Ebola outbreak in West Africa: considerations for strengthening Australia’s international health emergency response

Rosewell and colleagues1 recently discussed the Australian response to the Ebola virus disease outbreak in West Africa and commented that, as of January 2015, only one Master of Applied Epidemiology (MAE) scholar was deployed. Owing to the number of deploying agencies and the lack of a register of people providing assistance, it is difficult to identify people assisting with international public health emergencies. Since the publication of the article by Rosewell and colleagues, we attempted to identify all MAE alumni assisting with the Ebola response in West Africa. Two additional MAE scholars and a staff member were deployed to West Africa with the World Health Organization Global Outbreak Alert and Response Network in 2015. A total of 17 alumni and three MAE scholars were deployed, which was less than the estimated 15% in the article. In addition, most of the 22 MAE scholars around Australia during 2015 assisted health departments with the preparation for potential cases of Ebola virus disease and with the follow-up of returned travellers and workers from affected countries.

The MAE program has had a remarkable recovery following a cut to funding in 2011 that led to a national outcry.2 The Australian National University revised the model of funding to have federal, state and territory governments, and national centres of communicable disease control fund the entire cost of MAE scholarships. These generous scholarships of $50 000 annually attract high quality candidates to the 2-year field epidemiology-training program. Initially, the revitalised program placed five scholars in Australian public health institutions in 2011, but numbers have risen to 13 scholars in 2015 and in 2016.

The MAE program is an important resource for public health surge capacity. However, there are many considerations when sending scholars to international incidents, as some do not provide good training experiences. Deploying agencies often request staff with prior experience, and support can be lacking in emergencies. Poor management can lead to inadequate role definition and inefficient responses, which may compromise the trainee’s effectiveness and experience. Since the MAE program began in 1991, scholars have been deployed for international responses to outbreaks of severe acute respiratory syndrome, H1N1 influenza and Ebola virus disease, and to humanitarian emergencies such as typhoons. MAE scholars have assisted state, territory and national government responses to domestic public health events, such as multijurisdictional outbreaks of foodborne disease and influenza. The MAE program will continue to work with national and international agencies to ensure that scholars are deployed to roles where they can provide valuable service while developing skills in communicable disease control.