Global Health - emergence, hegemonic trends and biomedical reductionism
Global Health - emergence, hegemonic trends and biomedical reductionism
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全球健康-出现，霸权趋势和生物医学还原论
DOI：
10.1186/s12992-020-00573-4
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发表时间：
2020-05-06
影响因子：
10.8
通讯作者：
Holst, Jens
中科院分区：
文献类型：
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作者：
Holst, Jens
背景全球卫生越来越受到国际关注和重视。首先，跨境传染病的传播引起了媒体和公众的极大兴趣，正如它推动了教师和学术课程的研究重点一样。与此同时，全球卫生已成为慈善行动的一个主要领域。尽管“全球卫生”这一复杂的集体术语在过去二十年中获得了重要性，但今天仍然缺乏统一的用法。目的本文的目的是提出现有的全球健康的定义，并分析其含义和影响。该文件强调，“全球健康”一词超越了“全球”的地域含义，将地方和全球联系起来，并指的是一个明确的政治概念。全球卫生组织认为健康是一种基于权利的普遍利益;它考虑到社会不平等、权力不对称、资源分配不均和治理挑战。因此，它代表了公共卫生在面对各种普遍存在的全球挑战时的必要延续。然而，越来越多的国际参与者关注公私伙伴关系和私有化，并倾向于通过主要的技术解决方案促进生物医学简化论。此外，占主导地位的全球卫生概念反映了全球北方继承的霸权。它没有充分考虑到主要以非传染性疾病为特征的全球疾病负担，也没有充分考虑到健康的基本社会决定因素。除了为预防跨境疾病威胁而进行的复原力和流行病学准备之外，全球卫生必须关注健康的社会、经济和政治决定因素。生物医学和技术官僚的简化论在严重的健康危机时期可能是合理的，但却有选择性地获得医疗保健的风险。为了确保人人享有健康，并可持续地减少国家内部和国家之间的健康不平等现象，需要一致的全民健康政策。全球卫生必须首先致力于落实普遍健康权，并为克服全球霸权作出贡献。
Background Global Health has increasingly gained international visibility and prominence. First and foremost, the spread of cross-border infectious disease arouses a great deal of media and public interest, just as it drives research priorities of faculty and academic programmes. At the same time, Global Health has become a major area of philanthropic action. Despite the importance it has acquired over the last two decades, the complex collective term "Global Health" still lacks a uniform use today. Objectives The objective of this paper is to present the existing definitions of Global Health, and analyse their meaning and implications. The paper emphasises that the term "Global Health" goes beyond the territorial meaning of "global", connects local and global, and refers to an explicitly political concept. Global Health regards health as a rights-based, universal good; it takes into account social inequalities, power asymmetries, the uneven distribution of resources and governance challenges. Thus, it represents the necessary continuance of Public Health in the face of diverse and ubiquitous global challenges. A growing number of international players, however, focus on public-private partnerships and privatisation and tend to promote biomedical reductionism through predominantly technological solutions. Moreover, the predominant Global Health concept reflects the inherited hegemony of the Global North. It takes insufficient account of the global burden of disease, which is mainly characterised by non-communicable conditions, and the underlying social determinants of health. Conclusions Beyond resilience and epidemiological preparedness for preventing cross-border disease threats, Global Health must focus on the social, economic and political determinants of health. Biomedical and technocratic reductionism might be justified in times of acute health crises but entails the risk of selective access to health care. Consistent health-in-all policies are required for ensuring Health for All and sustainably reducing health inequalities within and among countries. Global Health must first and foremost pursue the enforcement of the universal right to health and contribute to overcoming global hegemony.