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。     

日本卫生发展援助及其对中国卫生合作的启示

目的梳理日本卫生发展援助现状及策略,探讨其对中国参与国际卫生合作的启示。方法使用PEST分析法,从政治(political)、经济(economic)、社会(social)和技术(technological)四方面分析日本卫生发展援助的外部环境,用近年日本卫生发展援助的统计数据分析日本卫生发展援助的特点,包括援助规模、途径、地区和领域。结果日本卫生发展援助具有有利的社会环境。2012—2016年日本卫生发展援助总额占官方发展援助总额的8.59%,卫生发展援助资金主要由多边机构提供,越南、印度等是援助资金的最大流入国,援助集中解决卫生政策、初级卫生保健等卫生问题。结论建议中国参与国际卫生合作时首先明确自身优势,注重打造国家品牌,通过双边卫生合作助力提升中国多边卫生议题的设置能力,进而提高中国全球卫生治理水平。     

传染病问题的全球治理机制及其完善

为了应对新发传染病带来的全球卫生危机,国际社会发展和完善了现代国际卫生合作机制,初步形成了传染病的全球治理机制。由于受到全球经济发展不平衡、国际民主失衡与冲突频发、多个并存的国际组织公共卫生职能重叠、非政府组织参与全球卫生治理的有效性有待提高等因素的影响,初具雏形的传染病全球治理机制还比较粗糙,有待在传染病治理的实践中接受检验并不断完善。建议加强世界卫生组织的领导地位、增加全球卫生投入、改善全球经济治理机构、推动国际政治民主化、协调伙伴关系、明确非政府组织的法律地位、重视健康的决定因素。     

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。     

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。     

全球卫生治理面临的挑战及其应对策略

人人享有健康是一项基本人权。全球卫生治理的使命就是要在全世界范围内促进“人人享有健康”。目前,全球卫生治理面临诸多重大挑战,如治理主体众多但目标不一致导致领导权威难以确立,以国家为中心的国际体制使跨国集体行动的达成存在一定困难,各国对公共卫生事项设置的优先顺序存在分歧,全球卫生资金投入不足且分配不均,全球卫生治理严重缺乏国际协调,全球卫生治理基本框架尚未完全形成等。为了应对挑战,建议深化全球卫生改革,提高全球卫生治理的能力与效率;国际社会与各国政府必须审思与重构自身卫生法律与政策,把重点放在促进卫生公平而非提高经济竞争力上;各国政府必须重点关注民生和民权,重视非卫生领域政策与卫生政策的协调,从根本上改善健康的决定因素;增加全球卫生治理的透明度、建立新型问责制,增强世界卫生组织的权威性;在全球层面构建全球卫生治理基本框架,增强全球卫生治理的有序性。     

全球卫生与医学卫生国际合作

全球卫生是国际上迅速发展的新兴学科和研究领域,其定义显示出其跨学科和多学科的特点;该学科研究范畴包括健康决定因素与卫生公平、全球卫生治理格局、卫生合作模式等热点问题。了解全球卫生研究的热点问题对我国医学与卫生界,特别是教育和研究机构应对全球卫生变化所带来的机遇与挑战,探讨新的合作模式,积极参与全球医学与卫生合作,具有指导意义     

国际利益相关者视角下中国参与全球卫生安全治理的作用研究

卫生安全治理是全球治理的重要方面。中国参与全球性突发公共卫生事件的应对,需要明确全球卫生治理的重要国际伙伴,才能制定有针对性的合作策略,更好地实现全球卫生安全的维持与治理。文章从利益相关者的角度,运用米切尔评分法,确定了与中国参与全球卫生安全治理相关的前10个主要国际利益相关者,分析了其利益诉求、合作态度,并依据其重要性进行分类,为完善中国参与全球卫生安全治理策略提供参考。     

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。     

中越卫生合作需求与策略

目的:通过分析越南的卫生合作需求,提出中越卫生合作的策略建议。方法:通过二手资料收集和定性访谈,收集健康相关可持续发展目标(SDG)数据、越南卫生发展规划、国际组织对越援助以及中越卫生合作现况。结果:越南以SDG为基础,规划优先发展领域。国际组织对越南卫生发展起到重要作用,但随着越南的经济发展,部分组织开始撤资。中越目前主要在多边合作框架下开展卫生合作,合作内容涉及卫生安全、卫生发展和医学创新。结论:中越卫生合作应根据两国卫生发展水平、卫生合作基础及国家发展规划决定合作的领域和方式。两国的卫生合作应随双方的发展进程和需求变化而动态调整。除了中越两国的资源,其他国际资源的有效利用也有助于卫生合作的推进。     

公共卫生人才全球化视野的内涵与培养

随着中国在国际舞台上的重要性不断提高,培养具有全球化视野的公共卫生人才成为关键问题。全球化视野包括对全球政治、经济、社会发展的深入理解,对全球卫生问题的历史、现状与发展趋势的掌握,对公共卫生全球治理与公共卫生专业本身关系的理解和感悟,在多元文化环境中对多元价值的理解、适应和自我发展,以及通过外交谈判手段获得问题解决方案的能力和向全球卫生治理提供中国案例的能力。培养这些能力,既需要打造理论与实践相结合的师资队伍,选择适宜人才进行后备队伍培养和教育,也需要提供多种多样的实践与培训,如到国外留学、到国际组织或者跨国机构任职、参与中国政府对外援助项目等。     

Sustainable network advantages: a game theoretic approach to community-based health care coalitions

Health care organizations often enter into a cooperative arrangement to create safety-net programs and coordinate care. Maintaining effective cooperation in such alliances poses special problems that can be examined using network analysis and explained in game theory terms. A mental health coalition case study is presented using network analysis and game theory interpretations. Had a positive-sum game approach been applied to the coalition's initial design, its subsequent suboptimal performance might have been averted. The application of network analysis plus a game theoretic paradigm has significant implications for improving both the design and the coordination of such coalitions.     

A network to promote health systems based on primary health care in the Region of the Americas]

OBJECTIVES: To identify the relational components of an international network of organizations that provide technical and financial assistance to promote the development of health systems based on primary health care in the countries of the Region of the Americas; to analyze the linkages that would allow the collaborating partners of the Pan American Health Organization (PAHO) to work together on health issues; and to determine the basic theoretical elements that can help to develop action strategies that support advocacy efforts by a network. METHODS: This was a qualitative and quantitative cross-sectional study based on identifying key informants and on analyzing social networks. Ethnographic and relational information from 46 international organizations was collected through a self-administered semistructured questionnaire. From 46 international health cooperation organizations, 29 decision makers from 29 organizations participated (63.0% response rate). The structure and the strength of the network was evaluated in terms of density, closeness, clustering, and centralization. The statistical analysis was done using computer programs that included UCINET, Pajek, and Microsoft Access. RESULTS: We found a structurally centralized theoretical network, whose nodes were clustered into four central subgroups linked by a shared vision. The leadership, influence, and political interests reflected the formal and technical-cooperation linkages, the formal support for health systems based on primary health care, and the flow of resources being more often technical ones than financial ones. CONCLUSIONS: The interorganizational relational components and the social-action ties that were identified could help in the development and consolidation of a thematic network for advocacy and for the management of technical and financial assistance that supports primary health care in the Americas. The linkages for joint action that were identified could advance international cooperation in developing health systems based on primary health care, once PAHO formulates clear implementation strategies and takes a leadership position in mobilizing financial resources and in creating informal and interpersonal linkages for action.     

The Global Alliance for Vaccines and Immunization: is it a new model for effective public-private cooperation in international public health?

The Global Alliance for Vaccines and Immunization (GAVI) has in many ways been remarkably successful in revitalizing the international coalition of institutions and organizations concerned with getting vaccines to the children of the poorest countries. Many have seen this high-profile venture in public-private cooperation as a model for other groups concerned with more effectively helping to solve health problems in the developing world. We examined major flaws in the GAVI and argue that in fact the alliance does not represent a new paradigm for international public health. However, the experience of the GAVI may suggest an alternative, and more effective, way to conceptualize future global initiatives.     

The art of partnerships for vaccines

The Developing Countries Vaccine Manufacturers Network (DCVMN) convened vaccine manufacturing experts and leaders from local and global public health organizations for its 19th Annual General Meeting. Lectures and panel discussions centered on international cooperation for better access to vaccines, and partnerships in areas ranging from vaccine research and process development, to clinical studies, regulatory, supply chain and emergency preparedness and response.Global vaccine market trends and changes that will impact vaccine financing and procurement methods were discussed as well as capital sources, including funding, for the development of new or improved vaccines.DCVMN members presented their progress in developing novel Hexavalent, Meningitis, Pneumococcal Conjugate Vaccine, Shigella, Mumps, Rotavirus, Yellow Fever, Polio, Hepatitis E and Dengue vaccines, and a novel monoclonal antibody cocktail for post-bite prophylaxis against rabies infections.Access to and availability of vaccines is enhanced through sharing of best practices for vaccine quality control, reducing redundant testing and promoting development of harmonized common standards. Eligible stakeholders were encouraged to join the WHO-National Control Laboratory Network for Biologicals which serves as a platform for collaboration and technical exchange in this area.Increasing regulatory convergence at the regional and global levels through mechanisms such as joint dossier review and the WHO Collaborative Registration Procedure can help to accelerate vaccine access globally. Additionally, four proposals for streamlining procedures and alignment of dossiers were discussed.Successful partnerships between a broad range of stakeholders, including international organizations, manufacturers, academic research institutes and regulators have provided support for, and in some cases accelerated, vaccine innovation, clinical trials and registration, WHO prequalification, vaccine introduction and access. Strong partnerships, based on experience and trust, help leverage opportunities and are critically important to advancing the shared goal of providing quality vaccines for all people.     

Report of the commission on health research for development and the countries of the south.

Of late, governments of affluent countries have become more brazen in using United Nations organizations and other global commissions as tools to serve their political and economic interests. WHO and UNICEF have been used by these governments to impose technocentric and dependence-promoting programs on countries of the South. The report of the Commission on Health Research for Development is yet another effort in that direction. It advocates international cooperation in health research. It merely adds to the bulk of documents on international health research. It is ahistorical. It does not analyze why WHO and UNICEF and the governments of affluent countries imposed global programs on immunization and diarrheal and respiratory diseases without bothering to gather even the most elementary data about them. There is a method in the brashness. Worse still, it ignores the rich heritage of health research of the past half a century in countries such as India, Indonesia, and Thailand. It is yet another effort to obscure the message of self-reliance contained in the Alma-Ata Declaration on Primary Health Care.