Mayhew Susannah, Van Belle Sara, Hammer Michael
Senior Lecturer, Global Health Department, London School of Hygiene & Tropical Medicine, London, UK.
J Health Serv Res Policy. 2014 Apr;19(2):124-7. doi: 10.1177/1355819613516943. Epub 2013 Dec 23.
At last, climate change does appear to have entered mainstream consciousness. In the scientific community, the climate change debate has shifted from focusing on establishing the truth of the claim that climate change is a reality to warming public opinion to the cause and acknowledging that climate change will have far-reaching effects on how we build, organize and manage climate-responsive social systems including health care systems. There is particular urgency to the debate for health services and systems in low income countries where some of the worst effects of climate change will be felt and where health systems are already over-stretched due to long-term lack of investment, a double burden of disease (preventive and non-communicable), a crisis in human resources and governance deficiencies. Despite the urgency, the health care systems development community appears insular in its interests and actions, and a clear leader that could coordinate the activities of different researchers, research bodies, policy makers and international organizations across relevant sectors including disaster management, climate and health care systems, has yet to emerge. This essay considers the political landscape, possible leaders and why it is necessary for health systems' professionals to move beyond the health sector in order to secure support for health and health care systems development in a post-Millennium Development Goals development framework that is defined by climate change.
最终，气候变化似乎确实已进入主流意识。在科学界，气候变化辩论已从聚焦于确定气候变化是现实这一说法的真实性，转向使公众舆论关注其成因，并承认气候变化将对我们构建、组织和管理包括医疗保健系统在内的应对气候变化的社会系统产生深远影响。对于低收入国家的卫生服务和系统而言，这场辩论尤为紧迫，因为在这些国家，气候变化的一些最严重影响将会显现，而且由于长期缺乏投资、疾病（预防性和非传染性）双重负担、人力资源危机以及治理缺陷，卫生系统早已不堪重负。尽管形势紧迫，但医疗保健系统发展界在其利益和行动上似乎很孤立，而且一个能够协调包括灾害管理、气候和医疗保健系统等相关部门不同研究人员、研究机构、政策制定者和国际组织活动的明确领导者尚未出现。本文探讨了政治格局、可能的领导者，以及为何卫生系统专业人员有必要超越卫生部门，以便在由气候变化定义的后千年发展目标发展框架中为卫生和医疗保健系统发展争取支持。
