Abstract
The Reform in Disease Prevention and Control The authors present examples of damages and disasters caused by a panic of Plague in India, an epidemic of mad cow disease in Europe, an embargo on imports of seafood from epidemic-stricken countries. These damages are due to mistakes in using technical knowledge in the control and prevention of diseases. This report also points out that non-communicable diseases are important and require a lot of technical knowledge to tackle. It is proposed that reform in disease prevention and control should be divided into two parts: intelligence and operational services. Intelligence services an intelligence organization, namely Institutes for Heath Surveillance, should be set up to be independent of the Ministry of Public Health. It should be an autonomous body governed by a board chaired by the Minister of Public Health. The duties of the Institute are: to gather technical knowledge related to disease control and prevention, both domestic and international; to continuously develop the country database systems for monitoring communicable and non-communicable diseases; to cooperate with the international community; to conduct and support research projects on disease control, and to develop human resources. The institute must have proper strategies for management that can coordinate resources among all domestic and international technical bodies. The institute must also be very efficient in mobilizing resources from all relevant sources. It is not necessary to have epidemiologists for all diseases, or regional branches or its own comprehensive laboratory. However, it should have budgets and the ability to make use of academics in other institutions and to work with the network of laboratories in every part of the country efficiently. Operational Services The operation of disease prevention and control can be divided into two parts; firstly the clinical process such as immunization, screening, treatment and prevention of disease complications and secondly measures other than public health services, e.g. social and legal measures, improvement on safety and environment, regulation of industrial and agricultural products, etc. The Ministry of Public Health should be responsible for disease prevention and control in the following areas: regulating rules, securing central budgets to support local needs, procuring supportive materials for local communities, providing special clinics for certain diseases, monitoring disease prevention and control activities. Clinical control will largely be under the responsibility of the health services, whose quality is assured by hospital accreditation processes. The Institutes for Health Surveillance would have to set standards for the quality of services related to preventive care, regardless of whether the service providers is private or under central or local governments control.
