Comparison and enlightenment of international legislation experience on tuberculosis control

doi:10.19982/j.issn.1000-6621.20220528

Abstract

Abstract:

Tuberculosis (TB), a chronic infectious disease mainly transmitted by respiratory tract, has been a serious threat to human health for thousands of years. And it remains a public health and social issue of global concern. At present, the global TB epidemic is still serious. In order to understand the legal experience of international TB control, this paper focuses on searching the laws, regulations and related guidelines of some international organizations and countries, such as WHO, Japan, South Korea and Russia, making a comparative study on the following six aspects: legislation model, government responsibility, TB service system, prevention and control measures, protection of patients’ rights and coercive administrative measures, to provide reference for China’s TB control legislation construction.

Key words: Tuberculosis, Preventive health services, Law enforcement, Internationality

CLC Number:

R-01
R52

Jia Fei, Cao Yanlin, Jiang Shiwen, Zhang Ke, Yi Min. Comparison and enlightenment of international legislation experience on tuberculosis control[J]. Chinese Journal of Antituberculosis, 2023, 45(3): 235-239. doi: 10.19982/j.issn.1000-6621.20220528

Figures/Tables 1

国际组织/ 国家	法律、法规、指南	类别	主要内容
WHO	《结核病与航空旅行——预防控制指南》	航空限制	WHO引用:1992—1994年期间,美国疾病预防控制中心与联邦及地方卫生部门合作,开展了7个相关研究,研究结果显示机舱上结核分枝杆菌传染的风险与火车、汽车旅行、任何的室内聚会等其他活动的风险是相似的。WHO提出:已知患有结核病的患者不能乘坐公共飞机,直到完成至少2周的充足的抗结核治疗;耐多药结核病患者不能旅行,直到已经被证实没有传染性(即培养阴性)
日本	《结核病预防法》	政府/部门责任	各级地方政府和医疗机构在健康诊断、预防接种和病情申报登记、费用负担等方面的具体责任,以及违反相应规定的惩罚措施
		服务体系	注重与社会福利相关政策的有机结合,推进结核病防治医疗、看护及患者家庭援助等保健福利事业,致力于为结核病患者提供优质且适当的服务
		预防控制措施	特殊职业及重点人群进行定期结核病检查、结核病预防接种、病例发现与报告、健康教育等
		患者权益保护	各都道府县负担诊疗费的95%,针对被隔离或限制从业的结核病患者,其治疗所产生的部分费用由都道府县负担
		患者强制措施	从业限制;政府有权要求传染性患者进入结核病疗养院所进行隔离;对有充足理由认为可能患有结核病的人员,进行强制检查
韩国	《结核病预防法》	政府/部门责任	各级政府和医疗机构在结核病防治工作中的责任,主要体现在结核病疫苗义务接种和政府保障措施
		服务体系	对结核病预防接种药品的生产及实施的预防接种医疗机构给予一定的补助费用;地方政府为管辖区域内居住的传染性结核病患者配置专门人力,如设立结核病管理要员(包括社区内专门的看护师、临床病理师、放疗师及看护助理师等);在预算的范围内对临床研究费用和面临结核病传染的危险性从业人员给予补偿金支付
		预防控制措施	结核病预防接种、病例发现与报告、健康教育等
		患者权益保护	注重保护患者的隐私权利及消灭康复患者就业歧视
		患者强制措施	禁止传染性结核病患者从事服务业或其他公共行业;对同居者或者第三者中可能存在被传染风险者,要求疑似患者或者其监护人入住结核病医院
俄罗斯	《防止结核病扩散法》	政府/部门责任	俄罗斯联邦国家政权机构、俄罗斯联邦主体国家政权机构及地方自治政权机构在防止结核病扩散领域的各种权利3个层面进行了规定,明确了各级政府的职责,为结核病防治工作的有效开展提供了制度保障
		服务体系	组织建立联邦级专业医疗机构,构建结核病防治体系;保障疫苗和生物免疫药品的生产、储藏和运输,以及上述用药的质量、药效和安全性;组织实施结核病监测
		预防控制措施	周期性对公民进行预防性医疗体检;与结核病患者有或曾有接触的人员根据俄罗斯联邦法律进行诊察,以查明这些人员是否患有结核病;结核病患者的信息统一申报
		患者权益保护	因结核病处于防治观察的人员和结核病患者在专业医疗机构门诊条件下按照联邦政府制定的办法保障结核病药品的免费获得;对于传染性结核病患者采取保留工作、发放社会保险补助金;优先为生活困难的传染性结核病患者和家庭提供单独的隔离居住地
		患者强制措施	由医生委员会作出进行或终止防治观察的医疗决定;屡次违反卫生防疫制度,故意逃避诊察或治疗的,由法院裁决进行强制治疗

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