Paradigm shift: contribution of field epidemiology training in advancing the "One Health" approach to strengthen disease surveillance and outbreak investigations in Africa.

The occurrence of major zoonotic disease outbreaks in Sub-Saharan Africa has had a significant impact on the already constrained public health systems. This has, as a result, justified the need to identify creative strategies to address threats from emerging and re-emerging infectious diseases at the human-animal-environmental interface, and implement robust multi-disease public health surveillance systems that will enhance early detection and response. Additionally, enhanced reporting and timely investigation of all suspected notifiable infectious disease threats within the health system is vital. Field epidemiology and laboratory training programs (FELTPs) have made significant contributions to public health systems for more than 10 years by producing highly skilled field epidemiologists. These epidemiologists have not only improved disease surveillance and response to outbreaks, but also improved management of health systems. Furthermore, the FETPs/FELTPs have laid an excellent foundation that brings clinicians, veterinarians, and environmental health professionals drawn from different governmental sectors, to work with a common purpose of disease control and prevention. The emergence of the One Health approach in the last decade has coincided with the present, paradigm, shift that calls for multi-sectoral and cross-sectoral collaboration towards disease surveillance, detection, reporting and timely response. The positive impact from the integration of FETP/FELTP and the One Health approach by selected programs in Africa has demonstrated the importance of multi-sectoral collaboration in addressing threats from infectious and non- infectious causes to man, animals and the environment.