Coronavirus disease 2019 (COVID-19) pandemic: how countries shouldbuild more resilient health systems for preparedness and response

Objective: A resilient health system plays a crucial role in pandemic preparedness and response. Althoughthe World Health Organization (WHO) has required all states parties to strengthen core capacities to respondto public health emergencies under the International Health Regulations (2005), the actions of most countriesto combating coronavirus disease 2019 (COVID-19) has showed that they are not well-prepared. This crosssectionalstudy aimed to examine the health system resilience of selected countries and analyze their strategiesand measures in response to the COVID-19 pandemic.Methods: This study selected five countries including the Iran, Japan, Republic of Korea (South Korea), the U.K.,and the U.S., based on the severity of the national epidemic, the geographical location, and the developmentlevel. Cumulative number of death cases derived from WHO COVID-19 dashboard was used to measure theseverity of the impact of the pandemic in each country;WHO State Parties Self-Assessment Annual Reporting (SPAR)Scores and Global Health Security (GHS) Index were applied to measure the national health system resilience;and research articles and press materials were summarized to identify the strategies and measures adopted bycountries during response to COVID-19. This study applied the resilient health systems framework to analyzehealth system resilience in the selected countries from five dimensions, including awareness, diversity, selfregulation,integration and adaptation.Results: The SPAR Scores and GHS Index of the four developed countries, Japan, South Korea, the U.K. and theU.S. were above the global and regional averages;the SPAR Scores of Iran were above the global average whilethe GHI Index lain below the global average. In terms of response strategies, Japan, the U.K. and the U.S. investedmore health resources in the treatment of severe patients, while South Korea and Iran had adopted a strategyof extensive testing and identification of suspected patients. In terms of specific measures, all the five countriesadopted measures such as restrictions on entry and international travel, closure of schools and industries,lockdown and quarantine. Nevertheless, the effectiveness of implementing these measures varied acrosscountries, based on the response strategies.Conclusion: Although SPAR Scores and GHS Index have evaluated the national core capacities for preparednessand response, the actions to cope with the COVID-19 pandemic has revealed the fact that most countries stilldo not build resilient health systems in response to public health emergencies. Health system strengtheningand health security efforts should be pursued in tandem, as part of the same mutually reinforcing approach todeveloping resilient health systems.

Surgical treatment of liver cancer and pancreatic cancer under the China Healthcare Security Diagnosis Related Groups payment system

BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers accounted for the highest number of new cases.Real-world data(RWD)is now widely preferred to traditional clinical trials in various fields of medicine and healthcare,as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated.Additionally,research results from the RWD match global reality better than those from traditional clinical trials.AIM To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors.METHODS This study analyzed RWD 1137 cases within the HB1 group(patients who underwent pancreatectomy,hepatectomy,and/or shunt surgery)in 2023.It distinguished different expenditure categories,including medical,nursing,technical,management,drug,and consumable costs.Additionally,it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal–Wallis test.This study used the Steel–Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables.RESULTS The study found that in HB11 and HB13,the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy.Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy,both were significantly longer than those who underwent liver resection.In HB15,no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy;however,both were significantly higher than those in hepatectomy.Additionally,the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection.CONCLUSION China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs.Further research could refine this grouping system and ensure continuous effectiveness and sustainability.

Experiment Study of Fiber Optic Sensing in Railway Security Monitoring

Aiming at some security problems in railway running and the application condition of existing technology, this paper studies some issues of using fiber optic sensing technology in railway security monitoring. Through field experiment measuring the strain of the rail and analyzing the experiment data, the method of diagnosing the health condition of rail and wheel is investigated.

Lessons for Epidemic Emergency Policy: A Scoping Review of Ebola and COVID-19 Pandemics in Africa

Ebola Virus Disease (EVD) outbreaks in Central and West Africa 2013-2020 were the deadliest, most intense and most widely spread. On top of this, the novel Corona Virus Disease 2019 (COVID-19) has given us all a new experience. It is imperative to draw lessons to prepare for future disease outbreaks. This was a scoping review, a method that allows the assessment of emerging evidence. The objectives of the review were to 1) describe the manifestation of the epidemics;2) elaborate on the social and economic effects;3) characterize the responses;and 4) draw lessons. The findings show that Ebola risk is permanent and even increasing. The next COVID-19 epidemic is around the corner. For Africa, the situation has been made worse by poverty and fragility of institutions. Africa’s incapacity to manufacture its own vaccines, medicines, diagnostics and protective wear has been detrimental in the management of epidemics. The need for personal and home hygiene has been emphatically brought to attention. The trust in the government and other agencies is the cornerstone in the management of emergencies. The use of armed soldiers should be discouraged, for they scare people from seeking help. It is much better to use trusted local leaders instead of strangers during pandemic emergencies. Understanding the local politics without getting involved in them is essential. It is critical to understand community and individual perception of the risk of the disease in question. Often neglected is the psycho-social aspect, which should be planned early. The science of response measures ought to be explained simply and transparently, as part of risk communication. Emergency funds should be raised, and made easy and quick to disburse. Mechanisms of sharing health technologies and knowledge need to be devised under the UN. People centeredness ought to guide the conduct of trans-border movements and all transactions during pandemics.

The Health Security of Drinking Water in Sacred City: the Hydraulic and Zam Zam Projects in Mecca as Cases

As the first Islamic sacred city,the health security of drinking water in Mecca has been highly concerned since ancient time.As a unique potable water resource of Mecca,the health security of Bir Zam Zam has aroused the high attention of Muslims and related countries all over the world,which is closely related to the special status generated by the origin of the role in the sa’y ceremony of the hajj.Because of this,Zam Zam water is widely regarded as‘sacred water’and appears the phenomenon of reli-gious alienation in its health function.In 2013,Saudi Arabia launched a new Bir Zam Zam project to improve water quality by more scientific and technological means.Relevant tests found that its water quality could meet the potable water standards of the World Health Organisation and the American Public Health Association,but there were also voices of doubt from abroad,and Saudi Arabia also responded to this.With the advent of the post-pandemic era and the resumption of the hajj for Muslims outside Saudi Arabia in 2022,the consumption of Bir Zam Zam by pilgrims and Muslims will rise to high levels,inevitably leading to an upward risk to international health security.

A One Health approach to fight antimicrobial resistance in Uganda: Implementation experience, results, and lessons learned

Uganda has been implementing the Global Health Security Agenda(GHSA)since 2015 to build its capacity according to World Health Organization(WHO)Benchmarks on International Health Regulations Capacities.The country remains prone to outbreaks,with more than 20 disease outbreaks reported in the past five years,including Ebola virus disease,Crimean-Congo haemorrhagic fever,Marburg haemorrhagic fever,measles,yellow fever,coronavirus disease 2019(COVID-19),and cholera.Antimicrobial resistance(AMR)is an ongoing challenge.Uganda scored capacity level 3 on infection prevention and control(IPC)and antimicrobial stewardship(AMS)in the 2017 Joint External Evaluation(JEE)assessment.Identified gaps were being addressed after a self-assessment in 2021.This paper describes the technical assistance approaches provided to Uganda by the Medicines,Technologies,and Pharmaceutical Services Program,funded by the United States(U.S.)Agency for International Development,and implemented by Management Sciences for Health.The program,through a One Health approach,supported systematic capacity strengthening based on the JEE's capacity advancement framework for global health security,specifically relating to AMR.The program's interventions impacted 32 WHO benchmark actions(7 for AMR multisectoral coordination,16 for IPC,and 9 for AMS),contributing to Uganda's strengthened GHSA capacity.Leveraging success built on the AMR platform,the program trained 745 health workers in IPC for the Ebola virus and provided support for simulation exercises by eight district IPC teams.The program also worked with the Ministry of Health to coordinate IPC for the COVID-19 response in five health regions,covering 45 districts and reaching 5,452 health workers at 858 health facilities.

Exploration of the financing and management model of a children＇s critical disease security system in China based on the implementation of Shanghai Children Hospital Care Aid

This study is designed to serve as a reference for the establishment of health security systems for children＇s critical diseases. Through analysis of the operation of Shanghai Children Hospital Care Aid （SCHCA）, this study explored the financing model and management of a children＇s critical disease healthcare system and analyzed the possibility of expanding this system to other areas. It is found that a premium as Iow as RMB 7 per capita per year under SCHCA can provide high-level security for children＇s critical diseases. With the good experience in Shanghai and based on the current basic medical insurance system for urban residents and the new rural cooperative medical scheme （NRCMS）, it is necessary and feasible to build a health security system for children＇s critical diseases at the national level.

健康发展力评价指标体系构建

目的构建健康发展力评价指标体系,用于分析地区健康水平,助力健康中国建设。方法用德尔菲法进行2轮专家咨询,分析咨询结果,筛选并修改指标,建立最终的评价指标体系。结果2轮咨询的专家积极系数分别为80%和73%,专家权威系数均数为0.73。第2轮咨询中,所有指标的重要性、数据可得性和敏感性评分的专家协调系数分别为0.403、0.466和0.266(P<0.05),所有指标的重要性、数据可得性和敏感性整体评分都在4.00分以上,专家支持率在75.00%以上,变异系数小于0.25。最终构建的健康发展力评价指标体系包括5个一级指标、18个二级指标、52个三级指标。结论构建的健康发展力评价指标体系专家积极性较高,专家权威程度、协调程度和集中程度较好,可用于评价地区健康发展力,发现地区健康水平的影响因素。

Diagnosis and Prevention of Swine Influenza

Swine influenza （SI） is an acute, febrile, highly contagious, respiratory infectious disease caused by swine influenza virus （SIV）, which is a common disease in intensive pig farms, and prevalent throughout the world. Disease in affected pigs was characterized by burst, high fever, rapid epidemic spread. The mortality of SI with secondary or mixed infection could be increased. Moreover, more researches showed that the outbreaks of human influenza are associated with the outbreak of swine influenza, and there are a striking parallel nature and relevance. In the present article, the pathogen, epidemiology, diagnosis, treatment and public health aspects were elaborated, so as to provide a reference for scientific prevention and treatment of SI.

Between Religious Obligation and Health Security:Saudi Hajj Governance Under COVID-19

Hajj is one of the‘Five Pillars’in Islam.However,the large-scale cross-border movement of pilgrims around the world poses huge challenges over health security.Saudi Hajj governance is not only a need to maintain health security,but also to a large extent the sharia considerations related to the prerequisites for Hajj.In recent years,Saudi Arabia has gained rich experience in dealing with the challenges of SARS,MERS and other infectious diseases on Hajj.With the spread of the COVID-19 to Mecca in February 2020,Saudi Arabia has been facing serious challenges.Based on domestic and global epidemic prevention considerations,the Saudi government finally introduced the new policy on 2020 Hajj,which for the first time halted the Hajj of overseas Muslims,and only selected a very limited number of pilgrims within Saudi territory to perform Hajj.Saudi actually balances three major structural contradictions between maintaining health security and fighting the epidemic,and to a certain extent ensuring the rights of Muslims around the world.With the easing of the epidemic in Saudi Arabia in 2021,how to ensure that the Hajj can be performed in 2021 under the COVID-19 has aroused great attention from the international community.For the current review,Saudi new Hajj policy in 2020 has achieved due results.Saudi Arabia continued the scaled-down Hajj policy in 2021 due to the constant mutations of the coronavirus.The formation of Saudi Hajj policy under COVID-19 directly comes from the rich experience of Saudi Arabia in effectively maintaining the Hajj health security during the spread of different global epidemics,and fundamentally rooted in the hygiene and cleanliness within the Islamic civilisation.

High-containment facilities and the role they play in global health security

Biological threats,whether naturally occurring or accidentally or deliberately released,have the potential to endanger lives and disrupt economies worldwide.Thus,high-containment protective measures should be implemented when handling bio-agents that can cause serious,highly contagious diseases,otherwise devastating pandemics can occur.In the fields of scientific investigation,healthcare,and product development,high-containment facilities play a critical role in preventing,detecting,and responding promptly and effectively to threats to global health security.In this paper,we present a summary of the main types of high-containment facilities,as well as their applications,challenges,and suggestions for the future.

Working Together Towards Fairer,More Equitable,Reasonable,and Inclusive Global Human Rights Governance——Summary of Academic Views on the “2022 Beijing Forum on Human Rights”

on July 26, 2022, the 2022 Beijing Forum on Human Rights, co-organized by the China Society for Human Rights Studies and the China Foundation for Human Rights Development, was successfully held in Beijing, with the theme of “Working Together Towards Fairer, More Equitable, Reasonable and Inclusive Global Human Rights Governance”. About 200 senior officials, experts, and scholars from more than 70 countries and international organizations delivered fruitful results in five parallel sessions on Sustainable Development and Human Rights protection, Democracy and Human Rights protection, public Health Security and Human Rights protection, Multilateralism and Global Human Rights Governance, and open and Inclusive Development and Human Rights protection.

Development of the Principle of International Solidarity and the Contribution of China

International solidarity is a fundamental value upheld by the united nations as well as a principle of international law recognized by independent experts on human rights The values and principle of international solidarity have played an important role in promoting human rights, improving the international economic order, driving sustainable development, and tackling global challenges, and they have gained wide support from most developing countries As unilateralism and protectionism continue to spread, global governance and multilateral cooperation are under threat Against this background, the united nations calls for the spirit and principle of international solidarity and the promotion of solidarity rights, including the right to development, and encourages the countries to safeguard global public health through joint actions and to avoid discrimination The concept of a community with a shared future for human beings proposed by China embodies international cooperation, mutual learning and exchanges, and collective efforts to promote and safeguard human rights It has made a positive contribution to enriching and boosting the principle of international solidarity and demonstrated the wisdom and responsibility of China as a major country.