建国以来传染病防治政策变迁的轨迹、逻辑与未来——基于历史制度主义的分析

The Trajectory,Logic,and Future of Changes in Infectious Disease Prevention and Control Policies Since the Founding of the People's Republic of China——Analysis Based on Historical Institutionalism

中国传染病防治政策经过七十多年的循序发展和渐进演变,其政策内容也随着传染病疾病谱的变化在进行不断更新与完善。通过对1949年至2022年的传染病防治政策及法律文件进行梳理和政策文本解读,将建国以来传染病防治政策变迁过程分为沿袭与开创、冻结与停滞、复苏与转型、发展与完善四个阶段。基于历史制度主义的历史分析范式研究中国传染病防治政策变迁背后的制度逻辑发现,宏观场域中的多要素影响并制约着政策的安排,制度成本、学习效应、协同效应和适应性预期等强化了政策的路径依赖、并在关键节点上焦点事件的触发下突破政策惯性的束缚,从而实现政策创新。基于此,传染病防治政策的向好变迁需要开放政策环境,培育政策联盟。

China's infectious disease prevention and control policy has undergone more than 70 years of gradual development and evolution,and its policy content is constantly updated and improved with the changes in the spec-trum of infectious diseases.By sorting out and interpreting the policy texts of infectious disease prevention and con-trol policies and legal documents from 1949 to 2022,the process of changes in infectious disease prevention and control policies since the founding of the People's Republic of China can be divided into four stages:inheritance and creation,freezing and stagnation,recovery and transformation,and development and improvement.Based on the historical analysis paradigm of historical institutionalism,the research on the institutional logic behind the changes of China's infectious disease prevention and control policies found that multiple factors in the macro field affect and restrict the policy arrangement.Institutional costs,learning effects,synergy effects and adaptive expectations have strengthened the path dependence of policies,and broken the shackles of policy inertia under the trigger of focus events at key nodes,so as to achieve policy innovation.Based on this,the positive transformation of infectious dis-ease prevention and control policies requires an open policy environment and the cultivation of policy alliances.