东非两国公共卫生体系的新探索与启示

New exploratory practices and insights on public health system in the East Africa: A study on cases in Tanzania and Kenya

东非面临传染病、慢性病、新发传染病流行的多重健康威胁,但其公共卫生体系仍偏向应对传染病问题,亟待探索建立一个综合性更强的公共卫生体系。本文通过东非坦桑尼亚和肯尼亚两国的案例发现,两国长期以来实行的是依赖西方援助的传染病单病种垂直公共卫生体系,存在很大局限,忽视了当下健康问题的综合性和长期性。对此,东非两国针对艾滋病患者中存在一定比例的慢性病患者和具有相对完善的艾滋病防治网络的事实基础,开展了将慢性病防治工作纳入艾滋病防治体系中的探索实践。正在建设中的非洲疾病预防控制系统,有着改变长期以来非洲公共卫生体系格局的可能。因此,中国参与建设非洲疾病预防控制系统的积极行动具有建设性意义。

The East Africa faces multiple health threats from infectious diseases(IDs),chronic non-communicable diseases(NCDs),and emerging infectious diseases(EIDs),but its public health system is still biased to dealing with IDs,and there is an urgent need to explore building a more comprehensive public health system.A study on the cases in two countries in the East Africa,i.e.Tanzania and Kenya finds that these two countries has long running a vertical public health system based on single disease types of IDs that relies heavily on Western aid,which has significant limitations and ignores the comprehensive and long-term characteristics of current health problems.In response,the aforesaid two countries in the East Africa carried out exploratory practices for integrating prevention and treatment of NCDs into the AIDS prevention and treatment system,based on the fact that a certain proportion of AIDS patients are NCDs patients as well as the two countries have relatively well-developed AIDS prevention and treatment networks.This exploratory public health governance practice in the East Africa and the ongoing development of the African Disease Prevention and Control Systems have the potential to change the long-standing pattern of the public health systems of Africa.That is why China s active participation in building African Disease Prevention and Control Systems has a constructive significance.