Druetz Thomas, Bicaba Frank, Zainabou Cissé, Bicaba Abel
Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada.
Centre de Recherche en Santé Publique, Montreal, QC, Canada.
Community Health Equity Res Policy. 2025 Jul;45(4):375-384. doi: 10.1177/2752535X241256414. Epub 2024 May 30.
ContextPresenting the COVID-19 crisis as a pandemic misleadingly implies a certain homogeneity between the regions of the Globe in terms of their burden and reactions. However, from the outset of the crisis, countries presented different epidemiological realities and sometimes adopted divergent, even opposing measures. Curiously, the heterogeneity of responses persisted as scientific evidence accumulated about COVID-19 and the strategies for dealing with it.Case studyThis commentary aims to recount the specific experience of Burkina Faso, and how it reoriented its initial biomedical response into a multisectoral strategy. Burkina Faso set up a committee specifically to examine the effects not only of the pandemic, but also of the control measures. This committee was mandated to decompartmentalize the lens through which the COVID-19 was dealt with. It entered into dialogue with a level of stakeholders often overlooked during national health crisis: communities. As a member of this "National Committee for Crisis Management of the Pandemic", one of the co-authors contributed to its orientations and has witnessed first-hand some of the challenges it faced.RecommendationsThis experience suggests that the project of extricating the field of public health from medicine is advancing in Burkina Faso. In order to manage future crises more effectively and across different sectors, there is an urgent need to establish state structures and to strengthen public health systems. States need coordination units that have the legitimacy, authority and resources required to mobilize a variety of actors at the community, national and international levels.
背景
将新冠疫情描述为大流行会误导性地暗示全球各地区在负担和应对措施方面存在某种同质性。然而，从危机一开始，各国就呈现出不同的流行病学现实，有时还采取了不同甚至相反的措施。奇怪的是，随着关于新冠疫情及其应对策略的科学证据不断积累，应对措施的异质性依然存在。
案例研究
本评论旨在讲述布基纳法索的具体经历，以及该国如何将最初的生物医学应对措施重新调整为多部门战略。布基纳法索专门成立了一个委员会，不仅审查疫情的影响，还审查控制措施的影响。该委员会的任务是打破应对新冠疫情时的条块分割视角。它与在国家卫生危机期间经常被忽视的一级利益相关者展开对话：社区。作为“大流行危机国家管理委员会”的成员之一，本文的一位共同作者为其工作方向做出了贡献，并亲眼目睹了它所面临的一些挑战。
建议
这一经历表明，布基纳法索正在推进将公共卫生领域从医学中分离出来的项目。为了更有效地管理未来的危机并跨越不同部门，迫切需要建立国家架构并加强公共卫生系统。各国需要有协调单位，这些单位要具备在社区、国家和国际层面动员各种行为体所需的合法性、权威和资源。
