小 结
艾滋病问题已经成为全球化时代最为严峻的挑战之一。它是一个无法从医学上彻底解决的难题,而且在疫情初期,各国政府、社会中普遍存在着偏见而错失了积极应对的最佳时机。它在很短的时间内便波及世界各国,并进一步成为全球性的公害问题。在国家层面,严重的艾滋病传播阻碍了国家为公民提供安全保障、维持社会经济事务正常运转的功能,并通过破坏教育与正常的政治秩序腐蚀公民对于国家权威的认同。在国际层面,它则增加了战争的风险,并损害国际共同体的生存与发展。而且,对这一问题的处理不善将进一步加剧南北矛盾,妨碍最基本的国际正义的实现。客观地说,艾滋病传播的确是国家与国际社会必须正视的安全威胁。
在艾滋病传播的应对上,已经有一些国家采取了积极的措施,有效地遏制了疾病的进一步蔓延。而且,国际社会也已经在一定程度上组织起来,通过多边合作的方式共同应对威胁。但是,必须注意到,在发展中国家中,仅仅依靠一己之力成功应对艾滋病传播的国家只是少数,而以全球艾滋病计划与联合国艾滋病规划署为代表的国际多边合作取得的成绩也仅仅是初步的。消除艾滋病传播这一国家与国际安全威胁可谓任重而道远。
在这一场与疾病的较量中,在很长时期内,发达国家采取了孤立的视角看待这一问题,把帮助发展中国家应对艾滋病当作不涉及本国直接利益的“慈善事业”,贡献相当有限。为了真正行动起来,抵御这一国际安全威胁,发达国家必须承担更大的责任。
【注释】
[1]余凤高:《瘟疫的文化史》,北京:新星出版社,2004年版,第200—201页。
[2]Laurie Garrett,HIV and National Security:Where are the Links?,2005,p.9,http://www.cfr.org/content/publications/attachments/HIV_National_Security.pdf.
[3]苏珊·桑塔格:《疾病的隐喻》,程巍译,上海:上海译文出版社,2003年版,第5页。
[4]贾雷德·戴蒙德:《枪炮、病菌与钢铁:人类社会的命运》,谢延光译,上海:上海译文出版社,2000年版,第203页。
[5]由于HIV本身包含的遗传物质是RNA而不是DNA,需要利用被其入侵的细胞,把RNA转变为DNA,以完成自身复制和遗传的过程,RNA变成DNA的这一过程被称为逆转录。所谓抗逆转录病毒药物,主要是一些合成DNA的原料类似物,它能在逆转录过程中“蒙混过关”、渗入新合成病毒的DNA中,通过破坏病毒的遗传物质而抑制病毒复制。
[6]Matthias Egger,“Morality of HIV-1-infected patients in the first year of antiretroviral therapy:comparison between low-income and high-income countries,”The Lancet,Vol.367,Issue 9513,2006,pp.817—824.
[7]见http://www.pbs.org/newshour/bb/health/july-dec99/aids_8-31.html。
[8]Tony Barnett,“A long-wave event:HIV/AIDS,Politics,Governance and‘security’:Sundering the Intergenerational Bond?”International Affairs,Vol.82,Issue 2,2006,p.298.
[9]Alok Jha,“We may never find vaccine for AIDS,says Nobel winner,”The Guardian,15 February,2008,http://www.guardian.co.uk/world/2008/feb/15/aids.medicalresearch.
[10]PBS,“Finding a Cure:Is an AIDS Vaccine Out of Reach?”http://www.pbs.org/wgbh/pages/frontline/aids/virus/vaccines.html.
[11]世界银行:《正视艾滋病——针对这一全球流行病的公共政策重点》,牛津:牛津大学出版社,1997年版,第51页。
[12]“Saving Lives:The Deadly Intersection of AIDS and Hunger,”108th Senate Hearings before the Committee on Foreign Relations,May11,2004,http://www.wfp.org/content/saving-lives-deadly-intersection-aids-and-hunger-testimony-senate-foreign-relationscommittee-united.
[13]见PBS,“AIDS in Africa,”http://www.pbs.org/newshour/bb/health/july-dec00/aids_7-13.html。
[14]约瑟夫·麦科明克、苏珊·费雪贺区:《第四级病毒——一对病毒学家与致命病毒的战争》,广东:汕头大学出版社,2004年版,第168—169页。
[15]Ronald Reagan,“The President's News Conference,”September17,1985,http://www.presidency.ucsb.edu/ws/index.php?pid=39125&st=news+conference&st1=.
[16]里根总统夫妇的撰稿人兰登·帕维(Landon Parvin)认为,总统之所以出席会议并发表演讲,并非出于对艾滋病问题的重视,而是由于泰勒的个人邀请。见http://www.pbs.org/wgbh/pages/frontline/aids/interviews/parvin.html。
[17]PBS,“The Age of AIDS”.
[18]阿维德·辛文德、埃弗雷特·罗杰斯:《直面艾滋病:媒体传播策略和安全套总动员》,王黎译,上海:上海科学技术出版社,2006年版,第46页。
[19]Elizabeth Fee,Manon Parry,“Jonathan Mann,HIV/AIDS,and Human Rights,”Journal of Public Health Policy,Vol.29,No.1,2008,pp.54—56.
[20]Andrew T.Price-Smith,Matthew Tubin,Robert L.Ostergard,Jr.,“The Decay of State Capacity:HIV/AIDSand South Africa's National Security,”in Robert L.Ostergard,Jr. ed.,HIV/AIDSand the Threats to National and International Security,Great Britain:PALGRAVE MACMILLAN,2007,p.242.
[21]罗尔·范德·维恩:《非洲怎么了——解读一个富饶而贫困的大陆》,赵自勇、张庆海译,广州:广东人民出版社,2009年版,第236页。
[22]Catherine Boone and Jake Batsell,“Politics and AIDSin Africa:Research Agendas in Political Science and International Relations,”in Robert L.Ostergard,Jr.ed.,HIV/AIDS and the Threats to National and International Security,p.10.
[23]见“Libya President Kadhafi calls AIDSa‘peaceful virus’defending Africa against recolonization,”July12,2003,http://www.freerepublic.com/focus/f-news/944970/posts。
[24]苏珊·桑塔格:《疾病的隐喻》,第101页。
[25]杨玲、朱雅雯、李建升:《艾滋病污名研究评述》,《西北师大学报》(社会科学版),2007年第7期,第61页。
[26]阿维德·辛文德、埃弗雷特·罗杰斯:《直面艾滋病、媒体传播策略和安全套总动员》,第155页。
[27]阿瑟·克莱曼:《道德的力量:在无常和危机前》,方丽译,上海:上海译文出版社,2008年版,第54页。
[28]Mark Schneider and Michael Moodie,The Destablilizing Impacts of HIV/AIDS,Washington,D.C.:the Center for Strategic and International Studies,2002,pp.9—11.
[29]陆忠伟编:《非传统安全论》,第410页。
[30]UNAIDS,“Fact sheet:Key facts by region—2007 AIDS Epidemic Update,”http://data.unaids.org/pub/EPISlides/2007/071118_epi_regional%20factsheet_en.pdf.
[31]UNAIDS,“Fact sheet:Key facts by region—2007 AIDS Epidemic Update,”
http://data.unaids.org/pub/EPISlides/2007/071118_epi_regional%20factsheet_en.pdf.
[32]戴维·赫尔德、安东尼·麦克格鲁编:《治理全球化:权力、权威与全球治理》,第142页。
[33]见《博茨瓦纳经济概况》,http://www.liuxue.net/special/2004visa/world/economy/bw.html。
[34]Jeremy Youde,“HIV/AIDSand Democratic Legitimacy and Stability in Africa,”in Robert L.Ostergard,Jr.ed.,HIV/AIDSand the Threats to National and International Security,p.208.
[35]Andrew T.Price-Smith,Matthew Tubin,Robert L.Ostergard,Jr.,“The Decay of State Capacity:HIV/AIDSand South Africa's National Security,”in Robert L.Ostergard,Jr. ed.,HIV/AIDSand the Threats to National and International Security,p.242.
[36]世界银行:《正视艾滋病——针对这一全球流行病的公共政策重点》,第18页。
[37]约瑟夫·麦科明克、苏珊·费雪贺区:《第四级病毒——一对病毒学家与致命病毒的战争》,第161页。
[38]J.Stephen Morrison,“The Africa pandemic hits Washington,”The Washington Quarterly,Winter,2000,p.199.
[39]见PBS,“AIDSin America”。
[40]南娜·波库:《全球性传染病:艾滋病》,第156页。
[41]Nana K.Poku,“HIV/AIDS financing:a case for improving the quality and quantity of aid,”International Affairs,Vol.82,Issue 2,2006,p.346.
[42]联合国经济和社会事务部:《艾滋病的影响》,http://www.un.org/esa/population/publications/AIDSimpact/21_EXEC_SUMMARY_Chinese.pdf。
[43]Jennifer Brower and Peter Chalk,The Global Threat of New and Reemerging Infectious Diseases:Reconciling U.S.National Security and Public Health Policy,Arlington:RAND,2003,p.46.
[44]Mark Schneider and Michael Moodie,The Destablilizing Impacts of HIV/AIDS,Washington,D.C.:the Center for Strategic and International Studies,2002,p.6.
[45]孙茹:《国际反艾滋病斗争——联合国艾滋病特别会议》,《国际资料信息》,2001年第9期,第11页。
[46]Stefan Elbe,“HIV/AIDS and the Changing Landscape of War in Africa,”International Security,Vol.27,No.2,2002,p.163.
[47]UNAIDS,AIDS and the Military,1998,p.3,http://www.aegis.org/news/ips/2000/IP000102.html.
[48]Sarin Radhika,“A New Security Threat:HIV/AIDS in the Military,”World Watch,Vol.16,Issue 2,2003,pp.16—23.
[49]Brazza Ville,“Health-Congo:AIDS The Number One Cause of Death in the Army,”Jan.10,2000,http://www.aegis.org/news/ips/2000/IP000102.html.
[50]UNAIDS,AIDSand the Military,p.7.
[51]USAID,“President's Emergency Plan for AIDS Relief 2008 Country Profile for Cote D'lovire,”http://www.usaid.gov/our_work/global_health/aids/Countries/africa/cotedivoire.html.
[52]联合国经济和社会事务部:《艾滋病的影响》。
[53]津巴布韦总统穆加贝承认其政府内三名内阁级别的部长死于艾滋病。见Robert L.Ostergard,Jr.,“Politics in the hot zone:AIDS and national security in Africa,”Third World Quarterly,Vol.23,No.2,2002,p.341。(https://www.daowen.com)
[54]Nana K.Poku and Alan Whiteide,“25 years of living with HIV/AIDS:challenges and prospects,”International Affairs,Vol.82,Issue 2,2006,p.252.
[55]Richard A.Fredland,“AIDSand Development:An Inverse Correlation?”The Journal of Modern African Studies,Vol.39,No.3,1998,pp.411—436.
[56]Tony Barnett,“HIV/AIDS,Politics,Governance and‘Security’:Sundering the Intergenerational Bond?”p.309.
[57]Ibid.,p.310.
[58]Robert L.Ostergard,Jr.,“Politics in the hot zone:AIDS and national security in Africa,”p.342.
[59]Andrew T.Price-Smith,Matthew Tubin and Robert L.Ostergard,Jr.,“The Decay of State Capacity:HIV/AIDSand South Africa's National Security,”pp.245—246.
[60]Dan Caldwell,Robert E.Williams,Jr.,Seeking Security in an Insecure World,p.81.
[61]恺蒂:《南非之南》,上海:上海书店出版社,2009年版,第154—155页。
[62]朱炎:《二十五载,全球抗艾——从医学问题到政治问题》,《南风窗》,2006年第8期下,第49页。
[63]罗伯特·基欧汉、约瑟夫·奈:《权力与相互依赖》,第9—10页。
[64]John Gerard Ruggie,“Reconstituting the Global Public Domain:Issues,Actors,and Practices,”pp.516—517.
[65]斯蒂芬·范·埃弗拉:《战争的原因》,何曜译,上海:上海人民出版社,2007年版,第141页。
[66]International Crisis Group,HIV/AIDS as a Security Issue,2001,p.21,http://www.crisisgroup.org/library/documents/report_archive/A400321_19062001.pdf.
[67]International Crisis Group,HIV/AIDS as a Security Issue,2001,p.21,http://www.crisisgroup.org/library/documents/report_archive/A400321_19062001.pdf.
[68]斯蒂芬·范·埃弗拉:《战争的原因》,第146页。
[69]Margaret Owen,“Widows Expose HIV War Threat,”Worldwoman News,June12,2001,p.1.
[70]Stefan Elbe,“HIV/AIDSand the Changing Landscape of War in Africa,”pp.167—171.
[71]Sarin Radhika,“A New Security Threat:HIV/AIDSin the Military,”pp.16—23.
[72]Sarin Radhika,“A New Security Threat:HIV/AIDSin the Military,”pp.16—23.
[73]Buane Bratt,“Blue Condoms:the Use of International Peacekeepers in the Fight against AIDS,”International Peacekeeping,Vol.9,No.3,2002,p.75.
[74]Buane Bratt,“Blue Condoms:the Use of International Peacekeepers in the Fight against AIDS,”p.75.
[75]孙茹:《国际反艾滋病斗争——联合国艾滋病特别会议》,第11页。
[76]苏珊·桑塔格:《疾病的隐喻》,第125页。
[77]Dan Caldwell,Robert E.Williams Jr.,Seeking Security in an Insecure World,p.85.
[78]恺蒂:《南非之南》,第143—144页。
[79]Catherine Boone and Jake Batsell,“Politics and AIDSin Africa:Research Agendas in Political Science and International Relations,”in Robert L.Ostergard,Jr.ed.,HIV/AIDS and the Threats to National and International Security,p.23.
[80]Amir Attaran,Jeffrey Sacks,“Defining and Refining International Donor Support for Combating the AIDSPandemic,”The Lancet,Vol.357,Issue.9249,2001,p.57.
[81]Joshua William Busby,“From Benign Neglect to Moral Awakening:Donor Responses to HIV/AIDS,”2006,p.5,http://www.princeton.edu/pai/events/past-events/spring-2006/05-05-06/aids-busby.pdf.
[82]Sarin Radhika,“A New Security Threat:HIV/AIDSin the Military,”pp.16—23.
[83]阿维德·辛文德、埃弗雷特·罗杰斯:《直面艾滋病:媒体传播策略和安全套总动员》,第54页。
[84]阿维德·辛文德、埃弗雷特·罗杰斯:《直面艾滋病:媒体传播策略和安全套总动员》,第21页。
[85]Catherine Boone and Jake Batsell,“Politics and AIDSin Africa:Research Agendas in Political Science and International Relations,”p.9.
[86]Ernest W.Lefever,“AIDS,Aid,and Africa”,http://www.weeklystandard.com/content/public/articles/000/000/013/536ledfn.asp?pg=2.
[87]“Ron Dellums,AIDS Activist”,http://www.thebody.com/content/art30687.html #dellums.
[88]Catherine Boone and Jake Batsell,“Politics and AIDSin Africa:Research Agendas in Political Science and International Relations,”p.9.
[89]《莱恩·怀特关怀法案》,法案号Pub.L.101—381,是美国规模最大的艾滋病毒感染者关怀项目。该法案名称是为了纪念死于艾滋病的印第安男孩莱恩·怀特。1984年,他经输血途径感染上艾滋病毒,因此被逐出学校。怀特及其父母开始了艰苦的维权之路,在这一过程中成为家喻户晓的艾滋病问题活动家。1990年4月,年仅18岁的怀特去世,包括当时第一夫人芭芭拉·布什在内的许多社会名流出席了他的葬礼。见Dirk Johnson,“Ryan White Dies of AIDS at18:His Struggle Helped Pierce Myths,”http://www.nytimes.com/1990/04/09/obituaries/ryan-white-dies-of-aids-at-18-his-struggle-helped-pierce-myths.html?pagewanted=2。
[90]阿维德·辛文德、埃弗雷特·罗杰斯:《直面艾滋病:媒体传播策略和安全套总动员》,第68—74页。
[91]Darren K.Carlson,“AIDS Ranks Third Among American's Most Urgent Health Problems,”http://www.gallup.com/poll/4543/AIDS-Ranks-Third-Among-Americans-Most-Urgent-Health-Problems.aspx.
[92]Hankan Seckinelgin,International Politics of HIV/AIDS:Global disease-local pain,New York:Routledge,2008,p.24.
[93]Ann Gibbons,“New Head of the WHO Global Program on AIDS,”Science,Vol. 248,No.4961,1990,p.1306.
[94]PBS,“The Age of AIDS”.
[95]戴维·赫尔德、安东尼·麦克格鲁编:《治理全球化:权力、权威与全球治理》,第146页。
[96]Michael E.Samuels,Jonathan Mann,C.Everett Koop,“Containing the Spread of HIV Infection:A World Health Priority,”Public Health Reports,Vol.103,No.3,1988,p.222.
[97]见“Peter Piot Interview,”http://www.pbs.org/wgbh/pages/frontline/aids/interviews/piot.html。
[98]刘云凯、刘茂凰、吕智军编译:《2002年全球艾滋病流行状况》,《口岸卫生控制》,2003年第3期,第42页。
[99]Wolfgang Hein,Sojia Bartsch and Lars Kohlmorgen,eds.,Global Health Governance and the Fight against HIV/AIDS,New York:PALGRAVE MACMILLAN,2007,p.139.
[100]联合国网站:“联合国推动抗击艾滋病的‘三个一协议’”,http://www.un.org/chinese/News/fullstorynews.asp?newsID=1524。
[101]Buane Bratt,“Blue Condoms:the Use of International Peacekeepers in the Fight against AIDS,”pp.76—77.
[102]Wolfgang Hein,Sojia Bartsch and Lars Kohlmorgen,eds.,Global Health Governance and the Fight against HIV/AIDS,pp.129—130.
[103]Jonathan Mann and Daniel Tarantola,“Responding to HIV/AIDS:A Historical Perspective,Health and Human Rights,Vol.2,No.4,1998,pp.5—6.
[104]阿瑟·克莱曼:《道德的力量:在无常和危机前》,第145页。
[105]Hakan Seckinelgin,International Politics of HIV/AIDS:Global Diseases—Local Pain,p.26.
[106]Tarantola Daneil and Gruskin Sofia,“Jonathan Mann:Founder of the Health and Human Rights Movement,”American Journal of Public Health,Vol.96,No.11,2006,p.1942.
[107]见“Peter Piot Interview,”http://www.pbs.org/wgbh/pages/frontline/aids/interviews/piot.html。
[108]Amir Attaran and Jeffrey Sachs,“Defining and Refining International Donor Support for Combating the AIDS Pandemic,”Lancet,Vol.357,2001,p.57,p.59.
[109]Wolfgang Hein,Sojia Bartsch and Lars Kohlmorgen,eds.,Global Health Governance and the Fight against HIV/AIDS,New York:PALGRAVE MACMILLAN,2007,p.126.
[110]Hakan Seckinelgin,International Politics of HIV/AIDS:Global Diseases—Local Pain,p.30.