Gill Stephen, Benatar Solomon
Department of Political Science, York University, Toronto, Canada.
Bioethics Centre, University of Cape Town, South Africa
Int J Health Serv. 2016;46(2):346-65. doi: 10.1177/0020731416631734. Epub 2016 Feb 16.
The Lancet-University of Oslo Commission Report on Global Governance for Health provides an insightful analysis of the global health inequalities that result from transnational activities consequent on what the authors call contemporary "global social norms." Our critique is that the analysis and suggested reforms to prevailing institutions and practices are confined within the perspective of the dominant-although unsustainable and inequitable-market-oriented, neoliberal development model of global capitalism. Consequently, the report both elides critical discussion of many key forms of material and political power under conditions of neoliberal development and governance that shape the nature and priorities of the global governance for health, and fails to point to the extent of changes required to sustainably improve global health. We propose that an alternative concept of progress-one grounded in history, political economy, and ecologically responsible health ethics-is sorely needed to better address challenges of global health governance in the new millennium. This might be premised on global solidarity and the "development of sustainability." We argue that the prevailing market civilization model that lies at the heart of global capitalism is being, and will further need to be, contested to avoid contradictions and dislocations associated with the commodification and privatization of health.
《柳叶刀》-奥斯陆大学全球卫生治理委员会报告对因作者所称当代“全球社会规范”导致的跨国活动所造成的全球卫生不平等进行了深刻分析。我们的批评意见是，对现行机构和做法的分析及所建议的改革局限于占主导地位的——尽管不可持续且不公平的——以市场为导向的新自由主义全球资本主义发展模式的视角之内。因此，该报告既回避了对新自由主义发展与治理条件下塑造全球卫生治理性质和优先事项的许多关键物质和政治权力形式的批判性讨论，也未能指出为可持续改善全球卫生所需的变革程度。我们提议，迫切需要一种基于历史、政治经济学和对生态负责的健康伦理的替代性进步概念，以便更好地应对新千年全球卫生治理的挑战。这可能以全球团结和“可持续性发展”为前提。我们认为，作为全球资本主义核心的现行市场文明模式正在且将进一步需要受到质疑，以避免与卫生商品化和私有化相关的矛盾与混乱。
