應對大流行病的全球衛生融資問題研究——以國際衛生法律文書談判為中心

Global Health Financing in the Context of Pandemic - Centered on the Negotiations of International Health Instruments

預防、防範和應對大流行病的全球衛生融資一方面呈現機構激增、主體與場域多元的特徵，另一方面也面臨融資優先事項失衡、慈善模式、融資框架無序、治理範式失衡以及可持續供資不足的多重困境。當前，《世衛組織大流行協定》草案和《國際衛生條例（2005）》修正案就融資議題已達成框架性共識。未來，推進這一議題可供選擇的路徑是：以公共衛生安全與健康公平基本價值間的平衡為導向，秉持人類衛生健康共同體理念，貫徹公平原則，承認發展中國家的能力差異，統籌長期公共衛生能力建設和短期快速應急融資需求，以世界衛生組織為主導統籌兩項文書下的融資協調機制，推動構建共商共治的全球衛生融資治理框架，發展可持續可預測的融資渠道。

Global health financing for pandemic prevention, preparedness and response is characterized by a proliferation of institutions and a multiplicity of arenas and actors. Meanwhile, it has to face multiple dilemmas related to imbalanced financing priorities, charity model, disordered financing frameworks, imbalanced governance paradigms, and insufficient sustainable funding. The Proposal of the WHO Pandemic Agreement and International Health Regulation (2005) Amendments have reached minimum consensus on this issue. Orientated by a balance between the fundamental values of public health security and health equity, adhering to the idea of A Global Community of Health for All, and implementing the principle of health equity are required, the ways forward in the future include giving full consideration to the differentiated capacities of developing countries, integrating long-term health capacity building and short-term rapid emergency financing needs, promoting coordination of financing mechanisms under these two instruments within WHO, improving the governance framework for global public health financing based on consultation and co-governance, and mobilizing sustainable and predictable financing resources.