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
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.
2007年9月6日 星期四
WHO’s Regional Committee for South-East Asia calls for continued solidarity to tackle the health challenges
這篇大致上是在描述東南亞國家面臨的一些問題
裡面有提到一個基金
還有提到下次(61屆)會在印度新德里舉辦
Thimphu, Bhutan, 3 September, 2007: The 60th session of WHO’s Regional Committee for South-East Asia concluded here today with a call for continued solidarity and joint endeavours for health development by Member countries. It noted with satisfaction the progress in the implementation of WHO’s collaborative programmes and activities in the Region.
The session took several momentous decisions and would be viewed, “As the session where regional solidarity and togetherness were further strengthened”, said Dr Samlee Plianbangchang, Regional Director for WHO South-East Asia Region.
Member countries of WHO’s South East Asia Region account for approximately 25% of the world population. However, they bear 40% of the world’s disease burden. The Region has the largest number of children missed by immunization, the highest number of deaths from measles, and from complications of pregnancy and childbirth.
Notably, the Committee adopted a resolution to establish the South-East Asia Regional Health Emergency Fund (SEARHEF). The Region is vulnerable to natural and man-made emergencies which impact human health, and accounted for 58% of deaths due to disasters worldwide. This Fund would provide financial support to Member Countries in the first three months after the onset of an emergency. It would be an instrument to tide over affected Member countries in the face of an emergency. The Fund is not meant to finance bulk relief, recovery, reconstruction and rehabilitation which are funded by established mechanisms like Flash Appeals, Consolidated Appeals Process (CAP) and Central Emergency Response Fund (CERF) The Fund would build a corpus from within countries and by raising voluntary contributions. Thailand announced a contribution of US $100,000 for the Fund, during the Regional Committee session.
The Committee deliberated on several issues of regional priority including: i)Nutrition and food safety, ii)Scaling up prevention and control of chronic noncommunicable diseases, iii) TB control iv)Revised malaria control strategy, v)Avian and pandemic influenza preparedness, vi) Public health, innovation and intellectual property rights, and vii) WHO and reforms of the UN system.
The Regional Committee decided that the Technical discussions in 2008 would be on the subject of “Revitalising Primary Health”.
The Regional Committee decided that its 61st session would be held at the SEARO office in New Delhi.
For any clarification or additional information, please contact Ms Vismita Gupta-Smith, the Public Information and Advocacy officer, phone: 91-11-23370971 and mobile: 91- 9871329861 Email: guptasmithv@searo.who.int and Ms Harsaran Pandey, STP-Information Officer, at telephone: 011 23309 465; mobile: 9811021001, email pandeyh@searo.who.int.
All press releases, fact sheets and other WHO media material may be found at: www.searo.who.int.
http://www.searo.who.int/en/Section316/Section503/Section2358_13505.htm
裡面有提到一個基金
還有提到下次(61屆)會在印度新德里舉辦
Thimphu, Bhutan, 3 September, 2007: The 60th session of WHO’s Regional Committee for South-East Asia concluded here today with a call for continued solidarity and joint endeavours for health development by Member countries. It noted with satisfaction the progress in the implementation of WHO’s collaborative programmes and activities in the Region.
The session took several momentous decisions and would be viewed, “As the session where regional solidarity and togetherness were further strengthened”, said Dr Samlee Plianbangchang, Regional Director for WHO South-East Asia Region.
Member countries of WHO’s South East Asia Region account for approximately 25% of the world population. However, they bear 40% of the world’s disease burden. The Region has the largest number of children missed by immunization, the highest number of deaths from measles, and from complications of pregnancy and childbirth.
Notably, the Committee adopted a resolution to establish the South-East Asia Regional Health Emergency Fund (SEARHEF). The Region is vulnerable to natural and man-made emergencies which impact human health, and accounted for 58% of deaths due to disasters worldwide. This Fund would provide financial support to Member Countries in the first three months after the onset of an emergency. It would be an instrument to tide over affected Member countries in the face of an emergency. The Fund is not meant to finance bulk relief, recovery, reconstruction and rehabilitation which are funded by established mechanisms like Flash Appeals, Consolidated Appeals Process (CAP) and Central Emergency Response Fund (CERF) The Fund would build a corpus from within countries and by raising voluntary contributions. Thailand announced a contribution of US $100,000 for the Fund, during the Regional Committee session.
The Committee deliberated on several issues of regional priority including: i)Nutrition and food safety, ii)Scaling up prevention and control of chronic noncommunicable diseases, iii) TB control iv)Revised malaria control strategy, v)Avian and pandemic influenza preparedness, vi) Public health, innovation and intellectual property rights, and vii) WHO and reforms of the UN system.
The Regional Committee decided that the Technical discussions in 2008 would be on the subject of “Revitalising Primary Health”.
The Regional Committee decided that its 61st session would be held at the SEARO office in New Delhi.
For any clarification or additional information, please contact Ms Vismita Gupta-Smith, the Public Information and Advocacy officer, phone: 91-11-23370971 and mobile: 91- 9871329861 Email: guptasmithv@searo.who.int and Ms Harsaran Pandey, STP-Information Officer, at telephone: 011 23309 465; mobile: 9811021001, email pandeyh@searo.who.int.
All press releases, fact sheets and other WHO media material may be found at: www.searo.who.int.
http://www.searo.who.int/en/Section316/Section503/Section2358_13505.htm
Something interesting
By Bush,
I searched google by "辛布+宣言+台灣",
and our blog came out in the first place of the search list.
Haahhh...
I searched google by "辛布+宣言+台灣",
and our blog came out in the first place of the search list.
Haahhh...
2007年9月4日 星期二
International Health Regulations (IHR) 2005
這個在這期的資訊中應該會常常看到，大家可以參考
http://www.who.int/csr/ihr/en/
International Health Regulations (2005)
The successful implementation of the International Health Regulations (2005) or IHR (2005), with the technical support of WHO, by all the countries who committed themselves to meet the new requirements of the Regulations will contribute significantly to enhancing national, regional and international public health security.
The entry into force of the IHR (2005) on 15 June 2007 is a public health landmark for the World Health Organization (WHO) and its Member States. The global community has a new legal framework to better manage its collective defences against acute public health risks that can spread internationally and have devastating impacts on human health as well as unnecessary negative interference on trade and travel.
連結裡面還有相關文件下載，關於辛布宣言中的東西可以延伸到這邊來查詢
http://www.who.int/csr/ihr/en/
International Health Regulations (2005)
The successful implementation of the International Health Regulations (2005) or IHR (2005), with the technical support of WHO, by all the countries who committed themselves to meet the new requirements of the Regulations will contribute significantly to enhancing national, regional and international public health security.
The entry into force of the IHR (2005) on 15 June 2007 is a public health landmark for the World Health Organization (WHO) and its Member States. The global community has a new legal framework to better manage its collective defences against acute public health risks that can spread internationally and have devastating impacts on human health as well as unnecessary negative interference on trade and travel.
連結裡面還有相關文件下載，關於辛布宣言中的東西可以延伸到這邊來查詢
辛布宣言
http://www.searo.who.int/en/Section316/Section503/Section2358_13502.htm
本次的東南亞衛生部長級會議對於本宣言相當有關係，大家可以從這邊尋找相關的議題
25th Meeting of Ministers of Health
Thimphu, Bhutan, 31 August – 1 September 2007
Thimphu Declaration on International Health Security in the South-East Asia Region
We, the Health Ministers of Member States of the World Health Organization’s South-East Asia Region participating in the Twenty-fifth Health Ministers’ Meeting in Thimphu, Bhutan, recognize that in the concept of International Health Security lies the realization that there is a need to reduce the vulnerability of people around the world to the escalation of existing, new, acute or rapidly spreading risks to health, particularly those that threaten to transcend international borders.
We also recognize that rapid globalization with easy, frequent travel, as well as large-scale trade, give an ample opportunity for communicable diseases to spread across borders quickly and with ease.
We are aware that the world climate is changing. Temperatures are rising; tropical storms are increasing in frequency and intensity; polar ice caps and permafrost regions are melting. The acute impact of climate change–related events may be local, but their causes are global.
We are also concerned that no single institution, sector or country has all the capacities needed to respond to international public health emergencies caused by epidemics, natural disasters and humanitarian or environmental emergencies.
We are of the view that the impact of the above threats on human health has serious implications for morbidity and mortality, and will delay internationally agreed upon development goals.
We reiterate our commitment to the World Health Assembly Resolutions related to Emergency Preparedness and Response and International Health Regulations (IHR) 2005.
We note the efforts of WHO’s Regional Office for South-East Asia to:
1)Systematize and measure emergency preparedness and response in health systems through benchmarks, standards and indicators;
2)Systematically support countries in the full implementation of the International Health Regulations (IHR) 2005 strengthening core capacities;
3)Support short-term strategies in stockpiling anti-virals, personal protective devices and pre-pandemic vaccines, as well as long-term strategies to increase influenza vaccine production capacity in the Region; and
4)To mobilize adequate resources to support these activities.
To achieve effective solutions to address issues related to International Health Security, we are committed to:
1.Take further action to improve emergency preparedness and response in line with the World Health Assembly and Regional Committee Resolutions WHA 58.1, WHA 59.20, SEA/RC 57/3, and SEA/RC 58/3;
2.Take further action to implement the International Health Regulations (IHR) 2005 in line with World Health Assembly and Regional Committee Resolutions WHA 58.3 and WHA 59.2, and SEA/RC 58/7;
3.Develop and systematically implement National Emergency Preparedness Plans, taking into account the significant role of private health providers based on country-specific priority benchmarks and indicators within one year and to revisit the plans regularly;
4.Develop and implement action plans towards strengthening core capacities for countries for International Health Regulations (IHR) 2005;
5.Develop and implement national action plans for mitigation and adaptation to address the health impacts of global warming and climate change.
6.Mobilize adequate resources for these initiatives and participate actively in developing and maintaining partnerships related to improving these areas of health.
We, the Health Ministers of WHO’s South-East Asia Region, fully support the establishment of the South-East Asia Regional Health Emergency Fund and commit to the function of the Working Group as well as efforts towards resource mobilization.
We, the Health Ministers of WHO’s South-East Asia Region, urge all Member States as well as the WHO Director-General and the Regional Director for the South-East Asia Region to continue to provide leadership and technical support in building partnerships between governments, United Nations and bilateral agencies, members of academia, professional bodies, NGOs, the private sector and the media and civil society, and to jointly advocate effective follow-up on all aspects of this Thimphu Declaration on International Health Security in the South-East Asia Region.
本次的東南亞衛生部長級會議對於本宣言相當有關係，大家可以從這邊尋找相關的議題
25th Meeting of Ministers of Health
Thimphu, Bhutan, 31 August – 1 September 2007
Thimphu Declaration on International Health Security in the South-East Asia Region
We, the Health Ministers of Member States of the World Health Organization’s South-East Asia Region participating in the Twenty-fifth Health Ministers’ Meeting in Thimphu, Bhutan, recognize that in the concept of International Health Security lies the realization that there is a need to reduce the vulnerability of people around the world to the escalation of existing, new, acute or rapidly spreading risks to health, particularly those that threaten to transcend international borders.
We also recognize that rapid globalization with easy, frequent travel, as well as large-scale trade, give an ample opportunity for communicable diseases to spread across borders quickly and with ease.
We are aware that the world climate is changing. Temperatures are rising; tropical storms are increasing in frequency and intensity; polar ice caps and permafrost regions are melting. The acute impact of climate change–related events may be local, but their causes are global.
We are also concerned that no single institution, sector or country has all the capacities needed to respond to international public health emergencies caused by epidemics, natural disasters and humanitarian or environmental emergencies.
We are of the view that the impact of the above threats on human health has serious implications for morbidity and mortality, and will delay internationally agreed upon development goals.
We reiterate our commitment to the World Health Assembly Resolutions related to Emergency Preparedness and Response and International Health Regulations (IHR) 2005.
We note the efforts of WHO’s Regional Office for South-East Asia to:
1)Systematize and measure emergency preparedness and response in health systems through benchmarks, standards and indicators;
2)Systematically support countries in the full implementation of the International Health Regulations (IHR) 2005 strengthening core capacities;
3)Support short-term strategies in stockpiling anti-virals, personal protective devices and pre-pandemic vaccines, as well as long-term strategies to increase influenza vaccine production capacity in the Region; and
4)To mobilize adequate resources to support these activities.
To achieve effective solutions to address issues related to International Health Security, we are committed to:
1.Take further action to improve emergency preparedness and response in line with the World Health Assembly and Regional Committee Resolutions WHA 58.1, WHA 59.20, SEA/RC 57/3, and SEA/RC 58/3;
2.Take further action to implement the International Health Regulations (IHR) 2005 in line with World Health Assembly and Regional Committee Resolutions WHA 58.3 and WHA 59.2, and SEA/RC 58/7;
3.Develop and systematically implement National Emergency Preparedness Plans, taking into account the significant role of private health providers based on country-specific priority benchmarks and indicators within one year and to revisit the plans regularly;
4.Develop and implement action plans towards strengthening core capacities for countries for International Health Regulations (IHR) 2005;
5.Develop and implement national action plans for mitigation and adaptation to address the health impacts of global warming and climate change.
6.Mobilize adequate resources for these initiatives and participate actively in developing and maintaining partnerships related to improving these areas of health.
We, the Health Ministers of WHO’s South-East Asia Region, fully support the establishment of the South-East Asia Regional Health Emergency Fund and commit to the function of the Working Group as well as efforts towards resource mobilization.
We, the Health Ministers of WHO’s South-East Asia Region, urge all Member States as well as the WHO Director-General and the Regional Director for the South-East Asia Region to continue to provide leadership and technical support in building partnerships between governments, United Nations and bilateral agencies, members of academia, professional bodies, NGOs, the private sector and the media and civil society, and to jointly advocate effective follow-up on all aspects of this Thimphu Declaration on International Health Security in the South-East Asia Region.
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