Changes of Global Infectious Disease Governance in 2000s: Rise of Global Health Security and Transformation of Infectious Disease Control System in South Korea / 의사학

This paper focus upon the changes of global infectious disease governance in 2000s and the transformation of infectious disease control system in South Korea. Traditionally, infectious disease was globally governed by the quarantine regulated by the international conventions. When an infectious disease outbreak occurred in one country, each country prevented transmission of the disease through the standardized quarantine since the installation of international sanitary convention in 1892. Republic of Korea also organized the infectious disease control system with quarantine and disease report procedure after the establishment of government. Additionally, Korea National Health Institute(KNIH) was founded as research and training institute for infectious disease. However, traditional international health regulation system faced a serious challenge by the appearance of emerging and re-emerging infectious disease in 1990s. As a result, global infectious disease governance was rapidly changed under the demand to global disease surveillance and response. Moreover, global health security frame became important after 2001 bioterror and 2003 SARS outbreak. Consequently, international health regulation was fully revised in 2005, which included not only infectious disease but also public health emergency. The new international health regime was differently characterized in several aspects; reinforcement of global cooperation and surveillance, enlargement of the role of supranational and international agencies, and reorganization of national capacity. KNIH was reorganized with epidemic control and research since late 1990s. However, in 2004 Korea Center for Disease Control and Prevention(KCDC) was established as a disease control institution with combining quarantine and other functions after 2003 SARS outbreak. KCDC unified national function against infectious disease including prevention, protection, response and research, as a national representative in disease control. The establishment of KCDC can be understood as the adoption of new international health regulation system based upon SARS experience.

Social representations of health surveillance among workers / Representaciones sociales de trabajadores acerca de la vigilancia sanitaria / Representações sociais sobre vigilância sanitária entre trabalhadores

This is a qualitative, exploratory-interpretative study, with the purpose of investigating the social representations of health surveillance among members of the National Health Surveillance Agency - ANVISA, in Rio Grande do Sul State. It was found that health surveillance is represented by subjects as a process that, despite the contradictions, is being constructed and lived in the job routine with signs of renovation of existing representations. Thus, health protection acquires a new understanding, deviating from the prevention limits that traditionally focus on disease in order to return to promotion itself. Also, the image of health police is displaced from punishment to health education, establishing links between normative and educative performance. Moreover, professionalism is based on responsibility and knowledge, and professional devaluation is anchored in the idea of exclusion. The results allow for an analysis of the elements that can be causing permanencies and influencing the movements of daily practice, being able to revert into a benefit for the construction of a professional profile.

Estudio cualitativo, exploratorio-interpretativo con el objetivo de conocer las representaciones sociales de trabajadores acerca de la vigilancia sanitaria en la Agencia Nacional de Vigilancia Sanitaria - ANVISA, RS. Vigilancia sanitaria fue representada por los sujetos como un proceso, el cual, a pesar de las contradicciones viene siendo construido y vivenciado en el cotidiano profesional con signos de renovación frente a las ya existentes. Así la protección de la salud adquiere una nueva comprensión, que se aleja de los límites de prevención, los que tradicionalmente enfocan a la enfermedad, para dirigirla en base a la noción de promoción. De la misma forma, la imagen de policía sanitaria, pasa de punición para educación sanitaria, estableciendo los ejes entre el hacer normativo y educativo. Por otro lado, el profesionalismo se fundamenta en la responsabilidad y conocimiento y en la falta de valor profesional basado en la exclusión. Los resultados favorecen un análisis de los elementos que pueden estar ocasionando su permanencia e influyendo en la práctica cotidiana, para posiblemente volverse en un beneficio para la construcción del perfil profesional.

Estudo qualitativo, exploratório-interpretativo, com o objetivo de conhecer as representações sociais sobre vigilância sanitária entre trabalhadores da Agência Nacional de Vigilância Sanitária - ANVISA, no Rio Grande do Sul. Verificou-se que vigilância sanitária é representada pelos sujeitos como um processo que, apesar das contradições, vem sendo construído e vivenciado no cotidiano da profissão, com sinais de renovação das representações existentes. Assim, proteção à saúde adquire novo entendimento, distanciando-se dos limites da prevenção que tradicionalmente focaliza a doença, para voltar-se à noção de promoção. Também, a imagem de polícia sanitária desloca-se da punição para a educação sanitária, estabelecendo os elos entre os fazeres normativo e educativo. Além disso, o profissionalismo assenta-se em responsabilidade e conhecimento, e a desvalorização profissional ancora-se na idéia de exclusão. Os resultados propiciam análise dos elementos que podem estar causando permanências e influenciando os movimentos da prática cotidiana, podendo reverter em benefício da construção de um perfil profissional.