全球卫生法:全球卫生治理的新趋势

全球化对全球人口的健康产生了深刻影响.疾病全球化呼吁公共卫生治理的全球化.全球卫生治理与传统的国际卫生治理在治理主体、治理方式、治理结构及价值取向等方面存在区别.全球卫生治理的目标是让全世界人民获得可能的最高水平的健康标准.人人享有健康的美好理想只有通过全球卫生"善治"才能实现.而实现全球卫生"善治"的主要机制是国际卫...     

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。     

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。     

非政府组织在全球健康治理中的作用研究

全球健康体系正在经历变革和更新,从而带来全球健康参与者的重大转变。非政府组织(Nongovernmental organization,NGO)作为全球健康体系中的一个关键参与者和决策者,具有全球健康治理的丰富经验,可以为中国参与全球健康决策与治理提供系统性的经验。本文旨在研究NGO在全球健康领域中的作用。结果发现,NGO在全球健康领域中的作用可以总结为四个方面:倡导、实施、支持和社区动员,但同时NGO也会给全球健康治理带来一些潜在的风险,如某些NGO所代表的国外组织或政府的利益和本国利益产生冲突;NGO组织可能会吸引当地卫生官员和技术人员加入,从而削弱了本国卫生人力和卫生体系;捐助者驱动的资助模式可能不能完全用于国家健康需要的优先领域。中国和中国NGO在借鉴经验的同时,也要合理规避这些风险。     

全球环境与卫生的关联性:科学认知的深化

本文基于历史和环境视角分析了全球环境与卫生之间关联性的科学认知的变化。环境问题对人类健康的影响越来越受到国际社会的关注和重视,现有科学研究已充分证明,环境问题与人类健康风险之间存在明显的因果关系,环境问题是导致人类各种疾病的重大因素之一;从全球层面对环境问题的健康影响进行量化研究是当前相关研究的重点、亮点和难点,目前国际上在研究方法和具体结论上都存在许多分歧,但定量研究方兴未艾;如何将现有的科学认知与全球层面的政策制定与实施有机结合起来是摆在全球环境与卫生治理面前的一大课题。     

全球健康的内涵与学科发展

全球化的纵深发展使人群健康状况得到明显改善的同时也带来许多新的健康问题,使世界卫生体系面临巨大挑战。运用全球健康的理念,采取跨国界的合作行动应对全球卫生问题成为各国的共识。本文从全球健康的概念出发,比较了全球健康、国际卫生和公共卫生的异同,指出:强调全球合作和参与主体的多元化、需要运用多学科知识、依靠全球治理来实现是全球健康的特征。我国的全球健康学科与世界相比仍存在着较大差距,应积极推动全球健康学科的发展,培养具有全球视野的专业人才,为我国参与全球卫生治理提供有力支撑。     

男性健康状况及其影响因素分斩

近年来，男性健康受到社会的关注，但大多仍局限于医药、卫生、人口和计划生育领域。“男性健康日”和相关的健康调查所关注主要是男性生殖系统疾病的检出率及其卫生科普知识的宣传。其实，     

嘉定区1995～1997年老年人口主要死因分析

<正> 人口老龄化已成为全球共同关注的社会问题,在资源有限,经济尚不发达的我国,老年保健及其服务将成为我国社会十分重要的任务。为了解嘉定区老年人口疾病死亡情况,本文对嘉定区1995～1997年65岁以上老年人口的死亡资料进行了分析,为制订老年人口预防保健措施提供科学依据。1 材料与方法1.1 资料来源 死亡资料来自上海市嘉定区卫生防疫站,1995～1997年居民病伤死亡原因年报表。人口资料由嘉定区公安局提供。     

全球卫生治理机制及中国参与的建议

随着全球化的纵深发展,全球卫生逐渐取代国际卫生,成为学界关注热点.全球卫生领域存在诸多亟需解决的问题,而这些问题的解决需要良好的全球卫生治理,实现全球卫生治理的五大功能,即达成价值观念的共识、制定相应的规则、实现治理的多元化、动员和分配资金、提供领导和协调等.针对全球卫生领域的不同趋势,建议确立以世界卫生组织为中心的全球卫生治理体系、在世界卫生组织框架内实现治理的多元化以及加强全球卫生立法等.中国作为新兴经济力量,在全球卫生治理中占有重要地位,应更为活跃地参与全球卫生治理.首先,建议中国制定国家层面的全球卫生战略;其次,积极参与全球行动网络和治理平台;最后,培养全球卫生研究和实践人才.     

全球健康治理策略与思考

目的探讨健康问题全球化背景下,国际社会应该如何利用健康峰会这一新途径来更好地参与全球健康治理,实现人类可持续发展目标。方法系统查阅近3年与健康主题相关的文献资料,运用主题内容分析法分析全球峰会与全球健康治理的相关内容,聚焦国际峰会的健康议题,总结更合理有效的全球卫生健康策略。结果检索的45篇文献中,全球性峰会15篇,占纳入文献的33.33%;区域性峰会30篇,占66.67%;峰会主题涉及政治、经济、安全、全球健康、环境、教育、文化和农业,其中,健康相关主题的文献仅占8.89%;2015年以后,健康相关议题有所增多,但仍然缺乏特定的健康峰会。峰会形成的健康议题成果大多是一些不具强制约束力的呼吁、倡议,很难落实为具体的卫生行动;峰会主办地也主要集中在欧洲、北美等发达地区,发展中国家的利益诉求呼声高涨;联合国框架下的全球性峰会虽然在全球卫生健康中占据着主导地位,但在新形势下也面临种种困境。结论国际社会对于"健康"议题的关注度日益提高,但是缺乏有效的统一行动。各国应紧紧围绕"2030可持续发展战略",充分利用健康峰会这一全球健康治理新途径,积极参与全球健康治理,加强资源整合,推动国际卫生体制改革,打造全球健康命运共同体。     

Mapping the future of public health: action on global health

We are challenged to develop a public health approach that responds to the globalized world. The present global health crisis is not primarily one of disease, but of governance: its key characteristic is a weakening of public policy and interstate mechanisms as a consequence of global restructuring. The response needs to focus on the political determinants of health, in particular on mechanisms that help ensure the global public goods that are required for a more equitable and secure development. A first step in this direction would be to take up the proposal from the recent 6th Global Conference on Health Promotion to explore the possibility of a new type of global health treaty which would help to establish the new parameters of global health governance. National public health associations should take the lead to establish health as a global public good and organize "National Global Health Summits" to discuss the possible mechanisms for the necessary political process. This means putting global health governance issues onto the agenda of other sectors such as foreign policy, as health is critical not only for poverty reduction but for human security as a whole.     

From conceptual pluralism to practical agreement on policy: global responsibility for global health

Background

As the human cost of the global economic crisis becomes apparent the ongoing discussions surrounding the post-2015 global development framework continue at a frenzied pace. Given the scale and scope of increased globalization moving forward in a post-Millennium Development Goals era, to protect and realize health equity for all people, has never been more challenging or more important. The unprecedented nature of global interdependence underscores the importance of proposing policy solutions that advance realizing global responsibility for global health.

Discussion

This article argues for advancing global responsibility for global health through the creation of a Global Fund for Health. It suggests harnessing the power of the exceptional response to the combined epidemics of AIDS, TB and Malaria, embodied in the Global Fund to Fight AIDS, Tuberculosis and Malaria, to realize an expanded, reconceptualized Global Fund for Health. However this proposal creates both an analytical quandary embedded in conceptual pluralism and a practical dilemma for the scope and raison d’etre of a new Global Fund for Health. To address these issues we offer a logical framework for moving from conceptual pluralism in the theories supporting global responsibility for health to practical agreement on policy to realize this end. We examine how the innovations flowing from this exceptional response can be coupled with recent ideas and concepts, for example a global social protection floor, a Global Health Constitution or a Framework Convention for Global Health, that share the global responsibility logic that underpins a Global Fund for Health.

Conclusions

The 2014 Lancet Commission on Global Governance for Health Report asks whether a single global health protection fund would be better for global health than the current patchwork of global and national social transfers. We concur with this suggestion and argue that there is much room for practical agreement on a Global Fund for Health that moves from the conceptual level into policies and practice that advance global health. The issues of shared responsibility and mutual accountability feature widely in the post-2015 discussions and need to be addressed in a coherent manner. Our article argues why and how a Global Fund for Health effectuates this, thus advancing global responsibility for global health.

     

The New Global Health

Global health reflects the realities of globalization, including worldwide dissemination of infectious and noninfectious public health risks. Global health architecture is complex and better coordination is needed between multiple organizations. Three overlapping themes determine global health action and prioritization: development, security, and public health. These themes play out against a background of demographic change, socioeconomic development, and urbanization. Infectious diseases remain critical factors, but are no longer the major cause of global illness and death. Traditional indicators of public health, such as maternal and infant mortality rates no longer describe the health status of whole societies; this change highlights the need for investment in vital registration and disease-specific reporting. Noncommunicable diseases, injuries, and mental health will require greater attention from the world in the future. The new global health requires broader engagement by health organizations and all countries for the objectives of health equity, access, and coverage as priorities beyond the Millennium Development Goals are set.     

Justification for a Nuclear Global Health Workforce: multidisciplinary analysis of risk,survivability &amp; preparedness,with emphasis on the triage management of thermal burns

Major challenges and crises in global health will not be solved by health alone; requiring rather a multidisciplinary, evidence-based analytical approach to prevention, preparedness and response. One such potential crisis is the continued spread of nuclear weapons to more nations concurrent with the increased volatility of international relations that has significantly escalated the risk of a major nuclear weapon exchange. This study argues for the development of a multidisciplinary global health response agenda based on the reality of the current political analysis of nuclear risk, research evidence suggesting higher-than-expected survivability risk, and the potential for improved health outcomes based on medical advances. To date, the medical consequences of such an exchange are not credibly addressed by any nation at this time, despite recent advances. While no one country could mount such a response, an international body of responders organized in the same fashion as the current World Health Organization’s global health workforce initiative for large-scale natural and public health emergencies could enlist and train for just such an emergency. A Nuclear Global Health Workforce is described for addressing the unprecedented medical and public health needs to be expected in the event of a nuclear conflict or catastrophic accident. The example of addressing mass casualty nuclear thermal burns outlines the potential triage and clinical response management of survivors enabled by this global approach.     

抗艾滋病、结核病和疟疾全球基金与主要捐赠国的合作及其对中国的启示

抗击艾滋病、结核病和疟疾的全球基金是一个旨在通过公私合作伙伴关系,加速终结艾滋病、结核病和疟疾等传染病流行的国际融资机构。全球基金成立20年以来,为艾滋病、结核病和疟疾流行的控制做出了重要贡献,影响力日益扩大。本文详细介绍了全球基金的治理结构以及筹资与分配模式,比较分析了主要捐赠国家与全球基金的合作方式,以及中国与全球基金的关系,并为中国参与全球基金等全球卫生多边平台提出了相应的政策建议。     

全球抗击艾滋病、结核病和疟疾基金的卫生筹资经验与启示

全球基金是全球卫生领域较为成功的筹资工具之一,在全球艾滋病、结核病和疟疾防控领域发挥了重要作用。本文通过分析全球基金筹资机制的形成、主要内容和成果,总结全球基金经验,对中国参与全球卫生筹资提出以下建议：支持建立需求导向的、结构化的全球卫生筹资机制;促进新兴捐助者在全球卫生筹资机制中的代表性和影响力;强化与私营部门、非政府组织在全球卫生筹资行动中的合作;推动和维持重要卫生议题在全球议程中的地位,激发全球卫生筹资活力。     

The principles and feasibility of disease eradication

Smallpox eradication framed disease eradication as a monumental public health achievement in global health equity. The principles of disease eradication are encapsulated in a constellation of four conditions: biologic feasibility, adequate public health infrastructure, sufficient funding, and sustained political/societal will. Where the constellation exists, national eradication occurs in the absence of a global initiative. Assessing the feasibility of global eradication requires determining the constellation gaps for nations of all regions and identifying the human and financial resources to fill the gaps. The economic and humanitarian benefits of eradication have strong appeal. Global polio and guinea worm efforts are underway. Regional eradication of measles and rubella has been achieved in the Americas and other diseases have been proposed. Global decisions on disease eradication should include careful consideration of opportunity costs and prioritization of limited global health resources, with the objective of providing the most appropriate, cost-beneficial, and equitable outcome of disease control.     

A Brief Talk on How to Promote China Health and Quarantine at Points of Entry in the Framework of Global Health

Global health concerns about the health of the global population and the concepts of global health are gradually being accepted by all of the countries in the world.China health and quarantine at points of entry(POEs) is an integral part of global health,and its duty of prevention and control of the communicable diseases in POEs is consistent with the duty of global health to promote the health of global population.Under the principle of "prevention first",health and quarantine organ carries out the work of disease prevention and control and international travel health care,the reinforcement of core capacity at POEs,and focuses on human rights protection.All the same,there are some gaps with the requirements of global health,such as the inadequate of health promotion planning capacity,ethics awareness and legal protection.The future work of health and quarantine should change ideas on communicable diseases prevention at POEs,focus more on ethical consideration,and should optimize system architecture and human resources,strengthen cooperation,maintain core capacity at POEs,thus to build points of entry public health system with Chinese characteristics,meanwhile to apply the concepts of global health deeply into every aspects of health and quarantine at POEs.     

Global health for undergraduates: "we are not alone"

This paper presents a review of an undergraduate global health curriculum implemented at the George Washington University School of Public Health and Health Services. It is in concert with the framework and principles of the Association of American Colleges and Universities and their vision of Shared Futures of Global Learning and Social Responsibility. The rationale for a deep and broad undergraduate public health curriculum, which includes a global health component, is clear. Global health is a necessary and timely pathway for undergraduate liberal arts education. The world has dramatically changed in the past 50 years, and undergraduate education must continue to keep pace with these changes. Pathogens will adapt to changing ecologies, demographics, disease burdens, and population distributions. They are able to cross the world in hours or days. No country is invulnerable to disease importation and consequent indigenous transmission. Broad epidemic preparedness is required across all academic disciplines from epidemiology to sociology, from medicine to economics. Global health is anchored in the complementary application of various disciplines effectively joined to address a particular problem and mitigate potential adverse consequences. Our students recognize the reality of this interconnected world and are eager to take their place as global citizens. Knowledge, understanding, technical acumen, and humility represent the foundation of the global citizenry required to address the changing global pattern of disease worldwide. Undergraduate public health, and particularly undergraduate global health, will enable our undergraduates to embark on a myriad of professional trajectories that include public health, medicine, biomedical research, law, policy, environmental studies, anthropology, economics, sociology and other disciplines. The "Y" Generation in the U.S. (individuals born between 1980 and 2000) is poised for action; we must give them the tools to succeed.     

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