Chattu Vijay Kumar, Knight W Andy, Adisesh Anil, Yaya Sanni, Reddy K Srikanth, Di Ruggiero Erica, Aginam Obijiofor, Aslanyan Garry, Clarke Michael, Massoud M Rashad, Jha Ashish
Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Division of Occupational Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Health Promot Perspect. 2021 Feb 7;11(1):20-31. doi: 10.34172/hpp.2021.04. eCollection 2021.
Africa is facing the triple burden of communicable diseases, non-communicable diseases (NCDs), and nutritional disorders. Multilateral institutions, bilateral arrangements, and philanthropies have historically privileged economic development over health concerns. That focus has resulted in weak health systems and inadequate preparedness when there are outbreaks of diseases. This review aims to understand the politics of disease control in Africa and global health diplomacy's (GHD's) critical role. A literature review was done in Medline/PubMed, Web of Science, Scopus, Embase, and Google scholar search engines. Keywords included MeSH and common terms related to the topics: "Politics," "disease control," "epidemics/ endemics," and "global health diplomacy" in the "African" context. The resources also included reports of World Health Organization, United Nations and resolutions of the World Health Assembly (WHA). African countries continue to struggle in their attempts to build health systems for disease control that are robust enough to tackle the frequent epidemics that plague the continent. The politics of disease control requires the crafting of cooperative partnerships to accommodate the divergent interests of multiple actors. Recent outbreaks of COVID-19 and Ebola had a significant impact on African economies. It is extremely important to prioritize health in the African development agendas. The African Union (AU) should leverage the momentum of the rise of GHD to (i) navigate the politics of global health governance in an interconnected world(ii) develop robust preparedness and disease response strategies to tackle emerging and reemerging disease epidemics in the region (iii) address the linkages between health and broader human security issues driven by climate change-induced food, water, and other insecurities (iv) mobilize resources and capacities to train health officials in the craft of diplomacy. The AU, Regional Economic Communities (RECs), and African Centres for Disease Control should harmonize their plans and strategies and align them towards a common goal that integrates health in African development agendas. The AU must innovatively harness the practice and tools of GHD towards developing the necessary partnerships with relevant actors in the global health arena to achieve the health targets of the Sustainable Development Goals.
非洲正面临传染病、非传染性疾病和营养失调的三重负担。多边机构、双边安排和慈善机构在历史上一直将经济发展置于比健康问题更优先的地位。这种关注导致了卫生系统薄弱，在疾病爆发时准备不足。本综述旨在了解非洲疾病控制的政治情况以及全球卫生外交（GHD）的关键作用。在Medline/PubMed、科学网、Scopus、Embase和谷歌学术搜索引擎上进行了文献综述。关键词包括医学主题词（MeSH）以及与这些主题相关的常用术语：“政治”、“疾病控制”、“流行病/地方病”和“非洲背景下的全球卫生外交”。资源还包括世界卫生组织、联合国的报告以及世界卫生大会（WHA）的决议。非洲国家在努力建立足以应对困扰该大陆频繁流行病的疾病控制卫生系统方面仍在苦苦挣扎。疾病控制的政治需要精心打造合作伙伴关系，以适应多个行为体的不同利益。最近的新冠疫情和埃博拉疫情对非洲经济产生了重大影响。在非洲发展议程中优先考虑健康极为重要。非洲联盟（AU）应利用全球卫生外交兴起的势头，（i）在相互关联的世界中驾驭全球卫生治理的政治；（ii）制定强有力的防范和疾病应对战略，以应对该地区新出现和再次出现的疾病流行；（iii）解决由气候变化引发的粮食、水和其他不安全因素所驱动的健康与更广泛的人类安全问题之间的联系；（iv）调动资源和能力，培训卫生官员掌握外交技巧。非洲联盟、区域经济共同体（RECs）和非洲疾病控制中心应协调其计划和战略，并使其朝着将健康纳入非洲发展议程的共同目标看齐。非洲联盟必须创新性地利用全球卫生外交的实践和工具，与全球卫生领域的相关行为体建立必要的伙伴关系，以实现可持续发展目标的卫生指标。
