In this assessment task, the aim is to investigate existing disease control strategies and potential future strategies, and to provide a reasoned argument for or against implementation of a new strategy. Such strategies could include those targeted at specific disease causes (such as immunisation), or broader approaches that not disease specific.
In Table below are four broad disease categories and suggested settings in which to consider their control. After reading through the assessment instructions, you should choose 1 of the 4 disease categories and then select a country that is consistent with the focus setting for that choice.
Table: Disease category choices and focus settings for Assessment
Option Disease Focus setting
1 Diarrhoeal diseases Low-middle resource setting
2 Pneumonia High resource setting
3 Vector-borne diseases Low-middle resource country
4 STIs High resource setting
Once you have selected a disease category and country setting, you need to complete the following tasks:
1. Briefly describe the epidemiology for the selected disease category in the country, highlighting the most important individual causes, any substantial changes over time and key risk factors (e.g. age etc.)
2. Describe the current disease control strategies used in your selected country and any identified impacts of these on your chosen disease category – there may be many control strategies, so you will need to prioritise and highlight the key ones, perhaps through a table.
3. Consider options to improve disease control, with brief descriptions of at least 3 potential new control strategies that could be attempted. These should be plausible in relation to your country setting but not currently used. These can include modifications to currently used strategies (for example, proposals to expand the coverage of existing strategy).
4. Choose one of these three control strategies and for this strategy only provide a more detailed summary of the intervention, drawing on evidence of effectiveness, acceptability and value for money (e.g. cost effectiveness). It is important that the strategy is clearly defined (e.g. the population targeted through the strategy, the disease control tools involved) and the objectives clearly stated (e.g. to reduce mortality in children less than 5 etc.).
5. If you were health minister, would you choose to implement this strategy? Argue for your decision, considering the evidence described in task 4, the country context and any potential weaknesses in the strategy.
In particular we are looking for:
Task 1: A concise description of the existing epidemiology that identifies the major causes of disease burden including key risk factors and any temporal changes in epidemiology. This section should demonstrate the ability to focus on key information based on public health priority.
Task 2: A brief description of disease control activities in relation to the chosen disease category in your setting, that focuses detail on the most significant such activities and indicates any effects of these activities.
Task 3: Descriptions of three new or revised disease control strategies including an outline of how the strategy works, and whether it has implemented elsewhere. Briefly summarise evidence of effectiveness. It is critical that these strategies are plausible in the chosen setting (e.g. consider cost, acceptability before listing strategies).
Task 4: Detailed description of the evidence regarding one of these three strategies, which interpretation in terms of the context (for instance you need to consider if clinical trial results in another setting would transfer to your country context).
Task 5: A concluding section that intelligently discusses implementation challenges associated with the proposed new strategy and that provides a recommendation in favour or against implementation. You may also take a more neutral viewpoint (e.g. need more evidence to make a decision) but regardless of the conclusion, this needs to be sensible, evidence-based decision.
PS. Disease control programs, particularly those featuring effective primary prevention of disease have been very successful at reducing or eliminating infectious disease threats. Vaccination in particularly has been highly successful, with immunisation programs responsible for preventing millions of deaths worldwide. The eradication of smallpox and elimination of diseases such poliomyelitis and measles from many parts of the world are examples of this success.
However, there remain many infectious diseases for which control programs can be improved. In addition, there remain broad categories of disease with largely infectious causes that result in high rates of morbidity and mortality in different settings.