病毒跨境傳染下的全球衛生治理：以2020年COVID-19之疫情擴散為例

Global Health Governance during the Era of Cross-border Transmission of Virus: The Case Studies of the 2020 COVID-19 Pandemic

譚偉恩(Wei-En Tan)

《全球政治評論》 70期 (2020/04) Pp. 55-85

摘要

「全球衛生治理」（global health governance, GHG）的初始概念發軔於19世紀的歐洲，基於拿破崙戰爭（Napoleonic Wars）結束後國內產業發展及國際貿易之需求，歐洲國家意識到對具傳播感染力的疫病跨境有必要以合作的方式進行控管。然而，2020年一場自中國爆發，隨之擴散全球的新型冠狀病毒肺炎（novel coronavirus pneumonia or COVID-19）凸顯出國際合作在公共衛生治理的力不從心。透過對現行GHG定義的回顧與反思，輔以世界衛生組織（World Health Organization, WHO）與主權國家因應COVID-19之具體事例；本文指出：（1）WHO現行制度設計上的瑕疵；（2）GHG在任務與工作範圍的過於寬泛；（3）以及「大政府」勢力的相對抬頭，等三個主要因素導致國際社會目前缺乏有效的集體行動治理COVID-19。由於涉足疫情治理的行為者眾多且橫跨國內和國際兩個層次，導致彼此間的利益衝突不易調和，因此無論是關於COVID-19的政府間合作還是納入非國家行為者的全球治理，在可預期之將來皆難以形成，或即便形式上存在也無法產生具體成效。

關鍵字

新型冠狀病毒肺炎 ； 全球衛生治理 ； 新現實主義 ； 國際合作

並列摘要

The concept of Global Health Governance (GHG) emerged in 19th-century Europe. Based on the demand for domestic industrial development and international trade after the end of Napoleonic Wars, European nations began to feel the need for controlling contagious diseases that could cause cross-border infections through cooperation. Yet, the 2020 novel coronavirus pneumonia (COVID-19) that began in China and later spread globally has demonstrated the weakness of international cooperation on matters of public health. Through the review of and reflection on the current definition of GHG to analyze recent events of how the World Health Organization (WHO) and nations respond to COVID-19, this article points out that: (1) there are flaws in the institutional design of WHO; (2) the definition of GHG is overly broad and vague; (3) the relative rise of the power in the hands of big governments around the world. All of these are the main cause for the international society to lack collective action to govern COVID-19. In other words, the facts that the pandemic governance involves many actors and entails both national and international levels lead to unresolvable conflict of interest. Therefore, neither international cooperation nor global governance for COVID-19 is achievable in the foreseeable future. Even if it is achievable, it will very likely fail to produce desirable outcome.

並列關鍵字

COVID-19 ； Global Health Governance ； Neorealism ； International Cooperation