小 结
以上的分析表明，尽管艾滋病传播对国家安全与国际安全造成威胁是客观事实，但在美国的政策议程中，它却是经过了“安全化”的过程才被真正当作安全事务来处理的。美国在这一阶段关注的重点是疾病传播对于国际安全造成的威胁，这与其国家的整体安全战略是相互契合的。可以看到，在美国国内进行的政策讨论中，具有如下三个特点：第一，认为艾滋病传播造成的威胁不受边界的制约；第二，认为为了有效地应对威胁，将各国组织起来进行集体行动将是必要的；第三，重视国际组织以及多边合作的方式在组织集体行动方面的优势。而在政策准备的过程中，美国则更为偏重国际层面的协调。这几个特点决定，多边合作将是美国主要的政策选择。
在具体的合作政策上，美国不仅利用现有的多边组织，更是倡议成立了新的全球多边机制。通过对多边手段的利用，美国将艾滋病问题融合进传统的国际安全议程中，并动员国际社会为应对这一威胁付出更大的努力。而美国政府对原先奉行的贸易至上政策的修正，事实上强化了发展中国家应对艾滋病问题的力量，为更好地应对这一新的国际安全问题创造了条件。
但与此同时，也应当看到，美国对于多边主义的理解与应用已经超越了二战后期以主权国家为主体的多边主义形式了。在全球问题的解决上，美国认识到与私人部门以及非政府组织合作是必不可少的手段，“公—私伙伴关系”可以说是这种“新多边主义”的重要特征之一。与此同时，作为这一冷战后唯一的超级大国，美国也长于利用本国的实力优势影响多边机制的设计，使其能够更好地掌握在自己手中。
【注释】
[1]Kimberly A.Hamilton ed.，Global HIV/AIDS：A Strategy for U.S.Leadership：A Consensus Report of the CSISWorking Group on Global HIV/AIDS，Washington，D.C.：Center for Strategic and International Studies，1994，p.2.
[2]The White House，A National Security Strategy for a New Century，1997，p.28；The White House，A National Security Strategy for a New Century，1998，p.33.
[3]J.Stephen Morrison，“The African Pandemic Hits Washington，”The Washington Quarterly，Vol.24，Issue.1，2001，p.199.
[4]罗伯特·古丁、汉斯 迪特尔·克林格曼编：《政治科学新手册》（上册），钟开斌等译，北京：三联书店，2006年版，第664页。
[5]Robert L.Otergard，Jr.，“Politics in the Hot Zone：AIDS and National Security in Africa，”p.339.
[6]Ole R.Holsti，Making American Foreign Policy，New York：Routledge，2006，p.242.
[7]“Why Investing Global Health is Good Politics，”http://www.globalhealth.org/news/article/231.
[8]“U.S.Pledges More to AIDS Fight，”http://www.cbsnews.com/stories/1998/12/01/national/main23943.shtml.
[9]Kaiser Family Foundation，“American Views on the AIDS Crisis in Africa：A National Survey，”http://www.kff.org/hivaids/loader.cfm？url=/commonspot/security/getfile. cfm&Page ID=13514.
[10]Paula J.Dobriansky，“U.S.Role in Global AIDSStruggle，”http://www.aidsresponsibility.org/efforts/display＿efforts.cfm？ID=-2090071784.
[11]“Ron Dellums，AIDS Activist，”http://www.thebody.com/content/art30687.html ＃dellums.
[12]Stewart Patrick and Shepard Forman，Multilateralism and U.S.Foreign Policy：Ambivalent Engagement，p.80.
[13]J.Stephen Morrison，“The African Pandemic Hits Washington，”p.201.
[14]Gwyn Prins，“AIDS and Global Security，”International Affairs，Vol.80，Issue.5，2004，p.491；“Halting the Spread of HIV/AIDS：Future Efforts in the U.S.Bilateral and Multilateral Response，”107 Senate Hearings，Feb.13—14，2002，http://frwebgate.access. gpo.gov/cgi-bin/getdoc.cgi？dbname=107＿senate＿hearings&docid=f：77846.wais.
[15]House of Representatives，“Infectious Diseases：A Growing Threat to America's Health and Security，”Hearing before Committee on International Relations，June 29，2000，p.9，http://www.gpo.gov/fdsys/pkg/CHRG-106hhrg67067/html/CHRG-106hhrg67067.htm.
[16]The Department of State，United States Strategic Plan for International Affairs，1999，p.42，http://www.springerlink.com/content/1ql4474240341556/.
[17]The White House，A National Security Strategy for a New Century，1999，p.3，http://www.dtic.mil/doctrine/jel/other＿pubs/nssr99.pdf.
[18]The White House，A National Security Strategy for a Global Age，2000，pp.20—21，http://www.bits.de/NRANEU/others/strategy/nss-0012.pdf.
[19]House of Representatives，“Infectious Diseases：A Growing Threat to America's Health and Security，”p.35.
[20]National Intelligence Estimate，The Global Infectious Disease Threat and Its Implications for the United States，2000，http://ftp.fas.org/irp/threat/nie99-17d.htm.
[21]Sandra Thurman，“Testimony before U.S.House of Representatives，Committee on Banking and Financial Services，”March 8，2000，http://commdocs.house.gov/committees/bank/hba63311.000/hba63311＿0.HTM＃23.
[22]House of Representatives，“Infectious Diseases：A Growing Threat to America's Health and Security，”Hearing before the Committee on International Relations，June 29，2000，p.7，http://ftp.resource.org/gpo.gov/hearings/106h/67067.pdf.
[23]Sandra Thurman，“Written Testimony Submitted to the Senate Committee on Foreign Relations Subcommittee on African Affairs，”February 24，2000，http://clinton4.nara. gov/ONAP/pub/african-affairs.html.
[24]Timothy Geithner，“Testimony before the House Committee on Banking and Financial Services，”March 8，2000，http://www.ustreas.gov/press/releases/ls442.htm.
[25]House of Representatives，“Infectious Diseases：A Growing Threat to America's Health and Security，”p.7.
[26]Ibid.，p.10.
[27]Lisa Richwine，“U.S.Calls Spread of AIDS Globally a Security Threat，”Boston Global，May1，2000，p.A12.
[28]Barton Gellman，“AIDS Is Declared Threat to US National Security，”Washington Post，April 30，2000，p.A1.
[29]“National Security Threat，”http://www.pbs.org/newshour/bb/health/jan-june00/aids＿threat＿5-2.html.
[30]“Special Assistant to the National Security Advisor，”http://clinton3.nara.gov/WH/EOP/NSC/html/health.html.
[31]J.Stephen Morrison，“What Role for U.S.Assistance in the Fight against Global HIV/AIDS？”p.70.
[32]Tom Malinowski，“The Epidemic and the Administration，”Washington Post，Feb. 9，2001，p.A29.
[33]Elizabeth Becker，“Gay Republican Will Run White House AIDS Office，”New York Times，April 9，2001，http://www.nytimes.com/2001/04/09/us/gay-republican-willrun-white-house-aids-office.html.
[34]Council on Foreign Relations，“Why Health Is Important to U.S.Foreign Policy，”2001，p.7，http://www.cfr.org/content/publications/attachments/Why-Health-Is-Important-To-Foreign-Policy.pdf.
[35]United States Institute of Peace，“Special Report：AIDSand Violent Conflict in Africa，”2001，p.8，http://www.usip.org/files/resources/sr75.pdf.
[36]联合国安全理事会：《第4087次会议逐字记录》，第9页，http://www.un.org/chinese/events/HIV/s-pv-4087（resumption）-1.pdf。
[37]The White House，A National Security Strategy for a Global Age，2000，p.21，http://www.bits.de/NRANEU/others/strategy/nss-0012.pdf.
[38]联合国安全理事会：《第4087次会议逐字记录》，第5页。
[39]Council on Foreign Relations，“Why Health Is Important to U.S.Foreign Policy，”p.14.
[40]Council on Foreign Relations，Addressing the HIV/AIDSPandemic：A U.S.Global AIDSStrategy for the Long Term，New York：Council on Foreign Relations and Milbank Memorial Fund，2004，p.5.
[41]The White House，A National Security Strategy for a Global Age，p.21.
[42]National Intelligence Estimate，The Global Infectious Disease Threat and Its Implications for the United States.
[43]The White House，A National Security Strategy for a Global Age，p.21.
[44]The White House，A National Security Strategy for a Global Age，p.21.
[45]Council on Foreign Relations，“Why Health Is Important to U.S.Foreign Policy，”p.2.
[46]National Intelligence Estimate，The Global Infectious Disease Threat and Its Implications for the United States.
[47]United States Institute of Peace，“Special Report：AIDSand Violent Conflict in Africa，”p.5.
[48]联合国安全理事会：《第4087次会议逐字记录》，第12—13页。
[49]Colin L.Powell，“Address at United Nations Special Session on HIV/AIDS，”June 25，2001，http://www.elca.org/Our-Faith-In-Action/Justice/Poverty-Ministries/HIV-and-AIDS/Colin-Powell.aspx.
[50]朱明权：《领导世界还是支配世界？——冷战后美国国家安全战略》，第176页。
[51]The White House，A National Security Strategy for a New Century，p.1.
[52]联合国安全理事会：《第4087次会议逐字记录》，第12页。
[53]The White House，A National Security Strategy for a New Century，p.25.
[54]The White House，A National Security Strategy for a New Century，p.25.
[55]“Africa Crisis Response Initiative（ACRI），”http://www.globalsecurity.org/military/agency/dod/acri.htm.
[56]House of Representatives，“Infectious Diseases：A Growing Threat to America's Health and Security，”p.10.
[57]“Interview with Peter Piot，”http://www.pbs.org/wgbh/pages/frontline/aids/interviews/piot.html.
[58]William J.Clinton，“Statement on Signing the Global AIDS and Tuberculosis Relief Act of 2000，”August19，2000，http://www.presidency.ucsb.edu/ws/index.php？pid=1428&st=HIV%2FAIDS&st1=.
[59]Michael Castle，“Testimony before U.S.House of Representatives，Committee on Banking and Financial Services，”March 8，2000，http://commdocs.house.gov/committees/bank/hba63311.000/hba63311＿0.HTM＃23.
[60]William J.Clinton，“Statement on Signing the Global AIDS and Tuberculosis Relief Act of 2000”.
[61]William J.Clinton，“Statement on Signing the Global AIDS and Tuberculosis Relief Act of 2000”.
[62]Council on Foreign Relations，“Why Health Is Important to U.S.Foreign Policy，”p.7.
[63]House of Representatives，“Infectious Diseases：A Growing Threat to America's Health and Security，”p.13.
[64]Paula J.Dobriansky，“U.S.Role in Global AIDSStruggle，”http://www.aidsresponsiblility.org/efforts/display＿effort.cfm？ID=2090071784.
[65]Jim Leach，Timothy Geithner，“Testimony before U.S.House of Representatives，Committee on Banking and Financial Services，”March 8，2000，http://commdocs.house. gov/committees/bank/hba63311.000/hba63311＿0.HTM＃23.
[66]Paul S.Zeitz，“Full Written Testimony to the House Committee on International Relations：Recommendations on the U.S.Role in the Global Fight on HIV/AIDS，”June 7，2001，http://www.globalaidsalliance.org/page/-/documents/Zeitz＿HIRC＿Testimony＿0607＿final.doc.
[67]House of Representatives，“Infectious Diseases：A Growing Threat to America's Health and Security，”pp.14，22.(https://www.daowen.com)
[68]Ibid.，p.33.
[69]联合国安全理事会：《第4087次会议逐字记录》，第12页。
[70]Ibid.，p.33.
[71]The Department of State，United States Strategic Plan for International Affairs，1999，p.42.http://www.state.gov/www/budget/stratplan＿index.html＃iasp.
[72]The White House，A National Security Strategy for a New Century，p.13.
[73]House of Representatives，“Infectious Diseases：A Growing Threat to America's Health and Security，”p.61.
[74]Council on Foreign Relations，“Why Health Is Important to U.S.Foreign Policy，”p.7.
[75]107th Congress，“Global Access to HIV/AIDS Prevention，Awareness，Education，and Treatment Act of 2001”，SEC.2，A.19，http://thomas.loc.gov/cgi-bin/query/z？c107：H.R.2069.
[76]106th Congress，“Global AIDS and Tuberculosis Relief Act of 2000”，SEC.111，http://thomas l.oc.gov/cgi-bin/bdquery/z？d106：HR03519：＠＠＠L&summ2=m&＃rel-bill-detail.
[77]107th Congress，“Global Access to HIV/AIDS Prevention，Awareness，Education，and Treatment Act of 2001”，SEC.2，B.11.
[78]巴瑞·布赞、奥利·维夫、迪·怀尔德：《新安全论》，第46页。
[79]Gwyn Prins，“AIDS and Global Security”，International Affairs，Vol.80，Issue 5，2004，p.491.
[80]“Interview：Richard Holbrooke，”http://www.pbs.org/wgbh/pages/frontline/aids/interviews/holbrooke.html.
[81]“Interview：Richard Holbrooke，”http://www.pbs.org/wgbh/pages/frontline/aids/interviews/holbrooke.html.
[82]参与讨论的安理会成员国为：美国、阿根廷、孟加拉国、加拿大、中国、法国、牙买加、马来西亚、马里、纳米比亚、荷兰、俄罗斯、突尼斯、乌克兰、英国。另外，参加讨论但没有表决权的国家包括：阿尔及利亚、澳大利亚、巴西、佛得角、古巴、塞浦路斯、刚果民主共和国、吉布提、埃塞俄比亚、印度尼西亚、意大利、日本、利比亚、蒙古、新西兰、尼日利亚、挪威、葡萄牙、韩国、塞内加尔、南非、乌干达、赞比亚和津巴布韦。见联合国安全理事会：《第4087次会议逐字记录》，http://www.un.org/chinese/events/HIV/s-pv-4087（resumption）-1.pdf。
[83]联合国安全理事会：《第4087次会议逐字记录》，第3页。
[84]联合国安全理事会：《第4087次会议逐字记录》，第7页。
[85]同上书，第30页。
[86]同上书，第24页。
[87]同上书，第9页。
[88]同上书，第10页。
[89]联合国安全理事会：《第4087次会议逐字记录》，第3页。
[90]同上书，第29页。
[91]同上书，第23页。
[92]同上书，第7页。
[93]安全理事会：《第1308（2000）号决议》，http://www.un.org/chinese/events/HIV/sres1308（2000）.html。
[94]Barton Gellman，“AID Is Declared Threat to US National Security，”Washington Post，April 30，2000，p.A1.
[95]Barton Gellman，“Turf Battles Slow Appointment of U.S.AIDSEnvoy：Agency Dispute Jurisdiction，Powers，”Washington Post，July19，2000，p.A6.
[96]William J.Clinton，“Statement Announcing the Appointment of the Presidential Envoy for AIDSCooperation，”Administration of William J.Clinton，August15，2000，p.1900.
[97]Barton Gellman，“AIDS Is Declared Threat to US National Security”.
[98]John W.Dietrich，“The Politics of PEPFAR：The President's Emergency Plan for AIDS Relief，”Ethics&International Affairs，Vol.21，Issue 3，2007，p.282.
[99]“Interview：Bill Clinton，”http://www.pbs.org/wgbh/pages/frontline/aids/interviews/clinton.html.
[100]Susan Peterson，“Human Securit，National Security，and Epidemic Disease，”in Jim Whitman ed.，HIV/AIDSand the Threats to National and International Security，New York：PALGRAVE MACMILAN，2006，p.49.
[101]Colin L.Powell，“Address at United Nations Special Session on HIV/AIDS，”June 25，2001，http://www.elca.org/Our-Faith-In-Action/Justice/Poverty-Ministries/HIV-and-AIDS/Colin-Powell.aspx.
[102]Alex Duval Smith，“AIDS，Trade and War Top Powell's African Agenda，”The Independent，2001，May 25，p.20.
[103]United States General Accounting Office，“U.S.Agency for International Development Fights AIDS in Africa，But Better Data Needed to Measure Impact，”2001，p.18，http://www.gao.gov/new i.tems/d01449.pdf.
[104]106th Congress，“Global AIDSand Tuberculosis Relief Act of 2000，”SEC111（b）.
[105]106th Congress，“Global AIDSand Tuberculosis Relief Act of 2000，”SEC.114.
[106]William M.Bellamy，“Testimony before the House Committee on International Relations Subcommittee on Africa，”July12，2001，http://www.reliefweb.int/rw/rwb.nsf/db900sid/ACOS-64D8NB？OpenDocument.
[107]The White House，A National Security Strategy for a Global Age，p.77.
[108]William M.Bellamy，“Testimony before the House Committee on International Relations Subcommittee on Africa”.
[109]Sarin Radhika，“A New Security Threat：HIV/AIDSin the Military，”pp.16—23.
[110]UN Press Release，“International Security Includes Peaceful War Against AIDS，Economic and Social Council Told，”Feb.28，2000，http://www.un.org/News/Press/docs/2000/20000228.ecosoc5884.doc.html.
[111]Duane Bratt，“Blue Condoms：The Use of International Peacekeepers in the Fight against AIDS，”p.75.
[112]PBSOnline News Hour，“Richard Holbrooke，”http://www.pbs.org/newshour/bb/health/july-dec00/aids＿7-13.html.
[113]联合国安全理事会：《第4087次会议逐字记录》，第31页。
[114]106th Congress，“Global AIDS and Tuberculosis Relief Act of 2000，”Subtitle B，Chapter1.
[115]Wolfgang Hein，Sonja Bartsch and Lars Kohlmorgen eds.，Global Health Governance and the Fight against HIV/AIDS，p.149.
[116]Wolfgang Hein，Sonja Bartsch and Lars Kohlmorgen eds.，Global Health Governance and the Fight against HIV/AIDS，p.149.
[117]孙茹：《国际反艾滋病斗争——联合国艾滋病特别会议》，第13页。
[118]孙茹：《国际反艾滋病斗争——联合国艾滋病特别会议》，第13页。
[119]“Fact Sheet：U.S.Leadership on Global Fund to Fight HIV/AIDS，Malaria and Tuberculosis，”http://www.presidency.ucsb.edu/ws/index.php？pid=78996&st=global+ fund&st1=.
[120]Office of Management and Budget，“Statement of Administration Policy：H.R.2506-Foreign Operations，Export Financing，and Related Programs Appropriations Bill，FY 2002，”http://www.presidency.ucsb.edu/ws/index.php？pid=24973&st=global+fund&st1=.
[121]The Global Fund to Fight AIDS，Tuberculosisand Malaria，“By-laws，”p.4，http://www.theglobalfund.org/documents/TGF＿Bylaws＿en.pdf.
[122]George W.Bush，“Remarks at the World Bank，”July17，2001，http://www.presidency.ucsb.edu/ws/index.php？pid=73621&st=global+fund&st1=.
[123]Wolfgang Hein，Sonja Bartsch and Lars Kohlmorgen eds.，Global Health Governance and the Fight against HIV/AIDS，p.153.
[124]全球基金：《全球基金的历史》，http://www.theglobalfund.org/cn/history/？lang=cn。
[125]《美专家呼吁专利法增设公众健康例外规定》，http://www.sipo.gov.cn/sipo2008/dtxx/gw/2008/200808/t20080814＿415103.html。
[126]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158页。
[127]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232页。
[128]Christopher May，“Challenging Global Norms：The State，Social Costs，and Legal Action，”in Robert L.Ostergard，Jr.，ed.，HIV/AIDSand the Threat to National and International Security，New York：PALGRAVE MACMILLAN，2007，p.174.
[129]“301条款”即美国《1974年贸易法》第301条的俗称，是美国贸易法中有关对外国立法或行政上违反协定、损害美国利益的行为采取单边行动的立法授权条款。
[130]Scott Thompson，“Why Al Gore Does Not Fight AIDS Holocaust，”http://www. larouchepub.com/other/2000/2731africa＿aids＿gore.html.
[131]Medecins Sans Frontieres，“MSFStatement on New UNAIDSProposal and Clinton's Executive Order on Access to HIV/AIDSMedicines，”May11，2000，http://doctorswithoutborders.org/press/release.cfm？id=598.
[132]The White House，“Access to HIV/AIDS Pharmaceuticals and Medical Technologies （Executive Order13155），”http://www.cptech.org/ip/health/africa/EO13155.pdf.
[133]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252页。
[134]Phyllida Brown，“Cheaper AIDS drugs due for Third World，”Nature，Vol.405，No.263，2000，p.263.
[135]Scott Thompson，“Why Al Gore Does Not Fight AIDS Holocaust，”http://www. larouchepub.com/other/2000/2731africa＿aids＿gore.html.
[136]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253页。
[137]美国对这一宣言的支持与“9·11”事件后其国内发生炭疽袭击关联紧密。袭击发生后，美国开始大量储备炭疽的治疗药物。德国拜尔公司拥有其中一种特效药的专利，而美国认为其定价过高，从而抬出了“强制许可权”的金牌，迫使拜尔公司大幅降低价格。这一经验使得美国无法继续反对其他国家对“强制许可权”的使用。同时，这一事件也说明，在全球卫生环境中，发达国家与发展中国家一样脆弱，它们利用自身卫生优势、剥削发展中国家的政策已经难以为继。