The Indispensable Role of Field Epidemiologists in Public Health
In an age characterized by the rapid spread of diseases and complex health emergencies, the significance of field epidemiologists cannot be overstated. Acting as the world’s “disease detectives,” they are at the forefront of public health, contributing to the early detection, control, and management of both communicable and non-communicable diseases. This article delves into the multifaceted role of field epidemiologists and underscores their importance in safeguarding global health.
The Frontline Warriors: COVID-19 and Beyond
As the COVID-19 pandemic has swept the globe, field epidemiologists have been pivotal in containment and management efforts. They have been involved in contact tracing, case investigations, community engagement, data collection and analysis, and much more. All pandemics, including COVID-19, begin as localized outbreaks, making field epidemiologists critical assets for early detection and control at the community level.
The Pillars of Public Health
Field epidemiologists contribute to every pillar of public health, from coordination and surveillance to operations. They are equipped with the skills to navigate a broad array of health challenges and establish sustainable surveillance systems. These capabilities are not only vital in immediate responses but also instrumental in preventing future health emergencies.
Driving Improvements in Health Systems
Studies and investigations led by field epidemiologists often result in substantial improvements in public health service delivery. Whether it’s optimizing sanitation systems or boosting vaccination coverage, their work serves as the empirical backbone for targeted interventions and policy decisions.
Evidence-Based Impact on Public Health Policies
Around the globe, field epidemiologists advance scientific understanding that informs and strengthens public health policies. Their grassroots-level knowledge and experience enable them to provide decision-makers with the information required to craft effective health interventions and programs.
One Health Paradigm
Field epidemiologists increasingly operate under the One Health framework, addressing health issues at the intersection of humans, animals, and the environment. This holistic approach allows them to respond effectively to a wide range of health issues, including those affecting vulnerable populations in conflict zones and humanitarian emergencies.
Vital Role in Animal Health
The importance of veterinary field epidemiologists has grown in response to the increasing number of zoonotic disease outbreaks. Approximately 60 to 70% of emerging infectious diseases in humans originate from animals. Veterinary field epidemiologists are critical for identifying and controlling these diseases, such as rabies and avian influenza, which can lead to substantial health and socioeconomic emergencies.
Building Multisectoral Capacity
There is a pressing need to enhance the capabilities of animal and environmental health sectors in the field of epidemiology. Animal health is not only vital for addressing zoonotic diseases but also crucial for food security, livelihoods, and economic stability.
One more thing: “Field” epidemiology??
In this article, you have read many different terms referring to the same thing. Just like epidemiological indicators may have different names in various countries (try translating the concept of “attack rate” in some languages), it is the same for “Field Epidemiology”. Francophone countries translate it literally (epidemiologie de terrain), others call it “Applied Epidemiology” (Germany, Australia), “Intervention Epidemiology”, “Consequential Epidemiology”, or even “Shoeleather Epidemiology”, to indicate that this area of epidemiology is primarily aimed at public health action (intervention, immediate collective measures). In the context of this article, they all mean the same thing: Generating scientifically valid evidence for public health action.
Conclusion
Field epidemiology serves as the backbone of public health, providing the evidence needed to drive impactful interventions. Whether investigating localized outbreaks or participating in the containment of global pandemics, field epidemiologists’ contributions are invaluable in shaping health policies and preparedness. Investing in the training and deployment of field epidemiologists, across both human and animal health sectors, will undeniably lead to stronger, more resilient public health systems worldwide.
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From One Idea to a Global Network
A visual journey through 70+ years of field epidemiology training around the world:
From One Idea to a Global Network: The Evolution and Impact of Field Epidemiology Training
In 1951, a simple but powerful idea took root at the U.S. Centers for Disease Control and Prevention (CDC): to train epidemiologists who could go into the field and investigate outbreaks at their source. That idea gave birth to the Epidemic Intelligence Service (EIS), the first Field Epidemiology Training Program (FETP), which laid the foundation for what would become a global network of disease detectives(1). Seven decades later, the legacy of that idea is seen in more than 80 countries, through interconnected Field Epidemiology (and Laboratory) Training Programs – FE(L)TPs. Together with regional FETP networks and thousands of alumni, this body of disease detectives forms a surge-ready global health workforce (2).
EIS: The Blueprint
The EIS was designed to be practical, hands-on, and responsive to public health threats. Its fellows, often called “disease detectives,” were deployed to investigate infectious disease outbreaks, environmental hazards, and bioterrorism events. Many public health leaders, including CDC directors and WHO staff, were trained through EIS (3). It established a model of learning by doing, with real-time service embedded in the training structure. The strength of EIS lies not only in its technical rigor but in its emphasis on mentorship, communication, and rapid deployment—a triad that remains central to all subsequent FETPs.
Using the EIS blueprint, countries started to copy this model. Canada was the first country outside the US to set up a national FETP in 1975, while Thailand set up the first Asian national programme in 1980. In the Western Pacific, the Master of Applied Epidemiology (MAE) program at the Australian National University was launched in 1991 as Australia’s national FETP. Over 30 years later, it remains one of the few programs to award a full academic degree in field epidemiology. By now, MAE has trained over 200 professionals and supported outbreak responses across the Asia-Pacific region. Its emphasis on Indigenous public health, regional deployment, and rigorous field placement exemplifies how national FETPs can strengthen both domestic and international health resilience (4). From that moment on, the FETPs developed rapidly; Colombia in 1992 as the first Latin American national FETP and Egypt in 1993 with the first national FETP on the African continent.
EPIET and the European Expansion
In 1995, the European Programme for Intervention Epidemiology Training (EPIET) was established as the first full regional FETP, with funding from the European Commission, and coordinated by a Steering Committee representing the Member States. The programme spawned national FETPs in EU Member States, sharing the same training modules, but training in their own country. Together with these EPIET-associated programs, EPIET was truly a programme for the states, by the states (5).
Later, it was coordinated through the new European Centre for Disease Prevention and Control (ECDC), which was established in 2005, composed mainly of EPIET Alumni, Supervisors, and Scientific Coordinators. In fact, ECDC itself can be considered a visible demonstration of the capacity-building power of EPIET and its associated programs.
EPIET’s hallmark was its EU-track approach: fellows trained outside their home country, fostering cross-border collaboration and harmonisation of outbreak response across Member States. To support countries that struggled to retain EU-trained fellows, EPIET launched a Member State Track, offering tailored capacity building to Ministries of Health and national institutes. In 2008, the launch of EUPHEM (European Programme for Public Health Microbiology Training) mirrored the EPIET model, focusing on laboratory-based outbreak detection and response. Together, these tracks formed the backbone of the EU’s field epidemiology and microbiology training ecosystem.
A Global Surge Capacity
One of the greatest strengths of FETPs is their dual role: building capacity during peacetime and providing surge capacity in crises. Fellows participate in real-world service placements, and alumni return to the public health workforce. This setup means that when emergencies arise, fellows can be assigned to national outbreak response teams, while alumni are already integrated into ministries, laboratories, and surveillance systems. Having two concurrent cohorts allows programs to reassign fellows to urgent tasks without stopping training entirely. During outbreaks of COVID-19, Ebola, and cholera, this model proved to be invaluable (6).
The Global Landscape
Following the EIS and EPIET models, national and regional programs emerged worldwide:
CFEP (Canada Field Epidemiology Program) was launched in 1975, becoming the first FETP established outside the U.S.
Thai FETP (1980) was the first Asian FETP, established with CDC support and hosted by Thailand’s Ministry of Public Health.
Tephinet, founded in 1997, became the first global FETP network, facilitating coordination, accreditation, and peer learning.
- EAN (EPIET Alumni Network) was created in 2000, representing the first regional FETP alumni association, supporting collaboration, continuous professional development, and response mobilization.
AFENET (Africa Field Epidemiology Network) and EMPHNET (Eastern Mediterranean Public Health Network) became critical regional hubs for training, mentorship, and deployment coordination.
- Pakistan FELTP (2006) introduced One Health approaches after the H5N1 outbreak and formally included military medical officers.
SAFETYNET (2009) (Southeastern Asia Field Epidemiology and Technology Network) linked Thailand, Vietnam, Malaysia, and others in Southeast Asia.
MediPIET (2013) (Mediterranean Programme for Intervention Epidemiology Training) covered the MENA region under EU coordination.
Programs in Egypt, Iraq, Colombia, Jordan, India, Vietnam, and Singapore have achieved national impact, training hundreds of professionals who now lead surveillance and outbreak response.
In 2015, the global roll-out of FETP-Frontline offered 3-month rapid training for district-level staff, while the Global Field Epidemiology Partnership (GFEP) launched in 2023 to coordinate efforts at the international level.
Why It Still Matters
In an era of pandemics, climate-related health threats, and complex emergencies, FETPs offer more than training: they represent an enduring investment in resilience. No software platform, AI model, or remote sensing system can replace a well-trained local field epidemiologist who knows the health system, understands the community, and can act immediately. FETPs offer a scalable, cost-effective way to strengthen core public health functions while maintaining a reserve of surge-ready professionals who can be rapidly mobilized.
From a single idea at CDC in 1951 to a global network today, the evolution of FETP is not just a success story—it is a strategic imperative for 21st-century health security.
References
(1) Langmuir AD. The Epidemic Intelligence Service of the Center for Disease Control. Public Health Rep. 1980 Sep-Oct;95(5):470-7. PMID: 6106957; PMCID: PMC1422746.
(3) Stephen B. Thacker, Andrew L. Dannenberg, Douglas H. Hamilton, Epidemic Intelligence Service of the Centers for Disease Control and Prevention: 50 Years of Training and Service in Applied Epidemiology, American Journal of Epidemiology, Volume 154, Issue 11, 1 December 2001, Pages 985–992, https://doi.org/10.1093/aje/154.11.985
(4) Davis, Stephanie, et al. “The Australian Master of Applied Epidemiology program: looking back, moving forward.” Communicable Diseases Intelligence 40 (2016): 326-333.
(5) Bosman A, Schimmer B, Coulombier D. Contribution of EPIET to public health workforce in the EU, 1995-2008. Euro Surveill. 2009;14(43):pii=19381. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19381
(6) Field Epidemiology Training Programs to accelerate public health workforce development and global health security. Martin, Rebecca et al. International Journal of Infectious Diseases, Volume 110, S3 – S5