Haynes Leigh, Legge David, London Leslie, McCoy David, Sanders David, Schuftan Claudio
People's Health Movement.
La Trobe University in Melbourne, Australia.
Health Hum Rights. 2013 Jun 14;15(1):E111-6.
The idea of a Framework Convention for Global Health (FCGH), using the treaty-making powers of the World Health Organization (WHO), has been promoted as an opportunity to advance global health equity and the right to health. The idea has promise, but needs more thought regarding risks, obstacles, and strategies. The reform of global health governance must be based on a robust analysis of the political economy out of which the drivers of inequality and the denial of the right to health arise. Some of the published commentary has focused on using the proposed FCGH to institutionalize a paradigm change regarding international aid for health care, i.e., reconceptualizing such aid as obligatory, based on human solidarity rather than strategic considerations, based on global stability and national security. We warn against limiting the project to questions of inter-governmental financial transfers because of the risk of neglecting the underlying structural determinants of health injustice. Such neglect would help to legitimize an unjust and unsustainable global economic regime. We raise further questions about the strategic logic informing any campaign for a FCGH. The governments of the United States and Europe have put considerable effort into weakening WHO through tight donor controls, and it would require heavy pressure to persuade them to sign on to a FCGH. Generating such pressure would require strong popular mobilization around the local and diverse priorities of different communities across the globe, and recognition of a common need for effective regulation at the global level. We argue for a broad-based campaign from which the need for more effective global health regulation (and a FCGH) would emerge as a common theme arising from myriad more specific claims. This type of campaign would respond to local needs, and would also be understood within a global, political, and economic perspective.
利用世界卫生组织（WHO）的条约制定权来制定《全球健康框架公约》（FCGH）的想法，被视作推动全球健康公平及健康权的契机。这一想法有可取之处，但在风险、障碍及策略方面还需深入思考。全球健康治理改革必须基于对政治经济的深入分析，不平等及健康权被剥夺的驱动因素就源自这种政治经济状况。一些已发表的评论聚焦于利用拟议中的《全球健康框架公约》将国际医疗援助的范式转变制度化，即把这种援助重新概念化为基于人类团结而非战略考量（基于全球稳定和国家安全）的强制性援助。我们警告不要将该项目局限于政府间资金转移问题，因为存在忽视健康不公正潜在结构决定因素的风险。这种忽视将有助于使不公正且不可持续的全球经济体制合法化。我们对推动《全球健康框架公约》的任何行动所依据的战略逻辑提出进一步质疑。美国和欧洲政府通过严格的捐助控制，在削弱世卫组织方面投入了大量精力，要说服它们签署《全球健康框架公约》需要巨大压力。要产生这种压力，需要围绕全球不同社区的地方和多样优先事项进行强有力的民众动员，并认识到全球层面有效监管的共同需求。我们主张开展一场基础广泛的运动，从中将产生对更有效全球健康监管（以及《全球健康框架公约》）的需求，这将作为众多更具体诉求中共同出现的一个主题。这类运动将回应地方需求，并且也能从全球、政治和经济角度得到理解。
