How can public health officials improve the lives of millions of people around the world if they lack the tools to monitor and address outbreaks of disease, especially among displaced populations?
This concerns , an alumna and faculty instructor of population assessment at USF鈥檚 (COPH), who presented at the annual meetings of the in Washington, D.C. and the in Toronto, Canada. Her topic, 鈥,鈥 addressed ways to fortify local disease surveillance systems and increase detection of pathogens.
Dr. Caitlin Wolfe (Courtesy of Wolfe)
What is the connection between infectious disease and displaced populations?
鈥淒isplacement impacts both the health of individuals and the ability of the health system to do its job,鈥欌 Wolfe said. 鈥淚f we think about individual people, population displacement increases the risk for transmission of communicable diseases in emergency situations.鈥
Wolfe鈥檚 lectures focused on migrant populations 鈥 including those forcibly displaced 鈥 because of their greater risk of communicable diseases and limited health care services. Many displaced people lack basic sanitation, shelter and nutrition, so diseases can spread rapidly.
鈥淪ustained conflict, forced migration and protracted displacement can lead to an increase in chronic diseases such as diabetes, hypertension and malnutrition,鈥欌 she said. 鈥淎dditionally, displacement interrupts vaccination schedules that can increase the risk of vaccine-preventable diseases, so measles and polio can make a resurgence.鈥欌
Wolfe鈥檚 interest in the subject began the year before she came to USF as a , while she was working with the as part of the Ebola response in Monrovia, Liberia. As the outbreak began to wane, officials worked to build a more resilient health system capable of preventing, detecting and responding to potential outbreaks.
鈥淭his meant strengthening the health system across all levels, starting at the community and working up through the health facility, district, county and national levels,鈥欌 she said.
Her experience led to an appreciation of community-based surveillance (CBS), which offers an opportunity to build local disease surveillance and increase early warning capacity. CBS involves the systematic detection and reporting of events of public health significance within a community and by community members.
In her time at USF, Wolfe collaborated with the (IOM) offices in Iraq and Libya on migrant health issues, including CBS. At the beginning of the COVID-19 pandemic, she worked with IOM colleagues in Iraq to design and implement a CBS system for COVID-19 detection among populations displaced internally within Iraq following the Islamic State crisis.
Following the success of that CBS program, including 99-percent acceptability among the 7,700 households that participated, it was expanded to include additional locations and diseases of concern. Soon after, Wolfe began collaborating with IOM鈥檚 office in Libya on strengthening disease surveillance among migrant communities.
But such programs can鈥檛 succeed without global support, much of which is shrinking or being eliminated altogether. Nearly 2.4 million people in Nigeria, Bangladesh and Nepal, for instance, depend on the delivery of highly nutritional, ready-to-use therapeutic foods, most of which are produced in the United States. These deliveries are no longer funded.
Dr. Wolfe riding in a World Health Organization helicopter. (Photo courtesy of Wolfe)
The United States provided 47 percent of the global humanitarian aid in 2024. However, the U.S. withdrawal from WHO and USAID operations 鈥渞epresents a monumental shift in the global health landscape,鈥欌 notes a 2025 study in the journal Frontiers in Public Health: 鈥淲hile domestic political considerations may drive this disengagement, the consequences for international health security, humanitarian aid and scientific collaboration are profound.鈥欌
The lack of humanitarian assistance has had a major impact on supply chain, data management and prevention efforts throughout the world, Wolfe added. This includes 鈥渟oft鈥欌 support such as community outreach and education campaigns that can help prevent such scourges as HIV and AIDS.
Dr. Wolfe on a research trip in Senegal (Photo courtesy of Wolfe)
鈥淭he global health funding cuts enacted by the U.S. government over the last year are devastating health systems worldwide, including surveillance systems responsible for detecting and responding to outbreaks,鈥欌 she said. 鈥淟ack of funding for prevention programs means more people are getting infected with HIV and it鈥檚 significantly more expensive to treat someone for HIV over the course of their entire life than it is to prevent infections from happening in the first place.鈥欌
Because infectious diseases don鈥檛 care about borders, Wolfe said they thrive among susceptible people and a favorable environment virtually anywhere. For this reason, community-based surveillance is critical if health officials want to stay a step ahead of disease outbreaks and prevent a large-scale and costly crisis, which leads to healthier communities. 鈥淭he work of Caitlin Wolfe is one anchor of our global public health agenda, including student opportunities,鈥 said Sten Vermund, COPH Dean. 鈥淢igration is increasing with civil unrest and climate pressures, and her work on testing best practices is vital.鈥
Assisting Wolfe in her research were COPH graduates Catharina Chipman and Nicole Nauman, along with Namit Choudhari, a PhD candidate in the 深夜看片 School of Geosciences.
Nicole Nauman (Photo courtesy of Nauman)
鈥淪ince the traditional means of public health surveillance needs to be modified to reach displaced populations, it鈥檚 vital that we work with these populations for disease and outbreak identification,鈥欌 Nauman said. 鈥淲hen we can鈥檛 rely on timely lab reports or widespread health access to identify cases, there鈥檚 a need to delve deeper into community connections for surveillance to prevent disease transmission.鈥欌