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通过药物手段确保流通:欧盟的抗病毒药物储备与大流行防范

Securing circulation pharmaceutically: Antiviral stockpiling and pandemic preparedness in the European Union.

作者信息

Elbe Stefan, Roemer-Mahler Anne, Long Christopher

机构信息

Department of International Relations, University of Sussex, UK.

出版信息

Secur Dialogue. 2014 Oct;45(5):440-457. doi: 10.1177/0967010614530072.

Abstract

Governments in Europe and around the world amassed vast pharmaceutical stockpiles in anticipation of a potentially catastrophic influenza pandemic. Yet the comparatively 'mild' course of the 2009 H1N1 pandemic provoked considerable public controversy around those stockpiles, leading to questions about their cost-benefit profile and the commercial interests allegedly shaping their creation, as well as around their scientific evidence base. So, how did governments come to view pharmaceutical stockpiling as such an indispensable element of pandemic preparedness planning? What are the underlying security rationalities that rapidly rendered antivirals such a desirable option for government planners? Drawing upon an in-depth reading of Foucault's notion of a 'crisis of circulation', this article argues that the rise of pharmaceutical stockpiling across Europe is integral to a governmental rationality of political rule that continuously seeks to anticipate myriad circulatory threats to the welfare of populations - including to their overall levels of health. Novel antiviral medications such as Tamiflu are such an attractive policy option because they could enable governments to rapidly modulate dangerous levels of (viral) circulation during a pandemic, albeit without disrupting all the other circulatory systems crucial for maintaining population welfare. Antiviral stockpiles, in other words, promise nothing less than a pharmaceutical securing of circulation itself.

摘要

欧洲及世界各国政府储备了大量药品,以防可能发生的灾难性流感大流行。然而,2009年甲型H1N1流感大流行的过程相对“温和”,这引发了公众对这些储备药品的广泛争议,人们开始质疑其成本效益、据称影响储备建立的商业利益以及其科学证据基础。那么,政府是如何将药品储备视为大流行防范规划中不可或缺的要素的呢?对于政府规划者而言,抗病毒药物迅速成为如此理想选择的潜在安全合理性是什么?通过深入研读福柯的“流通危机”概念,本文认为,欧洲各地药品储备的增加是一种政治统治的政府合理性的一部分,这种合理性不断试图预测对民众福祉——包括其整体健康水平——的无数流通威胁。像达菲这样的新型抗病毒药物是极具吸引力的政策选择,因为它们能使政府在大流行期间迅速调节(病毒)危险的传播水平,尽管不会扰乱维持民众福祉至关重要的所有其他流通系统。换句话说,抗病毒药物储备所承诺的,不亚于通过药物确保流通本身。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8211/8282641/faf34aaea00c/10.1177_0967010614530072-fig1.jpg

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