How trade in health services can strengthen and challenge health systems resilience?
How trade in health services can strengthen and challenge health systems resilience?
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卫生服务贸易如何增强和挑战卫生系统的复原力？
DOI：
10.1093/eurpub/ckx187.590
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发表时间：
2017
影响因子：
4.4
通讯作者：
Hanefeld J
中科院分区：
文献类型：
--
作者：
Hanefeld J
2014- 2015年西非埃博拉疫情是历史上最致命的埃博拉疫情，导致该地区1.1万多人死亡。由于没有有效的疫苗或治疗剂，疫情使本已薄弱的地方卫生系统不堪重负，同时暴露出一个毫无准备和不连贯的全球卫生系统。其结果对利比里亚、塞拉利昂和几内亚在人员、社会和经济方面都是毁灭性的，对世界各国来说代价高昂。虽然国际努力的重点是迅速扩大埃博拉治疗单位和大众传播，但利比里亚的大部分国际应对措施是在疫情消退后实施的。地方领导、社区行为调整、社区综合参与、临床护理和公共卫生对策对于结束这一流行病至关重要。利比里亚在疫情发生后建立复原力的方法侧重于加强其公共卫生职能，特别是发现和应对流行病的能力，并将社区参与放在首位。相比之下，国际机构继续把重点放在单一问题和短期解决办法上，同时有机会支持利比里亚的长期系统发展，同时建立更协调一致的流行病防范和应对国际系统，包括在流行病威胁的情况下更有效和公平地开发疫苗和治疗方法。
The 2014-15 Ebola virus epidemic in West Africa was the deadliest Ebola epidemic in history, resulting in over 11,000 deaths in the region. Without an effective vaccine or therapeutic agent, the epidemic overwhelmed the already weak local health systems, while exposing an unprepared and incoherent global health system. The result was devastating in human, social and economic terms for Liberia, Sierra Leone, and Guinea, and costly to countries around the world. Whereas international efforts focused the rapid expansion of Ebola treatment units and mass communications, most of the international response in Liberia was implemented after the epidemic was resolving. Local leadership, adaptation of behaviours by communities, and integrated community engagement, clinical care and public health responses were critical to ending the epidemic. Liberia’s approach to building resilience after the epidemic has focused on strengthening its public health functions, particularly the ability to detect and respond to epidemics, and to place community engagement in the forefront. In contrast, international agencies continue to focus on single-issue and short-term solutions, while opportunities exist to support long-term systems development in Liberia, while building more coherent international systems for epidemic preparedness and response, including a more effective and fair approach to vaccine and treatment development in the context of epidemic threats.