CDC, TEPHINET, and Partners Foster Knowledge Exchange to Build Global FETP Capacity to Fight Noncommunicable Diseases

According to the World Health Organization, noncommunicable diseases (NCDs) kill 41 million people each year and account for nearly three-fourths of all deaths. The majority of NCD-related deaths result from cardiovascular diseases (CVDs) including heart disease and stroke. More than three-fourths of global NCD deaths occur among people living in low- and middle-income countries. In order to fight the growing burden of NCDs, the Centers for Disease Control and Prevention (CDC) Global NCD Branch, or GNCDB, is collaborating with TEPHINET and other partners to integrate NCDs into the core Field Epidemiology Training Program (FETP) curriculum. Through increased training, technical assistance, and collaboration, FETPs will be better equipped to strengthen NCD (particularly CVD) field epidemiology and surveillance capacity in low- and middle-income countries.

Most FETP-trained field epidemiologists are well-trained in infectious diseases, but they are not prepared to address NCDs, due to, in part, a lack of training opportunities. Establishing an FETP-NCD field epidemiology track can expand their skills to generate and use data to inform NCD prevention and control. 

“State NCD programs generate a lot of data that are rarely analyzed,” says Dr. Rontgen Saigal, an FETP resident in India. “Using knowledge and skills acquired in the FETP NCD training, I analyze my state’s NCD data on at least a monthly basis to identify program challenges and provide feedback on improving the program to all of the stakeholders.”

With funding from Bloomberg Philanthropies and Resolve to Save Lives via a grant to the CDC Foundation, GNCDB has established NCD tracks in the advanced (two-year) FETPs in China, Ethiopia, India, and Thailand, focusing on CVD risk factors such as hypertension. The NCD track facilitates delivery of interactive CVD-specific training and provision of specific knowledge and tools such as case studies to reinforce learning and knowledge retention. Forty-one (41) FETP residents are currently being trained in these tracks.

“My previous epidemiology training was more focused on theory and did not include much practical experience,” says Dr. Ashish Krishna, an FETP resident in India. “But this NCD field epidemiology training program is giving more focus on the practical applications, giving me more hands-on experience, allowing us to practice skills needed for NCD field epidemiology. So, this is a very wonderful kind of experience that I am getting.”

GNCDB hosts technical exchanges to encourage cross-country collaboration and learn what is working well and what needs improvement. The first technical exchanges took place in person in India in 2019 and targeted FETP officials and mentors. Since in-person travel was not a possibility this year, GNCDB decided to be innovative and hold an expanded technical exchange from late June through mid-August of 2020.

The expanded format included several rounds of information gathering to allow for input from residents, program officials, and mentors, with the goal of facilitating peer learning and collaboration. Countries shared perceived best practices and gaps in NCD track implementation

The information-gathering stage allowed participants to share their experiences and was followed by a meeting to connect the countries, share findings, and highlight GNCDB’s plan for improving the NCD track. FETP officials, mentors, and residents identified several needs, including ongoing training (especially in the areas of scientific writing, presentation skills, analytics methods, and leadership and management); increased opportunities for cross-country exchange; a list of prioritized, feasible CVD research topics suitable for field epidemiology projects; and the creation of a CVD community of practice for field epidemiologists. 

“The 2019 technical exchange was a wonderful experience because we got to learn about how other countries implement the NCD track—the kind of system they have, their processes, and the mentor to mentee ratio,” says Dr. AK Savitha, an FETP mentor in India. “By learning what works in other countries, we can adopt the best measures and improve our training.”

GNCDB is using information and findings from the exchange to improve NCD training and will disseminate the findings broadly to inform planning for countries looking to incorporate an NCD track.