加载中…美国机构认为试点项目为增强全球卫生安全提供了模式
(2014-02-07 10:53:26)
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分类： 科学与技术 |
乌干达流行病学家采集各地样本以检测致命的埃博拉病毒。
华盛顿——根据美国疾病控制和预防中心（U.S. Centers for Disease Control and Prevention）1月30日在《发病率与死亡率周报》（Morbidity and Mortality Weekly Report）上发表的一篇文章，该中心分别与乌干达和越南两国展开的试点项目在疾病检测和应对方面取得诸多进展，有可能成为在世界其他地区加强全球卫生安全的一种模式。
美国疾病控制和预防中心说，全球卫生安全——保障世界安全而且不受传染病的威胁——可以通过尽早且尽可能有效地预防、检测和应对疫情而实现。
在六个月的深入协作中，美国疾病控制和预防中心与乌干达和越南卫生部一起，努力提高高风险病原体诊断测试的现代化水平，开发实时信息系统以便更迅速地应对疫情，并改善应急行动程序——包括安全包装和运输有潜在传染性的取样等。
美国疾病控制和预防中心1月30日在其网站上刊登的文章中指出，所取得的进展包括临床医生能够通过短信报告并跟踪可疑的高风险病原体病例；扩展由美国总统艾滋病紧急救援计划（President’s Emergency Plan for AIDS Relief）支持的样本转送和运输系统；在乌干达确认寨卡（Zika）病毒、克里米亚—刚果出血热病毒(Crimean-Congo hemorrhagic fever virus)、戊型肝炎病毒(hepatitis E virus)、脑膜炎球菌病(meningococcal disease)、黄热病(yellow fever)以及耐多药和广泛耐药结核病（multidrug-resistant and extensively drug-resistant TB）。
美国疾病控制与预防中心主任汤姆·弗里登博士（Tom Frieden）说：“美国的卫生安全与全世界所有国家的卫生安全息息相关。我们所有人都因摄入的食物、我们饮用的水以及我们呼吸的空气而联系在一起。在疾病爆发之始即加以遏制是在美国乃至全世界预防疾病并挽救生命的最有效、最节省资金的途径——而且这么做是正确的。乌干达在不到一年的时间内所取得的进展表明战略投资的效力有多大。”
美国疾病控制与预防中心说，全球卫生安全面临的威胁包括新型及再次出现的病原体，逐渐增强的抗药性和蓄意制造的生化武器。该机构说，尽管各国被要求在2012年7月前达到新修订的世界卫生组织（World Health Organization）《国际卫生条例》（International Health Regulations）有关应对公共卫生突发事件的规定，只有不足五分之一的国家能达到该防范水平。
美国疾病控制与预防中心的全球卫生安全项目旨在表明改善乌干达和越南的监测、实验室和应急机制的深入努力有助于满足《国际卫生条例》的相关要求。从2013年3月到9月，美国疾病控制与预防中心和卫生部门努力加强地方、区域和全国范围内，以及指定的国际港口、机场和陆地口岸的疾病检测和应对能力。
美国疾病控制与预防中心负责全球健康的主任汤姆•凯尼恩（Tom Kenyon）说：“乌干达和越南都面临着独特的卫生挑战。乌干达经历了埃博拉（Ebola）病毒、马堡（Marburg）、霍乱和耐多药结核病疫情，越南则经历了严重急性呼吸系统综合症（SARS）和H5N1禽流感疫情。他们在迅速提高新型疾病检测和应对能力方面所获得的成功表明，类似努力在其他国家也可奏效。这在经常出现中东呼吸综合症冠状病毒（Middle East Respiratory Syndrome Coronavirus）和H7N9禽流感等新病原体的世界中意义重大。
项目具体内容
乌干达项目侧重于三种主要疾病——耐多药和广泛耐药结核病、霍乱以及由埃博拉病毒导致的病毒性出血热——以衡量项目的影响作用。美国疾病控制与预防中心说，除了进行公共卫生防范演习外，乌干达卫生部还在乌干达北部一个日食观测点的大规模集会中启动了该国的应急行动中心（Emergency Operations Center），并支持国际机场在返国的朝觐（hajj）人员中检查与中东呼吸综合症冠状病毒感染相吻合的病例。
在越南项目中，30名越南官员在越南、位于亚特兰大（Atlanta）的美国疾病控制与预防中心应急行动中心和世界卫生组织西太平洋地区办事处（Western Pacific Regional Office）接受培训。项目在现有的越南卫生部系统和构架的基础上进一步加强，将为越南发展其应急行动中心的计划提供支持。
全球卫生安全示范项目在结束时进行了一系列相互关联的演习，来衡量实验室测试的改善程度、培训乌干达和越南卫生工作人员，并确认有助于满足《国际卫生条例》核心要求的信息和管理系统的互操作能力。
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U.S. Agency Says Projects Offer Model for Greater Health Security
Uganda epidemiologists collect samples from the field to test for deadly Ebola virus.
Washington —
According to an article in the
Global health security — keeping the world safe and secure from infectious disease threats — is achieved by preventing, detecting and responding to outbreaks as early and effectively as possible, CDC said.
During six months of intensive collaboration, CDC worked with Uganda’s Ministry of Health and Vietnam’s Ministry of Health to modernize diagnostic testing for high-risk pathogens, develop real-time information systems for faster outbreak response and improve emergency operations procedures including safe packaging and transport of potentially infectious samples.
CDC said in a January 30 posting on its website that improvements include clinicians’ ability to report and track suspected high-risk pathogen cases by text message; expansion of specimen referral and transportation systems supported by the President’s Emergency Plan for AIDS Relief; and confirmation of Zika virus, Crimean-Congo hemorrhagic fever virus, hepatitis E virus, meningococcal disease, yellow fever, and multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) cases in Uganda.
“The health security of the United States is only as strong as the health security of all nations around the world. We are all connected by the food we eat, the water we drink, and air we breathe,” said CDC Director Tom Frieden. “Stopping outbreaks where they start is the most effective and least costly way to prevent disease and save lives at home and abroad — and it’s the right thing to do. Progress in Uganda in less than a year shows how effective strategic investments can be.”
Threats to global health security, CDC said, include new and re-emerging pathogens, increasing antibiotic resistance and intentionally created bioweapons. Although countries were required to meet updated World Health Organization (WHO) International Health Regulations (IHR) requirements for responding to public health emergencies by July 2012, fewer than one in five countries has been able to meet that level of preparedness, the agency said.
The CDC global health security projects aimed to demonstrate that intensive efforts to improve surveillance, laboratory and emergency response systems in Uganda and Vietnam could contribute to meeting the IHR requirements. From March to September 2013, CDC and the ministries of health worked to strengthen disease detection and response capacities at local, regional and national levels, as well as at designated international ports, airports and ground crossings.
“Uganda and Vietnam have faced unique health challenges. Uganda has experienced Ebola, Marburg, cholera and MDR-TB outbreaks, and Vietnam has experienced SARS and H5N1 outbreaks,” said CDC Director for Global Health Tom Kenyon. “Their success at rapidly adding new disease detection and response skills suggests that similar efforts could work for other countries. This is important in a world that regularly sees new pathogens, such as Middle East Respiratory Syndrome Coronavirus and H7N9 influenza.”
SPECIFICS OF PROJECTS
The Uganda project focused on three priority diseases — MDR and XDR-TB, cholera, and viral hemorrhagic fever caused by Ebola virus — to measure the project’s impact. In addition to performing a public health preparedness exercise, the Uganda Ministry of Health also activated its Emergency Operations Center for a mass gathering at a solar eclipse in Northern Uganda and to support international airport screening for illness consistent with MERS-CoV infection among individuals returning from the hajj, CDC said.
For the Vietnam project, 30 Vietnamese officials received training in their country, at CDC’s Emergency Operations Center in Atlanta and at the WHO Western Pacific Regional Office. Project enhancements were built on existing Vietnam Ministry of Health systems and structures that will support Vietnam’s plans to develop its own emergency operations center.
The Global Health Security demonstration projects culminated with a series of inter-related drills that measured improvements of laboratory testing, trained Uganda and Vietnam health staff and confirmed interoperability of information and management systems contributing to meeting core IHR requirements.
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