The rise and fall of EPI INFO

For four decades, Epi Info™ has been a cornerstone tool in public health data collection and analysis. Developed and maintained by the U.S. Centers for Disease Control and Prevention (CDC), Epi Info empowered generations of field epidemiologists worldwide with an accessible, customizable, and cost-free software platform for outbreak investigation, surveillance, and program evaluation.

Origins and Purpose

Epi Info was first released in 1985, at a time when computing resources in public health were scarce. Written in Turbo Pascal, its initial goal was straightforward: provide epidemiologists with a portable, menu-driven program to design questionnaires, enter data, and perform rapid analysis—all without requiring programming skills. It quickly became a favorite among field epidemiology training programs (FETPs), ministries of health, and academic institutions.

Growth and Global Adoption

Throughout the 1990s, Epi Info evolved into a full-fledged DOS-based software suite. Versions 5 and 6 introduced features such as stratified analysis, cohort and case-control modules, mapping (via EpiMap), and nutrition assessment tools (EpiNut). Its flexibility and multilingual support made it an ideal choice for public health work in low-resource settings, and it was routinely bundled with FETP curricula.

By the early 2000s, Epi Info 2000 marked the transition to a Windows-based environment, aming at improved interfaces and relational database capabilities. However, this programme failed to deliver it’s promise and many users perceived this Windows experiment as a setback, compared to the versatile and reliable version 6.

Open Source Transformation

A major shift occurred in 2008 with the release of Epi Info™ 7, rebuilt in C#/.NET and made open-source. This allowed for integration with modern databases (MySQL, SQL Server) and paved the way for mobile, cloud, and web-based data capture. Epi Info’s modular architecture supported outbreak dashboards, spatial analysis, and advanced statistics like logistic regression—all without commercial licenses.

Field Utility and Training

Epi Info became deeply embedded in the global field epidemiology community. It was widely used in:

• Outbreak investigations: Rapid line-list analysis, epidemic curves, and risk factor analysis.

• Training: Incorporated into over 70 Field Epidemiology Training Programs (FETPs) globally.

• Routine surveillance: Customizable tools for district-level data capture and feedback.

Its low hardware requirements and ease of deployment made it indispensable during crises—ranging from Ebola to COVID-19—and in routine health system strengthening projects.

Sunsetting and Future Transition

In 2024, CDC announced the planned sunsetting of Epi Info. Downloads of the mobile apps and web components were phased out by February 2025, and official support ends on September 1, 2025. This decision aligns with CDC’s broader Data Modernization Initiative, redirecting resources toward cloud-native platforms, integrated data systems, and real-time interoperability across public health sectors.

While the desktop version of Epi Info 7 may continue functioning, no further updates, support, or official downloads will be provided.

A Critical Loss for Global Public Health Infrastructure

The sunsetting of Epi Info™, after nearly four decades of service, is more than a technical transition—it symbolizes a strategic retreat of the U.S. from its historic leadership role in global health intelligence.

Epi Info wasn’t just software. It was a public good—used in over 120 countries, embedded in dozens of Field Epidemiology Training Programs (FETPs), and provided for free by the CDC as part of the broader U.S. commitment to global disease surveillance capacity. Discontinuing support without offering a funded, interoperable alternative leaves a functional gap in many low- and middle-income countries.

Seen against the backdrop of:

• Decreased CDC global footprint, with the closure of overseas offices,
• Systematic underfunding and marginalization of USAID,
• Political attacks that undermined CDC’s domestic credibility during the COVID-19 pandemic, and
• Withdrawal from WHO partnerships under certain administrations,

…the Epi Info sunset signals an abrupt end to modernization, and feels like an abdication.

It’s especially troubling because the program was:

• Offline-capable (critical for remote or emergency settings),
• Localizable (available in many languages),
• Flexible (adopted into health information systems in fragile states),
• And above all: trusted.

Removing this tool without sustained transition support means many ministries of health, FETPs, and local health workers will be left with unfunded mandates to develop or adopt replacements—often under pressure from donors shifting toward cloud-first, commercial platforms, which may not meet field needs.