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流行病学在国家兽医服务中的应用:巴西面临的挑战与威胁

The application of epidemiology in national veterinary services: Challenges and threats in Brazil.

作者信息

Gonçalves Vitor Salvador Picão, de Moraes Geraldo Marcos

机构信息

EpiPlan, Faculdade de Agronomia e Medicina Veterinária, Universidade de Brasília, Campus Darcy Ribeiro, Asa Norte, ICC Sul-CP. 4508, Brasília CEP: 70.910-970, Brazil.

EpiPlan, Faculdade de Agronomia e Medicina Veterinária, Universidade de Brasília, Campus Darcy Ribeiro, Asa Norte, ICC Sul-CP. 4508, Brasília CEP: 70.910-970, Brazil; Coordenação de Planejamento, Avaliação e Controle Zoossanitário do Departamento de Saúde Animal, Secretaria de Defesa Agropecuária, Ministério da Agricultura, Pecuária e Abastecimento, Esplanada dos Ministérios, Bloco "D", Edifício Anexo-3° andar, Brasília CEP: 70.043-900, Brazil.

出版信息

Prev Vet Med. 2017 Feb 1;137(Pt B):140-146. doi: 10.1016/j.prevetmed.2016.11.018. Epub 2016 Dec 15.

Abstract

The application of epidemiology in national veterinary services must take place at the interface between science and politics. Animal health policy development and implementation require attention to macro-epidemiology, the study of economic, social and policy inputs that affect the distribution and impact of animal or human disease at the national level. The world has changed fast over the last three decades including the delivery of veterinary services, their remit and the challenges addressed by public and animal health policies. Rethinking the role of public services and how to make public programs more efficient has been at the heart of the political discussion. The WTO through its SPS Agreement has changed the way in which national veterinary services operate and how trade decisions are made. Most low and middle income countries are still struggling to keep up with the new international scene. Some of these countries, such as Brazil, have very important livestock industries and are key to the global food systems. Over the last two decades, Brazil became a leading player in exports of livestock products, including poultry, and this created a strong pressure on the national veterinary services to respond to trade demands, leading to focus animal health policies on the export-driven sector. During the same period, Brazil has gone a long way in the direction of integrating epidemiology with veterinary services. Epidemiology groups grew at main universities and have been working with government to provide support to animal health policy. The scope and quality of the applied epidemiological work improved and focused on complex data analysis and development of technologies and tools to solve specific disease problems. Many public veterinary officers were trained in modern epidemiological methods. However, there are important institutional bottlenecks that limit the impact of epidemiology in evidence-based decision making. More complex challenges require high levels of expertise in veterinary epidemiology, as well as institutional models that provide an appropriate environment for building and sustaining capacity in national veterinary services. Integrating epidemiology with animal health policy is a great opportunity if epidemiologists can understand the real issues, including the socio-economic dimensions of disease management, and focus on innovation and production of knowledge. It may be a trap if epidemiologists are restricted to answering specific decision-making questions and policy makers perceive their role exclusively as data analysts or providers of technological solutions. Fostering solutions for complex issues is key to successful integration with policy making.

摘要

流行病学在国家兽医服务中的应用必须在科学与政治的交汇点上进行。动物卫生政策的制定和实施需要关注宏观流行病学,即研究影响国家层面动物或人类疾病分布及影响的经济、社会和政策因素。在过去三十年里,世界发生了迅速变化,包括兽医服务的提供方式、其职责范围以及公共卫生和动物卫生政策所应对的挑战。重新思考公共服务的作用以及如何提高公共项目的效率一直是政治讨论的核心。世界贸易组织通过其《卫生与植物卫生措施协议》改变了国家兽医服务的运作方式以及贸易决策的制定方式。大多数低收入和中等收入国家仍在努力跟上新的国际形势。其中一些国家,如巴西,拥有非常重要的畜牧业,是全球粮食系统的关键。在过去二十年里,巴西成为包括家禽在内的畜产品出口的主要参与者,这给国家兽医服务带来了巨大压力,要求其回应贸易需求,导致动物卫生政策聚焦于出口驱动型部门。同一时期,巴西在将流行病学与兽医服务相结合方面取得了长足进展。主要大学的流行病学团队不断壮大,并一直与政府合作,为动物卫生政策提供支持。应用流行病学工作的范围和质量得到了改善,侧重于复杂数据分析以及解决特定疾病问题的技术和工具开发。许多公共兽医官员接受了现代流行病学方法的培训。然而,存在重要的体制瓶颈,限制了流行病学在循证决策中的影响。更复杂的挑战需要高水平的兽医流行病学专业知识,以及为国家兽医服务的能力建设和维持提供适宜环境的体制模式。如果流行病学家能够理解实际问题,包括疾病管理的社会经济层面,并专注于创新和知识生产,那么将流行病学与动物卫生政策相结合是一个巨大的机遇。但如果流行病学家仅限于回答特定的决策问题,而政策制定者仅将其角色视为数据分析师或技术解决方案提供者,那可能会陷入困境。推动解决复杂问题是成功与政策制定相结合的关键。

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