非政府组织与全球健康:国际经验与借鉴

非政府组织(Non-governmental organization,NGO)在全球健康领域发挥着重要作用。本专题集中研究NGO在全球健康领域的作用、治理工具、在政府全球健康战略中的地位、项目管理经验、中国NGO的发展状况等五个方面。研究认为,全球健康已初步形成大国、国际政府间组织和大型NGO主导的治理格局,中国仅靠政府力量并不能满足日益增长的全球健康需求。建议中国应将NGO纳入全球健康战略,建立NGO管理和合作机制,使其成为实施全球健康项目的重要补充力量;对中国非政府组织采取"重点扶持、整体改善"策略。     

全球健康领域政府对非政府组织的定位与合作——以世卫组织、美国和英国为例

非政府组织(NGO)在全球健康治理中发挥重要角色,已成为欧美发达国家和联合国系统全球健康战略的重要组成部分,联合国可持续发展目标也提出要强化NGO作为全球健康治理合作者的角色。本研究以全球健康战略比较成熟的世界卫生组织和美英两国为例,综述它们在全球健康战略中对NGO的定位和合作,为中国全球健康战略的制定以及与NGO的合作及定位提供参考建议。研究发现,世界卫生组织、美国和英国在其全球健康战略中均给予NGO明确定位,即加强相互合作,来扩大其在全球健康领域的影响力。因此,中国应将NGO纳入全球健康战略,建立NGO的管理和合作机制,使其成为全球健康的重要补充力量;严格筛选国际NGO进行合作,努力培育和支持本土NGO参与中国全球健康项目的实施;制定NGO合作清单和负面清单;同时加强监管和审核,规避NGO可能带来的风险。     

七个经合组织国家全球卫生战略比较研究

全球化对健康产生了广泛而深刻的影响,挑战了原有的国际卫生体系,推动了全球卫生概念的提出,开拓了全球卫生治理的新局面。经济合作与发展组织中的七个国家已经发布并实施了国家全球卫生战略。本文比较研究了这些国家出台全球卫生战略的背景、目标利益,指导价值理念、重点领域及战略的制定过程等,并对七国战略的共同点及不同特色进行了总结提炼,发现尊重和维护健康权、积极承担国际责任并发展合作伙伴的能力是共同的价值理念;维护和改善本国人民的健康并为改善全球健康做出贡献、促进国家利益的实现是共同的目标;基于本国比较优势满足发展中国家卫生合作的需求是确定重点领域的关键;加强全球卫生治理、影响健康的全球治理,以及影响全球的卫生治理的思想贯穿战略的始终;多部门和全社会参与战略制订的过程。在借鉴上述国家全球卫生战略核心思想和经验的基础上,提出对中国制订国家全球卫生战略的建议。     

全球卫生背景下的中国卫生检疫与跨国传染病控制

目的探讨中国卫生检疫在全球卫生治理背景下的发展策略。方法分析传染病在中国和全球间的互动和影响,以及全球卫生治理的必要性,从全球视野和体系建设、健康促进、卫生公平等方面探讨卫生检疫的未来发展趋势。结果中国加入全球化进程导致传染病风险具有全球化特征,全球卫生治理是适应全球传染病控制的有效进路。中国卫生检疫在跨国传染病防控中起到了重要作用。结论中国卫生检疫应从全球理念出发进行战略和机制调整,加大多部门、多组织参与的平台建设,促进全球监测和控制体系建设步伐,同时充分利用健康促进和公平促进更好的发挥传染病防控职能,以在未来的全球卫生中更好的发挥自己的作用。     

泰国参与全球和区域卫生安全治理的经验和启示

泰国通过参与全球和区域卫生安全治理不仅改善了本国的卫生和经济状况，而且提高了泰国在东亚地区乃至全球范围内卫生安全领域的影响力和话语权。中国和泰国同属东亚地区发展中国家，泰国参与全球和区域卫生安全治理的经验和途径对中国具有借鉴价值。本文分析泰国在宏观、中观和微观层面如何主动参与全球和区域卫生安全治理，对于提高中国在卫生安全治理领域的参与度和影响力有重要启发，同时为中国加强与联合国系统机构和东南亚国家的卫生安全合作提供案例。     

浅析医学社团助力中国参与全球卫生治理特点、路径及启示

目的 深入分析医学社团在全球卫生治理进程中的特点,参与路径;思考医学社团助力中国参与全球卫生治理带来的启示。 方法 本文通过文献检索,总结医学社团的特点,理解在全球卫生进程中发挥的作用;通过案例分析法,回顾中华预防医学会疫情期间国际交流工作实践,探索医学社团助力中国参与全球卫生治理的路径。 结果 医学社团利用专业性、灵活性和协同性等特点,在全球重大公共卫生问题应对、推动全球卫生倡议、促进全球卫生合作中发挥重要作用。医学社团通过组织学术交流会议、分享抗疫经验、搭建权威信息平台及争取国际组织任职等路径,帮助中国参与全球卫生治理进程。 结论 医学社团应提升能力,配合政府开展工作,主动将国际交流工作主动纳入中国参与全球卫生治理工作大局。     

全球健康领域的国际合作者分析——以在中国开展卫生合作的机构为例

在全球化背景下,健康影响因素与公共卫生治理已超越国界,而促进全球健康目标的实现需要多方协调和努力。在全球健康这一相对新兴的领域内,有越来越多的国际参与者,包括国家政府、联合国、其他国际组织、双边机构以及非国际组织、基金会等。本文主要通过查阅我国卫生合作项目的相关资料,对在中国开展合作的主要国际卫生机构及合作项目、重点合作领域进行总结,并对其特点进行比较分析,认为应完善以世界卫生组织为主导,其他国际组织、双边机构、非国际组织等为行动主体的多重治理,并提出加强顶层协调、促进非卫生领域参与卫生治理,以及建设多方沟通机制等建议,以促进国际合作者进一步参与中国全球健康领域国际合作。     

社会组织在公共卫生治理体系中的作用

社会组织作为社会协同和公众参与的重要载体,是国家治理的重要参与者和公共卫生治理体系的重要组成部分,在国家治理能力现代化进程中具有重要作用。本文以民间社会组织在公共卫生治理体系中的作用为研究视角,系统阐述社会组织在应对重大疫情时所发挥的特殊作用,并介绍近代中国民间社会组织在疫情应对中的有益经验,最后就如何充分发挥民间社会组织在公共卫生治理体系中的作用提出对策。     

中国全球健康相关非政府组织的发展策略浅析

国际非政府组织在全球健康治理中发挥了重要作用,也是各国发挥国际影响力的重要渠道,但中国非政府组织目前参与全球健康治理甚少。本文旨在分析中国非政府组织发展的社会政策环境、健康类非政府组织的发展现状并借鉴国外新兴的全球健康相关非政府组织的经验,为中国扶持非政府组织参与全球健康治理提供策略建议。本文发现,中国参与全球健康治理有较好国际机遇;国内社会组织发展环境趋势向好,但具有依附行政体系、政策定向发展等特点。因为专业性、公共服务属性以及与公共治理相关性小,非政府组织参与全球健康可以得到政府的全力支持。健康类非政府组织数量较少、基础较差、参与国际合作少。不同类型健康类社会组织各有长短,国际经验提示新兴机构主要依靠政府力量扶持非政府组织参与全球健康。建议我国政府采取"重点扶持,整体改善"的策略,制定中国全球健康发展战略,以政府附属与社会精英创办的大型非营利机构为重点扶持对象,引导和资助健康类非营利机构走向国际舞台。     

金砖国家卫生外交政策及其参与全球卫生治理的经验

全球化进程使各国将全球卫生治理作为重要战略关切,作为新兴国家代表的巴西、俄罗斯、印度、中国、南非这五个金砖国家(BRICS)在全球卫生治理领域发挥着日益重要的作用。本文比较和分析了金砖国家的卫生外交政策及其参与全球卫生治理的行动,总结了金砖国家参与全球卫生治理的特点及可供中国借鉴的经验,同时提出了作为多边合作机制的金砖国家在全球卫生领域中所面临的挑战。     

国际非政府组织参与全球健康治理的工具研究

非政府组织在全球健康治理中发挥着日益重要的作用。本研究筛选了10家在全球健康事务中有重要作用的关键非政府组织,总结非政府组织参与全球健康治理的工具,包括:"产生知识和证据"、"合作"、"参与"、"协商一致"、"透明性"、"组织建设"、"制定政策或战略方向"、"责任"和"规制"九个维度。实施型、倡导型、支持型和综合型非政府组织在参与全球健康治理的工具选择上具有共性和各自侧重点。中国应努力培育本土非政府组织,同时应注重其"透明性"、"参与"与"合作"。     

Strengthening community participation at health centers in rural Cambodia: role of local non-governmental organizations (NGOs)

Cambodia's health policy emphasizes community participation to improve health services. This study identifies factors facilitating community participation in health center management in rural Cambodia, focusing on roles of local NGOs. We conducted a questionnaire survey of 50 local NGOs regarding their understanding of new health systems and policies and NGO collaboration with health centers. Eight local NGOs and their partner health centers were selected for further field survey. Using an assessment tool developed by the authors, structured interviews were conducted with 35 stakeholders to measure the level of community participation in the management of health centers through health committees mandated for each health center by the new health policy. Roles and approaches of the eight NGOs were examined. Levels of community participation at the health centers varied and were associated with roles of the partner NGOs. Critical roles of NGOs in facilitating community participation were found to include: nurturing a base through community organizing and capacity building, and encouraging the community to apply community experiences in health; regularly communicating with, monitoring and providing management support to health centers; and linking local actors for health. To take such roles effectively, long-term commitments to specific localities and small financial inputs were found to be advantageous characteristics for NGOs. Local NGOs, even those without health expertise and with limited resources, can effectively promote and facilitate community participation in health center management. Such roles of local NGOs are critically important for sustainable health development, and therefore, should be further recognized and supported.     

The role of non-governmental organizations in global health diplomacy: negotiating the Framework Convention on Tobacco Control

The Framework Convention on Tobacco Control (FCTC) is an exemplar result of global health diplomacy, based on its global reach (binding on all World Health Organization member nations) and its negotiation process. The FCTC negotiations are one of the first examples of various states and non-state entities coming together to create a legally binding tool to govern global health. They have demonstrated that diplomacy, once consigned to interactions among state officials, has witnessed the dilution of its state-centric origins with the inclusion of non-governmental organizations (NGOs) in the diplomacy process. To engage in the discourse of global health diplomacy, NGO diplomats are immediately presented with two challenges: to convey the interests of larger publics and to contribute to inter-state negotiations in a predominantly state-centric system of governance that are often diluted by pressures from private interests or mercantilist self-interest on the part of the state itself. How do NGOs manage these challenges within the process of global health diplomacy itself? What roles do, and can, they play in achieving new forms of global health diplomacy? This paper addresses these questions through presentation of findings from a study of the roles assumed by one group of non-governmental actors (the Canadian NGOs) in the FCTC negotiations. The findings presented are drawn from a larger grounded theory study. Qualitative data were collected from 34 public documents and 18 in-depth interviews with participants from the Canadian government and Canadian NGOs. This analysis yielded five key activities or roles of the Canadian NGOs during the negotiation of the FCTC: monitoring, lobbying, brokering knowledge, offering technical expertise and fostering inclusion. This discussion begins to address one of the key goals of global health diplomacy, namely 'the challenges facing health diplomacy and how they have been addressed by different groups and at different levels of governance' (Kickbusch et al. 2007a: 972).     

全球最有效率的医疗卫生体系如何应对挑战?——香港特别行政区的医疗管理体制、医疗改革举措及对内地的启示

我国医药卫生体制改革取得了有目共睹的成绩,在深化医改的过程中,可以更多参考借鉴其他华人社会的成功经验并汲取其教训。香港特别行政区的医疗卫生体系蜚声国际,高居"全球最有效率卫生体系"之冠。本文主要评析香港特区的医疗管理体制,遇到的挑战,以及近年来的重要医改举措,并总结其对内地医改的启示。香港的医疗卫生治理结构充分实现了"管办分开",解决了"九龙治水"问题,医管局管理体制具有较高的效率和专业性。但是香港特区医疗系统也面临诸多挑战,特区政府近年来推行了自愿医保、公私营协作计划、长者医疗券等若干医改政策,其中许多改革理念和政策工具可供内地医改借鉴。     

The global financial crisis: whither women's health?

The global integration of trade and financial markets that has been the hallmark of the past 30 years of neoliberal globalization means that local economies can be shaped by economic events seemingly unrelated to the scale or geography where women's empowerment projects unfold. These global–local interactions raise questions so far largely absent in public discussions of the 2008 crisis precipitated by the US sub-prime loan scandal: what are the gendered effects of global financial crises; specifically, how do these crises affect women? And how do these market crises intersect with the non-market activities that are key to understanding gendered health issues in developing countries. This article addresses these questions by reviewing the literature on gendered health impacts of financial crises over the past two decades. We find that the manner in which national governments and the broader international community react to crises can either magnify (as illustrated through the impacts of structural adjustment programmes on women's health) or mitigate (as illustrated through the policies pursued following the loss of support from the collapsed Soviet Union on Cuban women's health) gendered health-negative effects. Lack of attention to gender-specific consequences of past crises or health-positive interventions into such crises has weakened the ability to advance policy advice on protecting women's health during the present crisis. The article concludes with a gender-focused critique of the dominant policy responses to the 2008 financial crisis and a call to undertake real-time investigation of gendered health risks and opportunities arising from the present crisis.     

Scales of governance: The role of surveillance in facilitating new diplomacy during the 2009–2010 H1N1 pandemic

The 2009–2010 H1N1 influenza pandemic has highlighted the importance of global health surveillance. Increasingly, global alerts are based on 'unexpected’ 'events’ detected by surveillance systems grounded in particular places. An emerging global governance literature investigates the supposedly disruptive impact of public health emergencies on mobilities in an interdependent world. Little consideration has been given to the varied scales of governance – local, national and global – that operate at different stages in the unfolding of an 'event', together with the interactions and tensions between them. By tracking the chronology of the H1N1 pandemic, this paper highlights an emergent dialogue between local and global scales. It also draws attention to moments of national autonomy across the global North and South which undermined the WHO drive for transnational cooperation.