De Cock Kevin M
Emerg Infect Dis. 2025 Jan;31(1):1-7. doi: 10.3201/eid3101.241026.
Despite earlier attempts to define global health, the discipline's boundaries are unclear, its priorities defined more by funding from high-income countries from the Global North than by global health trends. Governance and resource allocation are challenged by movements such as decolonizing global health. Inherent contradictions within global health derive from its historical evolution from tropical medicine and international health, as well as recent trends in infectious diseases. Demographic, socioeconomic, and epidemiologic transitions, including the rise in noncommunicable diseases, have eroded the concept of a binary world of developed and developing countries. Competitive tension has emerged between aspirations for global health security and health equity. Dominant principles should focus on vulnerable populations, transnational challenges such as migration and climate change, appropriate prevention and care, and epidemic preparedness and response capacity. As the 2030 target date for the United Nations Sustainable Development Goals approaches, reconceptualization of global health is required, or the discipline risks losing identity and relevance.
尽管此前曾尝试对全球健康进行定义,但该学科的边界仍不明确,其优先事项更多地由来自全球北方高收入国家的资金决定,而非全球健康趋势。治理和资源分配受到诸如全球健康去殖民化等运动的挑战。全球健康内部的固有矛盾源于其从热带医学和国际卫生的历史演变,以及传染病的近期趋势。人口、社会经济和流行病学转型,包括非传染性疾病的增加,已经削弱了发达国家和发展中国家二元世界的概念。全球健康安全与健康公平的目标之间出现了竞争性紧张关系。主导原则应侧重于弱势群体、移民和气候变化等跨国挑战、适当的预防和护理,以及疫情防范和应对能力。随着联合国可持续发展目标的2030年目标日期临近,需要对全球健康进行重新概念化,否则该学科有可能失去自身特性和相关性。