全球公共卫生治理的制度重叠及其应对之策

近年来,全球公共卫生治理体系彼此通过议题联结、成员联系和功能互动形成了密切的国际制度重叠,包括以世卫组织为核心的联合国诸公共卫生制度、以盖茨基金会等为代表的非正式公共卫生制度、以二十国集团为代表的涉卫新型国际制度以及特朗普政府试图打造的美式国际公共卫生制度。制度重叠是国际公共卫生秩序的结构性特征,可能会约束与限制世卫组织治理有效性的发挥。全球公共卫生议题的复杂性、全球公共卫生治理的政治化倾向和世卫组织的治理限度决定了协同治理具有必然性和紧迫性,为此,国际社会需要秉持人类卫生健康共同体理念,坚持公共卫生多边主义,警惕美国另起炉灶对全球公共卫生治理的冲击。同时,世卫组织发挥协同治理功能的制度化需求迫在眉睫。此外,新型国际公共卫生治理制度是推动多元制度协同治理的重要力量,将发挥愈加凸显的关键作用。作为国际公共卫生体系的重要成员,中国的负责任国际承诺为国际公共卫生制度重叠提供了重要的协调路径,中国支持世卫组织发挥领导作用,加强在联合国、二十国集团、世贸组织、金砖国家集团等多边制度框架内的协调配合和相互支撑,推动构建人类卫生健康共同体。

Institutional Overlap of Global Health Governance and Its Countermeasures

In recent years,the global health governance has formed a close international institutional overlap through topic connection,member connection and function interaction,including the United Nations’ health institutions with WHO as the core,the informal health institutions represented by the Gates Foundation,the new health-related international institutions represented by the G20,and the United States that Trump government tries to create international health institutions. Institutional overlap is a structural feature of the international public health order,which may restrict the effectiveness of WHO governance. The complexity of global health issues,the politicization of global health governance and the limits of WHO governance determine the necessity and urgency of collaborative governance. Therefore,the international community needs to uphold the idea of a community of common health for humanity,adhere to health multilateralism and be alert to the impact of the United States on global health governance.At the same time,it is urgent for WHO to play an institutionalized role of collaborative governance. In addition,the new international health institutions are important forces to promote multi-institutional collaborative governance,which will play an increasingly prominent key role. As an important member of the international health system,China’s responsible international commitment provides an important coordination path for the overlap of international health institutions. China supports WHO to play a leading role in strengthening coordination and mutual support within the framework of the United Nations,the G20,WTO and the BRICs group,so as to promote the construction of a community of common health for humanity.