针对埃博拉传染病的流行：44位科学家联名发布致欧洲各国政府的一封公开信

周 健 摘译

最新一期（384）《柳叶刀》杂志载文，针对埃博拉传染病的流行：44位科学家联名发布致欧洲各国政府的一封公开信。该文要点如下：

1、形势评估：科学家们认为，埃博拉传染病在西非国家已经完全失去控制，正在螺旋式的流行。由国际社会的忽视和无所作为，该病的流行不仅压倒了这些国家卫生系统的防控救治能力，而且还可能威胁到全世界。

2、策略建议：

（1）欧洲各国政府应该建立一种机制，允许卫生系统内的专业人员作为志愿者短期离开在本国的工作岗位，前往埃博拉流行的国家去从事专业工作，并由本国政府发给他们从事危险工作的津贴。

（2）埃博拉流行的国家，需要大量的技术和基础设施与设备。专业技术方面，例如流行病、微生物方面的各种设备和资源，诊断设备，移动通信软件和技术等。基础设施方面，如发电机、清洁水和燃料等。欧洲国家应及时提供相关资源、技术以及专业知识的指导。

（3）在医疗救治防控应用方面，急需个人防护设备和消毒剂。欧洲国家应更多地寻求和分发这些防护消毒用品到疫区。

（4）关于后勤和运输问题，欧洲各国政府应该动员军队和民间运输力量，分别从空中、海上和陆地将食品、物质、人员运送到疫区。

更多详细内容，请参见原文：

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61611-1/fulltext

Ebola:an open letter to European governments

Original Text

Jose M Martin-Morenoa, Walter Ricciardib,Vesna Bjegovic-Mikanovicc,Peggy Maguired,Martin McKeee, on behalf of 44 signatories

Aftermonths of inaction and neglect from the international community, the Ebolaepidemic in west Africa has now spiralled utterly out of control. Today, thevirus is a threat not only to the countries where the outbreak has overwhelmedthe capacity of national health systems, but also to the entire world. We urgeour governments to mobilise all possible resources to assist west Africa incontrolling this horrific epidemic. Based on our expertise in public health andemergency response, we believe the following measures would be particularlyeffective.

First,with regards to human resources, given the huge need for trained health-careprofessionals in west Africa, we urge European governments to create mechanismsthat allow professionals working in public health-care systems to volunteer fortemporary leave (with hazard pay) to contribute to the epidemic control effortsin the region. European countries can and should step up to contribute in linewith their capacity and potential.

Second,regarding technical and infrastructure support, there is a huge need for fieldlaboratories, epidemiological and microbiological surveillance resources,diagnostic equipment, and mobile communications software and technology. Theseneeds go hand in hand with basic infrastructure requirements such as electricgenerators, clean water, and fuel. European countries have the resources andthe knowledge to deploy them.

Third,with respect to medical supplies, health-care professionals and communities arein desperate need of personal protective equipment as well as disinfectants,such as soap and chlorine. While health-care centres should have priority, theyare completely overwhelmed, and many infected people are receiving care athome. European countries should actively seek to procure and distributeprotective clothing to all health-care professionals on the ground as well asto communities in need.

Finally,with regards to transport and logistics, governments should go beyondrequesting private companies to resume travel to the affected regions (a measurethat is not only epidemiologically unnecessary, but also counterproductive) andcreate strong incentives for them to do so, while also mobilising military andcivil transport by air, sea, and land to ship food, supplies, and personnel tothe affected regions.

Ifwe aim for our action to be truly effective, Europe's strategic approach toresponding is just as important as its financial and material commitments. Wecall on our governments to take an active and dedicated role, in partnershipwith west African countries and the UN, to ensure that the response over thenext months is managed transparently and effectively, and in ways that supportcomplementary goals for human and economic development in the region. First,aid should be channelled to organisations already on the ground, particularlythose led or primarily staffed by west Africans. This includes national, publichealth systems as well as non-governmental organisations. Médecins SansFrontières has been playing an important part, but groups run by west Africansare in the best position to engage local support, act as cultural mediatorsbetween international actors and local populations, and build capacity amongcommunity stakeholders.

Second,the response should catalyse the link between health and development. The Ebolaepidemic has eco-social origins and societal costs that go far beyond thehealth effects, so all possible efforts should be made to ensure thatinternational donations support—never replace—local economies and socialsystems.

Third,built-in mechanisms for governance, monitoring, and evaluation should beestablished. European governments have an obligation, both to their ownconstituencies and to the communities in need, to deter (and punish) waste andgraft so that scant resources are used as effectively as possible. In light ofthe