“The greatest success in field epidemiology is often the outbreak that never happens.”
Field epidemiology operates largely invisible to the public eye, yet its practitioners serve as the frontline defenders against infectious disease threats. This blog reflects on the 2026 World Field Epidemiology Day theme, “Protecting Communities from Behind the Scenes: The Power of Field Epidemiology,” examining the critical role of disease detectives in outbreak prevention and control. It highlights the persistent workforce gap, with Africa estimated to have just 1,900 field epidemiologists against a need for 6,000, while profiling the Competencies for One Health Field Epidemiology (COHFE) Framework as a transformative initiative. The piece argues for increased investment, workforce retention strategies, and expanded One Health integration to strengthen global health security. Ultimately, it celebrates the unseen victories-the outbreaks that never happen-as the greatest testament to field epidemiology’s power.
When people think of public health emergencies, they often picture doctors in protective suits, emergency hospitals, or disease outbreaks dominating the headlines. What they rarely see is the work that begins long before an emergency reaches the public.
The Quiet Victory
The most important outbreak you have never heard of was the one that never happened. This is the reality of field epidemiology, a profession whose success is measured not by the crises we see, but by the ones we prevent. Behind every health alert that does not escalate, behind every disease that does not cross borders, there is a network of “disease detectives” working in the shadows. World Field Epidemiology Day 2026, with its theme “Protecting Communities from Behind the Scenes: The Power of Field Epidemiology,” invites us to pull back the curtain and recognise this invisible workforce.
The Invisible Shield
What does “behind the scenes” actually look like? One of the most valuable lessons in field epidemiology is that surveillance does not begin at the hospital; it begins in the community . It looks like a spreadsheet at midnight. It looks like a forgotten health post where an epidemiologist notices a pattern in diarrhoea cases that does not quite make sense. It is the quiet phone call to a veterinarian about unusual livestock deaths. It is the laborious process of contact tracing, not the heroic sprint, but the methodical, exhausting walk. This behind-the-scenes work is our greatest strength. Field epidemiologists are the sentinels who identify threats before they become headlines. Since 1999, FETP trainees in Japan have been deployed to 419 outbreak investigations, investigating everything from COVID-19 to food poisoning outbreaks. In Brazil, over 4,000 professionals have been trained through the EpiSUS program since 2000. These are not statistics, they are stories of outbreaks contained.
The Numbers That Define Our Work
To understand the scale of this work, consider what is at stake. Over 30 emerging infectious diseases have been identified in the past three decades, most originating in animals, jumping to humans when environmental conditions allow. Over 75% of emerging infectious diseases are zoonotic. We cannot stop the next pandemic by looking only at humans. The response has been the Competencies for One Health Field Epidemiology (COHFE) Framework, a joint effort by WHO, FAO, and WOAH. This framework, with 1,300 knowledge, skills, and competency statements, provides global standards for training epidemiologists across the human, animal, and environmental health spectrum. Countries are already integrating it. In Bangladesh, a Multisectoral Working Group now guides One Health training, addressing barriers like data sharing and limited joint investigations. In India, the National Centre for Disease Control has aligned its Sector Connect program with all 14 COHFE domains. Yet the gap remains daunting. The International Health Regulations recommend one field epidemiologist per 200,000 people. Africa, with a population of over 1.5 billion, has an estimated 1,900 field epidemiologists against a need for 6,000. This shortfall means every missing epidemiologist is a potential outbreak undetected.
Humanising the Data
Let me put a face to these numbers. In early 2025, when Sudan ebolavirus resurfaced in Uganda, FETP teams moved quickly. They traced hundreds of contacts. They pinpointed areas of highest risk. They quarantined those exposed before symptoms began. The outbreak was contained in just six weeks-with no international spread. This is not luck. This is field epidemiology. In 2023, when anthrax hit Uganda, it was FETP fellows who traced the source to a black market for illegal meat. This discovery was not glamorous. It was dogged, detailed detective work—the kind that never makes headlines but saves countless lives. And in South Africa, during the COVID-19 pandemic, FETP teams identified a critical gap: more field epidemiologists were needed. Their response was to launch the country’s first Intermediate Field Epidemiology Training Program, expanding the workforce.
The Way Forward
So where do we go from here?
- First, investment must match ambition. We need to move from counting trained epidemiologists to ensuring they are deployed where they are most needed.
- Secondly, One Health integration must become the norm, not the exception. The COHFE Framework provides the roadmap; now we need to fully operationalise it across all regions.
- Thirdly, retention strategies must be developed. Without bonding agreements, we risk training professionals for export.
- Finally, we must expand the scope beyond infectious diseases. Field epidemiologists are essential for all public health threats, not just outbreaks.
A Call to Action
This World Field Epidemiology Day, let us not just celebrate the disease detectives. Let us advocate for a future where field epidemiology is not an afterthought but a foundational pillar of global health security. The outbreaks that never happen are our greatest public health victories, but they require investment, commitment, and a recognition that the work behind the scenes is where the future of global health is built.
This World Field Epidemiology Day, I pay tribute to the many professionals working behind the scenes- epidemiologists, surveillance officers, laboratory scientists, Border Health Services teams, provincial rapid response teams, community health workers, and countless partners whose dedication keeps our communities safe.
Our greatest achievements are often the stories that never make headlines. They are reflected in the lives protected, the outbreaks detected and contained at an early stage, the transmission chains interrupted, and the public health emergencies that were prevented before they could unfold.
Written by ISID Emerging Leaders, Nelisiwe Mhlabane & Nadia Noreen