关键节点、创业型领导与全球卫生伙伴关系的兴起

The Rise of Global Health Partnership:Ideational Change and Innovative Actions of the WHO

进入21世纪,以公私合作治理为创新特色的全球卫生伙伴关系迅速兴起,这使得非国家行为体直接参与全球卫生决策成为可能。这一新型卫生合作机制在应对新冠肺炎疫情中表现突出,已成为全球卫生治理中的重要力量。通过考察关键节点下国际组织推动创新的内部政治进程,可以对全球卫生伙伴关系兴起的因果机制做出解释。兼具创新精神及行政领导力的创业型领导的出现是制度创新的必要内部条件,跨国公私伙伴关系的兴起则是国际组织内的创业型领导抓住关键节点带来的改革机遇、采取针对性策略在利益及观念上说服组织内保守派的改革结果。分析世界卫生组织及其创业型领导参与全球疫苗免疫联盟的进程,可以对这一解释机制进行验证。分析结果表明,“最不可能”与私有部门展开密切合作的世卫组织在格罗·哈莱姆·布伦特兰等创业型领导的推动下,克服了改革的内部阻力,与私有部门构建了数量繁多的伙伴关系,最终推动了全球卫生伙伴关系的兴起。

Since the beginning of 21st century,the Global Health Partnerships( GHPs) characterized by cooperative governance among public and private actors have grown rapidly,which makes it possible for non-state actors to directly participate in global health decision-making.This new pattern of health cooperation has played a prominent role in the COVID-19 response and become an emerging force in global health governance.By examining the internal political dynamics of international organizations pursuing innovation at critical junctures,a causal explanation is presented for the rise of GHPs.The appearance of entrepreneurial leaders with both innovative spirit and effective administrative leadership is an endogenous prerequisite for institutional innovation.The rise of transnational public-private partnerships could be interpreted as a result of the reform process in which entrepreneurial leaders of international organizations seize reform opportunities brought by external shocks at critical junctures and take targeted strategies to persuade conservatives within organizations on the basis of interests and ideas.This causal mechanism is empirically illustrated with a case study of the GAVI led by WHO and its entrepreneurial leaders.The analysis shows that WHO,which was “least likely” to work closely with private sectors,was driven by entrepreneurial leaders such as Gro Harlem Brundtland to overcome internal resistance to reform and then forge a large number of partnerships with the latter,ultimately leading to the emergence of GHPs.