Инфекционные заболевания: профилактика и контроль

Tropical Diseases 2018: Defining health security: Neglected diseases in rural Alabama

Crystal M. James

The development of the concept of health security is traced to the World Health Organization’s (WHO) 1946 preamble to its constitution and WHO’s current definition of global health security and as a starting place for defining health security in the United States. It is argued that in ratifying the constitution the initial twenty counties accepted the intent and meaning of terms therein. The United States as one of the twenty initial ratifying nations and as a world leader in the detection and control of diseases has provided leadership and guidance to many lesser developed countries on how to address the environmental conditions and infectious agents that have marked a decrease in many illnesses that were prevalent in 1946. The United States Constitution has been interpreted to give the right to regulate for the general welfare of the people to the individual states in which citizens reside. Therefore, while there are many national agencies that have health policy authority the primary responsibility for the health status of individuals is determined by the state in which they reside. Highlighted are three ways that diseases are neglected and allowed to re-emerge in rural and other marginalized populations in the State of Alabama: 1) lack of surveillance; 2) lack of adequate environmental policies; 3) inadequate housing and other socio-economic indicators. Methods: Data from the Centers for Disease Control & Prevention, United State Census Bureau American Community Survey 2011-2015, and the United States Department of Labor, Bureau of Labor Statistics as compiled in the Community Commons database were used to develop a community health assessment for three counties in rural Alabama (Macon, Lowndes, and Tallapoosa Counties). Review of local and state policies regarding surveillance, sanitation, and environmental health were assessed for impact on the health status of the community as demonstrated in the community health assessment. Results: The health indicators reviewed demonstrated that individuals living in the rural communities selected suffer from many health disparities and have adverse health effects from infections that are deemed to be endemic in lesser developed countries and not found in the United States. Discussion & Conclusions: The local and state policies regarding surveillance, sanitation, and environmental health are not adequately enforced to provide the necessary data to determine prevalence for some illnesses and environmental contamination. Data gaps, inadequate housing and enforcement delays are issues that many marginalized populations in Alabama and other rural communities confront that have led to health disparities and inhibit a culture of health for these Americans.

 

There is developing acknowledgment of the idea of wellbeing security. Be that as it may, there are different and incongruent definitions, deficient elaboration of the idea of wellbeing security in general wellbeing operational terms, and inadequate compromise of the wellbeing security idea with network-based essential social insurance. Increasingly significant, there are significant contrasts in comprehension and utilization of the idea in various settings. Policymakers in industrialized nations accentuate insurance of their populaces particularly against outer dangers, for instance, fear-based oppression and pandemics; while wellbeing laborers and policymakers in creating nations and inside the United Nations framework comprehend the term in a more extensive general wellbeing setting. To be sure, the idea is utilized conflictingly inside the UN offices themselves, for instance, the World Health Organization's prohibitive utilization of the term 'worldwide wellbeing security'. Disparate understandings of 'wellbeing security' by WHO's part states, combined with fears of concealed national security plans, are prompting a breakdown of systems for worldwide participation, for example, the International Health Regulations. Some creating nations are starting to question that globally shared wellbeing observation information is utilized to their greatest advantage. Goals of these contrary understandings are a worldwide need.

In the wake of the 2003 episode of extreme intense respiratory condition (SARS), readiness for general wellbeing crises was impelled into the overall cognizance. The appearance and quick worldwide spread of SARS exhibited to all—including worldwide pioneers, pastors of wellbeing, executives, and heads of state—how an irresistible sickness can quickly cross outskirts and convey wellbeing dangers and monetary blows on an unfathomable scale. From that point forward, the entrenchment of profoundly pathogenic avian flu infection (H5N1) in poultry runs of Asian nations, and the spread of the infection across Europe and into Africa, has put the world on high alarm for a flu pandemic and certified the criticalness of reinforcing general wellbeing frameworks and limit around the world.

Aggravating the difficulties of dangers to general wellbeing security from new and reappearing irresistible maladies and the worries about purposeful scattering of compound or organic substances are the difficulties of guaranteeing singular wellbeing security. These last difficulties incorporate the incomplete plan of widening access to the medications, antibodies, and different mediations expected to control endemic illnesses, for example, intestinal sickness, intense lower respiratory tract contaminations, diarrheal maladies, measles, and tuberculosis, just as to address the continuous issues of HIV/AIDS, disregarded tropical infections, philanthropic crises, and worldwide natural changes.

The scale, range, and unpredictability of these advanced difficulties to wellbeing security call for new methodologies of similar measurement and quality. Shielding the world from transnational wellbeing dangers requests a worldwide general wellbeing point of view and interest in worldwide general wellbeing foundation. The subject of the current year's World Health Day and the World Health Report 2007 is "Worldwide general wellbeing security—the need to diminish the weakness of individuals around the globe to new, intense, or quickly spreading dangers to wellbeing, especially those that cross universal fringes". With a call to all countries to "put resources into wellbeing, and fabricate a more secure future," the World Health Organization (WHO) accentuates the requirement for cooperation among countries to expand our aggregate limit and foundation to react to potential worldwide wellbeing crises and other general wellbeing dangers. As late occasions have appeared, worldwide general wellbeing security is an intricate, expensive, and data serious endeavor that requires solid national general wellbeing administration and foundation, cross-outskirt coordinated effort, ability to recognize issues quickly and structure continuous proof based arrangements, very much prepared and well-prepared workforces, well-working research facilities and administration conveyance frameworks, ability to support intercessions, and capacity to react to startling occasions. Interest in these components will reinforce worldwide general wellbeing security as well as the framework expected to help expand access to human services benefits and improve singular wellbeing results, which would help break the patterns of neediness and political flimsiness and in this manner add to national monetary turn of events and accomplishment of the Millennium Development Goals.

A key driver in the push to reinforce worldwide general wellbeing security is the structure of the recently overhauled International Health Regulations (IHR [2005]), the lawfully restricting worldwide understanding intended to fabricate and fortify national alarm and reaction frameworks. Consistently settled upon by the World Health Assembly on May 23, 2005, the guidelines are the consequence of experience picked up and exercises found out about worldwide general wellbeing security in the course of recent years. This worldwide lawful structure establishes a "significant advancement in the utilization of global law for general wellbeing purposes". It incorporates a responsibility from WHO and from every one of its 193 part states to improve limit with respect to illness counteraction, location, and reaction and gives guidelines to address national general wellbeing dangers that can possibly become worldwide crises. The appropriation of the new guidelines finished a 10-year procedure of modification, invigorated by the pneumonic plague flare-up in India in 1994 and the Ebola hemorrhagic fever flare-up in previous Zaire in 1995. The overhauled guidelines have now gone into power for all WHO part states.