Article(id=1320438298141639314, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438168613138789, articleNumber=null, orderNo=null, doi=10.11847/zgggws1149238, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1762099200000, receivedDateStr=2025-11-03, revisedDate=1767628800000, revisedDateStr=2026-01-06, acceptedDate=1772812800000, acceptedDateStr=2026-03-07, onlineDate=1792746622834, onlineDateStr=2026-10-23, pubDate=1778342400000, pubDateStr=2026-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792746622834, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792746622834, creator=13701087609, updateTime=1792746622834, updator=13701087609, issue=Issue{id=1320438168613138789, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='5', pageStart='513', pageEnd='640', issueExtLink='null', onlineDate='null', pubDate='1778342400000', pubDateStr='2026-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792746591952, creator='13701087609', updateTime=1792748055079, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444305479684446, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438168613138789, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444305479684447, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438168613138789, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=635, endPage=640, ext={EN=ArticleExt(id=1320438299022443155, articleId=1320438298141639314, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Reform and prospect of the global public health security governance system, columnId=1320431897281413811, journalTitle=Chinese Journal of Public Health, columnName=Public Health Forum, runingTitle=null, highlight=null, articleAbstract=

Global public health security is confronted with multiple challenges, including population growth, rapid urbanization, climate change, and the misuse of antibiotics, while the transnational spread of emerging infectious diseases has become a major global threat. Large-scale epidemics have exposed the fragility of the global public health governance system. The 2014 Ebola outbreak in West Africa prompted the international community to strengthen the implementation mechanisms of the International Health Regulations (2005), facilitated the establishment of regional institutions such as the Africa Centres for Disease Control and Prevention, and promoted the enhancement of national public health capacities. However, the COVID-19 pandemic once again underscored deficiencies in global information sharing, coordination, and resource allocation, further reinforcing the need for governance reform. In May 2025, the 78th World Health Assembly adopted the World Health Organization Pandemic Agreement–a milestone accord designed to establish a pathogen access and benefit-sharing system, reinforce the One Health approach, enhance the resilience of global health systems, and promote the research, development, and equitable distribution of pandemic-related health products. This agreement reflects the international community′s commitment to multilateral cooperation, yet its implementation and compliance still face considerable challenges. In the future, global health security governance needs to keep strengthening multilateral collaboration and uphold WHO′s central coordinating role, increase investment in digital health technologies and public health system capacity to improve surveillance, early warning, and response mechanisms, advance cross-sectoral coordination under the One Health principle, and integrate national health security planning into broader development strategies to build a shared community of health for all humankind.

, authors=Minmin WANG1, 2, 3, Zuokun LIU4, Yinuo SUN4, Xinyi SONG4, Fangjing LIU4, Minghui REN1, 2, 3, 4, authorsList=Minmin WANG, Zuokun LIU, Yinuo SUN, Xinyi SONG, Fangjing LIU, Minghui REN, authorCompany=null, correspAuthors=Minghui REN, authorNote=null, correspAuthorsNote=
REN Minghui, E-mail:
, copyrightStatement=Copyright © 2026 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1320438301857792662, articleId=1320438298141639314, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=全球公共卫生安全治理体系变革与展望, columnId=1320431897449185973, journalTitle=中国公共卫生, columnName=公共卫生论坛, runingTitle=null, highlight=null, articleAbstract=

全球公共卫生安全面临着人口增长、城市化、气候变化和抗生素滥用等多重挑战,新发传染病的跨国传播已构成重大全球性威胁。重大疫情暴露了全球公共卫生治理体系的脆弱性。2014年西非埃博拉疫情促使国际社会加强《国际卫生条例(2025)》执行机制,推动非洲疾病预防控制中心等区域组织的建立,并促进各国公共卫生能力的建设。然而新冠病毒感染疫情再次凸显了全球在信息共享、协调合作和资源分配方面的不足,进一步推动了治理体系的改革需求。2025年5月,第78届世界卫生大会通过了《世界卫生组织大流行协定》,这一里程碑式的协议旨在建立病原体获取和惠益分享系统、强化“同一健康”方针、提升全球卫生系统韧性,并促进大流行相关卫生产品的研发与公平分配。该协定体现了国际社会对多边合作的坚持,但其生效与履约仍面临挑战。未来全球公共卫生安全治理需继续强化多边合作,充分发挥世界卫生组织的核心作用;加大对数字健康技术和公共卫生体系建设的投入,提升监测、预警和响应能力;秉承“同一健康”理念,加强跨部门协调;并将国家公共卫生安全规划深度融入发展战略,通过全球共同努力构建人类卫生健康共同体。

, authors=王敏敏1, 2, 3, 刘佐坤4, 孙一诺4, 宋心怡4, 刘芳静4, 任明辉1, 2, 3, 4, *, *, authorsList=王敏敏, 刘佐坤, 孙一诺, 宋心怡, 刘芳静, 任明辉, authorCompany=null, correspAuthors=任明辉, authorNote=

王敏敏(1995–),博士, 副研究员,研究方向:公共卫生体系创新、全球卫生

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全球公共卫生安全治理体系变革与展望
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王敏敏 1, 2, 3 , 刘佐坤 4 , 孙一诺 4 , 宋心怡 4 , 刘芳静 4 , 任明辉 1, 2, 3, 4, *, *
中国公共卫生 | 公共卫生论坛 2026,42(5): 635-640
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中国公共卫生 |公共卫生论坛 2026 , 42 (5) : 635 -640
全球公共卫生安全治理体系变革与展望
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2北京大学首都卫生与健康发展研究院,北京 100191
3国家卫生健康委员会卫生体系改革与治理研究重点实验室(北京大学),北京 100191
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王敏敏1, 2, 3, 刘佐坤4, 孙一诺4, 宋心怡4, 刘芳静4, 任明辉1, 2, 3, 4, *, *
作者信息
  • 1北京大学中国卫生发展研究中心,北京 100191
  • 2北京大学首都卫生与健康发展研究院,北京 100191
  • 3国家卫生健康委员会卫生体系改革与治理研究重点实验室(北京大学),北京 100191
  • 4北京大学公共卫生学院全球卫生学系,北京 100191
通讯作者:
任明辉,E-mail:
作者简介:

王敏敏(1995–),博士, 副研究员,研究方向:公共卫生体系创新、全球卫生

Reform and prospect of the global public health security governance system
Minmin WANG1, 2, 3, Zuokun LIU4, Yinuo SUN4, Xinyi SONG4, Fangjing LIU4, Minghui REN1, 2, 3, 4
Affiliations
  • 1PKU China Center for Health Development Studies, Beijing 100191, China
  • 2Beijing Institute for Health Development, Peking University, Beijing 100191, China
  • 3NHC Key Laboratory of Health System Reform and Governance (Peking University), Beijing 100191, China
  • 4Department of Global Health, School of Public Health, Peking University, Beijing 100191, China
  • Corresponding Author:
    REN Minghui, E-mail:
出版时间: 2026-05-10 doi: 10.11847/zgggws1149238
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全球公共卫生安全面临着人口增长、城市化、气候变化和抗生素滥用等多重挑战,新发传染病的跨国传播已构成重大全球性威胁。重大疫情暴露了全球公共卫生治理体系的脆弱性。2014年西非埃博拉疫情促使国际社会加强《国际卫生条例(2025)》执行机制,推动非洲疾病预防控制中心等区域组织的建立,并促进各国公共卫生能力的建设。然而新冠病毒感染疫情再次凸显了全球在信息共享、协调合作和资源分配方面的不足,进一步推动了治理体系的改革需求。2025年5月,第78届世界卫生大会通过了《世界卫生组织大流行协定》,这一里程碑式的协议旨在建立病原体获取和惠益分享系统、强化“同一健康”方针、提升全球卫生系统韧性,并促进大流行相关卫生产品的研发与公平分配。该协定体现了国际社会对多边合作的坚持,但其生效与履约仍面临挑战。未来全球公共卫生安全治理需继续强化多边合作,充分发挥世界卫生组织的核心作用;加大对数字健康技术和公共卫生体系建设的投入,提升监测、预警和响应能力;秉承“同一健康”理念,加强跨部门协调;并将国家公共卫生安全规划深度融入发展战略,通过全球共同努力构建人类卫生健康共同体。

全球卫生安全  /  大流行协定  /  治理体系

Global public health security is confronted with multiple challenges, including population growth, rapid urbanization, climate change, and the misuse of antibiotics, while the transnational spread of emerging infectious diseases has become a major global threat. Large-scale epidemics have exposed the fragility of the global public health governance system. The 2014 Ebola outbreak in West Africa prompted the international community to strengthen the implementation mechanisms of the International Health Regulations (2005), facilitated the establishment of regional institutions such as the Africa Centres for Disease Control and Prevention, and promoted the enhancement of national public health capacities. However, the COVID-19 pandemic once again underscored deficiencies in global information sharing, coordination, and resource allocation, further reinforcing the need for governance reform. In May 2025, the 78th World Health Assembly adopted the World Health Organization Pandemic Agreement–a milestone accord designed to establish a pathogen access and benefit-sharing system, reinforce the One Health approach, enhance the resilience of global health systems, and promote the research, development, and equitable distribution of pandemic-related health products. This agreement reflects the international community′s commitment to multilateral cooperation, yet its implementation and compliance still face considerable challenges. In the future, global health security governance needs to keep strengthening multilateral collaboration and uphold WHO′s central coordinating role, increase investment in digital health technologies and public health system capacity to improve surveillance, early warning, and response mechanisms, advance cross-sectoral coordination under the One Health principle, and integrate national health security planning into broader development strategies to build a shared community of health for all humankind.

global health security  /  pandemic agreement  /  governance system
王敏敏, 刘佐坤, 孙一诺, 宋心怡, 刘芳静, 任明辉. 全球公共卫生安全治理体系变革与展望. 中国公共卫生, 2026 , 42 (5) : 635 -640 . DOI: 10.11847/zgggws1149238
Minmin WANG, Zuokun LIU, Yinuo SUN, Xinyi SONG, Fangjing LIU, Minghui REN. Reform and prospect of the global public health security governance system[J]. Chinese Journal of Public Health, 2026 , 42 (5) : 635 -640 . DOI: 10.11847/zgggws1149238
随着人口增长、快速城市化、气候和环境恶化以及抗生素滥用等社会环境变化,全球健康威胁日益增加,尤其是新发突发传染病的跨国传播已成为全球性挑战。世界卫生组织(WHO)在《2007年世界卫生报告》中首次提出了“全球公共卫生安全”的概念[1],其内涵为:通过采取预见性和反应性行动,尽可能减少对国家内不同人群、团体、区域以及跨国群体健康的紧急公共卫生事件发生可能性。当前主要的全球公共卫生安全威胁包括新发再发传染病、食源性疾病、核生化事件、暴力冲突和人道主义危机、气候变化、自然灾害和环境污染,以及粮食危机和贫困。
新发传染病已成为21世纪全球公共卫生安全和社会发展的重大挑战。自20世纪70年代至今,全球已发现40余种新发传染病,平均每年新增1至2种[2]。在21世纪,非典(SARS)、埃博拉病毒病、寨卡病毒病、中东呼吸综合征(MERS)、人感染H7N9流感、猴痘等传染病相继暴发,并构成全球突发公共卫生事件。其中,SARS、甲型H1N1流感、新型冠状病毒感染等更是演变为全球大流行。2018年,世界卫生组织提出了“X疾病”概念[3],指由未知病原体引发、可能导致全球大流行的传染病,这一概念引发了全球对公共卫生安全的高度关注[4]。新发传染病的冲击不仅体现在直接的健康威胁上,还对全球经济、社会治理和国际关系产生深远影响。疫情防控措施往往导致交通运输、旅游、零售、餐饮等行业严重受挫,供应链和国际贸易中断,劳动力市场的萎缩、贫困与不平等的加剧,以及教育中断、医疗挤兑和社会心理压力的上升,进一步加剧了社会不稳定风险[5]。以新冠病毒感染疫情为例,国际货币基金组织报告显示,2020年全球经济萎缩达3.0%,为二战以来最严重的衰退[6]。
本研究旨在分析全球公共卫生安全治理体系变革,特别是介绍全球卫生安全新型治理工具《大流行协定》主要内容及生效程序,展望全球公共卫生安全治理体系发展方向,确保全球治理机制能够适应快速变化的全球健康形势与需求。
2014年,埃博拉疫情在西非几内亚暴发,并迅速蔓延至塞拉利昂、利比里亚等周边国家。几内亚、塞拉利昂和利比里亚成为重灾区,大量民众感染致死,众多家庭支离破碎。据统计,3国共报告病例28 616例,死亡11 310例,病死率高达40%[7]。疫情通过国际旅行等途径传播至其他国家,首次传入欧洲和美国,引发了全球范围内的恐慌。这一疫情充分暴露了全球卫生安全治理体系在面对突发公共卫生事件时的脆弱性,尤其是在疫情监测、医疗资源调配、国际合作等方面存在诸多不足,为后续的改革和完善敲响了警钟。
埃博拉疫情的暴发促使国际社会对全球公共卫生安全治理体系进行深刻反思,进而推动了一系列旨在加强全球公共卫生安全的改革和调整措施。
继SARS疫情推动《国际卫生条例》修改,埃博拉疫情推动国际社会加强了对《国际卫生条例(2005)》的执行和监测力度。在各国自我评估的基础上,WHO引入了自愿为基础的联合外部评估、行动后审查、模拟演习和国家卫生安全行动计划等新框架。这些措施旨在帮助各国更全面地、客观地评估自身公共卫生安全能力,及时发现薄弱环节,提高对公共卫生威胁的识别、评估和响应能力。各国在埃博拉疫情后加快了对公共卫生安全相关法规政策的完善进程,明确了在疫情报告、防控措施、医疗资源调配等方面的责任和义务,加强了对违反法规行为的监督和处罚力度。例如,利比里亚和塞拉利昂修订了国家公共卫生法,进一步明确了疫情报告的时限要求和分级责任;尼日利亚在《国家卫生法》中增加了传染病防控和医疗资源调配的条款。这些措施进一步完善了全球公共卫生安全治理的法律框架,为应对未来疫情提供了保障。
2016年,在非盟的支持下,非洲疾病预防控制中心成立,标志着非洲大陆在提升区域公共卫生安全能力方面迈出了重要一步。其目标是加强非洲国家的疾病监测、预防、控制和响应能力,以应对当前和未来的公共卫生威胁。在埃博拉疫情后的多次疫情应对中,非洲疾控中心发挥了协调各国资源、分享防控经验等重要作用,提升了非洲地区整体的疫情防控效率。埃博拉疫情也促使其他区域性组织反思自身公共卫生安全体系的不足。以东南亚国家联盟为例,2016年东盟在卫生部长级会议框架下重申了跨境传染病防控合作的重要性,推动建立了更完善的信息共享和疫情通报机制[8]。之后,东盟公共卫生紧急协调系统逐步发展为区域疫情信息交流与协调的核心平台,为成员国之间的疫情监测、数据共享和应急协作提供了制度化渠道。
埃博拉疫情后,各国积极制定和实施国家卫生安全行动计划,明确了在卫生应急事件中的责任分工、资源配置和行动步骤。塞拉利昂和利比里亚在自评报告中强调,通过国际援助与本国财政投入,显著提高了传染病收治医院的床位容量,并增设了负压隔离病房,以应对潜在的疫情扩散。此外,各国还开展了针对传染病防控的专业培训,提高医护人员的诊断、治疗和防护技能,并建立了医疗人员储备机制,确保在疫情暴发时能够迅速调配足够的专业人员投入抗疫工作[9]。
埃博拉疫情凸显了资金不足的问题,国际社会探索了多种创新融资机制,以便为受影响国家提供及时的资金支持。世界银行与世卫组织合作设立了公共卫生突发事件应对基金[10],该基金在世卫组织宣布国际关注突发公共卫生事件后即可启动,以支持应对措施所需资金。在世界经济论坛的推动下,2017年德国、日本、挪威和盖茨基金会、惠康基金会建立了流行病防范创新联盟(Coalition for Epidemic Preparedness Innovations, CEPI)[11],支持新发传染病的疫苗快速研发。这些机制加大了对公共卫生安全技术创新的投入,推动了数字化、人工智能等技术在疫情监测、病例管理和资源分配等方面的应用。例如,利用大数据技术实现更精准的疫情监测和预警,通过人工智能算法优化医疗资源配置。同时,疫苗研发的mRNA等技术取得了突破性进展,为传染病防控提供了更多手段。
埃博拉疫情之后,在成员国的积极推动下,世卫组织强化了应急部门的机构建设,从总部到地区办事处,重组组建了半垂直化管理的应急部门,并设立专门基金应对突发公共卫生事件。此外,WHO针对重大病原体研发短板,建立了新发传染病研发蓝图[12–13],定期组织全球科学家研判已知病原体的研发进展,提出优先重点研发传染病目录,并于2018年提出了“X疾病”的概念[3],旨在推动优先病种疫苗药物诊断试剂和媒介控制技术等的研发,推进其获取的可及性和公平性。同时,设立了应急医疗队项目,鼓励有能力的国家组建突发卫生事件应急医疗队,在必要时接受世卫组织派遣,为有需要的国家提供技术支持和服务[14–15]。WHO非洲区办公室开展了一系列改革,包括加强卫生应急行动中心建设,提高组织协调能力;增加卫生应急防范和应对的人财物资源,吸引了更多专业人才投身全球公共卫生安全工作。这些改革旨在提升世卫组织在面对卫生应急事件时的领导和协调能力,更有效地应对全球性公共卫生安全挑战。
新冠病毒感染疫情再次暴露了全球公共卫生安全治理体系在信息共享、协调合作、资源分配等方面的薄弱环节。地缘政治形势复杂,以及日益上升的民粹主义思潮,与疫情防控叠加,国家间的信息沟通不畅、信息延迟,甚至污名化、虚假信息泛滥等导致各国无法及时获取准确的疫情信息,难以制定科学有效的防控策略。协调合作机制的不完善使得全球应对疫情的行动缺乏统一性和高效性,资源分配的不合理进一步加剧了疫情防控的不平衡。疫情促使国际社会对全球公共卫生安全治理体系进行深入改革。成员国不断推动世界卫生组织秘书处调整和完善自身职能,加强对全球卫生安全事务的领导和协调,提高效率。同时,全球范围内积极探索建立更加公平、有效的疫苗分配机制和全球卫生应急储备体系,以提高全球应对公共卫生危机的能力。
2023年,第78届联合国大会举行了“大流行预防、防范和应对”高级别会议[16],一致通过了一项具有里程碑意义的政治宣言,承诺将防止再次出现新冠病毒感染疫情造成破坏性的卫生与社会经济危机的情况,增强世界抵御下一场大流行病的能力,同时努力在2030年前实现与公共卫生和全民健康覆盖相关的可持续发展目标。第78届世界卫生大会通过了《加强全球突发卫生事件防范、应对和抵御架构》,要求从治理、系统、筹资3个维度改革与强化全球公共卫生安全治理体系。在全球治理方面,世卫组织会员国正积极推动两项关键进程:一是通过政府间谈判机构(Intergovernmental Negotiating Body, INB)起草和谈判一项新的国际法律文书,以预防、防范和应对未来大流行;二是对《国际卫生条例(2005)》进行有针对性的修订,以提升全球卫生应急响应能力。
在筹资方面,当前全球每年需要约300亿美元用于有效的突发卫生事件防范,但存在约100亿美元的资金缺口。为此,在二十国集团的积极推动下,大流行基金于2022年11月正式启动,旨在为低收入和中等收入国家提供资金支持,加强其突发卫生事件防范和应对能力。仍需要建立新的资金调动机制,以在突发卫生事件发生时迅速扩增资金规模,确保及时有效的国际应对。
在系统建设方面,报告提出了“5C”的核心框架,即合作监测(collaborative surveillance)、社区保护(community protection)、安全和可扩展的服务(safe and scale care)、获得防控手段(access to countermeasures)和应急协调(emergency coordination)。这5个系统相互关联,共同构成应对突发卫生事件的基础。合作监测强调跨部门、跨层级的数据共享与风险评估;社区保护突出社区参与和多部门协作在突发卫生事件应对中的核心作用;安全和可扩展的服务要求卫生系统具备灵活性和韧性,以在危机期间维持基本医疗服务;获得防控手段则关注医疗对策的研发、生产和供应链保障;应急协调则强调跨层级、跨部门的统一指挥与协调机制。
为确保人人平等地获得预防大流行所需的工具(包括疫苗、个人防护装备、信息和专业知识等技术)以及获得卫生保健服务,2021年底举行的世界卫生大会特别会议成立了政府间谈判机构,旨在根据《世界卫生组织组织法》起草并谈判一项公约、协议或其他国际文书,以加强大流行病的预防、防范和应对。2025年4月16日,政府间谈判机构第十三次会议确定了《世界卫生组织大流行协定》(以下简称《大流行协定》)草案终稿。5月19日,第78届世界卫生大会以124票赞成、0票反对、11票弃权的结果,以投票方式通过了该协定。
《大流行协定》总计35条。其中,第4至第18条主要围绕大流行病的预防、准备、应对及国际合作等核心内容展开,强调了全球团结、公平获取、能力建设和技术支持等关键原则[17]。第4条强调各缔约方应通过国际合作,逐步加强大流行病的预防和监测能力,制定多部门综合计划,涵盖从人兽共患病防控、环境卫生改善到疫苗接种和感染控制等多方面措施,并特别关注抗微生物药物耐药性问题。第5条提出采用“同一健康”方针,推动人类、动物和环境健康的跨部门协作,识别和应对传染病出现的驱动因素,促进联合培训和能力建设。第6条要求各缔约方发展有韧性的卫生系统,特别是初级卫生保健服务,确保在大流行期间能够持续提供基本医疗服务,并加强实验室能力、数据系统和风险沟通机制。第7条关注卫生和照护人员队伍的建设,强调各国应投资、保护和支持一支训练有素、数量充足的卫生人力,特别是在人道主义环境中,并促进全球应急卫生队的协调与部署。第8条提出加强国家监管机构的能力,以加快对大流行相关卫生产品的审批和监管,推动监管信赖机制和国际协调,确保产品质量和安全。第9条强调研发合作的重要性,鼓励各国特别是发展中国家加强研发能力建设,推动信息共享、技术共创和公平获取研究成果,并在公共资助的研发协议中纳入促进公平获取的条款。第10条和第11条聚焦大流行相关卫生产品的可持续和地域多样化生产。第10条鼓励各国支持本地和区域生产设施建设,促进投资和技术转让,提升发展中国家的生产能力。第11条进一步强调通过许可、合作、能力建设等方式,推动技术转让,特别是在大流行期间鼓励制造商以合理条件共享技术和信息,提升全球供应能力。第12条建立“病原体获取和惠益分享系统”,旨在促进具有大流行潜力病原体的材料和序列信息的共享,并确保由此产生的疫苗、治疗药物和诊断工具等惠益能够公平、及时地分配给所有国家,特别是发展中国家。该系统将通过具有法律约束力的合同机制,确保制造商向世卫组织提供一定比例的产出用于全球公共卫生应对。第13条设立全球供应链和物流网络,由世卫组织协调,旨在确保在大流行期间各国能够公平、及时地获取所需卫生产品。该网络将整合采购、储备、分配和物流等功能,特别关注人道主义环境和发展中国家的需求。第14条规范采购和分配行为,鼓励透明披露采购协议条款,推动公平分配机制,避免资源浪费和不必要的储备。第15条倡导“全政府和全社会参与”方针,鼓励各国建立多部门协调机制,推动社区和利益攸关方的广泛参与,增强社会整体应对能力。第16条强调风险沟通和公众意识的重要性,要求各国提供科学、透明的信息,增强公众对防控措施的理解和信任。第17条提出国际合作与支持的具体措施,包括技术转让、能力建设、财政援助和法律支持,特别强调对发展中国家的支持,以实现协定的全球目标。第18条设立资金协调机制,旨在为协定实施提供可持续和可预测的资金支持,推动资源的高效配置和使用,确保各国特别是发展中国家具备应对大流行的能力。
按照《大流行协定》的相关安排,在第78届世界卫生大会审议通过主案文后,世界卫生组织将成立政府间工作组(intergovernmental working group, IGWG),就协定第12条病原体获取和惠益分享系统(pathogen access and benefit-sharing system, PABS)所述附件进行谈判,并成立专家委员会,为上述工作组和缔约方会议提供咨询意见。有关附件的谈判成果将提交第79届世界卫生大会审议,待该附件通过后,与《大流行协定》主案文一起向各成员国开放签署并按程序生效。在《大流行协议》中,PABS被设计为同一制度框架下统筹国家对病原资源的主权、企业的研发激励和产品的全球公共产品属性。当前,国际焦点集中在PABS附件适用范围、数字序列信息适用性、惠益分享的类型与约束力等问题。同时,南北方国家围绕配额优先权、技术转让强制性方面仍存在结构性分歧,与《名古屋议定书》和国内法的衔接问题尚未解决,特别是PABS中如何处理与双边协议的关系,也成为目前国际讨论的焦点。
《大流行协定》的生效履约仍存疑虑。在第78届世界卫生大会中,波兰、意大利、伊朗、俄罗斯、保加利亚、荷兰、以色列、危地马拉、巴拉圭、牙买加、斯洛伐克等11个国家投出了“弃权票”,其中波兰、意大利、荷兰、以色列、斯洛伐克5个高收入国家的弃权体现了发达国家与发展中国家对《大流行协定》的立场分歧,也引发了对未来《大流行协定》生效后履约实施情况的担忧。加之美国、阿根廷退出世界卫生组织,并没有派出代表团参加本次世界卫生大会,更是为《大流行协定》是否真正强化全球卫生安全治理蒙上阴影。在操作层面,多项分析指出,《大流行协定》在“监督、问责”方面明显偏软,资金与技术转让承诺偏原则化,缺乏硬性义务,国家层面的落地能力与政治意愿参差不齐,国家执行碎片化风险加剧。
在后埃博拉和新冠病毒感染疫情的多重冲击下,全球卫生安全治理体系进入了深刻的重构过程。首先,全球南方国家在疫情应对中展现出更强的团结与合作。通过区域组织以及南南合作机制,全球南方国家不仅在物资调配、信息共享和疫情防控经验交流中形成合力,同时也更加积极地在多边平台上争取话语权。例如,非洲国家在新冠病毒疫苗分配问题上联合发声,推动“疫苗知识产权豁免”议题进入世界贸易组织谈判。这表明,全球南方国家正在努力打破在全球健康治理中长期处于“规则接受者”的被动局面,转向更主动的规则参与者和塑造者。与此形成对比的是,全球北方国家在疫情治理中出现了一定程度的分化和弱化。在新冠病毒感染疫情早期,欧盟成员国之间的医疗物资出口限制和边境管控措施一度削弱了区域一体化的凝聚力;美国则宣布退出WHO,加剧了多边治理的分裂。这表明,全球北方国家在公共卫生危机中未能充分发挥应有的领导作用,反而在一定程度上动摇了既有治理秩序的稳定性。与此同时,成员国越来越强调世卫组织决策的透明度与包容性,希望能够更多地参与技术决策过程,避免由少数大国主导的政策倾向。其次,在全球信任体系层面,联合国和WHO面临着民间社会的信任危机。疫情中信息披露的争议、应对措施的迟缓以及疫苗分配的不均,引发了部分公众和媒体对国际组织治理权威和领导力的质疑。
综上所述,面对不断涌现的新发传染病与全球性公共卫生挑战,全球公共卫生安全治理体系需要不断发展与完善,确保全球治理机制能够适应快速变化的全球健康形势与需求。
进一步强化和支持联合国和世界卫生组织等国际组织在全球公共卫生安全治理中的核心地位,赋予其更多的资源和权力,提高其决策的科学性、透明性、公正性和权威性。完善现有区域合作框架,如上合组织、中国–东盟合作机制、金砖国家、二十国集团等在全球卫生领域的合作机制,促进发达国家与发展中国家之间的平等对话与合作,共同应对全球性公共卫生安全威胁。推动区域内国家在疫情监测、防控措施协调、医疗物资共享等方面开展更紧密的合作。建立区域公共卫生应急协调中心,加强区域内信息共享和资源调配,提高区域整体应对疫情的能力。
各国和国际社会应持续加大对公共卫生科技创新的投入,充分利用数字化、人工智能、大数据等技术手段,提升全球公共卫生安全治理的效率和精准度。对接整合已有的全球疫情监测数据平台,实现数据统一,实时、动态的监测和预警。通过数智技术,强化多点触发、多部门合作机制,可以在全球发挥引领作用。利用人工智能技术优化医疗资源配置,提高疫情防控决策的科学性。发展远程医疗和数字健康服务,改善医疗服务可及性,尤其是在偏远地区和资源匮乏地区。
加大对基层医疗卫生机构的投入,改善基层医疗设施和设备条件,提高基层医疗服务水平。加强基层医护人员培训,提升其传染病防控、诊断和治疗能力,使其能够在疫情早期发现和处理病例,发挥基层医疗卫生机构在公共卫生应急中的“哨点”作用。提升应急响应与科研能力,制定和完善公共卫生应急预案,定期组织应急演练,提高各国在疫情发生时的应急响应速度和协同作战能力。加强公共卫生科研能力建设,培养高素质的公共卫生科研人才,提高科研成果转化效率,为疫情防控提供科学技术支撑。加大对公共卫生科研项目的资助力度,鼓励科研人员开展前沿研究。
卫生行政及疾控部门应持续加强与农业、交通、教育等部门的合作,以及与私营部门、非政府组织和民间社会的合作。通过这种跨领域合作,更全面地识别和应对公共卫生安全威胁,提高政策的协调性和有效性[18]。例如,农业部门在动物疫病防控方面的工作有助于减少人兽共患病的传播风险,交通部门在疫情期间的人员流动管控措施对控制疫情扩散起到了重要作用。对于新通过的《大流行协定》,其范畴更加广阔,涉及大流行预防、监测、发现、评估、通报、应对、大流行合作、惠益分享、疫苗药物等多个环节,特别是生物标本和信息惠益分享、药品研发、知识产权转让等范畴。《大流行协定》履约还有一定时间,亟需以此为契机,建立跨部门协调的履约机制,保障大流行协定实施后的履约工作。
各国应结合本国实际情况,制定系统性的国家公共卫生安全战略规划,并将其核心目标与措施纳入国家整体发展战略,以实现公共卫生安全与经济社会发展目标的协同推进。在参与全球公共卫生安全治理方面,各国需在政策协调、资源分配和项目实施等环节加强国际合作,持续支持世界卫生组织等国际机构发挥核心作用,共同完善全球公共卫生治理体系。在此基础上,需着力构建全球治理与国家治理之间的联动协调机制。这包括推动国内传染病防治法规与国际卫生条例、《大流行协定》等国际规范有效衔接,促进法规体系的一致性。同时,应建立重点国家间的物资储备共享、技术交流与联合研发机制,并通过有针对性的对外援助支持,强化全球公共卫生安全的整体韧性。

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2026年第42卷第5期
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doi: 10.11847/zgggws1149238
  • 接收时间:2025-11-03
  • 首发时间:2026-10-23
  • 出版时间:2026-05-10
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  • 收稿日期:2025-11-03
  • 修回日期:2026-01-06
  • 录用日期:2026-03-07
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    1北京大学中国卫生发展研究中心,北京 100191
    2北京大学首都卫生与健康发展研究院,北京 100191
    3国家卫生健康委员会卫生体系改革与治理研究重点实验室(北京大学),北京 100191
    4北京大学公共卫生学院全球卫生学系,北京 100191

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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