Sir

In his Commentary article “Is China prepared for microbial threats?” (Nature 435, 421–424; 2005), David Ho called for China to train a cadre of public-health officers in programmes similar to those of the US Epidemic Intelligence Service. In fact, the Chinese Center for Disease Control and Prevention launched just such a programme in 2001: the Chinese Field Epidemiology Training Program (CFETP).

The CFETP is an international partnership with basic funding from the Chinese Ministry of Health and additional resources from the United Nations Children's Fund, the World Health Organization, the US Department of Health and Human Services and the US Centers for Disease Control and Prevention. It currently has 20 graduates, serving as field epidemiologists in 17 Chinese provinces, and offering guidance to 23 first- and second-year officers in 10 of these provinces.

On 19 February 2003, the CFETP sent six epidemiologists to Guangdong province to assist with surveillance and epidemiological investigation of the outbreak of atypical pneumonia now known as SARS. They demonstrated the effectiveness of personal protective measures for the prevention of transmission to hospital staff. When the outbreak spread to Beijing, the CFETP epidemiologists anchored surveillance efforts, investigated transmission chains and evaluated the effectiveness and utility of quarantine (J. Ou et al. Morb. Mort. Week. Rep. 52, 1037–1040; 2003).

Since the SARS outbreak, the CFETP has undertaken more than 100 investigations on a wide range of public-health problems, including human influenza, HIV/AIDS, paratyphoid fever, measles, brucellosis, meningococcal meningitis, childhood injuries and disasters such as the 2004 typhoon in Zhejiang province. A CFETP officer and graduate recently travelled to Qinghai province to investigate the possibility of H5N1 avian influenza transmission to humans following the outbreak in migratory waterfowl; no such transmission was found.

Set up as a temporary programme, the CFETP is in the process of becoming a permanent unit of the Chinese Center for Disease Control and Prevention. In addition to the national effort, several provinces have developed their own programmes to extend training in field epidemiology and surveillance to their local health officers.

Building the CFETP to meet the needs of this vast and populous nation will require years of investment and training, as well as finding new ways to rapidly train and support health workers in the provinces. We look upon Dr Ho's timely commentary as an opportunity to reinforce our activities.