The frontline: Building the next generation of Africa’s epidemiologists

March 31, 2022

Dr. Hesborn Wao, Training Coordinator at the African Population and Health Research Center, unpacks the CDAE Fellowship and what it means for disease surveillance and evidence generation in Africa.

It is apt that this fellowship is established when the world is coming to terms with the new reality presented by the Pandemic. How did the idea of the Capacity Development of Applied Epidemiologists in Eastern Africa come about?

We became aware of the European & Development Countries Clinical Trials Partnership (EDCTP) call at a time when COVID-19 had just hit the world! In the midst of this confusion, we decided to respond to the call as we viewed it as an excellent opportunity to work with other institutions with which we had longed for partnership. The purpose of the Call was to establish an African cohort of epidemiologists by supporting institutions in sub-Saharan Africa (SSA) and Europe that provide master’s training in epidemiology and biostatistics, as part of the Africa CDC’s framework for public health workforce development. Master’s courses with practical field research experience was preferred as they are relatively short and likely to deliver the required numbers, and high-quality fit-for-purpose calibre of personnel that are urgently needed in epidemic zones of SSA. After several brainstorming meetings and proposal-drafting, we settled on the title, ‘Capacity Development of Applied Epidemiology (CDAE) project in Eastern Africa Region’, as it captured salient features of our idea.

It is a partnership of African Population and Health Research Center (APHRC), Amref International University (AMIU), Jaramogi Oginga Odinga University of Science and Technology (JOOUST) in Kenya and Lund University, Sweden. It seeks to establish a networked cohort of highly skilled epidemiologists and biostatisticians, able to work with National Public Health Institutes (NPIs) and National Ministry of Health (MoH) Departments to improve their level of in preparedness, field surveillance, and response to disease outbreaks within the Eastern Africa region.

What informed the decision to partner with these specific institutions, in Kenya and Sweden?

The choice of partner institutions was not difficult because we were aware of what the call required, our strengths, and what we were looking for in collaborating institutions. Based on our experience running fellowship programs such as CARTA and ADDRF, just to mention a few, our role would be to manage the project. All we needed were institutions that could serve as excellent training ground for the fellows. We leveraged the collaborations that were being initiated by then.

AMIU came to mind first as we were in the process of finalizing a Memorandum of Understanding between. We also reached out to JOOUST through one faculty member whom Dr. Florah Karimi had met during a Supervisor Training Workshop hosted by IUCEA in Tanzania. AMIU had just started a Master of Public Health program, whereas JOOUST had run the program a few years. Lund University was looped in through a prior collaboration between APHRC (led by myself) and Lund (led by Prof. Eva Brodin) on a Swedish Research Council (SRC)-funded pilot study. Eva’s role in the project was to strengthen the capacity of supervisors. Together, the institutions would deliver on complementing work packages as required by the Call.

Paint us a picture of what the next three years looks like for the fellows (speak about what they are expected to do, some of the key highlights, etc).

Through concerted effort of a committed selection committee, we identified 15 fellows (where eight would be hosted by AMIU and the other seven at JOOUST) out of a pool of 706 applications from across the Continent. The process of sifting through the application and coming up with a shortlist was a difficult task as there were a number of very strong candidates. To date, a total of US$ 177,179.64 has been disbursed to the Epi fellows and the participating institutions (Epi fellows – US$45,000; JOOUST – US$64,938.82; AMIU – US$67,240.82).

The next three years will be characterized by a number of activities including:

•1st semester (Jan-April 2022) – fellows report and classes begin, joint orientation, fellows begin working on their proposals.

•2nd semester (May-Aug 2022) – fellows continue working on their research proposals, virtual hosting of the Joint Seminar (JS) Module 1 (Advanced Research Methodology in Applied Epidemiology) by APHRC, fellows assigned supervisors, and fellows to prepare research ethics, data collection and thesis writing plans.

•3rd semester (Sept-Dec 2022) – fellows participate in the JS Module 2 (Integrated Disease Surveillance and Community-Based Disease Surveillance hosted physically by AMIU and first Supervisory workshop hosted physically by AMIU is conducted

•4th semester (Jan-Apr 2023) – fellows prepare and/or participate in research conference and prepare publication plans.

•5th semester (May-Aug 2023) – JS Module 3 (Applied Data Analysis and Statistical Modelling in Epidemiology) is hosted physically by JOOUST, second supervisory workshop hosted physically by JOOUST, fellow prepare and submit thesis.

  • 6th and final semester (July-Dec 2023) – fellows defend theses, JS Module 4 (Advocacy for Research Output) hosted physically by APHRC. The fellows are expected to graduate between March and June of 2024.

What is the role of capacity-building programs like CDAEEA and the existing and needed capacity for response to COVID-19, particularly on the African continent?

Many countries in SSA still do not possess the requisite core public health competencies- including epidemiology and biostatistics skills- to manage strategic surveillance and appropriately respond to disease outbreaks such as COVID-19.

The CDAE program is thus timely in that it aims to: 1) create a well-connected cohort of highly competent professionals with masters’ degree qualifications in epidemiology and/or biostatistics (EPI fellows); 2) strengthen the research and policy engagement capacity of EPI fellows through a mentored and practical learning programme; and 3) strengthen the training, research, supervision capacity within targeted universities for effective delivery and support of academic and professional programmes in epidemiology and biostatistics.  The EPI fellows are expected to collaborate with one another and with APHRC, drawing from individual and institutional strengths, so as to contribute to the pool of much-needed epidemiologists and biostatisticians in the region.

Parting shot?

The CDAE program could not have come at a better time, with COVID-19 is wreaking havoc across Africa and the world all over. With the pool of epidemiologists and biostatisticians being created, we expect that the region will be more armed to handle this Pandemic and others in the future.