By Dr Oladipo Ogunbode
More than ever, competent field epidemiologists are needed worldwide.
This is largely driven by the occurrence of emerging and re-emerging infectious diseases, increasing burden of non-communicable diseases, antimicrobial resistance, and other public health threats.
For 12 years, the Nigeria Field Epidemiology Training Programme (NFETP) has developed field epidemiologic capacity to rapidly detect, respond to, and contain public health emergencies for Nigeria’s health security.Initially established and financed by the US Centers for Disease Control, the NFETP is now coordinated by the Nigeria Centre for Disease Control (NCDC) as mandated by the NCDC Establishment Act of 2018.
In this role, NCDC receives additional support from the US-CDC, World Bank and other partners for the implementation of the NFETP.
The programme trains health workers at frontline, intermediate and advanced levels who are provided with the skills to become disease detectives.
Although little may be known about the NFETP, their contribution to health security and public health activities in Nigeria is substantial.
So far, over 300 field epidemiologists have been trained through NFETP, and have responded to over 300 disease outbreaks. Perhaps an important example is the role NFETP played in the response to the 2014 West African Ebola outbreak in Nigeria and in supporting other West African countries.
The programme trainees were responsible for outbreak investigation, contact tracing, development and operationalisaton of disease surveillance systems among others.
More recently, NFETP trainees have played key roles in Nigeria’s response to the COVID-19 pandemic including leading Public Health Emergency Operations Centres (PHEOC) at national and state level, coordinating the establishment of public health laboratories, supporting port health response activities, risk communications among others.
In between large outbreaks and pandemics, NFETP trainees contribute to the continuous development of public health systems and capabilities across Local Governments, states, and national levels.
For decades, NFETP trainees supported government’s efforts that led to the elimination of polio in Nigeria through the National Stop Transmission of Polioprogramme.
They have also led the design and implementation of population-based serosurveys including the National HIV/AIDS Indicator Impact Survey in 2019, COVID-19 serosurvey in 2020 and 2021 among others.
Across Ministries of Health, disease control programmes and other public health agencies, NFETP trainees are contributing to stronger health security. In the last two years, NCDC has begun the implementation of activities to strengthen the NFETP.
Prior to 2020, Nigeria had never implemented the intermediate arm of the programme targeted at mid-career health workers with public health roles.
In 2020, the first cohort of the Intermediate began with 15 trainees from Health and Agriculture Ministries, Departments and Agencies across the country.
In addition, the frontline programme was implemented for two years, training disease surveillance and notification officers across 17 states in Nigeria. However, given several parallel similar programmes, a decision was taken to expand and adapt the curriculum to the Nigerian context and a new programme – the Integrated Training for Surveillance officers in Nigeria (ITSON) was developed.
ITSON synthesises various similar training programmes developed by global health institutions for more effective training for Nigerian health workers.
As known, new, and resurgent communicable diseases increase their global impact, the role of field epidemiologists cannot be over-emphasised.
Field epidemiologists are needed to understand why diseases occur, where they happen and develop interventions to prevent, detect and respond. Nigeria’s FETP graduates have continued to rise to positions of leadership where they contribute further to public health.
By training competent epidemiologists to manage public health events locally and support public health systems nationally, health security is enhanced.
The commemoration of the first World Field Epidemiology Day (WFED) on 7th September 2021 provides an opportunity to celebrate the accomplishments of Nigeria’s field epidemiology trainees and the contribution of NFETP to national and global health security. It also provides an opportunity to emphasise the need for continued support and investments for NCDC, as the agency coordinates the implementation of the NFETP.
The knowledge, skills and expertise of NFETP trainees are critical for national and global health security.
The ratio of field epidemiologists per population in Nigeria is 3 per 1 million, far from the global target of at least one trained epidemiologist per 200,000 people in every country. The NCDC remains committed to implementing interventions that enable further expansion of NFETP, and better utilisation of trainees.
In this age of globalisation, emergence of new disease pathogens, occurrence of large outbreaks and pandemics and the increasing global effects of known diseases, qualified field epidemiologists are needed more than ever.
This starts with increased support for the Nigeria Field Epidemiology Training Programme.
Dr Oladipo Ogunbode, Assistant Director and NFETP (Nigeria Field Epidemiology Training Programme) Coordinator at NCDC writes from Abuja.