新闻资讯

　　2013年1月11日，由印度卫生与家庭福利部主办的金砖国家卫生部长第二次会议在印度新德里召开，我部部长陈竺率团出席会议。印度卫生和家庭福利部部长阿扎德(Ghulam Nabi Azad)、巴西卫生部秘书长亚巴斯·巴尔博撒(Jarbas Barbosa)、俄罗斯卫生与社会发展部副部长谢尔盖·威尔玛亚金(Sergei Velmyaykin)、南非卫生部部长阿伦·莫措阿莱迪(Aaron Motsoaledi)，以及联合国艾滋病规划署执行主任西迪贝(Michel Sidibé)出席了会议。世界卫生组织总干事陈冯富珍(Margaret Chan)发表了录像讲话。

　　本次会议是根据2012年3月29日印度新德里举办的金砖国家领导人第四次会晤决议而举办的。会议发布了《金砖国家卫生部长第二次会议德里公报》。会议形成了关于疾病监测、针对传染病及非传染病的医疗技术、慢病防治与健康覆盖、药品研发、医疗技术五个领域的行动计划。会议决定将于2014年1月在南非举办金砖国家卫生部长第三次会议。

　　公报中英文全文如下：

　　金砖国家卫生部长第二次会议德里公报

　　一、金砖国家-巴西联邦共和国、俄罗斯联邦、印度共和、中华人民共和国和南非共和国的卫生部长，于2013年1月11日在新德里召开了金砖国家卫生部长第二次会议。

　　二、会议忆及2012年3月29日金砖国家领导人峰会《德里宣言》、2012年5月22日在日内瓦通过的金砖国家卫生部《联合公报》，确定了金砖国家各自牵头的具体工作领域。本次会议以“金砖国家携手促进全球稳定、安全与繁荣”为主题，以应对威胁人类健康的挑战。

　　三、部长们忆及，金砖国家合作机制是占世界43%人口的对话与合作平台。部长们重申2011年7月11日《北京宣言》的承诺，加强在五国公共卫生服务可及方面的合作，包括采取可负担、公平、可持续的措施应对共同的卫生挑战。部长们承诺加强金砖国家之间的合作，促进人民健康。金砖国家卫生部长决定，通过技术工作组继续开展卫生领域的合作。

　　四、部长们关注到非传染病带来的当前全球威胁，指出2008年80%非传染性疾病的死亡发生在中低收入国家。部长们认识到金砖国家在全球非传染病防控进程中发挥着重要作用，包括2011年4月发表的《莫斯科宣言》、2011年5月世卫大会通过的第64.11号决议以及2011年9月联合国大会的政治宣言。部长们认识到，金砖国家需就造成非传染性疾病的社会和经济决定因素开展更深入的研究。他们决定在促进全面、符合成本效益的预防、治疗和护理可及性、整合传染病管理方面开展合作，包括获得药品、诊断和其他技术。

　　五、部长们还认识到，需要通过采取综合措施应对精神障碍，如世界卫生大会第65.4号决议。考虑综合精神卫生行动计划，在精神卫生促进、诊断和管理方面，在金砖国家之间分享创新，交流最佳实践和经验。

　　六、部长们重申关于世界卫生组织《烟草控制框架公约》的承诺，强调世界卫生组织和其他利益相关者开展烟草使用和控制的社会和经济决定因素调查研究的重要性。

　　七、部长们认识到由于在社会边缘化和弱势群体中的高患病率和发病率，耐多药结核病在所有金砖国家中都是一个重大的公共卫生问题。他们决定在能力和基础设施建设发展方面加强协作，以减少结核病的患病率和发病率;通过新药、疫苗和诊断技术的创新以及结核病研究人员的联合，在药品疫苗临床试验方面开展合作;促进获得可负担的药品和提供高质量保健。部长们也认识到需要开展以下合作：应用或改善结核病病例报告体系和抗结核病药物在医疗机构的提供体系;改进初级卫生保健体系中的供应绩效、采购体系和物流，以及艾滋病相关结核病感染管理。

　　八、部长们要求继续努力应对艾滋病造成的严重威胁。他们关注开展艾滋病防治创新方法的合作，以促进预防服务、提供有效药品和提高诊断水平，并在新治疗方案、近期感染决定因素及艾滋病结核病双重感染方面交流经验。部长们同意在疾病监测、现有和新型的预防艾滋病战略领域交流经验和专业知识，以迅速扩大负担得起的治疗规模。他们重申承诺确保双边和区域贸易协定不会损害《与贸易有关的知识产权协议》(TRIPS)的灵活性，以确保发展中国家获得可负担的艾滋病抗病毒仿制药品。

　　九、部长们承诺加强疟疾控制合作，提升诊断方法和研发，协调促进金砖国家已有或正在开发的技术可及性。

　　十、部长们重申为有效控制传染病和非传染病所作出的承诺，通过共享已有的资源信息开展合作，开发风险评估工具、风险降低措施、转诊制度、生命周期研究方法、发挥社区功能，以及在国家和国际层面监测所有公共政策对健康影响的评估。

　　十一、部长们认识到有效的卫生监测，包括伤害监测，是控制传染病和非传染病的一个关键策略，同时监测也是实施《国际卫生条例》(2005)的基石。部长们进一步认识到，基于不同的国情和最佳实践，金砖国家使用不同的监测模式，因此承诺加强在疾病防控活动的计划、监测和评估机制方面的合作，以及有效的卫生监测体系的能力建设。

　　十二、部长们关注到金砖国家的独特优势，如可负担卫生产品的研发和生产能力、开展临床实验的能力。部长们要求加强生物技术应用领域的合作，以造福于金砖国家人民健康。

　　十三、部长们强调儿童生存战略的重要性，逐步降低产妇、婴儿、新生儿及5岁以下儿童死亡率，促进千年发展目标的实现。他们重申承诺，继续加强此领域的合作，开展最佳实践的交流。

　　十四、部长们讨论了世界卫生组织医疗产品研发筹资和协调问题磋商性专家工作组(CEWG)的建议，欢迎建立全球卫生研发观测点的建议，并支持通过召开区域磋商会研究设立研发观测试点项目。部长们呼吁，整个过程包括设立优先领域，要由世卫组织成员国主导，并应以各国尤其是发展中国家的公共卫生需求为基础，并将研发投入与成品价格相分离。

　　十五、部长们重申支持世卫组织改革及筹资工作的相关讨论，在有组织、有计划、可操作的条件下更好地应对全球卫生挑战，并欢迎世卫组织成员国共同以有序、透明的程序设定重点领域，以此建立一个筹资对话。

　　十六、部长们认识到传统医学的价值和重要性，需要交流经验共享知识以满足公共卫生需求。他们要求金砖国家加强专家互访、组织研讨会，以鼓励传统医学在所有卫生领域的应用。

　　十七、部长们支持联合国大会关于全民健康覆盖的决议，并承诺通过国家、地区和全球协作确保实现全民健康覆盖。

　　十八、部长们忆及2011年首次金砖国家卫生部长会议的《北京宣言》，强调技术转化是发展中国家的重要权利和需求。在此背景下，他们强调仿制药品在实现人民健康权方面发挥着重要作用。部长们重申，将加强卫生领域的全球合作，特别是开展南南合作;支持发展中国家人人享有健康的努力，并确定建立金砖国家技术合作网络。

　　十九、部长们认识到，为向边远地区提供符合成本效益的卫生服务，需要采用信息通信技术。他们鼓励金砖国家之间在电子健康，包括远程医学方面，加强合作、交流经验。

　　二十、部长们同意将在所有国际场合开展《与贸易有关的知识产权协议》(TRIPS)的灵活性与公共卫生相关的合作。

　　二十一、部长们同意在金砖国家合作机制框架下建立合作平台，为实现本公报明确的共同目标和目的与其他国家开展合作。

　　2nd BRICS Health Ministers Meeting

　　Delhi Communiqué

　　1. The BRICS countries, represented by the Ministers of Health of the Federative Republic of Brazil, the Russian Federation, India, People’s Republic of China and Republic of South Africa, met in New Delhi on 11 January 2013 at the Second BRICS Health Ministers’ Meeting.

　　2. The meeting recalled the Delhi Declaration of 29 March 2012 during the BRICS leaders summit and the Joint Communiqué of the BRICS Health Ministers at Geneva of 22 May 2012 including specific areas of work under the BRICS Health Platform for each Member State, focussed on the theme “BRICS Partnership for Global Stability, Security and Prosperity” to address emerging health threats.

　　3. The Ministers recalled that BRICS is a platform for dialogue and cooperation amongst countries representing 43% of the world’s population. The Ministers reiterated their commitment to the Beijing Declaration of July 2011 for strengthened collaboration in the area of access to public health and services in BRICS States including implementation of affordable, equitable and sustainable solutions for common health challenges. The Ministers committed to strengthen intra-BRICS cooperation for promoting health of the BRICS population. The BRICS Health Ministers resolved to continue cooperation in the sphere of health through the Technical Working Group.

　　4. The Ministers drew attention to the current global threat of non-communicable diseases and noted that in 2008, around 80% of all NCD deaths occurred in low and middle income countries. The Ministers recognized the significant role of BRICS countries in the global process of prevention and control of NCDs including the Moscow Declaration of April 2011, the WHA Resolution 64.11 of May 2011 and the Political Declaration of the UN General Assembly of September 2011.The Ministers recognized the need for more research into the social and economic determinants leading to occurrence of non-communicable diseases, amongst the BRICS countries. They resolved to collaborate and cooperate to promote access to comprehensive and cost-effective prevention, treatment and care for the integrated management of non-communicable diseases, including access to medicines and diagnostics and other technologies.

　　5. The Ministers also recognized the need to combat mental disorders through a multi-pronged approach including the World Health Assembly Resolution 65.4, consideration of a Comprehensive Mental Health Action Plan through sharing of innovations in the field of Mental Health Promotion, diagnosis and management, exchange of best practices and experiences amongst BRICS countries.

　　6. The Ministers renewed their commitment to the WHO Framework Convention on Tobacco Control and stressed the importance of research and study by WHO and other stakeholders into the social and economic determinants of tobacco use and its control.

　　7. The Ministers recognized that multi-drug resistant tuberculosis is a major public health problem for the BRICS countries due to its high prevalence and incidence mostly on the marginalized and vulnerable sections of society. They resolved to collaborate and cooperate for development of capacity and infrastructure to reduce the prevalence and incidence of tuberculosis through innovation for new drugs/vaccines, diagnostics and promotion of consortia of tuberculosis researchers to collaborate on clinical trials of drugs and vaccines, strengthening access to affordable medicines and delivery of quality care. The Ministers also recognized the need to cooperate for adopting and improving systems for notification of tuberculosis patients, availability of anti-tuberculosis drugs at facilities by improving supplier performance, procurement systems and logistics and management of HIV-associated tuberculosis in the primary health care system.

　　8. The Ministers called for renewed efforts to face the continued challenge posed by HIV. They committed to focus on cooperation in combating HIV/AIDS through approaches such as innovative ways to reach out with prevention services, efficacious drugs and diagnostics, exchange of information on newer treatment regimens, determination of recent infections and HIV-TB co-infections. The Ministers agreed to share experience and expertise in the areas of surveillance, existing and new strategies to prevent the spread of HIV, and in rapid scale up of affordable treatment. They reiterated their commitment to ensure that bilateral and regional trade agreements do not undermine TRIPS flexibilities so as to assure availability of affordable generic ARV drugs to developing countries.

　　9. The Ministers committed to strengthen cooperation to combat malaria through enhanced diagnostics, research and development and committed to facilitate common access to the technologies developed or under development in the BRICS countries.

　　10. The Ministers renewed their commitment for effective control of both communicable and non-communicable diseases through cooperation in sharing of existing resource information, development of risk assessment tools, risk mitigation methods, referral systems, life course approaches, community empowerment, monitoring health impact assessments of all public policies at national and international levels.

　　11. Recognizing that an effective health surveillance, including injury surveillance, is the key strategy for controlling both communicable and non-communicable diseases, that surveillance is also the cornerstone around which the implementation of the International Health Regulations (2005) is based and further recognizing that the countries may be using different models for surveillance based on different realities and best practices, the Ministers committed to strengthen cooperation in the mechanisms for planning, monitoring and evaluating disease prevention and control activities and capacity-building for effective health surveillance systems.

　　12. The Ministers urged focus on the unique strength of BRICS countries such as capacity for R & D and manufacturing of affordable health products, and capability to conduct clinical trials. The Ministers called for strengthened cooperation in application of bio-technology for health benefits for the population of BRICS countries.

　　13. The Ministers emphasized the importance of child survival through progressive reduction in the maternal mortality, infant mortality, neo-natal mortality and under-5 mortality, with the aim of achieving the Millennium Development Goals. They confirmed their commitment to a renewed effort in this area and to enhance collaboration through exchange of best practices.

　　14. The Ministers discussed the recommendations of the Consultative Expert Working Group on Health on coordination and financing of R & D for medical products and welcomed the proposal to establish a Global Health R&D observatory as well as the move on holding regional consultations to set up R&D demonstration projects. The Ministers urged that the entire process, including priority setting, should be driven by WHO Member States and should be based on public health needs, in particular those of developing countries, with the cost of R & D delinked from the final products.

　　15. The Ministers reiterated their support to the continued discussions on the process of reform of WHO, to better respond to global challenges in programmatic, organizational and operational terms, including the future financing of WHO, and welcomed the proposal to establish a financing dialogue based on priorities collectively set by WHO Member States in a structured and transparent process.

　　16. The Ministers acknowledged the value and importance of traditional medicine and need of experience and knowledge-sharing for securing public health needs. They urged for cooperation amongst the BRICS countries through visits of experts, organization of symposia to encourage the use of traditional medicine, in all spheres of health.

　　17. The Ministers confirmed their support for the United Nations General Assembly Resolution on universal health coverage and committed to work nationally, regionally and globally to ensure that universal health coverage is achieved.

　　18. The Ministers recalled the Beijing Declaration of the 1st BRICS Health Ministers’ Meeting in 2011, emphasizing the importance and need of technology transfer as a means to empower developing countries. In this context, they underlined the important role of generic medicines in the realization of the right to health. The Ministers renewed their commitment to strengthening international cooperation in health, in particular South-South cooperation, with a view to supporting efforts in developing countries to promote health for all and resolve to establish the BRICS network of technological cooperation.

　　19. The Ministers acknowledged the need of use of ICT in Health services to promote cost-effective treatment in the remote areas. They encouraged to strengthen cooperation amongst the BRICS countries to share their experiences in e-Health including tele-medicine.

　　20. The Ministers agreed to cooperate in all international fora regarding matters relating to TRIPS flexibilities with a public health perspective.

　　21. The Ministers agreed to establish platforms for collaboration within BRICS framework and with other countries with a view to realizing the goals and objectives outlined in this Declaration.