Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

Classifying disaster risk reduction strategies: conceptualizing and testing a novel integrated approach

BACKGROUND

Although disaster risk reduction (DRR) addresses underlying causes and has been shown to be more cost-effective than other emergency management efforts, there is lack of systematized DRR categorization, leading to insufficient coherence in the terminology, planning, and implementation of DRR. The aim of this study was to conceptualize and test a novel integrated DRR framework that highlights the intersection between two existing classification systems.

METHODS

Grounded theory was used to conceptualize a novel DRR framework. Next, deductive conceptual content analysis was used to categorize interventions from the 2019 Cities100 Report into the proposed DRR framework. The term "connection" indicates that an intervention can be categorized into a particular section of the novel integrated approach. A "connection" was determined to be present when the intervention description stated an explicit connection to health and to the concept within one of the categories from the novel approach. Further descriptive statistics were used to give insight into the distribution of DRR interventions across categories and into the application of the proposed framework.

RESULTS

The resulting framework contains nine intersecting categories: "hazard, prospective", "hazard, corrective", "hazard, compensatory", "exposure, prospective", "exposure, corrective", "exposure, compensatory", "vulnerability, prospective", "vulnerability, corrective", and "vulnerability, compensatory". The thematic analysis elucidated trends and gaps in the types of interventions used within the 2019 Cities100 Report. For instance, exposure-prospective, exposure-compensatory, and vulnerability-compensatory were the most under-utilized strategies, accounting for only 3% of the total interventions. Further descriptive statistics showed that upper middle-income countries favored "hazard, corrective" strategies over other DRR categories while lower middle-income countries favored "exposure, corrective" over other DRR strategies. Finally, European cities had the highest percentage of DRR connections (51.39%) compared to the maximum possible DRR connections, while African cities had the lowest percentage of DRR connections (22.22%).

CONCLUSIONS

The study suggests that the proposed DRR framework could potentially be used to systematically evaluate DRR interventions for missing elements, aiding in the design of more equitable and comprehensive DRR strategies.

A comparative study of international and Chinese public health emergency management from the perspective of knowledge domains mapping

BACKGROUND

At the end of 2019, the outbreak of coronavirus disease 2019 (COVID-19) severely damaged and endangered people's lives. The public health emergency management system in China has played an essential role in handling the response to the outbreak, which has been appreciated by the World Health Organization and some countries. Hence, it is necessary to conduct an overall analysis of the development of the health emergency management system in China. This can provide a reference for scholars to aid in understanding the current situation and to reveal new research topics.

METHODS

We collected 2247 international articles from the Web of Science database and 959 Chinese articles from the China National Knowledge Infrastructure database. Bibliometric and mapping knowledge domain analysis methods were used in this study for temporal distribution analysis, cooperation network analysis, and co-word network analysis.

RESULTS

The first international article in this field was published in 1991, while the first Chinese article was published in 2005. The research institutions producing these studies mainly existed in universities and health organizations. Developed countries and European countries published the most articles overall, while eastern China published the most articles within China. There were 52 burst words for international articles published from 1999-2018 and 18 burst words for Chinese articles published from 2003-2018. International top-ranked articles according to the number of citations appeared in 2005, 2007, 2009, 2014, 2015, and 2016, while the corresponding Chinese articles appeared in 2003, 2004, 2009, and 2011.

CONCLUSIONS

There are differences in the regional and economic distribution of international and Chinese cooperation networks. International research is often related to timely issues mainly by focusing on emergency preparedness and monitoring of public health events, while China has focused on public health emergencies and their disposition. International research began on terrorism and bioterrorism, followed by disaster planning and emergency preparedness, epidemics, and infectious diseases. China considered severe acute respiratory syndrome as the starting research background and the legal system construction as the research starting point, which was followed by the mechanism, structure, system, and training abroad for public health emergency management.

COVID-19: The World Community Expects the World Health Organization to Play a Stronger Leadership and Coordination Role in Pandemics Control

The coronavirus disease 2019 (COVID-19) pandemic has been accompanied by the return of the concept of national state and exhibited signs of crisis of globalism and liberalism. The pandemic affected most aspects of society and human activity, including socioeconomic impact. Economic problems, shortages of medical supplies and personnel, xenophobic sentiments, and misinformation led to the use of unethical practices and human rights violations. To navigate through this crisis, many countries resorted to traditional diplomacy in the absence of effective international instruments. Thus, the world faced the urgent need in functioning global governance. The pandemic also manifested the increasing importance of international organizations as sources of technical expertise, providing scientific basis for politicians to legitimize their decisions and actions. The article addresses the topic of implications of the pandemic for governance and forecasting a post-pandemic future. The research focus of this paper, therefore, is the assessment of the role of the World Health Organization (WHO) in prevention and response to pandemics. The work is aimed at identifying the functions of the WHO and assessing its activities in prevention and control of pandemics and response to the COVID-19 pandemic in particular. Furthermore, the objective of this article is to identify gaps in the WHO pandemic control efforts and formulate recommendations on addressing them.

Global Research on Public Health Emergency Preparedness From 1997 to 2019: A Bibliometric Analysis

OBJECTIVES

To access the trends and focuses of publications on public health emergency preparedness in the timeframe 1997-2019.

METHODS

Publications related to public health emergency preparedness (PHEP) were retrieved from the Web of Science Core Collection database. Bibliometric analyses including output statistics, co-authorship analysis, citation analysis, co-citation analysis, and co-occurrence analysis were performed and mapped using VOSviewer.

RESULTS

A total of 1058 publications on PHEP were included in this study. There was an increasing trend of publication output and citations since 2002. A total of 4605 authors from 1587 institutes and 92 countries contributed to the publications, and the United States lead the field. Disaster Medicine and Public Health Preparedness was the most active and co-cited journal among 243 journals. The knowledge foundation mainly focused on the professionals' capacity, education, and conceptions of PHEP. Epidemics, natural disasters, terrorism, education, and communication were the principle topics; while "vulnerable populations," "disaster medicine," and "hurricane" were the recent hotspots in this field.

CONCLUSIONS

Significant progresses had been achieved worldwide in the past 2 decades, however, improvement of research activity and international collaboration is still a need for most countries.

The public health emergency management system in China: trends from 2002 to 2012

Background

Public health emergencies have challenged the public health emergency management systems (PHEMSs) of many countries critically and frequently since this century. As the world’s most populated country and the second biggest economy in the world, China used to have a fragile PHEMS; however, the government took forceful actions to build PHEMS after the 2003 SARS outbreak. After more than one decade’s efforts, we tried to assess the improvements and problems of China’s PHEMS between 2002 and 2012.

Methods

We conducted two rounds of national surveys and collected the data of the year 2002 and 2012, including all 32 provincial, 139 municipal, and 489 county CDCs. The municipal and county CDCs were selected by systematic random sampling. Twenty-one indicators of four stages (preparation, readiness, response and recovery) from the National Assessment Criteria for CDC Performance were chosen to assess the ten-year trends.

Results

At the preparation stage, organization, mechanisms, workforce, and stockpile across all levels and regions were significantly improved after one decade’s efforts. At the readiness stage, the capability for formulating an emergency plan was also significantly improved during the same period. At the response stage, internet-based direct reporting was 98.8%, and coping scores were nearly full points of ten in 2012. At the recovery stage, the capabilities were generally lower than expected.

Conclusions

Due to forceful leadership, sounder regulations, and intensive resources, China’s PHEMS has been improved at the preparation, readiness, and response stages; however, the recovery stage was still weak and could not meet the requirements of crisis management and preventive governance. In addition, CDCs in the Western region and counties lagged behind in performance on most indicators. Future priorities should include developing the recovery stage, establishing a closed feedback loop, and strengthening the capabilities of CDCs in Western region and counties.

Strengthening global health security by embedding the International Health Regulations requirements into national health systems

The International Health Regulations (IHR) 2005, as the overarching instrument for global health security, are designed to prevent and cope with major international public health threats. But poor implementation in countries hampers their effectiveness. In the wake of a number of major international health crises, such as the 2014 Ebola and 2016 Zika outbreaks, and the findings of a number of high-level assessments of the global response to these crises, it has become clear that there is a need for more joined-up thinking between health system strengthening activities and health security efforts for prevention, alert and response. WHO is working directly with its Member States to promote this approach, more specifically around how to better embed the IHR (2005) core capacities into the main health system functions. This paper looks at how and where the intersections between the IHR and the health system can be best leveraged towards developing greater health system resilience. This merging of approaches is a key component in pursuit of Universal Health Coverage and strengthened global health security as two mutually reinforcing agendas.