High-Level Perspectives for this Epidemiologist: Exploring Global Disease Control Policies and Strategies

I just returned from participating in a Disease Control Strategies and Policies short course at the University of Heidelberg’s Institute of Global Health. It was a great opportunity for me to spend some time learning about high-level disease control and prevention efforts that have been made on a global scale to tackle communicable and non-communicable diseases. Additionally, it was a different experience for me to have to take a step back and reflect on the amount of work and time that is required to build public health infrastructure, strengthen health systems, and empower communities across the globe. At times, I have to admit, I was a bit discouraged as I listened to how easily politics, corruption, misinformation, poor communication, and a lack of cultural awareness can so easily reverse significant progress that has been made toward eradicating high-impact diseases. Overall, however, I came away with a deep understanding that there will always be work that needs to be done by versatile public health professionals. I would recommend this course to passionate individuals who are considering leadership roles in global health or have been practicing full-time in the field of public health (or at least a health-related field) for at least 3 years.

It was very stimulating to participate in this course with professionals from all over the world. One thing that was especially satisfying was that many participants were able to speak about how public health (we also had some pharmaceutical and economics/policy development perspectives) is practiced in their specific countries/regions. I found myself constantly learning as I compared and contemplated how different interventions mentioned by my peers could (or could not) be applied to my setting- I even gained better perspective on some of the public health activities that are undertaken and sustained even though they don’t appear to be very effective at preventing or limiting disease. Of course, I took time to acknowledge the different cultural and political factors that come into play and influence public health policies in different countries. Something I did not expect was that I would have the opportunity to represent the U.S., Texas (the state I worked in as an epidemiologist before taking my fellow position), and Zambia (a little knowledge goes a long way) on various topics. There were 3 or 4 of our lecturers that are doing work in Zambia so I also had the opportunity to learn more about their projects and see whether or not they were connected to any of the partners that our CDC office works with.

On to the highlights! My favorite part of this course was an interactive lecture where we got to role play that we were members of the WHO Strategic Advisory Group of Experts (SAGE) on Immunization deciding why we should or should not recommend a Dengue vaccine (there was also a group that had to role play being a country that had to decide on whether to introduce the vaccine). Dr. Annelies Wilder-Smith (WHO Advisor and Consultant) led the activity. This vaccine had caused many political, social, and public health challenges in the Philippines that made my jaw drop and emphasized how delicate public health support from the public is (especially during an election year). Ultimately, we learned that there are many different factors that are considered before a vaccine is recommended for public health use and that ministries of health have to use all available information to choose whether or not to introduce certain vaccines into their communities. The process we went through was very full-circle for me because it answered questions that I have had about where to find the most comprehensive information on public health vaccines so that I can serve as a better resource to those in my spheres of influence. Another assignment we had was to give presentations on Hepatitis A, B, C, and E. In my group, I focused on the epidemiology and global burden of Hepatitis E. This was an interesting topic for me because I had started seeing a few Hepatitis E lab reports being submitted to the health department I worked at in Texas. As a result of this assignment, I learned that the risk factors differ between developed vs. developing countries (undercooked meat consumptions vs poor sanitation) and that there are also different genotypes seen in developing vs. developed countries. Our last main assignment was to choose a prompt to write an essay on. I debated between The large Ebola outbreak in West Africa has been controlled by an effective vaccine and The HIV/AIDS pandemic will be ended by 2030. I was tempted to write on the first topic but then I decided that, since the majority of my office focuses on HIV (and my current role focuses on other diseases), this would be a great opportunity to better understand the work that they do. I was not disappointed! Overall, I concluded that the HIV/AIDS pandemic will not end by 2030 because, even though there is knowledge about how to protect against HIV and an effective treatment exists, cases continue to increase by millions each year. Additionally, men are underrepresented in the data and there are many community-level interventions that need to be implemented in diverse cultural settings (particularly in sub-Saharan Africa) in order to see the 90-90-90 goals reached by 2030.

Other lectures that stood out to me included presentations on Tobacco Control (Presented by Dr. Volker Winkler), Vector Control/Control of Arboviruses (Presented by Dr. Norbert Becker and Dr. Annelies Wilder-Smith, respectively), Global Diabetes Control (Presented by Dr. Florian Neuhann), and an exercise focused on ranking an individual’s risk of getting infected with Ebola virus based on varying exposures to an Ebola Virus Disease patient (Presented/Facilitated by Dr. Sabine Geis).

I thoroughly enjoyed my experience and hope that I can attend another course in the future! Feel free to see if there are some courses you may be interested in as well
Short Courses at Heidelberg Institute of Global Health!

Sophia Anyatonwu, MPH, CPH, CIC
Global Epidemiology Fellow | PHI/CDC Global Health Fellowship Program

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