Song Jinsong Source: Guangming Daily
Original title: Strengthen production capacity reserves of emergency products for public health incidents
After the SARS epidemic in 2003, my country has established an emergency management system based on the "one case, three systems" (emergency plan, emergency management system, mechanism, and legal system) based on emergency response plans. After the Wenchuan earthquake in 2008, efforts have been made to strengthen emergency management capabilities focusing on emergency management teams, emergency equipment and technology, and disaster relief supplies. The establishment of the Emergency Management Department in 2018 has greatly improved my country's emergency management capabilities for natural disasters and safety production accidents. With the continuous advancement of urbanization and economic globalization, the risk of infectious diseases developing into large-scale and global disasters has increased. Therefore, it is necessary to attach great importance to the production and storage of emergency protective materials to prepare for the next step of epidemic prevention and control and the response to similar public health events in the future.
Pay attention to the production capacity reserve of emergency products for public health incidents
my country's medical emergency reserve system was established in the 1970s. In order to meet the needs of combat readiness, the state allocated special funds to establish 13 drug reserve banks across the country to build my country's medical emergency reserve system. Since then, the role of medical reserves has gradually expanded from simple combat readiness to foreign aid, disaster relief, epidemic prevention, and emergency response. In response to the 2003 "SARS", the 2008 southern rain and snow disaster, the Wenchuan earthquake, the 2009 H1N1 influenza and this new crown pneumonia epidemic, my country's medical emergency reserves still exposed some weaknesses and need to establish public health events Production capacity reserves for emergency products.
The contradiction between normal and general overcapacity and insufficient capacity in emergency is prominent
Take vaccine production as an example. After SARS in 2003, the state and enterprises invested a lot of money to expand influenza vaccine production capacity. However, after 2006, the public influenza vaccine usage declined and vaccine companies reduced their influenza vaccine production capacity. In 2009, in response to influenza A, the government issued a "vaccine production plan" to 10 manufacturers in batches with a total of 795 batches of about 150 million doses. my country's annual production capacity of influenza A vaccine was expanded to 150 million doses. However, under normal circumstances, my country's influenza A vaccine demand is about one-fifth of vaccine production capacity. For example, in 2015, my country's influenza vaccine batches were about 30 million doses, which is only equivalent to the production capacity of a leading vaccine company, and the problem of vaccine overcapacity is prominent. The contradiction between general overcapacity in normal times and insufficient capacity in emergencies is bound to affect my country's timely and effective response to public health incidents such as large-scale infectious diseases.
National emergency production capacity reserve policy needs to be improved
In my country's emergency industrial mobilization, the method of "enterprise loans, government subsidies, participation in operations, and appropriate compensation" is often used for incentives. However, in actual operation, problems such as insufficient funding subsidies and unreasonable compensation have appeared. Not only that, the depreciation of fixed asset investment for emergency capacity expansion of enterprises requires 5-10 years of depreciation according to the accounting system. The time is too long to reasonably deduct temporary profits during the emergency. The tax payment of enterprises is high, and the production capacity is idle in subsequent years. The depreciation fee is too high and the company suffers serious losses.
Promote my country's public health incident emergency product capacity reserve
The development path of urbanization in my country is different from that of European and American countries. The urban population density and total population far exceed those of European and American countries. The risks of large-scale infectious diseases and other public health incidents are more severe. Only physical reserves and emergency production mobilization cannot meet emergency response. Response, especially in the early stage of emergency response, which is also the most critical period to contain the impact of emergencies. A unified emergency material security system should be improved, and related work mechanisms and emergency plans should be improved as soon as possible in accordance with the principles of centralized management, unified allocation, normal service, emergency response in disasters, combination of procurement and storage, and efficiency. Emergency products for public health incidents mainly include protective, preventive and therapeutic products. The storage period of disposable protective and therapeutic products is short, there is no universal preventive vaccine, and physical storage is not possible. my country must reserve the production capacity of emergency products for public health incidents and keep the production line "warm."
Scientifically calculate the target groups for the priority use of emergency products in public health events such as large-scale infectious diseases in my country
Taking vaccines as an example, the practice of the previous influenza pandemics in my country is that the first wave of vaccine demand is mainly to meet the needs of key populations, and prepare 1.5 million copies. The EU also implements a priority vaccination system. In response to the 2009 pandemic, the European Union first identified about 19.5% of the population as a priority group for vaccination, of which 2% were health workers, 1.5% were pregnant women, and 16% were suffering from potential chronic diseases or serious diseases over 6 months. In order to solve the contradiction between influenza vaccine supply and demand in large-scale periods, it has reached an advance purchase agreement with vaccine manufacturers to reserve a certain proportion of influenza vaccine production capacity. For example, according to the estimation method of priority groups for vaccination in the European Union, there are more than 20 million medical workers and pregnant women in my country, and more than 390 million people with potential chronic diseases and serious diseases are at high risk of infection. The number of target groups that need to be vaccinated is far Far exceeds vaccine production capacity.
Increase the utilization rate of health protection products in my country, strengthen personal protection, and maintain reasonable production capacity of related products
For example, vaccination is the best way to prevent influenza. The seasonal influenza vaccination rate in my country is 2%, which is far from the 20%-30% in Europe and America. If the seasonal influenza vaccination rate in my country is increased to 15%, my country's normal influenza vaccine production capacity can be maintained at about 200 million doses, which can not only greatly reduce the medical insurance costs for treating influenza patients, but also basically meet the vaccine needs of priority groups during the pandemic. Increasing the seasonal influenza vaccination rate will help maintain a reasonable production capacity of vaccines. Therefore, it is recommended to increase vaccine production capacity and increase seasonal influenza vaccination rates simultaneously to maintain vaccine production reserves. In 2004, when the H5N1 flu broke out, the US government invested in the construction of flu vaccine factories to get rid of vaccine imports, and recommended that 85% of Americans be included in the scope of seasonal flu vaccine. In 2009, the number of companies producing flu vaccines in the United States increased to 5. At present, the United States is the world's largest supplier of influenza vaccines, and its market share accounts for 40% of the seven major markets of the United States, Japan, France, Germany, Italy, Spain and the United Kingdom.
Improve the incentive mechanism and emergency requisition system for emergency product capacity reserves
After enterprises respond to emergency calls to expand production capacity, the state must provide scientific and reasonable economic incentives while providing spiritual incentives. The depreciation period for fixed investment in new emergency capacity can be shortened from 5~10 years to 1~2 years; the state appropriately compensates for the R&D investment of enterprises; the establishment of national special emergency requisition funds, perfect the requisition system, and make contributions to emergency response Citizens and enterprises receive adequate economic protection. In addition, we can also learn from the practices of some developed countries. For example, the government allocates special funds for the research and development of medical emergency supplies every year. After the candidate medical emergency supplies are quickly approved for certification, they are included in the "national strategic reserve."
(Author: Song Jinsong, the Department of National Social Science Fund Project "large-scale infectious disease emergency reserve production capacity study," head of the Central Party School] [National School of Administration professor Emergency Management Training Center)
(Editor in charge: Wu Zhaofei, Wan Peng)