Labonté Ronald
Canada Research Chair, Globalization/Health Equity, Faculty of Medicine, Institute of Population Health, 1 Stewart Street, Ottawa, Ontario, Canada K1N 6N5
Health Promot Int. 2014 Jun;29 Suppl 1:i48-58. doi: 10.1093/heapro/dau031.
Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach.
健康融入所有政策（HiAP）方法通常被视为一种针对国家或次国家层面公共政策制定的跨部门方法，即非卫生部门要充分考虑健康结果。然而，全球化产生了众多具有跨境因果关系的“内在全球性健康问题”，这就需要新形式的全球健康治理。尽管这种治理在议程设定和影响力方面通常包括国家行为体和非国家行为体（私营部门、民间社会），但不同行为体拥有不同程度的权力和权威，最终，批准直接或间接影响健康的政府间公约或规范性声明的是国家。这就要求在各国国内工作的公共卫生和健康促进从业者更加关注本国政府的外交政策。这些外交政策包括那些关乎国家安全、对外援助、贸易和投资以及传统外交形式的政策。一个新术语被创造出来，用以描述健康在政府外交政策中的定位方式：全球健康外交。要熟练掌握这种微妙的外交实践，需要熟悉不同的政策框架，通过这些框架，健康议题能够被纳入外交政策审议，进而进入政府间/全球治理谈判。本文讨论了六个这样的框架（安全、贸易、发展、全球公共产品、人权、伦理/道德推理），这些框架在分析评估更具连贯性且更有利于促进健康的外交政策潜力方面很有用处，即“所有（外交）政策中的健康”方法。
