Center for Bioethics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Ethics and Health Policy, School of Population Medicine and Public Health, Peking Union Medical College, Beijing, China.
Front Public Health. 2023 Jan 20;10:1076970. doi: 10.3389/fpubh.2022.1076970. eCollection 2022.
Since "Global Polio Eradication Initiative" was launched by World Health Assembly in 1988, the incidence rate of polio has been reduced by more than 99%, and the whole world has entered a post polio era nowadays. China has been a polio free status recognized by World Health Organization for 22 years and most people believe that no more public health concerns need to be given. How is the population of polio survivors in China? What strategies of health economics and actions of public health for those with polio are ethically appropriate? This article, first of all, deeply summarizes and analyzes the history, current situation and unmet needs of population with polio sequelae and post-polio syndrome in China, and then, puts forward important issues faced by polio survivors who natural infected and who due to vaccine associated paralytic polio and vaccine derived poliovirus. The management of polio survivor is not only a medical and rehabilitation problem involving accessibility, accommodations, but also a public health issue, and most importantly, an ethical concern. Furthermore, from the perspective of ethics such as Justice and Cooperation, the author demonstrates the rationality and necessity of continuing to pay more attention to polio sequela cases at this stage in China. Finally, many valuable suggestions and practical recommendations are given.
自 1988 年世界卫生大会发起“全球消灭脊髓灰质炎倡议”以来,脊髓灰质炎的发病率已经降低了 99%以上,全球目前已进入脊髓灰质炎后时代。中国已连续 22 年保持无脊灰状态,大多数人认为无需再关注公共卫生问题。那么中国的脊灰幸存者人口数量是多少?在经济健康策略和公共卫生行动方面,对于脊灰幸存者采取何种措施才是合乎伦理的?本文首先深入总结和分析了中国脊灰后遗留问题和脊灰后综合征患者的历史、现状和未满足的需求,然后提出了自然感染脊灰病毒和因疫苗相关麻痹性脊灰及疫苗衍生脊灰病毒而感染脊灰的幸存者所面临的重要问题。脊灰幸存者的管理不仅是一个涉及可及性、适应性的医疗和康复问题,还是一个公共卫生问题,最重要的是一个伦理问题。此外,作者从正义和合作等伦理角度出发,论证了在现阶段中国继续更加关注脊灰后遗留问题的合理性和必要性。最后,本文提出了许多有价值的建议和实用建议。