The UK Health Security Agency (UKHSA) International Health Regulations Strengthening Project (IHR-SP) Indo-Pacific Team delivered environmental epidemiology training in partnership with the Association of Southeast Asian Nations (ASEAN)+3 Field Epidemiology Training Network (FETN). This is in alignment with the strategic goal to enhance workforce capacity and development in ASEAN+3, as well as with ASEAN Health Cluster 2 priorities and Mitigation of Biological Threats (MBT) Work Programme activities.

The training took place on 2-6 December 2024 in Bangkok and was attended by 37 participants. It aimed to build the technical capacity for environmental epidemiology of the Thailand FETP Cohorts 2022-2024 and representatives from FETP programmes in the ASEAN region. Ten ASEAN Member State (AMS) Field Epidemiology Training Programme (FETP) Directors and supervisors, as well as representatives from Timor Leste’s FETP programme, also participated in the training to support them in integrating environmental epidemiology training into their own FETP.

UKHSA IHR SP co-developed the training curriculum, course content, training timetable and workshop structure in collaboration with the Thailand FETP and the ASEAN+3 FETN. Regular planning meetings identified external speakers and participants from the Government of Thailand and partner agencies, including United Nations Environment Programme (UNEP), World Health Organisation (WHO), and Food and Agriculture Organisation (FAO). The training module covers the following:

• environmental epidemiology as an applied public health science based on specific competencies in field epidemiology
• chemical incident response as a public health service based on combined effort of multisector agencies in the region
• the impacts of environmental and climate change on extreme events, infectious and non-infectious diseases.

The training was delivered through lectures from subject matter experts, problem-based learning through interactive case studies based on real word incidents and experience, and presentations from guest speakers.

Feedback received from 52 participants and observers showed that this was a successful training. Over 90% of participants reported that they felt the training was relevant to their roles, that the lecturers and facilitators were knowledgeable and delivered the material effectively, and that the learning objectives were achieved. All participants reported that they intend to apply the knowledge gained in their country’s FETP and their jobs. They recognised the importance of environmental epidemiology to prevention, detection, and response for the growing burden of disease attributable to environmental determinants and climate change. Participants noted the challenges in building capacity and capability in this area, highlighting financial, human resource, data availability, and multi-sectoral coordination and collaboration as the main barriers.

The training was followed by a half-day workshop focused on potential for and approaches to integrating the training into AMS FETP programmes. The workshop generated ideas on how the module can be made more impactful for countries and the wider region, including through field visits, more practical exercises, ASEAN-specific case studies and further contextualisation of the training materials, and increased focus on surveillance and incident response. Discussion on integrating environmental epidemiology into existing FETP modules and curricula was also insightful, particularly on the relative merit of this format compared to delivering it as a standalone module.

The workshop also affirmed the role of partners, including academic institutions, in supporting capacity and capability development for environmental epidemiology and environmental public health practice. Participants expressed interest in partner support in areas such as: training; technical assistance; facilitation of cross-sector collaboration; support for regional collaboration such as joint risk assessments, simulation exercises, and hosting FETP trainees to support incident investigation; and collaboration with academic institutions in areas including training and research.

The IHR-SP Indo-Pacific team is now working with the ASEAN+3 FETN and partners on the next steps, including:

• Outlining different approaches to integrating environmental epidemiology training into ASEAN+3 FETN Member State FETP
• Developing guidance on integrating environmental epidemiology content into core training modules and make content freely available
• Identifying ASEAN+3 FETN Member States to collaborate with to pilot integration of existing module content and to adapt module content for different levels of FETP
• Exploring opportunities for partner collaboration to respond to other suggested areas of partner support.