Joint Master's Program in Health Policy and Law, University of California, San Diego School of Medicine - California Western School of Law, San Diego, CA, USA.
National Institutes of Health, National Cancer Institute, U.S. Embassy, China Office, Beijing, China.
BMC Public Health. 2019 Jan 17;19(1):79. doi: 10.1186/s12889-019-6393-1.
On April 28, 2014, the World Health Organization (WHO) declared polio a "Public Health Emergency of International Concern" (PHIC) under the authority of the International Health Regulations. Although polio has been eradicated from nearly every nation on earth, Pakistan is one of three countries where wild polio and vaccine-derived polio strains remain, thwarting global eradication efforts.
Polio eradication progress is complicated by security and conflict issues at the border area between Pakistan and Afghanistan. In addition to security issues, other critical challenges, such as maintaining cold supply chain for vaccines, active and sentinel surveillance, false beliefs about vaccines, distrust of healthcare workers, and accessibility to conflict areas due to terrorist activities, all play a role in the continued persistence of Polio. In response to these challenges, we assess the local and international policy environment and its impact on polio eradication in Pakistan.
Based on our analysis of existing barriers and challenges associated with polio eradication in Pakistan, this study discusses why employing "vaccine diplomacy" represents a key policy and advocacy strategic approach to achieve the overall end game of polio eradication. Specifically, we identify a set of concrete public health, international development, and diplomatic and policy recommendations that can act synergistically under the umbrella of health and vaccine diplomacy to finally put an end to polio.
2014 年 4 月 28 日，世界卫生组织（WHO）根据《国际卫生条例》宣布脊髓灰质炎为“国际关注的公共卫生紧急事件”（PHIC）。尽管地球上几乎每个国家都已经消灭了脊髓灰质炎，但巴基斯坦是三个仍存在野生脊髓灰质炎和疫苗衍生脊髓灰质炎病毒的国家之一，这阻碍了全球消灭脊髓灰质炎的努力。
脊髓灰质炎的消灭工作受到巴基斯坦和阿富汗边境地区安全和冲突问题的复杂影响。除了安全问题之外，其他关键挑战，如维持疫苗冷链、积极和哨点监测、对疫苗的错误信念、对医疗保健工作者的不信任，以及由于恐怖主义活动而难以进入冲突地区，都对脊髓灰质炎的持续存在起到了作用。为应对这些挑战，我们评估了巴基斯坦国内和国际政策环境及其对脊髓灰质炎消灭工作的影响。
基于我们对巴基斯坦脊髓灰质炎消灭工作中存在的障碍和挑战的分析，本研究讨论了为什么采用“疫苗外交”是实现消灭脊髓灰质炎总体终局的关键政策和宣传战略方法。具体来说，我们确定了一系列具体的公共卫生、国际发展以及外交和政策建议，这些建议可以在卫生和疫苗外交的保护伞下协同作用，最终消灭脊髓灰质炎。
