Sirrs Christopher
Centre for History in Public Health, London School of Hygiene and Tropical Medicine, London, UK.
Int Hist Rev. 2019 Apr 2;42(2):371-390. doi: 10.1080/07075332.2019.1582550. eCollection 2020.
In recent years, universal health coverage (UHC) has returned with a vengeance to the international agenda, raising complex and highly political questions about how health systems should be organised and financed. Drawing upon an extensive analysis of archival material, this article examines the International Labour Organisation's (ILO) approach towards health systems financing in the second half of the twentieth century, exploring its evolving strategy towards social health protection in the context of international development, and its relationship with other international agencies, notably the World Health Organisation and World Bank. It argues that while the ILO's role in international development has come into question in recent decades, its officials have nevertheless made a meaningful contribution to the promotion of health protection worldwide. Despite the wider marginalisation of universalism in post-war international discourse, ILO officials continually shifted their strategy to ensure that mechanisms of health protection such as social health insurance were prioritised in health systems development. ILO support contributed to some notable successes, such as the achievement of UHC in Thailand in 2002.
近年来,全民健康覆盖(UHC)强势回归国际议程,引发了有关卫生系统应如何组织和筹资的复杂且极具政治性的问题。本文通过对档案材料的广泛分析,审视了20世纪下半叶国际劳工组织(ILO)在卫生系统筹资方面的做法,探讨其在国际发展背景下社会健康保护战略的演变,以及它与其他国际机构,特别是世界卫生组织和世界银行的关系。文章认为,尽管近几十年来国际劳工组织在国际发展中的作用受到质疑,但其官员仍为在全球推广健康保护做出了有意义的贡献。尽管战后国际话语中普遍主义被进一步边缘化,但国际劳工组织官员不断调整其战略,以确保在卫生系统发展中优先考虑诸如社会医疗保险等健康保护机制。国际劳工组织的支持促成了一些显著成就,比如泰国在2002年实现了全民健康覆盖。