保健所医師（公衆衛生医師）の情報が載っています。
https://www.phcd.jp/02/j_ishiboshu/pdf/panf_2020.pdf
公衆衛生医師となった方のエッセイ。月刊「公衆衛生情報」掲載。
https://www.phcd.jp/02/j_koushueisei/index.html#watashi
全国の保健所の様子がわかります。
保健所長のお仕事紹介〜現役公衆衛生医師のホンネに迫る〜
Offline: The tragic fallacy of global health reform
Richard Horton Send email to richard.horton@lancet.com
In Jorge Luis Borges's fantastical short story, Tlön, Uqbar, Orbis Tertius, written in 1940, he imagines the invention of a new world, Tlön, by a secret society of, among others, astronomers, biologists, and engineers.
Two important reform initiatives emerged. First, the Accra Reset, launched by Ghana's President John Mahama during the 2025 UN General Assembly, intends to end the political marginalisation aid recipients endured, where rules and instruments that shaped global health excluded the nations those same rules and instruments claimed to be serving.
１つめとしてアクラリセット（援助を受ける側の国が議論の辺縁にいる状態をやめること）
Second, WHO is hosting its own reform process—“a time-bound multilateral effort to support transformation of global health architecture”. A report on what this reform might look like is being prepared for the 2027 World Health Assembly by WHO's Director-General.
２つめとして多国間による共同サポート
What is sometimes forgotten is that global health is about power—and the rich world, despite its kindly reassurances, will not loosen the ties that keep countries constrained and dependent. And remember: reform has been a subject for rumination ever since global health entered our lexicon.
Councils, panels, and task forces will thrive and reproduce. And this vast displacement activity will likely contribute not one trace of benefit to the health of peoples.
このままでは誰の得にもならないのではないか。
https://www.sciencedirect.com/science/article/pii/S2666606526000842
Articles Volume 70101880 May 2026
Open access
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Asymptomatic tuberculosis in Japan: a 15-year national surveillance study, 2008–2022
Tomohiko Ukaia Send email to ukai_tomohiko@jata.or.jp ∙ Kaung Si Thua ∙ Kazuhiro Uchimuraa ∙ Akihiro Ohkadoa ∙ Takashi Yoshiyamaa,b ∙ Edine Tiemersmac
Articles Volume 26, Issue 9 p881-893 September 2026
Open access
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Expanding Xpert MTB/RIF Ultra and lateral flow urine lipoarabinomannan testing for diagnosis of tuberculosis among adults living with HIV admitted to hospitals in Tanzania and Mozambique (EXULTANT): a randomised controlled trial
タンザニアとモザンビークの11の病院で実施されました。入院後24時間以内に、結核の既往歴や最近の結核治療歴のないHIV感染成人（18歳以上）を連続的に登録しました。介入群は、症状の有無にかかわらず、喀痰、便、尿からのXpert MTB/RIF Ultra（Xpert Ultra）検査と、ラテラルフロー尿リポアラビノマンナン（LF-LAM）検査（Determine TB LAM Agアッセイ）を受けました。対照群は、WHOが推奨する症状に基づく標準的な喀痰Xpert UltraおよびLF-LAM検査を受けました。主要評価項目は、微生物学的に結核と確定診断された参加者のうち、72時間以内に治療を開始した者の割合でした。
World Report Volume 408, Issue 10557 p775-776 August 29, 2026
New CDC Director promises to protect vaccines and support the agency's “exhausted” scientists
Susan Jaffe
A week after Erica Schwartz took the helm at the beleaguered US Centers for Disease Control and Prevention (CDC) on Aug 12, she convened an all-staff meeting. Schwartz fielded questions from staff and pledged to advocate for the agency, which has been gutted through the loss of thousands of workers and steep funding cuts. She assured staff that she would not hesitate to disagree with her boss, Robert F Kennedy Jr, Secretary of the Department of Health and Human Services, who has presided over the reorganisation.
It recommends that seven immunisations be eliminated from the childhood vaccine schedule and the combined measles, mumps, and rubella (MMR) vaccine should be separated and administered in three separate medical visits.
Schwartz should not wait for the taskforce to meet, Houry said. “She can speak now to the evidence (100 peer countries do not separate the MMR vaccine and Japan, which removed the mumps component, has moved towards putting it back) and the unintended consequences that will result in harm to children with delayed vaccinations.”
Lessons from the 1970s for today's US opioid crisis - The Lancet
erspectives Book Volume 408, Issue 10556 p686-687 August 22, 2026
Lessons from the 1970s for today's US opioid crisis
Richard J Baum Send email to rjb83@georgetown.edu
確かに、薬物供給は進化を続けており、ニタゼン類やオルフィン類といった新しい種類の合成オピオイドが現在密売されており、今日の多剤併用はオピオイド依存症の効果的な治療をより複雑にしている。しかしながら、ダフトンが書いている1970年代初頭の連邦政府資金による全国的な薬物治療プログラムは、オピオイドアゴニスト薬と支援的な医療・社会サービスを組み合わせることで、治療成功率に大きな違いが生じることを教えてくれた。現在、オピオイド使用障害を抱えるアメリカ人の多くが、こうした治療を受け始めている。このことに気づくまでに50年もかかったのは残念なことだ。さらに、こうしたサービスから恩恵を受けることができるにもかかわらず、まだ支援を受けていない人々が数多くいる。継続的な進歩は、政府がオピオイド治療プログラムへの投資を減らすのではなく増やすことにかかっている。これらのプログラムには、ニクソン大統領が何年も前に初めて広く利用できるようにしたメサドンを含む薬物を提供する。
HIV care suffers under Senegal anti-gay law - The Lancet
World Report Volume 408, Issue 10554 p505 August 08, 2026
The introduction of harsh penalties for same-sex relations has created a climate of fear that is severely disrupting HIV services.
Patients have been left living in fear and others have gone to neighbouring countries such as The Gambia and Morocco.
Community health workers who were engaged in HIV testing, treatment, and prevention services, such as distribution of condoms, HIV-preventive pre-exposure prophylaxis (PrEP) medication, and monitoring patients, have been arrested. “The laws are incompatible with public health and human rights. Decriminalisation, competent and adequate health services, and measures against stigma and discrimination are the only sustainable ways out”, he said.
Senegal's HIV response has already been weakened by US funding cuts on international assistance that came into force in January, 2025. The HIV prevalence among men who have sex with men is estimated to be 27·6%, compared with 0·5% in the general population.
“Denying people health rights, regardless of their behaviour, drives people underground and does not improve public health”, Beyrer told The Lancet.
