《国际卫生条例》遵守的内在逻辑、现实困境与改革路径

The Inherent Logic,Realistic Dilemma and Reform Path of International Health Regulations

传染病的全球化与防治传染病的国际合作凸显了全球公共卫生治理的必要性以及对《国际卫生条例》机制成效的倚重性。基于功能主义理论成立的世界卫生组织向来以专门化组织自居,在《国际卫生条例》中借助"安全化"框架逻辑理念从共同安全的集体角度推进国际公共卫生合作,但国家主权与国际卫生利益的内在张力,国际公共卫生紧急事件机制规范性和透明度缺失使得《国际卫生条例》遵守面临诸多现实困境与挑战,从而产生了结构性的机制失灵。在分析全球传染病监测与控制机制的复杂体系和内在张力的基础上,应当确立"风险化"框架以弥合体系建设的内在张力与矛盾;明确宣布国际公共卫生紧急事件的要素和要件,增强其透明度,确保《国际卫生条例》的规范性和权威性;以人类命运共同体理念整合《国际卫生条例》与世界贸易组织相关条约,加强在贸易措施方面的协调,进而不断增强全球应对突发公共卫生事件的体制和能力。

The globalization of infectious diseases and international cooperation in their prevention and treatment have highlighted the necessity of global public health governance and the importance of an effective International Health Regulations(IHR)mechanism.The World Health Organization,established on the basis of functionalist theory,has always regarded itself as a specialized organization.IHR employ the logical concept of“security”to promote international public health cooperation from the collective perspective of common security.However,the inherent tension between national sovereignty and international health interests and the lack of standardization and transparency of PHEIC have led to many practical difficulties in and posed many challenges to the compliance with the IHR,resulting in structural failure of the mechanism.Based on the analysis of the complex system and internal tension of the global infectious disease surveillance and control mechanism,this paper proposes to establish a“risk-based”framework to ease the internal tensions and contradictions in system construction,clarify the elements and requirements of PHEIC and enhance its transparency,and guarantee the normative and authoritative nature of IHR.Moreover,this article argues that the international community should,based on the concept of a community with shared future for mankind,integrate IHR with treaties under WTO regime,strengthen the coordination of trade measures,and continuously enhance the system and capacity for the global response to public health emergencies.