Integrating one health in national health policies of developing countries: India's lost opportunities
Integrating one health in national health policies of developing countries: India's lost opportunities
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DOI：
10.1186/s40249-016-0181-2
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发表时间：
2016-10-03
影响因子：
8.1
通讯作者：
Chaturvedi, Sanjay
中科院分区：
文献类型：
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作者：
Chatterjee, Pranab;Kakkar, Manish;Chaturvedi, Sanjay
背景资料：在全球范围内，源自人-动物-环境界面的传染病，特别是新出现的传染病的威胁使卫生系统措手不及。由于预测未来病原体的出现将集中在亚洲、非洲和拉丁美洲的热点地区，因此迫切需要制定能够应对这一威胁的政策框架。讨论：禽流感和埃博拉病毒病等疾病的出现对社会造成了破坏，因此需要进行部门间协调/合作。这些活动促使印度开始建立制度化的合作框架，以采取“一个健康”的方法预防和控制疾病。然而，在流感控制方面取得的成果不能适用于其他传染病。部门间协调的进行时间很短，更多的是作为对威胁的反应。因此，无法持续开展这种努力的系统性失败，只会破坏协调一致的应对措施。最近的2015年国家卫生政策草案也未能确定在疾病控制方法方面进行部门间协调的必要性。由于忽视了必须认可人类健康、动物健康与畜牧业、农业和环境部门之间的联系，导致了反应系统的重复和薄弱，政策中没有对发展议程进行健康影响评估，对人、动物和环境的健康和福祉产生了负面影响。对这些关键部门的核心能力建设缺乏关注，进一步增加了设计和部署减缓战略的挑战。与发展中国家，如印度是家庭的一个主要部分，世界上最贫穷的畜牧业农民，没有一个政策话语，赞同一个健康的发展和卫生政策的方法是一个主要障碍，在消除贫困和贫困相关的疾病。结论：通过一个健康的方法在卫生和相关部门的政策是一个关键的政策要求，印度和其他发展中国家。目标不应仅仅是制定备灾计划，还应鼓励创造一种政策环境，将评估和减轻不同议程的下游影响纳入其中。
Background: Globally, the threat of infectious diseases, particularly emerging infectious diseases, originating at the human-animal-environment interface, has caught health systems off guard. With forecasts that future pathogen emergence will be centred in hotspots in Asia, Africa, and Latin America, the need to prepare policy frameworks that can combat this threat is urgent.Discussion: Emergence of diseases such as avian influenza and Ebola virus disease, which threatened social disruption, have established the need for intersectoral coordination/collaboration. These events led to the initiation of establishing institutionalised collaborative frameworks in India to adopt a One Health approach to disease prevention and control. However, the gains made in influenza control could not be adapted to other infectious diseases. Intersectoral coordination was briefly carried out, more as a reactive response to threats. The systemic failure to sustain such efforts have therefore, only undermined a coordinated response. The recent draft National Health Policy, 2015, has also failed to establish the need for intersectoral coordination in disease control approaches. Neglecting the need to endorse linkages between human health, animal health and husbandry, agriculture, and environmental sectors, has led to duplicative and weak response systems.The absence of health impact assessment with respect to the development agenda in policies, has cast negative effects on the health and wellbeing of man, animal, and the environment. Lack of attention to building core capacity in these critical sectors has further raised challenges in designing and deploying mitigation strategies. With developing countries like India being home to a major portion of the world's poorest livestock farmers, the absence of a policy discourse that endorses the One Health approach in development and health policies is a major hurdle in eliminating poverty and poverty-related diseases.Conclusions: The adoption of One Health approaches in health and related sectoral policies is a critical policy requirement for India and other developing countries. The goal should be to not just establish preparedness plans, but also to encourage a policy environment where assessment and mitigation of downstream impacts of different agenda are incorporated.