Health Security最新文献

Beginning in 2016, the Japanese Ministry of Health, Labour and Welfare (MHLW) began stationing liaisons within the US Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response to strengthen cooperation on bilateral health security engagement and collaboration. Notable accomplishments include the establishment of the US-Japan Health Security Committee and collaborations between the US-Japan Disaster Medical Assistance Team on mass event responses, such as the repatriation of American citizens from the Diamond Princess in February 2020 and the COVID-19 response. Japan has also embedded liaisons at the US Centers for Disease Control and Prevention to advance collaboration on public health. In 2021, with COVID-19 highlighting the importance of collaboration on pandemic preparedness, MHLW established a liaison program with the US National Institute of Allergy and Infectious Diseases. These liaisons with HHS agencies have paid dividends to health security collaboration, particularly by enabling greater connections between technical experts in MHLW and HHS.

Upon the commencement of their second term in 2025, the Trump Administration initiated significant policy shifts within health security, driven by an "America First" agenda. This marks a notable departure from the United States' long-standing role as a central and influential leader in global health security. Historically, the US has championed this domain through substantial financial contributions, the sharing of critical technical expertise, and the establishment and support of numerous international health initiatives. This leadership was underpinned by a bipartisan consensus that recognized global health as integral to American values, enhancing its soft power and global standing. Decades of this commitment yielded tangible progress in controlling infectious diseases, strengthening health systems in low- and middle-income countries (LMICs), and fostering essential international cooperation. However, this recent pivot in US policy carries profound implications for the established global health architecture. It is generating a cascade of both tangible and intangible consequences across various health security domains, including funding mechanisms, global health governance, preparedness and response capabilities, outcomes in LMICs, science diplomacy, US soft power, and ultimately, US national security. Given the inherent difficulty in predicting the next pandemic, global solidarity and collective international efforts are paramount. In this, effective prevention and management demand proactive, multidisciplinary preparations worldwide where continued US support and leadership through increased investment in surveillance networks, strengthened international collaboration, and data-driven decisionmaking are instrumental. There is an urgent need for prioritizing global health leadership and ensuring sensible health security policies that reverse the systematic dismantling of established public health infrastructure.

India bears a quarter of the world's tuberculosis (TB) burden. In 2018, the country set an ambitious goal to eliminate TB by 2025-5 years ahead of the global target. While India has launched several large-scale public health initiatives, including Pradhan Mantri TB Mukt Bharat Abhiyan and Ni-kshay Poshan Yojana, several challenges persist that threaten progress toward elimination. These include data transparency issues, overburdened healthcare systems, and an unrealistic timeline for achieving elimination. In this article, we highlight underaddressed health security challenges-including multidrug-resistant TB, weak biosafety infrastructure, relapse without posttreatment monitoring, environmental contributors like air pollution, and a lack of targeted strategies for tribal populations and undocumented immigrants-and call for a revised approach to TB elimination aligned with the global 2030 goal, emphasizing evidence-based policy, improved surveillance, workforce support, multisectoral coordination, and environmental and technological interventions.

Cross-border disease surveillance and response is critical for addressing the increasing burden of infectious disease outbreaks and heavy metal poisoning in West Africa, particularly between Niger and Nigeria. This study assesses the collaborative efforts of Niger and Nigeria in strengthening cross-border disease surveillance, addressing health security threats, and improving response strategies for heavy metal poisoning and infectious diseases. The West African Health Organization, in collaboration with regional partners, convened a cross-border meeting in June 2024, to bring together health experts and key stakeholders from both countries and from regional organizations. The meeting included technical sessions, working group meetings, and the development of a joint action plan. The discussions highlighted major challenges, including gaps in surveillance, delays in data sharing, and resource limitations. Key recommendations from the meeting included harmonizing surveillance tools, strengthening laboratory capacity, enhancing risk communication, and securing funding for sustainable cross-border health initiatives. Strengthened collaboration between Niger and Nigeria is essential to mitigate the public health risks associated with cross-border disease transmission. Policy actions, resource mobilization, and sustained engagement with regional and international partners are necessary for a robust and effective cross-border disease surveillance system.

Efforts to improve global health security should be a key international priority. In this commentary, I argue that while global health security is increasingly perceived as the domain of various professional and academic disciplines, ranging from global health to international relations, it is crucial to recognize it also as a value-based enterprise. Drawing on ethics literature, this commentary shows how a value-based approach is useful for analyzing ethical challenges in global health security in 4 key areas: analyzing the implicit values shaping global health security's problematic meaning, considering whether solidarity might be useful for grounding compensation for those facing an increased surveillance burden, examining how labelling outbreaks by origin can disguise questions of responsibility, and addressing how reasonable demands of nationalism are balanced. If global health security is not acknowledged as a value-based enterprise, there is a risk that those working in it will not develop the skills required to ask necessary moral questions or provide moral justifications that should be provided about their work, ultimately compromising global health security's potential to protect populations globally.

Following a nearly decade-long war in Eastern Ukraine, the conflict escalated in February 2022, and the World Health Organization swiftly began enhanced event-based surveillance (EBS) for the early detection of public health threats in Ukraine and refugee-hosting countries. The aim of this study was to assess the characteristics and trends of signals documented by WHO, especially examining how potential threats to human health in Ukraine and other affected countries were identified and presented during the first 4 months of the Ukraine crisis. The EBS process relied on the daily screening of information coming from different sources, and signals were categorized by public health risks. Between February 26 and June 30, 2022, a total of 208,484 articles were screened in the Epidemic Intelligence from Open Sources system and other sources, identifying 832 recorded signals. Most (94.1%) signals were reported within 2 days of publication of the relevant pieces of information. The most common categories of signals reported were "healthcare capacity" (n=283, 34.0%), followed by "technological hazards" (n=129, 15.5%), "population movement" (n=80, 9.6%), and "infectious diseases" (n=79, 9.5%). Among all signals, 85.5% were relevant to Ukraine. In Ukraine, the largest number of signals (20.4%) were reported from the city of Donetska. Although, resource intensiveness and appropriate balance for desired sensitivity and scope remains a challenge, EBS remains a vital surveillance method to rapidly identify potential health threats during public health events and humanitarian crises-when routine surveillance is weak or disrupted-and to contribute crucial data to guide health information management and planning.

During the COVID-19 pandemic, vaccination rates among pregnant women were notably lower due to concerns about vaccine safety and effectiveness. We investigated the impact of COVID-19 vaccination on hospitalization and illness severity due to COVID-19 among pregnant women. Data were obtained from the Korea Disease Control and Prevention Agency's COVID-19 National Health Insurance Service cohort, including 2,235 pregnant women and 6,733 nonpregnant women (1:3 matched) infected with COVID-19 between October 2020 and December 2021. COVID-19 vaccination status was categorized as unvaccinated, first dose only, and fully vaccinated (2 or more doses). Logistic regression was performed to identify factors associated with hospitalization and illness severity. Among pregnant women infected with COVID-19, 88.4% were unvaccinated, 4.6% received 1 dose, and 7.1% were fully vaccinated, compared to 61.3%, 8.1%, and 30.6%, respectively, for nonpregnant women. The odds ratio (OR) for hospitalization was significantly higher for pregnant women compared to nonpregnant women (OR=1.78). Within the pregnant women cohort, the OR for hospitalization was 0.92 for those who received the first vaccine dose and 0.37 for those who were fully vaccinated, demonstrating a significantly lower hospitalization rate only in the fully vaccinated group. A similar pattern was observed for illness severity, with ORs of 0.74 for the first dose and 0.33 for full vaccination, indicating a significantly lower rate of severe illness only in the fully vaccinated group. Additionally, high-risk pregnant women exhibited significantly higher odds of both hospitalization and severe illness. These findings demonstrate that full COVID-19 vaccination coverage (2 or more doses) is strongly associated with decreased hospitalization and severe illness among pregnant women. Addressing vaccine hesitancy through prenatal care discussions and improving vaccine accessibility is essential to enhance maternal health outcomes.

New York City has been the epicenter of multiple recent infectious disease outbreaks, including COVID-19 and mpox, due to its position as one of the largest international travel hubs in the United States. In response to the imperative need to transport patients to specialized biocontainment units during high-consequence infectious disease outbreaks, the Health and Human Services Region 2 Regional Emerging Special Pathogen Treatment Center at New York City Health + Hospitals/Bellevue and the NYC Department of Health and Mental Hygiene spearheaded a comprehensive patient transport system. Informed by real-world experiences, quarterly drills, and regional partner engagement, the updated Region 2 patient transport concept of operations (CONOPS) ensures safe and seamless patient transfers. This article elucidates key components of the patient transport CONOPS, the multifaceted partner engagement approach used to develop it, and the collaborative workshop that fine-tuned the plan. Organizational skills, partner engagement, and adaptability were all necessary for refining and operationalizing a robust patient transport CONOPS. The finalization of this plan speaks to the collaborative spirit and commitment of regional leaders to ensure the effective management of high-consequence infectious disease outbreaks and the safeguarding of public health within Region 2 and beyond.

US Supreme Court opinions from the inception of the COVID-19 pandemic to date are reshaping national and subnational abilities to respond to public health emergencies. Substantial impacts in emergency legal preparedness and response arise in multiple legal areas including: (1) federal executive authorities; (2) access to health services and emergency care; (3) public health emergency interventions and mandates; (4) race-based limitations in resource allocations; (5) misinformation; and (6) scope of liability during and after emergencies. Against this backdrop an array of legal options and critical takeaways may help mitigate the impacts of US Supreme Court opinions and advance effective emergency responses ahead.

The International Health Regulations (2005) (IHR) Monitoring and Evaluation Framework is designed to assist States Parties in assessing progress toward compliance and sustainable capacities under the IHR. The States Parties Self-Assessment Annual Report (SPAR) is the only mandatory tool in the 4-component framework. The current SPAR is the third version of the tool since its inception in 2010. The revisions, while reflecting evolving requirements for health security capacity under the IHR, hinder the ability to compare capacity scores between versions and prevent analysis of historical data. In this article, we describe a methodology that aligns capacities across the 3 versions of the tool by creating umbrella terms for common themes that can be adapted or applied to any future SPAR changes, providing a sustainable framework for ongoing assessment and analysis. Our methodology enables States Parties, policymakers, and other stakeholders to view and assess country capacity across the history of self-assessment. Mapping by common themes allows for a historical understanding of national, regional, and global efforts to strengthen health security capacity.