Kinsman John, Angrén John, Elgh Fredrik, Furberg Maria, Mosquera Paola A, Otero-García Laura, Snacken René, Derrough Tarik, Carrillo Santisteve Paloma, Ciotti Massimo, Tsolova Svetla
Department of Public Health and Clinical Medicine, Epidemiology and Global Health Unit, Umeå University, 901 87, Umeå, Sweden.
European CBRNE Centre, Umeå University, 901 85, Umeå, Sweden.
BMC Health Serv Res. 2018 Jul 6;18(1):528. doi: 10.1186/s12913-018-3326-0.
EU Decision 1082/2013/EU on serious cross-border health threats provides a legal basis for collaboration between EU Member States, and between international and European level institutions on preparedness, prevention, and mitigation in the event of a public health emergency. The Decision provides a context for the present study, which aims to identify good practices and lessons learned in preparedness and response to Middle East Respiratory Syndrome (MERS) (in UK, Greece, and Spain) and poliomyelitis (in Poland and Cyprus).
Based on a documentary review, followed by five week-long country visits involving a total of 61 interviews and group discussions with experts from both the health and non-health sectors, this qualitative case study has investigated six issues related to preparedness and response to MERS and poliomyelitis: national plans and overall preparedness capacity; training and exercises; risk communication; linking policy and implementation; interoperability between the health and non-health sectors; and cross-border collaboration.
Preparedness and response plans for MERS and poliomyelitis were in place in the participating countries, with a high level of technical expertise available to implement them. Nevertheless, formal evaluation of the responses to previous public health emergencies have sometimes been limited, so lessons learned may not be reflected in updated plans, thereby risking mistakes being repeated in future. The nature and extent of inter-sectoral collaboration varied according to the sectors involved, with those sectors that have traditionally had good collaboration (e.g. animal health and food safety), as well as those that have a financial incentive for controlling infectious diseases (e.g. agriculture, tourism, and air travel) seen as most likely to have integrated public health preparedness and response plans. Although the formal protocols for inter-sectoral collaboration were not always up to date, good personal relations were reported within the relevant professional networks, which could be brought into play in the event of a public health emergency. Cross-border collaboration was greatly facilitated if the neighbouring country was a fellow EU Member State.
Infectious disease outbreaks remain as an ongoing threat. Efforts are required to ensure that core public health capacities for the full range of preparedness and response activities are sustained.
欧盟关于严重跨境健康威胁的第1082/2013/EU号决定为欧盟成员国之间以及国际和欧洲层面机构之间在公共卫生紧急事件的防范、预防和缓解方面的合作提供了法律依据。该决定为当前的研究提供了背景，本研究旨在确定在中东呼吸综合征（MERS）（在英国、希腊和西班牙）和脊髓灰质炎（在波兰和塞浦路斯）的防范和应对方面的良好做法和经验教训。
基于文献综述，随后进行了为期五周的国别访问，共进行了61次访谈，并与卫生和非卫生部门的专家进行了小组讨论，这项定性案例研究调查了与MERS和脊髓灰质炎防范和应对相关的六个问题：国家计划和总体防范能力；培训和演练；风险沟通；政策与实施的联系；卫生和非卫生部门之间的互操作性；以及跨境合作。
参与国制定了MERS和脊髓灰质炎的防范和应对计划，并有高水平的技术专长来实施这些计划。然而，对以往公共卫生紧急事件应对措施的正式评估有时有限，因此经验教训可能未反映在更新后的计划中，从而有在未来重犯错误的风险。部门间合作的性质和程度因所涉部门而异，传统上合作良好的部门（如动物卫生和食品安全）以及对控制传染病有经济激励的部门（如农业、旅游业和航空业）被视为最有可能将公共卫生防范和应对计划整合起来。尽管部门间合作的正式协议并非总是最新的，但据报告在相关专业网络内存在良好的个人关系，在公共卫生紧急事件发生时可以发挥作用。如果邻国是欧盟成员国，则跨境合作会得到极大促进。
传染病暴发仍然是一个持续存在的威胁。需要做出努力，以确保维持全面防范和应对活动所需的核心公共卫生能力。
