Three decades of USAID investments in immunization through the child survival revolution.

The US Agency for International Development (USAID) launched a significant effort to improve global immunization coverage in the mid-1980s, beginning a long history of investments in various approaches to supporting the improvement of national vaccination programs in developing countries. As Primary Health Care evolved, USAID's approach to immunization also evolved, heavily influenced by the child survival revolution, a period when the global community struggled to define an approach that incorporated the essence of the Alma-Ata Conference with the selective primary health-care approach. Eventually, what became known as the 'twin engines' approach, a focus on two high impact interventions-immunization and oral rehydration therapy-would characterize USAID's child survival program.

The genesis and evolution of the African Field Epidemiology Network.

In an effort to contain the frequently devastating epidemics in sub-Saharan Africa, the World Health Organization (WHO) Regional Office for Africa launched the Integrated Disease Surveillance and Response (IDSR) strategy in an effort to strengthen surveillance and response. However, 36 sub-Saharan African countries have been described as experiencing a human resource crisis by the WHO. Given this human resource situation, the challenge remains for these countries to achieve, among others, the health-related Millennium Development Goals (MDGs).

Strengthening public health surveillance and response using the health systems strengthening agenda in developing countries.

There is increased interest in strengthening health systems for developing countries. However, at present, there is common uncertainty about how to accomplish this task. Specifically, several nations are faced with an immense challenge of revamping an entire system.

Field Epidemiology Training Programmes in Africa - Where are the Graduates?

Background: The current shortage of human resources for health threatens the attainment of the Millennium Development Goals. There is currently limited published evidence of health-related training programmes in Africa that have produced graduates, who remain and work in their countries after graduation. However, anecdotal evidence suggests that the majority of graduates of field epidemiology training programmes (FETPs) in Africa stay on to work in their home countries--many as valuable resources to overstretched health systems.