programs in low- and NCD capacity and systems in LMIC. Five being piloted in the six focus countries. middle- income countries because NCD countries (China, Thailand, Tanzania, Once these modules are finalized, they programs reduce poor health—leading Colombia and Jordan) were selected as ‘focus will be made available to the entire FETP to healthier, more productive people. countries’ to implement a FETP- NCD track, community. The modules are flexible and Implementing prevention strategies, and and a sixth country, Brazil, is being added can be delivered in both class room and working with countries to build capacity, for FY 2012. FETP, with its long history of non-class room settings. They can also be promote healthy behaviors, and save lives success in working with ministries of health modified as needed to include different is an important part of CDC’s mission.” to build capacity, provides an ideal platform to expand training on NCDs. The addition disease case studies to best serve a NCDs are rapidly becoming a factor in low- of NCDs to the FETP also provides CDC an country’s disease priorities. and middle-income countries where the opportunity to engage substantively with FETP residents have also begun NCD rise of NCDs—combined with the already ministries of health in the focus countries to field work. In China, FETP residents have heavy burden of infectious diseases—is develop comprehensive NCD plans, formalize conducted projects aimed at reducing salt creating a double toll on the health of agreements with CDC, and jointly launch intake among Beijing residents. They are populations globally. WHO estimates that new NCD prevention programs. Michael also studying the effects of China’s new NCDs account for 60% of deaths worldwide, Pratt, Senior Advisor for Global Health in policies preventing smoking in public and with the majority of these deaths CDC’s NCCDPHP commented that, “This is a places. In Jordan, FETP residents are occurring in low- and middle-income wonderful example of how existing global focusing on increasing physical activity countries, this trend will continue. experience and infrastructure at CDC can throughout the country. In Colombia, FETP be re-oriented to address new public health residents are analyzing national surveillance The Field Epidemiology Training Program priorities in LMIC. A few well trained and well systems for NCDs and risk behaviors. (FETP) has been in existence for over 30 placed epidemiologists will be able to have years and is widely recognized for its real impact on NCD prevention in the pilot CDC is hoping to finalize the development success in working with ministries of health countries.” of the NCD modules by the end of to build epidemiology capacity in low- September and begin to make them and middle-income countries. Although FETP residents focused on NCDs follow available to the FETP community. We are originally designed to help countries the same core curriculum as others in the also planning to begin adding additional respond to infectious disease threats, FETPs program but their field work, projects, countries to the ones mentioned earlier. have been increasingly part of the effort to and other opportunities focus on NCD address NCDs. In FY 2010, CDC’s Division detection, analysis, and disease management For further information, please contact of Public Health Systems and Workforce approaches. These residents also receive Bassam Jarrar at [email protected] or Victor Development (DPHSWD) and the National mentoring from CDC experts with the goal of Caceres at [email protected] www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 6 Updates from the Field... Graduate Corner South Africa-FELTP Graduate Reflects on her Residency Experience Interview with Genevie Ntshoe SA-FELTP 2009 Graduate Submitted by Ruth Cooke Gibbs and Shelly Bratton, DPHSWD

outh Africa is one of the countries burdened with a high prevalence Sof infectious diseases such as HIV and TB; this constitutes a major health problem for many of our communities. I studied public health and epidemiology to gain the experience necessary to understand and address factors affecting the health of our population. I heard about the South African Field Epidemiology and Laboratory Training Program (SA-FELTP) and was motivated to enroll because of its residency based Genevie Ntshoe SA-FELTP graduate examine specimen training. I completed my residency at in lab, 2009 the end of 2009 and went on to receive a Master of Public Health (MPH) degree People applying to SA-FELTP must be prepared to work harder, go an extra mile, from the University of Pretoria in April Genevie Ntshoe SA-FELTP graduate accepting Award 2011. I am very grateful to the SA-FELTP for best oral presentation during 2009 AFENET and manage time and travel both within because it afforded me a chance to Conference and outside of South Africa. However pursue a career in public health. they should not be frightened by the Service (EIS) conference in Atlanta, workload as they will be mentored and The SA-FELTP gives residents an Georgia in April 2009 as well as an oral will have hands-on training. At the end of opportunity to combine academic presentation at the 5th Regional TEPHINET the program they will not regret joining training with applied epidemiology and 3rd AFENET Scientific Conference in because they will be in position to build and laboratory management practices. Mombasa, Kenya in August/September and strengthen surveillance systems that This model allows residents to get 2009. I was awarded the prize for the best will in turn help in the prevention and an in-depth understanding of public oral presentation at this conference. These control of diseases/outbreaks among our health through the coursework and presentations were based on the work that communities. apply that knowledge by being actively I did during my training in collaboration engaged in public health related with the Epidemiology Division at As a result of the training and skills matters. Residents are also mentored South Africa’s National Institute for gained during my residency, I am now by senior epidemiologists and health Communicable Diseases (NICD). My most an epidemiologist in the Centre for practitioners. As a result, residents memorable assignment was participating Vaccines and Immunology (CVI) at the acquire epidemiological skills and in a team that screened patients suspected National Institute for Communicable develop invaluable competences during of contracting influenza A(H1N1)pdm09 Diseases (NICD) of the National Health the training period virus in South Africa in response to WHO Laboratory Service (NHLS). My areas of raising the influenza pandemic alert level responsibility include: data management, During my residency, I was involved in to 5. A 24-hour hotline was established conducting new epidemiologic research, different activities including: outbreak and specimens from patients meeting the assisting with surveillance and research investigation, , case definition were tested at the NICD. projects within the CVI and providing surveillance systems evaluation, data In South Africa, pneumonia, including epidemiologic support to other units management, and scientific writing. I that caused by influenza, is rated as the within the NICD and the Department of was also given an opportunity to share second leading cause of death. These Health. my work with other public health activities enhanced my communication professionals during international and computer skills and my ability to write For further information please contact conferences. I made a poster presentation scientific papers, work in a team, and pay Dr. Seymour Williams – SA- Resident at the 58th Annual Epidemic Intelligence attention to details. Advisor at [email protected] www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 7 Updates from the Field...

Training/Resources Leveraging resources and strengthening health systems through partnerships for IDSR and IHR (2005) Submitted by Dr. Helen Perry, DPHSWD

he Centers for Disease Control and Prevention’s (CDC) close Tcollaboration on the design, development, and implementation of Integrated Disease Surveillance and Response (IDSR) has developed strong Left to Right: Dr. Rudi Thetard, African Strategies for Health; Dr Helen Perry, IDSR Team Lead/CDC; Dr Peter Gaturuku, WHO-AFRO; Dr. Zebulon Yoti, WHO-AFRO; Dr Nathan Bakyaita, WHO-AFRO; Ms Victoria partnerships with the World Health Fort, ORISE Fellow; Ms Jenny Tegelvik, WHO/AFRO and USAID/EPT engaging in discussions about IDSR Organization’s Regional Office for Africa implementation in Africa. (WHO-AFRO) and the United States Agency for International Development (USAID). conference in Dar es Salaam, Tanzania, WHO-AFRO presented updates on IDSR IDSR is a strategy for strengthening the Division of Public Health Systems and IHR (2005) implementation from the national surveillance, laboratory, and and Workforce Development’s IDSR 46 African countries, and also included response systems that focus on the leading team collaborated with WHO-AFRO, The experiences with preparedness and causes of illness, death, and disability Stimson Center (a public policy institute), response to recent outbreaks in African in African countries. Activities for each and George Washington University to countries. These examples illustrated level of the system are designated for organize a workshop on “Partners and important challenges faced by countries disease detection, reporting, analysis, Frameworks for IDSR and IHR (2005) that not only need to strengthen their investigation, response, communication, Implementation”. The organizers invited public health workforce and infrastructure monitoring, evaluation, and preparedness. potential bilateral, multilateral, and capacities, but also adjust to the widening The IDSR framework also specifies African national partners with an interest in scope of public health events requiring a public health priorities including 40 IHR and IDSR implementation to share response due to environmental, industrial, priority diseases and conditions. These perspectives on sustainable investment and chronic disease causes. are diseases which are largely preventable in integrated disease surveillance and with well-known and efficacious responses. response, laboratory, and public health A national perspective on partner Through this collaboration we have workforce capabilities. The workshop was coordination for IDSR and IHR (2005) been successful in creating work plans, attended by surveillance officers, public implementation was given by the sharing financial resources and working health epidemiologists, and IHR focal Kenyan Ministry of Public Health and together as a multi-agency team. These points from several African countries. (MoPHS). A series of recent and other types of partnerships are vital Representatives of donor agencies and cholera outbreaks have occurred in to support countries in complying with disease specific programs from CDC, and Kenya and require a multi-sectoral the International Health Regulations (IHR) other organizations also participated. approach. To ensure effective use of (2005) requirements to improve core partner resources and linkages to capacities for surveillance, laboratory, Partners from the U.S. Department of Ministry goals and objectives, the and response. In the sub-Saharan region, Defense and U.S. Department of State MoPHS decided in 2011 to develop a WHO-AFRO, IHR (2005) core capacities are introduced their perspectives towards IHR strategic plan to improve coordination being met through the IDSR framework. (2005) implementation, and the Centers of partner expertise and resources. for Disease Control and Prevention shared During the joint planning exercise, more A recent workshop on implementation a brief history of its partnership activities than 20 national and external partners of IDSR and IHR (2005) illustrated how in African countries including technical identified and reviewed key activities partnerships are instrumental in meeting assistance, disease specific control and and grouped them into thematic areas IDSR and IHR (2005) requirements. For prevention programs, strengthening of of advocacy, resource mobilization example, in December 2011 during the 4th surveillance and response systems, and African Epidemiology Network (AFENET) applied epidemiology training programs. Continued on page 9 www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 8 Updates from the Field...

Training/Resources Sustainable Management Development Program Launches 2012 Webinar Series Submitted by Dacia Davis, DPHSWD

o support an online community of practice and provide continuing Teducation, the Division of Public Health Systems and Workforce Development’s Sustainable Management Development Program (SMDP) launched the 2012 webinar series with a session on Program Sustainability. In partnership with Washington University’s Center for Tobacco Policy Research in St. Louis, Missouri, SMDP was fortunate to have researcher Annaliese Calhoun facilitate the highly interactive session. Participants learned about a framework and tool for assessing sustainability, while sharing their own experiences. The sustainability framework was developed from a comprehensive literature review and expert-informed design. The assessment tool encompasses domains identified as The Program Sustainability Framework was created by Washington University’s Center for Tobacco essential to any public health program’s Policy Research. Throughout the year, SMDP will be featuring the different domains in its webinar series. sustainability. follow-up technical assistance via the SMDP When asked why SMDP chose to engage online community, hosted by TEPHINET. participants through this medium, Dr. Training Resources Elizabeth Howze, team lead for SMDP said, Coming in March: “How will Monday Leveraging resources “We are always looking for effective ways be different?” Stakeholders frequently continued from page 8 to leverage expertise and expand our recommend training as a solution to an reach, and we have found that webinars organization’s problem. It is not unusual for and coordination, laboratory, water are an engaging and cost-effective way to a training event to be announced before sanitation and , disease teach and learn. Through this and other a needs assessment is even conducted. prevention and health promotion, and upcoming webinars, in 90 minutes or less, In this session, participants will learn key disease outbreak preparedness and participants from around the world have questions to ask to better focus training response. The resulting 5-year plan is the opportunity to hear the best evidence and share experiences on conducting a organized around these thematic areas on program sustainability and other topics needs assessment that will lead course thus enabling the Ministry to improve and can interact with the facilitator and participants toward applying what they coordination of resources and coverage with each other to practice what they learned. The session is related to the of areas of highest risk for cholera. learn.” domain of Organizational Capacity in The examples shared during the the Washington University Sustainability SMDP plans regular webinars throughout workshop provided valuable insights Framework. the year, focusing on themes related to into how international and national the eight domains of the Sustainability For upcoming webinars, please visit the partners can work together on Framework, from the perspective of TEPHINET site for event announcements. common goals for improving disease management and leadership. surveillance, laboratory and response For questions or to suggest a webinar capacities that will improve the health Those who missed the webinar can view topic, please contact Denise Traicoff at and well-being of African communities. the archived version. SMDP is available for [email protected]. www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 9 Updates from the Field... Training/Resources Epi Info Software Training in Bamako, Mali Submitted by Sara Bedrosian CDC, Office of Surveillance, Epidemiology and Laboratory Services (OSELS)

n December 2011, public health officials in Bamako, Mali received training on CDC’s Ipublic domain statistical software for data analysis, Epi Info™ 3.5.3. Epidemiologists, doctors, chemists, biologists, and statisticians Roger Mir, CDC Computer Scientist (fourth from the left in the front row) and Gerald Jones, CDC IT received a comprehensive overview and Specialist (fourth from the left in the back row), both from OSELS/EAPO in Atlanta, GA, with participants hands-on training using Epi Info’s suite of in Mali who received the training on CDC’s public domain statistical software for epidemiology Epi Info™ tools. CDC’s Epidemiology and Analysis 3.5.3.participants from Mali. Program Office (EAPO) Staff members Info™ 7. The participants were impressed Have You Heard: Epi Info™ 7 is now conducted a five-day training that was by the Epi Info 7 feature that allows available for download! Epi Info 7 delivered in French and included lectures, Epi Info to support not only Microsoft provides rapid assessment of disease custom databases and Epi Map. Access databases but also MS SQL Server outbreaks; development of small databases. This feature enables concurrent Participants brought specific examples to mid-sized disease surveillance multi-user data entry and analysis while of their work to the training that were systems; ad hoc component integration still providing the flexibility to collect discussed at length. Topics included not with other large scale public health data on standalone machines. Roger Mir, only usage and best practices of the Epi Info information systems; and use as Computer Scientist with CDC, provided software but also data exchange practices continuous education of public health personal copies of Epi Info 7 and informed and interoperability of public health professionals. information tools. Epi Info will support the group that no administrative rights or the participants’ day-to-day activities and IT support is needed for setup. Epi Info 7 has a powerful new Visual Dashboard and gives the ability to improve aspects of their work, such as The CDC Epi Info team provides training visualize data on case-based cluster data quality and assurance, timeliness and to the Epi Info user community both maps (similar to Google maps), social completeness of reporting, data analysis, domestically and internationally at no network analysis graphs, create drag- visualization and presentation of data. fee. Epi Info training is available to both drop templates, have forms with more Spanish and French speakers. The Epi Info In addition, Gerald Jones, IT Specialist with than 255 fields, link records together to team also provides help desk support on CDC, presented the newly released Epi create exposure relationships or contact demand. tracing, and integrate Early Aberration Reporting System (EARS) algorithms.

Partnership Matters The Dar es Salaam Agenda for Action, Epi Info 7 is easily used in environments December 2011 continued from page 4 with limited resources, limited network connectivity, and limited IT support. 3. Action plan with budget: The Ministerial We hope that the Dar es Salaam Agenda Epi Info 7 is flexible and scalable, while Roundtable endorsed a 5-year action for Action will spread beyond the nine enabling data collection, advanced plan with a budget which will serve as ministries of health that signed it to all the statistical analyses, and geographic the principal advocacy tool used for 50 countries in the African Union. We also information system (GIS) mapping soliciting support from governments hope that this Agenda will lead to a decade capability similar to Google maps. Epi and partners. of FELTP development as a means to Info 7 can be downloaded and run 4. Mandate to AFENET: The Ministerial strengthen public health systems in Africa directly from a USB drive. Roundtable mandated AFENET for a healthier Africa. Download Epi Info 7 at www.cdc.gov/ to coordinate and monitor the Follow this link to read the Dar es Salaam epiinfo. For further information please implementation of African FELTPs in Agenda for Action: http://www.afenet.net/ contact Harold Collins at [email protected] addition to providing technical and new/images/stories/publications/dar-es- other assistance to countries with FELTPs. Salaam_Agenda_for_Action_signed.pdf www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 10 Updates from the Field... The goals of this initiative are to • Dr. Peter Nsubuga, who devoted 11 strengthen the capacity of national “What’s New?” years to developing and strengthening ministries of health to promote tobacco control policies and programs and to We Welcome: FETPs in the Africa region, has left the division to pursue other interests. We provide a multi-sector model for other • The Division’s Public Health Systems thank Peter for his commitment and NCD initiatives in SSA. Potential countries Strengthening Branch new Branch Chief dedication to the division and all the for consideration include those that have — Dr. Dennis Lenaway. Dennis comes to countries he worked with over the years. youth and adult data on tobacco use and the Division after working on key tobacco control measures. The • Andy Weathers shared this note: “When I strengthening domestic health systems following countries are scheduled to joined the Division in 2003, I worked with the Office of State, Tribal, Local, and implement the Global Adult Tobacco with Central Asia, Brazil and Kenya and Territorial Support (OSTLTS), and the Survey (GATS) in 2012-2014: Kenya, Southern Sudan. As with many things, Office of Surveillance, Epidemiology and Uganda, Nigeria, South Africa, and change is often necessary for growth. I Laboratory Services (OSELS). Cameroon. have been offered a position with the • Jacqueline Dudley, who joined FAETP in National Institute for Occupational Safety • The Bill and Melinda Gates Foundation January as a Management and Program and Health’s World Trade Center Health has provided funding to support the Analyst. Jacquie has worked at CDC for Program; one where I would be working Division’s efforts to assist in achieving 12 years and brings a variety of with the first responders of the 9/11/01 global polio eradication by decreasing experience from other federal agencies tragedy. I give my sincere thanks to all of the threat of polio virus importation and potential transmission in three key high as well. the people I have worked with over these risk countries in Africa by strengthening last several years and wish you all the best.” • Monique Tuyisenge-Onyegbula, has routine immunization and increasing the returned after maternity leave. Monique Publications: national capacity to detect and respond has a split appointment between SMDP • Rolle Italia V, Pearson M, Nsubuga P. to outbreaks of polio and other vaccine- and IDSR. Fifty-five years of international epidemic- preventable diseases. Ethiopia, Uganda, • James Ransom (JR) has joined the assistance investigations conducted by and South Sudan were chosen for this project based upon a history of re- Division as the Resident Advisor for FETP CDC’s disease detectives. Am J Epidemiol introduction, current risk designations in in South Sudan. Prior to joining CDC, JR 2011;174 (Suppl:S97–S112) was an epidemiologist with Doctors the polio risk assessment exercises, need • Volkov, B. B. (2011). Internal evaluation a Without Borders in Dadaab, Kenya, and for strengthening of the national quarter-century later: A conversation with immunization programs, presence of in Dawei, Myanmar. He has also served Arnold J. Love. In B. B. Volkov & M. E. Baron Field Epidemiology Training Program as the HIV/STI Research & Surveillance (Eds.), Internal evaluation in the 21st (FETP) or potential to join a regional FETP Specialist with the Ministry of Health in century. New Directions for Evaluation, 132, program, and feasibility. East Timor. He completed his graduate 5–12. studies at Antioch University and is Conferences: originally from Washington, DC. Speaking Engagements: • Nykiconia Preacely assisted with The • Denise Traicoff, SMDP, was the invited guest Programme for Advanced Research We Wish Them Well: speaker at the January 2012 meeting of the Epidemiology Training (APARET), in • Jim Vaughan was a International Society of Performance holding an Initiation Workshop for its Specialist with the FELTP program for Improvement (ISPI), Atlanta Chapter and first cohort of eight fellows from 9-20 many years. Before joining CDC, Jim spoke about SMDP’s work in this field by January 2012 in Kampala, Uganda. served eight years in the Air Force. Jim highlighting the development and During the workshop, residents retired from CDC in December 2011. deployment of their Management for (fellows), from Burkina Faso, Ghana, Improved Public Health online community Nigeria, Tanzania, Uganda, and • Hiari Imara-Jabbie was a Public Health of practice Denise described the three-year Zimbabwe, were introduced to their Advisor with FELTP Branch for 5 years. process of developing this online mentors. They also received knowledge She is now working with CDC’s Division community. In attendance were workforce and skills in project management, of . development professionals from business, clinical and epidemiological research, • Rebecca Moritz, who was with the FAETP nonprofit organizations and academic good clinical practice, ethics in Branch for the past 2 years, is now institutions. epidemiology, sample size computation, data collection, management and working in CDC’s Division of Viral Diseases. New Funding Partners: analysis, and report writing. • Elizabeth (Liz) Kim, worked with the • The Bloomberg Foundation has provided For more information please contact Global Public Health Informatics Program funding to support the Division’s initiatives Victoria Fort at [email protected] (GPHIP) for three years. Her last day with to strengthen national capacities for GPHIP was in January. tobacco control in sub-Saharan Africa (SSA). www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 11 Updates from the Field... • HIV Management 2012: The New York Course, 10 to 11 May 2012, New York, New York, United States, http:// Conferences/Events newyorkcourse.com Upcoming... • Environmental and Public Health (EPPH2012), Special Track • Fighting the Scourge of TB/HIV Co- within iCBBE2012 , 17 to 20 May 2012, Infection: Are Vaccine and Novel Shanghai, China, http://www.icbbe.org/ Diagnostics the Solution?, 3 March epph2012 2012, Munich, Germany, http://www. international-health.uni-muenchen.de/ • 12th World Congress on Environmental conferences_workshops/symposium_ Health: New Technologies, Healthy infect_immu/index.html Human Being and Environment, 21 to 27 May 2012, Vilnius, Lithuania, http://www. • Healthy People Conference - Healthy ifeh2012.org Aging, 6 to 7 March 2012, Loma Linda, California, http://www. • 2012 ISHEID: International Symposium healthypeopleconference.org on HIV & Emerging Infectious Diseases, 23 to 25 May 2012, Marseille, France, • NCDCV 2012-National Conference on • 12th Social Research Conference on HIV, http://www.isheid.com Exploring the Linkages between Drug Hepatitis C and Related Diseases-Theme: • Advances in Medicine 2012, 2 to 3 June Usage and Criminal Victimization, 8 to 10 Silence & Articulation, 12 to 13 April 2012, Hong Kong, Hong Kong, Hong March 2012, TIRUNELVELI, Tamil Nadu, 2012, Sydney, New South Wales (NSW), Kong, http://www.mect.cuhk.edu.hk/ India, http://www.ncdcv2012.edu.ms Australia, http://nchsrconference2012. AIM2012 • 5th International Online Medical Conference arts.unsw.edu.au/ • Turmoil and Tenacity: The Progress of (IOMC 2012), 3 to 11 March 2012, Online, • Disaster Resilient Communities, 17 to Public Health in Botswana, 3 to 12 June http://www.iomcworld.com/2012/ 18 April 2012, Melbourne, VIC, Australia, 2012, Gaborone, Botswana, http://www. http://innovativeem.com • The 8th International Symposium on ciee.org/ifds/seminars/botswana/index. Pneumococci and Pneumococcal Diseases, • The World Drug Safety Congress aspx 11 to 15 March 2012, Iguacu Falls, Brazil, Americas, 17 to 20 April 2012, Boston, • MedicReS World Congress GOOD http://www.kenes.com/isppd Boston, United States, http://www. MEDICAL RESEARCH, 6 to 9 June 2012, healthnetworkcommunications. • 28th Annual Scientific Conference and Vienna, Austria, http://www.ic2012. com/2012/world-drug-safety-congress/ General Meeting of the Association medicres.org of Public Health Physicians of Nigeria • 61st Annual Epidemic Intelligence • International Environment and Health (APHPN), 19 to 23 March 2012, Calabar, Service Conference, International Night, Conference (IEHC2012), 6 to 7 June 2012, Cross River State, Nigeria, http://www. Wednesday, April 18th, 2012 from 6-10 Penang, Malaysia, http://www.ppsk.usm. publichealthnigeria.com p.m., Crowne Plaza Ravinia, Atlanta, my/conference/ehc12.nsf/ • 15th World Conference on Tobacco or GA 30346, http://www.tephinet.org/ Health, 21 to 24 March 2012, Singapore, conferences • XXII World Congress: Global Wellbeing, 16 to 21 July 2012, Melbourne, Victoria, http://wctoh2012.org/ • e-Health Africa Conference 2012: Australia, http://ifhe2012.org • New Frontiers in Global Health Leadership; Integrating m-Health into e-Health Building Strong Health Systems to Respond Strategy Implementation, 18 to 19 April • XIX International AIDS Conference, 22 to Non-Communicable Diseases, 28 March 2012, Nairobi, Kenya, Kenya, http:// to 27 July 2012, Washington D.C, United 2012 to 1 April 2012, Tucson, AZ, United www.anadach.com/e-Health_Africa_ States, http://www.aids2012.org/ States, http://ghi.arizona.edu/news/2011/ Conference_2012.htm new-frontiers-global-health-leadership- • Global Forum 2012, 23 to 26 April 2012, building-strong-health-systems-respond- Cape Town, Western Cape, South Africa, non-commu http://www.forum2012.org Seeking Submissions… • 2012 3rd International Conference on • World Congress on Public Health, 23 to 27 Biotechnology and Food Science(ICBFS April 2012, Addis Ababa, Ethiopia, http:// If you would like your program to 2012), 7 to 8 April 2012, Bangkok, Thailand, wfpha.confex.com/wfpha/2012/cfp.cgi be featured in an upcoming issue of http://www.icbfs.org/ Updates from the Field, please send • - Methods and a 300-500 word summary of your • 20th International Conference on Health Challenges Conference, 24 to 26 April program’s activities and photos to Promoting Hospitals and Health Services, 2012, Birmingham, United Kingdom, Ruth Cooke Gibbs at [email protected]. 11 to 13 April 2012, Taipei, Taiwan, http:// http://www.populationhealthchallenges. www.hph2012.com/default.asp?page=10 com www.cdc.gov/globalhealth Updates from the Field: Spring 2012, Issue 6 12