Zoonotic and Emerging Infectious Diseases Training Program

The landmark National Academy of Medicine report, "Emerging Infections: Microbial Threats to Health in the United States" highlighted the importance of the epidemiology, pathogenesis, and improved control for zoonotic infectious diseases- 60% of all human pathogens are directly transmitted from or emergent from animal reservoirs. The emergence of the coronaviruses SARS-CoV2 and MERS-CoV, spread of H5N1 Influenza, and international spread of Mpox in the past decade illustrate the global impact of infectious disease. Understanding the behavior of zoonotic pathogens, including mechanisms of emergence, persistence and spread that underline effective surveillance and response, is essential to control of emerging infections prior to global spread. Critically, zoonotic pathogen emergence and transmission occur in "hotspots"-ecologically and epidemiologically defined regions where domestic animal and wildlife interactions with humans are concentrated and often exacerbated by presence of arthropod vectors responsible for transmission. Across sub-Saharan Africa the reliance on livestock for livelihoods, population growth and land pressure that increasingly brings people and domestic animals in contact with wildlife, and the persistent poverty and hunger that underlies consumption of bushmeat and sick or dead livestock all contribute to both a high endemic disease burden and elevated risk for pathogen emergence. East Africa represents this zoonotic disease burden and emerging pathogen risk: >80% of the population relies on agriculture with both pastoralists and settled "smallholder" farmers owing multiple species of poultry and livestock amid increasing pressure for arable land adjacent to a rich diversity of wildlife. Active surveillance, early detection, and effective response require resident expertise "parachute" responses are costly, both economically and in delayed response, leading to increased morbidity and mortality as the disease spreads, nationally, regionally, and globally. The highest priority to strengthen capacity is integrated post-graduate training for clinically trained individuals in both laboratory and field epidemiologic research. Medical and veterinary education in East Africa is highly clinically focused helping meet needs for clinical care but does not provide sufficient training to identify knowledge gaps, design approaches to address these gaps, conduct investigations, and analyze results/outcomes. We propose to address this expertise gap by i) recruiting and providing training to the PhD for an integrated cohort of 8 clinically trained physicians and veterinarians selected from a deep pool of highly qualified clinicians from Kenya, Tanzania, and Uganda; and ii) mentoring of an existing cohort of PhD clinicians to research independence.