Cummings School researchers and health professionals combat emerging pandemic threats

To combat outbreaks such as the Ebola virus, a pandemic that devastated many parts of West Africa, Tufts researchers have partnered with professors at the University of Minnesota (UMN) in a global network of health professionals. The goal of this network is to improve the existing health infrastructures in developing countries that are at a high risk for such outbreaks.

The team plans to improve health education institutions in developing nations by strengthening collaboration between medical professionals of varying specializations in those nations and in the United States. Their work is part of a broader national and international health agenda outlined by United States Agency for International Development (USAID) that recognizes the growing importance of interdisciplinary efforts to combat global health issues, according to a press release from USAID.

“This project isn’t focused on specific pathogens or disease outbreaks,” Felicia Nutter, senior Asia technical officer for the One Health Workforce (OHW) project, told the Daily in an email. “People working on both RESPOND [Responding to the Need for Family Planning] and OHW are focused on…the importance of collaboration to solving challenging problems, including outbreaks of emerging infectious diseases such as Ebola and Zika viruses.”

Students and professors at Tufts and UMN are just part of many global health professionals worldwide that subscribe to a One Health approach to solving medical problems involving people, animals and the environment, according to the American Veterinary Medical Association webpage.

“The whole One Health concept is all about collaboration,” Nutter said. “It’s about recognizing that no one discipline has all of the answers or all of the skills needed to solve some of these challenging problems.”

Nutter was a 1993 graduate of Tufts’ Cummings School of Veterinary Medicine and has continued to specialize as a wildlife veterinarian. As a Research Assistant Professor in the Department of Infectious Diseases and Global Health, she also serves as Director of International Veterinary Medicine at the Cummings school.

“The professional schools at Tufts were founded on the one medicine principal, which is the same idea as One Health — that we’re all on a continuum, humans and animals, and we share a lot of commonalities,” Nutter said. “I’ve always approached the work that I do as collaborative work because in wildlife conservation you have to take into account what people need, what domestic animals need and what wildlife needs.”

OHW is part of a larger program called the Emerging Pandemics Threat Program (EPT 2), according a Jan. 11 USAID factsheet. In its second cycle of the EPT program, the first of which was established in 2009 by means of USAID, Tufts and UMN will receive up to $50 million in a cooperative agreement with USAID, according to a Nov. 24, 2014 article on UMN’s website.

“The goal of the EPT program is to basically prevent, detect and respond to emerging pandemic threats in these countries,” Kristina Bradford, the project manager of the $50 million grant, said.

Tufts and UMN are working with universities in the targeted developing nations to enhance curriculum in medical schools and public health institutions, according to Bradford. Medical professionals from the U.S. analyze needs in each region and then work with existing faculty to provide them with the resources they need to implement the curriculum best suited to their institutions.

“We’re trying to find the institutions that are Kenyan, that are Ethiopian, that are Thai and build them up… as opposed to being a foreign institution coming in to develop entirely new curriculums,” Bradford said.

Bradford explained that by working directly with universities, instead of non-governmental organizations, OHW is able to target established institutions in these developing nations.

“We allow for people working in universities in the U.S. to work with universities [in developing nations],” Bradford said. “The idea of reciprocity [among faculty] is really important, and that is something that’s different from a lot of international development projects.”

The OHW is currently focusing its efforts on Southeast Asia and Central and East Africa. These regional networks are based in Thailand and Uganda, respectively, although both universities employ technical leads in each of the 12 nations involved, according to Bradford.

“We’re more on the response end,” Bradford said. “[We work on] how to develop a better workforce and respond to it. [Other EPT 2 projects] are trying to figure out how to do better disease surveillance, better analysis of the resources on the ground; and then others are working with the government to develop strategic response plans when there is an emerging pandemic threat.”

Nutter, who also worked in the first cycle of EPT as Senior Technical Veterinary Officer for a subset called RESPOND, described the first cycle of EPT as focused on building capacity and education.

“It was a broader project, incorporating everyone from the community level — people in villages and towns — to people at universities, which is what we’re focusing on now, and then all the way up to government agencies and government ministries,” Nutter said.

The multidisciplinary team members of the RESPOND project provided support to a One Health consistent investigation of a yellow fever outbreak in Uganda, according to Nutter.

“The lessons learned during that response were important during a subsequent response to an Ebola outbreak,” Nutter said. “In fact, several OHCEA [One Health Central and Eastern Africa] member countries and institutions sent trained specialists to assist during the Ebola outbreak in West Africa.”

The difference between the RESPOND project and OHW is OHW’s refined focus on universities, according to Nutter. The foundation laid by the RESPOND project allowed for the development of the two One Health university networks, in Southeast Asia and in Central and East Africa, respectively.

“Given the time frame that we have and the budget and the partners that we’re working with, it really made sense to focus on universities [in the second cycle of EPT],” Nutter said. “Universities train the future workforce, and they can also provide continuing education programs for the current workforce.”

The OHW is one of the three new projects that were awarded USAID grants to implement the objectives of the EPT 2 program, according to the USAID website. Partners in the program include the national and international health and disease control organizations, as well as academic and governmental institutions in the U.S.

“OHW is the combination of human health, animal health and environmental health,” Bradford said. “We want to avoid letting academic research and academic implementation operate in silos.”

The One Health Workforce also works to develop faculty through workshops, offering professors a variety of different teaching techniques and modules to implement in their curriculum. Bradford explained that there is an emphasis placed on integrating active, cased-based learning into these curriculums.

“We’ve seen some formal partnerships come out of this project,” Bradford said. “We’re providing continuing education for graduate students or even faculty that want to go back to school.”

Bradford said that if these students and faculty want to get public health certifications online, OHW makes those online resources available, and if a teacher wants to earn an extra masters degree, OHW helps to make that possible.

“A lot of these people, you know, 10, 20 years down the road may be in the Ministry of Health, may be a dean of that school … So we’re really trying to incorporate this One Health perspective because they will become the future health leaders of their countries,” Bradford said.