Coordinating Office for Global Health - DGPHCD

The China Field Epidemiology Training Program

Background

Established in October 2001, the Chinese Field Epidemiology Training Program (C-FETP) aims to strengthen China´s disease surveillance, applied epidemiology and response capacity for its 1.3 billion people. At the request of the China CDC, CDC’s Division of Global Public Health Capacity Development sent a senior consultant epidemiologist to Beijing to help develop the program during its critical formative years, and to provide high-priority technical assistance.

C-FETP is using as one of its models CDC´s Epidemic Intelligence Service (EIS) to respond to China´s unique public health strengths, challenges, and priorities. A key advantage of the EIS model is providing essential "service-in-training" while strengthening a country´s capacity and constituency for disease surveillance, applied epidemiology, and response. The wide variety of field investigations and other projects that C-FETP officers perform during their 2-year program provides decision-makers and other key constituencies with the highest quality recommendations and information to help guide public health policy and practice.

• China Ministry of Health, provincial and municipal CDC´s (currently, Anhui, Chongqing, Zhejiang, Fuijian, Guangdong, Jiangsu, Shangdong, Sichuan, and Shanghai)
• WHO China
• Global AIDS Program
• Other CDC programs

The primary objective of the C-FETP is to develop China´s disease surveillance, field epidemiology, and response capacity by training a network of field epidemiologists competent in the practical application of epidemiologic methods to a wide range of public health problems, including emerging infectious diseases. CDC is providing assistance by assigning an experienced field epidemiologist/ Resident Advisor to help guide field activities along with the C-FETP national director, developing training materials, teaching and mentoring C-FETP officers, and providing expert consultation on special epidemiologic issues.

The C-FETP has performed scores of outbreak investigations since its establishment in 2001, including high profile surveillance, investigation, prevention, and control activities for SARS, avian flu, and other high priority conditions. It is being increasingly recognized as an important international partner in disease surveillance and investigation, was selected to host the 2004 TEPHINET scientific conference, a consortium of more than 30 applied epidemiology training programs worldwide. In April, 2005, two C-FETP abstracts describing adenovirus and paratyphoid outbreak investigations were accepted for presentation (from more than a hundred submitted) at CDC´s EIS Conference International night. The latter, A large outbreak of waterborne paratyphoid fever attributed to a contaminated well in a rural junior high school ­ Guangxi Province, China, won the prestigious William Foege award for best presentation by a developing country. C-FETP continues to play an increasingly important role in strengthening China´s disease surveillance and outbreak investigation functions and responding to the evolving needs and interests of the China CDC. Thus, C-FETP has recently undertaken two key activities to strengthen capacity in those areas: establishing annual training of mentors and supervisors to meet the expanding demands of training greater numbers of C-FETP officers and field epidemiologists; and providing CDC experts to assess China´s public health laboratory capacity and recommend how to better respond to infectious disease outbreaks and other priorities. As of 2006, the C-FETP has graduated over 40 epidemiologists who have been placed in key field epidemiology positions throughout China.

A key C-FETP goal is to develop a strong, sustainable infrastructure of applied epidemiologists and mentors nationwide by 2008 (projected departure date for the CDC resident advisor). C-FETP currently has three full-time (director, administrator, assistant) staff, as well as US CDC´s resident advisor to train and supervise the current (two) C-FETP cohorts of 27 officers. To increase staff capacity and program sustainability, C-FETP is recruiting its best graduates (and also in the process of hiring two as staff in Beijing) to serve as mentors and field supervisors for incoming C-FETP officers, and also conducting mentoring workshops to assist C-FETP graduates and other staff better supervise C-FETP officers in over 9 participating provincial CDC´s. Also, there are plans to post a 2nd epidemiologist to assist the resident advisor and C-FETP director train new classes of officers. By thus increasing capacity and constituency in the provincial and local CDC´s, C-FETP continues to build interest in and support for the program nationwide, including hosting C-FETP officers at local and provincial CDC´s.

Other C-FETP priorities include assisting the C-CDC director improve the quality of outbreak investigations and response, and integration of epidemiology and laboratory support for these activities (including a recent US CDC assessment of China´s public health lab capacity and recommendations for strengthening its structure and function).

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