Gostin Lawrence O
Georgetown University Law Center, Washington, District of Columbia, United States.
J Law Med Ethics. 2025;53(S1):81-85. doi: 10.1017/jme.2025.24. Epub 2025 Apr 14.
In the decade since the first edition of Global Health Law was published, the world has moved incrementally towards global health with justice, at least by one basic metric: life expectancy has edged up globally, with more rapid gains in low- than high-income countries. But to look around the world, global health with justice still seems a distant dream. Health gaps between people in rich and poor countries remain shocking and unconscionable-as do health inequities within countries. The pandemic also gave salience to profound health injustices-from injustices in access to lifesaving vaccines to gaping disparities in morbidity and mortality based on income, race, and national origin. So did the Trump administration's decision to pause, and then slash, foreign assistance, bringing an end to lifesaving programs around the world. Guided by the overarching theme of justice, these reflections canvass the history of global health law as a field and discuss developments and challenges in the field across four core themes: multilateralism; equitable distribution of the benefits of scientific advancement; global health law for the poly-crises; and human rights and equity.
自《全球卫生法》第一版出版后的十年间,世界至少在一个基本指标上正逐步朝着公平的全球卫生迈进:全球预期寿命有所上升,低收入国家的增长速度高于高收入国家。但环顾全球,公平的全球卫生似乎仍是一个遥远的梦想。富国与穷国之间的健康差距依然令人震惊且不合理,一国内部的健康不平等亦是如此。这场大流行还凸显了深刻的卫生不公——从获得救生疫苗的不公到基于收入、种族和国籍的发病率和死亡率的巨大差距。特朗普政府暂停并随后大幅削减对外援助的决定也是如此,这导致世界各地的救生项目终止。以正义这一总体主题为指导,这些思考审视了全球卫生法作为一个领域的历史,并围绕四个核心主题讨论了该领域的发展与挑战:多边主义;科学进步成果的公平分配;应对多重危机的全球卫生法;以及人权与公平。