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平成１１年７月２６日
本日、「結核対策連絡協議会」が開催され、厚生大臣から「結核緊急事態宣言」が行われました。
なお、協議会の出席団体等は、以下のとおり。
（保健医療等関係団体：１７）
| （財）結核予防会 （財）結核予防会結核研究所 全国医学部長病院長会議 （社）全国結核予防婦人団体連絡協議会 （社）全国自治体病院協議会 （社）全国有料老人ホーム協会 全国老人福祉施設協議会 （社）全国老人保健施設協会 （社）全日本病院協会 （社）日本医師会 （社）日本医療法人協会 （社）日本看護協会 日本結核病学会 （社）日本歯科医師会 （社）日本精神病院協会 （社）日本病院会 （社）日本薬剤師会 |
（行政関係：１１）
| 国立療養所近畿中央病院 全国知事会 全国市長会 全国町村会 全国衛生部長会 保健所長会 法務省矯正局 外務省大臣官房領事移住部 文部省高等教育局 文部省体育局 労働省労働基準局 |
照会先：保健医療局結核感染症課 担 当：野村（内線2373）、勝又（内線2378） 直 通：03(3595)2257
結核は、かつて我が国において国民病と言われる時代がありましたが、国民の生活水準の向上や医学・医療の進歩、結核対策に携わってこられた関係者の献身的な努力により、以前に比べて大きく改善してきました。このような状況の下、一般の国民のみならず医療関係者や行政担当者までもが、結核は既に我が国で克服された過去の病気であると錯覚してきたのではないでしょうか。
結核は決して過去の病気ではありません。世界保健機関は、平成５年に結核の非常事態宣言を発表し、加盟各国に結核対策の強化を求めています。我が国においても、平成９年で約４万２千人の新規結核患者が発生し、約２千７百人が結核で亡くなるという我が国最大の感染症であります。さらに近年、多剤耐性結核の問題、多発する学校、医療機関、老人関係施設等における結核集団感染の問題、高齢者における結核患者の増加の問題、在日外国人における結核患者の問題等、緊急に対応を図らなければならない重要な課題が出現しております。また平成９年には、これまで減少を続けてきた新規発生結核患者数が３８年ぶりに、罹患率が４３年ぶりに増加に転じたことが明らかになっており、今後も引き続いて増加していく危険性が指摘されています。
現在の我が国の結核の状況は、今後、患者数が増加し多剤耐性結核がまん延する等、再興感染症として猛威をふるい続けるか否かの分岐点に立っており、まさに今日、医療関係者や行政担当者を含めた国民一人一人が結核を過去の病気として捉えるのを改め、国民の健康を脅かす大きな問題として取り組んでいかなければ、将来に大きな禍根を残すこととなります。
以上のことから、厚生省として、ここに結核緊急事態を宣言し、関係省庁、地方自治体や関係団体とともに、再興感染症としての結核問題の国民への普及啓発、健康診断を始めとする結核予防法に基づいた各種施策、結核発生動向調査事業や結核特別対策促進事業を強力に推進するとともに、国立療養所を拠点とする多剤耐性結核等への対応を含む専門医療体制を充実してまいります。
国民各位や関係団体等におかれても、結核の問題を再認識し、次のような対策の推進に取り組まれることを要請いたします。
結核が国民病といわれていた時代に逆戻りさせず、国民の健康を結核の脅威から守っていくために、厚生省を始めとして関係省庁や地方公共団体、各種関係団体、国民一人一人が結核の問題を再認識し、我が国が一丸となって結核対策に取り組んでいくことが求められています。私は、国民の一人一人が結核対策に御協力いただくことにより、我が国の結核対策は必ず成功し、結核を克服することができると確信いたしております。
重ねて皆様の御理解と御協力をお願いいたします。
平成１１年７月２６日
厚生大臣 宮下創平
There was a time in Japan when tuberculosis was referred to as the "national disease." That has changed dramatically, thanks to higher standards of living, medical and pharmaceu-tical advances, and the selfless efforts of those who long fought this dreaded disease. This success, however, has eng-endered the illusion that tuberculosis has been conquered forever and is now a disease mentioned only in history books.This false sense of security is, unfortunately, common not only in the general public, but also among members of the medical community and government officials.
Tuberculosis is by no means a disease of the past. In 1993,the World Health Organization declared a state of emergency with regard to tuberculosis and advised its member countriesto step up their efforts to treat and counter the spread of this contagion. In Japan, approximately 42,000 new cases were reported in 1997 alone.
In the same year, some 2,700 people lost their lives to thisdisease, making tuberculosis Japan's deadliest contagious disease.
Moreover, in recent years, Japan has come to face a wide range of serious problems pertaining to tuberculosis and calling for immediate action. These include the emergence of strains resistant to multiple drugs, the increasing fre-quency of group infections in schools,medical facilities,andfacilities for the elderly, the growing incidence of tuber-culosis among the elderly, and the presence of tubercular patients among foreign residents of Japan. It has now becomeapparent that, after many years of steady decline,the numberof new cases reported in 1997 marked the first increase in 38 years, while the morbidity rate increased for the first time in 43 years. There is a clear danger that these figureswill continue to move upward in the years ahead.
Conditions in Japan now indicate that the nation is at a critical turning point in its fight against tuberculosis, a turning point that may lead to its re-emergence as a nati-onal epidemic involving a vast increase in the number of patients infected by multiple-drug-resistant strains. This calls for a new awareness among each and every member of thepublic, including members of the health professions and government officials. We must not allow ourselves to be lulled into believing that tuberculosis is a disease of the past:rather, we must fight it,in the knowledge that it posesa serious threat to the health of the entire country.Failureto do so will certainly sow the seeds of future disaster.
For these reasons, the Ministry of Health and Welfare is he-reby declaring a state of emergency concerning tuberculosis.Henceforth, the Ministry shall work together with other re-lated ministries and government agencies, as well as with local governments and related organizations, to educate the public about the dangers of tuberculosis as a re-emergent epidemic, to implement countermeasures, such as medical examinations, provided for under the Tuberculosis PreventionLaw, and to actively conduct surveys of the occurrence of tuberculosis and promote special anti-tuberculosis programs.
Furthermore, we shall establish and expand a specialized medical care system to combat tuberculosis,endowing nationalsanatoriums with research center facilities to develop methods to fight multiple-drug-resistant tuberculosis and address related problems.
We call now on the general public and various private orga-nizations to join the fight against tuberculosis by instill-ing a new awareness of the dangers posed by this disease andby undertaking to promote the following types of actions.
1. We call on local governments to strengthen and upgrade the anti-tubercular capabilities of public health centers intheir respective districts,which represent the front line inour defenses against tuberculosis. Local governments are requested to take prompt and appropriate action from the standpoint of crisis management,including by conducting tho-rough medical examinations whenever a case of tuberculosis is reported.
2. We call on medical associations and hospital organiza- tions to direct their members to re-confirm their familiari-ty and basic knowledge of tuberculosis, to improve their diagnostic skills and technologies,to promote the preventionof intramural tubercular infections,and to provide informat-ion regarding appropriate responses when tubercular patientsare identified.
3. We call on organizations of facilities for the elderly and other types of institutions to direct their members to prevent the intramural transmission of tubercular infections,to provide information regarding appropriate responses when a tuberculosis patient is identified,and to conduct thoroughmedical examinations regularly and whenever necessary.
4. We call on research institutions and scientific associa-tions in fields related to tuberculosis to further promote research and training in its diagnosis and treatment.
5. We call on organizations directly involved in the fight against tuberculosis to redouble their efforts to combat tuberculosis, such as by disseminating correct information and knowledge more widely and frequently.
6. We call on each and every member of the public to informthemselves properly about tuberculosis. Furthermore,we stro-ngly urge the public to work to prevent the spread of tuber-culosis by undergoing regular medical examinations at every opportunity. Persistent coughs should not be regarded as merely a cold symptom: they should be examined by a doctor.
Japan must not return to the age when tuberculosis was the "national disease." To protect the health of the nation fromthe threat of tuberculosis, a new awareness of this threat must be developed in the Ministry of Health and Welfare, as well as among all related ministries and government agencies,local governments, related organizations, and each and everyindividual. All the forces of the nation must be united, based on this awareness, in the fight against tuberculosis. With the cooperation of all members of society, I firmly believe that we will prevail in this fight and ultimately overcome this disease.
In closing, I once again ask for your understanding and cooperation in this vital endeavor.
July 26, 1999
Sohei Miyashita
Minister of Health and Welfare
This is an English translation of declaration originally produced in Japanese. We did our utmost to ensure accuracy in our translation and believe it to be of the highest standard. However, in case of any discrepancies between the Japanese and English versions, the former should prevail as the official version.
Infectious Control Division
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