2012年5月,衛生部部長陳竺應瑞士日內瓦高等研究院邀請,在《全球衛生2012》特刊上發表《中國衛生外交》一文,闡述了中國的衛生外交政策,以及中國對全球衛生的立場與展望。文章中、英文全文如下:
中國衛生外交
中國衛生部部長 陳竺
人類進入21世紀,全球化進程達到前所未有的深度和廣度,對衛生産生了深遠的影響。衛生無處不再,無時不有,在全球舞臺上的戰略意義日益凸顯。衛生進入了全球發展議程,成為千年發展目標的核心;超越國界的疾病威脅全球人民的健康,成為重要的非傳統安全問題;國民健康是生産力的源泉,投資健康就是促進經濟增長;衛生關係社會公正,消除健康不公平,國際社會義不容辭;衛生體現國家軟實力,是外交政策的組成部分。今天的衛生部長,不僅要從生物醫學角度保護本國公民健康,更要以廣闊的視角和全球的高度,來審視公共衛生問題。他(她)肩負雙重責任:既要致力於保障本國人民的健康,也要為改善全球的健康做出貢獻。
實現衛生發展和維護衛生安全是全球衛生的兩大重點任務。2012年,全球進入千年發展目標期限倒計時後期,我們不容樂觀地看到,衛生相關的千年目標的實現依然任重道遠。實現目標最困難的國家是最需要全球協同努力給予幫助的國家。近十年來,非典、禽流感、甲流感等新發傳染病接踵而來,説明不能放鬆對衛生安全威脅的警戒。在日益相互依存的世界中,任何國家都不能獨善其身。維護國家和全球的衛生安全,必須採取集體的協同行動。我高興地看到,作為全球衛生外交舞臺,2012年第65屆世界衛生大會將衛生發展和衛生安全列為重點討論的議題。我相信,大會定能取得豐碩成果。
在衛生發展領域開展國際合作是中國衛生外交政策的重要組成部分。作為發展中大國,中國始終不渝地把支持非洲等廣大發展中國家的衛生事業視為己任。中國的衛生發展合作包括派遣醫療隊、建設醫院、設立瘧疾防治中心、培訓衛生技術和管理人員、提供藥品和醫療物資,也包括支持國際組織如世界衛生組織、聯合國艾滋病規劃署等聯合國機構,以及全球抗擊艾滋病、結核病和瘧疾基金等全球衛生新倡議,為改善全球衛生狀況做出了積極貢獻。新中國成立60多年來,在加強衛生系統建設、改善人民健康方面取得了可喜的成就,與衛生相關的千年目標已經實現或可望實現。我們願意和世界各國分享交流在衛生發展方面的經驗。
從中國衛生外交的實踐中,我認為:
一、全球衛生外交應尊重國際法準則,注重因時因地制宜。各國發展水平不同,面臨的衛生問題和挑戰不盡相同;既要加強國際合作與協調,也要充分考慮各國實際情況和不同關切,照顧各方接受程度;既要著力應對當前緊迫的衛生問題,也要著眼長遠,加強能力建設,遵循平衡原則。
二、全球衛生外交應加強統籌協調。衛生問題與貧困、就業、教育、貿易、氣候變化、知識産權等問題密切相關。各國和國際組織制訂相關政策和規則時,需要有全局觀念,通盤考慮相關因素與公共衛生之間的相互影響。衛生問題涉及一國多個政府部門和機構,有效開展衛生外交,需要建立高效的國內協調機制。國際衛生機構眾多,需要加強溝通協調,充分調動各方資源。中國支持世界衛生組織通過改革,在國際公共衛生領域發揮領導和協調作用,期待全球抗擊艾滋病、結核病和瘧疾基金等其它組織的改革,共同構築協調、高效、透明和問責的全球衛生治理框架。
三、全球衛生外交應注重實效。當前國際金融危機的深層次影響尚未消退,各國特別是發展中國家的衛生事業帶來了許多不利因素。確保對全球衛生的投入,推動如期實現與衛生相關的千年發展目標,是全球衛生外交當前及今後一個時期的工作重點。發達國家應儘快切實兌現國際承諾,在技術轉讓、促進藥品可及性和可負擔性、向發展中國家給予更多支持和援助。發展中國家應強化自身衛生體系建設,加大財政投入,協調各方資源,並加強南南合作。
建設持久和平、共同繁榮的和諧世界,增進中國人民與世界各國人民的了解和友誼,是中國和平外交的使命,也是中國衛生外交的重要職責。中國衛生外交將繼續開展南南合作、南北合作,加強自身能力建設,逐步完善中國的全球衛生戰略。我們將不斷總結中國醫藥衛生體制改革和發展的經驗,與國際社會分享,積極參與全球衛生事務,與各方共同攜手,為全球健康改善做出努力。
China’s Health Diplomacy: sharing experience and expertise
By Chen Zhu, Minister of Health, People’s Republic of China
In the 21st century, globalization has achieved unprecedented depth and breadth, exerting a profound influence on health. Health exists at every moment and everywhere. Its strategic relevance is increasingly highlighted in the global arena. Health has entered into the global development agenda and lies at the core of the Millennium Development Goals (MDGs). Diseases that transcend national boundaries threaten people’s lives and have become important non-conventional security issues. Since a healthy population is the source of productivity, investing in health boosts economic growth. Health bears on social equity and it is the responsibility of the international community to eliminate health inequity. As a component of a country’s diplomatic policies, health reflects that country’s soft power. Today, a health minister should not only protect national health from a biomedical perspective but must also view public health from a broader and global perspective. That person shoulders dual responsibilities: to ensure the health of his or her people and to contribute to the improvement of global health.
The two key tasks of global health are to achieve the improvement of health development and safeguarding of health security. The year 2012 brings the target dates of achieving the MDGs ever closer. Yet there is clearly still a long way to go to meet the health-related MDGs. The countries that find it most difficult to achieve the targets are indeed the ones that most urgently need globally coordinated help. In the past decade, emerging infectious diseases such as severe acute respiratory syndrome (SARS), avian influenza and H1N1 influenza have occurred one after another, indicating that no one can ever relax vigilance against health security threats. In a world of growing interdependence, no country can be immune from another’s problems. Protecting national and global health security requires collective and coordinated action. To my great delight, as the global platform of health diplomacy, the 65th World Health Assembly in 2012 has listed global development and health security among the items for key debates. I am confident that the assembly will yield fruitful results.
Conducting international cooperation in health development constitutes an important part of China’s policies of health diplomacy. As a major developing country, China has always believed that it is its responsibility to support developing countries, such as those in Africa, in promoting their health. China’s development cooperation for health includes dispatching medical teams, building hospitals, setting up malaria prevention and treatment centers, training health professionals and administrators, and providing medicine and medical supplies. China has also been a strong supporter of international agencies such as the World Health Organization (WHO) and UNAIDS and global health initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Over the past six decades, since the founding of the new China, the country has made remarkable progress in strengthening health systems and improving health outcomes. The health-related MDGs have already been or are being achieved in China. We are ready to share with other countries our experience in developing health.
In the light of China’s health diplomacy practices, I hold the following convictions. First, global health diplomacy should respect the norms of international laws and fully consider specific conditions. Countries are in different stages of development and they face different health problems and challenges.
While strengthening international cooperation and coordination, there must be adequate consideration given to the national conditions and different concerns, as well as to the acceptance of the stakeholders. Vigorous efforts shall be made to address pressing health problems. But, at the same time, efforts should also be forward-looking, should strengthen capacity building and follow the principle of balance.
Second, global health diplomacy should strengthen coordination. Health is closely linked to issues such as poverty, employment, education, trade, environmental protection, climate change and intellectual property. When formulating relevant policies and rules, countries and international organizations need to review the mutual impacts of the related factors and of public health in a general context. Health engages various government agencies and effective health diplomacy requires highly efficient domestic coordination. With the large number of international organizations that deal with health, it is necessary to strengthen communication and coordination and fully mobilize resources. China supports the WHO reform and wishes to see WHO play a leading role in coordinating international public health. China also looks forward to the reform of organizations such as the Global Fund so that a coordinated, highly efficient, transparent and accountable framework for global health governance can be built.
Third, global health diplomacy should focus on real effects. At present, the deep impact of the international financial crisis still haunts the world, bringing unfavorable factors to the health undertaking of all countries, especially developing ones. It remains a priority for global health diplomacy to ensure inputs into global health and to achieve the health-related MDGs as scheduled. Developed countries should honor their international commitments as soon as possible and provide more support and assistance to developing countries in areas such as technology transfer and the promotion of drug accessibility and affordability. Developing countries should enhance their health systems, increase fiscal inputs, coordinate resources and strengthen South-South cooperation.
It is the mission of China’s peaceful foreign policy, and an important responsibility of its health diplomacy, to build a harmonious world of lasting peace and common prosperity with deepened mutual understanding and friendship between the Chinese and people around the world. China’s health diplomacy will continue to develop South-South and South-North cooperation, enhance its own capacity building and gradually improve China’s global health strategies. We will constantly review and share our experience gained in health reform and development, actively engage in global health, work hand in hand with all stakeholders and make our contribution to improving global health.