International Association of National Public Health Institutes

The International Association of National Public Health Institutes (IANPHI) is a member organization of government agencies working to improve national disease prevention and response. IANPHI is made up of 86 members, 74 of which are national public health institutes (NPHIs), located in 77 countries. The goal of IANPHI is to improve health outcomes, particularly in low-resource countries, by strengthening or creating NPHIs.

IANPHI is based at the Emory University Global Health Institute (USA), the National Institute of Public Health (INSP) of Mexico and the Institute for Public Health Surveillance (InVS) of France. Coordinated by Secretary General Hernandez-Avila, the IANPHI team is responsible for member relations and programs (Mexico), policy, communications and NPHI development projects (USA) and the annual meeting scientific program (France).

The majority of funding for IANPHI has come from the Bill and Melinda Gates Foundation.[1][2] Since its creation in 2006, IANPHI has provided grant money for 60 individual projects in 38 different countries.[3] Today, IANPHI concentrates most of its resources on long-term projects, which take three or more years to implement.[4]

The national public health institute model

The NPHI model, exemplified by the China CDC, U.S. Centers for Disease Control and Prevention (CDC), National Institute for Public Health and Welfare of Finland, Public Health Agency of Canada and others, is an effective and cost-efficient way to systematically develop and sustain national public health systems. NPHIs, including China CDC, INSP in Mexico, FIOCRUZ in Brazil and others in 81 countries around the world, have been major contributors to reductions in morbidity and mortality from infectious and noncommunicable diseases. Many, including the CDC, and the National Institute for Health and Welfare-THL (Finland) have developed over several decades while others, including NPHIs in the United Kingdom and Canada, have been created following poorly managed threats such as BSE and SARS, in recognition that a coordinated system with a specialized institution is needed to effectively respond to disease threats.

NPHIs lead national efforts for disease surveillance and outbreak investigation (to monitor population health trends and detect and resolve outbreaks), laboratory services (to identify and confirm disease threats), health programs (including recommendations for immunizations and maternal and child health initiatives), and education and research (including new treatments and technologies). NPHIs give governments the ability to assess and address major disease threats in a country, both acute and long-term, using scientific, evidence-based policies and strategies.

Focused disease control programs driven by external priorities and investment have improved health in many countries. NPHIs are particularly valuable in low-resource countries, where they create a career home for public health researchers and scientists – fostering the evidence-based approaches necessary to ensure that government policies are based on scientific evidence rather than politics.

History and activities

In 2002, the directors of nearly 30 NPHIs met in Bellagio, Italy to share best practices and discuss opportunities for collaboration. In 2004, the group reconvened in Helsinki and declared its intention to forge an alliance.[5]

IANPHI was formally launched at the first General Assembly in Brazil in January 2006, with 39 founding members and a one-year grant from the Gates Foundation. Under a subsequent five-year grant from the Gates Foundation awarded in late 2006, the membership has expanded to 81 institutes in 73 countries around the world.[5]

IANPHI's activities fall into three areas:[6]

Peer-to-Peer Partnerships

One of IANPHI’s distinctive features and strengths is a peer-assistance approach that facilitates sharing of expertise and experience among member NPHIs.[7] The model clearly benefits the recipient NPHI by identifying strategies to address priority needs and raising standards of performance for organizing and conducting public health functions. But it rewards the contributing institute as well – by sharing skills and assets to benefit others while also linking resources and solutions to address regional and global health threats and opportunities.

For the network of IANPHI members, the model provides unique opportunities for NPHIs to link with others that are geographically or linguistically similar or are struggling with similar technical or programmatic issues, such as information system development or pandemic preparedness. This collaborative approach also provides a platform for developing research or programs to address shared issues, whether laboratory safety or avian influenza, tobacco use or injury.

Current peer-to-peer partnerships include:

Heymann Mentorship Program

The IANPHI Heymann Mentorship Program aims to encourage public health leadership growth by facilitating one-on-one relationships between established public health leaders and less-experienced counterparts in low-resource countries.[8] It is part of an ongoing IANPHI effort to build human capacity and provide a career path for public health professionals through training in strategic leadership and management. Part of this commitment involves providing current and future NPHI leaders with the tools, training, and support they need to develop their full potential.

The Heymann Mentorship Program provides each mentee (“fellow”) an opportunity to develop an ongoing relationship with a mentor with career experience as a public health expert and leader. The program focuses on current and future leaders of NPHIs in IANPHI project sites and strategically targets persons interested in guidance, coaching, counseling, and professional development.

List of IANPHI members

IANPHI Member NPHIs

  1. Afghanistan: Afghan Public Health Institute[9]
  2. Albania: Institute of Public Health[10]
  3. Angola: National Public Health Institute
  4. Argentina: National Laboratories and Health Institutes Administration (ANLIS) "Dr. Carlos G. Malbrán"[11]
  5. Bangladesh: Institute of Epidemiology, Disease Control & Research - IEDCR[12]
  6. Belgium: Scientific Institute of Public Health[13]
  7. Brazil: Oswaldo Cruz Foundation - FIOCRUZ[14]
  8. Cambodia : National Institute of Public Health[15]
  9. Canada: Public Health Agency of Canada[16]
  10. Chile: Public Health Institute of Chile[17]
  11. China: Chinese Center for Disease Control and Prevention[18]
  12. China: Centre for Health Protection, Hong Kong[19]
  13. Colombia: National Institute of Health[20]
  14. Costa Rica: National Institute for Research on Nutrition and Health[21]
  15. Côte d'Ivoire : National Public Health Institute
  16. Croatia: Croatian National Institute of Public Health[22]
  17. Cuba: Institute of Tropical Medicine "Pedro Kouri"[23]
  18. Czech Republic: National Institute of Public Health SZU[24]
  19. Denmark: State Department of Public Health[25]
  20. Ecuador: National Institute for Public Health Research[26]
  21. England: Public Health England
  22. Estonia: National Institute for Health Development[27]
  23. Ethiopia : Ethiopian Public Health Institute[28]
  24. Finland: National Institute for Health and Welfare - THL[29]
  25. France: Institut National de la Santé et de la Recherche Médicale[30]
  26. France: French Institute for Public Health Surveillance InVS[31]
  27. Germany: Robert Koch Institute[32]
  28. Ghana: Noguchi Memorial Institute for Medical Research[33]
  29. Guinea: National Institute of Public Health Guinea (Guinea NPHI)
  30. Guinea Bissau: National Institute of Public Health (INASA)
  31. Hungary: National Center for Epidemiology[34]
  32. Iceland: The Directorate of Health[35]
  33. India: National Centre for Disease Control[36]
  34. Iran: National Institute of Health Research[37]
  35. Ireland: The Institute of Public Health in Ireland[38]
  36. Israel: Israel Center for Disease Control[39]
  37. Italy: National Institute of Health[40]
  38. Japan: National Institute of Public Health of Japan[41]
  39. Kenya: Kenya Medical Research Institute[42]
  40. Libya: Libya National Centre for Disease Control
  41. Macedonia: Institute of Public Health[43]
  42. Malawi: Public Health Institute of Malawi [44]
  43. Mexico: National Institute of Public Health[45]
  44. Moldova: National Center of Public Health[46]
  45. Mongolia : National Center of Public Health[47]
  46. Morocco: Institute Pasteur of Morocco[48]
  47. Morocco: National Institute of Hygiene[49]
  48. Mozambique: National Institute of Health
  49. Myanmar: National Health Laboratory[50]
  50. Nepal: School of Public Health and Community Medicine B.P. Koirala Institute of Health Sciences[51]
  51. Netherlands: Netherlands National Institute for Public Health and the Environment[52]
  52. Nigeria: Nigerian Institute of Medical Research NIMRNigerian Institute of Medical Research[53]
  53. Nigeria: Centre for Disease Control
  54. Norway: Norwegian Institute of Public Health[54]
  55. Pakistan: College of Physicians and Surgeons of Pakistan[55]
  56. Panama: Gorgas Memorial Institute for Health Studies[56]
  57. Peru : Peruvian National Institute of Health[57]
  58. Poland : National Institute of Public Health[58]
  59. Portugal: Institute of Hygiene and Tropical Medicine[59]
  60. Portugal: National Institute of Health INSA[60]
  61. Republic of Korea: Korea Centers for Disease Control and Prevention 국립보건연구원[61]
  62. Russian Federation: National Research Center for Preventive Medicine[62]
  63. Serbia: Institute of Public Health of Serbia[63]
  64. Slovenia: Institute of Public Health of the Republic of Slovenia[64]
  65. South Africa: National Institute for Communicable Diseases - NICD[65]
  66. Spain: Carlos III Health Institute[66]
  67. Sudan: National Public Health Institute[67]
  68. Sweden: Public Health Agency of Sweden[68]
  69. Tanzania: National Institute for Medical Research - NIMR[69]
  70. Thailand: National Institute of Health, Dept. of Medical Sciences, Ministry of Public Health[70]
  71. Togo: National Institute of Hygiene[71]
  72. Turkey: Refik Saydam Hygiene Center[72]
  73. Uganda: Uganda Virus Research Institute UVRI [73]
  74. United States: U.S. Centers for Disease Control and Prevention[74]
  75. Vietnam: National Institute of Hygiene and Epidemiology - NIHE[75]
  76. Wales: Public Health Wales

IANPHI Associate Member NPHIs

  1. Australia: Australian National Preventive Health Agency (ANPHA)
  2. Canada: National Institute of Public Health Institut national de santé publique du Quebec
  3. Bolivia: Health Laboratories National Institute (INLASA)
  4. El Salvador: Ministry of Public Health and Social Assistance[76]
  5. Ghana: Ghana Health Service[77]
  6. Jordan: Jordan Ministry of Health
  7. Nepal: School of Public Health and Community Medicine B.P. Koirala Institute of Health Sciences[78]
  8. Nigeria: National Primary Health Care Development Agency[79]
  9. Papua New Guinea: National Department of Health[80]
  10. Saudi Arabia: Ministry of Health
  11. Wales:[81]

Organization

IANPHI is managed by an executive board and secretariat. Executive board members consider and vote on issues of strategic direction and policy and on project and funding recommendations. There are currently 9 active members on the executive board:[82]

  1. Pekka Puska, IANPHI President - Director General, National Institute for Health and Welfare, Finland
  2. Mwele Malecela, IANPHI Vice President - Director General, National Institute for Medical Research, Tanzania
  3. Jeffrey P. Koplan, IANPHI Immediate Past President - Director, Emory University Global Health Institute
  4. Igbal A. B. Abukarig, Member - Director, Public Health Institute, Sudan
  5. Reinhard Burger, Member - President, Robert Koch Institute, Germany
  6. David Butler-Jones, Member - Director, Public Health Agency, Canada
  7. Cesar Cabezas, Member - Head, National Institute of Health, Peru
  8. L.S. Chauhan, Member - Director, National Centre For Disease Control(NCDC), India
  9. Ilesh Jani, Member - Director General, National Institute of Health, Mozambique
  10. Maris Jesse, Member - Director, Estonian National Institute for Health Development, Estonia
  11. Amha Kebede, Member - Director General, Ethiopian Health & Nutrition Research Institute (EHNRI), Ethiopia
  12. Mahmudur Rahman, Member - Director, Institute of Epidemiology, Disease Control and Research, Bangladesh
  13. Mauricio Hernández-Avila - Director, Instituto Nacional de Salud Publica, Mexico

Emeritus Members

  1. Rajae El Aouad - Former Director, National Institute of Hygiene, Morocco[83]
  2. Reinhard Burger - President, Robert Koch Institute, Germany[83]
  3. Paulo Buss - Former President, Oswaldo Cruz Foundation/FIOCRUZ, Brazil[84]
  4. David Butler Jones - Public Health Agency of Canada[85]
  5. Mohammed Hassar - Former Director, Institute Pasteur du Maroc, Morocco
  6. Oni Idigbe - Former Director General, Nigerian Institute of Medical Research, NIMR Director of Research
  7. Ilesh Jani - Director General, National Institute of Health, Mozambique
  8. Justin McCracken - Former Chief Executive, Health Protection Agency, United Kingdom
  9. Tsehaynesh Messele - Former Director General, Health and Nutrition Research Institute, Ethiopia
  10. Amabelia Rodrigues - Former President, National Institute of Public Health, Guinea Bissau
  11. Mario Henry Rodriguez - Former General Director, National Institute of Public Health, Mexico
  12. Pathom Sawanpanyalert - Director General, National Institute of Health
  13. Barry Schoub - Former Executive Director, National Institute of Communicable Diseases, South Africa
  14. Marc Sprenger - Director, European Centre for Disease Prevention and Control, Netherlands
  15. Geir Stene-Larsen - Director General, Norwegian Institute of Public Health
  16. Jaroslav Volf - Former Director, National Institute of Public Health, Czech Republic
  17. Yu Wang - Director-General, Chinese Center for Disease Control and Prevention
  18. Jane Wilde - Former Chief Executive, Institute of Public Health in Ireland

The secretariat, co-located in Atlanta, U.S. and Cuernavaca, Mexico, is responsible for the day-today activities of the organization.[86]

IANPHI long-term projects

IANPHI’s long-term projects help public health systems in low-resource countries respond to modern public health challenges, improve outcomes, and support healthy populations and strong economies. These intensive multi-year engagements develop and strengthen national public health institutes (NPHIs), moving them forward on a continuum from those least developed to those with a comprehensive and coordinated scope of public health responsibilities. Currently, IANPHI has ongoing long-term projects in Bangladesh, Ethiopia, Ghana, Guinea-Bissau, Malawi, Morocco, Mozambique, Nigeria, Tanzania, and Togo.[87]

Bangladesh: Strengthen disease surveillance and outbreak response in Bangladesh[88]

Bangladesh has limited ability to get accurate data quickly from its 400-plus local disease reporting sites and integrateit at the sub-national and national levels. This three-year project is addressing that deficit, so that the country’s Institute of Epidemiology, Disease Control and Research (IEDCR) can track potential outbreaks and emerging threats that typically show up first in far-flung locations. IEDCR is enhancing its capacity for real-time disease intelligence by expanding its innovative web-based information gathering and evaluation system to the local level. The project will lay the foundation for noncommunicable disease surveillance and a national laboratory network. Given IEDCR’s strong leadership and capacity, substantive relationships with national and international partners, and potential for linkages with its new Field Epidemiology and Laboratory Training Program (FELTP), this project will be a model for countries in Asia and Africa with pressing needs to expand evidence-based decision making.

Ethiopia Establish Ethiopia NPHI[89]

IANPHI supports the creation of an emergency operations center and enhanced laboratory capacity to detect disease outbreaks in Ethiopia. Project partners and collaborators include WHO, which has offered expertise on emergency response preparedness planning; the U.S. CDC, which has based its FELTP at EHNRI and is providing technical assistance on emergency preparedness; and the Association of Public Health Laboratories, which is actively involved in strengthening laboratory components. IANPHI’s member from Norway has expressed interest in providing technical assistance. Perkins+Will, a U.S.-based architectural firm, is designing the new emergency operations center.

Ghana: Establish Ghana CDC[90]

Ghana has worked for several decades to build a national primary health care network and has developed substantive capacity at the Ghana Health Service and the School of Public Health in research, surveillance, monitoring and evaluation, and other public health functions. IANPHI is working to develop and fund a strengthened and streamlined public health system through a new “Ghana CDC” that will better respond to health threats and address the major causes of death and disability in the country. It will link and strengthen maternal and child health, surveillance, vaccine and immunization coverage, lab capacity, health promotion, environmental and occupational health, and training. IANPHI will assess current public health capacity, facilitate development of a strategic framework for health, and help implement and fund a redesigned, expanded public health system.

Guinea-Bissau: Transform the national public health system by creating a new NPHI[91]

IANPHI, with technical assistance from Brazil’s FIOCRUZ, led efforts to bring together Guinea-Bissau’s disjointed public health system into a new NPHI that links its National Laboratory of Public Health, the Bandim Health Project (field epidemiology), the Ministry of Health’s epidemiology unit, and the National School of Public Health. With IANPHI support, the ministry has renovated the partially destroyed headquarters and national lab. The new institute in Guinea-Bissau will strengthen core public health functions including laboratory science, data collection and analysis, disease outbreak monitoring, and training. As the first donor to the new institute, IANPHI has leveraged funds from the World Bank, WHO, and the governments of Brazil, China, and Portugal, which have provided lab equipment, phones, computers, generator fuel, library materials, and human resource consultation.

Mozambique: Establish Mozambique NPHI[92]

Following discussions with IANPHI, Mozambique intends to transform the country’s National Institute of Health (NIH) into a comprehensive NPHI focusing on collecting data to inform public health decisions. That will require significant organizational, human resource, and infrastructure changes. Without a central reference lab or adequate human resources, NIH cannot quickly identify major disease threats or outbreaks nor contain them. IANPHI is partnering with Brazil’s FIOCRUZ, and architects HDR CUH2A’s Design 4 Others to help Mozambique strengthen disease monitoring and outbreak investigation, create a formal system to collect and analyze health data to promote evidence-based decision making, and build a coordinated system of public health laboratories, linked to a new NPHI facility. The U.S. CDC in Maputo will oversee $9 million in budgeted PEPFAR funding.

Morocco: Establish the Morocco NPHI[92]

Morocco faces multiple public health burdens: infectious diseases, high maternal mortality rates, a growing incidence of noncommunicable diseases, and risks posed by environmental toxins. Inadequate laboratories and surveillance as well as a lack of technical and research expertise hinder evidence-based decision making. Based on input from IANPHI-funded workshops and public health experts from the U.S. and Norway, Morocco’s National Institute of Hygiene is exploring creation of a new NPHI that would monitor, assess, and respond to health threats. Envisioned is an institute responsible for environmental health, non-communicable diseases, poison control, pharmacovigilence, maternal child health, and research. The NPHI would coordinate public health functions, enhance technical expertise (including new laboratories and training), and strengthen surveillance and health information. Pilot surveillance projects under consideration include assessments of environmental hazards, maternal mortality, and tobacco and other NCD health risks. Morocco also is exploring several partnerships: a twinning program to help build applied research capacity, laboratory design by architecture firm Perkins+Will, and creation of an FELTP by the CDC.

Nigeria: Build ability to rapidly identify and treat MDR-TB[93]

The Nigerian Institute for Medical Research (NIMR)—one of the first to conduct national surveys using the new WHO-approved Hain Assay—found that 6.1% of patients had organisms resistant to both INH and rifampin. Partners, including the U.S. CDC, South Africa’s National Institute of Communicable Diseases, Hain Lifescience, and the Harvard School of Public Health, have donated instruments to perform liquid cultures, a power generator, a vehicle to transfer samples, lab expansion, and training. In the third year of IANPHI funding, NIMR will continue to strengthen its public health capacity through collaborative efforts to expand MDR-TB surveillance and training. The project is a model for other developing countries and has attracted the interest of WHO, resulting in Green Light Committee approval for Nigeria to obtain second-line antituberculosis drugs at reduced cost for treatment of MDR-TB.

Nigeria: Study the Factors Influencing Community Attitudes Toward Timely Perinatal Care[94]

Nigerian Institute of Medical Research (NIMR) will study the factors influencing community attitudes toward timely perinatal care with the goal of improving maternal and neonatal outcomes. More than 140 women die each day in Nigeria from pregnancy and childbirth complications—the world’s second highest number of maternal deaths. The project, which is expected to be a model for all of Nigeria, will use a 10-step community participation process that has improved perinatal health and outcomes in other developing countries.

Tanzania: Transform NPHI by adding NCD capacity.[95]

The burden of noncommunicable diseases (NCDs) is increasing, but in the past, there has been limited information about NCDs and risk factors such as tobacco use. IANPHI is working with the National Institute for Medical Research (NIMR) in Tanzania to help NIMR take on major new responsibilities in NCD surveillance and control and layer NCD surveillance onto existing infrastructure for infectious diseases. A pioneer in Africa in establishing the national Integrated Disease Surveillance and Response System for infectious diseases, NIMR now plans to be a forerunner on the continent in the field of chronic disease surveillance. IANPHI’s efforts—and good timing—kick started the project, which is now underway on several levels. IANPHI’s grant included funding for two FELTP fellows and work on STEPS and vital statistics. AFENET and the University of Copenhagen are providing training at the community level. IANPHI is funding district and regional surveillance and, with the U.S. CDC, analysis of vital statistics. A prevention component will also be developed. NIMR leaders expect to gain valuable experience through this project that can be applied to other NPHIs hoping to add NCD functions. Project partners also include Finland’s THL and Columbia University.

Togo: Create Togo NPHI[96]

Togo has seen dramatic declines in its economy, living standards, and health outcomes since the early 1990s. Despite many challenges—minimal donor presence, fragile infrastructure, human resource deficits, and underfunded public health sector—the country’s leaders, including the president, believe that a comprehensive national public health institute is needed to meet the nation’s many health challenges. After an initial assessment, IANPHI recommended some immediate actions to improve and modernize l’Institut National d’Hygiene (INH)—the government’s designated agenda for public health leadership—as a foundation for development into an NPHI. These first steps focus on improving the quality of laboratory services for disease surveillance and outbreak response and integrating laboratory and epidemiologic efforts. In addition to strengthening core public health functions at the national and sub-national levels, the project provides an opportunity to increase Togo’s visibility among international donors and partners and integrate Togo into regional and global public health initiatives. The Institute Pasteur of Morocco is an active partner, providing technical assistance on site as well as training opportunities in Morocco. Partners include Germany’s international cooperation agency (GTZ) and France’s Institut de Veille Sanitaire, which may use Togo’s experience as a model project for a new global assistance initiative.

Uganda: Research the Ecology, Behavior and Genetic Variability of Aedes Africanus Arbovirus Vector.[97]

The Uganda Virus Research Institute (UVRI) will research the ecology, behavior and genetic variability of Aedes africanus arbovirus vector in order to predict the risks of arboviral outbreaks and design more effective disease control strategies such as insecticide spraying and vaccinations. One of the larger goals of the grant is for UVRI to create a mosquito specimen and DNA repository that will provide baseline information for larger research studies relevant to the control of Ae africanus species. Several diseases in Uganda have been traced to Aedes africanus arbovirus spread by mosquitoes including epidemics of yellow fever, Rift Valley fever, dengue, and West Nile virus.

Vietnam: Use Molecular Methods to Study and Identify the cagA Gene in H. pylori Infected Gastric Cancer Patients[98]

Vietnam National Institute of Hygiene & Epidemiology (NIHE) will use molecular methods to study and identify the cagA gene in H. pylori infected gastric cancer patients. H. Pylori has been shown to be associated with gastric cancer, and NIHE is hoping to determine the role of the cagA gene in H. Pylori. NIHE hopes to get a better understanding of the biological mechanism for gastric cancer in order to provide better diagnosis and treatment options for people in Vietnam, where gastric cancer is the second most common cancer found in men and the third most common in women.

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  93. ↑ http://ianphi.org/what-we-do/project-detail.cfm/proj_id/6DE549AF-123F-73FE-8906121BF3498462
  94. ↑ http://ianphi.org/member-countries/country.cfm/count_id/6C8CD4B2-123F-73FE-89832D8993C21636
  95. ↑ http://ianphi.org/what-we-do/project-detail.cfm/proj_id/6DE8F2C2-123F-73FE-893CB015D304B0C2
  96. ↑ http://ianphi.org/what-we-do/project-detail.cfm/proj_id/C5D9AE23-5056-B807-EC52EC7616D7D32B
  97. ↑ http://ianphi.org/member-countries/country.cfm/count_id/6C9A90A0-123F-73FE-891C8ACC5D180EEE
  98. ↑ http://ianphi.org/member-countries/country.cfm/count_id/6C9C1329-123F-73FE-8906979C977B63DC#institute1

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