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全球健康与卫生安全——通过健康实现稳定的相互冲突的概念?

Global health and health security - conflicting concepts for achieving stability through health?

作者信息

Holst Jens, Razum Oliver

机构信息

Department of Health Sciences, Fulda University of Applied Sciences Fulda, Germany.

Department of Epidemiology & International Public Health, Faculty of Health Sciences, Bielefeld University Bielefeld, Germany.

出版信息

Glob Public Health. 2022 Dec;17(12):3972-3980. doi: 10.1080/17441692.2022.2049342. Epub 2022 Mar 8.

DOI:10.1080/17441692.2022.2049342
PMID:35259063
Abstract

Global health has become fashionable and an important topic on the international policy agenda. Even before the COVID-19 pandemic, cross-border infectious diseases had provoked a great deal of media and public interest, academic research and foreign-policy agendas. This paper analyses the relevance of health security in global health. It stresses global health as an explicitly political concept taking into consideration existing inequalities and power asymmetries. Global health represents the necessary evolution of public health in the face of ubiquitous global challenges and the growing number of international players. Some of them tend to divert global health towards technification, marketisation and privatisation, promoting biomedical reductionism and predominantly technological solutions. Overall, the current global health concept fails to adequately consider the global burden of disease, which is largely determined by non-communicable conditions. Global health goes beyond preventing infectious diseases and health security and must first and foremost focus on the social, economic, ecologic and political determination of health, which interacts with non-communicable and communicable diseases, turning them into syndemics. Health-in-all policies in a global perspective are required for sustainably reducing health inequalities within and between countries, instead of primarily focusing on security and safeguarding the status quo in a changing world.

摘要

全球健康已成为热门话题,并在国际政策议程中占据重要地位。甚至在新冠疫情之前,跨境传染病就已引发了媒体和公众的广泛关注、学术研究以及外交政策议程。本文分析了卫生安全在全球健康中的相关性。它强调全球健康是一个明确的政治概念,要考虑到现存的不平等和权力不对称。面对无处不在的全球挑战以及越来越多的国际行为体,全球健康代表了公共卫生的必然演变。其中一些行为体倾向于将全球健康引向技术化、市场化和私有化,推崇生物医学还原论并主要采用技术解决方案。总体而言,当前的全球健康概念未能充分考虑疾病的全球负担,而这在很大程度上是由非传染性疾病决定的。全球健康不仅仅是预防传染病和卫生安全,首先必须关注健康的社会、经济、生态和政治决定因素,这些因素与非传染性疾病和传染性疾病相互作用,形成了综合征。从全球视角来看,需要实施“健康融入所有政策”,以可持续地减少国家内部和国家之间的健康不平等,而不是主要关注安全并在不断变化的世界中维护现状。

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