Zoonotic and Emerging Infectious Diseases Training Program

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Project Summary The landmark Institute 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. Critically, zoonotic pathogen emergence and transmission occurs in “hot spots”—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. Understanding the behavior of zoonotic pathogens, including mechanisms of emergence, persistence and spread that underlie effective surveillance and response, is widely recognized as critically important to addressing emerging infections. Both endemic and epidemic zoonotic diseases have a disproportionate impact in 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 this high endemic disease burden and elevated risk for pathogen emergence. Kenya is representative of this zoonotic disease burden and risk: two-thirds of the population are farmers with >80% having livestock amid increasing pressure for arable land adjacent to a rich diversity of wildlife. 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 Kenya, culminating in a bachelor degree in either medicine or veterinary medicine, 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 training gap using two tracks: i) PhD training for clinically- trained individuals currently at a junior level and whose positions allow full-time commitment (6 individuals; training duration of 4 years), and ii) structured modular training for individuals currently in ministerial and other governmental positions to strengthen capacity in situ (two 2-year cohorts, each of 5 individuals). We have identified a strong candidate pool, all of whom have completed MSc/MPH/MMed training. Critically, in both training tracks, physicians and veterinarians will be a single, integrated cohort. Training, including field and laboratory research, will take place in Kenya, an integrated collaboration among the University of Nairobi College of Medicine and Faculty of Veterinary Medicine, Washington State University, and the Kenya Medical Research Institute.