Worsnop Catherine Z, Grépin Karen A, Lee Kelley, Marion Summer
University of Maryland, USA.
University of Hong Kong, Hong Kong.
Int Stud Perspect. 2022 Sep 21;24(1):39-66. doi: 10.1093/isp/ekac010. eCollection 2023 Feb.
Why do some international agreements fail to achieve their goals? Rather than states' engaging in cheap talk, evasion, or shallow commitments, the World Health Organization's (WHO) International Health Regulations (IHR)-the agreement governing states' and WHO's response to global health emergencies-point to the unintended consequences of information provision. The IHR have a dual goal of providing public health protection from health threats while minimizing unnecessary interference in international traffic. As such, during major outbreaks WHO provides information about spread and severity, as well as guidance about how states should respond, primarily regarding border policies. During COVID-19, border restrictions such as entry restrictions, flight suspensions, and border closures have been commonplace even though WHO recommended against such policies when it declared the outbreak a public health emergency in January 2020. Building on findings from the 2014 Ebola outbreak, we argue that without raising the cost of disregarding (or the benefits of following) recommendations against border restrictions, information from WHO about outbreak spread and severity leads states to impose border restrictions inconsistent with WHO's guidance. Using new data from COVID-19, we show that WHO's public health emergency declaration and pandemic announcement are associated with increases in the number of states imposing border restrictions.
为何一些国际协定无法实现其目标?世界卫生组织(WHO)的《国际卫生条例》(IHR)——一项规定各国及世卫组织应对全球卫生突发事件的协定——表明,问题并非在于各国进行廉价空谈、逃避责任或做出表面承诺,而是信息提供产生了意想不到的后果。《国际卫生条例》有双重目标,即提供针对健康威胁的公共卫生保护,同时尽量减少对国际交通的不必要干扰。因此,在重大疫情爆发期间,世卫组织会提供有关疫情传播和严重程度的信息,以及各国应如何应对的指导意见,主要涉及边境政策。在新冠疫情期间,诸如入境限制、停飞航班和关闭边境等边境限制措施屡见不鲜,尽管世卫组织在2020年1月宣布该疫情为突发公共卫生事件时就不建议采取此类政策。基于2014年埃博拉疫情的研究结果,我们认为,如果不提高无视(或遵循)反对边境限制建议的成本(或收益),世卫组织发布的有关疫情传播和严重程度的信息会导致各国实施与世卫组织指导意见不符的边境限制措施。利用新冠疫情的新数据,我们表明,世卫组织发布的突发公共卫生事件声明和大流行公告与实施边境限制措施的国家数量增加有关。