Dr Richard Murray Trostle: Why we gave AFENET seed funds at inception

While working with the now defunct United States Agency for International Development (USAID) Dr Murray authorized the very first grant that breathed life into the African Field Epidemiology Network (AFENET). In an interview with him this year, Dr Murray shared his connections with AFENET and why he decided to fund the start up.

Could you please tell us about yourself and your relationship with AFENET?

In 1999 or 2000, I was appointed as the director of the Infectious Disease Surveillance Unit, which was a new group started up at USAID, and it was through that unit that I began to work with TEPHINET [Training Programs in Epidemiology and Public Health Interventions Network] and that led into my relationship with AFENET.

I can’t remember the exact year, but it was in the early 2000s at a TEPHINET meeting in France. I realized that TEPHINET was not focusing on development of programs in Africa that much. They were particularly looking at Asia and Europe and the Americas, so I met three program representatives from the African programs.

There were only four African programs at that time, and I had lunch with the three representatives, and we talked about what could be done to strengthen African programs and a good friend of mine, Peter Nsubuga, was at CDC at the time. Him and I talked later about this and that led then to a broader meeting with all four program representatives in Kampala and we talked again about how to strengthen the programs in Africa and at a follow-up meeting to that in Ghana.

The African programs directors decided to name their network AFENET and that was the first time that the name was used, and I know Peter offered some support to the program through CDC. I offered financial support through my work as director of the surveillance unit at USAID and that became the relationship that we had with AFENET.

The director of USAID appointed me as deputy director of the avian influenza unit that he was just starting up, and this was just after the SARS outbreak, and the surveillance unit didn’t have very much money. I mean it was probably on an annual basis, less than a million dollars to spend globally. The unit to address avian influenza had a lot of money and so I was able to influence some of the activities there and steer some of the money towards AFENET and that enabled me to be a little more influential in supporting AFENET.

But that was how the program began from my perspective. It was always my desire to see African programs strengthened and supported through Africans. I didn’t want foreigners coming in and running programs. Africans are very well suited to run these activities in their own countries, and I think AFENET is a good example of that. They’ve done a remarkable job in expanding their own activities.

What inspired you to put money into this unknown that was being created? Where did you get the confidence to fund this startup?

Well, I think the confidence I had was in the people that I met. When we had those meetings in Kampala and in Ghana, there was open and frank discussions of how to expand the field epidemiology programs throughout Africa and how to not just expand training but the impact of those programs. How to expand the impact of the students once they have been trained. I was very impressed with the vision of the people that were at the university level, the people that were running these activities.

I think that really gave me confidence that African experts could manage their own activities and do a very good job of it. I don’t think I was ever concerned about that. One thing that we did, I think it was at the Kampala meeting, we decided to hire David Mukanga as the, I’m not sure exactly what his title was, but sort of the manager [Executive Director] of the new organization.

David is an excellent person. I mean, he worked very hard and he at first had a very small staff, but eventually AFENET did bring on excellent people to carry forward the Network. They had good people to draw from in the African environment. This became very apparent to me from the early meetings that we had. I was convinced that there was no real reason to bring in foreigners to manage or to conduct these activities in Africa. And that we had good people there. They were more than capable. They’re well-educated and we could just build the capacity on the continent to conduct the work. I hate to say this, but I think that there are some development organizations that don’t necessarily agree with this. They like to hire their own people and send them in to do the work. It’s sort of a neocolonialism. I thought this was a good way to manage affairs and it has been proven that this is effective because we started with just a few people, and we had just a little bit of money. I don’t know if there was ever an issue of lack of confidence in AFENET.

The AFENET you helped to start was initially in four countries and now has a presence in 40 plus countries. How do you feel about that?

Oh, I’m ecstatic about that. And that’s one of the key reasons why as a development agency, you know, I’ll talk like USAID still exists, but if I was still working there and as a development agency, I would be so supportive of a group like AFENET. It’s because USAID doesn’t, never did work in all those 40 countries and so and it’s my belief that the purpose of a development agency is to help people move forward regardless of what country they live in and regardless of what religion they are in, regardless of what race they are, all these things.

There’re 52 countries in sub-Saharan Africa, I believe. Forgive me if I’ve gotten that wrong [54 -Editor], but the ideal objective of a development agency should be to see this capacity built in every one of those countries and yet USAID didn’t work in all those countries.

So, if you take the humanitarian objective of wanting to see epidemiological capacity in disease prevention delivered to all these countries and all these people, then you could only do this through a group like AFENET. USAID could never do it because we could never gain access to all these countries and so this is the reason why supporting a group like AFENET is essential and it should be the way it would work and I think that just the story of AFENET moving forward and going from the original four, I mean I always expected that there would be progress from the original four, but at the last founders meeting, when I saw it was 40 plus I mean I practically fell out of my chair. I had to turn the video off so nobody could see me jumping up and down.