Building Africa’s Public Health Workforce: Shifting from Donor Dependency to Sustainable Field Epidemiology Capacity

For decades, Africa’s field epidemiology capacity has primarily been funded by external donors, supporting training programs, outbreak response initiatives, and public health surveillance systems. While this funding has been invaluable, it has also led to dependency that limits the continent’s ability to build a self-sustaining workforce. To achieve long-term resilience and self-reliance, African nations must prioritize domestic investments in public health workforce capacity, particularly in field epidemiology. Here’s how this can be achieved:

1. Political Commitment and Policy Integration
Strong political commitment is essential for sustainable workforce development. African governments should integrate field epidemiology training and workforce development into national health policies and long-term strategic plans. The Africa Centres for Disease Control and Prevention (Africa CDC) has set an example by advocating for establishing a skilled workforce under the New Public Health Order, emphasizing the importance of locally-led capacity building.

2. Sustainable Domestic Financing for Training Programs
Shifting from donor dependency requires increased national budget allocations for public health workforce training. Governments should invest in Field Epidemiology Training Programs (FETPs) and Field Epidemiology and Laboratory Training Programs (FELTPs), ensuring sustainability beyond donor cycles. Innovative financing mechanisms, such as taxation on high-revenue sectors and health bonds, could provide necessary funding for epidemiology training and workforce expansion.

3. Institutionalizing Field Epidemiology Training Programs (FETPs)
Many African countries currently host FETPs/FELTPs supported by external donors. To ensure sustainability, these programs should be fully institutionalized within national universities and public health institutes. Some countries have begun integrating FETPs/FELTPs into national structures, reducing reliance on external support. Establishing government-funded epidemiology fellowships will further strengthen national disease surveillance and outbreak response capabilities.

4. Expanding Local Training Institutions and South-South Collaboration
Currently, many African field epidemiologists receive training abroad due to limited in-country programs. Expanding local training institutions and promoting regional collaboration can build capacity while reducing costs. African countries should collaborate on training programs, allowing experts to train within the continent. For instance, the African Field Epidemiology Network (AFENET) provides a strong platform for fostering regional expertise and knowledge sharing.

5. Career Pathways and Retention Strategies for Epidemiologists
A well-trained epidemiology workforce must be retained to ensure long-term impact. Many trained professionals leave for better opportunities abroad due to limited career prospects in their home countries. Governments should create structured career pathways, competitive salaries, and incentives such as research grants and leadership opportunities to retain skilled epidemiologists within national health systems.

6. Leveraging Technology for Training and Surveillance
Digital health tools and e-learning platforms can expand access to epidemiology training. African countries should invest in technology-driven training approaches, such as virtual FETPs/FELTPs and online epidemiology courses, to reach more public health professionals. Digital surveillance systems and informatics tools, such as the District Health Information System 2 (DHIS2), should be integrated into epidemiology training to enhance real-time disease tracking and response capabilities.

7. Public-Private Partnerships in Workforce Development
Engaging the private sector can mobilize additional resources for workforce training. Pharmaceutical companies, health technology firms, and philanthropic foundations can support local training programs through scholarships, mentorship programs, and infrastructure development. Such partnerships can also facilitate in-service training opportunities for field epidemiologists.

8. Strengthening Regional and Continental Coordination
African countries must collaborate to create a unified approach to field epidemiology workforce development. Africa CDC and regional bodies should coordinate efforts to harmonize training curricula, establish cross-border exchange programs, and ensure a continuous pipeline of skilled epidemiologists across the continent.

Conclusion
Africa’s public health resilience depends on a well-trained, sustainable field epidemiology workforce. By shifting from donor dependency to domestic investment, institutionalizing training programs, leveraging technology, and fostering regional collaboration, African nations can build a strong epidemiology workforce capable of addressing current and future public health threats. Investing in local capacity today will ensure that Africa is prepared to manage health crises independently, securing the continent’s long-term health security.