Liang K C
Bull Pan Am Health Organ. 1975;9(4):295-9.
The planning of health activities begins with the setting of priorities--that is to say, the selection and arrangement of the problems to be attacked in an order consistent with their gravity and the possibilities that exist for the adoption of effective measures for their soultion. The assignment of priorities not only implies financial, administrative, and manpower support, but also involves the continuing renewal of health workers' interest in fulfilling the tasks that have been entrusted to them. According to the extent and severity of the problem, priorities may have to be envisaged on a world, continental, regional, or local scale. Ever since the beginning of the present century the Governments of the Americas have accorded high priority to malaria control and, since 1954, to its eradication. In recent years malaria programs in the Americas have been classified into three groups according to their epidemiologic status and prospects for the future. As of 1974, Group I included the 12 political units (countries or territories) in which malaria had been eradicated. These units should give suitable priority to activities for ensuring that they remain free of the disease. Group II was composed of eight units whose prospects of achieving eradication within a short period were good. Here the highest priority should go to efforts designed to eliminate residual foci and to complete the last steps toward ultimate eradication. Group III contained 14 units, the majority of which had part of their territories in the consolidation or maintenance phase. In some of these Group III units malaria eradication could be achieved within a short period if additional funds are found; in others the situation is quite different and eradication cannot be expected in a foreseeable time. The latter units should therefore give high priority to activities that will conserve the gains already made (in those areas which are in the consolidation and maintenance phases) and that will gradually reduce the incidence of malaria in areas that are still in the attack phase. In general, when a malaria program is given high priority by the Government concerned, adequate funds for the campaign can be obtained more redily, either through the regular budget or from international and bilateral agencies.
卫生活动的规划始于确定优先事项,也就是说,要按照问题的严重程度以及采取有效措施解决问题的可能性,对拟解决的问题进行选择和排序。确定优先事项不仅意味着要提供财政、行政和人力支持,还涉及不断激发卫生工作者对完成交付给他们的任务的兴趣。根据问题的范围和严重程度,可能需要在全球、大洲、区域或地方层面确定优先事项。自本世纪初以来,美洲各国政府一直高度重视疟疾防治工作,自1954年起则致力于疟疾根除工作。近年来,美洲的疟疾防治项目根据其流行病学状况和未来前景分为三类。截至1974年,第一类包括已根除疟疾的12个政治单位(国家或地区)。这些单位应适当优先开展确保无疟疾的活动。第二类由8个单位组成,它们在短期内实现根除的前景良好。这里应将最高优先事项放在旨在消除残余疫点和完成最终根除的最后步骤的努力上。第三类包括14个单位,其中大多数地区处于巩固或维持阶段。在第三类中的一些单位,如果能找到额外资金,可在短期内实现疟疾根除;而在其他一些单位,情况则大不相同,在可预见的时间内无法实现根除。因此,后一类单位应高度优先开展活动,以巩固已取得的成果(在处于巩固和维持阶段的地区),并逐步降低仍处于流行阶段地区的疟疾发病率。一般来说,当相关政府高度重视疟疾防治项目时,无论是通过正常预算还是从国际和双边机构,都能更轻松地获得开展该运动所需的充足资金。