The role of National Immunization Technical Advisory Groups (NITAG) in strengthening health system governance: Lessons from three middle-income countries—Argentina,Jordan, and South Africa (2017–2018)

IntroductionToward the Global Vaccine Action Plan 2020 goal, almost 90% of countries have established a National Immunization Technical Advisory Group (NITAG). However, little is known about NITAG's contributions to governance.MethodsIn 2017–2018, a two-step, qualitative retrospective study was conducted. Jordan (JO), Argentina (AR), and South Africa (SA) were selected owing to government-financed NITAGs from middle-income countries (MICs), geographic diversity, and a vaccine introduction with NITAG support. Country case studies were developed, collecting data through desk review and face-to-face key informant interviews (KIIs) from Ministry of Health (MoH) and NITAG. Case studies were analyzed together, to assess governance applying the European Observatory on Health Systems and Policies framework focusing on transparency, accountability, participation, integrity, and policy capacity (TAPIC).ResultsDocument review and 53 KII (22 AR, 20 SA, 11 JO) showed NITAGs played a pivotal role as advisors promoting a culture of evidence-informed policies. NITAGs strengthened governance, although practices varied among countries. Meetings were conducted behind-closed-doors, participation restricted to members, only in one country agendas, and recommendations were public (AR). To increase participation, policy capacity, and transparency, countries considered adding experts in communications, advocacy, and economics. AR and SA contemplated including community members. NITAGs functioned autonomously from the government, with no established internal or external monitoring or supervision. NITAG meeting minutes allowed the review of integrity, adherence to terms of reference, standard operating procedures, and conflict of interest (CoI). For the most part, NITAGs abided by their mandates. Significant issues were related to the level of MoH support and oversight of CoI declaration and documentation.ConclusionsSystematically implementing governance approaches could improve processes, better tailor policies, and implementation. The long-term survival and resilience of NITAGs in these countries showed they play a significant role in strengthening governance. Lessons learned could be useful to those promoting country-driven evidence-informed decision-making.     

Hacia el buen gobierno por la salud: incorporación de la diversidad de percepciones en salud urbana

ObjectiveTo analyse the similarities and differences in the discourse surrounding the conceptualisation of health and the perceived health assets and needs in the neighborhoods and city of Bilbao in a participatory process.MethodParticipatory workshops were held with professionals, neighbors and associated citizens. The differences in perceptions of the three content blocks were analysed on the basis of the health model referred, as well as the typologies —of a more individual or structural nature— of identified health needs and assets.ResultsThe conceptualisation of health from a biopsychosocial perspective was clearer among professionals, although both profiles pointed to the importance of its social determinants. The formulation of needs and assets in health by the neighbors was made from the impact on their daily life and from a position of users with respect to a service provider administration. Among the associated citizens and professionals, intermediate and structural determinants were more frequently mentioned, as well as issues related to the administration's scope of action.ConclusionsThe inclusion of the multiplicity and diversity of perceptions in planning is key to good local government for health. To address their contradictions, a commitment by governments to effectively incorporate citizen participation is needed.     

现代中医药发展战略思考

建国几十年来，由于党和政府的大力提倡和扶持，中医药得到了很大发展，但相对于西医的发展势头仍显不足。尤其是近10多年来，由于现代科技及现代管理学的有力推动，西医获得了突飞猛进的发展，然而，中医却由于种种原因发展相对缓慢。在这各行各业竞相发展的现代社会，中医要生存，就蓝须发展，中医要发展，就妊须总揽全局，从战略高度克服中医药发展的各种不利因素，充分发挥各方面的有利条件。     

中药现代化的思考

中药现代化就是将中国传统医药的优势与现代科学技术紧密地结合起来,继承传统,走出传统,走向现代。中医药的优势在于整体观念、辨证施治、因人而异和复方用药,弥补了西方医学在诊治上的不足之处,这在疾病的治疗和预防上具有导向性的作用。由于西方医学对治疗疑难症和抗衰老上的效果不尽如人意,使人们对中医药需求增加,中西医优势互补的新医学体系将会逐步形成。从研发中药的角度,对传统中医药理论、整理和规范中药材及中药市场、中药炮制、微量元素测定、质量控制、制剂工艺、生物技术及专利保护等方面来探讨中药现代化,实现对传统中药的超越,把传统中药提高到现代药学的水平,能被国际社会所接纳,造福于全人类。     

中药指纹图谱研究的有关技术要点探讨

简要介绍了中药指纹图谱的原理，提出了在进行中药指纹图谱研究时，选择中药材来源、样品处理方法、检测技术及参照物的原则和注意事项。探讨了用高效液相色谱技术制备中药指纹图谱的有关技术要点问题，样品洗脱应尽可能选用等度或线性梯度洗脱，检测器的选择应尽可能采用二极管阵列检测器，以方便地选定适合于指纹图谱检测的最佳检测波长。指纹图谱相似度评价软件的引入，不仅可大大降低人工计算指纹图谱相似度的工作强度，而且减少了人为判断的随意性和主观性，提高了中药指纹图谱量化评判的客观标准。     

论加速建立现代化中药制造工业的若干制药工程技术问题

本文针对我国中药制造工业存在的若干制药工程技术问题 ,首先着重分析了中药制药工程学的领域问题 ,指出其研究的目标和任务 ;其次 ,针对中药制药工程技术及工艺问题 ,分析了中药产品质量达不到稳定均一的原因所在 ;最后详细分析了现有中药粉碎设备、提取设备、制剂设备等中药制药设备的有关技术问题。在此基础上 ,指出了中药制造工业和国外存在的差距 ,建议加快推广先进适用的高新技术 ,优先研发中药制药过程全程质量控制技术及中药工业集成制造技术 ,以推动中药制造工业的技术进步。     

中药炮制机理初探

开展中药炮制机理研究，揭示其炮制内涵变化实质，是确定中药饮片最佳炮制工艺，制定饮片质量标准，提高临床治疗疗效，发展炮制学科理论水平的关键。     

试析中国医学科学院药物研究所知识产权概况及相关管理

介绍中国医学科学院药物研究所近20多年来的专利工作情况及存在问题，探讨中药及天然产物研究与知识产权保护的密切关系，提出“知识产权保护是中药现代化的标志之一”的论点。