改善大流行防范能力:COVID-19教训(2022年)

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改善大流行防范能力:COVID-19教训(2022年)

 

 C ON TEN TS

  vi x

 F o re w o rd Ackn o wl ed gm e nts

  2

 E XEC U T I VE

 SUMMAR Y

  13

 IN TR ODUC T ION

  1 5

 A

 Rap id

 S p r ead ,

 a

 Gr im

 T o ll ,

 and

 an

 Eco n o mic

 Disaster

  18

 A

 F ailur e

 t o Heed

 W ar ning s

  19

 FI NDI NGS

  20

 3 4

 T he

 Ine vitabi lit y

 of Pandemic

 T hr eats

 and

 the

 L ogic of Pr ep ar edness

 W hat

 W en t

 W r o ng

 Glo bally

  5 1

 W hat

 W en t

 W r o ng

 Do mestic ally

  68

 RECOMMEND A T IONS

 70

  82

 A do pt

 a

 R o b ust

 Strateg y

 fo r

 Do mestic

 and

 Glo bal Pandemic

 Pr ep ar edness

 Bo lster

 Pandemic

 Pre v en tio n

  89

 Im p r o v e

 Pandemic

 Detec tio n

  9 4

 Str eng then

 Pandemic

 R esponse

  101

 CONCLUSION

 10 3

 A d diti onal an d

 Disse ntin g

 Vi e w s

  10 9

 En dn o t e s

  12 2

 Acronyms

  1 25

 T a sk

 F o rc e

 Me mbe rs

  136

 T a sk

 F o rc e

 Ob se r v e rs

  1 40

 Contr i b utin g

 CFR

 St aff

 v

 FO RE W O RD

  In

 the

 p a st

 six

 m o nths ,

 CO VI D -19

 ha s

 u pended

 our

 liv es

 t o an

 e xten t f e w

 imagined.

 At

 the

 time

 this

 r epo r t

 w en t

 t o p r in t

 in

 ear ly

 September 20 20,

 the

 vir us

 had

 alr eady

 in f ec ted

 at

 lea st

 t w en t y -fiv e

 millio n

 peo ple ar ound

 the

 w o r ld ,

 killing

 o v er

 846,0 0 0,

 n umbers

 that

 alm ost

 cer tain ly under estimate

 the

 e xten t

 of the

 t o ll .

 And

 the y

 will

 co ntin ue

 t o moun t . T he

 pandemic

 ha s

 also

 tr igg er ed

 the

 b igg est

 eco n o mic

 co llapse

 sin ce the

 Gr eat

 Depr essio n .

 As

 the

 T a s k

 Fo rce

 r ightly

 a sserts ,

 w e

 ar e

 living amid

 the

 “ w o rst

 glo bal

 c ata str o p he

 sin ce

 Wo r ld

 W ar

 II .”

 D uring

 the

 ear ly

 stag es

 of the

 pandemic,

 valuab le

 time

 wa s

 lost bec ause

 of China’s

 d issemb ling

 o v er

 the

 nat ur e

 of the

 vir us ,

 the

 e xten t t o w hic h

 it

 had

 sp r ead

 within

 its

 bo r ders,

 and

 its

 f ailur e

 t o loc k

 down the

  coun tr y .

  A

  n umber

  of

 statemen ts

  made

  b y

  the

  Wo r ld

  Health Organization

 (WHO)

 made

 a

 bad

 sit uatio n

 w o rse .

 But

 w hile

 all

 this he lps

 e xplain

 h o w

 a

 loc al

 outb r eak

 bec ame

 a

 pandemic,

 it

 is

 f ar

 f r o m the

 w h o le

 st o r y .

 W hat

 is

 str iking

 is

 that

 o n ce

 CO VI D -19

 w en t

 glo bal , natio nal

  per fo r man ces

  greatly

  d iv erg ed .

  So me

  dem ocrac ies

  ha v e success f ully

 co n tained

 the

 vir us

 w hile

 others

 ha v e

 str uggled ;

 the

 same h o lds

 fo r

 auth o r itar ian

 sy stems .

 So me

 r e lativ e ly

 high -in co me

 coun tr ies ar e

  f ar ing

  m uc h

  w o rse

  than

  their

  lo w er -in co me

  coun ter p ar ts .

  T he single

 m ost

 im po r tan t

 determinan t ,

 it

 t ur ns

 out ,

 ha s

 been

 the

 qualit y

 of politic al

 leadership

 and

 e x ec utio n .

 T he

  United

  States

  testi fies

  t o

 the

  co nsequen ces

  of

 a

  f ailur e

  in

 politic al

 leadership.

 A

 coun tr y

 with

 just

 o v er

 4

 percen t

 of the

 w o r ld’s po pu lation

  n o w

  accoun ts

  fo r

  o ne-quar ter

  of

 the

  w o r ld’s

  kn o wn c a ses

 and

 m o r e

 than

 20 percen t

 of attr i b uted

 deaths.

 T hir t y

 millio n Amer ic ans

 ar e

 unemp lo y ed ,

 w hile

 U.S gr oss

 do mestic

 p r oduc t

 f e ll

 9.5 percen t

 in

 the

 seco nd

 quar ter

 of 20 20,

 the

 larg est

 quar ter ly

 decline

 in the

 natio n’s

 hist o r y .

  vi

 F or e w or d

  T he

 T a s k

 Fo rce

 co rr ec tly

 co n c ludes

 the

 United

 States

 wa s “ un p r ep ar ed

 fo r

 CO VI D -19”

 and

 its

 r esponse

 wa s

 “deep ly

 fla w ed .” On ce

 CO VI D -19

 r eac hed

 Amer ic an

 sh o r es ,

 the

 f ederal

 g o v er nmen t

 d id n ot m o b i li ze

 a

 natio nal

 r esponse ,

 instead

 lea ving

 it

 t o states

 t o larg e ly figur e

 it

 out

 fo r

 themse lv es .

 T he

 administratio n

 f ailed

 t o co mm unic ate a

 co nsisten t ,

 sc ien ce-ba sed

 messag e ,

 instead

 politic izing

 ma s k -w ear ing. It

 d id

 n ot de v e lo p

 a

 natio nwide

 sy stem

 fo r

 the

 so r t

 of testing

 that

 w ou ld ha v e

 made

 a

 d iffer en ce—testing

 that

 p r o vides

 quic k ,

 acc urate

 r esu lts w her e

 the

 test

 is

 administer ed—and

 neglec ted

 t o b uild

 the

 c ap ac it y t o co nduc t

 co n tac t

 trac ing.

 T he

 e v en t ual

 r esponse ,

 w hic h

 attem pted t o

 balan ce

  pu b lic

  health

  co n cer ns

  with

  eco n o mic

  co nsideratio ns , r esulted

 in

 w o rse

 outco mes

 acr oss

 both

 d imensions .

 T he

 T a s k

 Fo rce d ip lo matic ally

  co n c ludes

  “ the

  nation

  and

  its

  leaders

  cou ld—and sh ould—ha v e

 do ne

 m uc h

 better .”

 W hile

 w e

 ar e

 sti ll

 living

 amid

 the

 pandemic,

 and

 ar e

 lik e ly

 t o r emain

 so

 fo r

 so me

 time

 t o co me ,

 w e

 c an

 alr eady

 iden ti f y

 im po r tan t

 lessons that

 m ust

 be

 ap p lied

 so

 that

 the

 United

 States

 and

 the

 w o r ld

 ar e

 better p r ep ar ed

 fo r

 f utur e

 wa v es

 of this

 pandemic

 and

 the

 ne xt

 o ne—and ther e

 will

 be

 a

 ne xt

 o ne .

 T he

 T a s k

 Fo rce

 puts

 fo r war d

 a

 h ost

 of po lic y p r escr i ptio ns

 that

 w e

 w ou ld

 be

 wise

 t o ado pt .

 Most

 f undamen tally ,

 the auth o rs

 em phasi ze

 the

 need

 t o r ecognize

 the

 thr eat

 in f ec tious

 d isea ses pose

 t o the

 United

 States ,

 mak e

 pandemic

 p r ep ar edness

 a

 natio nal sec ur it y

 p r io r it y

 o n

 p ar

 with

 natio nal

 de f ense ,

 and

 o rgani ze

 and

 in v est acco r d ingly .

 T he

 auth o rs

 also

 reco mmend

 that

 the

 United

 States

 re for m the

 Cen ters

 fo r

 Disea se

 Co n tr o l

 and

 Pre v en tio n ,

 c lari f y

 f ederal

 and state

 auth o r ities

 and

 r o les

 fo r

 pandemic

 r esponse ,

 cr eate

 a

 natio nwide strateg y

 fo r

 testing

 and

 co n tac t

 trac ing,

 and

 tak e

 steps

 t o en han ce

 the r esi lien ce

 of med ic al

 su pp ly

 c hains.

 With out

 suc h

 r e fo r ms ,

 the

 auth o rs

 war n ,

 “an y

 f utur e

 pandemic

 r esponse

 will

 be

 n o better

 than

 the

 c ur r en t , m uddled

 per fo r man ce ,

 with

 high

 h uman

 and

 eco n o mic

 costs .”

 In

 add itio n

 t o p r o posing

 do mestic

 r e fo r ms ,

 the

 T a s k

 Fo rce

 r ightly po in ts

  out

  that

  “ the

  natio nal

  and

  in ter natio nal

  d imensions

  of

 the pandemic

  ar e

  m ut ually

  r ein fo rc ing

  and

  c ann ot

 be

  co nsider ed

  in iso lation .”

 In

 the

 sh o r t

 r un ,

 the

 r epo r t

 c alls

 fo r

 estab lishing

 a

 glo bal f rame w o r k

  t o

 ensur e

  the

  equitab le

  alloc atio n

  of

 vacc ines .

  Ov er

  the lo ng er

 ter m ,

 the

 auth o rs

 p r o pose

 n umer ous

 r e fo r ms

 t o m u lti lateral instit utio ns ,

 urging

 the

 United

 States

 t o lead

 these

 effo r ts .

 T his

 w ou ld en tai l

 r e jo ining

 WHO

 and

 w o r king

 within

 the

 o rgani zation

 t o en han ce its

 effec tiv eness .

 R ecogni zing

 that

 e v en

 a

 str eng thened

 WHO

 w ou ld be

 unable

 b y

 itself

 t o lead

 an

 effec tiv e

 pandemic

 r esponse ,

 the

 T a s k Fo rce

 adv oc ates

 that

 the

 United

 Nations

 a ssume

 a

 m o r e

 p r o minen t r o le

 and

 that

 the

 United

 States

 spear head

 the

 cr eatio n

 of a

 flexi b le in ter natio nal

 coalitio n

 t o m o b i li ze

 the

 eco n o mic ,

 sec ur it y ,

 and

 p r ivate- sec t o r

  r esponse

  t o

 pandemic

  thr eats .

  T he

  auth o rs

  f ur ther

  p r o pose that

 the

 United

 States

 he lp

 estab lis h

 a

 glo bal

 epidemic

 sur v ei llan ce and

 fo r ec a sting

 c ap ac it y

 that

 mak es

 glo bal

 health

 sec ur it y

 m uc h

 less dependen t

 o n

 the

 transpar en c y

 of ear ly

 affec ted

 states

 and

 the

 r is k a ssessmen ts

  of

 the

  WHO

  Emerg en c y

  Co mmittee .

  T he

  T a s k

  Fo rce reco mmends

 that

 the

 United

 States

 p ar tner

 with

 other

 nations

 and in ter natio nal

  finan ce

  instit utio ns

  t o

 a ssist

  lo w er -in co me

  coun tr ies in

 co ping

 with

 the

 c ur r en t

 pandemic

 and

 im p r o ving

 their

 pandemic p r ep ar edness

 c ap ab i lities .

 T hese

 ar e

 all

 w o r thwhile

 endea v o rs , b ut

  I

  w ou ld

  h o pe

  the

  United

  States

  w ou ld

  also

  co nsider

  bac king the

  estab lis hmen t

  of

 an

  aut o n o mous

  w a t c h d o g

  g r o u p

  t h a t

  w o u l d r e p o r t

 o n

 c o m p l i a n c e

 with

 the

 In ter natio nal

 Health

 R egu lations ,

 the in ter natio nal

 legal

 f oundatio n

 fo r

 glo bal

 health

 sec ur it y ,

 giv en

 the

 r eal possi b i lit y

 that

 an y

 group

 a ssoc iated

 with

 the

 UN

 sy stem

 will

 n ot be wi lling

 t o c halleng e

 po w er f u l

 member

 coun tr ies .

 It

 is

 im po r tan t

 also

 t o thin k

 about

 w hat

 CO VI D -19

 te lls

 us

 about

 the

 w o r ld

 in

 w hic h

 w e

 liv e .

 T he

 pandemic

 is

 a

 te xtboo k

 mani f estatio n

 of globali zation .

 W hat

 happened

 in

 W u han

 d id

 n ot sta y

 in

 W u han.

 T his vir us

 does

 n ot r espec t

 an y

 bo r ders.

 A dd itio nal

 glo bal

 health

 c halleng es will

 co ntin ue

 t o p r esen t

 themse lv es ,

 a s

 will

 other

 r isks

 a ssoc iated

 with globali zation ,

 f r o m

 c limate

 c hang e

 t o c y berthr eats

 and

 ter r o r ism .

 In r ecen t

 y ears ,

 m uc h

 atten tio n

 ha s

 been

 de v oted

 t o U.S .-China

 r elations , w hic h

  is

  understandable,

  b ut

  w hat

  mak es

  this

  era

  d iffer en t

  is

  that in ter natio nal

  o r der

  will

  n ot

 sim p ly

  be

  a

  f un ctio n

  of

 gr eater

  po w er dynamic s

 b ut

 will

 also

 r e flec t

 the

 w o r ld’s

 ab i lit y

 t o co me

 t og ether

 t o meet

 glo bal

 c halleng es .

  viii

 F or e w or d

 W hat

  is

  so

  r emar kable,

  then ,

  is

  that

  the

  r esponse

  t o

 this

  glo bal cr isis

 ha s

 been

 alm ost

 en tir e ly

 natio nal.

 T her e

 is

 little

 in ter natio nal coo peration

  and

  coo r d ination

  occ ur r ing.

  T he

  United

  States

  f ailed t o

 c atalyze

  a

  co llec tiv e

  r esponse

  thr ough

  either

  WHO,

  the

  Gr oup of T w en t y ,

 Gr oup

 of Se v en ,

 o r

 the

 UN

 Sec ur it y

 Counc i l .

 Coun tr ies ar e

  c losing

  bo r ders,

  h oar d ing

  med ic al

  equip men t ,

  and

  co m peting t o de v e lo p

 a

 vacc ine .

 T he

 loo ming

 questio n

 is

 w hat

 will

 ...

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