国家新型公共卫生与预防医学体系建立的几点思考

Several considerations on the establishment of a new public health and preventive medicine system in national level

本文基于健康中国战略赋予公共卫生的新使命以及本次新型冠状病毒肺炎疫情应对的不足,从宏观系统层面、中观组织层面和微观个人层面提出当前公共卫生与预防医学体系存在的问题:包括战略规划不足、资源投入、机构协调、人才培养与队伍建设等。提出在国家卫生健康委之外设立疾病预防控制局,实行国家-省(自治区、直辖市)-市-区(县)四级自上而下的垂直管理。疾病预防控制局内设战略研究院、疾病预防控制中心、人才培养与培训基地和科学研究所,各司其职,互相依托。提升原有体系战略规划、统筹协调、循证决策的功能;强调科学研究的前瞻性和延续性;让疾病预防控制中心更专注于健康管理和突发事件应对。从而保障公众健康,提高全民健康水平与生命质量,确保社会稳定与发展。

Based on the new mission of public health set in the Healthy China strategy and the insufficient response to COVID-19,this article pointed out the problems of the current public health and preventive medicine system from the macro-system level,meso-organization level,and micro-individual level,including insufficient strategic planning,resource input,institutional coordination,talent training and team building.It was creatively proposed that a disease prevention and control bureau should be set up outside the health commission to implement the vertical management at four levels,from national level to province-level,including autonomous region,municipality directly under the central government,city-level and district/county-level.The disease prevention and control bureau should consist of a strategic research institute,a center for disease prevention and control(CDC),a human resources training base,and a scientific research institute,which could perform their own duties and rely on each other.Enhancing the functions of strategic planning,overall coordination,and evidence-based decision-making in the original system,emphasizing the foresight and continuity of scientific research,and allowing the CDC to focus more on health management and emergency response could better facilitate in protecting the public health,improving the health and quality of life of the entire population,and guaranteeing the social stability and development.