Bridging the commitment-compliance gap in global health politics: Lessons from international relations for the global action plan on antimicrobial resistance
Bridging the commitment-compliance gap in global health politics: Lessons from international relations for the global action plan on antimicrobial resistance
复制标题
DOI：
10.1080/17441692.2020.1788623
复制
发表时间：
2020-07-03
影响因子：
3.3
通讯作者：
Hoffman, Steven J.
中科院分区：
文献类型：
--
作者：
Weldon, Isaac;Hoffman, Steven J.
2015年，196个国家大胆承诺解决全球抗菌素耐药性(AMR)问题。现在，五年过去了，进度报告表明，AMR活动的实施远远低于最初承诺的水平。克服承诺-合规差距的挑战并不是AMR独有的，在国际政治的其他领域也很常见。因此，全球卫生政策制定者可以借鉴国际关系理论和其他部门的经验。我们回顾了国际关系学术，提出了五个假设，说明为什么国家可能遵守或不遵守其全球承诺。然后，我们对过去三个关于生物多样性、气候变化和核武器的国际协议进行了公共政策分析，以检验这些假设，并找出鼓励各国遵守全球卫生协议的教训，并将其具体应用于全球AMR政策。为了弥合承诺与遵守之间的差距，国际领导人应该：(1)制定激励措施，使行动利益最大化；(2)寻求执行机制，以诱导国家行为；(3)强调通过为行动提供相互保证来建立信任文化；(4)包括管理表现不佳的人的机制；以及(5)寻找持续的社会学习机会。协议的设计应具有灵活性、数据共享和争端解决机制，并向交付能力较弱的国家提供资金和技术援助。
In 2015, 196 countries boldly committed to address global antimicrobial resistance (AMR). Now, five years later, progress reports suggest the implementation of AMR activities is vastly below what was initially promised. The challenge of overcoming the 'commitment-compliance gap' is not unique to AMR and is common in other areas of international politics. Global health policymakers can therefore learn from theories of international relations and experience in other sectors. We reviewed international relations scholarship to generate five hypotheses for why states might comply or not comply with their global commitments. We then conducted a public policy analysis of three past international agreements on biological diversity, climate change, and nuclear weapons to test these hypotheses and identify lessons for encouraging country compliance with global health agreements, with specific application to global AMR policies.To bridge the commitment-compliance gap, international leaders should: (1) frame incentives to maximise interests for action; (2) pursue enforcement mechanisms to induce state behaviour; (3) emphasise building a culture of trust by providing mutual assurance for action; (4) include mechanisms for managing poor performers; and (5) find opportunities for continual social learning. Agreements should be designed with flexibility, data sharing, and dispute settlement mechanisms and provide financial and technical assistance to states with less capacity to deliver.