2012年5月，衛(wèi)生部部長(zhǎng)陳竺應(yīng)瑞士日內(nèi)瓦高等研究院邀請(qǐng)，在《全球衛(wèi)生2012》特刊上發(fā)表《中國(guó)衛(wèi)生外交》一文，闡述了中國(guó)的衛(wèi)生外交政策，以及中國(guó)對(duì)全球衛(wèi)生的立場(chǎng)與展望。文章中、英文全文如下：
中國(guó)衛(wèi)生外交
中國(guó)衛(wèi)生部部長(zhǎng) 陳竺
人類進(jìn)入21世紀(jì)，全球化進(jìn)程達(dá)到前所未有的深度和廣度，對(duì)衛(wèi)生產(chǎn)生了深遠(yuǎn)的影響。衛(wèi)生無處不再，無時(shí)不有，在全球舞臺(tái)上的戰(zhàn)略意義日益凸顯。衛(wèi)生進(jìn)入了全球發(fā)展議程，成為千年發(fā)展目標(biāo)的核心；超越國(guó)界的疾病威脅全球人民的健康，成為重要的非傳統(tǒng)安全問題；國(guó)民健康是生產(chǎn)力的源泉，投資健康就是促進(jìn)經(jīng)濟(jì)增長(zhǎng)；衛(wèi)生關(guān)系社會(huì)公正，消除健康不公平，國(guó)際社會(huì)義不容辭；衛(wèi)生體現(xiàn)國(guó)家軟實(shí)力，是外交政策的組成部分。今天的衛(wèi)生部長(zhǎng)，不僅要從生物醫(yī)學(xué)角度保護(hù)本國(guó)公民健康，更要以廣闊的視角和全球的高度，來審視公共衛(wèi)生問題。他（她）肩負(fù)雙重責(zé)任：既要致力于保障本國(guó)人民的健康，也要為改善全球的健康做出貢獻(xiàn)。
實(shí)現(xiàn)衛(wèi)生發(fā)展和維護(hù)衛(wèi)生安全是全球衛(wèi)生的兩大重點(diǎn)任務(wù)。2012年，全球進(jìn)入千年發(fā)展目標(biāo)期限倒計(jì)時(shí)后期，我們不容樂觀地看到，衛(wèi)生相關(guān)的千年目標(biāo)的實(shí)現(xiàn)依然任重道遠(yuǎn)。實(shí)現(xiàn)目標(biāo)最困難的國(guó)家是最需要全球協(xié)同努力給予幫助的國(guó)家。近十年來，非典、禽流感、甲流感等新發(fā)傳染病接踵而來，說明不能放松對(duì)衛(wèi)生安全威脅的警戒。在日益相互依存的世界中，任何國(guó)家都不能獨(dú)善其身。維護(hù)國(guó)家和全球的衛(wèi)生安全，必須采取集體的協(xié)同行動(dòng)。我高興地看到，作為全球衛(wèi)生外交舞臺(tái)，2012年第65屆世界衛(wèi)生大會(huì)將衛(wèi)生發(fā)展和衛(wèi)生安全列為重點(diǎn)討論的議題。我相信，大會(huì)定能取得豐碩成果。
在衛(wèi)生發(fā)展領(lǐng)域開展國(guó)際合作是中國(guó)衛(wèi)生外交政策的重要組成部分。作為發(fā)展中大國(guó)，中國(guó)始終不渝地把支持非洲等廣大發(fā)展中國(guó)家的衛(wèi)生事業(yè)視為己任。中國(guó)的衛(wèi)生發(fā)展合作包括派遣醫(yī)療隊(duì)、建設(shè)醫(yī)院、設(shè)立瘧疾防治中心、培訓(xùn)衛(wèi)生技術(shù)和管理人員、提供藥品和醫(yī)療物資，也包括支持國(guó)際組織如世界衛(wèi)生組織、聯(lián)合國(guó)艾滋病規(guī)劃署等聯(lián)合國(guó)機(jī)構(gòu)，以及全球抗擊艾滋病、結(jié)核病和瘧疾基金等全球衛(wèi)生新倡議，為改善全球衛(wèi)生狀況做出了積極貢獻(xiàn)。新中國(guó)成立60多年來，在加強(qiáng)衛(wèi)生系統(tǒng)建設(shè)、改善人民健康方面取得了可喜的成就，與衛(wèi)生相關(guān)的千年目標(biāo)已經(jīng)實(shí)現(xiàn)或可望實(shí)現(xiàn)。我們?cè)敢夂褪澜绺鲊?guó)分享交流在衛(wèi)生發(fā)展方面的經(jīng)驗(yàn)。
從中國(guó)衛(wèi)生外交的實(shí)踐中，我認(rèn)為：
一、全球衛(wèi)生外交應(yīng)尊重國(guó)際法準(zhǔn)則，注重因時(shí)因地制宜。各國(guó)發(fā)展水平不同，面臨的衛(wèi)生問題和挑戰(zhàn)不盡相同；既要加強(qiáng)國(guó)際合作與協(xié)調(diào)，也要充分考慮各國(guó)實(shí)際情況和不同關(guān)切，照顧各方接受程度；既要著力應(yīng)對(duì)當(dāng)前緊迫的衛(wèi)生問題，也要著眼長(zhǎng)遠(yuǎn)，加強(qiáng)能力建設(shè)，遵循平衡原則。
二、全球衛(wèi)生外交應(yīng)加強(qiáng)統(tǒng)籌協(xié)調(diào)。衛(wèi)生問題與貧困、就業(yè)、教育、貿(mào)易、氣候變化、知識(shí)產(chǎn)權(quán)等問題密切相關(guān)。各國(guó)和國(guó)際組織制訂相關(guān)政策和規(guī)則時(shí)，需要有全局觀念，通盤考慮相關(guān)因素與公共衛(wèi)生之間的相互影響。衛(wèi)生問題涉及一國(guó)多個(gè)政府部門和機(jī)構(gòu)，有效開展衛(wèi)生外交，需要建立高效的國(guó)內(nèi)協(xié)調(diào)機(jī)制。國(guó)際衛(wèi)生機(jī)構(gòu)眾多，需要加強(qiáng)溝通協(xié)調(diào)，充分調(diào)動(dòng)各方資源。中國(guó)支持世界衛(wèi)生組織通過改革，在國(guó)際公共衛(wèi)生領(lǐng)域發(fā)揮領(lǐng)導(dǎo)和協(xié)調(diào)作用，期待全球抗擊艾滋病、結(jié)核病和瘧疾基金等其它組織的改革，共同構(gòu)筑協(xié)調(diào)、高效、透明和問責(zé)的全球衛(wèi)生治理框架。
三、全球衛(wèi)生外交應(yīng)注重實(shí)效。當(dāng)前國(guó)際金融危機(jī)的深層次影響尚未消退，各國(guó)特別是發(fā)展中國(guó)家的衛(wèi)生事業(yè)帶來了許多不利因素。確保對(duì)全球衛(wèi)生的投入，推動(dòng)如期實(shí)現(xiàn)與衛(wèi)生相關(guān)的千年發(fā)展目標(biāo)，是全球衛(wèi)生外交當(dāng)前及今后一個(gè)時(shí)期的工作重點(diǎn)。發(fā)達(dá)國(guó)家應(yīng)盡快切實(shí)兌現(xiàn)國(guó)際承諾，在技術(shù)轉(zhuǎn)讓、促進(jìn)藥品可及性和可負(fù)擔(dān)性、向發(fā)展中國(guó)家給予更多支持和援助。發(fā)展中國(guó)家應(yīng)強(qiáng)化自身衛(wèi)生體系建設(shè)，加大財(cái)政投入，協(xié)調(diào)各方資源，并加強(qiáng)南南合作。
建設(shè)持久和平、共同繁榮的和諧世界，增進(jìn)中國(guó)人民與世界各國(guó)人民的了解和友誼，是中國(guó)和平外交的使命，也是中國(guó)衛(wèi)生外交的重要職責(zé)。中國(guó)衛(wèi)生外交將繼續(xù)開展南南合作、南北合作，加強(qiáng)自身能力建設(shè)，逐步完善中國(guó)的全球衛(wèi)生戰(zhàn)略。我們將不斷總結(jié)中國(guó)醫(yī)藥衛(wèi)生體制改革和發(fā)展的經(jīng)驗(yàn)，與國(guó)際社會(huì)分享，積極參與全球衛(wèi)生事務(wù)，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.
