| 摘要: | Background: The International Health Regulations (IHR) serve a vital role in assisting countries in developing capacities to prevent, detect, and respond to potential future pandemics. Although previous studies have demonstrated the benefits of IHR implementation, outbreaks have persisted in numerous countries worldwide, resulting in severe negative consequences. Therefore, by analyzing the State Party Self-Assessment Annual Report (SPAR) scores of the countries, this study was conducted to evaluate the efficacy and effectiveness of IHR implementation during an ongoing pandemic is necessary, along with an assessment of countries' current preparedness to address future threats. Furthermore, considering the significant impact of the prior COVID-19 pandemic, this study aims to assess the outcomes of infectious disease control from various angles, not solely focusing on health aspects. All of these assessments are based on the analysis of the State Party Self-Assessment Annual Report (SPAR).
Methods: To achieve the objectives of this dissertation, three ecological studies were conducted. The choice of an ecological study design was based on the fact that the International Health Regulations (IHR) serve as a globally applied legal framework for controlling infectious diseases, taking into account the borderless nature of disease transmission due to globalization. All three studies utilized secondary data obtained from open-source databases. In this dissertation, the Systemic Rapid Assessment Toolkit (SYSRA) framework was adopted, as it incorporates socioeconomic and political factors when analyzing health policies. The evaluation of efficacy involved assessing significant changes in countries' core IHR capacity, as measured by modifications in their SPAR scores. To assess effectiveness, the extent to which countries' SPAR scores accurately reflected the capacity and severity of the health problem's impact from both health and non-health perspectives was examined. The analysis utilized SPSS 18, with statistical significance defined as p<0.05. Ethical considerations were not applicable in all studies since no human subjects were involved as research participants.
Results: In Study 1, the importance of SPAR scores in monitoring core IHR capacities, especially during the COVID-19 pandemic, was revealed. Although there have been some improvements in the scores, the global average remains inadequate, indicating a lack of sufficient global capacity to effectively manage the pandemic. Study 2 emphasized the necessity of including non-health factors in the SPAR framework to improve the assessment of countries' capacities and consider the impact on quality of life during health emergencies. Furthermore, Study 3 addressed the deficiency in monitoring and evaluating countries' awareness and capacities to address the threat of Antimicrobial Resistance (AMR). It stressed the significance of integrating the One Health approach in future IHR implementations to address this issue.
Conclusions: Through three conducted studies, this dissertation concludes that the implementation of the IHR as a global instrument demonstrates both efficacy and effectiveness in controlling infectious diseases, as evidenced by the analysis of SPAR scores. |
