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
Epidemiologist
Global Epidemiology Fellow | PHI/CDC Global Health Fellowship Program

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African Field Epidemiology Network: My Experience Attending the 2018 AFENET Conference in Maputo, Mozambique

I attended the African Field Epidemiology Network (AFENET) from November 12th-16th in Maputo, Mozambique. It was a great opportunity to hear about the on-the-ground public health work being conducted in 31 countries on the African continent and efforts being made to build field epidemiology capacity. The theme of the conference was, “Building Resilient and Sustainable Public Health Systems in Africa Through Field Epidemiology Training.” My first session to participate in was the preconference workshop, “Orientation to International Outbreak Response with WHO and Global Outbreak Alert and Response Network (GOARN) in the African Region.” Participants spent a full day learning about how to become involved in international public health deployments through the AFENET network, working through complex exercises in groups, and assessing our individual readiness to deploy if needed. Attendees from Zambia, Guinea, Cameroon, Nigeria, Uganda, and many other countries were represented at this session.

There were also great plenary sessions. My top three sessions (of those I had the opportunity to attend) included: 1) Implementation Science in Public Health (presentation given by Dr. Echezona Ezeanolue), 2) Transforming Public Health Surveillance – Proactive Measures for Prevention Detection and Response (presentation given by Dr. Scott JN McNabb), and 3) North-South Collaboration for Public Health Workforce Development: The Case of Washington University & University of Zimbabwe (Dr. Janet Baseman, Dr. Notion Gombe and Audrey Hu). All of these sessions either resonated with me or challenged me to think outside the box to take needed risks as a public health professional.

Now, the real reason I had the opportunity to attend the AFENET conference was to provide support and technical assistance to the Zambia Field Epidemiology Training Program (Zambia FETP). Zambia FETP had 6 residents present a mixture of poster and oral presentations over the course of 5 days. Our residents shined not only in the scientific sessions but also when it came time to share about the nation of Zambia during the International Night that was held towards the end of the week. Overall, I learned that providing support also meant helping showcase a popular Zambian dance, assisting with handing out small gifts and pamphlets to colleagues from other countries, and participating in insightful conversations about what true mentorship looks like.

Some highlights of the conference included catching up with two of my fellow PHI/CDC Global Health Fellows, having breakfast with my mentor, being near the beach, building relationships with our residents, meeting our points of contacts from CDC Atlanta, connecting with the Nigerian FETP and, of course, networking with a diverse array of public health leaders from the African continent. There were a few challenges as well. I was sick for the first few days of the conference. There were many hiccups that occurred prior to the conference which led to me only being able to attend last minute. Finally, the theme of the conference made me reflect on gaps I see in epidemiology capacity when I consider situations like the current Ebola outbreak in the Democratic Republic of the Congo (DRC) and wonder what, if any, impact I may be able to make during my time here.

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

 

International Infection Prevention Week: Snapshot from the Field

 

During the last two weeks of September, I had the opportunity to participate in a week-long surveillance training and a week-long Ebola/Cholera Preparedness Training, respectively. Here at the CDC Zambia office I work with the Field Epidemiology Training Program. Our goal is to provide technical assistance and expertise in order to build local epidemiology capacity in Zambia. The surveillance training we conducted was geared towards surveillance officers that work in various districts throughout Zambia. These officers are accepted into a Frontline program as residents and trained on the public health surveillance cycle over the course of 3 months. The training is both classroom learning and hands-on application as residents are given projects that take them through the surveillance cycle and provide them with an opportunity to explore the data in their jurisdictions. My role during this first training was to lead excel trainings and assist with daily pre and post tests. I enjoyed the surveillance workshop so much that I feel a similar curriculum should be provided to all entry-level epidemiologists working in governmental public health in the states.

The Ebola/Cholera Preparedness Training was very intense. It was a collaboration between CDC Zambia, WHO, Zambia National Public Health Institute, local universities, and the Ministry of Health. Lectures and hands-on training were incorporated into this workshop as well. The participants consisted of surveillance officers, environmental health technicians, laboratory specialists, and health directors from various districts. These individuals make up a newly developed rapid response team that is being built in Zambia. During the Ebola preparedness portion of the training, participants were trained on triage, wearing proper PPE, lab specimen packing/shipping, setting up a treatment center, and transporting ill patients. The cholera preparedness portion consisted of a discussion about what went well and what didn’t go so well during last year’s cholera outbreak that lasted ~8 months. Participants walked through the process of investigating an outbreak and creating products such as epi curves and line lists. I could see the light bulbs going off for many people as they realized how efficient this was for ensuring data quality and tracking cases. Lightbulbs also went off during discussions about how to appropriately use the Incident Command System. My duties consisted of helping in the triage station, acting out scenarios, and helping with pre and post tests. Participants are now tasked with going back to their jurisdictions to train others.

Some interesting things to note is that we have built in “tea times” where you can take a coffee or tea break and grab a snack, someone is also asked to pray at the beginning and end of the day, and there are usually lengthy delays when it comes to gathering large groups together for training/workshops (but things come together at the end).

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

 

 

 

Health in All Policies Faculty Development Workshop-June 18-20 in Washington, DC

The World Health Organization (WHO) in collaboration with the Association of Schools and Programs of Public Health (ASPPH) and the National Environmental Health Association (NEHA) invites you to attend a Health in All Policies (HiAP) skill-building workshop from June 18-20 in Washington, DC to build education/training and practice approaches that move policy in support of both health and the environment. Air pollution will be used to provide case examples throughout the workshop.

The deadline for applications is April 25, 2018. To apply online, please visit the ASPPH page here. The WHO site provides more background here.

 

National Public Health Week is Here!

National Public Health Week (NPHW) is a great opportunity for public health professionals to rally together and raise awareness about work that is being carried out around the nation. NPHW will take place from April 2nd to April 6th this year. It specifically highlights, “Generation Public Health,” a movement focused on creating the healthiest nation in one generation by supporting initiatives and policies that improve social and environmental factors which impact health. No matter what stage you are at in your public health career, you can get involved this week!

The theme of NPHW 2018 is Changing Our Future together. The key focus is to:

Additionally, daily themes will be highlighted in order to focus on one public health topic a day.

 

 

Ways To Get Involved

 

Feel free to also highlight and share social media posts of events that are being held in local neighborhoods, schools, workplaces, and public health organizations near you! Make sure to include the following hashtags with your pictures and social media posts: #NPHW, #1BillionSteps, @ih_section, #ih_section!

 

NPHW 2018: Healthiest Nation Poem/Song

We want to be the healthiest nation
in one generation
for communities to have a solid foundation
where safety is the norm and we can all be free
to live life to the fullest and pursue our dreams
as we breathe clean air while we sleep, work, and play
our youth go to school and graduate
Our jobs lead to wealth, health, and have meaning
but there are services in place “for the time being” 
when we reach those moments that we fall through the cracks
or fall on hard times and it’s hard to come back
our nation truly practices justice for all
communities are well informed to sound the call
for various needs like fresh water and meals
or access to sidewalks for bicycle wheels
healthcare and prevention go hand in hand
so that unhealthy practices have low demand
Yes, the healthiest nation 
is what we aim to be 
in one generation is when we hope to see
public health infrastructure and improved capacity
to truly serve our nation and support communities

Listen here: https://soundcloud.com/sophianyatonwu/nphw-healthiest-nation

Sophia Anyatonwu, MPH, CPH, CIC
Epidemiologist II