全球公共卫生治理中PHEIC运行困境及应对策略

Operational Difficulties and Response Strategies of PHEIC in Global Public Health Governance

摘要: 近年来埃博拉、新冠病毒、猴痘传染病公共卫生危机在全球范围内造成巨大影响。PHEIC是在《国际卫生条例(2005)》(以下简称“《条例》”)框架下为及时预警和协调国际合作抗疫而设立的机制，然而“是否宣布”及“何时宣布”是公认的难题。历次疫情应对过程中，WHO运用PHEIC机制的能力和效果持续引发争议。WHO难以避免的政治化引起了国际社会对WHO专业性的质疑，影响其在全球公共卫生合作中的权威性，最终导致缔约国不遵守WHO的政策规范，形成“决策困境–专业性质疑–领导监督力减弱–缔约国不遵守”的链条。故有人提出将强制解决办法引入以期一劳永逸，这一建议无异于推翻《条例》协调意志的底层逻辑。笔者认为应对PHEIC运行困境并非仅为得出WHO需加强治理与改革或者缔约国需重新开启《条例》谈判的简单推论，而需从全球公共卫生治理的各主体入手，增强国际社会关于全球公共卫生治理的共同体意识。

Abstract: In recent years, the public health crises of Ebola, COVID-19 and monkeypox infectious diseases have had a huge impact on the world. PHEIC is a mechanism established under the framework of the International Health Regulations (2005) for timely warning and coordination of international cooperation in the fight against epidemic diseases. However, “whether to declare” and “when to declare” are recognized as difficult problems. The ability and effectiveness of WHO to use the PHEIC mechanism have continued to cause controversy in the past epidemic response. The inevitable politicization of WHO caused the international community to question the professionalism of WHO affected its authority in global public health cooperation, and finally led to the failure of the contracting parties to comply with the policy norms of WHO, forming a chain of “decision-making dilemma—professional questioning—weakening of leadership and supervision—failure of the contracting parties to comply”. Therefore, some people have proposed to introduce the compulsory solution with a view to once and for all. This proposal is tantamount to overturning the underlying logic of the Regulation to coordinate the will. The author believes that dealing with the operational dilemma of PHEIC is not only to draw a simple conclusion that WHO needs to strengthen governance and reform or that the contracting parties need to reopen the negotiations on the Regulation, and to strengthen the common consciousness of the international community on global public health governance from the perspective of the main bodies of global public health governance.