ABSTRACT
On the basis of systematic evaluation of 32 provincial capital cities and municipalities in their capacity for preventing and controlling emerging infectious diseases, focus analysis is made on Wuhan in relation to its advantages and disadvantages as follows:There has been a legal basis for epidemic prevention according to law, but it has not translated into effective action.There has been an organizational basis for responding to epidemic, but coordination mechanism has not been effectively established.The management mechanism has been complete, but the division of responsibilities among different departments has not been clear.The monitoring network has been set up, but its role of "predictive warning" has not been played.Insufficiency of public health service delivery was observed owing to lack of financial investment.In cities of China, advantages and disadvantages have been both existent in their capacity to prevent and control of emerging infectious disease.We should be vigilant in this regard. It is imperative to "fill defects, stop leaks and strengthen weakness".There is a Chinese saying:"It is not too late to mend a fold after the sheep have been stolen".
ABSTRACT
Recent studies reveal that Sub-Saharan African (SSA) countries are now experiencing rapid scaling up of health services and improvement of health status. It is reported that services related to HIV/AIDS, tuberculosis and malaria are rapidly expanding especially after 2005. According to the latest household surveys (such as Demographic and Health Surveys and Malaria Indicator Surveys) conducted after 2000, annual rate of reduction in under five mortality rate of 5% or more is observed in more than 10 countries. This revolutionary change in SSA was triggered at least partly by development assistance for health (DAH), which increased 5 folds after 2000. On the other hand, DAH to SSA by the Japanese government (bilateral basis only and excluding contributions to multi-lateral organizations and global health partnerships such as GFATM) represents merely 1% of the total, which is equivalent to $0.1 per person living in Africa. The impact, therefore, may be limited. Increase in quantity of DAH including partial support for recurrent expenditures, contribution to rule making and monitoring of DAH use within the partner coordination framework, better targeting on selected number of countries, focus on health systems strengthening, and scientific and multi-sectoral analysis of success factors of high-performing countries, are recommended as future directions of Japanese DAH to SSA.
ABSTRACT
<b>Introduction</b><br> On 8 March 2009, the Workshop on Infectious Diseases Control Programmes and Health System Strengthening (HSS) was conducted in the 24th East Japan Regional Conference of the Japan Association for International Health. This article reports the discussion in the Workshop and the internet-based open forum that followed. <br><b>Method</b><br> After four presentations reflecting on the field-based experiences regarding the relation between disease-specific programmes and HSS, following three aspects were discussed: 1) health system-wide barriers perceived through the implementation of disease-specific programmes; 2) shortcomings of the disease-specific initiatives in light of the HSS; and 3) how the disease-specific initiatives can contribute to the HSS. <br><b>Results</b><br> As the system-wide barriers, insufficient quantity and quality of health human resources, lack of health infrastructure and material resources and limitation of the technology applicable to community level of developing countries were commonly perceived. Shortfall of disease-specific programmes in light of the HSS included the lacked coordination between different programmes and donors, duplicated heavy workload put on community health workers especially in recording and reporting, dissociation between local health needs and programme priorities, lack of contributions to strengthening mid-level health administration, deviation of resources to the priority programmes and lack of sharing of potentially sharable material resources. It was proposed that the disease-specific initiatives should contribute to resource mobilization, programme management models, capacity building of mid-level health administration, supplementing personnel cost and presenting hardware and software outcome resources to the HSS. <br><b>Conclusions</b><br> The disease-specific initiatives need to pursue the above mentioned practical contributions to the HSS. At the same time, a wider scope addressing political and policy-wise justifications of the form of the overall health system needs to be further discussed with developing countries stakeholders.