Global health goals: lessons from the worldwide effort to eradicate poliomyelitis

被引:40
作者
Aylward, RB
Acharya, A
England, S
Agocs, M
Linkins, J
机构
[1] WHO, Dept Vaccines & Biol, Global Polio Eradicat Initiat, CH-1211 Geneva 27, Switzerland
[2] WHO, Communicable Dis Cluster, Stop TB Dept, Stop TB Partnership Secretariat, CH-1211 Geneva 27, Switzerland
[3] Univ Sussex, Inst Dev Studies, Brighton, E Sussex, England
[4] US Ctr Dis Control & Prevent, Polio Eradicat Branch, Global Immunizat Div, Natl Immunizat Program, Atlanta, GA USA
关键词
D O I
10.1016/S0140-6736(03)14337-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The Global Polio Eradication Initiative was launched in 1988. Assessment of the politics, production, financing, and economics of this international effort has suggested six lessons that might be pertinent to the pursuit of other global health goals. First, such goals should be based on technically sound strategies with proven operational feasibility in a large geographical area. Second, before launching an initiative, an informed collective decision must be negotiated and agreed in an appropriate international forum to keep to a minimum long-term risks in financing and implementation. Third, if substantial community engagement is envisaged, efficient deployment of sufficient resources at that level necessitates a defined, time-limited input by the community within a properly managed partnership. Fourth, although the so-called fair-share concept is arguably the best way to finance such goals, its limitations must be recognised early and alternative strategies developed for settings where it does not work. Fifth, international health goals must be designed and pursued within existing health systems if they are to secure and sustain broad support. Finally, countries, regions, or populations most likely to delay the achievement of a global health goal should be identified at the outset to ensure provision of sufficient resources and attention. The greatest threats to poliomyelitis eradication are a financing gap of US$210 million and difficulties in strategy implementation in at most five countries.
引用
收藏
页码:909 / 914
页数:6
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