Health security as a public health concept: a critical analysis
Health security as a public health concept: a critical analysis
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DOI：
10.1093/heapol/czn030
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发表时间：
2008-11-01
影响因子：
3.2
通讯作者：
Aldis, William
中科院分区：
文献类型：
--
作者：
Aldis, William
人们越来越接受健康保障的概念。然而，存在着各种不一致的定义，从公共卫生业务角度对卫生安全概念的阐述不完整，卫生安全概念与基于社区的初级保健之间的协调不够。更重要的是，在不同的背景下，对这一概念的理解和使用存在重大差异。工业化国家的决策者强调保护本国人民，特别是保护他们免受恐怖主义和流行病等外部威胁;而发展中国家和联合国系统内的卫生工作者和决策者则从更广泛的公共卫生角度来理解这一术语。事实上，联合国各机构本身对这一概念的使用并不一致，例如世界卫生组织对全球卫生安全一词的使用就有限制。世卫组织成员国对卫生安全的不同理解，加上对隐藏的国家安全议程的担忧，正在导致《国际卫生条例》等全球合作机制的崩溃。一些发展中国家开始怀疑国际共享的卫生监测数据是否符合其最佳利益。解决这些互不相容的理解是一个全球优先事项。
There is growing acceptance of the concept of health security. However, there are various and incompatible definitions, incomplete elaboration of the concept of health security in public health operational terms, and insufficient reconciliation of the health security concept with community-based primary health care. More important, there are major differences in understanding and use of the concept in different settings. Policymakers in industrialized countries emphasize protection of their populations especially against external threats, for example terrorism and pandemics; while health workers and policymakers in developing countries and within the United Nations system understand the term in a broader public health context. Indeed, the concept is used inconsistently within the UN agencies themselves, for example the World Health Organizations restrictive use of the term global health security. Divergent understandings of health security by WHOs member states, coupled with fears of hidden national security agendas, are leading to a breakdown of mechanisms for global cooperation such as the International Health Regulations. Some developing countries are beginning to doubt that internationally shared health surveillance data is used in their best interests. Resolution of these incompatible understandings is a global priority.