Harvard Humanitarian Initiative, Harvard University & T.H. Chan School of Public Health, Cambridge, MassachusettsUSA.
Woodrow Wilson International Center for Scholars, Washington, DCUSA.
Prehosp Disaster Med. 2020 Jun;35(3):237-246. doi: 10.1017/S1049023X20000424. Epub 2020 Apr 8.
Public health emergencies of international concern, in the form of infectious disease outbreaks, epidemics, and pandemics, represent an increasing risk to the world's population. Management requires coordinated responses, across many disciplines and nations, and the capacity to muster proper national and global public health education, infrastructure, and prevention measures. Unfortunately, increasing numbers of nations are ruled by autocratic regimes which have characteristically failed to adopt investments in public health infrastructure, education, and prevention measures to keep pace with population growth and density. Autocratic leaders have a direct impact on health security, a direct negative impact on health, and create adverse political and economic conditions that only complicate the crisis further. This is most evident in autocratic regimes where health protections have been seriously and purposely curtailed. All autocratic regimes define public health along economic and political imperatives that are similar across borders and cultures. Autocratic regimes are seriously handicapped by sociopathic narcissistic leaders who are incapable of understanding the health consequences of infectious diseases or the impact on their population. A cross section of autocratic nations currently experiencing the impact of COVID-19 (coronavirus disease 2019) are reviewed to demonstrate the manner where self-serving regimes fail to manage health crises and place the rest of the world at increasing risk. It is time to re-address the pre-SARS (severe acute respiratory syndrome) global agendas calling for stronger strategic capacity, legal authority, support, and institutional status under World Health Organization (WHO) leadership granted by an International Health Regulations Treaty. Treaties remain the most successful means the world has in preventing, preparing for, and controlling epidemics in an increasingly globalized world."Honesty is worth a lot more than hope…" The Economist, February 17, 2020.
国际关注的公共卫生突发事件，以传染病暴发、流行和大流行的形式，对世界人口构成越来越大的威胁。管理需要跨多个学科和国家进行协调应对，并且有能力进行适当的国家和全球公共卫生教育、基础设施和预防措施。不幸的是，越来越多的国家由独裁政权统治，这些政权通常未能投资于公共卫生基础设施、教育和预防措施，以跟上人口增长和密度的步伐。独裁领导人直接影响健康安全，对健康产生直接负面影响，并造成不利的政治和经济条件，使危机进一步复杂化。这在卫生保护受到严重和故意限制的独裁政权中最为明显。所有独裁政权都根据经济和政治需要来定义公共卫生，这些需要在国界和文化之间是相似的。独裁政权受到病态自恋领导人的严重阻碍，这些领导人无法理解传染病的健康后果或对其人口的影响。目前正在审查一些正在经历 COVID-19（2019 年冠状病毒病）影响的独裁国家，以展示自私自利的政权未能管理卫生危机并使世界其他地区面临更大风险的方式。现在是时候重新审视 SARS（严重急性呼吸系统综合征）前的全球议程了，这些议程呼吁在世界卫生组织（WHO）领导下加强战略能力、法律权威、支持和机构地位，并根据《国际卫生条例条约》赋予的支持。条约仍然是世界在日益全球化的世界中预防、准备和控制流行病的最成功手段。“诚实比希望更有价值……”《经济学人》，2020 年 2 月 17 日。
