兩岸疾病預防控制體系之比較探討-以SARS疫災前後之變革為例

Abstract

兩岸於1949年分治後，即各自走向民主政府及共產政府體制運作，而疾病預防控制體系分別參照蘇聯與西方國家模式建置。中國大陸自20世紀80年代起，由於社會主義市場化經濟體制改革的影響，其防疫系統幾乎完全顛覆過去數十年運作的本質；而臺灣的防疫架構亦曾經歷多次整合重組。2003年SARS疫災可以視為兩岸疾控效能的試金石，本文透過文獻內容分析與歷史分析的方法，針對兩岸政府疾控體系的組織層面、財政層面，以及人事層面這三個面向，就中國大陸與臺灣在SARS發生之前的特色、SARS發生後所帶來的轉變，以及經過轉變後當前的特色，來分別進行分析與比較，並進而探討SARS疫災與兩岸疾控體系變革之間的因果關係。此外，本文以兩岸疾控體系於後SARS時期之變革演進為基礎，也嘗試去分析各項防疫缺失或弱點之修正情形，從而進行兩岸疾控現況比較與合作互動之展望。

Since the political separation across the Taiwan Strait in 1949, Taiwan has steered towards democracy while the opposite side has been advocating communism. Due to the economic reforms after the 1980s, the disease control and prevention system in Mainland China has taken a totally different approach than that in Taiwan during the past several decades. In the meantime, the structure of the disease control and prevention system in Taiwan has undergone a series of reorganization. The SARS epidemic can be seen as the touchstone of disease control and prevention efficiency at both sides across the Strait. Through the analysis of documents and history, this thesis focuses on three aspects of the disease control and prevention systems across the Strait -- organization, budgeting, and personnel. Along these three facets, this thesis will dissect and compare the characteristics before the SARS epidemic, the changes caused by the SARS epidemic, and the characteristics after the changes found in the two systems across the Taiwan Strait. In addition, the relationship between the SARS epidemic and the changes in the disease control and prevention systems across the Strait are also discussed. Furthermore, according to the evolution of the disease control and prevention systems across the Strait, the thesis will also probe their drawbacks and weakness. Finally, the current situation of the two systems is compared, which will yield implications for envisaging the likely cooperation and interaction between the two sides in the future.