美国应对突发公共卫生事件的机制及其启示

美国是世界上公共卫生体系较为健全、公共卫生基础较为坚实的国家之一,同时也是各类突发公共卫生事件发生较多的国家之一。美国公共卫生体系和应对突发公共卫生事件机制是在对一个个接踵而至的传染病疫情防控中逐步建立起来的,其形成与发展大致经历三个阶段,并受到美国政治体制及其所决定的卫生体制、公共卫生基础设施状况和对卫生安全形势认识等因素的影响。美国应对突发公共卫生事件的机制可分为疫前应急准备机制、疫中响应机制和疫后恢复机制三个部分。把公共卫生纳入国家安全范畴、从国家战略和国家安全的层面规划应对措施,并将之建立在法律的基础上,强调跨地区和跨部门合作,加强国际合作和卫生援助,是美国应对突发公共卫生事件机制和响应措施的主要特点。目前新冠病毒肺炎疫情暴发暴露出美国应对突发公共卫生事件机制存在的内在缺陷。在新发传染病疫情高发的全球卫生形势下,研究美国应对疫情的经验及教训,对有效预防和控制新发传染病疫情暴发,增进全球公共卫生安全具有重要意义。

U.S.Public Health Emergency Response Mechanism and Its Implications

The United States has a well-established public health system,one of the more solid public health infrastructures in the world,yet the country experiences public health crises most often in the world.The U.S.public health system and emergency response mechanism respond slowly in countering the spread of one after another infectious diseases.This process can be roughly divided into three phases.Its formulation and development is affected by the health system s dependence on its political system,by the nature of its public health infrastructure,and by perceptions of the public health security situation.The U.S.public health emergency mechanism consists of three systems:pre-emergency preparedness,emergency response,and post-emergency recovery.Its main characteristics consider public health within national security so that countermeasures can be related to national strategy and security and be built on the bases of law,emphasizing regional and interagency cooperation,and enhancing international cooperation and health assistance.The current coronavirus outbreak(COVID-19)reveals the inherent weakness of the U.S.public health emergency mechanism.In the global context of the frequent emergence of infectious diseases,it is very important to study aspects of the U.S.public health emergency response mechanism for the effective prevention and control of the outbreak and spread of emerging infectious diseases and an enhanced global health security.