The study was conducted as a mixed-methods investigation with public health stakeholders in the UAE between November 2024 and February 2025. The published analysis concentrates on the qualitative strand of the data, which came from two complementary sources: open-ended responses in an online survey completed by 19 participants, and semi-structured interviews with 12 senior decision-makers. Rather than treating these datasets separately, the researchers integrated the survey’s free-text answers with the interview transcripts and analysed them thematically as a single dataset, a technique that strengthens the depth of interpretation when participant numbers are small. The authors are explicit that the findings describe this bounded group of experts in depth rather than producing generalisable estimates for the entire workforce.

Two established frameworks anchored the analysis. The first is the WHO–ASPHER Competency Framework, developed by the World Health Organization together with the Association of Schools of Public Health in the European Region, which defines the knowledge, skills and behaviours that a modern public health professional should command, from epidemiology and health protection to leadership, ethics and communication. The second is the WHO Health System Building Blocks Framework, which decomposes a health system into six core components: service delivery, the health workforce, health information systems, access to essential medicines, financing, and governance. By reading stakeholder testimony through both lenses simultaneously, the team could connect individual-level skill gaps to system-level structural weaknesses, a technical move that distinguishes this study from simpler workforce surveys.

The thematic analysis surfaced six overarching themes: fragmented governance, competency and training gaps, misalignment between curriculum and practice, Emiratization and career barriers, lessons drawn from COVID-19, and the need for a unified national strategy. Each theme represents a distinct failure mode, but the researchers emphasise that they are interlocking. Fragmented governance, for example, is not merely an administrative inconvenience; it fragments workforce planning itself, so that different institutions train, credential and deploy public health staff against different assumptions. When governance is disjointed, competency frameworks lose their anchoring function, because no single body is responsible for defining what a public health professional in the country should be able to do.

Among the most consequential findings is the limited awareness and use of competency frameworks among stakeholders. International frameworks such as WHO–ASPHER exist precisely to give workforce planners a common vocabulary: they specify the domains in which practitioners must be proficient and allow education providers to design curricula that map onto real occupational requirements. If practising managers and policymakers are largely unaware of these tools, the link between training and employment breaks down. The study found exactly this weak alignment between education and practice, with academic programmes not consistently reflecting the competencies that public health roles in Abu Dhabi actually demand. Graduates may therefore enter the workforce with credentials that employers do not fully recognise, and employers may struggle to articulate the skills they need in a form that educators can act upon.

The question of Emiratization, the national policy of increasing Emirati participation in the workforce, emerged as a theme with particular technical and social complexity. Stakeholders reported limited Emiratization in public health roles specifically, alongside career barriers that discourage nationals from entering or remaining in the field. Public health occupies an awkward position in many health labour markets: it is neither clinical medicine, with its clear prestige and licensure pathways, nor administration, with its conventional civil-service ladders. Without defined career structures, competency-based promotion criteria and visible professional identity, the field struggles to attract and retain national talent. The study suggests that workforce reform cannot be separated from career-pathway design; training pipelines only function when there is a destination at the end of them.

The COVID-19 pandemic functions as both backdrop and catalyst throughout the findings. The authors note that reforming the public health workforce in Abu Dhabi and across the UAE became increasingly urgent during and after the pandemic, alongside wider pressures from evolving public health challenges and health-system transformation. Pandemics are, in effect, unrequested stress tests of workforce planning. They expose shortfalls in surveillance capacity, outbreak investigation, risk communication and health information systems, and they reveal whether governance structures can coordinate across emirates and federal institutions at speed. The stakeholders in this study treated the pandemic experience as a source of concrete lessons about where the UAE’s public health machinery performed well and where structural fragilities appeared, and the researchers folded those lessons directly into their thematic framework.

Governance and policy, together with education and training, were the concerns most consistently raised across both data sources, the survey’s open-ended items and the interviews. That convergence matters methodologically. When two independent modes of data collection, one written and asynchronous, the other conversational and probing, produce the same priority concerns, the risk that findings are artefacts of a single instrument diminishes. The institutional landscape that stakeholders described involves multiple actors, including the Department of Health, the Abu Dhabi Public Health Centre, and the Ministry of Health and Prevention, operating across federal and emirate-level jurisdictions. Fragmentation across these governance structures, the study reports, impedes coherent workforce planning and dilutes accountability for implementing reform.

The study’s conclusions translate these findings into a reform agenda with clearly specified components. The authors argue that public health workforce reform in Abu Dhabi requires a coordinated cross-sector response that aligns competencies, curricula, regulation and career pathways, while strengthening governance, integration and long-term sustainability. In practical terms, that means adopting a national competency framework as the reference standard for job descriptions, accreditation and continuing professional development; redesigning academic curricula so that they map onto that framework; establishing regulatory recognition of public health as a distinct professional discipline; and building career ladders that make the field attractive to Emirati graduates. Each element reinforces the others, which is why the researchers frame the agenda as systemic rather than piecemeal.

The research also carries significance beyond the Gulf. Many health systems, in high-income and middle-income countries alike, confront the same triad of weak workforce data, unclear competency standards and fragmented governance, and the World Health Organization has repeatedly identified health workforce strengthening as one of the binding constraints on universal health coverage and pandemic preparedness. By applying internationally recognised frameworks to a specific national context and publishing the results open access, the team has produced a template that other countries in the Gulf Cooperation Council and beyond can adapt. The study was supported by a research grant from United Arab Emirates University and approved by the university’s Institutional Review Board, with informed consent obtained from all participants. Its authors, spanning institutions in the UAE, Portugal, the Netherlands, Poland and the Czech Republic, present the work as a pathway toward evidence-based policy, and the evidence they have assembled suggests that the pathway runs directly through the people who make public health happen.

Subject of Research: Public health workforce reform and competency-based workforce planning in Abu Dhabi and the United Arab Emirates

Article Title: Public health workforce reform in Abu Dhabi: a pathway to evidence-based policy and global standards alignment

Article References: Al Qadiri, T., Elbarazi, I., Elkonaisi, I., Paulo, M. S., Sheek-Hussein, M., Koornneef, E., Czabanowska, K., & Grivna, M. (2026). Public health workforce reform in Abu Dhabi: a pathway to evidence-based policy and global standards alignment. BMC Medical Education. https://doi.org/10.1186/s12909-026-10518-x

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10518-x

Keywords: public health workforce, Abu Dhabi, United Arab Emirates, WHO-ASPHER Competency Framework, health workforce planning, competency frameworks, medical education, health policy, Emiratization, COVID-19, governance, BMC Medical Education

The scale of the shortage the program addresses is substantial. According to the editorial, attrition during the COVID-19 pandemic worsened an existing deficit in the public health workforce, which now needs an estimated 80,000 full-time workers to provide basic community services. Agencies at every level of government are understaffed, and the authors attribute this largely to a lack of qualified applicants rather than a lack of available positions. The paradox at the heart of the problem is that the pipeline of public health students has never been larger. Undergraduate public health degrees awarded in the United States grew from just 1,480 in 2001 to 18,289 in 2020, and in the spring of 2020 the number of bachelor’s degrees conferred surpassed the number of public health master’s degrees for the first time. Yet only about one in ten graduates holding an undergraduate public health degree reports employment with a government agency, meaning that the vast majority of this expanding talent pool never enters the governmental public health sector where the need is most acute.

The Lewis Scholars Program was designed to close that gap by intervening early in students’ academic trajectories. Over eight to eleven weeks, scholars participate in classroom learning and hands-on internships, supported throughout by intensive mentoring, professional development, and networking opportunities. A series of articles in the same special issue of the journal details how the programs function at each site and what they have accomplished over more than a decade of operation. The demand for these opportunities is striking: in total, the programs have accepted roughly 2,000 students from a pool of more than 40,000 applicants, an acceptance rate that underscores both the competitiveness of the program and the appetite among undergraduates for meaningful public health training.

The outcomes for program alumni suggest that the model is working. More than half of former scholars have gone on to enroll in advanced degree programs, including Master of Public Health, PhD, and MD programs. Forty-five percent of alumni work or have worked in public health or biomedical science roles, and another 20 percent have pursued careers in other areas of health care. Alumni now serve in health departments, advocacy organizations, community-based nonprofits, tribal health programs, and academic research centers, forming a distributed network of trained professionals across the breadth of the public health enterprise. For a field struggling to recruit qualified candidates into government positions, these figures represent a measurable return on a relatively modest educational investment.

Michael A. Joseph, PhD, MPH, Vice Dean for Education at Columbia Mailman and a co-author of the editorial, frames the program as more than a recruitment tool. The Lewis Scholars Program, he says, is a powerful model for how cultivating the talents of young public health students can open new pathways to fill the need for public health careers, particularly in government and in service of local communities. Recruitment is deliberate and targeted. The program intentionally seeks out first-generation college students and individuals who are members of groups that have historically been underrepresented in public health and biomedical science careers. The goal, Joseph explains, is to build a public health workforce that reflects the diversity of communities across the country, composed of professionals who are deeply connected to the communities and populations most in need.

A companion article in the special issue, authored by Troy Hoffman, MPA, director of SPHSP and Educational Initiatives at Columbia Mailman, examines the mentoring approach that underpins the program’s results. The programs offer scholars what the authors describe as a web of support designed to cultivate both academic and professional development. Each scholar is paired with one or more internship mentors who engage trainees in real-world public health challenges across a variety of domains, including governmental agencies, academic institutions, and community-based organizations. The scale of this mentoring effort is considerable: in 2025, across all seven sites, the programs recruited and trained 190 professionals to serve as mentors. Beyond internship mentors, scholars are also supported by advisors, preceptors, coaches, and near-peer mentors, creating multiple layers of guidance throughout the program and beyond.

Hoffman emphasizes that the support structure is holistic and responsive to individual circumstances. The program makes sure scholars get support where they are and when they need it, he says. Crucially, mentorship does not end when scholars complete the summer program. Instead, the programs create career-long connections with program staff, researchers, faculty, and community-facing public health professionals, all of whom continue to shape alumni trajectories in public health long after the formal training period concludes. This sustained engagement distinguishes the Lewis Scholars model from shorter-term internship programs and may help explain the strong rates of advanced degree enrollment and public health employment among its graduates.

The pathway from scholar to public health professional is illustrated by the experience of Kennedy Wade, MPH ’26, who applied to SPHSP in 2023 as a rising senior at Xavier University of Louisiana, a historically Black university. A public health major, Wade was drawn to the opportunity to do hands-on work in the field. After her acceptance, she expressed an interest in environmental health and housing, and the program placed her in an internship with a researcher studying smoke-free policies in public housing in New York City. Wade describes the placement as her first experience doing community-based public health work, an experience that deepened her interest in environmental health and helped her grow substantially as an aspiring public health professional.

Wade’s trajectory continued at Columbia Mailman itself. She is one of 25 SPHSP graduates who have gone on to study for a master’s degree at the school since 2023, when Columbia Mailman took over leadership of the program from Columbia’s Vagelos College of Physicians and Surgeons. After graduating with a Columbia Mailman MPH in Epidemiology earlier this year, Wade became a CDC/CSTE Injury Epidemiology Fellow at the New York City Department of Health and Mental Hygiene, where she works in the Bureau of Environmental Surveillance and Policy. Since starting the position over the summer, she has explored a different side of environmental health, with work ranging from traffic-related injuries to falls among older adults. In November, she is scheduled to present her research on the impact of greened vacant lots on adolescent victimization and perpetration at the American Public Health Association’s annual meeting.

Three years after her own summer in the program, Wade says its influence remains strong. She credits the program with providing learning, hands-on experience, and a feeling of community, and notes that she is still close with everyone in her cohort, with program leaders remaining in her corner from the beginning. Her account, like the editorial’s broader analysis, points to the central argument of the special issue: that investing early in a diverse, well-mentored cohort of undergraduates can transform individual lives while simultaneously addressing a national staffing shortfall. As public health agencies continue to grapple with an estimated 80,000-worker gap, the Lewis Scholars Program offers a documented, replicable template for converting the growing population of public health graduates into the government workforce that communities depend on.

Subject of Research: The CDC John R. Lewis Undergraduate Public Health Scholars Program as a workforce development model for public health

Article Title: CDC undergraduate pathway program offers a model of success at Columbia Mailman and beyond

Article References: CDC undergraduate pathway program offers a model of success at Columbia Mailman and beyond. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: public health workforce, CDC, John R. Lewis Scholars Program, Columbia Mailman, undergraduate training, mentorship, health equity, epidemiology, government employment, workforce shortage, SPHSP, public health education

The core of the concern raised by APIC and SHEA is operational rather than abstract. Infection preventionists and healthcare epidemiologists working on the front lines of American medicine depend daily on the CDC’s science, surveillance systems, and guidance documents to make decisions that protect both patients and healthcare personnel. When a hospital investigates a cluster of healthcare-associated infections, when a nursing home must respond to an outbreak of a respiratory pathogen, or when an outpatient clinic needs to update its vaccination protocols, the technical foundation for those decisions typically originates at the federal agency. According to the joint statement, that foundation is visibly weakening: guidance is slower to arrive, technical assistance is harder to reach, and scientific expertise is thinner precisely when it is most needed.

The timing of the reported workforce losses amplifies the risk. Healthcare facilities are entering the respiratory virus season without updated federal vaccine recommendations, a gap that leaves infection prevention teams without the authoritative national benchmarks they have historically relied upon to standardize immunization practices across institutions. At the same time, facilities are preparing for potential measles exposures, a disease that demands rapid identification, isolation, and contact tracing protocols grounded in current epidemiological evidence. The organizations also point to the monitoring of imported threats such as Ebola, which requires sustained laboratory capacity, surveillance infrastructure, and rapid communication channels between federal scientists and local practitioners. Each of these scenarios depends on a functioning national public health partner, and each becomes more hazardous when that partner is operating with a substantially reduced workforce.

Infection prevention is a discipline built on the rapid translation of scientific evidence into bedside practice. Infection preventionists are the specialists who design and enforce the protocols that prevent healthcare-associated infections, which affect millions of patients worldwide each year and represent one of the most common adverse events in medical care. Healthcare epidemiologists complement this work by applying epidemiological methods to detect outbreaks, evaluate antimicrobial resistance patterns, and assess the effectiveness of preventive interventions within healthcare settings. Both professions operate within a distributed network in which local expertise is amplified by national coordination. The CDC functions as the hub of that network, synthesizing data from thousands of facilities, issuing evidence-based recommendations, and providing the laboratory and technical infrastructure that individual institutions cannot replicate on their own.

APIC President Kathy Ward, a registered nurse with advanced credentials in infection control, framed the relationship between frontline practitioners and the federal agency as a partnership that is now under strain. In the statement, she emphasized that infection preventionists safeguard the nation’s healthcare system against healthcare-associated infections and that the profession depends on the CDC to provide timely, evidence-based guidance. She warned that the losses described in the reporting put that partnership, and patient safety itself, at risk. Her comments reflect a practical reality: when federal guidance is delayed or unavailable, individual facilities must improvise, and improvisation in infection control can lead to inconsistent practices, gaps in protection, and ultimately preventable infections.

SHEA President Lisa Maragakis, a physician and epidemiologist, directed her warning toward a longer-term consequence of workforce erosion. In the statement, she observed that healthcare epidemiology is built on sound science and trusted data, and she characterized the CDC’s scientific independence and expert workforce as national assets that cannot be rebuilt overnight once they are lost. This point carries particular technical weight. The scientists who staff the agency’s emerging infectious disease and respiratory disease centers accumulate institutional knowledge, methodological expertise, and operational experience that are not easily transferred or replaced. Experienced federal scientists develop the capacity to recognize early signals of emerging threats, to design surveillance systems that capture meaningful data, and to communicate complex findings to practitioners who need actionable guidance. When such experts depart, their institutional memory departs with them, and rebuilding that capacity requires years of recruitment, training, and mentorship.

The downstream effects of a weakened CDC do not remain contained within the agency. As APIC and SHEA describe it, when the national partner is weakened, the burden shifts to already stretched healthcare facilities and to state and local health departments, many of which have faced their own staffing and funding challenges in recent years. State and local public health agencies depend on federal technical assistance, laboratory confirmation capabilities, and coordinated data systems to carry out their mandates. When federal capacity contracts, these agencies absorb responsibilities they may lack the resources to fulfill, and the resulting gaps propagate outward to patients and communities, who ultimately bear the consequences in the form of increased exposure to preventable infections and slower responses to outbreaks.

In response to the situation, the two organizations have issued a three-part call to action directed at Congress and the Administration. First, they urge the restoration and sustained support of CDC staffing in infectious disease programs, healthcare quality promotion, and laboratory operations, the specific divisions whose expertise underpins infection prevention practice nationwide. Second, they call for the protection of the agency’s scientific independence, reflecting a concern that political interference in scientific processes would further undermine the credibility and reliability of federal guidance. Third, they demand that funds appropriated for state and local public health partners be distributed promptly, ensuring that the frontline agencies responsible for local outbreak response receive the resources that Congress has already allocated. Together, these recommendations address the workforce, the institutional safeguards, and the funding pipelines that the organizations view as the essential infrastructure of national infection prevention capability.

The statement also situates the current moment within a broader understanding of how healthcare safety is produced. The prevention of healthcare-associated infections is not achieved by any single institution acting alone; it is the product of a layered system in which federal science, state and local public health infrastructure, and frontline clinical expertise reinforce one another. Surveillance data collected by the CDC inform the guidelines that infection preventionists implement in their facilities, and the observations of those frontline practitioners in turn feed back into national evidence. Disruption at any layer degrades the entire system, but disruption at the federal layer is particularly consequential because it affects every facility simultaneously. The organizations’ warning suggests that the reported loss of nearly a third of the agency’s workforce represents precisely such a systemic disruption, one whose effects are already observable in delayed guidance and reduced access to technical assistance.

As respiratory virus season proceeds and as facilities continue to prepare for measles exposures and monitor imported threats, the concerns articulated by APIC and SHEA are likely to frame an ongoing policy debate about the nation’s public health readiness. The organizations’ message is that the expertise housed within the CDC constitutes a form of national infrastructure comparable in importance to physical systems, and that its loss carries consequences measured not in budget figures but in patient outcomes. Their statement serves as both a diagnosis of the current strain on the infection prevention community and a formal request to federal policymakers to restore the scientific capacity on which American healthcare safety has long depended. Whether that request translates into legislative and administrative action remains to be seen, but the two societies have made clear that, in their assessment, the window for protecting this critical national asset is narrowing.

Subject of Research: Impact of CDC workforce reductions on infection prevention and healthcare epidemiology

Article Title: APIC and SHEA Statement on reported erosion of CDC capacity

Article References: APIC and SHEA Statement on reported erosion of CDC capacity. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: CDC, APIC, SHEA, infection prevention, healthcare epidemiology, public health workforce, healthcare-associated infections, respiratory virus season, vaccine recommendations, measles, Ebola, health policy