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. 2025 Sep 25;10(9):e017454.
doi: 10.1136/bmjgh-2024-017454.

It is not just about the training: rethinking strategies to strengthen the global emergency response workforce

Mays Shamout  1 , Adela Hoffman  2 , Sonya Panjwani  2 , Mariama Tejan  2 , Cassandra Boutelle  2 , Claire Corkish  2 , Tasha Stehling-Ariza  2 , Hannah Lofgren  2 , Coralie Giese  2 , Dante Bugli  2 , Ashley Lauren Greiner  2
Affiliations

It is not just about the training: rethinking strategies to strengthen the global emergency response workforce

Mays Shamout et al. BMJ Glob Health. .

Abstract

Introduction: Public health rapid response teams (RRTs) are critical to timely and effective emergency response. The US Centers for Disease Control and Prevention (CDC) has trained country-level public health emergency managers on RRT programme design, management and operations. However, countries continue to face challenges in RRT programming, requiring further elucidation of the supportive and challenging factors.

Methods: In April 2021, 86 CDC-trained participants on RRT programme management were sent an anonymous online survey with questions regarding their country's RRT programme capacity (fully functional (FF-RRT) vs partially functional (PF-RRT)) and factors that affected programme implementation. Descriptive analyses were conducted; factors were stratified by respondent-reported RRT programme capacity and gross national income (low-lower middle (L-LM) and upper middle-high (UM-H) using a χ2 test.

Results: 55 (64%) participants from 24 countries responded, most from the African region (75%) and 46% from L-LM countries. Most participants (82%) reported an RRT programme in their country, 65% PF-RRT and 35% FF-RRT. The greatest supportive factors for RRT programme implementation included a dedicated RRT management team (65%) and leadership understanding (65%). The major challenge was lack of funding (68%). L-LM countries cited greater challenges with funding (74% vs 38%; p=0.04) and equipment (46% vs 0%; p=0.01), while UM-H countries cited poor standard operating procedure development (50% vs 11%; p=0.04) and leadership understanding (50% vs 11%; p=0.01). Available funding was a more supportive factor for PF-RRTs than for FF-RRTs (48% vs 19%; p=0.004). More FF-RRTs (100% vs 62%; p=0.005) cited the lack of RRT surge staff as a challenging factor.

Conclusion: Training RRTs is not enough. Addressing foundational factors such as sustainable funding and leadership support is essential for the long-term success of RRT programmes. With the challenges elucidated here, future global health initiatives can consider tailoring support based on RRT country capacity status and income level to ensure effective emergency response capacity.

Keywords: COVID-19; Decision Making; Global Health; Health policy; Public Health.

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Conflict of interest statement

Competing interests: None declared.

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