Asunto(s)
Contaminación del Aire Interior , COVID-19 , Control de Enfermedades Transmisibles , Exposición a Riesgos Ambientales , SARS-CoV-2 , Humanos , Contaminación del Aire Interior/análisis , Contaminación del Aire Interior/prevención & control , Control de Enfermedades Transmisibles/métodos , COVID-19/prevención & control , COVID-19/virología , Exposición a Riesgos Ambientales/análisis , Exposición a Riesgos Ambientales/prevención & controlRESUMEN
The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security--its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? In the context of the governance of global health, including WHO reform, it will be important to distil lessons learned from the Ebola outbreak. The Lancet invited a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for next steps. Their contributions describe some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed. Their common goal is a more sustainable and resilient society for human health and wellbeing.
Asunto(s)
Salud Global , Fiebre Hemorrágica Ebola/epidemiología , Fiebre Hemorrágica Ebola/prevención & control , África Occidental/epidemiología , Atención a la Salud/organización & administración , Atención a la Salud/tendencias , Epidemias , Reforma de la Atención de Salud/organización & administración , Humanos , Cooperación InternacionalAsunto(s)
Brotes de Enfermedades , Diagnóstico Precoz , Fiebre Hemorrágica Ebola/diagnóstico , Fiebre Hemorrágica Ebola/epidemiología , República Democrática del Congo/epidemiología , Fiebre Hemorrágica Ebola/prevención & control , Fiebre Hemorrágica Ebola/transmisión , Humanos , Sistemas de Atención de Punto , Juego de Reactivos para DiagnósticoAsunto(s)
Brotes de Enfermedades/prevención & control , Vacunas contra el Virus del Ébola/farmacología , Fiebre Hemorrágica Ebola/epidemiología , Tasa de Supervivencia/tendencias , Atención a la Salud/economía , República Democrática del Congo/epidemiología , Vacunas contra el Virus del Ébola/administración & dosificación , Ebolavirus , HumanosAsunto(s)
Partería/normas , Atención Perinatal/normas , Atención Prenatal/normas , Femenino , Humanos , EmbarazoRESUMEN
Advancing the health of the poor requires aligning a wide array of interests, all of which influence how health care is delivered. Global health professionals often face difficult decisions that can affect their working relationships with government officials, local colleagues, nongovernmental organizations (NGOs), and private sector interests. This article proposes a "compass-based" framework that urges global health professionals to act in a way that is both morally sound and pragmatically effective. Global health professionals must follow their "moral compass" and act in alignment with the interests of the communities they seek to serve while, at the same time, utilizing their "effectiveness compass" to navigate complex situations in ways that ensure achievement of practicable change that can motivate better health outcomes for those in need.
Asunto(s)
Ética Clínica , Salud Global , Personal de Salud/ética , Cooperación Internacional , Relaciones Interprofesionales , Profesionalismo , Responsabilidad Social , Conducta Cooperativa , Atención a la Salud/ética , Gobierno , Humanos , Principios Morales , Organizaciones , Pobreza , Sector Privado , Características de la ResidenciaAsunto(s)
Brotes de Enfermedades/prevención & control , Fiebre Hemorrágica Ebola/prevención & control , Modelos Teóricos , Vacunación/estadística & datos numéricos , República Democrática del Congo/epidemiología , Vacunas contra el Virus del Ébola/uso terapéutico , Ebolavirus/aislamiento & purificación , Fiebre Hemorrágica Ebola/epidemiología , HumanosRESUMEN
Challenges in data availability and quality have contributed to the longest and deadliest Ebola epidemic in history that began in December 2013. Accurate surveillance data, in particular, has been difficult to access, as it is often collected in remote communities. We describe the design, implementation, and challenges of implementing a smartphone-based contact tracing system that is linked to analytics and data visualization software as part of the Ebola response in Guinea. The system, built on the mobile application CommCare and business intelligence software Tableau, allows for real-time identification of contacts who have not been visited and strong accountability of contact tracers through timestamps and collection of GPS points with their surveillance data. Deployment of this system began in November 2014 in Conakry, Guinea, and was expanded to a total of 5 prefectures by April 2015. To date, the mobile system has not replaced the paper-based system in the 5 prefectures where the program is active. However, as of April 30, 2015, 210 contact tracers in the 5 prefectures were actively using the mobile system to collectively monitor 9,162 contacts. With proper training, some investment in technical hardware, and adequate managerial oversight, there is opportunity to improve access to surveillance data from difficult-to-reach communities in order to inform epidemic control strategies while strengthening health systems to reduce risk of future disease outbreaks.