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ประชาคมอาเซียน : โอกาสและความท้าทาย การป้องกันควบคุมโรค พื้นที่ชายแดนและแรงงานต่างด้าว PowerPoint PPT Presentation


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ประชาคมอาเซียน : โอกาสและความท้าทาย การป้องกันควบคุมโรค พื้นที่ชายแดนและแรงงานต่างด้าว. สพ.ญ. ดาริกา กิ่งเนตร , DVM , MPH ผู้อำนวยการสำนักงานความร่วมมือระหว่างประเทศ กรมควบคุมโรค โทรศัพท์ 02 590 3835, 02 590 3832, โทรสาร 02 591 3625, 02 591 3624

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ประชาคมอาเซียน : โอกาสและความท้าทาย การป้องกันควบคุมโรค พื้นที่ชายแดนและแรงงานต่างด้าว

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4248736

:

.. , DVM, MPH

02 590 3835, 02 590 3832, 02 591 3625, 02 591 3624

: [email protected], [email protected]

: http://oic.ddc.moph.go.th


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ASEAN Community AC


Asean association of southeast asian nations

()ASEAN :Association of Southeast Asian Nations

  • .. 2010

  • Thailand

  • Malaysia

  • Indonesia

  • Philippines

  • Singapore

  • BruneiDarussalam .. 2527

  • Viet Nam.. 2538

  • Lao PDR .. 2540

  • Myanmar .. 2540

  • Cambodia .. 2542

(Bangkok Declaration) 8 2510


31 2558

31 2558

ASEAN Community : AC


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ASEAN Community - ACOne Vision, One Identity, One Community

.

.

..

.. 2553


Asean one community comes with opportunities and threats

Opportunities

Larger markets, higher economic growth

More work opportunities

Better IT network

More exchange and collaborations

etc.

ASEAN One communitycomes with opportunities and threats

  • Threats

  • Easier and more cross-border movements of people, workforce; hence, the source of infections

  • Influx of poor quality foods, drugs, chemicals, alcohol & tobacco

  • More accidents

  • Overload of health service

  • Drainage of HCW

  • etc.


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ASEAN(Thailand, Malaysia, Indonesia, Philippines, Singapore, BruneiDarussalam, Viet Nam, Lao PDR, Myanmar, Cambodia) 600 ( 2555)

  • ASEAN+3

  • 2,120

  • 1 3

+

  • ASEAN+6

  • 3,352

  • 1 2

Internet World Stats 30 2555

Total World Population7,017,846,922

China 1,343,239,923, India 1,205,073,612, Indonesia 248,645,008, Japan 127,368,088, South Korea50,004, 441

Australia22.68 Million New Zealand 4.43 million


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ASEAN 10 countries : 583 Millions of Pop. (9 % of the world's population)

GDP 1,275 BillionsUSD (2% of the worlds GDP)

ASEAN+3 :2,068 Millions of Pop.(31 % of the world's population) GDP 9,901 BillionsUSD (18% of the worlds GDP)

ASEAN+6: 3,284 Millions of Pop. (50 % of the world's population)

GDP 12,250 BillionsUSD (22% of the worlds GDP)


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MOU ..

----


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Health Collaborative Networks

Global health

APEC

ASEAN

ACMECS

Regional & Trans-regional APEC, ASEAN,

Sub-regional - GMS, LMI, ACMECS,

Bilateral- TUC, JICA, TICA, China, UK HPA,

- Neighboring countries :Cambodia,

Lao PDR, Myanmar, Malaysia

UN Agencies -WHO, UNICEF, FAO, OIE, ..

NGOs - MBDS, KENAN, .

MBDS


Asean socio cultural community ascc

ASEAN Socio-cultural Community - ASCC


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ASEAN Health Ministerial Meeting (AHMM)

Senior Officials Meeting on Health Development (SOMHD)

ASEAN Expert Group on Commu-nicable Diseases (AEGCD)

ASEAN Working Group on

Pandemic Preparedness and Responses (AWGPPR)

ASEAN Task Force on Non Communicable Disease (ATFNCD)

ASEAN Technical Focal Point on AIDS (ATFOA)

ASEAN Focal Point on Tobacco Control (AFPTC)

ASEAN Expert Group on Food Safety (AEGFS)

ASEAN Working Group on Pharma-ceutical Develop. (AWGPD)

ASEAN Task Force on Traditional Medicine (ATFTM)

ASEAN Task Force on Maternal and Child Health (ATFMCH)

ASEAN Mental Health Task Force (AMT)

  • ASEAN+3

  • FETN

  • APL

  • Risk Communication

Health & Communicable Diseases, ASEAN Secretariat,

Provide coordinating support to AMS,

4 staff, project based staff


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Main Land ASEAN

CLMV

Cambodia, Lao PDR, Myanmar, Vietnam


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Globalization, Global Warming, Ageing Society

AC and ASEAN Connectivity,.

Nothing on earth is more International than

Disease

KeertiBhusanPradhan, WHO


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Distribution of migrants in Bangkok


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2558


E ver ready for emerging infectious diseases

?Ever-Ready for emerging Infectious Diseases


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Preparedness for

Public Health Crisis is paid off

If we want peace,

we need

Preparedness

King Rama VI


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2 .. 2540.

.... ... ... ............. ...


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2 .. 2540.

: ..If we look at some faces in Bangkok we can surmise that they came from foreign countries illegally. We do not know what diseases they carried, there must be some. We have to seek out those who carry a disease to provide them with some medical treatment. Whether they came in illegally or not, the diseases they carry have also entered the country illegally. Nevertheless, we must fight the diseases regardless of whether it came legally or illegally. We must help, otherwise the disease will surge up and spread out again. This is the duty or it could be called the future mission that we have to do in the future. We cannot rest on our laurels after our victory, we cannot stop working.


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11

.. 2555-2559


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1.

2.

3.

4.


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(ASEAN)

(.. . )

(Capacity Building)

.

.

.

.

.

.

.

.


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2563


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6

2.

1.

3.

6.

4.

5.

: . ..


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  • ()

  • ()

  • ( )


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Plague Outbreaks

India, 1994

Economic Loss:1,700 Mil.USD

Between 1348 and 1359 the Black Death wiped out an estimated 30 percent of the population in Europe and Asia.


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Influenza A/H7N9 in China

February 2013January 2014

  • Summary of confirmed human infections*:

  • Median age = 58 years (range: 3-91)

  • 72% cases male

  • Apparent case fatality rate = 24%

  • Cases in clusters (2 or more) = at least 5%

  • Cases with connections to China = 100%

  • Cases with likely contact with poultry = at least 34%

  • Cases involving health workers = 0%

  • Cases with basic data** = 55%

Sources = World Health Organization, Food and Agriculture Organization, OIE, ProMed, Flutrackers, and scientific publications through 1/23/14; * may be biased towards more-severe cases that are more-easily recognized. ** includes age, gender, location, clinical outcome, and dates for symptom onset, hospitalization, death (if applicable) in publicly-available reports

= male; = female

^ Anhui (4), Beijing (2), Fujian (12), Hebei (1), Henan (4), Hunan (2), Jiangxi (6), Shandong (2), Taiwan (2)


Components of c ommunicable disease control measures

Social mobilization

Case Management

Co-ordination

Surveillance &

Laboratory

investigation

Logistics & Security

Components of CommunicableDisease Control Measures

Risk Communication

Outbreak

Communication

Crisis Communication

(All Hazards)


Success stories in thailand

Success Stories in Thailand

Plague eliminated (1952)

Smallpoxeradicated (1962)

Yaws (no cases since 1966) few cases re-emerged in some

years, 22 cases in 2004

Poliomyelitis (no cases since 1997)

Vaccine preventable diseases

Human diseases (Diphtheria, Pertussis, Tetanus, Mump, JE)

Zoonoses(Anthrax, Rabies,)

Filariasis, Leprosy (under controlled)

HIV/AIDS(substantially controlled)


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Emerging Infectious Diseases (EIDs)

  • New infectious diseases

  • New geographical areas

  • Re-emerging infectious diseases

  • Antimicrobial resistant organisms

  • Deliberate use of bio-weapons


Eids of major concern s

EIDs of Major Concerns

Avian influenza and Pandemic influenza

Re-emerging TB (MDR and XDR)

Drug Resistant Malaria,

HIV/AIDS (more focus in youths)

Severe HFMD (Enterovirus 71, .)

EIDs and Re-EIDs from abroad e.g.

- Plague, SARS

- Encephalitis (Nipah, West Nile..)

- Hemorrhagic Fever (Ebola, Marburg.), Yellow Fever

- Chikungunya

- Vaccine preventable diseases (diptheria,.)

Antimicrobial resistance pathogens


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Risk for areas with recent local transmission of SARS

?

?

!!!

Low (+)

Case in area of exportation

?

Medium (++)

High (+++)

Low (+) : Imported probable SARS case(s) have produced only one generation of local probable cases, all of whom are direct personal contacts of the imported case(s)

Medium (++) : More than one generation of local probable cases, but only among persons that have been previously identified and followed-up as known contacts of probable SARS cases

High (+++) : High transmission pattern other than described above in (+) and (++)

Uncertain : Insufficient information available to specify areas or extent of local transmission


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WHO Issues first travel advisory 15 March

WHO Issues Global Alert

12 March

SARS !

  • Global cooperation

  • National transparency

  • National preparedness

  • Naming diseases carefully


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2547 2549

( 25 17 .. 49)

..-.. 47

..-.. 47

..-.. 48

..-..49

..-..50

H5N1 Fujian-like (clade 2)

H5N1

Vietnam-like (clade 1)


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HPAI Task Force

Prov. Gov. (Director)

Provincial Livestock Office

Provincial Health Office

HPAI Task Force

District Gov. (Director)

District Livestock Officer

District Health Office

Local municipalities

Sub-District Health Unit

Chief of village/ Livestock volunteer/ Poultry owner

Public Health Volunteer

Intregrated management of HPAI at provincial level


Voices of reason quieter than voices of panic hilary m babcock md mph

() 2009

Voices of reason quieter than voices of panicHilary M Babcock, MD, MPH


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Response in public health emergency

Response in Public Health Emergency

Botulism Outbreak (163 cases) from Canned Bamboo shoot, Nan, 2006


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2555


Pher orphan drugs risk communication

, PHER, Orphan drugs, Risk Communication

Confirm case

Carrier

27

26

21

22

23

24

1

14

18

20

4

5

7

8

15

17

25

19

12

16

11

6

2

3

9

10

13


Expected roles of national health authority

?

Expected roles of national health authority

  • Policy and strategy development

  • Knowledge management

  • Technology assessment & development

  • Standardization of disease control practices

  • Surveillance

  • Regulatory

  • International cooperation

  • monitoring and evaluation

  • Financing

  • Information

  • manpower development


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  • (DCCD) (DHS)

  • IHRs(2005)


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()

  • (Surveillance and Rapid Response Team : SRRT)

  • .


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  • MBDS

  • HIV/AIDS,

    TB, Malaria, EIDs (Avian Flu, Plague, Diptheria, Emerging Zoonoses, .)

  • Event-based surveillance

    (Public Health Emergency of International Concern : PHEIC)


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..2005

International Health Regulations (2005) : IHRs (2005)

(Points of Entry check list)

-

- PoE (Routine)

- PoE

(PHEIC)


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  • cholera, plague and yellow fever


National ihr core capacity requirements

8 Core capacities

Legislation and Policy

. .........

Coordination

Surveillance

Response

Preparedness

Risk Communications

Human Resources

Laboratory

3 levels

National

Intermediate

Peripheral/Community

National IHR Core Capacity Requirements

  • Potential Hazards

    • Biological

      • Infectious

      • Zoonoses

      • Food safety

    • Chemical

    • Natural Disaster

    • Radiological and nuclear

    • Eventsat Points of Entry

WHO


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  • /

  • .

  • ./

    • /

Global health

APEC

ASEAN

ACMECS

MBDS


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Disease Control Competent District (DCCD)

:


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(District Health System : DHS) (DCCD) Health Promotion Hospitals - PCU (Close to client)


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(District Health System : DHS)

UCARE :

Unity -

Community -

Appreciation -

Resource sharing -

Essential care -


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..

// / .

45 1


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( 3 .) (3 .)

. 6.1 ( 3 ) , ,

. 6.2 ,,

. 6.3 ,

. 10 (5 .) ( 30 )

. 10.1 (10 .)

. 10.2 (3 .)

. 10.3 (7 .),

. 10.4 (7 .),

. 10.5 ( 3 .),

.9 (3 .) (15 .)

. 9.1 ,,

( 5 .)

. 9.2 ( 3 .)

. 9.3 () (7 .)

10

.

(Laos)

. 7 (3 .)(3 .)

. 7.1 ,, , ( 3 . )

. 7.2 ,

. 7.3

(Myanmar)

6

. 8 (2 .) ( 4 )

. 8.1 , ( 2 .)

. 8.2 , ( 2 .)

8

6))

5

2

(Cambodia)

1

4

. 2

,,,,

1

. 5 (4 .) (12 .)

. 5.1 (3 .)

. 5.2 (2 .)

. 5.3 (4 .)

. 5.4 .(3 .)

. 4 (4 .) ( 22 . )

. 4.1 (10 .),

. 4.2 (3 .)

. 4.3 (5 .)

. 4.4 (4 .)

. 1

1.

2.

3.

4.

. 3 (5 .) ( 25 .)

. 3.1 (2 .) ,

. 3.2 (5 .) ,

. 3.3 (4 .)

. 3.4 (6 .)

. 3.5 (8 .)

11

. 11 (5 .)( 33 )

. 11.1 (5 .),

. 11.2 (9 .) ,

. 11.3 (8 .)

. 11.4 (6 .)

. 11.5 (5 .)

. 12 (4 .) ( 23 )

. 12.1 (5 .)

. 12.2 ( 7 .) ,

. 12.3 ( 6 .)

. 12.4 ( 5 .)

(Malaysia)

21 2555


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Bilateral/ Multilateral/ Regional Collaboration

  • International Organizations for Technical Support

  • Development Partners TICA, JICA, USAID, MBDS, KINAN, etc.

  • Bilateral Collaboration TUC /

  • (Twin Cities)

    --, -, -, -, -

    --, -, -

    --, -, -


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/

  • Global Fund ()

  • WHO, USA (USAID, LMI, TUC.)

  • JICA (Training, Disaster)

  • China (GMS, Bilateral,)

  • UK HPA (PHEM, Mass gathering..)

  • : , , , , ...

  • : ,Lab,

  • PHEM (ICS,.. ), ,.....


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/

  • ( 2556)/.

  • ., ., .

  • .() Thailand International Development Cooperation

  • Agency (TICA)

  • Training


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2557


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  • ()

  • PPP

    (Public-Private Partnership)

  • (NGOs)

Is it a Beautiful Network ?


The 4 words starting with co

Successin controlling diseases is dependent not only on

the authorities efforts but also on local people's active

participation and supports in the efforts. For securing the

participation and supports we need the following.

Communication

coordination

collaboration

cooperation

Communicationis a prerequisite for the rest of the words.

ShiroYoshimura, OIE Coordination, Bangkok Sub-Regional Office for SEA, August, 2007

The 4 words starting with co


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- . .

-

-

  • -

  • -

  • -

1-12

NGOs


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: ?

  • Networks

  • Policy, Strategy, System, Mechanism

  • Action plan

  • Emergency response plan

  • Resources

  • Core capacities IHRs (2005)


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Terimakasih

,

Salamat

Khob Jai

Terimakasih

Salamat

Thank you

Khob Kun

Cam On

Thank You


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