世卫组织宣布国际关注的公共卫生事件：不建议任何措施干涉旅行和贸易

来源：公共卫生突发事件咨询服务与研究中心  作者：转自WHO微信公众号  发布时间：2020-01-31  查看次数：807

世卫组织总干事根据《国际卫生条例（2005）》召集的突发事件委员会于2020年1月30日举行会议，讨论2019新型冠状病毒疫情以及其他国家出现的输入病例情况。会上，委员会同意，本次疫情现已符合国际关注的突发公共卫生事件标准，并建议发布临时建议。

 “这一宣布的主要缘由不在于中国正在发生的事情，而在于其它国家正在发生的事情。我们最大的担忧是这种病毒有可能扩散到卫生系统薄弱的国家，而这些国家并没有做好应对准备，”世卫组织总干事谭德塞表示：“这一宣布不是对中国的不信任投票。相反，世卫组织继续对中国控制疫情的能力抱有信心。”
对中国政府最高领导人的领导作用、政治承诺和在透明度方面的决心，以及为调查和控制当前疫情所做的努力，委员会表示欢迎。

谭德塞博士说：“我从北京返回后，曾反复讲过，应当庆幸的是，中国政府为遏制疫情采取了非同寻常的措施，尽管这些措施对中国人民带来了严重的社会和经济影响。如果不是中国政府的努力，以及其在保护本国人民和世界人民方面取得的进展，我们现在会在中国之外看到更多病例——可能还有死亡。”

但委员会也承认，仍有许多未知因素。世卫组织已有五个区域（共六个）在一个月内报告了病例，并且在武汉以外和中国境外发生了人际传播。委员会认为，只要各国采取强有力的措施，及早发现、隔离和治疗病例，追踪接触者，并提倡针对风险程度采取相应的减少社交接触的措施，仍然有可能阻断病毒传播。委员会认为需要全球协作来加强对防范和应对的支持，特别是在需要额外帮助的区域。

“比宣布突发公共卫生事件更加重要的是，委员会为防止病毒传播和确保以证据为基础慎重应对疫情而提出的建议，”谭德塞博士表示。

突发事件委员会对世卫组织、中国以及其他国家提出了系列建议。这些建议可被总结如下：

1. 实施基于证据和与公共卫生风险相称的应对措施。委员会不建议任何措施干涉旅行和贸易。
2. 必须支持卫生系统薄弱的国家。
3. 加快疫苗、治疗方法和诊断工具的开发。
4. 抵制谣言和错误信息的传播。
5. 审查防范计划，找出差距，评估识别、隔离和护理病人以及防止传播所需的资源。
6. 与世卫组织和全世界分享数据、知识和经验。
7. 所有国家本着团结合作的精神共同努力。

什么是《国际卫生条例》？

《国际卫生条例（2005）》是一项具有约束力的国际法律协定，对包括世卫组织所有会员国在内的全球196个国家适用。其目的是帮助国际社会预防和应对有可能跨越国界并威胁到世界各国人民的紧急公共卫生风险。《国际卫生条例（2005）》的目的和范围是，以针对公共卫生风险，同时又避免对国际交通和贸易造成不必要干扰的适当方式，预防、抵御和控制疾病的国际传播，并提供公共卫生应对措施。

《国际卫生条例》突发事件委员会如何运作？

突发事件委员会由国际专家组成，就“国际关注的突发公共卫生事件”（PHEIC）情况向世卫组织总干事提供技术建议。该委员会就以下方面提出意见：

  • 事件是否构成国际关注的突发公共卫生事件；

  • 经历国际关注的突发事件的国家或其它国家为防止或减少疾病国际传播并避免对国际贸易和旅行造成不必要干扰而应采取的临时建议；以及

  • 国际关注的突发公共卫生事件的结束。


总干事根据突发事件委员会的意见，成员国和科学专家提供的信息，以及对人类健康风险、疾病国际传播风险和干扰国际旅行的风险的评估，就是否构成国际关注的突发公共卫生事件和应对局势的临时建议作出最后决定。

根据《国际卫生条例（2005）》，临时建议在公布三个月后自动失效。因此突发事件委员会至少每三个月举行一次会议，审查流行病学现状并审议是否继续维持国际关注的突发公共卫生事件以及是否需要更改临时建议。突发事件委员会每次会议后的声明公布在世卫组织网站上。

什么是国际关注的突发公共卫生事件？

《国际卫生条例》（2005）将国际关注的突发公共卫生事件定义为“通过疾病的国际传播构成对其他国家的公共卫生风险，以及可能需要采取协调一致的国际应对措施的不同寻常事件”。该定义意味着：

  • 情况严重、突然、不寻常或意外；

  • 公共卫生影响超出了受影响国家的边界；

  • 可能需要立即采取国际行动。



 Public Health Emergency of International Concern declared: No travel or trade restrictions recommended
 
The second meeting of the Emergency Committee convened by the world health Organization (WHO) Director-General under the International Health Regulations (IHR) (2005) regarding the outbreak of novel coronavirus 2019 (2019-nCoV)took place on Thursday, 30 January 2020. The Committee’s role is to give advice to the Director-General, who makes the final decision on the determination of a Public Health Emergency of International Concern (PHEIC). The Committee agreed that the outbreak now meets the criteria for a Public Health Emergency ofInternational Concern and Temporary Recommendations were issued.

 “The main reason for this declaration is not because of what is happening in China, but because of what is happening in other countries. Our greatest concern is the potential for the virus to spread to countries with weaker health systems, and which are ill-prepared to deal with it. Let me be clear: this declaration is not a vote of no confidence in China. On the contrary, WHO continues to have confidence inChina’s capacity to control the outbreak,” said by the Director-General of the WHO, Dr Tedros Adhanom Ghebreyesus.

The Committee welcomed the leadership and political commitment of the very highest levels of the Chinese government, their commitment to transparency, and the efforts made to investigate and contain the current outbreak.

Dr Tedros said: “As I have said repeatedly since my return from Beijing, the Chinese government is to be congratulated for the extraordinary measures it has taken to contain the outbreak, despite the severe social and economic impact those measures are having on the Chinese people. We would have seen many more cases outside China by now – and probably deaths – if it were not for the government’s efforts, and the progress they have made to protect their own people and the people of the world.”

However, the Committee also acknowledged that there are still many unknowns, cases have now been reported in five (out of six) WHO regions in one month, and human-to-human transmission has occurred outside Wuhan and outside China. The Committee states that they believe that it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect the disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk. The Committee felt that a global coordinated effort is needed to enhance preparedness in other regions of the world that may need additional support.

“More important than the declaration of a public health emergency are the committee’s recommendations for preventing the spread of the virus and ensuring a measured and evidence-based response,” Dr Tedros said.

Temporary Recommendations

The Emergency Committee issued a set of recommendations for WHO, China and the rest of the world. These can be broadly summarized as follows:

1. Implement response measures that are evidence-based and commensurate with public health risks – to this end, the Committee does not recommend any travel and trade restrictions
2. Support countries with weaker health systems
3. Accelerate the development of vaccines, therapeutics and diagnostics
4. Combat the spread of rumours and misinformation
5. Review preparedness plans, identify gaps and evaluate the resources needed to identify, isolate and care for cases, and prevent transmission
6. Share data, knowledge and experience with WHO and the world
7. Work together in a spirit of solidarity and cooperation.
 
“This is the time for facts, not fear. This is the time for science, not rumours. This is the time for solidarity, not stigma,” Dr Tedros concluded.


What are the International Health Regulations?

The International Health Regulations (2005), or IHR (2005), represents a binding international legal agreement involving 196 countries across the globe, including all the Member States of WHO. Their aim is to help the international community prevent and respond to acute public health risks that have the potential to cross borders and threaten people worldwide. The purpose and scope of the IHR (2005) is to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.

How does the IHR Emergency Committee work?

The Emergency Committee is made up of international experts who provide technical advice to the WHO Director-General in the context of a“public health emergency of international concern” (PHEIC) The Committee provides views on:

  • whether the event constitutes a public health emergency of international concern (PHEIC);
  • the Temporary Recommendations that should be taken by the country experiencing an emergency of international concern, or by other countries, to prevent or reduce the international spread of disease and avoid unnecessary interference with international trade and travel; and
  • the termination of a PHEIC.

The Director-General makes the final determination of a PHEIC and temporary Recommendations to address the situation, based on advice from the emergency Committee, information provided by the State Parties, scientific experts and an assessment of risk to human health, risk of international spread of disease and of risk of interference with international travel.

Under the IHR (2005), Temporary Recommendations automatically expire three months after their issuance. Emergency Committees are therefore convened at least every 3 months to review the current epidemiological situation and to review whether the event continues to be a public health emergency of international concern and whether changes need to be made to the Temporary Recommendations. A statement of the Emergency Committee meeting is published on the WHO website after each meeting of the Committee.

What is a public health emergency of international concern?

A PHEIC is defined in the IHR (2005) as, “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”. This definition implies a situation that is:

  • serious, sudden, unusual or unexpected;
  • carries implications for public health beyond the affected State’s national border; and
  • may require immediate international action.


更多疫情相关信息，可通过以下链接或“阅读全文”参考世卫组织官网新型冠状病毒专题页面：
https://www.who.int/zh/emergencies/diseases/novel-coronavirus-2019
 
世卫组织关于疫情最新动态请前往@世界卫生组织官方微博。