A final example is the relationship between the Massachusetts state public health laboratory system and public health clinics in Peru, whereby sputum specimens and isolates from Peru are sent to Massachusetts on a daily basis for drug resistance testing. This arrangement could serve as a model for a much larger, market-based approach to sharing limited public health resources.


As noted above, the trend toward bidirectionality in transnational education and training, whereby southern partners have as much to gain as their northern collaborators, reflects a growing awareness that a sustainable global capacity to respond to infectious disease threats requires the full and equal participation of developing countries where infectious diseases are endemic. It is vitally important that the intellectual, technological, and health care workforce capacities of the developing world be strengthened, both for the sake of improving the health of local populations and because so many of the world’s infectious diseases arise in tropical countries and spread via nonindigenous travelers. One-third of all new infectious diseases identified over the past 25 years were discovered in Latin America. The Gorgas Course in Clinical Tropical Medicine and other international training programs offered by the Instituto de Medicina Tropical “Alexander von Humboldt” (IMT) in Lima, Peru, and several of the overseas training programs sponsored by FIC exemplify this trend toward bidirectionality, as described in this section.

Nevertheless, in addition to improving the capacity of the developing world, one of the primary goals of these programs remains the education and training of northern students, researchers, and practitioners. Despite the progress made over the past decade in providing increasing numbers of opportunities for U.S. students and health care practitioners to gain experience overseas, including experience with the treatment and control of tropical infectious diseases, much work remains to be done. Efforts of the American Society of Tropical Medicine and Hygiene (ASTMH) and others to improve the training of U.S. students in tropical infectious disease medicine are also summarized here.

Workshop participants expressed serious concern that too few medical and veterinary school students receive adequate public health training in general, let alone training in tropical infectious diseases. It is vital for front-


This section is based on the workshop presentations by Barry (2002), Demin (2002), and Gardner (2002).

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