本次時程
10/3-9資料收集
10/10-14撰稿
請在14號以前交稿
工作分配
主題：芳盈
國外：豪哥、民浩、佳真
國內：光狐、浩哥
麻煩大家了！
2007年10月2日 星期二
下一次主題：世界心臟日
我是芳盈，這次輪到我寫主題的部份囉~^^
前幾天我上WHO網站看了一下，發現9/30是世界心臟日，因此和光狐討論之後，決定以此為這期的主題。
我覺得這個議題應該還滿好發揮的，由於心血管疾病是種「文明病」，發生率和死亡率越來越高，因此在現在非常受到重視。我的部份當然就是有關WHO對心血管疾病做了哪些預防工作，他們也出版了許多相關的書籍，再帶一些有關世界心臟日的東西；如果寫台灣議題的伙伴們，當然也可以提到心血管疾病一直是十大死因的常客(還是VIP級的咧~^^")，國際的部份可以寫9/30是否有配合做什麼活動，或是該國心血管疾病的狀況，是否造成什麼問題或影響及預防政策等，以上只是我的建議啦~~~~
大家加油！！^^
確切的工作分配表就請光狐公告囉~
前幾天我上WHO網站看了一下，發現9/30是世界心臟日，因此和光狐討論之後，決定以此為這期的主題。
我覺得這個議題應該還滿好發揮的，由於心血管疾病是種「文明病」，發生率和死亡率越來越高，因此在現在非常受到重視。我的部份當然就是有關WHO對心血管疾病做了哪些預防工作，他們也出版了許多相關的書籍，再帶一些有關世界心臟日的東西；如果寫台灣議題的伙伴們，當然也可以提到心血管疾病一直是十大死因的常客(還是VIP級的咧~^^")，國際的部份可以寫9/30是否有配合做什麼活動，或是該國心血管疾病的狀況，是否造成什麼問題或影響及預防政策等，以上只是我的建議啦~~~~
大家加油！！^^
確切的工作分配表就請光狐公告囉~
2007年9月27日 星期四
0926期稿件
食品安全控管恢恢 黑心中國銷售全球 吳佳真
中國劣質食品已成為「黑心」產品的代名詞，近來引起全球恐慌的中國黑心食品如致癌大閘蟹、頭髮醬油、假酒、毒寵物食品等使消費者失去信心，掀起了抵制中國產品的風潮，在台灣及歐美國家甚至出現了以非中國製造標籤來提昇產品形象及安全性的做法中國黑心食品的販賣情形。
事實上，WHO自2000年開始，為了減少開發中國家食物引起的疾病，將食品安全列為主要公共衛生議題之一，開始建構食物感染疾病之監控系統、食品安全標準、風險評估、品質要求計畫，在基改食品出現後，加強了新科技產品的安全檢驗，亦鼓勵政府應與民眾進行正確的風險溝通，並加強各會員國疫情資源的利用等等。 食品的化學性污染漸漸是食品安全的一大焦點，跨國性組織CAC(Codex Alimentarius Commission )確立國際間的食物標準Codex Standards予各國參考，成為各國食品管制的訂定指標。
日漸氾濫的中國黑心食品不僅顯示食品安全標準及檢測的重要，亦是檢驗各國食品安全控管系統的完整性之時機。2004十月Global Fora of Food Safety Regulators在泰國孟買舉行第二屆全球食品安全控管會議，以「建立有效的食品安全控制管制系統」為題，邀請各國一同分享管制經驗及討論相關的重要議題。印度政府以該國「出口食品的控制及檢定」的經驗，建議出口食品量大的國家應確認進口國家的食物標準及檢測方法，與進口國家達成食品檢定決議，藉著自我食品檢定確保出口食品的安全，不但能保護消費者，建立國家信譽，亦能減少出口末端食品認證的時間和金錢，避免負擔退貨的額外損失。
美國政府亦指出，其各自有兩個單位控管進口食品，FSIS(The Food Safety and Inspection Service)規定進口肉類、禽類及蛋類國家應與美方有相同的食品管制檢查機制，HHS/FDA(The U.S. Food and Drug Administration within the Department of Health and Human Services) 則規定各國進口的其他所有食品之製造程序應符合美國當局的安全要求，違反規定即無法進口至美國。
國際貿易將食品從製造國送往世界的另一頭，各國進出口的食品控管系統各自面對互相折衷規範的情形。中國食品在此氛圍露出劣質原形，遭受各國譴責，其後兩領導人胡錦濤及溫家寶皆誓言加強產品安全監管力度和法律體系建設，從而使全球消費者的權益得到更好的保障。但在強力管制之前，中國食品的製造源頭之原料、生產製造、販賣等過程仍有錯綜複雜的問題有待當局解決為先。
參考資料：
1. 維基百科，黑心食品
2. WHO，http://www.who.int/features/qa/19/en/index.html
What is WHO doing to help countries improve food safety?
3. WHO，http://www.who.int/foodsafety/codex/en/
Food standards (Codex Alimentarius)
4. Ms Shashi Sareen, Director, Export Inspection Council, India ，Food Export Control And Certification，Second FAO/WHO Global Forum of Food Safety Regulators，Bangkok， Thailand， 12-14 October 2004
5. the United States of America，Food Export Control And Certification，Second FAO/WHO Global Forum of Food Safety Regulators ， Thailand， 12-14 October 2004
中國應重新面對產品品質不良的問題 顏稚浩
從今年(2007)四五月間開始，美國媒體開始大幅度報導有關中國的黑心食品，該月就有257項中國大陸被以安全問題為由，拒絕入境美國。之後又爆發了一連串的黑心產品事件，從震驚全球的巴拿馬的毒感冒糖漿事件、導致美國境內許多家庭飼養的寵物死亡的有毒飼料、義大利和西班牙查獲的有毒牙膏，到屬於美國境內的回收含鉛的玩具、有問題的輪胎、零食的調味料被驗出受沙門氏菌(salmonella)污染和被檢驗出含有禁用的抗生素的海鮮等。這些事件顯示出作為世界上重要的產品輸出國家，中國在管制其輸出食品的安全把關上出現了一些問題，導致有越來越多的人開始把”中國製造”和”不安全”畫上等號，據報導甚至也有製造商在其商品上標榜”非中國製造”來使消費者安心。
隨著其他國家對中國製的食品質疑的聲浪越來越高漲之際，中國起初維持其一貫的否認作風，將問題歸咎於其他國家的檢驗誤差、安全檢測的標準不同之外，其官方還宣稱美國輸入中國食品的近三年平均合格率只有98.9%，低於中國輸美食品99%以上的合格率。也有學者說今年上半年中國對美國出口總值達1072億美金，順差更高達739.1億美金，較去年同期增加了18.6%，這讓美國政府感到不悅，所以認為黑心食品問題的突然爆發，很大的一部分只是美國政府用來發洩對巨大的貿易逆差問題的不滿而已。不過隨著問題食品如滾雪球般越滾越大，北京當局也不得不承認確實在食品的安全管制系統出現了問題，像是權責不明，很多機構都對食品和藥物有檢測權，導致責任上出現重疊; 相關的規定執法不嚴;部分製造商鑽法律漏洞，以次級品替代來謀取暴利; 沒有建立起一套完整、統一的檢測系統來應付中國這個快速成長和流動的經濟等。不過值得一提的是，中國政府在同時也加強檢查其他國家輸入的食品作為反制，這兩個月來包括美國進口的內類和家禽製品被沙門氏菌汙染、日本的奶粉含鋅量低於包裝標示、印尼的水產品含有過量的微生物、菲律賓的食品也被驗出含有重金屬等事件也陸續爆發。
不過也有人把這項舉動解讀為中國政府在有能力完全解決自身的問題前，對其他國家進行的反抹黑手段。
中國民眾對這些事件的看法深受媒體的影響，食品問題剛爆發時，中國的媒體多數把它訴諸於貿易障礙問題，而不認為那是真正食品出了問題。不過最近開始有少數的媒體認為應該屏棄那種看法，而開始認真面對來自國外的質疑聲浪。
一般民眾對於國內的食品安全也有信心動搖的情況，很多消費者對層出不窮的問題食品新聞感到難以招架，根據報載，有些民眾已經不知道什麼東西可以吃，什麼東西有問題不能吃了，他們也不知道政府如何在食品安全上做把關，他們只知道安全可供食用的食物已經越來越少了。
在本身的食品安檢系統的改進上，北京當局在六月間由國家會議(state council)發表聲明說，中國將全面改革其食品和藥物的安全規定，這是至今中國對於食品安全問題最強烈的談話。七月間，中國皆露了新的食品和不合格的輸出品的管制措施，中國官方也誓言加強管理運用在內類和海鮮的化學藥品。七月底中美兩國在北京就食品安全議題舉行會談，八月間中國也派出代表團到華盛頓，與美方做近一步的討論，預計雙方在今年底前會就食品安全簽署備忘錄，在雙方進行會談之際，中國政府也關閉了三家違反食品安全規定的公司，這三家公司分別涉及了巴拿馬含二甘醇有毒感冒糖漿，和生產含有三聚氯胺(melamine)的寵物飼料的事件。北京當局也計劃在2010年時建立一套對食品藥物進出口以及藥物隨機檢測的管制標準，雖然他們還沒有說明是否會提供更多的資金在這件事上，以及由哪一個機構執行這項業務。幾個月前，北京當局將其前食品與藥物管理局局長判處死刑並已執行槍決。他被控收受廠商賄賂，讓未經檢測的藥物合法上市。
雖然這件事不免讓人對其食品安全檢測系統的公信力有了懷疑，不過從中國政府鐵腕處理這件醜聞來看，可以看出其改善食品安全的決心。
大部分的外國政府官員對於中國的改革措施均表示樂觀其成，不過他們也表示如果中國的產品持續出現問題，他們還是會做近一步的限制。不過有部分專家則對中國的宣示抱持懷疑的態度，他們認為有一部分是之前就已經做過的承諾了，而且中國並沒有承認所有的問題，其官方不斷指控這是國際媒體誇大了中國有問題的產品。有些專家也認為部分問題已經根深蒂固了，改革不可能進行的很快速，中國的經濟快速成長，要建立起能夠監控所有產品的系統所耗費的成本相當大，這實非一朝一夕就可以達成的。不過還是有評論家認為，對照之前一直不願意承認問題的中國政府來說，現在他們對這個問題的處理態度令人感到樂觀。
參考資料
1. 工商時報 B1-2版 96.08.12
2. 中國時報 A13版 96.08.01
3. http://www.nytimes.com/ (紐約時報)
4. http://www.cnn.com/ (CNN)
黑心食品的最大受害者—中國 林民浩
當世界上把”Made in China”當作一種警語，對於中國製造的產品採取高規格檢驗措施的同時，我們卻忽略了中國當地的民眾，他們的生活周遭充斥著黑心商品，這些中國民眾才是黑心食品的最大受害者。據指出，百分之八十二的大陸民眾擔心食品安全問題，更有高達百分之九十一的受訪者表示，曾經在生活中遭遇到食品安全的問題(王信賢，中國大陸黑心食品問題，陸委會)。
近年來，中國大陸重大的黑心食品事件層出不窮：2004年爆發黑心商人收集理髮店剪下的頭髮，經由化工廠以化學藥劑提煉出胺基酸溶液，並加入醬油中，以減少大豆的使用，達到降低成本的目的，但這些自頭髮提煉出來的胺基酸溶液，含有砷、鉛、氯丙醇等，而製成的醬油中則帶有4-甲基咪唑，可誘發癲癇，甚至致癌，受害人數不明；2003年阜陽劣質奶粉事件：安徽省阜陽縣自2003年底，陸續發現有嬰兒出現「頭極大，但軀幹發育不良」的情況，經調查，發現這些嬰兒使用黑心奶粉，比起一般奶粉蛋白質含量介於12%至18%間，該黑心奶粉的蛋白質含量只有0.37%，其營養價值遠低於一般奶粉，使得嬰兒在發育過程中營養不良，最後甚至死亡，據統計，至少有12人死亡，超過二百人有營養不良的情形，除了安徽外，在其他省分也有類似事件傳出。除此之外，還有成千上百的黑心食品，危害著中國民眾的健康。
一般咸信看得到的黑心商品只是冰山一角，還有許許多多黑心商品，是尚未被揭露的，但目前中國大陸資訊傳播受到管制，相關訊息無法被傳播及接收，再加以中國本身的官僚制度，黑心商品的檢舉訊息往往被掩蓋，民眾無法得知相關訊息的情況下，只能無辜受害。然而世界衛生組織在解決中國黑心食品方面，毫無著力點。而國際間的貿易手段，效力只及於中國大陸的進出口商品，對於中國內部的貨物品質問題乃至於內政問題，除譴責外，也毫無辦法。儘管中國官方已宣稱著手解決相關問題，甚至與國際合作，參與訂定食品安全國際標準，但成效如何，仍令人存疑。目前黑心食品問題只能仰賴中國大陸本身自覺，徹底落實相關食品安全管理，亦期待國際間能對此投注更多關注的眼神，並採取更積極的方式迫使中國面對、解決問題。
參考資料：
1. http://www.mac.gov.tw/big5/risk/2-3.pdf
2.http://zh.wikipedia.org/wiki/%E9%BB%91%E5%BF%83%E9%A3%9F%E5%93%81
中國經濟與安全應同時並進 陳治平
經濟的發展是否真的讓我們吃的更健康？這對於中國來說似乎要打上一個問號。中國目前雖然在經濟上有明顯的發展，但是對於產品的品質要求上仍在原地踏步，從今年數種產品發生問題似乎可見一番。
中國在今年陸續在食品上發生問題，有寵物食品的成分不良造成寵物腎臟問題，使得美國有相當數量的寵物因此死亡。而中國出口的海產也因檢驗出內含重金屬可能造成人體傷害。這些食品衛生問題更近一步到達產品安全上，中國出產的玩具外層塗料上含有過量的鉛，另一方面部分牙膏產品內含工業用的二丁醇也存在致癌風險等。這些問題都顯現出在低成本取向的中國產品，存在著另一層的健康及安全衛生的隱憂。
這似乎不是一個單純的問題。一般我們多數會認為在經濟開始發展以後，能夠將生活水準有所提升，但是對於中國這樣的發展狀況，利用低工資、低成本吸引國際投資及進駐，在於汙染及環境保護的支出似乎就不甚重視，雖然近年中國更改經濟政策，希望從低成本高勞力的產業，改走向有永續發展、重視生活環境的經濟發展。但內陸的省份為求能和沿海發展快速的省份有相同的競爭力，勢必在部份限制及管理上必需妥協及讓步，這往往都是環保及衛生限制。這也帶來了更多的食品及衛生問題。
這造成兩種途徑的食品安全衛生問題：第一，部份商人為求低成本生產，在品質檢驗不完善及相關衛生條件未能強力執行下(執法機關收賄等)，使用工業用或是不符合標準的材料來製作食品(先前曾被報導的紙餡包子即是比較誇張的案例)，這往往會造成直接食用者中毒的案例發生。對於出口的產品來說，相對可能發生的案例數量會比較低，但是對於國內的使用者來說，卻往往是被隨著極高的風險。第二，長期生產高污染性的產品(如電鍍、電池等)，對於環境將留有重大的汙染，而污染物也將帶入食物鏈當中，人也將有可能吃到這樣的產物(中國海鮮存在重金屬就可能是這樣的問題)。
這對於中國來說，直接的衝擊是食品安全上的不信任及產品的信譽遭受損害，進而使得經濟上受到損失。這對於中國來說，似乎是個不大好的消息。中國必須在經濟發展的同時，提高國內對於食品衛生上的要求，更近一步對於整個產品製造上的標準及執行上更加嚴格。這是對於中國面對現有產品受到國際不信任所必須做的改進，另一方面，中國人民一直處在如此隨時可能因不良食品而有生命威脅的情況下，食品安全及衛生上的保障，將也是中國改進人權問題的必要措施。
資料來源：
1. BBC NEWS, “China food safety head executed”, 10 July 2007, http://news.bbc.co.uk/2/hi/asia-pacific/6286698.stm
2. BBC NEWS, ” China cracks down on food safety”, 9 May 2007, http://news.bbc.co.uk/2/hi/business/6638113.stm
3. economist, “China's food safety”, Jun 12th 2007, http://www.economist.com/daily/news/displaystory.cfm?story_id=9325404
4. MSNBC, “China's food safety woes now a global concern”, April 12, 2007, http://www.msnbc.msn.com/id/18078824/from/ET/
5. BBC NEWS, “US checks toothpaste for toxins”, 24 May 2007, http://news.bbc.co.uk/2/hi/americas/6686627.stm
黑心氾濫，民眾如何自保 李芳盈
近來黑心食品氾濫，令人聞之色變，唯恐自己不小心買到或是誤食黑心食品。在媒體的報導之下，將所有不合乎理想期待的食品，都簡化歸類為「黑心食品」，造成這個名詞的濫用，到底什麼是「名符其實」的黑心食品呢？
按照中華民國行政院衛生署消費者資訊網所提供的定義，簡單來說：不該給人吃的，拿來給人吃，以及對消費者的健康、權益有重大危害的食品，都算是「黑心食品」。前者例如病死豬肉，病死豬肉屬於廢棄物，應該按照規定的相關管道回收或銷毀，不能再食用，若把這些病死豬肉當作食品，無論是否真的危害人體健康，都算是黑心食品。而食物中若出現不該添加的防腐劑，蔬菜水果使用不該使用的殺蟲劑，養雞鴨使用不該使用的抗生素，或是添加合法但過量的防腐劑、使用「合法」的抗生素，卻沒有適當的停藥時間等，也算是黑心食品。而隨著所添加的成份不同，黑心食品對人體的健康也造成不同的危害，例如過氧化氫，大多使用在病死的家禽家畜，將其漂白及殺菌，避免肉品發出腐敗的味道，若食用過量，則會造成頭痛、嘔吐，對皮膚及腸胃道都有腐蝕性的傷害。為了讓食品賣相更好，添加二氧化硫讓食品的顏色更鮮艷，但二氧化硫可能引發哮喘、呼吸困難等症狀。
為了因應層出不窮的黑心食品事件，政府對食品這個部份的把關越來越嚴格，包括賣場產品的標示抽查、抽驗以及生產源頭的管理。但由於賣場產品的標示抽查及抽驗屬於產品上市後的管理，可能等到不合格的檢驗報告出來時，產品早已銷售出去，因此對於食品的管理，從源頭就開始把關才是最重要的。因此行政院消費者保護委員會積極推動多項措施，除協調農委會、環保署等單位強化「環境污染與食品安全衛生監控機制」、「聯合查核(緝)行動」等防制黑心食品的合作機制外，並建立整體「食品製造業履歷管理機制」，以確實掌握食品產製及販售流向、研擬「管制黑心再生商品計畫」，就工廠管理、商品檢驗、商品標示及廢棄物回收處理等各項措施積極規範、評估試辦乳製品履歷制度之可行性、設立黑心食品免付費檢舉專線電話、規劃建立「食品安全警報紅綠燈機制」、研議修正「食品衛生管理法」，加重不法業者之行政罰鍰及罰金額度等。
其中「食品安全紅綠燈」這項措施對民眾最有助益，在第一時間內為民眾帶來最即時最詳盡的建議；食品安全的事件發生時，專家小組會在6~8小時以內，提供食品相關資訊：包含發佈日、燈號、事件過程、處置建議，讓民眾作為參考，其中「紅燈」指的是對人體有立即危害，包括遭下毒、重金屬或是抗生素超過標準值的食品，此外，即使對人體無害，但是以不該給人吃的原料製作的食品，也納入其中、「黃燈」指的是對人體有安全疑慮、或是添加物違反規定的食品、「綠燈」就是可以安心食用的指標，指的是原料雖不符合規定，但是這項瑕疵不影響食用安全的食品。
除了從政策上改善之外，許多政府單位更設立與食品安全相關的網站供民眾瀏覽查閱，例如：「消費者資訊網」、「食品資訊網」、「不安全進口產品資訊網」等，有些網站還提供諮詢專線及申訴信箱，歡迎民眾共同檢舉不法的黑心食品。想要徹底打擊黑心食品，需要政府與民間共同合作，由政府做好源頭把關及過程中的查驗，民眾也要記得切勿貪小便宜，購買來路不明或標示不清的食品，向信用良好之企業經營者購買，才能安心食用各種食品。
參考資料：
1. 行政院衛生署消費者資訊網 http://consumer.doh.gov.tw/fdaciw/pages/index.jsp
2. 食品資訊網 http://food.doh.gov.tw/chinese/chinese.asp
3. 不安全進口產品資訊網 http://www.unsafeimports.nat.gov.tw
(4) 行政院消費者保護委員會 http://www.cpc.gov.tw/fp.asp?id=317
Reflection behind the “Black-Hearted Food”:
Media’s effect on food safety in Taiwan 陳柏翰
Have you ever worried about the food you bought from the market when you see news on TV concerning the safety of the similar items? Maybe some of us are clever enough to differentiate the black-hearted products and ones with officially acknowledged labels, but many others are not. The media are capable of magnifying some certain insignificant events in our society, and the phenomenon gets even worse in Taiwan. On one hand, the media environment in Taiwan is among the freest in Asia and extremely competitive. On the other hand, the multitude is ravenous for gossips, which results in great competitions that the agencies always run after acerbic news to cater public tastes. The reasons above both result in categorizing all the products under expectation into the range of black-hearted food. Therefore as soon as we know what the black-hearted food is and what Taiwan government has done regarding food safety, we will identify the black-hearted food handily.
What is Black-Hearted Food?
The black-hearted food is, in official definition, the food that is not esculent for human, but produced and proffered by wicked dealer. The diseased meat, for example, are classic events occurring quite often in Taiwan. It is viewed as waste which should be recycled or destroyed by burning whether it is harmful to human health or not. Besides, food that is detrimental to consumer’s health and right is another definition for black-hearted food. For instance, unexpected antiseptics in food, fruit and vegetables with illegal pesticide are typical items of black-hearted food. Moreover, poultry products applying legal antibiotics without appropriate suspension period is also classified into black-hearted food.
The Certification, Traceability Systems and Labels
What has Taiwan government done toward food safety? To protect consumers from hazards of black-hearted food, the Council of Agriculture (COA) and acknowledged organizations started to advance some products certification and traceability systems, and labeling as well.
The COA began to implement the agriculture products resume information system in 2006. In the primary step, carrots and organic paddy are the two first products detailed by the system. Consumers can check all the producing procedures, including soil conditions, fertilizer and pesticides applications…etc, through the bar-code and resume checking machines in the supermarkets. And more and more product resumes will be added in the system. In addition to the resume information system, the authority concerned has also established the quality certification system. The three measures COA adopted in 2006 certification system are that coaching to establish brands, reinforcing marketing strategies and enlarging visibility, also including strengthening the tracing mechanism.
The traceability system was implemented in 2005. The system achieved the establishment of Taiwan Good Agriculture Practices (TGAP) for some of agricultural products. Also some demonstration pilots are promoted and educated to conduct paper records and pesticides application management. The scope of 2006 work plan is to integrate resume information system and recording methods of different certified organizations. The most important event is to upload the paper records to the information tracing platform. Besides, Department of Health has also implemented GHP (Good Hygienic Practice) and HACCP (Hazard Analysis and Critical Control Point) to reinforce source control in the food manufacturing process.
Labeling, the friendliest measure, is still considered an effective way against black-hearted food. Following is the brief introduction of some common labels concerning food safety in Taiwan.
(A) (B) (C)
Label (A) presents Good Manufacturing Practice (GMP), which is certified by Food Industry Research and Development Institute (FIRDI). The GMP label promotes the industry to implement good manufacturing practice. Its main scope concerns the fundamental management of “4M”, which are Man, Material, Machine, and Method. There exist 25 different categories of food labeling GMP in the market, which enables the consumers to shop at ease.
CAS (Chinese Agricultural Standard), the label (B), is certified by the COA, Executive Yuan. Its goal is to raise the quality standard of agricultural products and its artifacts. The characteristics of the products labeling CAS include consistent quality and composition, the manufacturing process under the Act Governing Food Sanitation, intact packing with precise composition details, and homegrown raw materials.
The third label is called Good Agricultural Practice (GAP). COA plays the role in certifying fruit and vegetables to insure quality and safety. The three circles in the label indicate Coaching, Inspection, and Control in reminding farmers of following appropriate agricultural practice.
The Department of Health (DOH), Executive Yuan are also aware of the demand-side concerning food safety. DOH has constructed several websites to inform and educate the mass population with correct general knowledge, simplified regulations and the latest updated food information. Consumers can check certain food information they are interested in the websites such as Consumer Information Website and Food Information Website. The interactive activities DOH has developed, for instance, are Diet Quotient Quizzes and Food Safety Alert Mechanism. Diet Quotient Quizzes are some problems testing general population’s common knowledge about food safety. Consumers can not only examine their general sense but also get correct information. On the other hand, Food Safety Alert Mechanism reminds the consumers of the latest updated information through green-yellow-red light. If there are any news about black-hearted food, consumers can surf the website to see which light shines for the certain food. In conclusion, the mass population can receive instant official information by way of internet, which can eliminate the magnified effect by the news agencies.
True amplified examples in Taiwan
(I) In June 2005, United States confirmed that the second annual case of prion disease had occurred. Since then, the news agencies and many representatives began appealing not buying and eating American beef. In addition, the opinionists asked suppliers to remove all the related products from the markets. By such acrimonious movement, many consumers would be most likely considering all the American beef products were infected with prion disease. It seemed to be that there existed great possibilities that any one who ate American beef would be attacked by the prion protein. Although the concepts above would be considered silly by some consumers with medical background, the anti-beef movement brought the masses no practical benefit, but panic. According to the proclamation of U.S. Meat Export Federation, the infected beef was not in part of any food supply chain. As a result, the mass media and Taiwan government should cooperate to stress the regulation and inspection of quality of American beef as part of mass health education.
(II) In recent years, there was a case that a carcinogenic risk assessment study of oyster was misemployed in a news report. Some news agencies neglected the conditions under the study and overemphasized the study result that the carcinogenic risk was 500 times higher than the standard set by the U.S. Environmental Protection Agency (EPA). Due to the overblow of the mass media, consumers were afraid of excess uptake of the heavy metals and the related industry suffered uncountable damage. The event again indicates the importance in stressing the expertise of the news agencies and the role of government regarding the media environment management.
Source
1. 藥物食品安全周報
http://www.nlfd.gov.tw/uploadfile/File/%E8%97%A5%E7%89%A9%E9%A3%9F%E5%93%81%E5%AE%89%E5%85%A8%E9%80%B1%E5%A0%B1/%E8%97%A5%E7%89%A9%E9%A3%9F%E5%93%81%E5%AE%89%E5%85%A8%E9%80%B1%E5%A0%B1%E7%AC%AC002%E6%9C%9F.pdf
2. Food Information Website
http://food.doh.gov.tw/chinese/chinese.asp
http://food.doh.gov.tw/chinese/libary/libary5_2_7.htm
http://food.doh.gov.tw/chinese/history_post_1.asp?idx=129
3. BBC News, Taiwan profile
http://news.bbc.co.uk/1/hi/world/asia-pacific/country_profiles/1285915.stm
4. 2006 Year Book
http://www7.www.gov.tw/EBOOKS/TWANNUAL/show_book.php?path=8_011_061
5. Agriculture and Food Agency
http://www.afa.gov.tw/content_en.asp?pcatid=1&ycatid=1&lcatid=327&hcatid=331&sub=t
6. News
http://food.doh.gov.tw/files/paper/0094.jpg
中國劣質食品已成為「黑心」產品的代名詞，近來引起全球恐慌的中國黑心食品如致癌大閘蟹、頭髮醬油、假酒、毒寵物食品等使消費者失去信心，掀起了抵制中國產品的風潮，在台灣及歐美國家甚至出現了以非中國製造標籤來提昇產品形象及安全性的做法中國黑心食品的販賣情形。
事實上，WHO自2000年開始，為了減少開發中國家食物引起的疾病，將食品安全列為主要公共衛生議題之一，開始建構食物感染疾病之監控系統、食品安全標準、風險評估、品質要求計畫，在基改食品出現後，加強了新科技產品的安全檢驗，亦鼓勵政府應與民眾進行正確的風險溝通，並加強各會員國疫情資源的利用等等。 食品的化學性污染漸漸是食品安全的一大焦點，跨國性組織CAC(Codex Alimentarius Commission )確立國際間的食物標準Codex Standards予各國參考，成為各國食品管制的訂定指標。
日漸氾濫的中國黑心食品不僅顯示食品安全標準及檢測的重要，亦是檢驗各國食品安全控管系統的完整性之時機。2004十月Global Fora of Food Safety Regulators在泰國孟買舉行第二屆全球食品安全控管會議，以「建立有效的食品安全控制管制系統」為題，邀請各國一同分享管制經驗及討論相關的重要議題。印度政府以該國「出口食品的控制及檢定」的經驗，建議出口食品量大的國家應確認進口國家的食物標準及檢測方法，與進口國家達成食品檢定決議，藉著自我食品檢定確保出口食品的安全，不但能保護消費者，建立國家信譽，亦能減少出口末端食品認證的時間和金錢，避免負擔退貨的額外損失。
美國政府亦指出，其各自有兩個單位控管進口食品，FSIS(The Food Safety and Inspection Service)規定進口肉類、禽類及蛋類國家應與美方有相同的食品管制檢查機制，HHS/FDA(The U.S. Food and Drug Administration within the Department of Health and Human Services) 則規定各國進口的其他所有食品之製造程序應符合美國當局的安全要求，違反規定即無法進口至美國。
國際貿易將食品從製造國送往世界的另一頭，各國進出口的食品控管系統各自面對互相折衷規範的情形。中國食品在此氛圍露出劣質原形，遭受各國譴責，其後兩領導人胡錦濤及溫家寶皆誓言加強產品安全監管力度和法律體系建設，從而使全球消費者的權益得到更好的保障。但在強力管制之前，中國食品的製造源頭之原料、生產製造、販賣等過程仍有錯綜複雜的問題有待當局解決為先。
參考資料：
1. 維基百科，黑心食品
2. WHO，http://www.who.int/features/qa/19/en/index.html
What is WHO doing to help countries improve food safety?
3. WHO，http://www.who.int/foodsafety/codex/en/
Food standards (Codex Alimentarius)
4. Ms Shashi Sareen, Director, Export Inspection Council, India ，Food Export Control And Certification，Second FAO/WHO Global Forum of Food Safety Regulators，Bangkok， Thailand， 12-14 October 2004
5. the United States of America，Food Export Control And Certification，Second FAO/WHO Global Forum of Food Safety Regulators ， Thailand， 12-14 October 2004
中國應重新面對產品品質不良的問題 顏稚浩
從今年(2007)四五月間開始，美國媒體開始大幅度報導有關中國的黑心食品，該月就有257項中國大陸被以安全問題為由，拒絕入境美國。之後又爆發了一連串的黑心產品事件，從震驚全球的巴拿馬的毒感冒糖漿事件、導致美國境內許多家庭飼養的寵物死亡的有毒飼料、義大利和西班牙查獲的有毒牙膏，到屬於美國境內的回收含鉛的玩具、有問題的輪胎、零食的調味料被驗出受沙門氏菌(salmonella)污染和被檢驗出含有禁用的抗生素的海鮮等。這些事件顯示出作為世界上重要的產品輸出國家，中國在管制其輸出食品的安全把關上出現了一些問題，導致有越來越多的人開始把”中國製造”和”不安全”畫上等號，據報導甚至也有製造商在其商品上標榜”非中國製造”來使消費者安心。
隨著其他國家對中國製的食品質疑的聲浪越來越高漲之際，中國起初維持其一貫的否認作風，將問題歸咎於其他國家的檢驗誤差、安全檢測的標準不同之外，其官方還宣稱美國輸入中國食品的近三年平均合格率只有98.9%，低於中國輸美食品99%以上的合格率。也有學者說今年上半年中國對美國出口總值達1072億美金，順差更高達739.1億美金，較去年同期增加了18.6%，這讓美國政府感到不悅，所以認為黑心食品問題的突然爆發，很大的一部分只是美國政府用來發洩對巨大的貿易逆差問題的不滿而已。不過隨著問題食品如滾雪球般越滾越大，北京當局也不得不承認確實在食品的安全管制系統出現了問題，像是權責不明，很多機構都對食品和藥物有檢測權，導致責任上出現重疊; 相關的規定執法不嚴;部分製造商鑽法律漏洞，以次級品替代來謀取暴利; 沒有建立起一套完整、統一的檢測系統來應付中國這個快速成長和流動的經濟等。不過值得一提的是，中國政府在同時也加強檢查其他國家輸入的食品作為反制，這兩個月來包括美國進口的內類和家禽製品被沙門氏菌汙染、日本的奶粉含鋅量低於包裝標示、印尼的水產品含有過量的微生物、菲律賓的食品也被驗出含有重金屬等事件也陸續爆發。
不過也有人把這項舉動解讀為中國政府在有能力完全解決自身的問題前，對其他國家進行的反抹黑手段。
中國民眾對這些事件的看法深受媒體的影響，食品問題剛爆發時，中國的媒體多數把它訴諸於貿易障礙問題，而不認為那是真正食品出了問題。不過最近開始有少數的媒體認為應該屏棄那種看法，而開始認真面對來自國外的質疑聲浪。
一般民眾對於國內的食品安全也有信心動搖的情況，很多消費者對層出不窮的問題食品新聞感到難以招架，根據報載，有些民眾已經不知道什麼東西可以吃，什麼東西有問題不能吃了，他們也不知道政府如何在食品安全上做把關，他們只知道安全可供食用的食物已經越來越少了。
在本身的食品安檢系統的改進上，北京當局在六月間由國家會議(state council)發表聲明說，中國將全面改革其食品和藥物的安全規定，這是至今中國對於食品安全問題最強烈的談話。七月間，中國皆露了新的食品和不合格的輸出品的管制措施，中國官方也誓言加強管理運用在內類和海鮮的化學藥品。七月底中美兩國在北京就食品安全議題舉行會談，八月間中國也派出代表團到華盛頓，與美方做近一步的討論，預計雙方在今年底前會就食品安全簽署備忘錄，在雙方進行會談之際，中國政府也關閉了三家違反食品安全規定的公司，這三家公司分別涉及了巴拿馬含二甘醇有毒感冒糖漿，和生產含有三聚氯胺(melamine)的寵物飼料的事件。北京當局也計劃在2010年時建立一套對食品藥物進出口以及藥物隨機檢測的管制標準，雖然他們還沒有說明是否會提供更多的資金在這件事上，以及由哪一個機構執行這項業務。幾個月前，北京當局將其前食品與藥物管理局局長判處死刑並已執行槍決。他被控收受廠商賄賂，讓未經檢測的藥物合法上市。
雖然這件事不免讓人對其食品安全檢測系統的公信力有了懷疑，不過從中國政府鐵腕處理這件醜聞來看，可以看出其改善食品安全的決心。
大部分的外國政府官員對於中國的改革措施均表示樂觀其成，不過他們也表示如果中國的產品持續出現問題，他們還是會做近一步的限制。不過有部分專家則對中國的宣示抱持懷疑的態度，他們認為有一部分是之前就已經做過的承諾了，而且中國並沒有承認所有的問題，其官方不斷指控這是國際媒體誇大了中國有問題的產品。有些專家也認為部分問題已經根深蒂固了，改革不可能進行的很快速，中國的經濟快速成長，要建立起能夠監控所有產品的系統所耗費的成本相當大，這實非一朝一夕就可以達成的。不過還是有評論家認為，對照之前一直不願意承認問題的中國政府來說，現在他們對這個問題的處理態度令人感到樂觀。
參考資料
1. 工商時報 B1-2版 96.08.12
2. 中國時報 A13版 96.08.01
3. http://www.nytimes.com/ (紐約時報)
4. http://www.cnn.com/ (CNN)
黑心食品的最大受害者—中國 林民浩
當世界上把”Made in China”當作一種警語，對於中國製造的產品採取高規格檢驗措施的同時，我們卻忽略了中國當地的民眾，他們的生活周遭充斥著黑心商品，這些中國民眾才是黑心食品的最大受害者。據指出，百分之八十二的大陸民眾擔心食品安全問題，更有高達百分之九十一的受訪者表示，曾經在生活中遭遇到食品安全的問題(王信賢，中國大陸黑心食品問題，陸委會)。
近年來，中國大陸重大的黑心食品事件層出不窮：2004年爆發黑心商人收集理髮店剪下的頭髮，經由化工廠以化學藥劑提煉出胺基酸溶液，並加入醬油中，以減少大豆的使用，達到降低成本的目的，但這些自頭髮提煉出來的胺基酸溶液，含有砷、鉛、氯丙醇等，而製成的醬油中則帶有4-甲基咪唑，可誘發癲癇，甚至致癌，受害人數不明；2003年阜陽劣質奶粉事件：安徽省阜陽縣自2003年底，陸續發現有嬰兒出現「頭極大，但軀幹發育不良」的情況，經調查，發現這些嬰兒使用黑心奶粉，比起一般奶粉蛋白質含量介於12%至18%間，該黑心奶粉的蛋白質含量只有0.37%，其營養價值遠低於一般奶粉，使得嬰兒在發育過程中營養不良，最後甚至死亡，據統計，至少有12人死亡，超過二百人有營養不良的情形，除了安徽外，在其他省分也有類似事件傳出。除此之外，還有成千上百的黑心食品，危害著中國民眾的健康。
一般咸信看得到的黑心商品只是冰山一角，還有許許多多黑心商品，是尚未被揭露的，但目前中國大陸資訊傳播受到管制，相關訊息無法被傳播及接收，再加以中國本身的官僚制度，黑心商品的檢舉訊息往往被掩蓋，民眾無法得知相關訊息的情況下，只能無辜受害。然而世界衛生組織在解決中國黑心食品方面，毫無著力點。而國際間的貿易手段，效力只及於中國大陸的進出口商品，對於中國內部的貨物品質問題乃至於內政問題，除譴責外，也毫無辦法。儘管中國官方已宣稱著手解決相關問題，甚至與國際合作，參與訂定食品安全國際標準，但成效如何，仍令人存疑。目前黑心食品問題只能仰賴中國大陸本身自覺，徹底落實相關食品安全管理，亦期待國際間能對此投注更多關注的眼神，並採取更積極的方式迫使中國面對、解決問題。
參考資料：
1. http://www.mac.gov.tw/big5/risk/2-3.pdf
2.http://zh.wikipedia.org/wiki/%E9%BB%91%E5%BF%83%E9%A3%9F%E5%93%81
中國經濟與安全應同時並進 陳治平
經濟的發展是否真的讓我們吃的更健康？這對於中國來說似乎要打上一個問號。中國目前雖然在經濟上有明顯的發展，但是對於產品的品質要求上仍在原地踏步，從今年數種產品發生問題似乎可見一番。
中國在今年陸續在食品上發生問題，有寵物食品的成分不良造成寵物腎臟問題，使得美國有相當數量的寵物因此死亡。而中國出口的海產也因檢驗出內含重金屬可能造成人體傷害。這些食品衛生問題更近一步到達產品安全上，中國出產的玩具外層塗料上含有過量的鉛，另一方面部分牙膏產品內含工業用的二丁醇也存在致癌風險等。這些問題都顯現出在低成本取向的中國產品，存在著另一層的健康及安全衛生的隱憂。
這似乎不是一個單純的問題。一般我們多數會認為在經濟開始發展以後，能夠將生活水準有所提升，但是對於中國這樣的發展狀況，利用低工資、低成本吸引國際投資及進駐，在於汙染及環境保護的支出似乎就不甚重視，雖然近年中國更改經濟政策，希望從低成本高勞力的產業，改走向有永續發展、重視生活環境的經濟發展。但內陸的省份為求能和沿海發展快速的省份有相同的競爭力，勢必在部份限制及管理上必需妥協及讓步，這往往都是環保及衛生限制。這也帶來了更多的食品及衛生問題。
這造成兩種途徑的食品安全衛生問題：第一，部份商人為求低成本生產，在品質檢驗不完善及相關衛生條件未能強力執行下(執法機關收賄等)，使用工業用或是不符合標準的材料來製作食品(先前曾被報導的紙餡包子即是比較誇張的案例)，這往往會造成直接食用者中毒的案例發生。對於出口的產品來說，相對可能發生的案例數量會比較低，但是對於國內的使用者來說，卻往往是被隨著極高的風險。第二，長期生產高污染性的產品(如電鍍、電池等)，對於環境將留有重大的汙染，而污染物也將帶入食物鏈當中，人也將有可能吃到這樣的產物(中國海鮮存在重金屬就可能是這樣的問題)。
這對於中國來說，直接的衝擊是食品安全上的不信任及產品的信譽遭受損害，進而使得經濟上受到損失。這對於中國來說，似乎是個不大好的消息。中國必須在經濟發展的同時，提高國內對於食品衛生上的要求，更近一步對於整個產品製造上的標準及執行上更加嚴格。這是對於中國面對現有產品受到國際不信任所必須做的改進，另一方面，中國人民一直處在如此隨時可能因不良食品而有生命威脅的情況下，食品安全及衛生上的保障，將也是中國改進人權問題的必要措施。
資料來源：
1. BBC NEWS, “China food safety head executed”, 10 July 2007, http://news.bbc.co.uk/2/hi/asia-pacific/6286698.stm
2. BBC NEWS, ” China cracks down on food safety”, 9 May 2007, http://news.bbc.co.uk/2/hi/business/6638113.stm
3. economist, “China's food safety”, Jun 12th 2007, http://www.economist.com/daily/news/displaystory.cfm?story_id=9325404
4. MSNBC, “China's food safety woes now a global concern”, April 12, 2007, http://www.msnbc.msn.com/id/18078824/from/ET/
5. BBC NEWS, “US checks toothpaste for toxins”, 24 May 2007, http://news.bbc.co.uk/2/hi/americas/6686627.stm
黑心氾濫，民眾如何自保 李芳盈
近來黑心食品氾濫，令人聞之色變，唯恐自己不小心買到或是誤食黑心食品。在媒體的報導之下，將所有不合乎理想期待的食品，都簡化歸類為「黑心食品」，造成這個名詞的濫用，到底什麼是「名符其實」的黑心食品呢？
按照中華民國行政院衛生署消費者資訊網所提供的定義，簡單來說：不該給人吃的，拿來給人吃，以及對消費者的健康、權益有重大危害的食品，都算是「黑心食品」。前者例如病死豬肉，病死豬肉屬於廢棄物，應該按照規定的相關管道回收或銷毀，不能再食用，若把這些病死豬肉當作食品，無論是否真的危害人體健康，都算是黑心食品。而食物中若出現不該添加的防腐劑，蔬菜水果使用不該使用的殺蟲劑，養雞鴨使用不該使用的抗生素，或是添加合法但過量的防腐劑、使用「合法」的抗生素，卻沒有適當的停藥時間等，也算是黑心食品。而隨著所添加的成份不同，黑心食品對人體的健康也造成不同的危害，例如過氧化氫，大多使用在病死的家禽家畜，將其漂白及殺菌，避免肉品發出腐敗的味道，若食用過量，則會造成頭痛、嘔吐，對皮膚及腸胃道都有腐蝕性的傷害。為了讓食品賣相更好，添加二氧化硫讓食品的顏色更鮮艷，但二氧化硫可能引發哮喘、呼吸困難等症狀。
為了因應層出不窮的黑心食品事件，政府對食品這個部份的把關越來越嚴格，包括賣場產品的標示抽查、抽驗以及生產源頭的管理。但由於賣場產品的標示抽查及抽驗屬於產品上市後的管理，可能等到不合格的檢驗報告出來時，產品早已銷售出去，因此對於食品的管理，從源頭就開始把關才是最重要的。因此行政院消費者保護委員會積極推動多項措施，除協調農委會、環保署等單位強化「環境污染與食品安全衛生監控機制」、「聯合查核(緝)行動」等防制黑心食品的合作機制外，並建立整體「食品製造業履歷管理機制」，以確實掌握食品產製及販售流向、研擬「管制黑心再生商品計畫」，就工廠管理、商品檢驗、商品標示及廢棄物回收處理等各項措施積極規範、評估試辦乳製品履歷制度之可行性、設立黑心食品免付費檢舉專線電話、規劃建立「食品安全警報紅綠燈機制」、研議修正「食品衛生管理法」，加重不法業者之行政罰鍰及罰金額度等。
其中「食品安全紅綠燈」這項措施對民眾最有助益，在第一時間內為民眾帶來最即時最詳盡的建議；食品安全的事件發生時，專家小組會在6~8小時以內，提供食品相關資訊：包含發佈日、燈號、事件過程、處置建議，讓民眾作為參考，其中「紅燈」指的是對人體有立即危害，包括遭下毒、重金屬或是抗生素超過標準值的食品，此外，即使對人體無害，但是以不該給人吃的原料製作的食品，也納入其中、「黃燈」指的是對人體有安全疑慮、或是添加物違反規定的食品、「綠燈」就是可以安心食用的指標，指的是原料雖不符合規定，但是這項瑕疵不影響食用安全的食品。
除了從政策上改善之外，許多政府單位更設立與食品安全相關的網站供民眾瀏覽查閱，例如：「消費者資訊網」、「食品資訊網」、「不安全進口產品資訊網」等，有些網站還提供諮詢專線及申訴信箱，歡迎民眾共同檢舉不法的黑心食品。想要徹底打擊黑心食品，需要政府與民間共同合作，由政府做好源頭把關及過程中的查驗，民眾也要記得切勿貪小便宜，購買來路不明或標示不清的食品，向信用良好之企業經營者購買，才能安心食用各種食品。
參考資料：
1. 行政院衛生署消費者資訊網 http://consumer.doh.gov.tw/fdaciw/pages/index.jsp
2. 食品資訊網 http://food.doh.gov.tw/chinese/chinese.asp
3. 不安全進口產品資訊網 http://www.unsafeimports.nat.gov.tw
(4) 行政院消費者保護委員會 http://www.cpc.gov.tw/fp.asp?id=317
Reflection behind the “Black-Hearted Food”:
Media’s effect on food safety in Taiwan 陳柏翰
Have you ever worried about the food you bought from the market when you see news on TV concerning the safety of the similar items? Maybe some of us are clever enough to differentiate the black-hearted products and ones with officially acknowledged labels, but many others are not. The media are capable of magnifying some certain insignificant events in our society, and the phenomenon gets even worse in Taiwan. On one hand, the media environment in Taiwan is among the freest in Asia and extremely competitive. On the other hand, the multitude is ravenous for gossips, which results in great competitions that the agencies always run after acerbic news to cater public tastes. The reasons above both result in categorizing all the products under expectation into the range of black-hearted food. Therefore as soon as we know what the black-hearted food is and what Taiwan government has done regarding food safety, we will identify the black-hearted food handily.
What is Black-Hearted Food?
The black-hearted food is, in official definition, the food that is not esculent for human, but produced and proffered by wicked dealer. The diseased meat, for example, are classic events occurring quite often in Taiwan. It is viewed as waste which should be recycled or destroyed by burning whether it is harmful to human health or not. Besides, food that is detrimental to consumer’s health and right is another definition for black-hearted food. For instance, unexpected antiseptics in food, fruit and vegetables with illegal pesticide are typical items of black-hearted food. Moreover, poultry products applying legal antibiotics without appropriate suspension period is also classified into black-hearted food.
The Certification, Traceability Systems and Labels
What has Taiwan government done toward food safety? To protect consumers from hazards of black-hearted food, the Council of Agriculture (COA) and acknowledged organizations started to advance some products certification and traceability systems, and labeling as well.
The COA began to implement the agriculture products resume information system in 2006. In the primary step, carrots and organic paddy are the two first products detailed by the system. Consumers can check all the producing procedures, including soil conditions, fertilizer and pesticides applications…etc, through the bar-code and resume checking machines in the supermarkets. And more and more product resumes will be added in the system. In addition to the resume information system, the authority concerned has also established the quality certification system. The three measures COA adopted in 2006 certification system are that coaching to establish brands, reinforcing marketing strategies and enlarging visibility, also including strengthening the tracing mechanism.
The traceability system was implemented in 2005. The system achieved the establishment of Taiwan Good Agriculture Practices (TGAP) for some of agricultural products. Also some demonstration pilots are promoted and educated to conduct paper records and pesticides application management. The scope of 2006 work plan is to integrate resume information system and recording methods of different certified organizations. The most important event is to upload the paper records to the information tracing platform. Besides, Department of Health has also implemented GHP (Good Hygienic Practice) and HACCP (Hazard Analysis and Critical Control Point) to reinforce source control in the food manufacturing process.
Labeling, the friendliest measure, is still considered an effective way against black-hearted food. Following is the brief introduction of some common labels concerning food safety in Taiwan.
(A) (B) (C)
Label (A) presents Good Manufacturing Practice (GMP), which is certified by Food Industry Research and Development Institute (FIRDI). The GMP label promotes the industry to implement good manufacturing practice. Its main scope concerns the fundamental management of “4M”, which are Man, Material, Machine, and Method. There exist 25 different categories of food labeling GMP in the market, which enables the consumers to shop at ease.
CAS (Chinese Agricultural Standard), the label (B), is certified by the COA, Executive Yuan. Its goal is to raise the quality standard of agricultural products and its artifacts. The characteristics of the products labeling CAS include consistent quality and composition, the manufacturing process under the Act Governing Food Sanitation, intact packing with precise composition details, and homegrown raw materials.
The third label is called Good Agricultural Practice (GAP). COA plays the role in certifying fruit and vegetables to insure quality and safety. The three circles in the label indicate Coaching, Inspection, and Control in reminding farmers of following appropriate agricultural practice.
The Department of Health (DOH), Executive Yuan are also aware of the demand-side concerning food safety. DOH has constructed several websites to inform and educate the mass population with correct general knowledge, simplified regulations and the latest updated food information. Consumers can check certain food information they are interested in the websites such as Consumer Information Website and Food Information Website. The interactive activities DOH has developed, for instance, are Diet Quotient Quizzes and Food Safety Alert Mechanism. Diet Quotient Quizzes are some problems testing general population’s common knowledge about food safety. Consumers can not only examine their general sense but also get correct information. On the other hand, Food Safety Alert Mechanism reminds the consumers of the latest updated information through green-yellow-red light. If there are any news about black-hearted food, consumers can surf the website to see which light shines for the certain food. In conclusion, the mass population can receive instant official information by way of internet, which can eliminate the magnified effect by the news agencies.
True amplified examples in Taiwan
(I) In June 2005, United States confirmed that the second annual case of prion disease had occurred. Since then, the news agencies and many representatives began appealing not buying and eating American beef. In addition, the opinionists asked suppliers to remove all the related products from the markets. By such acrimonious movement, many consumers would be most likely considering all the American beef products were infected with prion disease. It seemed to be that there existed great possibilities that any one who ate American beef would be attacked by the prion protein. Although the concepts above would be considered silly by some consumers with medical background, the anti-beef movement brought the masses no practical benefit, but panic. According to the proclamation of U.S. Meat Export Federation, the infected beef was not in part of any food supply chain. As a result, the mass media and Taiwan government should cooperate to stress the regulation and inspection of quality of American beef as part of mass health education.
(II) In recent years, there was a case that a carcinogenic risk assessment study of oyster was misemployed in a news report. Some news agencies neglected the conditions under the study and overemphasized the study result that the carcinogenic risk was 500 times higher than the standard set by the U.S. Environmental Protection Agency (EPA). Due to the overblow of the mass media, consumers were afraid of excess uptake of the heavy metals and the related industry suffered uncountable damage. The event again indicates the importance in stressing the expertise of the news agencies and the role of government regarding the media environment management.
Source
1. 藥物食品安全周報
http://www.nlfd.gov.tw/uploadfile/File/%E8%97%A5%E7%89%A9%E9%A3%9F%E5%93%81%E5%AE%89%E5%85%A8%E9%80%B1%E5%A0%B1/%E8%97%A5%E7%89%A9%E9%A3%9F%E5%93%81%E5%AE%89%E5%85%A8%E9%80%B1%E5%A0%B1%E7%AC%AC002%E6%9C%9F.pdf
2. Food Information Website
http://food.doh.gov.tw/chinese/chinese.asp
http://food.doh.gov.tw/chinese/libary/libary5_2_7.htm
http://food.doh.gov.tw/chinese/history_post_1.asp?idx=129
3. BBC News, Taiwan profile
http://news.bbc.co.uk/1/hi/world/asia-pacific/country_profiles/1285915.stm
4. 2006 Year Book
http://www7.www.gov.tw/EBOOKS/TWANNUAL/show_book.php?path=8_011_061
5. Agriculture and Food Agency
http://www.afa.gov.tw/content_en.asp?pcatid=1&ycatid=1&lcatid=327&hcatid=331&sub=t
6. News
http://food.doh.gov.tw/files/paper/0094.jpg
2007年9月23日 星期日
Food Safety
WHO主要重視的部份
http://www.who.int/foodsafety/en/
The Department of Food Safety, Zoonoses and Foodborne Diseases (FOS) strives to reduce the serious negative impact of foodborne diseases worldwide. Food and waterborne diarrhoeal diseases are leading causes of illness and death in less developed countries, killing approximately 1.8 million people annually, most of whom are children.
Recent trends in global food production, processing, distribution and preparation are creating an increasing demand for food safety research in order to ensure a safer global food supply. FOS works with other WHO departments, Regional Offices and WHO collaborating centres as well as other international and national agencies. In particular, WHO works closely with the Food and Agriculture Organization of the United Nations (FAO) to address food safety issues along the entire food production chain--from production to consumption--using new methods of risk analysis. These methods provide efficient, science-based tools to improve food safety, thereby benefiting both public health and economic development. FOS endeavours to help all WHO Member States, both developing and developed, through the approaches outlined in the WHO Global Strategy for Food Safety.
http://www.who.int/foodsafety/en/
The Department of Food Safety, Zoonoses and Foodborne Diseases (FOS) strives to reduce the serious negative impact of foodborne diseases worldwide. Food and waterborne diarrhoeal diseases are leading causes of illness and death in less developed countries, killing approximately 1.8 million people annually, most of whom are children.
Recent trends in global food production, processing, distribution and preparation are creating an increasing demand for food safety research in order to ensure a safer global food supply. FOS works with other WHO departments, Regional Offices and WHO collaborating centres as well as other international and national agencies. In particular, WHO works closely with the Food and Agriculture Organization of the United Nations (FAO) to address food safety issues along the entire food production chain--from production to consumption--using new methods of risk analysis. These methods provide efficient, science-based tools to improve food safety, thereby benefiting both public health and economic development. FOS endeavours to help all WHO Member States, both developing and developed, through the approaches outlined in the WHO Global Strategy for Food Safety.
China's food safety
http://www.economist.com/daily/news/displaystory.cfm?story_id=9325404
Jun 12th 2007
From the Economist Intelligence Unit ViewsWire
A new plan to improve standards of food and drugs
When pet cats and dogs in the US started dying in April, few would have thought that the deaths would have much relevance for the Chinese export juggernaut. But the issue looks like spiralling into a major problem for international traders, and in an effort to cool the controversy China was forced to release on June 6th its first five-year plan to improve food-and-drug safety standards. The plan has a political as well as practical motive, as the government is keen to undo the reputational damage from scandals ranging from food contamination to the sale of fake antibiotics. However, implementation of the plan is likely to be difficult.
China is no stranger to quality problems, be it in food, drugs or toys. The US pet deaths—stemming from the contamination by melamine, a chemical toxin, of a vegetable protein used in animal foods—were not all that different from many other past cases in China. However, the massive scale of the pet-food recall, involving thousands of retail products, was unprecedented. The issue also touched on an unusually emotive subject at a time of rising Sino-US trade tensions. That was not all. The story was followed by a plethora of articles in the foreign media highlighting similar cases, ranging from a series of alleged deaths in Panama last year caused by the use of industrial toxins in cough medicine exported from China to the US Food and Drug Administration's warnings over chemicals in Chinese-made toothpaste. China was on the verge of a global PR disaster.
Investigations into such cases have thrown light on the tangled morass of the Chinese regulatory system. The State Food and Drug Administration (SFDA), the General Administration of Quality Supervision, Inspection and Quarantine and other agencies have a tendency to pass the buck between each other, denying responsibility for mistakes. That allows producers and traders to get on with business as usual. In many cases a lack of regulatory clarity and co-ordination prevents the authorities from tackling abuses. In others, businesses simply buy the required documentation.
Deadly consequences
It has been an ironic coincidence that the latest furore has come as the former head of the SFDA, Zheng Xiaoyu, was on trial for accepting bribes in return for granting government approval for various medicines in 2005. Amid the international uproar over tainted Chinese products, there was little surprise when the court imposed the death sentence when he was found guilty. But for regulators still trying to save their necks, they now have the unenviable task of sifting through all the drugs and pharmaceutical firms approved for licences under Mr Zheng in an attempt to make sure they did not breach standards.
As Mr Zheng's case—which did not involve exports—showed, this is not purely a problem for foreigners who buy Chinese products. It is a safe to say that many more Chinese people than foreigners are harmed by ingesting toxic or substandard foods and drugs each year. In one particularly tragic case in Anhui in 2004, for example, several babies died of malnutrition after consuming fake baby-milk powder. Investigative programmes exposing factories, farms and restaurants engaged in various nefarious practices with food are a stomach-churning staple of Chinese television.
Yet Chinese officials' reflexive response to more serious cases remains the cover-up. The pet-food case saw a classic hash of a government PR job. First came denial: "The poisoning of American pets has nothing to do with China," claimed a report in the People's Daily. This was followed by a blustering counter-attack noting that food contamination occurred both within the US and with US exports to China. "No food-inspection system is foolproof," pointed out Li Yuanping, director general of the Import and Export Food Safety Bureau. "It's like an airplane. Flying is said to be the safest way to travel, but sometimes you have plane crashes".
Only later did officials start revealing more substantive measures to address the problem, including the release of the five-year food-and-drug safety plan. The plan calls for more inspections of food exports, improved procedures for recalling faulty or tainted products, more pollution monitoring in food-producing areas, as well as an improved structure for monitoring--and blacklisting--food trading companies. According to the Chinese state media, the plan also aims to implement a system of special inspections for 90% of food producers. It also calls for more stringent controls on the use of additives and pesticides, and for nationwide monitoring of the ill effects of medication. However, despite the plan's laudable aims, corruption and inefficiency will continue to leave doors wide open for companies wanting to cut corners.
Legal fallout?
For foreign businesses, the lack of quality control in China is not someone else's problem. Several lawyers have argued that, since Chinese regulatory bodies are demonstrably unfit for purpose, any company accepting Chinese exports with official quality or safety certificates could theoretically be held liable for problems that subsequently emerge. Once again, this dilemma highlights the importance for companies of detailed knowledge of their supply chains in China, and of not taking documentary or verbal assurances at face value. To help deal with such challenges, bigger companies should establish their own internal quality-control mechanisms. But for smaller traders, the costs of such systems could undermine their profitability. For many importers then, the best acid test may well be that if a product's price looks too good to be true, it probably is.
Jun 12th 2007
From the Economist Intelligence Unit ViewsWire
A new plan to improve standards of food and drugs
When pet cats and dogs in the US started dying in April, few would have thought that the deaths would have much relevance for the Chinese export juggernaut. But the issue looks like spiralling into a major problem for international traders, and in an effort to cool the controversy China was forced to release on June 6th its first five-year plan to improve food-and-drug safety standards. The plan has a political as well as practical motive, as the government is keen to undo the reputational damage from scandals ranging from food contamination to the sale of fake antibiotics. However, implementation of the plan is likely to be difficult.
China is no stranger to quality problems, be it in food, drugs or toys. The US pet deaths—stemming from the contamination by melamine, a chemical toxin, of a vegetable protein used in animal foods—were not all that different from many other past cases in China. However, the massive scale of the pet-food recall, involving thousands of retail products, was unprecedented. The issue also touched on an unusually emotive subject at a time of rising Sino-US trade tensions. That was not all. The story was followed by a plethora of articles in the foreign media highlighting similar cases, ranging from a series of alleged deaths in Panama last year caused by the use of industrial toxins in cough medicine exported from China to the US Food and Drug Administration's warnings over chemicals in Chinese-made toothpaste. China was on the verge of a global PR disaster.
Investigations into such cases have thrown light on the tangled morass of the Chinese regulatory system. The State Food and Drug Administration (SFDA), the General Administration of Quality Supervision, Inspection and Quarantine and other agencies have a tendency to pass the buck between each other, denying responsibility for mistakes. That allows producers and traders to get on with business as usual. In many cases a lack of regulatory clarity and co-ordination prevents the authorities from tackling abuses. In others, businesses simply buy the required documentation.
Deadly consequences
It has been an ironic coincidence that the latest furore has come as the former head of the SFDA, Zheng Xiaoyu, was on trial for accepting bribes in return for granting government approval for various medicines in 2005. Amid the international uproar over tainted Chinese products, there was little surprise when the court imposed the death sentence when he was found guilty. But for regulators still trying to save their necks, they now have the unenviable task of sifting through all the drugs and pharmaceutical firms approved for licences under Mr Zheng in an attempt to make sure they did not breach standards.
As Mr Zheng's case—which did not involve exports—showed, this is not purely a problem for foreigners who buy Chinese products. It is a safe to say that many more Chinese people than foreigners are harmed by ingesting toxic or substandard foods and drugs each year. In one particularly tragic case in Anhui in 2004, for example, several babies died of malnutrition after consuming fake baby-milk powder. Investigative programmes exposing factories, farms and restaurants engaged in various nefarious practices with food are a stomach-churning staple of Chinese television.
Yet Chinese officials' reflexive response to more serious cases remains the cover-up. The pet-food case saw a classic hash of a government PR job. First came denial: "The poisoning of American pets has nothing to do with China," claimed a report in the People's Daily. This was followed by a blustering counter-attack noting that food contamination occurred both within the US and with US exports to China. "No food-inspection system is foolproof," pointed out Li Yuanping, director general of the Import and Export Food Safety Bureau. "It's like an airplane. Flying is said to be the safest way to travel, but sometimes you have plane crashes".
Only later did officials start revealing more substantive measures to address the problem, including the release of the five-year food-and-drug safety plan. The plan calls for more inspections of food exports, improved procedures for recalling faulty or tainted products, more pollution monitoring in food-producing areas, as well as an improved structure for monitoring--and blacklisting--food trading companies. According to the Chinese state media, the plan also aims to implement a system of special inspections for 90% of food producers. It also calls for more stringent controls on the use of additives and pesticides, and for nationwide monitoring of the ill effects of medication. However, despite the plan's laudable aims, corruption and inefficiency will continue to leave doors wide open for companies wanting to cut corners.
Legal fallout?
For foreign businesses, the lack of quality control in China is not someone else's problem. Several lawyers have argued that, since Chinese regulatory bodies are demonstrably unfit for purpose, any company accepting Chinese exports with official quality or safety certificates could theoretically be held liable for problems that subsequently emerge. Once again, this dilemma highlights the importance for companies of detailed knowledge of their supply chains in China, and of not taking documentary or verbal assurances at face value. To help deal with such challenges, bigger companies should establish their own internal quality-control mechanisms. But for smaller traders, the costs of such systems could undermine their profitability. For many importers then, the best acid test may well be that if a product's price looks too good to be true, it probably is.
China defends food safety in WHO report
http://www.cnn.com/2007/WORLD/asiapcf/08/28/china.who.reut/index.html?iref=newssearch
BEIJING, China (Reuters) -- China has sent a notice to the World Health Organization defending its food safety standards and repeating what is becoming a standard line that more than 99 percent of its food exports are up to standard.
A series of scandals involving substandard Chinese exports ranging from pet food and toothpaste to toys has put increasing pressure on Beijing to clean up its manufacturing sector.
The notice, posted on the Health Ministry's Web site (www.moh.gov.cn) on Wednesday but sent one week ago also said that China was willing to cooperate globally to tackle the problem.
"The Chinese government is willing to increase information exchange and communication with international society and other countries in line with its attitude of openness and transparency," the notice said.
"We hope the World Health Organization gives support and help to China's food safety work and also reports on the situation to member states."
The notice detailed the actions and laws China has adopted to ensure food safety, explained the roles of the various watchdog bodies and promised to "strike hard" against illegal behavior by companies.
"The Chinese government pays great attention to friendly cooperation in the food safety field with other countries, regions and international bodies, and emphasizes drawing on the experience of advanced global management and examination and testing technology," the ministry said.
"This will push the raising of the general quality of China's food."
It said overall quality of farm products had increased hugely.
"At present ,more than 94 percent of vegetables meet chemical residue standards," the notice said.
A spokeswoman for the WHO in Beijing said though it had not requested the Health Ministry's report, it welcomed it.
"We have been working pretty closely with the government to strengthen food safety in China," said spokeswoman Joanna Brent. "While there's nothing specifically new in it, it does shows that China has recognized it has a challenge and is working to address it. We're pretty positive about that."
BEIJING, China (Reuters) -- China has sent a notice to the World Health Organization defending its food safety standards and repeating what is becoming a standard line that more than 99 percent of its food exports are up to standard.
A series of scandals involving substandard Chinese exports ranging from pet food and toothpaste to toys has put increasing pressure on Beijing to clean up its manufacturing sector.
The notice, posted on the Health Ministry's Web site (www.moh.gov.cn) on Wednesday but sent one week ago also said that China was willing to cooperate globally to tackle the problem.
"The Chinese government is willing to increase information exchange and communication with international society and other countries in line with its attitude of openness and transparency," the notice said.
"We hope the World Health Organization gives support and help to China's food safety work and also reports on the situation to member states."
The notice detailed the actions and laws China has adopted to ensure food safety, explained the roles of the various watchdog bodies and promised to "strike hard" against illegal behavior by companies.
"The Chinese government pays great attention to friendly cooperation in the food safety field with other countries, regions and international bodies, and emphasizes drawing on the experience of advanced global management and examination and testing technology," the ministry said.
"This will push the raising of the general quality of China's food."
It said overall quality of farm products had increased hugely.
"At present ,more than 94 percent of vegetables meet chemical residue standards," the notice said.
A spokeswoman for the WHO in Beijing said though it had not requested the Health Ministry's report, it welcomed it.
"We have been working pretty closely with the government to strengthen food safety in China," said spokeswoman Joanna Brent. "While there's nothing specifically new in it, it does shows that China has recognized it has a challenge and is working to address it. We're pretty positive about that."
Chinese product scares prompt US fears
http://news.bbc.co.uk/2/hi/americas/6275758.stm
More products are being imported to the US from China than ever before - but a series of scares has left some wondering whether they are safe.
From pet food to toothpaste, tyres to jewellery and seafood to toys, questions have been raised over the reliability of Chinese-made goods.
As the death of a child who swallowed a magnet from a Chinese-made toy last year and the illness of others who have consumed contaminated food suggest, the risks presented by unsafe goods can be great.
In Panama, the deaths of some 51 people have been blamed on cough syrup tainted with Chinese-made diethylene glycol, commonly used in antifreeze. The same chemical has been found in toothpastes from China sold in the US and Canada.
Earlier this year, more than 100 brands of cat and dog food were pulled from the shelves in the US after pets died from eating food contaminated with the chemical melamine, traced back to wheat gluten from China.
With Chinese imports totalling $288bn last year - nearly triple the figure of five years ago - is enough being done to protect consumers?
'Time needed'
The execution for corruption on Tuesday of the former head of China's State Food and Drug Administration, Zheng Xiaoyu, suggests Beijing is keen to show it is taking the problem seriously.
But part of the problem is that the speed of China's expansion into the global export market has not been matched by the growth of a countrywide regulatory infrastructure.
The Chinese authorities say they are making efforts to improve supervision of safety standards, but that it will take time for them to catch up with the West.
American officials whose job it is to ensure the safety of imported products acknowledge there are problems - but say they are doing all they can to identify suspect goods.
For example, the US Food and Drug Administration (FDA) recently imposed a nationwide hold on the import of five types of farmed fish and seafood from China.
Some shipments were found to have traces of antibiotics and disinfectants that are banned in US fish production. Other inspections uncovered fish products described as "filthy" or tainted with salmonella and pesticides.
The US imports about a fifth of its seafood from China.
'Out of nowhere'
Another danger comes when contaminants which would not normally be tested for end up in the food chain - such as melamine, a chemical used in plastic products which caused kidney failure in pets.
David Acheson, the FDA's assistant commissioner for food safety, said: "The bottom line message is to focus the testing on areas where we have identified problems. We cannot even begin to test on everything.
"There are certain things we can predict are going to be a problem because we've seen it before, other countries have had the problem... but sometimes things come out of nowhere, completely unexpected. The melamine was an example of that."
Meanwhile the FDA has to juggle the need to avoid inaccurate advice or over-reaction with the desire to warn people of a potential risk as quickly as possible.
"I would always like us to react faster. We react as quickly as we can on the information we have," Mr Acheson said.
The FDA does not have the resources to send lots of inspectors into China, Mr Acheson added, so is working with the Chinese authorities to address the issues.
'Very scary'
Of course, China is not the only country to experience food safety problems.
US-grown spinach last year caused an E.coli outbreak that left one woman dead and some 200 others unwell. The FDA has previously halted imports of Mexican cantaloupes because of salmonella.
The difference, however, seems to be the frequency with which Chinese products are being pulled up.
Dietician Ruth Frechman, a California-based member of the American Dietetic Association, says the recent run of scares has heightened people's anxieties.
While no clients have yet asked her for advice on avoiding Chinese products, she says, one has started making her own dog food following the pet food alert.
The chief problem is that food labels do not identify where all the ingredients have come from - and even restaurants and wholesalers may not know, Ms Frechman said.
"It's very scary for consumers and really as a consumer you have no idea that the product is even coming from China... so there's really not a lot the consumer can do," she said.
Toxic lead
The US Consumer Product Safety Commission (CPSC), which monitors the safety of imported non-food goods, says it has seen increased concern among consumers.
Its officials are seeking to co-operate with their Chinese counterparts, with CPSC inspectors travelling to factories in Beijing, Shanghai and big manufacturing regions.
"The first step for us is to educate all of those people who we are working with on US safety standards. Many of those standards have saved lives," CPSC spokesman Scott Wolfson said.
"Our goal is to see as much progress as we can - and what that might mean here for us in the US is fewer recalls of Chinese-made products."
Overall, at least 60% of recalls issued by the agency since last October have involved goods from China.
In the first week of July alone, they included hammock stands, children's toys and metal jewellery, all of which were potentially dangerous.
One of the biggest recalls, in June, involved some 1.5m Thomas and Friends toy trains containing lead paint, which can be toxic to young children if swallowed.
Mr Wolfson urges consumers, particularly worried parents, to subscribe to the CPSC's free e-mail alerts for the latest advice.
Success story
A lesson may lie in the approach taken by the fireworks industry, which has focused on education and stringent product testing within China.
In the late 1980s and early 1990s, standards for Chinese-made fireworks were so low that as many as 75% failed US safety tests.
To tackle the problem, US importers were encouraged to pay for a testing operation set up in China - the American Fireworks Standards Laboratory (AFSL) - to monitor production straight from the assembly line.
At least three-quarters of US fireworks importers are signed up to the scheme and the lab has about 50 technicians in China.
Since 1994, injury rates among US consumers have dropped by more than two-thirds and sales of fireworks have increased greatly. About 99% of the fireworks used in the US come from China.
John Rogers, executive director of the AFSL, said: "It's had a very positive impact for the American public, for the government that regulates fireworks and obviously for the companies."
He admits that initially Chinese factories "weren't happy" about the AFSL's checks but, as Chinese-language guidelines were produced to help them meet US requirements, attitudes changed.
"What the manufacturers understand is that safer, better quality fireworks translates into bigger sales, so now they like what we do," he said.
"I think that every industry that imports products from China could very well benefit from this kind of a programme."
Of course, the majority of goods imported from China are perfectly safe - but until standards improve across the board, US consumers must rely on officials to sift out potential hazards before they cause harm.
More products are being imported to the US from China than ever before - but a series of scares has left some wondering whether they are safe.
From pet food to toothpaste, tyres to jewellery and seafood to toys, questions have been raised over the reliability of Chinese-made goods.
As the death of a child who swallowed a magnet from a Chinese-made toy last year and the illness of others who have consumed contaminated food suggest, the risks presented by unsafe goods can be great.
In Panama, the deaths of some 51 people have been blamed on cough syrup tainted with Chinese-made diethylene glycol, commonly used in antifreeze. The same chemical has been found in toothpastes from China sold in the US and Canada.
Earlier this year, more than 100 brands of cat and dog food were pulled from the shelves in the US after pets died from eating food contaminated with the chemical melamine, traced back to wheat gluten from China.
With Chinese imports totalling $288bn last year - nearly triple the figure of five years ago - is enough being done to protect consumers?
'Time needed'
The execution for corruption on Tuesday of the former head of China's State Food and Drug Administration, Zheng Xiaoyu, suggests Beijing is keen to show it is taking the problem seriously.
But part of the problem is that the speed of China's expansion into the global export market has not been matched by the growth of a countrywide regulatory infrastructure.
The Chinese authorities say they are making efforts to improve supervision of safety standards, but that it will take time for them to catch up with the West.
American officials whose job it is to ensure the safety of imported products acknowledge there are problems - but say they are doing all they can to identify suspect goods.
For example, the US Food and Drug Administration (FDA) recently imposed a nationwide hold on the import of five types of farmed fish and seafood from China.
Some shipments were found to have traces of antibiotics and disinfectants that are banned in US fish production. Other inspections uncovered fish products described as "filthy" or tainted with salmonella and pesticides.
The US imports about a fifth of its seafood from China.
'Out of nowhere'
Another danger comes when contaminants which would not normally be tested for end up in the food chain - such as melamine, a chemical used in plastic products which caused kidney failure in pets.
David Acheson, the FDA's assistant commissioner for food safety, said: "The bottom line message is to focus the testing on areas where we have identified problems. We cannot even begin to test on everything.
"There are certain things we can predict are going to be a problem because we've seen it before, other countries have had the problem... but sometimes things come out of nowhere, completely unexpected. The melamine was an example of that."
Meanwhile the FDA has to juggle the need to avoid inaccurate advice or over-reaction with the desire to warn people of a potential risk as quickly as possible.
"I would always like us to react faster. We react as quickly as we can on the information we have," Mr Acheson said.
The FDA does not have the resources to send lots of inspectors into China, Mr Acheson added, so is working with the Chinese authorities to address the issues.
'Very scary'
Of course, China is not the only country to experience food safety problems.
US-grown spinach last year caused an E.coli outbreak that left one woman dead and some 200 others unwell. The FDA has previously halted imports of Mexican cantaloupes because of salmonella.
The difference, however, seems to be the frequency with which Chinese products are being pulled up.
Dietician Ruth Frechman, a California-based member of the American Dietetic Association, says the recent run of scares has heightened people's anxieties.
While no clients have yet asked her for advice on avoiding Chinese products, she says, one has started making her own dog food following the pet food alert.
The chief problem is that food labels do not identify where all the ingredients have come from - and even restaurants and wholesalers may not know, Ms Frechman said.
"It's very scary for consumers and really as a consumer you have no idea that the product is even coming from China... so there's really not a lot the consumer can do," she said.
Toxic lead
The US Consumer Product Safety Commission (CPSC), which monitors the safety of imported non-food goods, says it has seen increased concern among consumers.
Its officials are seeking to co-operate with their Chinese counterparts, with CPSC inspectors travelling to factories in Beijing, Shanghai and big manufacturing regions.
"The first step for us is to educate all of those people who we are working with on US safety standards. Many of those standards have saved lives," CPSC spokesman Scott Wolfson said.
"Our goal is to see as much progress as we can - and what that might mean here for us in the US is fewer recalls of Chinese-made products."
Overall, at least 60% of recalls issued by the agency since last October have involved goods from China.
In the first week of July alone, they included hammock stands, children's toys and metal jewellery, all of which were potentially dangerous.
One of the biggest recalls, in June, involved some 1.5m Thomas and Friends toy trains containing lead paint, which can be toxic to young children if swallowed.
Mr Wolfson urges consumers, particularly worried parents, to subscribe to the CPSC's free e-mail alerts for the latest advice.
Success story
A lesson may lie in the approach taken by the fireworks industry, which has focused on education and stringent product testing within China.
In the late 1980s and early 1990s, standards for Chinese-made fireworks were so low that as many as 75% failed US safety tests.
To tackle the problem, US importers were encouraged to pay for a testing operation set up in China - the American Fireworks Standards Laboratory (AFSL) - to monitor production straight from the assembly line.
At least three-quarters of US fireworks importers are signed up to the scheme and the lab has about 50 technicians in China.
Since 1994, injury rates among US consumers have dropped by more than two-thirds and sales of fireworks have increased greatly. About 99% of the fireworks used in the US come from China.
John Rogers, executive director of the AFSL, said: "It's had a very positive impact for the American public, for the government that regulates fireworks and obviously for the companies."
He admits that initially Chinese factories "weren't happy" about the AFSL's checks but, as Chinese-language guidelines were produced to help them meet US requirements, attitudes changed.
"What the manufacturers understand is that safer, better quality fireworks translates into bigger sales, so now they like what we do," he said.
"I think that every industry that imports products from China could very well benefit from this kind of a programme."
Of course, the majority of goods imported from China are perfectly safe - but until standards improve across the board, US consumers must rely on officials to sift out potential hazards before they cause harm.
China cracks down on food safety
http://news.bbc.co.uk/2/hi/business/6638113.stm
Last Updated: Wednesday, 9 May 2007, 11:49 GMT 12:49 UK
China has pledged to clean up its tainted food and drug industry after a series of safety scares that have aroused global concern.
The announcement comes as two company managers were detained, accused of adding melamine to food additives.
The contaminated ingredient used in pet food led to the death of a number of cats and dogs, US inspectors allege.
Unregulated drugs have also been a concern. China's top drugs regulator is to go on trial charged with corruption.
State media said the trial of Zheng Xiaoyu, sacked in 2005 as head of the State Food and Drug Administration, would open this month.
He is accused of taking large bribes to approve untested medicine.
His case prompted the government to review the licences granted to around 170,000 medicines approved during his tenure.
Standards overhaul
China's State Council, or Cabinet, said the nationwide crackdown on woefully corrupt practices in the country's drug and food industry would compel companies to adopt "standards used in food-importing countries".
They also pledged to test products made in animal feed and food for humans, including cooking oil, flour, beverages and baby food.
Melamine has no nutritional value but because it is rich in nitrogen, it makes food that uses it an ingredient appear to have more protein than it actually does and so meet required contractual obligations.
It is illegal to add melamine to food or animal feed in the US.
The two firms accused of exporting melamine-spiked food additives were named as Binzhou Futian Biology Technology and Xuzhou Anying Biologic Technology Development Company.
Both firms have denied any wrongdoing.
Officials from the US Food and Agriculture department have arrived in China to help investigate how the melamine compound got into the batch of feed that killed pets in the US.
They say Washington has considered a ban on imports of wheat gluten and rice protein from China.
Last Updated: Wednesday, 9 May 2007, 11:49 GMT 12:49 UK
China has pledged to clean up its tainted food and drug industry after a series of safety scares that have aroused global concern.
The announcement comes as two company managers were detained, accused of adding melamine to food additives.
The contaminated ingredient used in pet food led to the death of a number of cats and dogs, US inspectors allege.
Unregulated drugs have also been a concern. China's top drugs regulator is to go on trial charged with corruption.
State media said the trial of Zheng Xiaoyu, sacked in 2005 as head of the State Food and Drug Administration, would open this month.
He is accused of taking large bribes to approve untested medicine.
His case prompted the government to review the licences granted to around 170,000 medicines approved during his tenure.
Standards overhaul
China's State Council, or Cabinet, said the nationwide crackdown on woefully corrupt practices in the country's drug and food industry would compel companies to adopt "standards used in food-importing countries".
They also pledged to test products made in animal feed and food for humans, including cooking oil, flour, beverages and baby food.
Melamine has no nutritional value but because it is rich in nitrogen, it makes food that uses it an ingredient appear to have more protein than it actually does and so meet required contractual obligations.
It is illegal to add melamine to food or animal feed in the US.
The two firms accused of exporting melamine-spiked food additives were named as Binzhou Futian Biology Technology and Xuzhou Anying Biologic Technology Development Company.
Both firms have denied any wrongdoing.
Officials from the US Food and Agriculture department have arrived in China to help investigate how the melamine compound got into the batch of feed that killed pets in the US.
They say Washington has considered a ban on imports of wheat gluten and rice protein from China.
China food safety head executed
http://news.bbc.co.uk/2/hi/asia-pacific/6286698.stm
The former head of China's State Food and Drug Administration, Zheng Xiaoyu, has been executed for corruption, the state-run Xinhua news agency reports.
He was convicted of taking 6.5m yuan ($850,000; £425,400) in bribes and of dereliction of duty at a trial in May.
The bribes were linked to sub-standard medicines, blamed for several deaths.
China has been criticised over a number of recent cases involving tainted goods, and correspondents say Zheng had become a symbol of the crisis.
Zheng had appealed against his sentence, arguing that it was "too severe" and saying he had confessed his crimes and co-operated with police.
But his appeal, heard in mid-June, was rejected shortly afterwards.
Toxic chemicals
Zheng, who headed the administration from 1998 to 2005, was found guilty of accepting bribes from firms to register their products without making them undergo the necessary checks.
Following his sacking, the Chinese government announced an urgent review of about 170,000 medical licences that were awarded during his tenure at the agency.
Zheng's sentence was seen as unusually harsh for such a senior figure, but the BBC's Dan Griffiths in Beijing says the government hopes the execution shows it is getting to grips with the crisis.
However, food and drug safety standards vary widely across the country and reform will be a major challenge, our correspondent adds.
At a news conference in Beijing on Tuesday, the food and drug agency admitted it had a huge job ahead to improve its supervision of safety standards.
"As a developing country, China's food and drug supervision work began late and its foundations are weak," spokeswoman Yan Jiangying said.
"Therefore, the food and drug safety situation is not something we can be optimistic about."
She said Zheng Xiaoyu's case had "brought shame" on the department, adding that anyone who abused their power would be punished.
Chinese officials have already acknowledged that the country could face social unrest and a tarnished image abroad unless improvements are made.
Dozens of people have died in China because of poor quality or fake food and drugs, sparking widespread international fears about the safety of Chinese exports.
Thirteen babies died of malnutrition in 2005 after being fed powdered milk that had no nutritional value.
US inspectors have blamed exported Chinese pet food ingredients, contaminated with melamine, for the deaths of cats and dogs in North America.
And they recently halted shipments of toothpaste from China to investigate reports that they may be contaminated with toxic chemicals.
The former head of China's State Food and Drug Administration, Zheng Xiaoyu, has been executed for corruption, the state-run Xinhua news agency reports.
He was convicted of taking 6.5m yuan ($850,000; £425,400) in bribes and of dereliction of duty at a trial in May.
The bribes were linked to sub-standard medicines, blamed for several deaths.
China has been criticised over a number of recent cases involving tainted goods, and correspondents say Zheng had become a symbol of the crisis.
Zheng had appealed against his sentence, arguing that it was "too severe" and saying he had confessed his crimes and co-operated with police.
But his appeal, heard in mid-June, was rejected shortly afterwards.
Toxic chemicals
Zheng, who headed the administration from 1998 to 2005, was found guilty of accepting bribes from firms to register their products without making them undergo the necessary checks.
Following his sacking, the Chinese government announced an urgent review of about 170,000 medical licences that were awarded during his tenure at the agency.
Zheng's sentence was seen as unusually harsh for such a senior figure, but the BBC's Dan Griffiths in Beijing says the government hopes the execution shows it is getting to grips with the crisis.
However, food and drug safety standards vary widely across the country and reform will be a major challenge, our correspondent adds.
At a news conference in Beijing on Tuesday, the food and drug agency admitted it had a huge job ahead to improve its supervision of safety standards.
"As a developing country, China's food and drug supervision work began late and its foundations are weak," spokeswoman Yan Jiangying said.
"Therefore, the food and drug safety situation is not something we can be optimistic about."
She said Zheng Xiaoyu's case had "brought shame" on the department, adding that anyone who abused their power would be punished.
Chinese officials have already acknowledged that the country could face social unrest and a tarnished image abroad unless improvements are made.
Dozens of people have died in China because of poor quality or fake food and drugs, sparking widespread international fears about the safety of Chinese exports.
Thirteen babies died of malnutrition in 2005 after being fed powdered milk that had no nutritional value.
US inspectors have blamed exported Chinese pet food ingredients, contaminated with melamine, for the deaths of cats and dogs in North America.
And they recently halted shipments of toothpaste from China to investigate reports that they may be contaminated with toxic chemicals.
2007年9月18日 星期二
第一期英文翻譯稿
World Rabies Day Knocks at the World Chen, Chih-Ping
September 8th , 2007 is World Rabies Day. WHO associates with Harris County Public Health and Environmental Services(HCPHES), World Organization for Animal Health (OIE) and Pan American Health Organization (PAHO) to raise the public awareness about the current worldwide rabies situation and its prevention through vaccines.
Rabies is infected through animals or patients with rabies infection since their saliva carry the virus. Rabies virus enters human bodies from those infected saliva by scratching and biting while sometimes via skin wound and mucosal. Thus, scratching by rabies infected animals is also dangerous and the reason is that animals will lick their feet. Rabies can transmit to any mammal. But the major infectious animals to human are cats, dogs, raccoons and bats. These animals have more chances to contact human beings especially cats and dogs while raccoons and bats are easier to encounter in the outdoor activities.
Nowadays one single person dies of rabies in every ten minutes on the world. It mainly happens in Asia and Africa especially in India and China. In fact, thanks too the current medical treatment, these people do not really have to face the death. Rabies vaccines can highly prevent the disease occurrence. On the other hand, as far as the infected mammals are concerned, the similar oral vaccines have been produced. For those animal threatened by rabies into extinction, probably this is another solution.
Although rabies is curable, still many people die of rabies on the world and the majority is children. Such a problem may not totally result from the medical problems but the accessible treatment for every possible infected person. It may result from the insufficient vaccines and the high medical price. Moreover, in China, the rapid growing of pet raising will increase the possibility of infection due to the insufficient awareness of public health, the lack of social ethics and the increase of stray dogs.
The record of rabies in Taiwan can be dated back to 1947 from Shanghai to Taiwan. After the first reported case in 1948, still some minor cases continued to happen. Then, the vaccination of pet dogs and the killing of stray dogs had been launched. Since 1959, human rabies no longer occurred. After January 1961, animal rabies no longer occurred as well. Taiwan so far is non-epidemic area. Only in 2002, one imported case from China was reported. Thus, the principal threat in Taiwan so far is from imported infection. Health inspection and quarantine will be the main prevention. However, due to the serious trafficking between Taiwan and China, there are still relatively huge chances to transmit the disease from imported cases or the origin of infection.
The important mission of World Rabies Day is to appeal the public awareness and attention to rabies and to make everyone understand the pathogenic mechanism and situation of such an exiting disease. Through the prevention and complete treatment, rabies is expected to become a noun in the history.
Data resources:
1. http://www.worldrabiesday.org/index_en.php
2. http://www.who.int/mediacentre/events/2007/world_rabies_day/en/index.html
3. http://www.economist.com/science/PrinterFriendly.cfm?story_id=8023437
4. http://www.cdc.gov.tw/index_info_info.asp?data_id=848
5. http://www.bbc.co.uk/dna/h2g2/A673599
6. http://www.avma.org/onlnews/javma/aug07/070815l.asp
7. http://news.bbc.co.uk/2/hi/asia-pacific/3235830.stm
The Unsolved Problems of Rabies in China Lee, Fang-Ying
Rabies is globally widespread especially in Asia, the major infectious area of rabies and death cases. Currently the incidence rate of rabies in China is only second to India, the second highest on the world while the difficulty in tackling rabies in both countries is slightly different. According to the statistics, in the first half of this year, 1400 people are infected rabies while about 1100 people die in China. Thus, after Taiwan initiated the small three links in Kinmen, the pandemic information in China should keep a more precise eye.
Rabies always stands for top three pandemics with high death rate in China. Facing this situation, the Chinese government does not really take some actions. For examples, every province has set up the regulation of pet raising and issued the permit of pet raising. However, the problem of rabies in China still remains unresolved. Where does the problem come from?
First, though the registration of the pet raising permit is regulated, the registration fee is too costly. For example, in Guanzhou, the registration fee is 10,000NTD? or RMB? and 6000 NTD or RMB is paid for annual inspection. Thus, some pet keepers are speculated and keep the ‘illegal’ dogs without applying for the permit.
Second, the quality of vaccines is unstable and the vaccination is not completed. Rabies vaccination is the most effective prevention from the disease. Selecting the most qualified rabies vaccines is the priority. However, not only the amount of the vaccines prepared in China is insufficient but also some fake vaccines killed people. Hence, Ministry of Health in PRC and State Food and Drug Administration issued the emergent notice to enhance the control and supervision of rabies vaccines and to stop the unexamined vaccines entering the operating sector. However, in the end of July, this year, one case of fake drug was investigated in HeiLongJiang Province, China including the fake rabies vaccines.
Third, due to the increasing amount of pet dogs and the stray dogs in the suburb and rural areas, it is hard to collect data and to control the exact amount of dogs and the situation. This makes the public lack of awareness including the government.
‘As far as I understand, rabies is not increasing in China. China is a huge country. It is normal that some cases appear in rural areas.’stated Mr. Jiang Zuojun, vice minister of Ministry of Health in a press conference.
Additionally, due to the lack of professional management and detention centers, people do not know where to apply for the permit. Even though there are many illegal dogs, no one appeals and even no one deals with it. Under the circumstance of the unorganized management, and the ignorance of the regulation, the related regulation is like a blank sheet.
From those above mentioned problems, China should change the policy toward the decrease of rabies. Currently the Chinese government usually uses the so-called management, vaccination and killing to deal with stray dogs. However, it is not successful and many pet dogs are forced to or mistaken to be killed. This appeals many objections from animal protection groups. In fact, the brutal killing should not be launched but the principal management to tackle the rabies since it always depends on keepers’ determination and social ethics. The most principal reason for dog trouble is that irresponsible dog keepers do not keep their own dogs well. Thus, the legislation restricts those keepers. What important is that the legislation must be enforced precisely. There was no special legislation in the past. However, many loopholes happen because of the loose enforcement. For example, huge dogs are transferred to somewhere else during the check. After the check is finished, they can be moved back. In addition, some packaged policy should be launched to lower down the registration fee and annual checking fee, to manage the dog market, to strengthen the animal disease prevention and the function of control center, to provide free rabies vaccines or to launch pet-raising regulatory group in order to supervise dog keepers in the neighborhood. In conclusion, promoting civilized pet raising for keepers without bothering some other else and following the regulation will be the efficient and principal ways to tackle rabies.
Data resources:
http://www.39kf.com/focus/zt/Rabies/
http://www.cdc.gov.tw/
The Booming India. The Highest rabies Infection Wu, Chia-Cheng
Vaccination and animal control project can prevent from rabies 100%. However, India is still highly dangerous for rabies. Due to the expensive vaccines and medicine, time-consuming and painful vaccination treatment and large amount of stray dogs suffering from rabies, rabies disease in that country remains on top. According to the neighborhood survey in 2003 by APCRI, about more than 20,000 people in every 100,000 people are estimated to suffer from rabies and most of them are male adults living in rural areas without any vaccination.
The animal prevention area is only short-term effective.
The prevention way of animal rabies include that the public is forced to do the pet registration and pet vaccination. Otherwise, the pets would be dealt as stray dogs. The number of stray dogs should be controlled and dogs are induced to be fed the oral rabies vaccine. Meanwhile, those which are infected rabies should be caught and killed. Then, the regular inspection or the killing of suspicious stray dogs should be carried out. All the above-mentioned strategies only apply to the last prevention in a small area. Thus, the effect can be paid off in a short time. However, due to the huge mobility of stray dogs, the control of funding and the difficult resource of vaccines, the rabies can not be prevented in a longer term. The long-term governmental animal prevention strategy should start to investigate the origin of all the stray dogs, to launch dog castration in order to stop the growth of stray dogs. Meanwhile, the education of rabies prevention should be strengthened on publics. The public should get away from stray dogs. They should also take their own pets to do the castration and vaccination in animal clinics and even should not abandon their pets to increase the member of stray dogs. Thus, the problems of dog rabies infection can really eliminate from the bottom.
The value of the importance of vaccine prevention.
The Indian government should cooperate with the drug sector.
Though the dog bite is the major reason for rabies infection in India, apart from the animal prevention to control the disease, medical staffs in India indicate that due to the expensive vaccines and medical treatment, and the 14 day vaccination, most of the patients do not complete the treatment and a loophole occurs in the rabies prevention.
According to the first chapter Rabies Vaccines in India in the first part Is it just vaccines? in New Technologies in Public Health – Who pays and who benefits？published by Indian National Coordination Committee and JSA(Jan Swasthya Abhiyan) in 2007, the Indian government is accused of using the outdated, expensive and unsafe rabies vaccines prepared with sheep brain. Indian drug controllers never negotiate with MNC pharmaceutical company to lower down the price of safer and new cell-cultured vaccines and to generalize it. The Intra Dermal route of new vaccines can lower down the dose for money saving and security reason. However, two brands of MNC pharmaceutical company, Rabipur and Verorab, are never registered for this technology. Thus, in India, more dose of intramuscular vaccination is widely applied.
Rabies disease in India is still very popular. It not only influences the domestic progress in politics and economics but also becomes a huge loophole for the global disease prevention. Before the international organizations force the government to conduct the precise control, if the drug controllers can focus on the problems of the expensive price of vaccines and the outdated vaccination skills and negotiate in a proper political way, India can be shown as a real country with cultures, economic boom and humanism worth of the global investment and respect.
Data resources:
1. Indian doctors want cheaper rabies drugs ,http://news.bbc.co.uk/2/hi/south_asia/822457.stm
2. The safety and efficacy of the oral rabies vaccine SAG2 in Indian stray dogs , F. Cliquet, J.P. Gurbuxani, H.K. Pradhan,Vaccine ,Volume 25, Issue 17, 30 April 2007, Pages 3409-3418
3. Human rabies in India: epidemiological features, management and current methods of prevention. Dutta JK. Trop Doct. 1999 Oct;29(4):196-201
4. Epidemiology of dog bites: a community-based study in India. Agarwal N, Reddajah VP. Trop Doct. 2004 Apr;34(2):76-8.
5. http://phm-india.org/pdf/nha2/New_technologies.pdf ,New Technologies in Public Health – Who pays and who benefits?
Does Taiwan Face the Potential Outbreak of Rabies? Yen, Chi-Hao
Since 1959, there has been no human rabies case in Taiwan while since 1961, there has been no animal rabies case. The term, rabies, for young Taiwanese generation, is rather unknown. But it may not be known that Taiwan is one of the seven non-epidemic countries on the world. The rest of the six are Japan, the UK, Sweden, Australia, New Zealand and Iceland. It may be more unclear that rabies in fact is a disease sharing between animals and human beings. The major infection is among warm-blooded hosts. People usually are infected by the bite, scratches and wound licking from rabies infected cats and dogs. Though there are rabies vaccines, it is useless to inject the vaccines until the infection. The death rate of rabies is almost 100 percent. Though currently Taiwan is a non-epidemic area, Taiwan faces several hidden worries of the outbreak of rabies which are the most neglected parts by the public.
1. The insufficient resources of international health information
Due to the restriction of international political situation, Taiwan is not eligible to participate in the important international health organization like World Health Organization as a member state. An outbreak of a serious pandemic in Taiwan will affect Taiwan to obtain the disease-related information on time and also the international aids will be restrained because of that. The most apparent example is in the beginning of 2003, when the outbreak of SARS occurred in Taiwan, not only the related information and samples were not easily obtained but also due to some reasons even the experts from WHO could only arrive at Taiwan to help until May when the disease had been controlled. If the outbreak of rabies occurred in Taiwan, probably the similar situation like SARS would repeat.
2. The non-transparent disease information in China and the booming trafficking in the islets
According to the statistics from Ministry of Health, China, the first half of this year, 1400 people are reported to be infected rabies while about 1100 people died in China. In this January, 217 reported rabies cases and the number of the death cases were 182. The fatality rate reached 83.87 percent. In the serial eight months, rabies stands the highest number of death among Chinese legal infectious diseases, far more than the second one, tuberculosis(94 cases). Thus, China has become the important rabies disease area. For Taiwan, adjacent to China, is a worry. Two following situations are even more threatening to Taiwan. First, the Chinese government is always trying hard to hide their domestic disease information. For example, several years ago, SARS expanded from the regional disease to the global pandemic. One important reason was that the Chinese government hided the disease information and lied to the WHO inspectors. In addition, many rural areas far away in China lack of the resources and their external transportation connection are not that available. Those health statistics collected by the central government might neglect those areas and influence the value of those statistics. Second, Chinese coastlines are very close to Taiwanese islets. The bilateral people contact each other very often. The trafficking is also common. In fact, those imported cats and dogs should be inspected by Bureau of Animal and Plant Health Inspection and Quarantine, Council of Agriculture, Executive Yuan, Taiwan and install the chips inside of them. However, these measures are applied to those legally-imported animals. If they are from the trafficking and also not inspected by the custom, the loophole will be very worrying.
3. The problems of stray dogs in Taiwan
Stray animals in Taiwan are always a complicated issue. It has caused some problems of environment and personal safety. Once Taiwan unluckily happened to be the rabies epidemic area, those stray dogs would become the individual virus carriers. It would cause a huge impact on the public’s daily life. Moreover, some people do not respect the life and do not consider about their personal condition to adopt the pets. When they get bored of them, they just throw them. It makes the problem of stray animals can not really resolved effectively and also increases the complication of the prevention.
To sum up, in order to eliminate those above-mentioned worries, the government can strengthen the cooperation regarding the health issues with the diplomatic allies and participate in the related events and conferences in WHO in the international community with Taiwanese disease prevention experience and technology to support developing countries for the visibility of Taiwan in the international community.
In the daily life, the government should promote the prevention and inspection- related knowledge to the public and stress on the inspection of trafficking and penalty. Our nationals should respect life and do not traffic those un-inspected animals back to Taiwan. Pet keepers should fulfill their duty as well. Those pets should be taken to animal clinics or animal disease control centers in any county and city to do rabies vaccination. If keepers can not afford raising the pets, they should contact official institutions such as cleaning units and animal detention centers to arrange some available keepers to take on without producing other social problems.
Data resources:
1. http://www.doh.gov.tw/cht2006/index_populace.aspx
2. http://tw.news.yahoo.com/article/url/d/a/070804/5/i99i.html
3. http://web.kinmen.gov.tw/371022800g/news/news16.htm
4. http://www.baphiq.gov.tw/mp.asp?mp=1 (農委會動植物防檢局)
5. http://www.cdc.gov.tw/index.asp (疾病管制局)
Past, Present and Future about Rabies in Taiwan Lin, Min-Hao
It is believed that rabies was transmitted from Shanghai to Taiwan in 1947 while according to some documents, some rabies cases were discovered in Taiwan during the Japanese colonial time. The first human rabies case in Taiwan was diagnosed by Doc. Lin, Tzeng-Yi in National Taiwan University Hospital on April 15th 1948. Then some disease cases occurred and rabies reached the climax between 1951 and 1952. In these two years, there were 238 and 102 cases respectively. Until 1959, there was no human rabies. After 1961, there was no longer animal rabies. But in 2002, one imported case was discovered and stunned the public health sector in Taiwan.
According to Dog Rabies Inspection Survey in Taiwan in 2003 conducted by Animal Health Research Institute, Council of Agriculture, Executive Yuan, no rabies cases were discovered after the investigation. Thus, Taiwan is still non-epidemic area. Taiwanese dogs’ positive rate of antibody is about 50.4 percent. (Please refer to the table one. Lee, Shu-Hui et al., 2003). However, lots of efforts still need to be done for the lowest positive rate maintenance between 54% and 62% according to WHO’s standard.
In Asia, apart from Japan and Taiwan are non-epidemic areas, other countries are still epidemic areas. Nowadays, the transportation is so convenient that there might be some loopholes. What’s more, the bilateral trafficking is booming. Thus, in future, dogs in Taiwan should be stressed on the improvement of the positive rate of antibody and the government should expand the scale of rabies vaccination to increase Taiwanese dog group immunity. Only this can avoid the outbreak of rabies in Taiwan in future.
Second, apart from the current Statue for Prevention and Control of Infectious Animal Disease, the legislation of pet management should be launched. The legislation should force pet keepers to register chips into their pets and also include the regular inspection and vaccination. Thus, the related management can be supported by the legislation. The consciousness of keepers should no longer be relied on to make a loophole of the prevention. Moreover, the last outbreak of rabies in Taiwan was over half of century ago. The young generation might know very little about rabies and even do not think that it would occur in Taiwan. Thus, the government should keep educating the related prevention of rabies to the public in order to increase the public awareness of the risk and the active cooperation.
Last but not least, rabies supervising system should be set up. For stray dogs, pets and other warm-blooded animals, the supervising system should be built up and collected the tissues, blood samples and clinical symptoms of all warm-blooded animals. The databank of epidemiology should be set up to realize the change of the disease and to take some proper actions.
In the past, the prevention made Taiwan become one of the seven non-epidemic countries on the world. If the prevention can be carried on more thoroughly in the future, it is believed that rabies can be officially declared that it is extinct in Taiwan as another great achievement of public health in Taiwan.
Table One: the examination result of dog rabies vaccine antibody ELISA
Origin Amount of Serological Test Positive Number(Positive Rate)
Pets 1,559 980 (62.9%)
Stray dogs 2,099 863 ( 41.1%)
Total 3,658 1,843 (50.4%)
Data Resource：Dog Rabies Inspection Survey in Taiwan in 2003, Animal Health Research Institute, Council of Agriculture, Executive Yuan
Data Resources:
1. http://vettech.nvri.gov.tw/Articles/report/886.html
2. http://www.adccyl.gov.tw/Animal_Dise/rabies/rabies.htm
3. http://www.cdc.gov.tw/index.asp (疾病管制局)
4. http://www.rabies.com/
September 8th , 2007 is World Rabies Day. WHO associates with Harris County Public Health and Environmental Services(HCPHES), World Organization for Animal Health (OIE) and Pan American Health Organization (PAHO) to raise the public awareness about the current worldwide rabies situation and its prevention through vaccines.
Rabies is infected through animals or patients with rabies infection since their saliva carry the virus. Rabies virus enters human bodies from those infected saliva by scratching and biting while sometimes via skin wound and mucosal. Thus, scratching by rabies infected animals is also dangerous and the reason is that animals will lick their feet. Rabies can transmit to any mammal. But the major infectious animals to human are cats, dogs, raccoons and bats. These animals have more chances to contact human beings especially cats and dogs while raccoons and bats are easier to encounter in the outdoor activities.
Nowadays one single person dies of rabies in every ten minutes on the world. It mainly happens in Asia and Africa especially in India and China. In fact, thanks too the current medical treatment, these people do not really have to face the death. Rabies vaccines can highly prevent the disease occurrence. On the other hand, as far as the infected mammals are concerned, the similar oral vaccines have been produced. For those animal threatened by rabies into extinction, probably this is another solution.
Although rabies is curable, still many people die of rabies on the world and the majority is children. Such a problem may not totally result from the medical problems but the accessible treatment for every possible infected person. It may result from the insufficient vaccines and the high medical price. Moreover, in China, the rapid growing of pet raising will increase the possibility of infection due to the insufficient awareness of public health, the lack of social ethics and the increase of stray dogs.
The record of rabies in Taiwan can be dated back to 1947 from Shanghai to Taiwan. After the first reported case in 1948, still some minor cases continued to happen. Then, the vaccination of pet dogs and the killing of stray dogs had been launched. Since 1959, human rabies no longer occurred. After January 1961, animal rabies no longer occurred as well. Taiwan so far is non-epidemic area. Only in 2002, one imported case from China was reported. Thus, the principal threat in Taiwan so far is from imported infection. Health inspection and quarantine will be the main prevention. However, due to the serious trafficking between Taiwan and China, there are still relatively huge chances to transmit the disease from imported cases or the origin of infection.
The important mission of World Rabies Day is to appeal the public awareness and attention to rabies and to make everyone understand the pathogenic mechanism and situation of such an exiting disease. Through the prevention and complete treatment, rabies is expected to become a noun in the history.
Data resources:
1. http://www.worldrabiesday.org/index_en.php
2. http://www.who.int/mediacentre/events/2007/world_rabies_day/en/index.html
3. http://www.economist.com/science/PrinterFriendly.cfm?story_id=8023437
4. http://www.cdc.gov.tw/index_info_info.asp?data_id=848
5. http://www.bbc.co.uk/dna/h2g2/A673599
6. http://www.avma.org/onlnews/javma/aug07/070815l.asp
7. http://news.bbc.co.uk/2/hi/asia-pacific/3235830.stm
The Unsolved Problems of Rabies in China Lee, Fang-Ying
Rabies is globally widespread especially in Asia, the major infectious area of rabies and death cases. Currently the incidence rate of rabies in China is only second to India, the second highest on the world while the difficulty in tackling rabies in both countries is slightly different. According to the statistics, in the first half of this year, 1400 people are infected rabies while about 1100 people die in China. Thus, after Taiwan initiated the small three links in Kinmen, the pandemic information in China should keep a more precise eye.
Rabies always stands for top three pandemics with high death rate in China. Facing this situation, the Chinese government does not really take some actions. For examples, every province has set up the regulation of pet raising and issued the permit of pet raising. However, the problem of rabies in China still remains unresolved. Where does the problem come from?
First, though the registration of the pet raising permit is regulated, the registration fee is too costly. For example, in Guanzhou, the registration fee is 10,000NTD? or RMB? and 6000 NTD or RMB is paid for annual inspection. Thus, some pet keepers are speculated and keep the ‘illegal’ dogs without applying for the permit.
Second, the quality of vaccines is unstable and the vaccination is not completed. Rabies vaccination is the most effective prevention from the disease. Selecting the most qualified rabies vaccines is the priority. However, not only the amount of the vaccines prepared in China is insufficient but also some fake vaccines killed people. Hence, Ministry of Health in PRC and State Food and Drug Administration issued the emergent notice to enhance the control and supervision of rabies vaccines and to stop the unexamined vaccines entering the operating sector. However, in the end of July, this year, one case of fake drug was investigated in HeiLongJiang Province, China including the fake rabies vaccines.
Third, due to the increasing amount of pet dogs and the stray dogs in the suburb and rural areas, it is hard to collect data and to control the exact amount of dogs and the situation. This makes the public lack of awareness including the government.
‘As far as I understand, rabies is not increasing in China. China is a huge country. It is normal that some cases appear in rural areas.’stated Mr. Jiang Zuojun, vice minister of Ministry of Health in a press conference.
Additionally, due to the lack of professional management and detention centers, people do not know where to apply for the permit. Even though there are many illegal dogs, no one appeals and even no one deals with it. Under the circumstance of the unorganized management, and the ignorance of the regulation, the related regulation is like a blank sheet.
From those above mentioned problems, China should change the policy toward the decrease of rabies. Currently the Chinese government usually uses the so-called management, vaccination and killing to deal with stray dogs. However, it is not successful and many pet dogs are forced to or mistaken to be killed. This appeals many objections from animal protection groups. In fact, the brutal killing should not be launched but the principal management to tackle the rabies since it always depends on keepers’ determination and social ethics. The most principal reason for dog trouble is that irresponsible dog keepers do not keep their own dogs well. Thus, the legislation restricts those keepers. What important is that the legislation must be enforced precisely. There was no special legislation in the past. However, many loopholes happen because of the loose enforcement. For example, huge dogs are transferred to somewhere else during the check. After the check is finished, they can be moved back. In addition, some packaged policy should be launched to lower down the registration fee and annual checking fee, to manage the dog market, to strengthen the animal disease prevention and the function of control center, to provide free rabies vaccines or to launch pet-raising regulatory group in order to supervise dog keepers in the neighborhood. In conclusion, promoting civilized pet raising for keepers without bothering some other else and following the regulation will be the efficient and principal ways to tackle rabies.
Data resources:
http://www.39kf.com/focus/zt/Rabies/
http://www.cdc.gov.tw/
The Booming India. The Highest rabies Infection Wu, Chia-Cheng
Vaccination and animal control project can prevent from rabies 100%. However, India is still highly dangerous for rabies. Due to the expensive vaccines and medicine, time-consuming and painful vaccination treatment and large amount of stray dogs suffering from rabies, rabies disease in that country remains on top. According to the neighborhood survey in 2003 by APCRI, about more than 20,000 people in every 100,000 people are estimated to suffer from rabies and most of them are male adults living in rural areas without any vaccination.
The animal prevention area is only short-term effective.
The prevention way of animal rabies include that the public is forced to do the pet registration and pet vaccination. Otherwise, the pets would be dealt as stray dogs. The number of stray dogs should be controlled and dogs are induced to be fed the oral rabies vaccine. Meanwhile, those which are infected rabies should be caught and killed. Then, the regular inspection or the killing of suspicious stray dogs should be carried out. All the above-mentioned strategies only apply to the last prevention in a small area. Thus, the effect can be paid off in a short time. However, due to the huge mobility of stray dogs, the control of funding and the difficult resource of vaccines, the rabies can not be prevented in a longer term. The long-term governmental animal prevention strategy should start to investigate the origin of all the stray dogs, to launch dog castration in order to stop the growth of stray dogs. Meanwhile, the education of rabies prevention should be strengthened on publics. The public should get away from stray dogs. They should also take their own pets to do the castration and vaccination in animal clinics and even should not abandon their pets to increase the member of stray dogs. Thus, the problems of dog rabies infection can really eliminate from the bottom.
The value of the importance of vaccine prevention.
The Indian government should cooperate with the drug sector.
Though the dog bite is the major reason for rabies infection in India, apart from the animal prevention to control the disease, medical staffs in India indicate that due to the expensive vaccines and medical treatment, and the 14 day vaccination, most of the patients do not complete the treatment and a loophole occurs in the rabies prevention.
According to the first chapter Rabies Vaccines in India in the first part Is it just vaccines? in New Technologies in Public Health – Who pays and who benefits？published by Indian National Coordination Committee and JSA(Jan Swasthya Abhiyan) in 2007, the Indian government is accused of using the outdated, expensive and unsafe rabies vaccines prepared with sheep brain. Indian drug controllers never negotiate with MNC pharmaceutical company to lower down the price of safer and new cell-cultured vaccines and to generalize it. The Intra Dermal route of new vaccines can lower down the dose for money saving and security reason. However, two brands of MNC pharmaceutical company, Rabipur and Verorab, are never registered for this technology. Thus, in India, more dose of intramuscular vaccination is widely applied.
Rabies disease in India is still very popular. It not only influences the domestic progress in politics and economics but also becomes a huge loophole for the global disease prevention. Before the international organizations force the government to conduct the precise control, if the drug controllers can focus on the problems of the expensive price of vaccines and the outdated vaccination skills and negotiate in a proper political way, India can be shown as a real country with cultures, economic boom and humanism worth of the global investment and respect.
Data resources:
1. Indian doctors want cheaper rabies drugs ,http://news.bbc.co.uk/2/hi/south_asia/822457.stm
2. The safety and efficacy of the oral rabies vaccine SAG2 in Indian stray dogs , F. Cliquet, J.P. Gurbuxani, H.K. Pradhan,Vaccine ,Volume 25, Issue 17, 30 April 2007, Pages 3409-3418
3. Human rabies in India: epidemiological features, management and current methods of prevention. Dutta JK. Trop Doct. 1999 Oct;29(4):196-201
4. Epidemiology of dog bites: a community-based study in India. Agarwal N, Reddajah VP. Trop Doct. 2004 Apr;34(2):76-8.
5. http://phm-india.org/pdf/nha2/New_technologies.pdf ,New Technologies in Public Health – Who pays and who benefits?
Does Taiwan Face the Potential Outbreak of Rabies? Yen, Chi-Hao
Since 1959, there has been no human rabies case in Taiwan while since 1961, there has been no animal rabies case. The term, rabies, for young Taiwanese generation, is rather unknown. But it may not be known that Taiwan is one of the seven non-epidemic countries on the world. The rest of the six are Japan, the UK, Sweden, Australia, New Zealand and Iceland. It may be more unclear that rabies in fact is a disease sharing between animals and human beings. The major infection is among warm-blooded hosts. People usually are infected by the bite, scratches and wound licking from rabies infected cats and dogs. Though there are rabies vaccines, it is useless to inject the vaccines until the infection. The death rate of rabies is almost 100 percent. Though currently Taiwan is a non-epidemic area, Taiwan faces several hidden worries of the outbreak of rabies which are the most neglected parts by the public.
1. The insufficient resources of international health information
Due to the restriction of international political situation, Taiwan is not eligible to participate in the important international health organization like World Health Organization as a member state. An outbreak of a serious pandemic in Taiwan will affect Taiwan to obtain the disease-related information on time and also the international aids will be restrained because of that. The most apparent example is in the beginning of 2003, when the outbreak of SARS occurred in Taiwan, not only the related information and samples were not easily obtained but also due to some reasons even the experts from WHO could only arrive at Taiwan to help until May when the disease had been controlled. If the outbreak of rabies occurred in Taiwan, probably the similar situation like SARS would repeat.
2. The non-transparent disease information in China and the booming trafficking in the islets
According to the statistics from Ministry of Health, China, the first half of this year, 1400 people are reported to be infected rabies while about 1100 people died in China. In this January, 217 reported rabies cases and the number of the death cases were 182. The fatality rate reached 83.87 percent. In the serial eight months, rabies stands the highest number of death among Chinese legal infectious diseases, far more than the second one, tuberculosis(94 cases). Thus, China has become the important rabies disease area. For Taiwan, adjacent to China, is a worry. Two following situations are even more threatening to Taiwan. First, the Chinese government is always trying hard to hide their domestic disease information. For example, several years ago, SARS expanded from the regional disease to the global pandemic. One important reason was that the Chinese government hided the disease information and lied to the WHO inspectors. In addition, many rural areas far away in China lack of the resources and their external transportation connection are not that available. Those health statistics collected by the central government might neglect those areas and influence the value of those statistics. Second, Chinese coastlines are very close to Taiwanese islets. The bilateral people contact each other very often. The trafficking is also common. In fact, those imported cats and dogs should be inspected by Bureau of Animal and Plant Health Inspection and Quarantine, Council of Agriculture, Executive Yuan, Taiwan and install the chips inside of them. However, these measures are applied to those legally-imported animals. If they are from the trafficking and also not inspected by the custom, the loophole will be very worrying.
3. The problems of stray dogs in Taiwan
Stray animals in Taiwan are always a complicated issue. It has caused some problems of environment and personal safety. Once Taiwan unluckily happened to be the rabies epidemic area, those stray dogs would become the individual virus carriers. It would cause a huge impact on the public’s daily life. Moreover, some people do not respect the life and do not consider about their personal condition to adopt the pets. When they get bored of them, they just throw them. It makes the problem of stray animals can not really resolved effectively and also increases the complication of the prevention.
To sum up, in order to eliminate those above-mentioned worries, the government can strengthen the cooperation regarding the health issues with the diplomatic allies and participate in the related events and conferences in WHO in the international community with Taiwanese disease prevention experience and technology to support developing countries for the visibility of Taiwan in the international community.
In the daily life, the government should promote the prevention and inspection- related knowledge to the public and stress on the inspection of trafficking and penalty. Our nationals should respect life and do not traffic those un-inspected animals back to Taiwan. Pet keepers should fulfill their duty as well. Those pets should be taken to animal clinics or animal disease control centers in any county and city to do rabies vaccination. If keepers can not afford raising the pets, they should contact official institutions such as cleaning units and animal detention centers to arrange some available keepers to take on without producing other social problems.
Data resources:
1. http://www.doh.gov.tw/cht2006/index_populace.aspx
2. http://tw.news.yahoo.com/article/url/d/a/070804/5/i99i.html
3. http://web.kinmen.gov.tw/371022800g/news/news16.htm
4. http://www.baphiq.gov.tw/mp.asp?mp=1 (農委會動植物防檢局)
5. http://www.cdc.gov.tw/index.asp (疾病管制局)
Past, Present and Future about Rabies in Taiwan Lin, Min-Hao
It is believed that rabies was transmitted from Shanghai to Taiwan in 1947 while according to some documents, some rabies cases were discovered in Taiwan during the Japanese colonial time. The first human rabies case in Taiwan was diagnosed by Doc. Lin, Tzeng-Yi in National Taiwan University Hospital on April 15th 1948. Then some disease cases occurred and rabies reached the climax between 1951 and 1952. In these two years, there were 238 and 102 cases respectively. Until 1959, there was no human rabies. After 1961, there was no longer animal rabies. But in 2002, one imported case was discovered and stunned the public health sector in Taiwan.
According to Dog Rabies Inspection Survey in Taiwan in 2003 conducted by Animal Health Research Institute, Council of Agriculture, Executive Yuan, no rabies cases were discovered after the investigation. Thus, Taiwan is still non-epidemic area. Taiwanese dogs’ positive rate of antibody is about 50.4 percent. (Please refer to the table one. Lee, Shu-Hui et al., 2003). However, lots of efforts still need to be done for the lowest positive rate maintenance between 54% and 62% according to WHO’s standard.
In Asia, apart from Japan and Taiwan are non-epidemic areas, other countries are still epidemic areas. Nowadays, the transportation is so convenient that there might be some loopholes. What’s more, the bilateral trafficking is booming. Thus, in future, dogs in Taiwan should be stressed on the improvement of the positive rate of antibody and the government should expand the scale of rabies vaccination to increase Taiwanese dog group immunity. Only this can avoid the outbreak of rabies in Taiwan in future.
Second, apart from the current Statue for Prevention and Control of Infectious Animal Disease, the legislation of pet management should be launched. The legislation should force pet keepers to register chips into their pets and also include the regular inspection and vaccination. Thus, the related management can be supported by the legislation. The consciousness of keepers should no longer be relied on to make a loophole of the prevention. Moreover, the last outbreak of rabies in Taiwan was over half of century ago. The young generation might know very little about rabies and even do not think that it would occur in Taiwan. Thus, the government should keep educating the related prevention of rabies to the public in order to increase the public awareness of the risk and the active cooperation.
Last but not least, rabies supervising system should be set up. For stray dogs, pets and other warm-blooded animals, the supervising system should be built up and collected the tissues, blood samples and clinical symptoms of all warm-blooded animals. The databank of epidemiology should be set up to realize the change of the disease and to take some proper actions.
In the past, the prevention made Taiwan become one of the seven non-epidemic countries on the world. If the prevention can be carried on more thoroughly in the future, it is believed that rabies can be officially declared that it is extinct in Taiwan as another great achievement of public health in Taiwan.
Table One: the examination result of dog rabies vaccine antibody ELISA
Origin Amount of Serological Test Positive Number(Positive Rate)
Pets 1,559 980 (62.9%)
Stray dogs 2,099 863 ( 41.1%)
Total 3,658 1,843 (50.4%)
Data Resource：Dog Rabies Inspection Survey in Taiwan in 2003, Animal Health Research Institute, Council of Agriculture, Executive Yuan
Data Resources:
1. http://vettech.nvri.gov.tw/Articles/report/886.html
2. http://www.adccyl.gov.tw/Animal_Dise/rabies/rabies.htm
3. http://www.cdc.gov.tw/index.asp (疾病管制局)
4. http://www.rabies.com/
中國黑心商品背後的“全球共犯結構”
我覺得這篇報導提出的思想方向滿特別的，
可以給寫國際延伸的夥伴參考囉~
芳盈
http://www5.chinesenewsnet.com/MainNews/Opinion/2007_9_16_19_18_57_577.html
楊偉中﹕中國黑心商品背後的“全球共犯結構”
中國黑心商品的問題層出無窮﹐之所以引起國內外普遍的關注﹐
一方面固然是因為其問題的嚴重性不容忽視﹐另一方面﹐毋庸諱言的
﹐也有微妙復雜的國際政治經濟因素（如貿易競爭和防范中國崛起等）
在其中發揮作用。
黑心商品不管來自何國﹐既然對人體對環境造成危害﹐當然都要
尋找源頭﹑追究責任。然而追尋下去﹐我們將會發現﹐問題絕比想像
中更為復雜﹐至少不是中國人沒有良心﹑道德淪喪等這麼簡單的理由
可以說明的。
今年七月中﹐《華爾街日報》刊登了一篇題為〈電子垃圾的全球
路線圖〉的文章﹐把部分中國黑心商品生產背後復雜的“全球共犯結
構”進行了揭露。大家都知道﹐一些中國出口的兒童玩具與飾品含有
鉛﹐甚至是銅﹑銻﹐這些金屬成份將對使用這些玩具的幼兒和制造產
品的工人（指出這點是重要的﹐因為當我們關注黑心產品進口國民眾
的健康時﹐很少人想到制造這些產品的工人）造成嚴重傷害。但進一
步的問題是﹕鉛從哪裡來﹖為何要使用鉛﹖這些產品的進口者有把關嗎﹖
《華爾街日報》引述了黑心產品出口地﹑關注毒物問題的美國環
保團體－硅谷毒物聯盟以及學者的研究報告指出﹕中國制造商使用的
這些鉛中有一部分來自西方國家傾倒至中國的廢棄電腦和其它電子產
品﹐原來在此類黑心商品的背後﹐是一個有毒物質的全球化循環﹕美
國高科技垃圾中的有毒材料﹐出口到了中國﹐經過加工制造後變成了
對孩子有害的商品又轉回了美國。
這些制造黑心商品的毒物如何出口﹖原來是在出口國被定義為無
毒廢棄物﹐規避了相關的環保法律﹐以便輸出到第三世界國家加工再
制。跟黑心工廠下訂單的採購商（往往是知名的跨國公司）知情嗎﹖
他們可能會堅稱不知情﹐但對于生產廠商來說﹐這是一樁買家賣家心
照不宣的交易﹐廠商使用便宜的鉛以壓低售價﹐而買家自然也降低進
口成本。
除此之外﹐黑心食品的問題或許也比想像中復雜。黑心食品之所
以有毒有害﹐一方面固然是食品生產加工業者為了牟取利潤﹐或是使
用惡質原材料﹐或是添加有害物質﹐或是在生產過程中滲進了有毒物
質等。這些都還是制造者有知覺有意識下的作為﹐更難追查的是水與
土壤的嚴重污染帶進食品中的毒物。
今天的中國﹐不僅是世界工廠﹐也如過去的臺灣和許多第三世界
國家一樣成為世界垃圾場。除了中國本地企業制造的污染外﹐來自全
球的跨國公司也是中國環境破壞的首謀與共犯。中國公眾與環境研究
中心在八月公布了一份在中國制造污染的企業名單﹐其中跨國公司就
有一百多家﹐包括大家耳熟能詳的百事﹑雀巢﹑通用﹑肯德基﹑杜邦
等﹐也包括來自韓國和第三世界國家如印尼﹑印度的跨國公司。
描繪這個黑心商品生產的全球路線圖﹐並非要替中國生產者脫罪。
在三十多年來一股腦向西方大量生產﹑大量消費模式看齊的資本主義
狂潮下﹐盲目招商引資﹑踐踏環境﹑傷害勞動人權﹐中國的統治菁英
可以說是惡名昭彰的人權罪犯。
但是﹐在全球生產﹑全球銷售的今天﹐黑心商品的出現與氾濫﹐
突顯的問題不是單單是中國的種種結構性弊病﹐也突顯了資本主義全
球體系的病症。面對中國黑心產品﹐我們要可能要多做點功課﹐才能
對症下藥。
可以給寫國際延伸的夥伴參考囉~
芳盈
http://www5.chinesenewsnet.com/MainNews/Opinion/2007_9_16_19_18_57_577.html
楊偉中﹕中國黑心商品背後的“全球共犯結構”
中國黑心商品的問題層出無窮﹐之所以引起國內外普遍的關注﹐
一方面固然是因為其問題的嚴重性不容忽視﹐另一方面﹐毋庸諱言的
﹐也有微妙復雜的國際政治經濟因素（如貿易競爭和防范中國崛起等）
在其中發揮作用。
黑心商品不管來自何國﹐既然對人體對環境造成危害﹐當然都要
尋找源頭﹑追究責任。然而追尋下去﹐我們將會發現﹐問題絕比想像
中更為復雜﹐至少不是中國人沒有良心﹑道德淪喪等這麼簡單的理由
可以說明的。
今年七月中﹐《華爾街日報》刊登了一篇題為〈電子垃圾的全球
路線圖〉的文章﹐把部分中國黑心商品生產背後復雜的“全球共犯結
構”進行了揭露。大家都知道﹐一些中國出口的兒童玩具與飾品含有
鉛﹐甚至是銅﹑銻﹐這些金屬成份將對使用這些玩具的幼兒和制造產
品的工人（指出這點是重要的﹐因為當我們關注黑心產品進口國民眾
的健康時﹐很少人想到制造這些產品的工人）造成嚴重傷害。但進一
步的問題是﹕鉛從哪裡來﹖為何要使用鉛﹖這些產品的進口者有把關嗎﹖
《華爾街日報》引述了黑心產品出口地﹑關注毒物問題的美國環
保團體－硅谷毒物聯盟以及學者的研究報告指出﹕中國制造商使用的
這些鉛中有一部分來自西方國家傾倒至中國的廢棄電腦和其它電子產
品﹐原來在此類黑心商品的背後﹐是一個有毒物質的全球化循環﹕美
國高科技垃圾中的有毒材料﹐出口到了中國﹐經過加工制造後變成了
對孩子有害的商品又轉回了美國。
這些制造黑心商品的毒物如何出口﹖原來是在出口國被定義為無
毒廢棄物﹐規避了相關的環保法律﹐以便輸出到第三世界國家加工再
制。跟黑心工廠下訂單的採購商（往往是知名的跨國公司）知情嗎﹖
他們可能會堅稱不知情﹐但對于生產廠商來說﹐這是一樁買家賣家心
照不宣的交易﹐廠商使用便宜的鉛以壓低售價﹐而買家自然也降低進
口成本。
除此之外﹐黑心食品的問題或許也比想像中復雜。黑心食品之所
以有毒有害﹐一方面固然是食品生產加工業者為了牟取利潤﹐或是使
用惡質原材料﹐或是添加有害物質﹐或是在生產過程中滲進了有毒物
質等。這些都還是制造者有知覺有意識下的作為﹐更難追查的是水與
土壤的嚴重污染帶進食品中的毒物。
今天的中國﹐不僅是世界工廠﹐也如過去的臺灣和許多第三世界
國家一樣成為世界垃圾場。除了中國本地企業制造的污染外﹐來自全
球的跨國公司也是中國環境破壞的首謀與共犯。中國公眾與環境研究
中心在八月公布了一份在中國制造污染的企業名單﹐其中跨國公司就
有一百多家﹐包括大家耳熟能詳的百事﹑雀巢﹑通用﹑肯德基﹑杜邦
等﹐也包括來自韓國和第三世界國家如印尼﹑印度的跨國公司。
描繪這個黑心商品生產的全球路線圖﹐並非要替中國生產者脫罪。
在三十多年來一股腦向西方大量生產﹑大量消費模式看齊的資本主義
狂潮下﹐盲目招商引資﹑踐踏環境﹑傷害勞動人權﹐中國的統治菁英
可以說是惡名昭彰的人權罪犯。
但是﹐在全球生產﹑全球銷售的今天﹐黑心商品的出現與氾濫﹐
突顯的問題不是單單是中國的種種結構性弊病﹐也突顯了資本主義全
球體系的病症。面對中國黑心產品﹐我們要可能要多做點功課﹐才能
對症下藥。
2007年9月17日 星期一
自由時報8/31的報導
http://food.doh.gov.tw/files/paper/960831am-04_p03.jpg
內容看看就好 XD
重要的是裡面有提到政府已經成立跨部會專案小組
文章裡面也有提到一些網站
我去瀏覽過了，感覺還不錯
大家可以去參考一下
內容看看就好 XD
重要的是裡面有提到政府已經成立跨部會專案小組
文章裡面也有提到一些網站
我去瀏覽過了，感覺還不錯
大家可以去參考一下
主題報導:黑心食品
主題報導
各位好，我是佳真!
我想要把這次的主題再明確的介定一下，
食品衛生包括的範圍很廣，不過這期的焦點是中國的黑心食品，
我學芳盈去維基百科上查：
黑心食品的定義
維基百科，自由的百科全書
黑心食品是指原材料有害人體，製作過程不合格，只以大量生產謀取暴利的食品；或以非法原料製成「高」品質食品。「黑心」一詞源自2000年代台灣《蘋果日報》指中國不斷出現之劣質食品。韓戰時期，中國也有資本家 （中國實行社會主義經濟是1955年以後的事）為志願軍提供黑心產品[。雖然說世界各國都有不肖商人生產黑心食品，但由於嚴重程度及（黑心食品）比例上的差異，目前中國製造已成為黑心產品代名詞，且其層出不窮的黑心產品亦引起了全球抵制中國產品的風潮，尤其在台灣及歐美國家甚至出現了以非中國製造標籤來提昇產品形象及安全性的做法[1]。
主題介紹中，我會介紹目前ＷＨＯ在食品安全上的控管現況及不足的地方，以帶入各位撰寫的黑心食品相關報導之中。各位除了可介紹國內或國際上類似事件以外，也可以討論該國食品安全管制出現了什麼漏洞，黑心食品對該國的相關產業造成什麼打擊？（隨便講，臺灣進口某國鰻魚有污染，於是大家什麼鰻魚都不敢吃）這樣的心態該怎麼解決？諸如此類。總之，一定要以「黑心食品」為主，事件的描述為輔，多討論並解釋那些現象，可看性會比較高喔。
各位好，我是佳真!
我想要把這次的主題再明確的介定一下，
食品衛生包括的範圍很廣，不過這期的焦點是中國的黑心食品，
我學芳盈去維基百科上查：
黑心食品的定義
維基百科，自由的百科全書
黑心食品是指原材料有害人體，製作過程不合格，只以大量生產謀取暴利的食品；或以非法原料製成「高」品質食品。「黑心」一詞源自2000年代台灣《蘋果日報》指中國不斷出現之劣質食品。韓戰時期，中國也有資本家 （中國實行社會主義經濟是1955年以後的事）為志願軍提供黑心產品[。雖然說世界各國都有不肖商人生產黑心食品，但由於嚴重程度及（黑心食品）比例上的差異，目前中國製造已成為黑心產品代名詞，且其層出不窮的黑心產品亦引起了全球抵制中國產品的風潮，尤其在台灣及歐美國家甚至出現了以非中國製造標籤來提昇產品形象及安全性的做法[1]。
主題介紹中，我會介紹目前ＷＨＯ在食品安全上的控管現況及不足的地方，以帶入各位撰寫的黑心食品相關報導之中。各位除了可介紹國內或國際上類似事件以外，也可以討論該國食品安全管制出現了什麼漏洞，黑心食品對該國的相關產業造成什麼打擊？（隨便講，臺灣進口某國鰻魚有污染，於是大家什麼鰻魚都不敢吃）這樣的心態該怎麼解決？諸如此類。總之，一定要以「黑心食品」為主，事件的描述為輔，多討論並解釋那些現象，可看性會比較高喔。
中國誓言加強產品安全監管
Chinese WSJ.com Editors (Editors.Chinese@dowjones.com)
2007年9月7日 下午 06:18:13
這是中國方面的消息
消息來源是華爾街日報電子報中文版
中國誓言加強產品安全監管
2007年09月07日10:35
在當前產品安全問題面臨國際社會輿論廣泛批評的形勢下﹐中國兩位高級領導人分別在不同場合作出承諾﹐要加強產品安全監管力度和法律體系建設﹐從而使全球消費者的權益得到更好的保障。
中國總理溫家寶週四在於東北城市大連召開的世界經濟論壇年會上表示﹐要努力解決產品安全問題。近段時間來﹐中國成為一系列產品質量和食品安全事件的焦點﹐由此也引發了國內就如何避免使“中國製造”成為劣質產品代名詞而展開的一場廣泛辯論。
“中國政府高度重視產品質量和食品安全﹐正在加強法律體系和質量標準體系建設﹐加大質量監管力度﹐切實解決存在的問題。”溫家寶對參加年會的全球商界領袖們說。
與此同時﹐正在悉尼參加亞太經合組織峰會的中國國家主席胡景濤在與美國總統布什會面時也表示﹐中國願與其他國家一起共同完善產品質量監管。
據美聯社(Associated Press)報導﹐布什週四在與胡錦濤晤面後表示：“胡錦濤明確談及了產品安全問題﹐我對他的講話表示讚賞。”
溫家寶還承諾繼續在其它領域積極進行改革。他指出雖然中國經濟增長強勁﹐但是面臨著很多盤根錯節的問題﹐其中包括經濟低效增長、環境惡化、通貨膨脹壓力加劇以及根深蒂固的官僚阻力等。
溫家寶指出﹐唯一的解決辦法就是深化改革。在過去幾個月中﹐一些退休的中國共產黨黨員批評政府改革速度過快﹐警告須防範社會問題﹐並主張政府採取更為慎重的態度。不過﹐溫家寶暗示需要加快而不是放緩社會改革的步伐。
雖然溫家寶並未直接提及改革派和保守派的分歧﹐但是他暗示兩派意見能夠在黨內共存。長期以來﹐中國共產黨一直排除向多黨民主轉變的可能性﹐但是承諾給予黨內批評人士更多空間。溫家寶暗示﹐中國共產黨內部的改革對國家的發展至關重要。他指出﹐沒有政治改革﹐經濟改革就不會取得成功。
溫家寶還對一些批評人士對中國政府表示的擔憂作出了回應。他指出﹐中國必須讓國家的發展更為平衡。雖然中國各地的收入水平都出現了增長﹐但失衡現象更為嚴重﹔富庶的沿海地區和貧困的內陸地區之間存在著巨大的差異。
溫家寶還保證加強宏觀監管﹐以防範通貨膨脹壓力。中國央行(PBOC)的確採取了這樣的措施﹐該行週四宣佈今年第七次上調銀行存款準備金率。商業銀行的存款準備金率將被上調50個基點﹐至12.5%。
中國領導人正在著手準備下月召開的中國共產黨第十七次全國代表大會。中國的全國黨代會每五年召開一次﹐會議中往往會確立黨的領導班子﹐並為國家政策制定總體方針。雖然預計此次會議不會對領導層做出重大調整﹐但此次會議的召開正值中國面臨著一系列經濟及政治挑戰之時。
Ian Johnson
2007年9月7日 下午 06:18:13
這是中國方面的消息
消息來源是華爾街日報電子報中文版
中國誓言加強產品安全監管
2007年09月07日10:35
在當前產品安全問題面臨國際社會輿論廣泛批評的形勢下﹐中國兩位高級領導人分別在不同場合作出承諾﹐要加強產品安全監管力度和法律體系建設﹐從而使全球消費者的權益得到更好的保障。
中國總理溫家寶週四在於東北城市大連召開的世界經濟論壇年會上表示﹐要努力解決產品安全問題。近段時間來﹐中國成為一系列產品質量和食品安全事件的焦點﹐由此也引發了國內就如何避免使“中國製造”成為劣質產品代名詞而展開的一場廣泛辯論。
“中國政府高度重視產品質量和食品安全﹐正在加強法律體系和質量標準體系建設﹐加大質量監管力度﹐切實解決存在的問題。”溫家寶對參加年會的全球商界領袖們說。
與此同時﹐正在悉尼參加亞太經合組織峰會的中國國家主席胡景濤在與美國總統布什會面時也表示﹐中國願與其他國家一起共同完善產品質量監管。
據美聯社(Associated Press)報導﹐布什週四在與胡錦濤晤面後表示：“胡錦濤明確談及了產品安全問題﹐我對他的講話表示讚賞。”
溫家寶還承諾繼續在其它領域積極進行改革。他指出雖然中國經濟增長強勁﹐但是面臨著很多盤根錯節的問題﹐其中包括經濟低效增長、環境惡化、通貨膨脹壓力加劇以及根深蒂固的官僚阻力等。
溫家寶指出﹐唯一的解決辦法就是深化改革。在過去幾個月中﹐一些退休的中國共產黨黨員批評政府改革速度過快﹐警告須防範社會問題﹐並主張政府採取更為慎重的態度。不過﹐溫家寶暗示需要加快而不是放緩社會改革的步伐。
雖然溫家寶並未直接提及改革派和保守派的分歧﹐但是他暗示兩派意見能夠在黨內共存。長期以來﹐中國共產黨一直排除向多黨民主轉變的可能性﹐但是承諾給予黨內批評人士更多空間。溫家寶暗示﹐中國共產黨內部的改革對國家的發展至關重要。他指出﹐沒有政治改革﹐經濟改革就不會取得成功。
溫家寶還對一些批評人士對中國政府表示的擔憂作出了回應。他指出﹐中國必須讓國家的發展更為平衡。雖然中國各地的收入水平都出現了增長﹐但失衡現象更為嚴重﹔富庶的沿海地區和貧困的內陸地區之間存在著巨大的差異。
溫家寶還保證加強宏觀監管﹐以防範通貨膨脹壓力。中國央行(PBOC)的確採取了這樣的措施﹐該行週四宣佈今年第七次上調銀行存款準備金率。商業銀行的存款準備金率將被上調50個基點﹐至12.5%。
中國領導人正在著手準備下月召開的中國共產黨第十七次全國代表大會。中國的全國黨代會每五年召開一次﹐會議中往往會確立黨的領導班子﹐並為國家政策制定總體方針。雖然預計此次會議不會對領導層做出重大調整﹐但此次會議的召開正值中國面臨著一系列經濟及政治挑戰之時。
Ian Johnson
The International Food Safety Authorities Network (INFOSAN)
建立INFOSAN的起源及以及其功能http://www.who.int/foodsafety/fs_management/infosan/en/index.html
The International Food Safety Authorities Network (INFOSAN)
:: INFOSAN Information Note Archive
The rapid globalization of food production and trade has increased the potential likelihood of international incidents involving contaminated food. Food safety authorities all over the world have acknowledged that ensuring food safety must not only be tackled at the national level but also through closer linkages among food safety authorities at the international level. This is important for exchanging routine information on food safety issues and to have rapid access to information in case of food safety emergencies.
Since 2000, the World Health Assembly has adopted several resolutions on the subject of food safety. Member States have called for WHO to be more proactive in communicating about food safety. WHO has also been asked to provide tools and support to Member States to increase their capacity to respond to health emergencies posed by natural, accidental and intentional contamination of food. Furthermore, WHO's recent report on the terrorist threats to food identified a food safety emergency network as one of the basic preparedness measures that needed to be taken.
In view of the need for all countries to promote the exchange of food safety information and to improve collaboration among food safety authorities at national and international level, WHO has launched a new International Food Safety Authorities Network (INFOSAN). A food safety emergency network (INFOSAN Emergency) will be an integral part of INFOSAN. The food safety emergency network is intended to complement and support the existing WHO Global Outbreak Alert and Response Network (GOARN) which includes a Chemical Alert and Response component.
The International Food Safety Authorities Network (INFOSAN)
:: INFOSAN Information Note Archive
The rapid globalization of food production and trade has increased the potential likelihood of international incidents involving contaminated food. Food safety authorities all over the world have acknowledged that ensuring food safety must not only be tackled at the national level but also through closer linkages among food safety authorities at the international level. This is important for exchanging routine information on food safety issues and to have rapid access to information in case of food safety emergencies.
Since 2000, the World Health Assembly has adopted several resolutions on the subject of food safety. Member States have called for WHO to be more proactive in communicating about food safety. WHO has also been asked to provide tools and support to Member States to increase their capacity to respond to health emergencies posed by natural, accidental and intentional contamination of food. Furthermore, WHO's recent report on the terrorist threats to food identified a food safety emergency network as one of the basic preparedness measures that needed to be taken.
In view of the need for all countries to promote the exchange of food safety information and to improve collaboration among food safety authorities at national and international level, WHO has launched a new International Food Safety Authorities Network (INFOSAN). A food safety emergency network (INFOSAN Emergency) will be an integral part of INFOSAN. The food safety emergency network is intended to complement and support the existing WHO Global Outbreak Alert and Response Network (GOARN) which includes a Chemical Alert and Response component.
What is WHO doing to help countries improve food safety?
What is WHO doing to help countries improve food safety?
資料來源: http://www.who.int/features/qa/19/en/index.html
WHO改善各國食物衛生的幾項方針，概分為幾個面向:
1.預防:建立標準、風險評估、品質要求計畫、新科技產品的檢查、正確的溝通
2.控制:改善監控系統、加強各會員國疫情資源的利用
Q: What is WHO doing to help developing countries respond to food safety issues?
A: Recent trends in global food production, processing, distribution, and preparation are creating an increasing demand for food safety research in order to ensure a safer global food supply. WHO has adopted a "farm to fork" approach in order to identify and focus efforts on those points of the food production chain where contamination of food is most likely to occur or most likely to be prevented.
To reduce the burden of foodborne diseases, WHO is working with countries to build and strengthen national food safety systems in order to effectively manage their food supply. Key areas of work include:
•improving the surveillance of foodborne diseases and monitoring of chemicals;
•improving the ability of Member States to have timely information on foodborne disease outbreaks and food contamination events, to share that information via the INFOSAN network of food safety authorities, and thus to mitigate the effects of foodborne disease outbreaks;
•setting standards for the content and quality of food via the Codex Alimentarius Commission (together with the Food and Agriculture Organization of the United Nations);
•developing methods for the risk assessment of new foods, including nutrients and functional foods;
•providing guidance on the containment of the antimicrobial resistance which can spread from animals to humans when the animals in question are consumed as food;
•conducting laboratory and epidemiology training courses for the human health, animal health and food safety sectors through WHO Global Salm-Surv (a global network of laboratories and individuals involved in surveillance, isolation, identification and antimicrobial resistance testing of Salmonella) in order to improve the surveillance of foodborne diseases;
•providing an external quality assurance programme and reference testing service and supplies to laboratories;
•examining the safety of new food technologies, including foods derived from biotechnology;
•building effective communication on food-related risks;
•developing training and communications tools in support of good food handling and preparation practices: these include the Five keys to safer food;
•increasing international cooperation on and support for food safety issues.
資料來源: http://www.who.int/features/qa/19/en/index.html
WHO改善各國食物衛生的幾項方針，概分為幾個面向:
1.預防:建立標準、風險評估、品質要求計畫、新科技產品的檢查、正確的溝通
2.控制:改善監控系統、加強各會員國疫情資源的利用
Q: What is WHO doing to help developing countries respond to food safety issues?
A: Recent trends in global food production, processing, distribution, and preparation are creating an increasing demand for food safety research in order to ensure a safer global food supply. WHO has adopted a "farm to fork" approach in order to identify and focus efforts on those points of the food production chain where contamination of food is most likely to occur or most likely to be prevented.
To reduce the burden of foodborne diseases, WHO is working with countries to build and strengthen national food safety systems in order to effectively manage their food supply. Key areas of work include:
•improving the surveillance of foodborne diseases and monitoring of chemicals;
•improving the ability of Member States to have timely information on foodborne disease outbreaks and food contamination events, to share that information via the INFOSAN network of food safety authorities, and thus to mitigate the effects of foodborne disease outbreaks;
•setting standards for the content and quality of food via the Codex Alimentarius Commission (together with the Food and Agriculture Organization of the United Nations);
•developing methods for the risk assessment of new foods, including nutrients and functional foods;
•providing guidance on the containment of the antimicrobial resistance which can spread from animals to humans when the animals in question are consumed as food;
•conducting laboratory and epidemiology training courses for the human health, animal health and food safety sectors through WHO Global Salm-Surv (a global network of laboratories and individuals involved in surveillance, isolation, identification and antimicrobial resistance testing of Salmonella) in order to improve the surveillance of foodborne diseases;
•providing an external quality assurance programme and reference testing service and supplies to laboratories;
•examining the safety of new food technologies, including foods derived from biotechnology;
•building effective communication on food-related risks;
•developing training and communications tools in support of good food handling and preparation practices: these include the Five keys to safer food;
•increasing international cooperation on and support for food safety issues.
2007年9月16日 星期日
下期電子報工作進度表
本次工作期間為
9/17-26
工作進度為
9/17-22資料蒐集
0/22-26為文稿撰寫
本次主題為食品衛生
重點在於中國黑心食品上
麻煩大家了！
本次工作分配：
主題撰寫：佳真、
國際議題：光狐、浩哥
國內議題：民浩、豪哥、芳盈
麻煩有疑問或是需要幫助請儘速提出！感謝！
9/17-26
工作進度為
9/17-22資料蒐集
0/22-26為文稿撰寫
本次主題為食品衛生
重點在於中國黑心食品上
麻煩大家了！
本次工作分配：
主題撰寫：佳真、
國際議題：光狐、浩哥
國內議題：民浩、豪哥、芳盈
麻煩有疑問或是需要幫助請儘速提出！感謝！
2007年9月15日 星期六
0914期稿件
辛布宣言將宣示東南亞國家的合作---顏稚浩
第25屆的東南亞衛生部長級會議和第60屆東南亞區域委員會會議在不丹的首都-辛布舉辦。WHO東南亞區域的會員國有孟加拉、不丹、北韓、印尼、印度、馬爾地夫、緬甸、尼泊爾、斯里蘭卡、泰國和東帝汶共11個國家，這幾個會員國入會的時間從最早的泰國(1947年9月26日)到前幾年才剛獨立的國家-東帝汶(2002年9月27日)。WHO的東南亞地區會員國佔了世界上25%的人口，但是卻承擔了世界40%的疾病負擔，所以東南亞區域委員會 (regional committee)根據辛布宣言想要建立了一個基金，就是東南亞地區健康緊急基金(South-East Asia Regional Health Emergency Fund (SEARHEF))，這個基金在緊急事件爆發前三個月會提供會員國財務上的援助，這個基金是由一些以建立起的機制，例如Flash Appeals、Consolidated Appeals Process (CAP)和Central Emergency Response Fund (CERF)所資助的。這些基金是由會員國家採自由募捐的方式累積而成，像是泰國就在這次的區域委員會會議上提供了10萬美金。
這次會議的日期為8/31~9/1，會議的流程為：8/31是由不丹的政要和WHO的高級官員主持的兩個會議的聯合開幕儀式，WHO的總幹事Dr Margaret Chan、SEAR的區域主任Dr Samlee Plianbangchang、SEAR的區域副主任Dr Poonam Khetrapal Singh都會出席參與這兩場會議，接下來是8/31舉行的第25屆SEAR的衛生部長級會議，9/1~9/3是第六十屆的SEAR地區委員會會議。衛生部長級會議的重要性在於提供一個機會來交換各國在政治、經濟和社會等面向的民眾健康的經驗，以及東南亞國家在衛生的議題上團結一致的平台。這次的衛生部長級會議以辛布宣言作為基礎，來討論東南亞地區國際間的健康安全，辛布宣言的精神認為全球化帶來的便捷的交通和頻繁的貿易、氣候變遷和極地永凍層的溶解、新興的傳染病是國際間衛生安全的威脅，上述的威脅也會對各國的罹病率和死亡率造成嚴重的影響，辛布宣言也認為沒有任何單一的機構或國家，有能力單獨處理因天災人禍造成的健康緊急危害。這次委員會會議主要的討論議題有以下八點：
一、營養和食物安全
二、加強對於慢行非傳染疾病的預防和管制
三、肺結核的管控
四、修正瘧疾的管控策略
五、禽流感和全球性傳染病的預防準備
六、公共衛生、創新和智慧財產權
七、世界衛生組織和聯合國的組織改革
八、區域健康緊急事件的基金
地區委員會在會議結束後決定下一屆(第61屆)的會議將在東南亞區域組織位在印度新德里的辦公室舉辦。
參考資料：
http://www.searo.who.int/en/Section316/Section503/Section2358_13505.htm
http://www.searo.who.int/en/Section316/Section503/Section2358_13491.htm
http://www.searo.who.int/en/Section316/Section503/Section2358_13500.htmhttp://www.searo.who.int/en/Section316/Section503/Section2358_13502.htm以上皆為WHO官方網站
藍圖雖在，困難重重---林民浩
在本次東南亞衛生部長級會議後，做出了辛布宣言，對東南亞地區公共衛生未來的發展，畫了一個美麗的藍圖，但東南亞地區想逐步改善公共衛生條件，重重問題阻礙著改革的腳步。
若從個人的角度來看，儘管東南亞國家經濟成長率高，但卻有嚴重所得分配不均的問題，以菲律賓為例，該國約有10%為富人，20%為中產階級，其餘為窮人，再加以其社會福利體系不周全，大多數人在生病時並無能力負擔醫療照護費用，萬一生病就只好靠偏方或是放任病情發展。世界衛生組織 (WHO) 估計，現今三分之一之世界人口未能取得必需藥物 (essential drugs) ，在非洲及亞洲最貧窮之部份，此數值高於50%。
而從國家的角度來看，東南亞國家相較於歐美，科技較為落後，許多醫藥技術的發展，如疫苗，必須仰賴歐美國家發展，然而歐美國家在研發上，往往優先考量本身的需求及經濟效益，根據WHO統計，1957年至1999年間，共有1,400多種新藥物產生，但其中僅有13種藥物是針對熱帶性疾病及肺結核等屬於低度開發國家中最盛行的傳染病。而全球藥品銷售量之百分之九十是在已開發國家銷售，但相對的，因傳染性疾病而死亡者中卻有百分之九十是發生在開發中國家(鄭師安, 2004)，即使新的醫藥技術開發，也會因種種專利限制及貿易障礙，原先經濟就不富裕的東南亞國家必須付出龐大代價以獲得新技術，，然而這樣的狀況，對於改善東南亞地區的衛生條件，毫無助益，相反地，由於這些國家的醫藥技術大幅落後，在疾病爆發流行時，成為了防治的死角。
綜上所述，國際間目前應思考的是：
(1)降低藥價，特別是關稅及專利權造成的藥價昂貴。目前世界上共有151個國家加入世界貿易組織(WTO)，這其中也包含許多無製藥能力的國家，因此應全力協助這些國家利用「與貿易有關之智慧財產權協定」(Agreement on Trade-Related Aspects of Intellectual Property Rights, TRIPs)之強制授權規定及其他專利權的除外規定，以解決專利造成的藥價問題。另一方面，各國對於衛生用品的稅務問題，也應採免稅或降低關稅，例如烏干達在2000年，取消用於抗瘧疾之蚊帳及殺蟲劑之賦稅與進口關稅，使得更多蚊帳及殺蟲劑價格降低，更多人能負擔得起購買的費用，此一經驗值得其他東南亞國借鏡。
(2)提升東南亞國家醫療教育水平，各國除協助東南亞國家開發新技術外，應更根本的協助東南亞國家提升本身對於醫藥技術的研發能力，教他們釣魚，而不單單只是給魚吃。甚至更深入的將衛生教育觀念推廣至「民眾」的層級，藉由教育，由「民眾」的層次改變衛生環境，才能徹底解決東南亞地區的衛生問題。
參考資料：
http://www.who.int/3by5/en/
http://www.ieatpe.org.tw/magazine/127l.htm
http://140.112.119.150/WTO%20and%20PH/medicine.htm
http://www.bioweb.com.tw/
http://www.searo.who.int/en/Section316/Section503/Section2358_13502.htm
印尼與辛布宣言---陳治平
本次的辛布宣言，東南亞各國相當重視所謂的全球化所帶來的疾病快速傳遞及如何去防範因全球性暖化而逐漸擴張的疾病傳染範圍。就東南亞各國而言，從2003年的SARS到現在尚未爆發但在東南亞持續有疫情傳出的禽流感，都存在相當的威脅性。對於印尼來說，現在不斷出現的禽流感病例，更是正面衝擊到印尼的經濟發展。
相對於中國時常對於疫情的隱瞞，印尼一直在於提供禽流感病毒樣本上，持續採取不合作的動作，這對許多需要協助的國家來說，印尼的作為反而是令人十分不解的。而這些問題事實上因於印尼希望在提供病毒樣本下，自己國家能夠得到足夠的禽流感治療藥物(克流感,Tamiflu)，但是這個要求在已經有許多國家已經向藥廠預定藥物下，似乎是不可能的。而這些國家又多是已開發的富有國家下，富國與窮國的對立問題似乎更延伸到健康議題上。
對於現在的世界衛生問題上，往往窮國是最可能成為疾病爆發的源頭，而他們也往往是最需要資源及協助的地方，但是因為經濟能力的不足，無法提升基礎的公共衛生建設及滿足最基本的疫苗、營養品的需求。如此惡性循環下去，更使得窮國的衛生條件日漸惡化。而富有國家則利用自己的經濟優勢，使得自己國家能夠取得更多的衛生資源，使國家在生產力、國家建上上更加強大，也更不容易爆發疾病。但是這樣的問題，在於全球化的發展下，富國將無法獨善其身，因為快速國與國的交流下，窮國常是低成本生產力的來源，這樣的狀況下，一但國際上爆發疾病的大流行，受害的將不僅是該國，更代表高額的經濟損失。
而印尼在走出亞洲金融風暴後，也與東南亞其他國家一樣成為世界的製造中心，但是禽流感持續在印尼發生病例，這樣是否會讓投資人產生疑慮，影響到該國的經濟發展，是一個必須要考量的問題。而在部分的觀光點(如巴里島)若發生疫情，也將正面衝擊當地觀光人口的觀光意願以及當地的觀光收益。這也可能是印尼最近鬆口願意提供病毒樣本的原因。為將巴里島禽流感病例的觀光衝擊降到最低，所以WHO的協助是相當重要的。但是仍沒有辦法解決現有藥廠無法滿足所有國家在藥物上的需求，以及印尼要自我生產的要求。
對於印尼來說，用病毒樣本換取WHO的支持是一種手段，但對其他國家來說，往往得要等到爆發後才會受到囑目，但傷害卻也往往已經造成，而這樣的情況在未來，若沒有辦法在窮國及富國間，取得合作的基礎，將會漸形惡化。面對新的傳染疾病將會更需要國與國的合作，才能夠在快速交流的世界讓人類活的更健康。
參考資料：
Economist, “How Dr Chan intends to defend the planet from pandemics”, Jun 14th 2007
http://www.economist.com/world/international/displaystory.cfm?story_id=9340488
Economist, “Calls for more money as the threat looms ever larger”, Nov 11th 2005
http://www.economist.com/agenda/displaystory.cfm?story_id=E1_VTPQVST
SEAR,” Thimphu Declaration on International Health Security in the South-East Asia Region”, 31 August – 1 September 2007
http://www.searo.who.int/en/Section316/Section503/Section2358_13502.htm
中央社,” 印尼峇里島 傳出禽流感病例 ”, 2007.09.11 11:28 am, http://udn.com/NEWS/LIFE/LIF2/4008435.shtml
法新社,” 印尼峇里島婦女疑死於禽流感”, 20070821
http://times.hinet.net/news/20070821/internationality/9f2d78ba8f05.htm
探索最快樂的窮國──不丹---李芳盈
今年WHO東南亞地區的成員國衛生部長所參與的第25屆衛生部長會議以及東南亞的WHO地區委員會第60次會議均選在不丹舉行。有「最後的香格里拉」之稱的不丹，全境均隱匿於高聳的喜馬拉雅山區中，使這個國家蒙上一層神秘的面紗；其實不丹在公共衛生方面有許多大家所不熟知的成就，以下將做整理與介紹：
公共衛生成就
雖然不丹的平均國民所得僅一千四百美元，但從1961年起展開一系列「五年計畫」，在尋求經濟發展之下，間接地帶動不丹的公共衛生、教育、醫療等各層面大幅進步。在不丹總理H.E. Lyonpo Kinzang Dorji的就職演說中，他列舉了一些不丹的公共衛生成就：將近90%的鄉村地區已有水的供應；相對於WHO於1988年發起全球消滅脊髓灰質炎活動，不丹從1986年起就沒有報告顯示骨髓灰質炎病例的發生，且痲瘋病和缺碘的情況也已經被消除。1998年，不丹在日內瓦建立「不丹健康信託基金」( Bhutan Health Trust Fund )，這也是世界上第一次建立的健康信託基金，用以提供鄉村社區基礎醫療用的疫苗和基本藥物。並且不丹於全國實行免費醫療，基本醫療服務已嘉惠全國90％以上的人口；人民平均壽命自1977年到1999年這段期間當中，從46.1歲大幅增加到66.3歲。此外，自2004年12月17日起，不丹政府實行禁煙令，成為全球最先全面禁煙的國家。(1) H.E. Lyonpo Kinzang Dorji表示這些健康促進措施有助於公共衛生的成功。(2)
「一個追求快樂的國家，才是最偉大的國家。」
健康是一種生理上的、心理上的和社會關系上的良好狀態，因此有關心理層面的議題也是公共衛生非常重要的一環。根據2006年7月由英國萊斯特大學所公布的「世界快樂地圖」(World Map of Happiness)，不丹的快樂，在全球排名第八。由不丹人口普查局最新調查顯示，97％的民眾表示他們覺得很「快樂」。
「國家快樂力比國民生產毛額重要！」
(圖片來源：商業週刊)剛卸任的國王吉莫．辛吉．旺楚克(Jigme Singye Wangchuck) 成功帶領不丹 轉型成全球「最快樂的窮國」。內政部長吉莫．廷禮(Lyonpo Jigme Y. Thinley)說，當時吉莫國王還沒有明確喊出「國家快樂力」的口號，就已發現：政府應該替人民追求的是整體的幸福感，而不光只是物質上的滿足。因此在1974年，吉莫國王就提出以「國家快樂力」(Gross National Happiness，GNH)取代「國內生產毛額」(Gross Domestic Production，GDP)的施政方向，要讓不丹成為平等尊重與平衡發展的國家。他也是全球第一位不以經濟發展為優先，提出「快樂立國」觀念的執政者。
除了喊出口號，吉莫國王必須面對的最大挑戰就是他該如何突破資源稀少的困境？答案就是「完善的資源分配」！今日的不丹，醫療與教育預算分別為12%及18%，共占國家總預算的三成，如此安排，勢必擠壓其他預算；吉莫的策略是以「外交合作」與「經濟合作」換取「零國防」，由於國防預算是零，所以能讓全國極為有限的資源全部用在民生上，也因此吉莫得以展開幾項重要變革，其中較為重要的便是完成不丹的免費醫療體制，讓每個國民有平等的生存權、提供免費教育，讓每個國民都有接受教育的機會，而教育正彰顯了因平等而快樂的不丹。(3)
針對不丹對於「國家快樂力」的支持，世界衛生組織的總幹事Dr. Margaret Chan也稱讚這樣的政策為真正發展進步的最好方式，她表示不丹能達到這樣的成就，與WHO憲章對於健康的綜合定義是非常接近的。(2)當然不丹所施行的各項政策並非完美無缺，例如：儘管政府十分努力，民眾的醫療轉介費用仍不段上漲(4)。但是在嘗試尋求環境、經濟、人民福祉等各方面的最佳平衡點的政策方向之中，我們看人民的快樂。相較於不丹，台灣的經濟指數或許還在成長，但是快樂指數呢？這點值得我們深思。
參考資料：
(1) http://world.people.com.cn/BIG5/8212/72474/72475/5049343.html
(2) http://www.searo.who.int/en/Section316/Section503/Section2358_13500.htm
(3)商業週刊第1000期目錄
http://www.businessweekly.com.tw/menu.php?id=1031&mid=0000000001
(4) http://www.bhutan.gov.bt/citizen/index.php
The Sixtieth Session of WHO’s Regional committee for South-East Asia: Commitment Compared with Taiwan
Po-Han Brian Chen
Before the verdant summer changes its color, the annual WHO’s regional committee session and the meeting of health ministers from the SEAR countries were held in Thimpu, Bhutan. The meeting mainly focused on the adoption of Thimpu Declaration, which involves the commitments of International Health Regulation (IHR). The IHR is a legally binding international agreement endorsed by the 58th World Health Assembly (WHA) in 2005. Due to the enforcement of the new regulations of IHR began on June 15th, 2007, the topic became the major issue of the latest meeting.
The main focus of the IHR
The old IHR were proposed against four major international spread diseases, namely smallpox, yellow fever, cholera and plaque. Because of the eradication of the smallpox and the occurrence of the emergent contagious diseases (e.g. Avian Flu and SARS), the scope of IHR was expanded in 2005. Following is the abstract of the new IHR:
l Requirements of the member states
1) Designate a national IHR focal point
2) Deepen the ability to detect, report, and react rapidly to the public health events
3) Assess the events that can constitute Public Health Emergency of International Concern (PHEIC) occurring in the territory and to notify WHO within 24 hours
4) Routine inspection at international gateways (seaport, airport…etc)
5) Build a framework legally and administratively in line with IHR
l Member’s benefits
1) Capacities will be strengthened to report and respond to the public health risks
2) Clear guidelines will be offered by WHO upon request in the case of a PHEIC
3) Be eligible for support from the Global Outbreak Alert and Response Network
l WHO’s obligation
1) Play a mediation role in settling the international public health differences
2) Designate a IHR contact point at all levels
3) Conduct global surveillance to detect significant public health risks
4) Determine the constitution of a PHEIC
5) Offer technical assistance guidance for all areas of capacities
6) Develop and recommend measures to a member states during a PHEIC
7) Update IHR to maintain its validity
Is Regulations in Taiwan in line with the new IHR?
Due to the tensions across the Taiwan Strait, Taiwan is now in a predicament in joining the WHO. However, with all its strength, Taiwan tries to parallel the member states of WHO by building up public health regulations and emergency systems in a similar framework.
According to the latest updated strategy plan and annual report of CDC, the department of health and its subsidiary centers for disease control have set up many strategies and plan of the preparedness and response toward the outbreaks of communicable diseases. For instance, centers for disease control have ratified “Strategy Plan for Execution of Influenza Pandemic Response” in order to response to the strategies and guidelines that WHO announced. In addition, the “National Influenza Pandemic Preparedness Plan” and the “Mobilization and Preparedness Plan for Influenza Pandemic Prevention” are also relating strategies the Executive of Yuan has constituted. These programs are put into practice domestically offering guidelines fro all levels of government organizations and health man powers in different epidemic phases in one hand. And on the other hand, the responsible centers, namely the National Health Command Center (NHCC) and the National Influenza Center (NIC), play the command, mediate, and communication (domestically and internationally) roles during the preparedness and response phases of infectious diseases.
Aiming to strengthen the core capacities to detect and response to infectious diseases, the Taiwan CDC has constructed the National Disease Surveillance Systems (NDSS) to monitor the national health status and to detect outbreaks rapidly by integrating various infectious diseases surveillance networks. The Notifiable Disease Surveillance System and Syndromic Surveillance Systems, for example, are two of the many implemented surveillance networks built to collect timely, complete and precise information of infectious diseases. Besides the domestic surveillance, the Regulations Governing Quarantine (RGQ) was revised by Taiwan CDC to prevent the imports of the diseases by aircrafts and ships. The RGQ totally meets the IHR2005 requirements with all necessary quarantine measures against inbound crafts and ships, especially in the two terminals in the “Three Mini-Links” with China.
The dilemma of Taiwan in the foreign affairs has positioned itself like an off-globe island. Nevertheless Taiwan still tires to catch up with WHO member states’ pace in maintaining public health with its paralleling health regulations and emergency systems accompanying the experience overcoming the SARS crisis.
Source
SEAR www.searo.who.int.
http://www.searo.who.int./en/section316/section503/section2358_13491.htm
Strategy Plan for Execution of Influenza Pandemic Response,
Department of Health, Executive Yuan
http://www.cdc.gov.tw/WebSite_En/Programs%20&%20Campaigns/Policy%20Program/Strategy_Plan_for_Execution_of_Influenza_Pandemic_Response.doc
2007 Annual report, CDC, Taiwan
http://www.cdc.gov.tw/WebSite_En/Publication/annualreport2007.pdf
東南亞辛布宣言簽署 臺灣受惠---吳佳真
在全球化的發展之下，臺灣與東南亞國家的關係日漸密切。我國對當地的貿易投資興盛，東南亞外籍人數多，引進外籍勞工比率高，而前往東南亞各國旅遊觀光數量近年來亦增加不少，東南亞外籍配偶已達國內的6.7%。密切的合作交流有助於彼此經濟的進步，卻影響國內登革熱疫情，今年七月中前已有58個東南亞境外移入的感染案例。
人口來往密切 臺灣登革熱疫情亮起紅燈
臺灣總人口約為2300萬。其中，根據勞工委員會職業訓練局統計，今年七月底外籍勞工人數約為35萬人，印尼籍最多，約有10萬人，占外籍勞工總數的30.02%，其次為泰國籍約9萬人，占25.52%，菲律賓籍約8萬6千人，占24.69%，位居第三。[i]內政部統計處統計，95年國人結婚登記約14萬對，其中外籍配偶(不含大陸港澳人士)約有9500人，占國人結婚對數的6.7%。[ii]可見國內的東南亞居民已成為不可忽視的重要族群，而這個族群人口勢必會持續增加。
國人前往東南亞旅遊也非常頻繁，去年國內八百多萬的出國人數中，前往東南亞的人數約為130萬，以泰國38萬人次居首，其次為越南24萬人次，新加坡20萬，印尼19萬、馬來西亞18萬[iii]。
我國與東南亞各國人口交流密切，使不少遊客在當地感染登革熱。今年1月1 日至7月17日的統計顯示，本年累計通報登革熱(含DHF/DSS)568例中，130例確定案例有58例為境外移入，感染源皆來自東南亞，分別是印尼31例、越南15例、泰國3例、菲律賓2例，新加坡、柬埔寨、寮國、緬甸、馬來西亞各1例。[iv]
期盼公共衛生進步 創造國際互動的雙贏
今年8月31日及9月1日，不丹舉行了東南亞衛生部長級會議，同時簽訂辛布宣言，期望能針對全球化和氣候變遷帶來的健康影響做出更進一步的國內應變計畫並強化國際合作。隨著東南亞各個國家的產業進步，國際貿易及人口流通大幅提升，辛布宣言的簽署若能開啟其公共衛生進步的大門，對來往密切的臺灣必為一大福音。
[i] 行政院勞工委員會---職業訓練局，A提要分析外籍勞工，2007/07
[ii] 內政部統計資訊服務網，九十六年第二週（95年國人結婚之外籍與大陸配偶人數統計），2007/1/11
[iii] 中華民國交通部觀光局，2006年近6年中華民國國民出國目的地人數統計，2006
[iv] 疾病管制局疫情報導網站，國內重要疫情摘要報導，2007/08/09
第25屆的東南亞衛生部長級會議和第60屆東南亞區域委員會會議在不丹的首都-辛布舉辦。WHO東南亞區域的會員國有孟加拉、不丹、北韓、印尼、印度、馬爾地夫、緬甸、尼泊爾、斯里蘭卡、泰國和東帝汶共11個國家，這幾個會員國入會的時間從最早的泰國(1947年9月26日)到前幾年才剛獨立的國家-東帝汶(2002年9月27日)。WHO的東南亞地區會員國佔了世界上25%的人口，但是卻承擔了世界40%的疾病負擔，所以東南亞區域委員會 (regional committee)根據辛布宣言想要建立了一個基金，就是東南亞地區健康緊急基金(South-East Asia Regional Health Emergency Fund (SEARHEF))，這個基金在緊急事件爆發前三個月會提供會員國財務上的援助，這個基金是由一些以建立起的機制，例如Flash Appeals、Consolidated Appeals Process (CAP)和Central Emergency Response Fund (CERF)所資助的。這些基金是由會員國家採自由募捐的方式累積而成，像是泰國就在這次的區域委員會會議上提供了10萬美金。
這次會議的日期為8/31~9/1，會議的流程為：8/31是由不丹的政要和WHO的高級官員主持的兩個會議的聯合開幕儀式，WHO的總幹事Dr Margaret Chan、SEAR的區域主任Dr Samlee Plianbangchang、SEAR的區域副主任Dr Poonam Khetrapal Singh都會出席參與這兩場會議，接下來是8/31舉行的第25屆SEAR的衛生部長級會議，9/1~9/3是第六十屆的SEAR地區委員會會議。衛生部長級會議的重要性在於提供一個機會來交換各國在政治、經濟和社會等面向的民眾健康的經驗，以及東南亞國家在衛生的議題上團結一致的平台。這次的衛生部長級會議以辛布宣言作為基礎，來討論東南亞地區國際間的健康安全，辛布宣言的精神認為全球化帶來的便捷的交通和頻繁的貿易、氣候變遷和極地永凍層的溶解、新興的傳染病是國際間衛生安全的威脅，上述的威脅也會對各國的罹病率和死亡率造成嚴重的影響，辛布宣言也認為沒有任何單一的機構或國家，有能力單獨處理因天災人禍造成的健康緊急危害。這次委員會會議主要的討論議題有以下八點：
一、營養和食物安全
二、加強對於慢行非傳染疾病的預防和管制
三、肺結核的管控
四、修正瘧疾的管控策略
五、禽流感和全球性傳染病的預防準備
六、公共衛生、創新和智慧財產權
七、世界衛生組織和聯合國的組織改革
八、區域健康緊急事件的基金
地區委員會在會議結束後決定下一屆(第61屆)的會議將在東南亞區域組織位在印度新德里的辦公室舉辦。
參考資料：
http://www.searo.who.int/en/Section316/Section503/Section2358_13505.htm
http://www.searo.who.int/en/Section316/Section503/Section2358_13491.htm
http://www.searo.who.int/en/Section316/Section503/Section2358_13500.htmhttp://www.searo.who.int/en/Section316/Section503/Section2358_13502.htm以上皆為WHO官方網站
藍圖雖在，困難重重---林民浩
在本次東南亞衛生部長級會議後，做出了辛布宣言，對東南亞地區公共衛生未來的發展，畫了一個美麗的藍圖，但東南亞地區想逐步改善公共衛生條件，重重問題阻礙著改革的腳步。
若從個人的角度來看，儘管東南亞國家經濟成長率高，但卻有嚴重所得分配不均的問題，以菲律賓為例，該國約有10%為富人，20%為中產階級，其餘為窮人，再加以其社會福利體系不周全，大多數人在生病時並無能力負擔醫療照護費用，萬一生病就只好靠偏方或是放任病情發展。世界衛生組織 (WHO) 估計，現今三分之一之世界人口未能取得必需藥物 (essential drugs) ，在非洲及亞洲最貧窮之部份，此數值高於50%。
而從國家的角度來看，東南亞國家相較於歐美，科技較為落後，許多醫藥技術的發展，如疫苗，必須仰賴歐美國家發展，然而歐美國家在研發上，往往優先考量本身的需求及經濟效益，根據WHO統計，1957年至1999年間，共有1,400多種新藥物產生，但其中僅有13種藥物是針對熱帶性疾病及肺結核等屬於低度開發國家中最盛行的傳染病。而全球藥品銷售量之百分之九十是在已開發國家銷售，但相對的，因傳染性疾病而死亡者中卻有百分之九十是發生在開發中國家(鄭師安, 2004)，即使新的醫藥技術開發，也會因種種專利限制及貿易障礙，原先經濟就不富裕的東南亞國家必須付出龐大代價以獲得新技術，，然而這樣的狀況，對於改善東南亞地區的衛生條件，毫無助益，相反地，由於這些國家的醫藥技術大幅落後，在疾病爆發流行時，成為了防治的死角。
綜上所述，國際間目前應思考的是：
(1)降低藥價，特別是關稅及專利權造成的藥價昂貴。目前世界上共有151個國家加入世界貿易組織(WTO)，這其中也包含許多無製藥能力的國家，因此應全力協助這些國家利用「與貿易有關之智慧財產權協定」(Agreement on Trade-Related Aspects of Intellectual Property Rights, TRIPs)之強制授權規定及其他專利權的除外規定，以解決專利造成的藥價問題。另一方面，各國對於衛生用品的稅務問題，也應採免稅或降低關稅，例如烏干達在2000年，取消用於抗瘧疾之蚊帳及殺蟲劑之賦稅與進口關稅，使得更多蚊帳及殺蟲劑價格降低，更多人能負擔得起購買的費用，此一經驗值得其他東南亞國借鏡。
(2)提升東南亞國家醫療教育水平，各國除協助東南亞國家開發新技術外，應更根本的協助東南亞國家提升本身對於醫藥技術的研發能力，教他們釣魚，而不單單只是給魚吃。甚至更深入的將衛生教育觀念推廣至「民眾」的層級，藉由教育，由「民眾」的層次改變衛生環境，才能徹底解決東南亞地區的衛生問題。
參考資料：
http://www.who.int/3by5/en/
http://www.ieatpe.org.tw/magazine/127l.htm
http://140.112.119.150/WTO%20and%20PH/medicine.htm
http://www.bioweb.com.tw/
http://www.searo.who.int/en/Section316/Section503/Section2358_13502.htm
印尼與辛布宣言---陳治平
本次的辛布宣言，東南亞各國相當重視所謂的全球化所帶來的疾病快速傳遞及如何去防範因全球性暖化而逐漸擴張的疾病傳染範圍。就東南亞各國而言，從2003年的SARS到現在尚未爆發但在東南亞持續有疫情傳出的禽流感，都存在相當的威脅性。對於印尼來說，現在不斷出現的禽流感病例，更是正面衝擊到印尼的經濟發展。
相對於中國時常對於疫情的隱瞞，印尼一直在於提供禽流感病毒樣本上，持續採取不合作的動作，這對許多需要協助的國家來說，印尼的作為反而是令人十分不解的。而這些問題事實上因於印尼希望在提供病毒樣本下，自己國家能夠得到足夠的禽流感治療藥物(克流感,Tamiflu)，但是這個要求在已經有許多國家已經向藥廠預定藥物下，似乎是不可能的。而這些國家又多是已開發的富有國家下，富國與窮國的對立問題似乎更延伸到健康議題上。
對於現在的世界衛生問題上，往往窮國是最可能成為疾病爆發的源頭，而他們也往往是最需要資源及協助的地方，但是因為經濟能力的不足，無法提升基礎的公共衛生建設及滿足最基本的疫苗、營養品的需求。如此惡性循環下去，更使得窮國的衛生條件日漸惡化。而富有國家則利用自己的經濟優勢，使得自己國家能夠取得更多的衛生資源，使國家在生產力、國家建上上更加強大，也更不容易爆發疾病。但是這樣的問題，在於全球化的發展下，富國將無法獨善其身，因為快速國與國的交流下，窮國常是低成本生產力的來源，這樣的狀況下，一但國際上爆發疾病的大流行，受害的將不僅是該國，更代表高額的經濟損失。
而印尼在走出亞洲金融風暴後，也與東南亞其他國家一樣成為世界的製造中心，但是禽流感持續在印尼發生病例，這樣是否會讓投資人產生疑慮，影響到該國的經濟發展，是一個必須要考量的問題。而在部分的觀光點(如巴里島)若發生疫情，也將正面衝擊當地觀光人口的觀光意願以及當地的觀光收益。這也可能是印尼最近鬆口願意提供病毒樣本的原因。為將巴里島禽流感病例的觀光衝擊降到最低，所以WHO的協助是相當重要的。但是仍沒有辦法解決現有藥廠無法滿足所有國家在藥物上的需求，以及印尼要自我生產的要求。
對於印尼來說，用病毒樣本換取WHO的支持是一種手段，但對其他國家來說，往往得要等到爆發後才會受到囑目，但傷害卻也往往已經造成，而這樣的情況在未來，若沒有辦法在窮國及富國間，取得合作的基礎，將會漸形惡化。面對新的傳染疾病將會更需要國與國的合作，才能夠在快速交流的世界讓人類活的更健康。
參考資料：
Economist, “How Dr Chan intends to defend the planet from pandemics”, Jun 14th 2007
http://www.economist.com/world/international/displaystory.cfm?story_id=9340488
Economist, “Calls for more money as the threat looms ever larger”, Nov 11th 2005
http://www.economist.com/agenda/displaystory.cfm?story_id=E1_VTPQVST
SEAR,” Thimphu Declaration on International Health Security in the South-East Asia Region”, 31 August – 1 September 2007
http://www.searo.who.int/en/Section316/Section503/Section2358_13502.htm
中央社,” 印尼峇里島 傳出禽流感病例 ”, 2007.09.11 11:28 am, http://udn.com/NEWS/LIFE/LIF2/4008435.shtml
法新社,” 印尼峇里島婦女疑死於禽流感”, 20070821
http://times.hinet.net/news/20070821/internationality/9f2d78ba8f05.htm
探索最快樂的窮國──不丹---李芳盈
今年WHO東南亞地區的成員國衛生部長所參與的第25屆衛生部長會議以及東南亞的WHO地區委員會第60次會議均選在不丹舉行。有「最後的香格里拉」之稱的不丹，全境均隱匿於高聳的喜馬拉雅山區中，使這個國家蒙上一層神秘的面紗；其實不丹在公共衛生方面有許多大家所不熟知的成就，以下將做整理與介紹：
公共衛生成就
雖然不丹的平均國民所得僅一千四百美元，但從1961年起展開一系列「五年計畫」，在尋求經濟發展之下，間接地帶動不丹的公共衛生、教育、醫療等各層面大幅進步。在不丹總理H.E. Lyonpo Kinzang Dorji的就職演說中，他列舉了一些不丹的公共衛生成就：將近90%的鄉村地區已有水的供應；相對於WHO於1988年發起全球消滅脊髓灰質炎活動，不丹從1986年起就沒有報告顯示骨髓灰質炎病例的發生，且痲瘋病和缺碘的情況也已經被消除。1998年，不丹在日內瓦建立「不丹健康信託基金」( Bhutan Health Trust Fund )，這也是世界上第一次建立的健康信託基金，用以提供鄉村社區基礎醫療用的疫苗和基本藥物。並且不丹於全國實行免費醫療，基本醫療服務已嘉惠全國90％以上的人口；人民平均壽命自1977年到1999年這段期間當中，從46.1歲大幅增加到66.3歲。此外，自2004年12月17日起，不丹政府實行禁煙令，成為全球最先全面禁煙的國家。(1) H.E. Lyonpo Kinzang Dorji表示這些健康促進措施有助於公共衛生的成功。(2)
「一個追求快樂的國家，才是最偉大的國家。」
健康是一種生理上的、心理上的和社會關系上的良好狀態，因此有關心理層面的議題也是公共衛生非常重要的一環。根據2006年7月由英國萊斯特大學所公布的「世界快樂地圖」(World Map of Happiness)，不丹的快樂，在全球排名第八。由不丹人口普查局最新調查顯示，97％的民眾表示他們覺得很「快樂」。
「國家快樂力比國民生產毛額重要！」
(圖片來源：商業週刊)剛卸任的國王吉莫．辛吉．旺楚克(Jigme Singye Wangchuck) 成功帶領不丹 轉型成全球「最快樂的窮國」。內政部長吉莫．廷禮(Lyonpo Jigme Y. Thinley)說，當時吉莫國王還沒有明確喊出「國家快樂力」的口號，就已發現：政府應該替人民追求的是整體的幸福感，而不光只是物質上的滿足。因此在1974年，吉莫國王就提出以「國家快樂力」(Gross National Happiness，GNH)取代「國內生產毛額」(Gross Domestic Production，GDP)的施政方向，要讓不丹成為平等尊重與平衡發展的國家。他也是全球第一位不以經濟發展為優先，提出「快樂立國」觀念的執政者。
除了喊出口號，吉莫國王必須面對的最大挑戰就是他該如何突破資源稀少的困境？答案就是「完善的資源分配」！今日的不丹，醫療與教育預算分別為12%及18%，共占國家總預算的三成，如此安排，勢必擠壓其他預算；吉莫的策略是以「外交合作」與「經濟合作」換取「零國防」，由於國防預算是零，所以能讓全國極為有限的資源全部用在民生上，也因此吉莫得以展開幾項重要變革，其中較為重要的便是完成不丹的免費醫療體制，讓每個國民有平等的生存權、提供免費教育，讓每個國民都有接受教育的機會，而教育正彰顯了因平等而快樂的不丹。(3)
針對不丹對於「國家快樂力」的支持，世界衛生組織的總幹事Dr. Margaret Chan也稱讚這樣的政策為真正發展進步的最好方式，她表示不丹能達到這樣的成就，與WHO憲章對於健康的綜合定義是非常接近的。(2)當然不丹所施行的各項政策並非完美無缺，例如：儘管政府十分努力，民眾的醫療轉介費用仍不段上漲(4)。但是在嘗試尋求環境、經濟、人民福祉等各方面的最佳平衡點的政策方向之中，我們看人民的快樂。相較於不丹，台灣的經濟指數或許還在成長，但是快樂指數呢？這點值得我們深思。
參考資料：
(1) http://world.people.com.cn/BIG5/8212/72474/72475/5049343.html
(2) http://www.searo.who.int/en/Section316/Section503/Section2358_13500.htm
(3)商業週刊第1000期目錄
http://www.businessweekly.com.tw/menu.php?id=1031&mid=0000000001
(4) http://www.bhutan.gov.bt/citizen/index.php
The Sixtieth Session of WHO’s Regional committee for South-East Asia: Commitment Compared with Taiwan
Po-Han Brian Chen
Before the verdant summer changes its color, the annual WHO’s regional committee session and the meeting of health ministers from the SEAR countries were held in Thimpu, Bhutan. The meeting mainly focused on the adoption of Thimpu Declaration, which involves the commitments of International Health Regulation (IHR). The IHR is a legally binding international agreement endorsed by the 58th World Health Assembly (WHA) in 2005. Due to the enforcement of the new regulations of IHR began on June 15th, 2007, the topic became the major issue of the latest meeting.
The main focus of the IHR
The old IHR were proposed against four major international spread diseases, namely smallpox, yellow fever, cholera and plaque. Because of the eradication of the smallpox and the occurrence of the emergent contagious diseases (e.g. Avian Flu and SARS), the scope of IHR was expanded in 2005. Following is the abstract of the new IHR:
l Requirements of the member states
1) Designate a national IHR focal point
2) Deepen the ability to detect, report, and react rapidly to the public health events
3) Assess the events that can constitute Public Health Emergency of International Concern (PHEIC) occurring in the territory and to notify WHO within 24 hours
4) Routine inspection at international gateways (seaport, airport…etc)
5) Build a framework legally and administratively in line with IHR
l Member’s benefits
1) Capacities will be strengthened to report and respond to the public health risks
2) Clear guidelines will be offered by WHO upon request in the case of a PHEIC
3) Be eligible for support from the Global Outbreak Alert and Response Network
l WHO’s obligation
1) Play a mediation role in settling the international public health differences
2) Designate a IHR contact point at all levels
3) Conduct global surveillance to detect significant public health risks
4) Determine the constitution of a PHEIC
5) Offer technical assistance guidance for all areas of capacities
6) Develop and recommend measures to a member states during a PHEIC
7) Update IHR to maintain its validity
Is Regulations in Taiwan in line with the new IHR?
Due to the tensions across the Taiwan Strait, Taiwan is now in a predicament in joining the WHO. However, with all its strength, Taiwan tries to parallel the member states of WHO by building up public health regulations and emergency systems in a similar framework.
According to the latest updated strategy plan and annual report of CDC, the department of health and its subsidiary centers for disease control have set up many strategies and plan of the preparedness and response toward the outbreaks of communicable diseases. For instance, centers for disease control have ratified “Strategy Plan for Execution of Influenza Pandemic Response” in order to response to the strategies and guidelines that WHO announced. In addition, the “National Influenza Pandemic Preparedness Plan” and the “Mobilization and Preparedness Plan for Influenza Pandemic Prevention” are also relating strategies the Executive of Yuan has constituted. These programs are put into practice domestically offering guidelines fro all levels of government organizations and health man powers in different epidemic phases in one hand. And on the other hand, the responsible centers, namely the National Health Command Center (NHCC) and the National Influenza Center (NIC), play the command, mediate, and communication (domestically and internationally) roles during the preparedness and response phases of infectious diseases.
Aiming to strengthen the core capacities to detect and response to infectious diseases, the Taiwan CDC has constructed the National Disease Surveillance Systems (NDSS) to monitor the national health status and to detect outbreaks rapidly by integrating various infectious diseases surveillance networks. The Notifiable Disease Surveillance System and Syndromic Surveillance Systems, for example, are two of the many implemented surveillance networks built to collect timely, complete and precise information of infectious diseases. Besides the domestic surveillance, the Regulations Governing Quarantine (RGQ) was revised by Taiwan CDC to prevent the imports of the diseases by aircrafts and ships. The RGQ totally meets the IHR2005 requirements with all necessary quarantine measures against inbound crafts and ships, especially in the two terminals in the “Three Mini-Links” with China.
The dilemma of Taiwan in the foreign affairs has positioned itself like an off-globe island. Nevertheless Taiwan still tires to catch up with WHO member states’ pace in maintaining public health with its paralleling health regulations and emergency systems accompanying the experience overcoming the SARS crisis.
Source
SEAR www.searo.who.int.
http://www.searo.who.int./en/section316/section503/section2358_13491.htm
Strategy Plan for Execution of Influenza Pandemic Response,
Department of Health, Executive Yuan
http://www.cdc.gov.tw/WebSite_En/Programs%20&%20Campaigns/Policy%20Program/Strategy_Plan_for_Execution_of_Influenza_Pandemic_Response.doc
2007 Annual report, CDC, Taiwan
http://www.cdc.gov.tw/WebSite_En/Publication/annualreport2007.pdf
東南亞辛布宣言簽署 臺灣受惠---吳佳真
在全球化的發展之下，臺灣與東南亞國家的關係日漸密切。我國對當地的貿易投資興盛，東南亞外籍人數多，引進外籍勞工比率高，而前往東南亞各國旅遊觀光數量近年來亦增加不少，東南亞外籍配偶已達國內的6.7%。密切的合作交流有助於彼此經濟的進步，卻影響國內登革熱疫情，今年七月中前已有58個東南亞境外移入的感染案例。
人口來往密切 臺灣登革熱疫情亮起紅燈
臺灣總人口約為2300萬。其中，根據勞工委員會職業訓練局統計，今年七月底外籍勞工人數約為35萬人，印尼籍最多，約有10萬人，占外籍勞工總數的30.02%，其次為泰國籍約9萬人，占25.52%，菲律賓籍約8萬6千人，占24.69%，位居第三。[i]內政部統計處統計，95年國人結婚登記約14萬對，其中外籍配偶(不含大陸港澳人士)約有9500人，占國人結婚對數的6.7%。[ii]可見國內的東南亞居民已成為不可忽視的重要族群，而這個族群人口勢必會持續增加。
國人前往東南亞旅遊也非常頻繁，去年國內八百多萬的出國人數中，前往東南亞的人數約為130萬，以泰國38萬人次居首，其次為越南24萬人次，新加坡20萬，印尼19萬、馬來西亞18萬[iii]。
我國與東南亞各國人口交流密切，使不少遊客在當地感染登革熱。今年1月1 日至7月17日的統計顯示，本年累計通報登革熱(含DHF/DSS)568例中，130例確定案例有58例為境外移入，感染源皆來自東南亞，分別是印尼31例、越南15例、泰國3例、菲律賓2例，新加坡、柬埔寨、寮國、緬甸、馬來西亞各1例。[iv]
期盼公共衛生進步 創造國際互動的雙贏
今年8月31日及9月1日，不丹舉行了東南亞衛生部長級會議，同時簽訂辛布宣言，期望能針對全球化和氣候變遷帶來的健康影響做出更進一步的國內應變計畫並強化國際合作。隨著東南亞各個國家的產業進步，國際貿易及人口流通大幅提升，辛布宣言的簽署若能開啟其公共衛生進步的大門，對來往密切的臺灣必為一大福音。
[i] 行政院勞工委員會---職業訓練局，A提要分析外籍勞工，2007/07
[ii] 內政部統計資訊服務網，九十六年第二週（95年國人結婚之外籍與大陸配偶人數統計），2007/1/11
[iii] 中華民國交通部觀光局，2006年近6年中華民國國民出國目的地人數統計，2006
[iv] 疾病管制局疫情報導網站，國內重要疫情摘要報導，2007/08/09
2007年9月7日 星期五
Calls for more money as the threat looms ever larger
http://0rz.tw/a433H
這是在2005年IHR時的相關討論，可以了解到印尼、土耳其、羅馬尼亞所面臨的困境
在禽流感及剛過的SARS問題上，疾病流行的爆發所存在的經濟損失。
Calls for more money as the threat looms ever larger
Nov 11th 2005
From Economist.com
At a meeting in Geneva, development banks and health agencies have called for much more money to respond to the outbreak of bird flu and the threat of a human pandemic. Rich countries are working on their own plans in case the co-ordinated global response fails
IN RECENT weeks, the world’s public health officials have been afflicted with a sort of pandemic of meetings about bird flu. Much of this culminated, this week, in a meeting of officials from nations around the world at the headquarters of the World Health Organisation (WHO) in Geneva. Plans were hatched for how best to respond to the threat from a virus that is threatening poultry around the world and which, it is feared, may trigger a pandemic of human flu. And money was discussed. Lots of it.
The meeting revealed a broad consensus that the best short-term strategy was to tackle and eliminate the animal disease. Already, 150m birds have been culled around the world. Countries such as Japan and Malaysia have reacted quickly to eliminate outbreaks of highly pathogenic bird flu and have now been declared free from virus. However, poor countries in Asia such as Vietnam, Cambodia, Thailand and Laos have neither the veterinary facilities for surveillance, the laboratories to test samples, nor the ability to respond swiftly to eradicate outbreaks. It is increasingly clear that the world’s richer nations will have to pay for these countries to raise their capacity in these areas.
While everyone seems to agree that the best strategy for dealing with the threat of a human pandemic is to control flu in birds, little clarity emerged in Geneva on how money would be allocated. The World Bank said it would create a programme to make $500m available to countries in South-East Asia struggling to contain the outbreak; overall, the bank believes that up to $1 billion will be needed over the next three years to handle the poultry crisis. In addition, the Asian Development Bank said it could commit at least $470m (as a mixture of grants and loans) to support Asia’s response—a sum that also includes money to help countries stockpile drugs.
In the short term, international agencies such as the WHO, the Food and Agriculture Organisation (FAO) and the World Organisation for Animal Health (OIE) say they need about $35m to respond. They are worried that some countries appear to be overwhelmed by the disease. There is also great concern that flu might be carried to poor African nations by migrating birds. It has already spread to the edges of the European Union: last month, the deadly H5N1 strain of the virus was confirmed in poultry in Turkey and Romania. And on Friday, Kuwait announced the first confirmed case in the Middle East.
There is likely to be more clarity in January as to how all this money would be allocated, at yet another bird-flu meeting. However, some overlapping requirements are already emerging. The FAO and OIE have for some time had a largely unfunded global strategy for fighting avian flu. As the disease spreads to new countries, the costs of this plan are spiralling—from $100m earlier this year to $500m now. So far, less than a tenth of this has been made available. Instead, much of the money being discussed by the big international lenders will go directly to individual countries.
More information also emerged this week on the cost-effectiveness of such spending. Milan Brahmbhatt, lead economist for the East Asia and Pacific region at the World Bank, pointed out that while there were huge uncertainties over the severity of any future flu pandemic, the disruption caused by the SARS virus in 2003 led to $200 billion of economic losses in one three-month period. Because a human pandemic could easily cause disruption lasting a year, reports suggest it would cost some $800 billion in global losses; America alone could suffer losses of $100 billion-200 billion from a pandemic that made 50m people ill and killed between 100,000 and 200,000. The Asian Development Bank reckons that a demand shock from a severe outbreak would cause up to $283 billion in damage to Asia’s economies and could tip the world economy into recession.
Although the disease is currently a threat mainly to poultry, many are worried about the supply of anti-viral drugs and vaccines for a human pandemic. Some countries are reported to be stockpiling enough anti-virals for 25% of the population, while others have little or no access to such medicines because of their high costs or shortage of stocks.
So far, 50 countries have placed orders with Roche, a Swiss company, for its drug Tamiflu, which is one of two anti-viral treatments thought to be effective in protecting humans from bird flu. Margaret Chan, assistant director-general of communicable diseases at the WHO, hinted on Wednesday that further funding for new stockpiles of anti-virals was likely to be announced soon, including additional money from the World Bank.
Although the supply of Tamiflu currently outstrips demand, Roche is ramping up production in anticipation of a sharp rise in orders. This year, the company plans to produce 55m doses, a tenfold increase on its capacity in 1999; this is expected to rise to 150m in 2006 and 300m in 2007. Although Roche is delivering the drug on a first-come-first-served basis, there have been some notable exceptions to this rule: the company was quick to send tens of thousands of packs to Indonesia, Turkey and Romania during their recent outbreaks.
So far, Roche has been approached by 150 companies and countries that are interested in working with the firm to produce Tamiflu. Most, though, only have the capability to put the active ingredient into capsules, as opposed to making it themselves. Although there have been reports that Roche will supply ingredients and know-how to allow Vietnam to manufacture the drug, in fact the ongoing negotiations are only about encapsulation. Of the 64 people who have so far died of bird flu, 42 were infected in Vietnam.
Roche says it wants to select partners by the end of November to help it speed up its own processes and add production capacity. Some countries and companies have said they will reverse-engineer and produce Tamiflu without help from Roche; it emerged this week that Chinese government scientists are trying to develop their own version of the drug. A Roche spokesperson said on Wednesday it would do everything it can to avoid this, and that it was “not on a collision course with any government in the world”. The company currently charges governments in rich countries €15 ($18) per course of ten Tamiflu tablets, and those in poor countries €12. It says this is well below its normal price, and rules out further reductions.
The big question, though, is how prepared the world’s governments want to be. The level of 25% (of population covered by stockpiles) is based on previous pandemics that suggest about a quarter of all people would get sick. Some countries have ordered more than this so that emergency workers can take the drug continuously to prevent them catching the virus.
Last week, the United States revealed that it would spend $7.1 billion preparing for a flu pandemic. Much of this money will be spent on buying drugs, while only $250m will be made available for foreign assistance. Such a wide disparity between the finance available for national and international programmes is by no means unique. While the most rational way to tackle the problem is to focus resources on stamping out highly contagious bird flu in a co-ordinated global way, rich countries are obliged to draw up their own fall-back plans in case such a strategy fails. However, the costs of responding at home are far higher than elimination at source.
這是在2005年IHR時的相關討論，可以了解到印尼、土耳其、羅馬尼亞所面臨的困境
在禽流感及剛過的SARS問題上，疾病流行的爆發所存在的經濟損失。
Calls for more money as the threat looms ever larger
Nov 11th 2005
From Economist.com
At a meeting in Geneva, development banks and health agencies have called for much more money to respond to the outbreak of bird flu and the threat of a human pandemic. Rich countries are working on their own plans in case the co-ordinated global response fails
IN RECENT weeks, the world’s public health officials have been afflicted with a sort of pandemic of meetings about bird flu. Much of this culminated, this week, in a meeting of officials from nations around the world at the headquarters of the World Health Organisation (WHO) in Geneva. Plans were hatched for how best to respond to the threat from a virus that is threatening poultry around the world and which, it is feared, may trigger a pandemic of human flu. And money was discussed. Lots of it.
The meeting revealed a broad consensus that the best short-term strategy was to tackle and eliminate the animal disease. Already, 150m birds have been culled around the world. Countries such as Japan and Malaysia have reacted quickly to eliminate outbreaks of highly pathogenic bird flu and have now been declared free from virus. However, poor countries in Asia such as Vietnam, Cambodia, Thailand and Laos have neither the veterinary facilities for surveillance, the laboratories to test samples, nor the ability to respond swiftly to eradicate outbreaks. It is increasingly clear that the world’s richer nations will have to pay for these countries to raise their capacity in these areas.
While everyone seems to agree that the best strategy for dealing with the threat of a human pandemic is to control flu in birds, little clarity emerged in Geneva on how money would be allocated. The World Bank said it would create a programme to make $500m available to countries in South-East Asia struggling to contain the outbreak; overall, the bank believes that up to $1 billion will be needed over the next three years to handle the poultry crisis. In addition, the Asian Development Bank said it could commit at least $470m (as a mixture of grants and loans) to support Asia’s response—a sum that also includes money to help countries stockpile drugs.
In the short term, international agencies such as the WHO, the Food and Agriculture Organisation (FAO) and the World Organisation for Animal Health (OIE) say they need about $35m to respond. They are worried that some countries appear to be overwhelmed by the disease. There is also great concern that flu might be carried to poor African nations by migrating birds. It has already spread to the edges of the European Union: last month, the deadly H5N1 strain of the virus was confirmed in poultry in Turkey and Romania. And on Friday, Kuwait announced the first confirmed case in the Middle East.
There is likely to be more clarity in January as to how all this money would be allocated, at yet another bird-flu meeting. However, some overlapping requirements are already emerging. The FAO and OIE have for some time had a largely unfunded global strategy for fighting avian flu. As the disease spreads to new countries, the costs of this plan are spiralling—from $100m earlier this year to $500m now. So far, less than a tenth of this has been made available. Instead, much of the money being discussed by the big international lenders will go directly to individual countries.
More information also emerged this week on the cost-effectiveness of such spending. Milan Brahmbhatt, lead economist for the East Asia and Pacific region at the World Bank, pointed out that while there were huge uncertainties over the severity of any future flu pandemic, the disruption caused by the SARS virus in 2003 led to $200 billion of economic losses in one three-month period. Because a human pandemic could easily cause disruption lasting a year, reports suggest it would cost some $800 billion in global losses; America alone could suffer losses of $100 billion-200 billion from a pandemic that made 50m people ill and killed between 100,000 and 200,000. The Asian Development Bank reckons that a demand shock from a severe outbreak would cause up to $283 billion in damage to Asia’s economies and could tip the world economy into recession.
Although the disease is currently a threat mainly to poultry, many are worried about the supply of anti-viral drugs and vaccines for a human pandemic. Some countries are reported to be stockpiling enough anti-virals for 25% of the population, while others have little or no access to such medicines because of their high costs or shortage of stocks.
So far, 50 countries have placed orders with Roche, a Swiss company, for its drug Tamiflu, which is one of two anti-viral treatments thought to be effective in protecting humans from bird flu. Margaret Chan, assistant director-general of communicable diseases at the WHO, hinted on Wednesday that further funding for new stockpiles of anti-virals was likely to be announced soon, including additional money from the World Bank.
Although the supply of Tamiflu currently outstrips demand, Roche is ramping up production in anticipation of a sharp rise in orders. This year, the company plans to produce 55m doses, a tenfold increase on its capacity in 1999; this is expected to rise to 150m in 2006 and 300m in 2007. Although Roche is delivering the drug on a first-come-first-served basis, there have been some notable exceptions to this rule: the company was quick to send tens of thousands of packs to Indonesia, Turkey and Romania during their recent outbreaks.
So far, Roche has been approached by 150 companies and countries that are interested in working with the firm to produce Tamiflu. Most, though, only have the capability to put the active ingredient into capsules, as opposed to making it themselves. Although there have been reports that Roche will supply ingredients and know-how to allow Vietnam to manufacture the drug, in fact the ongoing negotiations are only about encapsulation. Of the 64 people who have so far died of bird flu, 42 were infected in Vietnam.
Roche says it wants to select partners by the end of November to help it speed up its own processes and add production capacity. Some countries and companies have said they will reverse-engineer and produce Tamiflu without help from Roche; it emerged this week that Chinese government scientists are trying to develop their own version of the drug. A Roche spokesperson said on Wednesday it would do everything it can to avoid this, and that it was “not on a collision course with any government in the world”. The company currently charges governments in rich countries €15 ($18) per course of ten Tamiflu tablets, and those in poor countries €12. It says this is well below its normal price, and rules out further reductions.
The big question, though, is how prepared the world’s governments want to be. The level of 25% (of population covered by stockpiles) is based on previous pandemics that suggest about a quarter of all people would get sick. Some countries have ordered more than this so that emergency workers can take the drug continuously to prevent them catching the virus.
Last week, the United States revealed that it would spend $7.1 billion preparing for a flu pandemic. Much of this money will be spent on buying drugs, while only $250m will be made available for foreign assistance. Such a wide disparity between the finance available for national and international programmes is by no means unique. While the most rational way to tackle the problem is to focus resources on stamping out highly contagious bird flu in a co-ordinated global way, rich countries are obliged to draw up their own fall-back plans in case such a strategy fails. However, the costs of responding at home are far higher than elimination at source.
How Dr Chan intends to defend the planet from pandemics
關於這次SEAR會議，我想要負責處理SEAR會員國的印尼針對辛布宣言裡面所重視的部份進行探討它的因素！
光狐
http://0rz.tw/a931U
The World Health Organisation
基本上講述印尼為什麼不提供禽流感病毒樣本的原因來自於窮國雖然提供疾病的樣本，但是卻無法拿到足夠的疫苗來預防疾病，而這些國家卻也是最有可能爆發流行的國家。所以這就是現在的WHO秘書長陳馮富珍所以想辦法解決的問題。
How Dr Chan intends to defend the planet from pandemics
Jun 14th 2007 | GENEVA
From The Economist print edition
The new powers vested in a UN agency's boss should, in theory, cut the risk of killer diseases raging round the world
WITH its big electronic screens and global satellite links, the command centre feels like the heart of a vast military campaign. Every morning, there are strategy sessions to mull the latest intelligence, and rapid-response teams are sent to remote places at the commander's bidding.
In this case, the control room answers not to any general, but to the World Health Organisation (WHO)—the Geneva-based United Nations agency whose job is to monitor and respond to infectious diseases. In recent years, it has nipped in the bud over six dozen outbreaks that could have led to global crises. Unless outbreaks are spotted early, and virus strains shared with researchers worldwide, there is a recurring risk of a pandemic similar to the strains of influenza which caused havoc over the past century (see table).
That may sound obvious, but in practice, countries don't always help the WHO. In 2002, when the respiratory disease dubbed SARS emerged in China, the authorities hid the early signs for fear of hurting trade and tourism. More recently, Indonesia has been mired in a more intractable dispute—raising hard questions about the balance of economic power in the world.
Last year, the Indonesians stopped giving the WHO samples of the H5 virus which is responsible for avian flu, a disease that has forced a mass slaughter of poultry in many countries and could, if it mutates, cause a deadly epidemic among humans. Indonesia won some sympathy for its complaint that it was giving away precious intellectual property, while it might well be unable to afford the vaccines which are then developed. There was little the WHO could do in response.
However the agency's hand will be strengthened by a treaty that enters force on June 15th. The new “international health regulations” (IHRs) oblige governments to co-operate with Margaret Chan, the WHO's director-general, and report potential pandemics at once. If it succeeds, this could lead to a “good-governance revolution” in disease prevention, says David Fidler of Indiana University.
But will it work? Sceptics are not short of arguments. The new system requires countries to do a lot of things to improve public health, but provides no money. Implementing the treaty could prove hard in federal states like Canada and the United States, adds Kumanan Wilson of the University of Toronto; some of the actions required by the IHRs are handled at state or provincial level. Even so, the IHRs have one advantage over treaties like the Kyoto protocol on climate change. At least in the short term, Kyoto imposes heavy costs on some countries that are hard to explain to voters. But every country has an immediate, obvious interest in avoiding pandemics. That, in principle, could put a great deal of power in Dr Chan's hands.
The new treaty commits countries to tell her within 24 hours of any emerging global health threat, something they have often failed to do. In a break with normal UN practice, the WHO will no longer be required only to rely on data from member governments: it can now use non-government sources, including the press and the internet, in its surveillance. If a country tries to hide vital data about a potential pandemic, Dr Chan can override national sensitivities and ring the alarm bells.
That sounds promising, but it does not quite deal with the problem raised by Indonesia. Poor countries, where most potential pandemics start, rarely have the health facilities or vaccine-making capacity to combat a serious outbreak on their own; they rely on external help and vaccine imports. They complain that big firms in rich countries are exploiting their vulnerability. Indonesian officials put it bluntly: why should they hand over precious virus strains when the resultant vaccine may never benefit their people?
The Indonesians have a point. It is true that most of the factories that make pandemic vaccines are located in rich countries, and those plants cannot make enough to cover even the rich world's needs. And in previous global health panics, it has been obvious that rich states think of their own voters first. So at a WHO assembly in May, rich countries agreed that the poor must have access to life-saving vaccines in the event of a pandemic; Indonesia duly agreed to share its virus samples again. On June 13th Dr Chan announced plans to create a global stockpile of avian flu vaccine with the help of donations from GlaxoSmithKline, a British drugs firm, and others.
Fine, but how exactly any strategic stockpile will be split up during a global pandemic remains a mystery. The new rules do not offer much help on that front.
What Indonesia and other poor states really want is to have vaccine-making units within their borders. The WHO has helped a few poor countries to start such plants, but the technology involved is tricky. Not every country in the world can expect to have such factories; and those that do may well resist the idea of helping rival states. As Laurie Garrett of America's Council on Foreign Relations notes, Indonesian politicians would balk at sharing vaccines with Papua New Guinea. That explains why stockpiling and building new factories are partial answers at best to the global challenge.
Perhaps the best reason to take the IHRs seriously is that by making it harder for governments to hide pandemic data, they make innovation more likely. And innovation is desperately needed: today's vaccines cannot be made in the volume needed for the whole world, and they cannot keep up with the evolution of some virus strains. But as Joseph Hogan of GE, an industrial firm with a health division, points out, smarter vaccines and more efficient manufacturing may solve that problem. Vijay Samant of Vical—one of several firms now investing heavily in a new generation of pandemic technology—also welcomes the increased powers for Dr Chan and her agency. “Without access to the latest strains, researchers can't come up with new vaccines,” he argues. Dr Chan faces a big job, and big expectations.
光狐
http://0rz.tw/a931U
The World Health Organisation
基本上講述印尼為什麼不提供禽流感病毒樣本的原因來自於窮國雖然提供疾病的樣本，但是卻無法拿到足夠的疫苗來預防疾病，而這些國家卻也是最有可能爆發流行的國家。所以這就是現在的WHO秘書長陳馮富珍所以想辦法解決的問題。
How Dr Chan intends to defend the planet from pandemics
Jun 14th 2007 | GENEVA
From The Economist print edition
The new powers vested in a UN agency's boss should, in theory, cut the risk of killer diseases raging round the world
WITH its big electronic screens and global satellite links, the command centre feels like the heart of a vast military campaign. Every morning, there are strategy sessions to mull the latest intelligence, and rapid-response teams are sent to remote places at the commander's bidding.
In this case, the control room answers not to any general, but to the World Health Organisation (WHO)—the Geneva-based United Nations agency whose job is to monitor and respond to infectious diseases. In recent years, it has nipped in the bud over six dozen outbreaks that could have led to global crises. Unless outbreaks are spotted early, and virus strains shared with researchers worldwide, there is a recurring risk of a pandemic similar to the strains of influenza which caused havoc over the past century (see table).
That may sound obvious, but in practice, countries don't always help the WHO. In 2002, when the respiratory disease dubbed SARS emerged in China, the authorities hid the early signs for fear of hurting trade and tourism. More recently, Indonesia has been mired in a more intractable dispute—raising hard questions about the balance of economic power in the world.
Last year, the Indonesians stopped giving the WHO samples of the H5 virus which is responsible for avian flu, a disease that has forced a mass slaughter of poultry in many countries and could, if it mutates, cause a deadly epidemic among humans. Indonesia won some sympathy for its complaint that it was giving away precious intellectual property, while it might well be unable to afford the vaccines which are then developed. There was little the WHO could do in response.
However the agency's hand will be strengthened by a treaty that enters force on June 15th. The new “international health regulations” (IHRs) oblige governments to co-operate with Margaret Chan, the WHO's director-general, and report potential pandemics at once. If it succeeds, this could lead to a “good-governance revolution” in disease prevention, says David Fidler of Indiana University.
But will it work? Sceptics are not short of arguments. The new system requires countries to do a lot of things to improve public health, but provides no money. Implementing the treaty could prove hard in federal states like Canada and the United States, adds Kumanan Wilson of the University of Toronto; some of the actions required by the IHRs are handled at state or provincial level. Even so, the IHRs have one advantage over treaties like the Kyoto protocol on climate change. At least in the short term, Kyoto imposes heavy costs on some countries that are hard to explain to voters. But every country has an immediate, obvious interest in avoiding pandemics. That, in principle, could put a great deal of power in Dr Chan's hands.
The new treaty commits countries to tell her within 24 hours of any emerging global health threat, something they have often failed to do. In a break with normal UN practice, the WHO will no longer be required only to rely on data from member governments: it can now use non-government sources, including the press and the internet, in its surveillance. If a country tries to hide vital data about a potential pandemic, Dr Chan can override national sensitivities and ring the alarm bells.
That sounds promising, but it does not quite deal with the problem raised by Indonesia. Poor countries, where most potential pandemics start, rarely have the health facilities or vaccine-making capacity to combat a serious outbreak on their own; they rely on external help and vaccine imports. They complain that big firms in rich countries are exploiting their vulnerability. Indonesian officials put it bluntly: why should they hand over precious virus strains when the resultant vaccine may never benefit their people?
The Indonesians have a point. It is true that most of the factories that make pandemic vaccines are located in rich countries, and those plants cannot make enough to cover even the rich world's needs. And in previous global health panics, it has been obvious that rich states think of their own voters first. So at a WHO assembly in May, rich countries agreed that the poor must have access to life-saving vaccines in the event of a pandemic; Indonesia duly agreed to share its virus samples again. On June 13th Dr Chan announced plans to create a global stockpile of avian flu vaccine with the help of donations from GlaxoSmithKline, a British drugs firm, and others.
Fine, but how exactly any strategic stockpile will be split up during a global pandemic remains a mystery. The new rules do not offer much help on that front.
What Indonesia and other poor states really want is to have vaccine-making units within their borders. The WHO has helped a few poor countries to start such plants, but the technology involved is tricky. Not every country in the world can expect to have such factories; and those that do may well resist the idea of helping rival states. As Laurie Garrett of America's Council on Foreign Relations notes, Indonesian politicians would balk at sharing vaccines with Papua New Guinea. That explains why stockpiling and building new factories are partial answers at best to the global challenge.
Perhaps the best reason to take the IHRs seriously is that by making it harder for governments to hide pandemic data, they make innovation more likely. And innovation is desperately needed: today's vaccines cannot be made in the volume needed for the whole world, and they cannot keep up with the evolution of some virus strains. But as Joseph Hogan of GE, an industrial firm with a health division, points out, smarter vaccines and more efficient manufacturing may solve that problem. Vijay Samant of Vical—one of several firms now investing heavily in a new generation of pandemic technology—also welcomes the increased powers for Dr Chan and her agency. “Without access to the latest strains, researchers can't come up with new vaccines,” he argues. Dr Chan faces a big job, and big expectations.
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