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应用“同一健康”原则:预防和应对裂谷热疫情的跨部门协调框架

Applying the One Health principles: a trans-sectoral coordination framework for preventing and responding to Rift Valley fever outbreaks.

作者信息

de La Rocque S, Formenty P

出版信息

Rev Sci Tech. 2014 Aug;33(2):555-67. doi: 10.20506/rst.33.2.2288.

Abstract

Rift Valley fever (RVF) is a good example of a disease for which a One Health approach can significantly improve the management of outbreaks: RVF is a vector- borne zoonotic disease, its dynamics differ between eco-epidemiological patterns and are modulated by eco-climatic factors. Therefore, collaboration between sectors, disciplines and role players, as well as an understanding of the local epidemiology of the disease, are key prerequisites for proper risk assessment and outbreak control. These principles drove the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) to develop an inter-sectoral strategic approach, with specific actions recommended for each of the four periods in the development of the outbreak (forecasting and preparedness, alert, epidemic control, post-epidemic). Through several outbreak response missions between 2006 and 2012 in various countries, an implementation framework was developed by WHO, FAO and the national authorities of affected countries and used to build national response action plans. The framework proposes a structured attribution of duty and responsibilities to committees made up of representatives of the various institutional and operational role players, and with clear mandates and terms of reference (TOR). Such an approach, ensuring real-time sharing of information, coherence in the various aspects of the response, and ownership of the strategy, has proven its efficiency. It could also be used, with appropriate adjustments in the TOR, for other zoonotic diseases.

摘要

裂谷热(RVF)是一种采用“同一健康”方法可显著改善疫情管理的疾病的典型例子:裂谷热是一种媒介传播的人畜共患病,其动态在生态流行病学模式之间存在差异,并受生态气候因素调节。因此,各部门、学科和参与者之间的合作以及对该疾病当地流行病学的了解,是进行适当风险评估和疫情控制的关键先决条件。这些原则促使联合国粮食及农业组织(粮农组织)和世界卫生组织(世卫组织)制定了一种跨部门战略方法,并针对疫情发展的四个阶段(预测与准备、警报、疫情控制、疫情后)分别推荐了具体行动。通过2006年至2012年期间在各国开展的数次疫情应对任务,世卫组织、粮农组织和受影响国家的国家当局制定了一个实施框架,并用于制定国家应对行动计划。该框架提议对由各机构和业务参与者代表组成的委员会进行职责和责任的结构化分配,并赋予其明确的任务和职权范围(TOR)。这种方法确保了信息的实时共享、应对各方面的一致性以及战略的自主性,已证明其有效性。对职权范围进行适当调整后,它也可用于其他人畜共患病。

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