摘要：The World Health Organization’s determination of the Ebola virus disease outbreak as a public health event of international concern prompted nonaffected countries to implement measures to prevent, detect, and manage the introduction of the virus in their territories. The outbreak provided an opportunity to assess the operational implementation of the International Health Regulations’ core capacities and health systems’ preparedness to handle a potential or confirmed case of Ebola virus disease. A public health framework implemented in Latin America and Caribbean countries encompassing preparatory self-assessments, in-country visits, and follow-up suggests that the region should increase efforts to consolidate and sustain progress on core capacities and health system preparedness to face public health events with national or international repercussions. The current outbreak of Ebola virus disease in West Africa is showing the world that the work on communicable diseases is far from over and that the well-known epidemiological transition from communicable diseases to noncommunicable diseases should be taken with a grain of salt in many countries. 1–3 Latin America and the Caribbean is a diverse geographical region with low-, middle-, and high-income countries where both noncommunicable diseases and communicable diseases need the utmost attention of leaders and policymakers to ensure proper balance when allocating resources and to be able to face the growing threats. For the purposes of this article, “Latin America and the Caribbean” refers to 33 countries: Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, Uruguay, and Venezuela. While the risk of introducing Ebola virus disease in Latin America and the Caribbean has been considered low, the fact is that the region has all the ingredients to have imported cases of Ebola virus disease and of any other emerging and reemerging infectious diseases, with the potential of further spread if essential public health functions are not established, or maintained, as part of a dynamic preparedness process; this process should constitute a priority in the political and development agenda of the leaders of the region. Tourism, vibrant trading economies, porous borders, and the globalized interconnected world we live in are some of the enabling factors that could lead to the Ebola virus disease reaching Latin America and Caribbean countries. A year ago nobody would have thought that Guinea, Liberia, and Sierra Leone were on their way to facing a devastating outbreak. Latin America and the Caribbean are already confronting serious epidemics of dengue and chikungunya viruses, with negative socioeconomic and health consequences for the region. 4,5 Furthermore, the risk faced by the region with regard to emerging and reemerging infectious diseases may be illustrated in the increasing number of events of potential international public health concern. In 2014, 93 public health events of potential international concern were identified and assessed in Latin America and the Caribbean. 6 Of these 93 events, 47 (51%) were of substantiated international public health concern that affected 27 countries and territories. The largest proportion of these 47 events was attributed to infectious hazards (34 events, 72%), and the etiology most frequently recorded was chikungunya virus (20 events) followed by zoonotic hazards.
