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Meet Sarah Legare, MPH, CPHQ, a surveillance fellow based in Tbilisi, Georgia with the Division of Global Health Protection. Sarah’s fellowship journey began in 2020 in Addis Ababa, Ethiopia, where she supported laboratory systems by expanding COVID-19 testing and respiratory disease surveillance. In early November 2021, the US Embassy in Ethiopia ordered the departure of its staff due to the ongoing civil war, which caused Sarah to evacuate. She says, “with very little notice and a lot of support from my mentor and colleagues, I was able to come to Georgia as my ‘safe haven’ location, while continuing to support Ethiopia remotely”. In March 2022, Sarah completely transitioned her work to supporting the CDC offices for Georgia and the Eastern Europe and Central Asia Region, as the lead for the antimicrobial resistance portfolio.

While Sarah’s work in both Ethiopia and Georgia have been affected by war, she says that out of those horrible circumstances have come opportunities to understand the value of public health in a crisis. Sarah says that one of the advantages of relocating during her fellowship is the opportunity to connect with additional mentors and coworkers, ultimately resulting in a network of connections all over the world.

“I have been lucky to work with so many incredible and supportive people. Every time I struggle or need guidance, I have someone to ask whose opinion I trust.”

Sarah admires the qualities of her colleagues, who she says are strategic thinkers, clear communicators, detail-oriented, kind, and humble, but not afraid to speak up. She says that colleagues and leadership have created a caring and nurturing environment, which has made her experience even better.

Entering the Field of Global Health

Sarah shared that it was her Peace Corps volunteer experience in Senegal that sparked her interest in global public health. She says, “without really understanding it, I was doing surveillance work in the Peace Corps: monitoring the growth of children, counting mosquito net availability and usage, identifying which mosquito species were in homes, and more.” She says her experience in Senegal working on malaria prevention and treatment helped her realize that surveillance is a core part of public health and a determining factor in the success of programs.

Aside from her previous experience as a Peace Corps volunteer, Sarah worked with CDC as a graduate student employee in the Entomology Branch in Atlanta, Georgia, and had support from the CDC country office in Tbilisi, where she is currently based during her graduate thesis research with Emory University. She also worked with the state health department in Virginia, which furthered her understanding of public health systems and started her work in antimicrobial resistance and healthcare-associated infections. The desire to do this type of work globally motivated her to seek out a global health fellowship. The PHI/CDC Global Health Fellowship program offered first-hand experience in a CDC country office; an opportunity Sarah considers “valuable and not easy to access as someone in their early career”.

Along with her previous experience working in public health programs and in laboratory settings, Sarah believes her Bachelor of Science (BS) in Biological & Biomedical Sciences and Master of Public Health (MPH) degrees greatly contributed to her ability to apply complex concepts in her current role. Sarah recognizes the importance of her MPH as preparation for working in surveillance and credits her BS for deepening her understanding of biological systems, including the process of infection, gene transmission, laboratory diagnostics, and how diseases operate on the cellular level, all of which is essential knowledge for her particular fellowship role.

Building Surveillance in Antimicrobial Resistance

As the lead for the antimicrobial resistance portfolio, Sarah is required to both understand the science and guide its implementation and is grateful that “CDC has a range of subject matter experts to rely on for advice on technical and strategic approaches”. Sarah says that in the field of antimicrobial resistance there is always more to learn, and that her mentor encourages her to keep abreast of published literature, which is necessary to stay informed.

Sarah shared that last summer, CDC’s regional office in Georgia was able to secure funding for a health response in Ukraine, which included funding to combat antimicrobial resistance. She says this support was critical, particularly because resistant infections can easily develop and transmit when people are injured, treated with emergency measures, and transferred for additional care in an overstretched health system, all of which occur during war.

With this funding, Sarah has been advising and leading the coordination of work in three states in Ukraine to support the prevention, diagnosis, and treatment of resistant infections. She says her work on this “has been devastating but inspirational and has given [her] the opportunity to work with and learn from resilient Ukrainian people”.

“With this experience, I don’t think I could turn away from global health.”

Sarah shared that in her role as the lead for the antimicrobial resistance portfolio, building surveillance for antimicrobial resistance involves working with laboratories, physicians, epidemiologists, policymakers, and other stakeholders. Sarah coordinates work that includes “assuring the quality of laboratory diagnostics so that doctors trust and use them, building systems to coordinate national policy and programming, technical training for physicians to better manage the treatment of patients with resistant infections, assessing laboratory and program capacities and addressing gaps, improving hospital and laboratory data systems, measuring antimicrobial prescribing, linking epidemiological to laboratory data and using them to improve interventions”.

“It’s good to feel that your work is important, and I have that with the surveillance track.”

Photos above courtesy of Sarah Legare, 2023

Sarah says that within the area of antimicrobial resistance, her technical experience is relatively broad rather than specialized, which has allowed her to take on multiple roles and understand when to seek help in specialized areas. She says that joining the fellowship program with this kind of experience has been valuable for guiding the work of partners and has taught her she would most enjoy pursuing a technical role related to global antimicrobial resistance, post-fellowship. She is pleased in her ability to advise on technical public health details in low and middle-income countries, where it is valued.

Sarah says that “unlike developing countries where technical resources are harder to access, the U.S. is equipped with both knowledge and resources, and therefore, it is relatively easier to access technical guidance and support”. Aside from maintaining a technical role in antimicrobial resistance, Sarah’s post-fellowship plans include her pursuit of a PhD in a related area, as she believes that “antimicrobial resistance is only getting worse and there is a lot of need both now and in the future”.

“The opportunities this fellowship experience has provided me are invaluable; from the people it’s connected me with to how it’s allowed me to advance in my career, I’m very grateful.”

If you’d like to connect with Sarah, please message her on LinkedIn.

Read more about CDC’s global health impact in Georgia:

CDC in Georgia

Funding for Antimicrobial Resistance

CDC Archives – U.S. Embassy in Georgia

Updating the National Antimicrobial Resistance Strategy

Lauren Sebesta, Program Administrative Assistant