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1.
Global Health ; 17(1): 25, 2021 03 06.
Artículo en Inglés | MEDLINE | ID: mdl-33676512

RESUMEN

BACKGROUND: The 2005 International Health Regulations (IHR (2005)) require States Parties to establish National Focal Points (NFPs) responsible for notifying the World Health Organization (WHO) of potential events that might constitute public health emergencies of international concern (PHEICs), such as outbreaks of novel infectious diseases. Given the critical role of NFPs in the global surveillance and response system supported by the IHR, we sought to assess their experiences in carrying out their functions. METHODS: In collaboration with WHO officials, we administered a voluntary online survey to all 196 States Parties to the IHR (2005) in Africa, Asia, Europe, and South and North America, from October to November 2019. The survey was available in six languages via a secure internet-based system. RESULTS: In total, 121 NFP representatives answered the 56-question survey; 105 in full, and an additional 16 in part, resulting in a response rate of 62% (121 responses to 196 invitations to participate). The majority of NFPs knew how to notify the WHO of a potential PHEIC, and believed they have the content expertise to carry out their functions. Respondents found training workshops organized by WHO Regional Offices helpful on how to report PHEICs. NFPs experienced challenges in four critical areas: 1) insufficient intersectoral collaboration within their countries, including limited access to, or a lack of cooperation from, key relevant ministries; 2) inadequate communications, such as deficient information technology systems in place to carry out their functions in a timely fashion; 3) lack of authority to report potential PHEICs; and 4) inadequacies in some resources made available by the WHO, including a key tool - the NFP Guide. Finally, many NFP representatives expressed concern about how WHO uses the information they receive from NFPs. CONCLUSION: Our study, conducted just prior to the COVID-19 pandemic, illustrates key challenges experienced by NFPs that can affect States Parties and WHO performance when outbreaks occur. In order for NFPs to be able to rapidly and successfully communicate potential PHEICs such as COVID-19 in the future, continued measures need to be taken by both WHO and States Parties to ensure NFPs have the necessary authority, capacity, training, and resources to effectively carry out their functions as described in the IHR.


Asunto(s)
Notificación de Enfermedades/legislación & jurisprudencia , Reglamento Sanitario Internacional , Administración en Salud Pública/legislación & jurisprudencia , COVID-19 , Brotes de Enfermedades/prevención & control , Salud Global , Humanos , Encuestas y Cuestionarios , Organización Mundial de la Salud
2.
Lancet ; 385(9980): 1884-901, 2015 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-25987157

RESUMEN

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 Internacional
4.
Astrobiology ; 24(3): 230-274, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38507695

RESUMEN

As focus for exploration of Mars transitions from current robotic explorers to development of crewed missions, it remains important to protect the integrity of scientific investigations at Mars, as well as protect the Earth's biosphere from any potential harmful effects from returned martian material. This is the discipline of planetary protection, and the Committee on Space Research (COSPAR) maintains the consensus international policy and guidelines on how this is implemented. Based on National Aeronautics and Space Administration (NASA) and European Space Agency (ESA) studies that began in 2001, COSPAR adopted principles and guidelines for human missions to Mars in 2008. At that point, it was clear that to move from those qualitative provisions, a great deal of work and interaction with spacecraft designers would be necessary to generate meaningful quantitative recommendations that could embody the intent of the Outer Space Treaty (Article IX) in the design of such missions. Beginning in 2016, COSPAR then sponsored a multiyear interdisciplinary meeting series to address planetary protection "knowledge gaps" (KGs) with the intent of adapting and extending the current robotic mission-focused Planetary Protection Policy to support the design and implementation of crewed and hybrid exploration missions. This article describes the outcome of the interdisciplinary COSPAR meeting series, to describe and address these KGs, as well as identify potential paths to gap closure. It includes the background scientific basis for each topic area and knowledge updates since the meeting series ended. In particular, credible solutions for KG closure are described for the three topic areas of (1) microbial monitoring of spacecraft and crew health; (2) natural transport (and survival) of terrestrial microbial contamination at Mars, and (3) the technology and operation of spacecraft systems for contamination control. The article includes a KG data table on these topic areas, which is intended to be a point of departure for making future progress in developing an end-to-end planetary protection requirements implementation solution for a crewed mission to Mars. Overall, the workshop series has provided evidence of the feasibility of planetary protection implementation for a crewed Mars mission, given (1) the establishment of needed zoning, emission, transport, and survival parameters for terrestrial biological contamination and (2) the creation of an accepted risk-based compliance approach for adoption by spacefaring actors including national space agencies and commercial/nongovernment organizations.


Asunto(s)
Marte , Vuelo Espacial , Humanos , Medio Ambiente Extraterrestre , Exobiología , Contención de Riesgos Biológicos , Nave Espacial
6.
Lancet ; 373(9660): 325-31, 2009 Jan 24.
Artículo en Inglés | MEDLINE | ID: mdl-19167061

RESUMEN

This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series.


Asunto(s)
Comercio , Atención a la Salud , Salud Global , Política de Salud , Relaciones Interinstitucionales , Salud Laboral , Comercio/economía , Comercio/organización & administración , Comercio/tendencias , Atención a la Salud/economía , Atención a la Salud/organización & administración , Atención a la Salud/tendencias , Humanos , Cooperación Internacional
7.
Bull World Health Organ ; 86(3): 215-20, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18368209

RESUMEN

The International Health Regulations (IHR), the principal legal instrument guiding the international management of public health emergencies, have recently undergone an extensive revision process. The revised regulations, referred to as the IHR (2005), were unanimously approved in May 2005 by all Member States of the World Health Assembly (WHA) and came into effect on 15 June 2007. The IHR (2005) reflect a modernization of the international community's approach to public health and an acknowledgement of the importance of establishing an effective international strategy to manage emergencies that threaten global health security. The success of the IHR as a new approach to combating such threats will ultimately be determined by the ability of countries to live up to the obligations they assumed in approving the new international strategy. However, doing so may be particularly challenging for decentralized countries, specifically those with federal systems of government. Although the IHR (2005) are the product of an agreement among national governments, they cover a wide range of matters, some of which may not fall fully under the constitutional jurisdiction of the national government within many federations. This tension between the separation of powers within federal systems of government and the requirements of an evolving global public health governance regime may undermine national efforts towards compliance and could ultimately jeopardize the regime's success. We hosted a workshop to examine how federal countries could address some of the challenges they may face in implementing the IHR (2005). We present here a series of recommendations, synthesized from the workshop proceedings, on strategies that these countries might pursue to improve their ability to comply with the revised IHR.


Asunto(s)
Gobierno Federal , Regulación Gubernamental , Cooperación Internacional , Desarrollo de Programa/métodos , Salud Pública , Planificación en Desastres/organización & administración , Brotes de Enfermedades/prevención & control , Política de Salud , Humanos , Vigilancia de la Población
8.
J Clin Invest ; 113(6): 799-804, 2004 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15067309

RESUMEN

A revolution in the governance of global infectious disease threats is under way, accelerated by events triggered by the outbreak of SARS in 2003. This review article analyzes pre-SARS trends in the governance of infectious diseases, examines the impact of the SARS outbreak on these trends, and posits that germ governance is now a criterion of "good governance" in world affairs.


Asunto(s)
Control de Enfermedades Transmisibles , Administración en Salud Pública , Salud Pública , Control de Enfermedades Transmisibles/tendencias , Enfermedades Transmisibles Emergentes/epidemiología , Predicción , Humanos , Salud Pública/tendencias , Administración en Salud Pública/tendencias , Síndrome Respiratorio Agudo Grave/epidemiología , Organización Mundial de la Salud
9.
J Law Med Ethics ; 35(4): 616-28, 512, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-18076513

RESUMEN

The incident in May-June 2007 involving a U.S. citizen traveling internationally while infected with drug-resistant tuberculosis involved the U.S. federal government's application of its quarantine and isolation powers. The incident and the isolation order raised numerous important issues for public health governance, law, and ethics. This article explores many of these issues by examining how the exercise of quarantine powers provides a powerful lens through which to understand how societies respond to and attempt to govern threats posed by dangerous, contagious pathogens. The article considers historical aspects of governmental power to quarantine and isolate individuals and groups; analyzes the current state of quarantine and isolation law in the United States in light of the recent incident with drug-resistant tuberculosis; and explores global aspects of public health governance and law highlighted by this incident.


Asunto(s)
Salud Pública/legislación & jurisprudencia , Cuarentena , Tuberculosis Resistente a Múltiples Medicamentos/prevención & control , Derechos Humanos/legislación & jurisprudencia , Humanos , Masculino , Cuarentena/ética , Cuarentena/legislación & jurisprudencia , Viaje
10.
Health Promot Int ; 21 Suppl 1: 51-8, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17307957

RESUMEN

This paper explores the importance for health promotion of the rise of public health as a foreign policy issue. Although health promotion encompassed foreign policy as part of 'healthy public policy', mainstream foreign policy neglected public health and health promotion's role in it. Globalization forces health promotion, however, to address directly the relationship between public health and foreign policy. The need for 'health as foreign policy' is apparent from the prominence public health now has in all the basic governance functions served by foreign policy. The Secretary-General's United Nations (UN) reform proposals demonstrate the importance of foreign policy to health promotion as a core component of public health because the proposals embed public health in each element of the Secretary-General's vision for the UN in the 21st century. The emergence of health as foreign policy presents opportunities and risks for health promotion that can be managed by emphasizing that public health constitutes an integrated public good that benefits all governance tasks served by foreign policy. Any effort to harness globalization for public health will have to make health as foreign policy a centerpiece of its ambitions, and this task is now health promotion's burden and opportunity.


Asunto(s)
Política de Salud , Promoción de la Salud/organización & administración , Cooperación Internacional , Práctica de Salud Pública , Naciones Unidas/organización & administración , Salud Global , Humanos , Medicina Reproductiva , Fumar/legislación & jurisprudencia
18.
Health Policy Plan ; 25(6): 505-9, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20595331

RESUMEN

The International Health Regulations (2005) [IHR(2005)] represent a potentially revolutionary change in global health governance. The use of the regulations by the World Health Organization (WHO) to respond to the outbreak of pandemic influenza A 2009-H1N1 highlights the importance of the regulations to protecting global health security. As the 2009-H1N1 pandemic illustrated, the IHR(2005) have provided a more robust framework for responding to public health emergencies of international concern (PHEICs), through requiring reporting of serious disease events, strengthening how countries and WHO communicate concerning health threats, empowering the WHO Director-General to declare the existence of PHEICs and to issue temporary recommendations for responding to them, and requiring countries not to implement measures that unnecessarily restrict trade and travel or infringe on human rights. However, limitations to the effectiveness of the IHR(2005) revealed in the 2009-H1N1 pandemic include continuing inadequacies in surveillance and response capacities within some countries, violations of IHR(2005) rules and a potentially narrowing scope of application only to influenza-like pandemic events. These limitations could undermine the IHR(2005)'s potential to contribute to national and global efforts to detect and mitigate future public health emergencies. Support for the IHR(2005) should be broadened and deepened to improve their utility as a tool to strengthen global health security.


Asunto(s)
Política de Salud/legislación & jurisprudencia , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/epidemiología , Cooperación Internacional/legislación & jurisprudencia , Pandemias , Salud Pública/legislación & jurisprudencia , Humanos , Organización Mundial de la Salud
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