Choi Eun Kyung, Lee Jong-Koo
Institute of Medical History and Culture, Seoul National University Hospital.
JW LEE Center for Global Medicine, Office of Policy Development for Health Society, Seoul National University College of Medicine.
Uisahak. 2016 Dec;25(3):489-518. doi: 10.13081/kjmh.2016.25.489.
This paper focus upon the changes of global infectious disease governance in 2000s and the transformation of infectious disease control system in South Korea. Traditionally, infectious disease was globally governed by the quarantine regulated by the international conventions. When an infectious disease outbreak occurred in one country, each country prevented transmission of the disease through the standardized quarantine since the installation of international sanitary convention in 1892. Republic of Korea also organized the infectious disease control system with quarantine and disease report procedure after the establishment of government. Additionally, Korea National Health Institute(KNIH) was founded as research and training institute for infectious disease. However, traditional international health regulation system faced a serious challenge by the appearance of emerging and re-emerging infectious disease in 1990s. As a result, global infectious disease governance was rapidly changed under the demand to global disease surveillance and response. Moreover, global health security frame became important after 2001 bioterror and 2003 SARS outbreak. Consequently, international health regulation was fully revised in 2005, which included not only infectious disease but also public health emergency. The new international health regime was differently characterized in several aspects; reinforcement of global cooperation and surveillance, enlargement of the role of supranational and international agencies, and reorganization of national capacity. KNIH was reorganized with epidemic control and research since late 1990s. However, in 2004 Korea Center for Disease Control and Prevention(KCDC) was established as a disease control institution with combining quarantine and other functions after 2003 SARS outbreak. KCDC unified national function against infectious disease including prevention, protection, response and research, as a national representative in disease control. The establishment of KCDC can be understood as the adoption of new international health regulation system based upon SARS experience.
本文聚焦于21世纪全球传染病治理的变化以及韩国传染病控制系统的转型。传统上,传染病由国际公约规定的检疫措施进行全球治理。自1892年国际卫生公约设立以来,当一个国家发生传染病疫情时,各国通过标准化检疫措施防止疾病传播。韩国在建国后也建立了包括检疫和疾病报告程序在内的传染病控制系统。此外,韩国国立卫生研究院(KNIH)作为传染病研究和培训机构而成立。然而,20世纪90年代出现的新出现和重新出现的传染病给传统的国际卫生监管系统带来了严峻挑战。结果,在全球疾病监测和应对需求的推动下,全球传染病治理迅速发生变化。此外,在2001年生物恐怖袭击和2003年非典疫情爆发后,全球卫生安全框架变得至关重要。因此,2005年对国际卫生条例进行了全面修订,其中不仅包括传染病,还涵盖公共卫生紧急情况。新的国际卫生制度在几个方面具有不同的特点;加强全球合作与监测、扩大超国家和国际机构的作用以及重组国家能力。自20世纪90年代末以来,KNIH进行了重组,承担疫情防控和研究工作。然而,在2003年非典疫情爆发后,2004年韩国疾病控制与预防中心(KCDC)作为一个整合了检疫和其他职能的疾病控制机构而成立。KCDC作为国家疾病控制的代表,统一了国家针对传染病的预防、保护、应对和研究等职能。KCDC的成立可以被理解为基于非典经验对新的国际卫生监管系统的采纳。