世界卫生组织的建立与职能:功能主义视角

Hangyu Ko, Chang-yup Kim
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摘要

世界卫生组织(WHO)自1948年成立以来,以“能达到的最高健康”为目标,尝试并推动了公共卫生领域的国际合作,取得了天花、小儿麻痹症等疾病的根除等成果,成为国际公共卫生的代表。然而,在冷战时期,成员国之间存在分歧,世卫组织的地位在其成立后经历了起起落落。卫生组织作为具有代表性的国际卫生组织,也没有摆脱国际制度变化的影响,这意味着应进一步扩大关于卫生组织运作的内因的讨论。在本研究中,功能主义作为一种试图解释世界卫生组织的建立和作用的国际关系理论进行了检验。特别地,本研究运用Imber的五步骤理论,按时间顺序排列Mitrany的理论,分析了WHO所面临的问题和解决问题的过程。我们主要调查了二手资料,从世卫组织成立期间的作用和职能、冷战时期以及国际公共卫生合作等方面描述了世卫组织兴衰的历史事实。通过选取世界卫生组织在后冷战时期取得的成果,分析了世界卫生组织的作用。Imber的功能主义安排在一定程度上解释了WHO的成立和作用。第一步是1851年的国际卫生会议,使各国认识到公共卫生的国际合作。第二步是建立了世界卫生组织,作为一个国际组织处理公共卫生。《烟草控制框架公约》和国际卫生条例最近的案例表明,每个国家都同意一项国际准则,即它们必须相互合作,以解决传染病和吸烟问题,这意味着这些都是全球治理的出现。这一过程是Imber理论的第三步(各国从国际合作中获益,同意国际组织权威的扩大)。然而,理论的最后两个步骤仍然没有实现。世卫组织的部分成功是基于世卫组织处理非政治因素的职能要素、以专业人员为中心的人力资源和民主决策程序。这种本质和非政治性的特点意味着,尽管全球卫生治理面临更多挑战,但在全球治理时代,世卫组织推动国际合作的必要性仍将继续存在。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Establishment and Functions of World Health Organization: With a Functionalism Perspective
Since its establishment in 1948, World Health Organization (WHO) has tried and facilitated international cooperation of public health under the goal of "the highest attainable health," and gained outcomes like the eradication of smallpox and polio, turning itself into the representative of international public health. However, there was discord between member nations during the cold war era, and the status of WHO experienced rise and fall after its establishment. WHO, the representative international health organization, also has not been freed from influences from international regime changes, which means that the discussion on the internal causes of WHO functionings should be expanded more. In this study, functionalism was tested as one of international relations theory that tries to explain the establishment and role of WHO. Especially, this study analyzed the problems and problem-solving process that WHO had to face by using Imber`s five steps theory that arranged chronologically the theory of Mitrany. We mainly investigated the secondary source that described historic facts on the rise and fall of WHO in terms of roles and functionings during establishment of WHO, the cold war era, and international cooperation of public health. The roles of WHO were analyzed by selecting the gains of WHO in the post cold war era. The functionalism arrangement of Imber was appropriate to some extent in explaining the establishment and role of WHO. The first step was International Sanitary Conference in 1851 that made nations to recognize international cooperation of public health, and the second step was the establishment of WHO that handles public health as an international organization. Recent cases of the Framework Convention on Tobacco Control and International Health Regulations showed that each nation agreed with an international norm that they had to cooperate each other to tackle infectious diseases and smoking, and this implies that these were emergence of global governance. This process was the third step of Imber`s theory (nations had a gain from international cooperation would agree with the expansion of authority of international organization). However, the last two steps of the theory are still not realized. The partial success of WHO was based on the functional elements that WHO deals with non-political elements, human resources centering on professionals, and democratic decision making process. This essential and non-political characteristics mean that necessity of international cooperation catalyzed by WHO would continue despite of the global governance era when global health governance get faced more challenges.
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