Lancet:世界卫生组织：全球公民倡议

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The COVID-19 pandemic has cost more than 4 million lives, left millions of people with persistent symptoms (ie, long COVID), and has devastated societies, with already disadvantaged communities being hit hardest. The tragedy is that much of this harm was preventable, as shown early on by many Asia-Pacific countries that pursued elimination of COVID-19 and protected both their public health and economies.

 The rest of the world can still work towards elimination. The World Health Network (WHN) is a coalition of citizens and experts who are committed to global action to protect public health through progressive elimination of COVID-19.

Elimination means bringing cases down to sufficiently low numbers so that no community transmission occurs for extended periods of time. Outbreaks might occur but will be rapidly detected and controlled. Despite the manifest success of this approach, many governments rejected it outright, and after repeated lockdowns and substantial losses to life and economy, these governments now speak of learning to live with the virus. Many governments’ responses have been shaped by false dichotomies, pitting public health against the economy and collective wellbeing against individual liberty.

 Effective responses have been hampered by vested interests, rampant and organised misinformation, short-term thinking, and resistance to important facts, including airborne transmission, the role of children and schools in transmission, and the value of facemasks and ventilation. Exceptionalism (ie, a belief that the consequence of similar policies will somehow be different in a given context), the refusal to learn from experiences of other countries, and the failure to adopt the precautionary principle (ie, taking action in the face of uncertainty to prevent harm, such as the use of masks to prevent the spread of an airborne pathogen) led to the same avoidable errors being repeated in different countries. Even the arrival of effective vaccines, which are traditionally the basis of elimination, has not changed the thinking of many governments that ongoing community transmission with inevitable consequences of death and disability for many people should be accepted. Additionally, the reliance on vaccination alone as the main response strategy to the pandemic without controlling transmission risks the emergence of dangerous escape variants.

An effective global strategy is required with solidarity and collective action at the individual, local, national, and international levels for progressive elimination of COVID-19. This major change in direction from a strategy of living with the virus to global progressive elimination will require the involvement of citizens with diverse expertise, including scientists, journalists, health-care workers, educators, lawyers, ethicists, human rights groups, and people with first-hand experience of COVID-19. To meet this need, we have created the WHN: an international grassroots initiative.

The WHN includes independent advisory and advocacy teams and citizens’ action initiatives (appendix). Over the past year, our members have guided successful elimination efforts in multiple countries, advised governments and institutions, built accessible data analytical platforms (eg, the End Coronavirus platform), advocated for airborne precautions and school safety, produced scientific consensus documents,

 and engaged in public communication and community-based efforts to promote individual and public health. On July 14–15, 2021, we held the Global Summit to End Pandemics virtually, connecting 70 crossdisciplinary and crosscountry teams and over 300 scientists and other advocates.

We aim to achieve elimination by assembling rigorous scientific evidence and guidelines; sharing experience and expertise between countries; coordinating international strategies and actions; empowering citizen actions to improve public health, support vaccine uptake, and shape policy; addressing the role of inequality, inequity, and marginalisation in health; campaigning for vaccine equity and sharing; and challenging misinformation, nationalism, and exceptionalism.

The WHN is a citizens’ initiative, bringing together like-minded experts and passionate advocates of public health. It is independent from any political body or government, being guided by compassion, scientific rigour, transparency, social justice, and value for life, which have been absent in many pandemic strategies.

The challenges facing the world are daunting, but we believe that this movement will help to progressively eliminate SARS-CoV-2, build more resilient and fairer systems than currently exist to support the health of all, and tackle global challenges beyond COVID-19, including structural inequalities and climate change. Join us to contribute to this global community.

全文翻译（仅供参考）

新冠病毒-19大流行已经夺去了400多万人的生命，使数百万人出现持续性症状（即长冠状病毒），并摧毁了社会，已经处于不利地位的社区受到的打击最为严重。悲剧在于，正如许多追求消灭新冠病毒并保护其公共健康和经济的亚太国家早些时候所表明的那样，这种危害在很大程度上是可以预防的。

世界其他地区仍然可以为消除贫困而努力。世界卫生网络（WHN）是一个由公民和专家组成的联盟，他们致力于通过逐步消除新冠病毒来保护公共健康的全球行动。

消除意味着将病例数量降至足够低的水平，以便在较长时间内不会发生社区传播。疫情可能会发生，但会被迅速发现和控制。尽管这一方法取得了明显的成功，但许多政府断然拒绝了这一方法。在多次封锁、生命和经济遭受重大损失后，这些政府现在开始谈论学会与病毒共存。许多政府的反应是由错误的二分法形成的，将公共卫生与经济对立起来，将集体福利与个人自由对立起来。

既得利益集团、猖獗且有组织的错误信息、短期思维以及对重要事实的抵制（包括空中传播、儿童和学校在传播中的作用以及面罩和通风设备的价值）阻碍了有效应对。例外论（即认为类似政策的后果在特定环境下会有所不同）、拒绝学习其他国家的经验以及未能采取预防原则（即，在面临不确定性时采取行动以防止伤害，例如使用口罩以防止空气中病原体的传播）导致相同的可以避免的错误在不同的国家重演。即使是传统上作为消灭基础的有效疫苗的到来，也没有改变许多政府的想法，即应接受对许多人造成死亡和残疾不可避免后果的持续社区传播。此外，仅依靠疫苗接种作为大流行的主要应对策略，而不控制传播，有可能出现危险的逃逸变种。

需要一个有效的全球战略，在个人、地方、国家和国际各级采取团结一致和集体行动，逐步消除新冠病毒。从与病毒共存的战略到全球逐步消除的这一重大转变将需要具有不同专长的公民的参与e、 包括科学家、记者、卫生保健工作者、教育工作者、律师、伦理学家、人权组织和有新冠病毒19型第一手经验的人。为了满足这一需求，我们创建了WHN：一项国际草根倡议。

WHN包括独立的咨询和宣传团队以及公民行动计划（附录）。在过去一年中，我们的成员在多个国家指导了成功的消除工作， 为政府和机构提供建议，建立可访问的数据分析平台（例如，终端冠状病毒平台），提倡空气传播预防措施和学校安全， 制作了科学共识文件，

在2021年7月14日至15日，我们举行了全球峰会，以虚拟方式结束流行病，将70个跨学科和跨国家团队以及300多名科学家和其他倡导者联系在一起。

我们的目标是通过以下方式实现消除：收集严格的科学证据和指导方针；在各国之间分享经验和专业知识；协调国际战略和行动；授权公民行动以改善公共卫生、支持疫苗接种和制定政策；解决不平等、不平等和边缘化的作用在健康领域；为疫苗公平和共享而斗争；挑战错误信息、民族主义和例外论。

WHN是一项公民倡议，汇集了志同道合的专家和热心的公共卫生倡导者。它独立于任何政治机构或政府，以同情、科学严谨、透明、社会正义和生命价值为指导，而这些在许多流行病战略中都不存在。

世界面临的挑战是艰巨的，但我们相信，这项运动将有助于逐步消除SARS-CoV-2，建立比目前更具弹性和更公平的系统，以支持所有人的健康，并应对新冠病毒-19以外的全球挑战，包括结构性不平等和气候变化。与我们一起为此作出贡献国际社会。

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https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02246-7/fulltext