Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique.
Int J Health Plann Manage. 2020 Sep;35(5):997-1000. doi: 10.1002/hpm.3015. Epub 2020 Jul 10.
The COVID-19 pandemic lead scientists and governmental authorities to issue clinical and public health recommendations based on progressively emerging evidence and expert opinions and many of these fast-tracked to peer-reviewed publications. Concerns were raised on scientific quality and generalizability of this emerging evidence.
However, this way acting is not entirely new and often public health decisions are based on flawed and ambiguous evidence. Thus, to better guide decisions in these circumstances, in this article we argue that there is a need to follow fundamental principles in order to guide best public health practices. We purpose the usefulness of the framework of principalism in public which has been proved useful in real life conditions as a guide in the absence of reliable evidence.
It is recommended the implementation of these principles in an integrated manner adopting an holistic system approach to health policies adapted to specificities of local contexts.
COVID-19 大流行促使科学家和政府当局基于不断涌现的证据和专家意见发布临床和公共卫生建议，其中许多建议被快速发表在同行评议的出版物上。人们对这些快速出现的证据的科学性和普遍性提出了质疑。
然而，这种做法并非全新的，而且公共卫生决策通常基于有缺陷和模糊的证据。因此，为了在这些情况下更好地指导决策，我们认为有必要遵循一些基本原则，以指导最佳的公共卫生实践。我们认为，在缺乏可靠证据的情况下，实用主义原则框架在公共卫生领域具有指导作用，这是有意义的。
建议综合实施这些原则，采取整体系统方法制定卫生政策，以适应当地具体情况的特殊性。
