比利时应对大流感和危机的机制及措施

为应对全球大流感，比利时于2006年正式组建了一系列相应机构。完善的应急机制是实施比利时大流感应急计划和措施的保证。本文对比利时公共卫生体系、非危机时期的机制、危机时期的机制、比利时应急机制与世界卫生组织（WHO）等级比较、政府在应对大流感中的作用等进行介绍。     

Sustainable Health Financing for COVID-19 Preparedness and Response in Asia and the Pacific

To make health systems more resilient to shocks and crises, it is critical for governments to invest in core health system functions such as financing, service delivery, and governance. Ensuring sufficient resources for health is necessary for basic infrastructure including vaccines; the overall level of health expenditure and the public sources of funding are important. Funding for public health services, including infection prevention and control, surveillance, and information systems, is fundamental to ensure health systems are prepared for and respond to health emergencies. Funding should be made available for a quick and effective response to emergencies, requiring a supportive flexible public financial management system. Moreover, it is essential to mitigate the potential risks of health system collapses through innovative ways, for example, telemedicine, and mobilizing private sector providers. Vulnerable groups who are even more impacted during crises need special attention. Multisectoral cooperation is paramount to health system resilience during pandemic response.     

Structural reliability of conjoint measurement in health care: an empirical investigation

This paper is concerned with the structural reliability of conjoint measurement when applied in a health care setting. The clinical context was the diagnosis and treatment of knee injuries. A conjoint measurement study was conducted which used the pairwise choice approach to preference elicitation. Each choice included two scenarios: a conventional treatment approach to management (arthroscopy) and an approach using magnetic resonance imaging. In order to test for structural reliability two separate conjoint measurement exercises were conducted: exercise A where scenarios were defined in terms of three attributes and exercise B where scenarios included all four attributes. The assessment of structural reliability involved a comparison of two random effects probit models, for exercises A and B. Data were collected on a total of 176 students of sports science. The results strongly indicate that the models for the two exercises are different, although the instability is limited to the constant term and a single model attribute (i.e. the avoidance of surgery). The finding of instability in the constant coefficient raises important questions about the appropriateness of labelling scenarios in conjoint measurement exercises.     

Foresight tools for participative policy-making in inter-governmental processes in developing countries: Lessons learned from the eLAC Policy Priorities Delphi

The paper shows how international foresight exercises, through online and offline tools, can make policy-making in developing countries more participatory, fostering transparency and accountability of public decision-making. A five-round Delphi exercise (with 1454 contributions), based on the priorities of the 2005-2007 Latin American and Caribbean Action Plan for the Information Society (eLAC2007), was implemented. This exercise aimed at identifying future priorities that offered input into the inter-governmental negotiation of a 2008-2010 Action Plan (eLAC2010). It is believed to be the most extensive online participatory policy-making foresight exercise in the history of intergovernmental processes in the developing world to date. In addition to the specific policy guidance provided, the major lessons learned include (1) the potential of Policy Delphi methods to introduce transparency and accountability into public decision-making, especially in developing countries; (2) the utility of foresight exercises to foster multi-agency networking in the development community; (3) the usefulness of embedding foresight exercises into established mechanisms of representative democracy and international multilateralism, such as the United Nations; (4) the potential of online tools to facilitate participation in resource-scarce developing countries; and (5) the resource-efficiency stemming from the scale of international foresight exercises, and therefore its adequacy for resource-scarce regions. Two different types of practical implications have been observed. One is the governments' acknowledgement of the value of collective intelligence from civil society, academic and private sector participants of the Delphi and the ensuing appreciation of participative policy-making. The other is the demonstration of the role that can be played by the United Nations (and potentially by other inter-governmental agencies) in international participatory policy-making in the digital age, especially if they modernize the way they assist member countries in developing public policy agendas.     

从防控甲型H1N1流感看印度应对公共卫生紧急事件运作体系的特点

本文介绍了印度预防和控制甲型H1N1流感的措施，并以此为切入点论述、分析了印度应对公共卫生紧急事件运作体系中一些积极有效的特点，包括：各级专门的协调指挥机构；有法可依；设有专项资金；有专门应对灾害的科研院所和专家队伍；具有一个能够使各项资源优化结合的运作体系。     

Examining the long-term mortality effects of early health shocks

A growing literature in economics and other disciplines has tied exposure to early health shocks, particularly in utero influenza, to reductions in a variety of socioeconomic and health outcomes over the life course. However, less evidence exists that examines this health shock on mortality because of lack of available data. This paper uses recently released restricted-access files from the large, representative National Longitudinal Mortality Study in the United States to explore the mortality effects of the 1918 influenza pandemic for those in utero. While the results on socioeconomic outcomes mimic those in the literature, showing reductions in completed schooling and income fifty years following influenza exposure, the findings also suggest no effect on overall mortality or by categories of cause-of-death. These results are unexpected in their contrast with the many reported effects of in utero insults on later cardiovascular health as well as the literature linking education with later mortality.     

美国应对甲型H1N1流感的经验及防控建议

甲型H1N1（猪）流感这一新型流感病毒的突然爆发是对世界公共卫生系统防治流行病传播的一次考验。美国以及世界各国在应对此次甲型H1N1流感爆发中展示了应对流行疾病防控能力和经济实力，当然，也暴露了不少不足之处。倘若疫情的范围进一步扩大、严重性增加，美国公共卫生系统会无法承受。本文简要阐述美国智囊组织对美国应对甲型H1N1流感爆发的经验和防控建议，以及作者的几点启示。     

新冠肺炎疫情期间城市公园绿地运行管理 研究

新冠肺炎(COVID-19)疫情期间,城市公园绿地作 为重要的绿色基础设施,成为公众日常生活中不可或缺的公共 空间环境,对疫情防控和维持公众身心健康具有积极意义。从 疫情期间公园绿地的功能作用分析入手,结合新冠肺炎病毒传 播特点、防控要求和国内典型城市应对疫情管理实践,提出了 疫期公园绿地运行管理的基本原则和构建公园绿地防疫体系、 建立内外联防联动机制、实施分级分类分区域管控、综合确定 疫期游人规模、施行管控与疏导相结合等系列策略,以及启动 应急管理、安全评估与分级管控、园内环境卫生消毒、疫期优 质管养、员工健康维护、正向科普宣传等对策措施,以期提升 城市公园绿地应对突发重大公共卫生事件的能力和运行管理水 平,为做好疫情期间公园绿地的科学管理和安全运行提供参考 依据。     

The economic effects of lowering HIV incidence in South Africa: A CGE analysis

South Africa has the highest UNAIDS HIV severity rating: “generalised pandemic”. A country with this classification requires public health interventions aimed at the general population. This paper investigates the efficacy of one such policy, examining the national economic effects of an increase in condom use. We use an epidemiological model to estimate the impact of condom use on HIV infections distinguished by age, gender and race. The epidemiological model's outputs are input to an economy-wide dynamic general equilibrium model that distinguishes labour market participants by age, gender, race, labour market status and HIV status. We find that the programme generates gains in real consumption with a present value of approximately USD $30 billion, or USD $2000 per household.     

重大突发公共卫生事件科技研发应急体系运行机制研究

在突发事件应急管理过程中,科技研发支撑作用十分关键,亟需建立突发公共卫生事件科研应急体系长效运行机制。基于科技研发应急体系的复杂性、适应性特征,从主体属性和体系架构两个层面入手,分析重大突发公共卫生事件科技研发应急体系的复杂适应系统特征,运用复杂适应系统理论模型和动态闭环螺旋模型,研究重大突发公共卫生事件科技研发应急体系运行机制。研究发现,重大突发公共卫生事件背景下,科技研发应急体系具有复杂适应系统的7个基本特征,是典型的复杂适应系统;科技研发应急体系中,科研攻关专家组、诊疗医院、科技部门等科研主体具有各自内部模型,并通过6大标识进行聚集;科技研发应急体系存在事件—需求引导、主体协同、资源交互、成果转化机制。同时,新冠病毒肺炎疫情应对实践表明,疫情防控救治进程中科技研发应急体系存在并遵循上述运行机制。     

Learning through games? Evaluating the learning effect of a policy exercise on European climate policy

One of the arguments for the use of simulation-gaming approaches in policy appraisal has consistently been their potential to stimulate learning. Yet few studies seek to ascertain the learning effects of these methods in a systematic manner; on the whole, participants' learning from interactive appraisal processes remains both under-conceptualised and under-evaluated. This paper seeks to contribute to filling this gap by developing a typology of learning effects (cognitive, relational, and normative) that can be expected from policy games. We subsequently present a set of tools for measuring them and test our approach on the case of a policy exercise on burden sharing in future European climate policy involving policy-makers and experts.On the basis of our measurements, we found limited evidence for learning from the policy exercise, mostly in the cognitive and the relational domain. In this context, the use of concept maps is an interesting methodological innovation. Employed as pre- and post-measurements, they proved a useful tool for tracing conceptual change through the exercise among participants. The paper concludes with a plea for more systematic assessment of the learning effects of interactive appraisal exercises, with a view to enabling a deeper discussion on the benefits and limitations of these methods.     

欧洲卫生技术评估网络发展概况

面对医疗技术更新、民众医疗服务需求提升和医疗投入有限等多重卫生系统压力,欧洲国家力图在其卫生政策制定、管理、报销或监管过程中利用卫生技术评估（Health Technology Assessment,HTA）方法,在充分进行医疗组织、经济、社会和伦理等方面论证的基础上,综合透明、科学和可靠的证据,确定卫生政策优先领域,推动卫生体系的健康可持续发展。欧洲在卫生技术评估方面的有益经验,对我国强化卫生技术评估理念和做法,支持卫生政策制定,具有积极的借鉴意义。     

Public–private mix of health expenditure: A political economy and quantitative analysis

This paper constructs a simple model to examine decisions on public and private health spending under majority voting. In the model, agents with heterogeneous incomes choose how much to consume and spend on health care and vote for public health expenditure. The health status of an agent is determined by a CES composite of public and private health expenditure. The existence and uniqueness of the voting equilibrium are established. A quantitative exercise reveals the importance of the relative effectiveness of public and private health expenditure and their substitutability in determining the public‐private mix of health expenditure and in accounting for the observed differences across a sample of 22 advanced democratic countries.     

Impact of infectious disease pandemics on individual lifetime consumption: An endogenous time preference approach

This paper considers the impact of the coronavirus disease 2019 (COVID-19) pandemic on long-term individual lifetime consumption profiles. The framework for the analysis is a model that extends Strulik (2021) to include the government sector, where time preference is determined by individual health damage (deficit) distinct from normal aging. Thus, the health damage caused by COVID-19 changes the rate of time preference and consequently affects the Euler equation for consumption. Our theoretical contribution is the consistent incorporation of public health investment into the existing model to understand the effect of government measures against a pandemic. Numerical analysis based on this model is used to estimate changes in health status over time, trends in the rate of time preference, and individual lifetime consumption profiles, taking into account differences in age at the time of the pandemic and the nature of the government responses. Because the long-term negative economic impact would be enormous, we should avoid advocating for “living with COVID-19” without due consideration. The reopening of the economy must be accompanied by a commitment to the containment and elimination of infections with future novel coronaviruses.     

意大利国家流感预防和应对计划

本文介绍了意大利《国家流感预防和应对计划》的设立背景、目的和相关应对措施以及在此次甲型H1N1流感疫情出现后，意大利政府所采取的防控措施，希望能给我国在应对此次流感的过程中提供些借鉴和参考。     

浅谈高校体育教学中的心理健康教育

在全面实施素质教育,树立“健康第一”的指导思想的过程中,健康体魄是青少年为祖国和人民服务的基本前提,是中华民族旺盛生命力的体现。因此,应该将体育教育和健康教育紧密结合起来,形成以身体锻炼,体育保健和心理健康有机结合的学校体育教育,以提高学校体育活动,改善心理状态,克服心理障碍,活动的乐趣和成功的感觉,使学生身心得到全面健康发展。     

Social contact in a pandemic: Rationality vs. heuristics

During the Covid pandemic, people weighed the benefits of social contact against the risks to their health. Ideally, people would respond based on the true infection rate; this is the rational model. However, there was high uncertainty, so perhaps people relied upon the heuristic model instead. I estimate revealed preferences for health and social contact at the county level and find evidence in favor of the heuristic model. This is important since many models of optimal policy assume that people respond to the true infection rate.     

Demography and welfare economics

The focusing on demographic issues as an important part of welfare-economic assessment shifts the evaluative space in the direction of public discussion and social concern. A commoditycentred view of individual success and social welfare is often used in economics. But the linkage between our economic wealth and our ability to live as we would like has strong limits. This is partly because of interpersonal variations between individuals, but also because of variations in public and social arrangements (for example, for public health care, education and social security). The use of demographic perspectives can enrich economic analysis in several ways. In particular a demographically oriented system of evaluation can not only focus on variables that we all value, but it also gives us the freedom to decide what weights would be most appropriate for the exercise in which we might be engaged. The problem of valuation in welfare economics is ultimately a social-choice issue, requiring the use of explicit judgments on which the society can achieve some consensus through political processes.Lecture presented to the annual meeting of the Austrian Economic Association in Vienna, 24 May 1994. The author is grateful for support from the National Science Foundation for the research on which this paper draws.     

Genetic engineering in agriculture: New approaches for risk management through sustainability reporting

Genetically modified crops and foodstuff have been highly controversial for environmental, health, and ethical reasons. The controversies have been worldwide, but most prominent in the European Union, for reasons that include distrust of the regulatory authorities, scientists and technocratic decision making. An informal moratorium in the EU came recently to an end, without solving the underlying problems. In response to the criticisms, the European governments have attempted to improve the risk assessment methods and their scientific basis, and to tailor public policies to the growing demand for transparency, accountability, and public participation.This paper proposes a novel approach to including the public in evaluating the impacts of food and agricultural biotechnology and present and future applications modeled after the growing practice of sustainability reporting by companies. The most visible among those, Global Reporting Initiative (GRI), when implemented properly, includes a wide range of stakeholders, including the financial institutions, companies, NGOs and the civil society, in an interactive multi-stakeholder discourse and collaboration. The reporting exercise would open the discussion about the R&D around new GMO products, and could mitigate potential adverse effects in an early stage (Constructive Technology Assessment). We specifically propose initiating a broadly based societal initiative aimed at developing of a new sectoral supplement of GRI Guidelines, specifically designed for the food and agricultural biotechnology sector.This approach can be conceptualized as experimentation on a small scale with a multitude of stakeholders involved (Bounded Socio-Technical Experiment or BSTE) which is an effective venue for higher-order learning among participants. Sustainability reports and BSTEs have been so far applied in limited cases, none of which included highly controversial technologies such as biotechnology; they need further elaboration and testing to become possibly highly effective concepts and tools for mitigating conflicts on the societal implications of emerging technologies, and to lead to better public policies and greater social trust.     

Valuing the Arsenic Contamination of Groundwater in Bangladesh

The use of groundwater in Bangladesh has in the past been promoted as a means of avoiding waterborne diseases associated with the consumption of untreated surface water. Unfortunately, the recent discovery of high levels of naturally occurring arsenic in groundwater in Bangladesh used for drinking purposes has led one international agency to describe the situation as a major public health emergency. Arsenic ingestion is associated with an elevated risk of various cancers. Epidemiological dose–response functions combined with survey estimates of arsenic concentrations in groundwater, and the number of households in Bangladesh relying on groundwater for drinking are used to derive an estimate of annual mortality and morbidity cases attributable to arsenic contamination. The estimated health impacts include 6500 fatal cancers and 2000 non-fatal cancers. Aggregate willingness to pay to avoid these health impacts is estimated to be $2.7 billion annually using purchasing power parity exchange rates. The methodology and results presented in this paper may have application to other countries.