全球健康领域的国际合作者分析——以在中国开展卫生合作的机构为例

在全球化背景下,健康影响因素与公共卫生治理已超越国界,而促进全球健康目标的实现需要多方协调和努力。在全球健康这一相对新兴的领域内,有越来越多的国际参与者,包括国家政府、联合国、其他国际组织、双边机构以及非国际组织、基金会等。本文主要通过查阅我国卫生合作项目的相关资料,对在中国开展合作的主要国际卫生机构及合作项目、重点合作领域进行总结,并对其特点进行比较分析,认为应完善以世界卫生组织为主导,其他国际组织、双边机构、非国际组织等为行动主体的多重治理,并提出加强顶层协调、促进非卫生领域参与卫生治理,以及建设多方沟通机制等建议,以促进国际合作者进一步参与中国全球健康领域国际合作。     

全球卫生治理机制及中国参与的建议

随着全球化的纵深发展,全球卫生逐渐取代国际卫生,成为学界关注热点.全球卫生领域存在诸多亟需解决的问题,而这些问题的解决需要良好的全球卫生治理,实现全球卫生治理的五大功能,即达成价值观念的共识、制定相应的规则、实现治理的多元化、动员和分配资金、提供领导和协调等.针对全球卫生领域的不同趋势,建议确立以世界卫生组织为中心的全球卫生治理体系、在世界卫生组织框架内实现治理的多元化以及加强全球卫生立法等.中国作为新兴经济力量,在全球卫生治理中占有重要地位,应更为活跃地参与全球卫生治理.首先,建议中国制定国家层面的全球卫生战略;其次,积极参与全球行动网络和治理平台;最后,培养全球卫生研究和实践人才.     

全球卫生治理面临的挑战及其应对策略

人人享有健康是一项基本人权。全球卫生治理的使命就是要在全世界范围内促进“人人享有健康”。目前,全球卫生治理面临诸多重大挑战,如治理主体众多但目标不一致导致领导权威难以确立,以国家为中心的国际体制使跨国集体行动的达成存在一定困难,各国对公共卫生事项设置的优先顺序存在分歧,全球卫生资金投入不足且分配不均,全球卫生治理严重缺乏国际协调,全球卫生治理基本框架尚未完全形成等。为了应对挑战,建议深化全球卫生改革,提高全球卫生治理的能力与效率;国际社会与各国政府必须审思与重构自身卫生法律与政策,把重点放在促进卫生公平而非提高经济竞争力上;各国政府必须重点关注民生和民权,重视非卫生领域政策与卫生政策的协调,从根本上改善健康的决定因素;增加全球卫生治理的透明度、建立新型问责制,增强世界卫生组织的权威性;在全球层面构建全球卫生治理基本框架,增强全球卫生治理的有序性。     

加强国际间协作 搞好合作中心的建设

广东从化世界卫生组织初级卫生保健合作中心,是根据1979年12月,我国卫生部与世界卫生组织协议,由联合国开发计划署援助我国的“发展卫生人力和研究”项目文件精神,在我国基层首次与世界卫生组织合作而建立起来的机构。从化县初级卫生保健合作中心建立的宗旨是:为实现世界卫生组织提出的“2000年人人享有卫生保健”的战略任务;通过《中心》总结中国建立基层三级(县、区、乡)     

世界卫生组织在华合作中心培训班在京举行

世界卫生组织（WHO）在华合作中心培训班于2009年6月29晶在北京举行。来自世界卫生组织西太区办事处和驻华代表处的官员、卫生部国际司、有关省市卫生厅局以及WHO在华各合作中心的代表100余人参加了培训班。     

世界卫生组织在华合作活动管理系统建设的现状与思考

世界卫生组织(以下简称"世卫组织")在华合作活动管理系统,即世卫组织在华合作中心网站意为各世卫组织在华合作中心提供信息展示、经验交流、成果传播的平台,并以各在华合作中心为窗口展示我国卫生事业发展研究成果的一部分,讲好"中国故事"。该文在简要回顾了世卫组织在华合作活动管理系统建设历程的基础上,介绍了该系统建设的目标与原则、设计与架构、主要功能与内容,并总结了该系统运行维护管理机制方面的现状,针对存在的问题提出了促进该系统可持续发展的建议。     

传染病问题的全球治理机制及其完善

为了应对新发传染病带来的全球卫生危机,国际社会发展和完善了现代国际卫生合作机制,初步形成了传染病的全球治理机制。由于受到全球经济发展不平衡、国际民主失衡与冲突频发、多个并存的国际组织公共卫生职能重叠、非政府组织参与全球卫生治理的有效性有待提高等因素的影响,初具雏形的传染病全球治理机制还比较粗糙,有待在传染病治理的实践中接受检验并不断完善。建议加强世界卫生组织的领导地位、增加全球卫生投入、改善全球经济治理机构、推动国际政治民主化、协调伙伴关系、明确非政府组织的法律地位、重视健康的决定因素。     

初级卫生保健与世界卫生组织合作中心的关系

笔者有幸在今年4月参加了卫生部召开的“中国的世界卫生组织合作中心主任会议”,体会到初级卫生保健与世界卫生组织合作中心的关系极为密切。在会议的开幕式上,顾英奇副部长提出我国的54个世界卫生组织合作中心取得了较好的成绩。首先是初级卫生保健工作的不断深入发展,增强了大卫生观念和人民群众自我保健和参与卫生工作的意识。世界卫生组织提出的“2000年人人享有卫生保健”的全球战略目标,已被我国政府承诺。与世界卫生组织技术合作,引进了资金和技术,吸收了国外先进的科学技术和管理经验,培训了大量专业技术人才。在卫生情报信息资源     

全球卫生与医学卫生国际合作

全球卫生是国际上迅速发展的新兴学科和研究领域,其定义显示出其跨学科和多学科的特点;该学科研究范畴包括健康决定因素与卫生公平、全球卫生治理格局、卫生合作模式等热点问题。了解全球卫生研究的热点问题对我国医学与卫生界,特别是教育和研究机构应对全球卫生变化所带来的机遇与挑战,探讨新的合作模式,积极参与全球医学与卫生合作,具有指导意义     

2008中国健康教育与健康促进大会倡议书 崇尚健康生活 共创和谐社会

30年前，世界卫生组织和联合国儿童基金会联合通过了对全球卫生工作具有指导意义的《阿拉木图宣言》。宣言明确了实现“人人享有卫生保健”全球战略目标的途径和策略，为健康教育与健康促进事业的发展奠定了理论基础。     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.