区域公共产品与东亚卫生合作（2002-2009）

【作者】 陈霞；

【导师】 樊勇明；

【作者基本信息】 复旦大学 ， 国际政治， 2010， 博士

【摘要】 2002-2003年爆发的SARS危机深刻揭示了传染病在全球化背景下的巨大威力。这场危机已经过去7年,但是艾滋病、高致病性禽流感、甲型H1N1流感等各类新发和复发传染病依旧在不断威胁着人类的健康与安全,也在悄然影响着国家间的政治经济交往。公共卫生正在日益成为影响国际关系的一个重要变量。东亚是受SARS危机打击最严重的地区。危机意识薄弱,公共卫生水平低下,国家间协调与合作不力,都加重了东亚地区在面对公共卫生危机时的脆弱性。不过,与1997年金融危机不同的是,东亚国家在危机期间就迅速达成一致,主要依靠域内国家的通力合作成功抵御了这场危机。东亚卫生合作正是从SARS危机期间建立区域联防联控机制起步的。这一案例为研究区域公共产品的有效供给对地区稳定与繁荣的作用,以及区域公共产品与地区合作和地区一体化的关系提供了生动的素材和启发性的思考。区域公共产品理论是研究和解释地区合作和地区一体化趋势的一个新的理论视角。在国际公共产品供给不足的情况下,由域内国家联合起来对适用于本地区、服务于本地区的相关区域公共产品进行筹措、融资和管理的做法,将是今后国际关系中的一大趋势。区域公共产品的政策含义在于,国家可以通过为公共产品承担一定的成本而不是“搭便车”的做法,来分享地区机制建设的收益。参与区域公共产品的供给,推动地区合作,对东亚国家来说同样具有吸引力。不过,东亚合作过程中所面临的政治安全因素、价值认同因素和域外因素这三大障碍决定了东亚区域公共产品的供给不是市场内在的需求,与欧盟和北美自由贸易区相比,由危机推动东亚区域公共产品供给的特征十分明显。因此,东亚一体化复制欧盟从自由贸易区、关税同盟、共同市场、经济与货币联盟到完全经济一体化的“五段论模式”是不现实的。东亚合作必须寻找新的突破点。从公共卫生入手扩充东亚的区域公共产品是一个新思路。公共卫生是一个充满善意的领域,它关乎健康、生存、安全的人类共同价值,在这个非政治、非传统、非典型的领域里提供区域公共产品可以降低东亚国家间合作的壁垒与成本,培养信任基础,为进一步扩大合作机制摸索探路。从这个意义上说,在公共卫生领域提供区域公共产品对东亚合作和一体化具有先导作用。本文的论述就是从理论和事实两个方面来证明,卫生公共产品的供给能够对地区政治和经济产生积极的外部收益,以卫生合作为突破口,是推动东亚走向全面合作的有效路径。对中国的地区战略来说,同样也必须重视公共卫生。中国外交在SARS危机期间的得失对比恰恰证明,为区域卫生公共产品做贡献更容易赢得邻国的尊重。中国的“地区大国责任”如何以更令邻国信服的、放心的、欢迎的方式来体现,这是对中国外交智慧的考验。本文最后的观点是,积极主动地提供区域公共产品是中国为地区做贡献的主要途径,公共卫生尽管不是中国外交战略的重点,但却应当成为中国区域公共产品供给中的优先序列对象。东亚卫生合作的时间并不长,区域卫生公共产品的成果有限。因此,本文从区域公共产品的角度切入对东亚卫生合作的研究,很大程度上是探索性、启发性和思考性的。无论如何,公共卫生是一个值得在理论和实践中引起重视的新领域。更多还原

【Abstract】 The outbreak of SARS crisis in 2002-2003 convincingly demonstrated how destructive an infectious disease could become in a globalizing world. Today, almost seven years after SARS burst onto the pages of medical history, AIDS, H5N1 avian influenza, H1N1 flu and other kinds of newly emerging or reemerging infectious diseases continue to wreak havoc on public health and safety, and are subtly affecting political and economic relations among countries. Public health has thus become an increasingly important factor in international relations.East Asia was most severely affected by SARS. Relaxed vigilance against potential crises, inadequate public health services and poor regional coordination and cooperation increased the vulnerability of East Asia to a public health crisis. As opposed to their behaviors during the financial crisis in 1997, however, East Asian countries promptly reached a consensus on fighting SARS, cooperated closely with each other and finally prevailed. It was from the war on SARS that East Asian countries began to cooperate on public health issues by establishing a regional crisis prevention and management regime. The SARS crisis is inspiring in the sense that it is a vivid example of how effective supplies of regional public goods can impact on regional stability and prosperity and promote regional cooperation and integration.The theory of regional public goods is a new perspective in the study and interpretation of the trends towards regional cooperation and integration. In the context of inadequate supplies of international public goods, it will become more and more common that regional countries supply, finance and manage supplementary public goods for the benefit of the region. One of the policy implications of supplying regional public goods is that a country can benefit from the regional regime by bearing certain costs in the supply of regional public goods rather than by acting as a "free rider". This strategy is also attractive to East Asian countries.However, political and security considerations, value conflicts and external factors are all barriers to the regional cooperation in East Asia. Accordingly, there is no inherent demand for regional-public goods. As opposed to the situations in EU and NAFTA, the supply of regional public goods in East Asia is always driven by an urgent need to handle a crisis. Therefore, while EU has developed step by step from a free trade area, customs union, common market, economic and monetary union to full economic integration, it is unrealistic for East Asia to follow suit. New modes are required for the regional integration of East Asia.Supplying more regional public goods in East Asia by focusing on public health issues is one such mode. Public health is a field for the common good, incorporating such universal values as improving survival, promoting health and ensuring security for the human beings. In this non-political, non-traditional and non-typical field, supplying regional public goods can help eliminate barriers to and reduce costs of cooperation, build up trust and explore ways to promote cooperation in Ease Asia. In this sense, supplying regional public goods for health will pave the way for cooperation and integration in East Asia. This paper, therefore, is aimed at proving that supplying regional public goods for health is beneficial to regional political and economic development, and health cooperation can effectively promote cooperation in East Asia.Appreciating the importance of public health is also critical to China’s regional strategy. China’s foreign relations during the SARS crisis demonstrated that making contributions to regional public goods for health would more likely help China win respect from neighboring countries. As a regional big power, China must respond to the challenge as to how to carry out its responsibilities in an assuring way that will be welcomed by its neighbors. This paper concludes that affirmatively and actively supplying regional public goods is a major way through which China can contribute to the regional welfare. Although public health is not a key issue in China’s foreign relations strategies, it should become one of China’s priorities in supplying regional public goods.Health cooperation in East Asia is new to the region, with only modest achievements so far. Therefore, this paper is only a preliminary study on the health cooperation in East Asia from the perspective of regional public goods. Nevertheless, public health is a new issue worthy of more extensive intellectual exploration.更多还原