马得懿 周明园
2019 年12 月31 日,世界卫生组织中国办事处报道了有关中国湖北省武汉市发现的不明病因的肺炎病例。此后,泰国、日本、韩国相继报告了首例新冠肺炎的输入性病例,这场疫情随即在全球范围内蔓延开来。①WHO, 21 January 2020, Coronavirus disease (COVID-2019) situation reports-1,https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/,last visited 20 Feb 2020.2020 年1 月30 日,世卫组织总干事根据《国际卫生条例》召集了第二次突发事件委员会,宣布新冠肺炎疫情构成“国际关注的突发公共卫生事件”(Public Health Emergency of International Concern,以下简称 “PHEIC”),同时采纳并发布了突发事件委员会提出的临时建议。②WHO, 23 January 2020, Statement on the second meeting of the International Health Regulations (2005)Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV),https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-healthregulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov),last visited 20 Feb 2020.自此,新冠肺炎疫情的暴发成为了《国际卫生条例》实施以来的第6 起PHEIC,也是首次在中国境内引发的事件。③此前五起PHEIC分别为2009年甲型H1N1、2014年脊髓灰质炎、2014年西非埃博拉、2016年巴西寨卡、2018年刚果(金)埃博拉疫情。应对包括PHEIC 在内的各类公共卫生安全事件,《国际卫生条例》授权成员国执行不同程度的公共卫生措施以获取必要的健康保护。第一类是广泛适用的一般性公共卫生措施;④《国际卫生条例》第23-41条。第二类是根据世卫组织临时建议或长期建议采取的特殊性公共卫生措施;⑤《国际卫生条例》第15-16条。第三类是为应对特定公共卫生风险或PHEIC,根据成员国国内法或其他国际条约采取的额外性公共卫生措施。⑥《国际卫生条例》第43条。相较而言,第一类和第二类公共卫生措施属于条例框架下较为明确的规定,第三类公共卫生措施则给予了成员国较大的自由裁量权。换言之,针对PHEIC,成员国可以依据国家主权执行额外性公共卫生措施以获取与世卫组织的建议相同或更高水平的健康保护。⑦《国际卫生条例》第43条。然而,成员国面对PHEIC 时往往反应过激,执行过度公共卫生措施给受灾国家带来了疫情之外的惨痛伤害。
PHEIC 是《国际卫生条例》中的一个崭新概念,即指根据条例规定所确定的不同寻常的事件,或是通过疾病的国际传播构成对其他国家的公共卫生风险,或是需要采取协调一致的国际应对措施。⑧《国际卫生条例》第1条。在评估某一公共卫生事件是否构成PHEIC 时,需要综合考虑事件的公共卫生影响是否严重、是否不寻常或意外、是否有国际传播的严重危险以及是否有限制国际旅行或贸易的严重危险这四方面因素。⑨《国际卫生条例》附件二。在此基础上,总干事可以与成员国进行充分磋商并考虑突发事件委员会的意见,最终决定PHEIC 的宣布以及临时建议的发布。⑩《国际卫生条例》第49条。
在PHEIC 期间,各国可以根据其本国法律和国际法义务采取额外性公共卫生措施,但这并非意味着《国际卫生条例》对此类措施毫无限制。条例要求所有的公共卫生措施都应当以透明和无歧视的方式实施。就额外性公共卫生措施而言,其对国际交通的限制和对人员的侵扰不应超过能够适当保护健康的其他合理的替代措施。具体的执行标准应取决于科学原则、有关健康危险的科学证据和信息以及世卫组织的指导和建议。⑪⑪ 《国际卫生条例》第42、43条。⑫ Barbara von Tigerstrom, The Revised International Health Regulations and Restraint of National Health Measures,13 Health L.J. 35,67(2005).⑬ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,11-13(2017).⑭ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,13-14(2017).可见,过度公共卫生措施意指超出《国际卫生条例》授权范围内的公共卫生措施,具体包括非透明或歧视性措施、并非应对现有科学证据支持的已确定健康风险的措施、与科学依据缺乏合理联系的措施以及限制性高于避免风险的必要程度内的措施等。⑫⑪ 《国际卫生条例》第42、43条。⑫ Barbara von Tigerstrom, The Revised International Health Regulations and Restraint of National Health Measures,13 Health L.J. 35,67(2005).⑬ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,11-13(2017).⑭ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,13-14(2017).
2014 至2016 年,西非埃博拉疫情被宣布为PHEIC,在此期间各国采取的各类公共卫生措施为分析成员国是否有违《国际卫生条例》的规定,执行过度公共卫生措施提供了很好的样本。世卫组织调查人员收集了196 个成员国中187 个国家采取相关公共卫生措施的数据后表示,有58 个(31%)成员国采取了超出或无视条例建议的过度公共卫生措施。其中43 个(23%)国家禁止从埃博拉病毒广泛传播的国家出境的外国人入境,另有15 个(8%)国家对这类旅客实施了审查、隔离等强制措施。⑬⑪ 《国际卫生条例》第42、43条。⑫ Barbara von Tigerstrom, The Revised International Health Regulations and Restraint of National Health Measures,13 Health L.J. 35,67(2005).⑬ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,11-13(2017).⑭ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,13-14(2017).第一,此类措施很难被证明是符合公共卫生原则和科学依据的。例如,阿富汗要求入境人员提供其没有感染埃博拉病毒的医疗证明。然而,埃博拉病毒的潜伏期最长为21 天,而基于聚合酶链反应的诊断测试对受感染的个体直至症状出现的第三天均可能产生阴性结果。因此,基于这种诊断测试结果的医学证明不能保证该入境人员此时没有受到感染,也不能保证其在三周后不会染上埃博拉病毒。这种认证的结果仅仅是传递给旅行者、边境官员和整个社区一种安全的错觉。⑭⑪ 《国际卫生条例》第42、43条。⑫ Barbara von Tigerstrom, The Revised International Health Regulations and Restraint of National Health Measures,13 Health L.J. 35,67(2005).⑬ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,11-13(2017).⑭ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,13-14(2017).第二,更难避免的负面后果是一些明显的歧视性政策。在埃博拉疫情暴发的一个阶段,澳大利亚限制了所有非澳大利亚公民或澳大利亚永久居民的入境。伊拉克政府要求几乎所有从受埃博拉疫情影响国家进入伊拉克的旅客提供健康证明,但外交护照持有人则可予以豁免。⑮⑮ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,14(2017).⑯ Ali Tejpar& Steven J. Hoffman, Canada's Violation of International Law during the 2014-2016 Ebola Outbreak, 54 Can. Y.B. Int'l L. 366,375(2016).⑰ WHO,17 July 2019,Déclaration sur la réunion du Comitéd’urgence du Règlement sanitaire international (RSI) concernant la maladie à virus Ebola enRépubliquedémocratique du Congo du 17 juillet 2019,https://www.who.int/fr/news-room/detail/17-07-2019-statement-on-the-meeting-of-theinternational-health-regulations-(2005)-emergency-committee-for-ebola-virusdisease-in-the-democratic-republic-of-the-congo-on-17-july-2019,last visited 20 Feb 2020.⑱ David P. Fidler, To Declare or Not to Declare: The Controversy over Declaring a Public Health Emergency of International Concern for the Ebola Outbreak in the Democratic Republic of the Congo, 14 Asian J. WTO &Int'l Health L &Pol'y 287,306(2019).加拿大政府在申请日前三个月内停止受理任何曾位于埃博拉疫情地区人员的签证申请,这比21 天的病毒潜伏期上限长了四倍之多,足以造成对跨国旅行的不必要干扰;而来自西非的加拿大旅客则不受这些限制,“好像加拿大政府认为其公民对埃博拉病毒免疫”。⑯⑮ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,14(2017).⑯ Ali Tejpar& Steven J. Hoffman, Canada's Violation of International Law during the 2014-2016 Ebola Outbreak, 54 Can. Y.B. Int'l L. 366,375(2016).⑰ WHO,17 July 2019,Déclaration sur la réunion du Comitéd’urgence du Règlement sanitaire international (RSI) concernant la maladie à virus Ebola enRépubliquedémocratique du Congo du 17 juillet 2019,https://www.who.int/fr/news-room/detail/17-07-2019-statement-on-the-meeting-of-theinternational-health-regulations-(2005)-emergency-committee-for-ebola-virusdisease-in-the-democratic-republic-of-the-congo-on-17-july-2019,last visited 20 Feb 2020.⑱ David P. Fidler, To Declare or Not to Declare: The Controversy over Declaring a Public Health Emergency of International Concern for the Ebola Outbreak in the Democratic Republic of the Congo, 14 Asian J. WTO &Int'l Health L &Pol'y 287,306(2019).成员国采取以上种种措施显然并不符合《国际卫生条例》的规定,超出了PHEIC 下额外性公共卫生措施的界限,属于过度公共卫生措施。
此前,就2018 年刚果(金)埃博拉疫情是否构成PHEIC 这一问题,世卫组织分别于2018 年10 月17 日、2019 年4 月12 日、2019 年6 月14 日召开了三次突发事件委员会。突发事件委员会的意见中反复出现了 “尤为重要的是,不应采取国际旅行或贸易限制措施” 这一措辞。2019 年7 月17 日,总干事在第四次会议上最终宣布前述疫情构成PHEIC,同时在临时建议中强调,“任何国家都不应关闭边境或对旅行和贸易设置任何限制。这些措施通常是出于恐惧而实施的,并无科学依据。它们会促使人员和货物流向不受监测的非正式过境口岸,从而增加传播疾病的风险。更重要的是,这些限制措施还可能危害当地经济,并在安全和物流方面对应对行动产生负面影响。国家主管部门应与航空公司以及其他运输和旅游业合作,以确保它们不超出世卫组织关于国际运输的建议。”⑰⑮ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,14(2017).⑯ Ali Tejpar& Steven J. Hoffman, Canada's Violation of International Law during the 2014-2016 Ebola Outbreak, 54 Can. Y.B. Int'l L. 366,375(2016).⑰ WHO,17 July 2019,Déclaration sur la réunion du Comitéd’urgence du Règlement sanitaire international (RSI) concernant la maladie à virus Ebola enRépubliquedémocratique du Congo du 17 juillet 2019,https://www.who.int/fr/news-room/detail/17-07-2019-statement-on-the-meeting-of-theinternational-health-regulations-(2005)-emergency-committee-for-ebola-virusdisease-in-the-democratic-republic-of-the-congo-on-17-july-2019,last visited 20 Feb 2020.⑱ David P. Fidler, To Declare or Not to Declare: The Controversy over Declaring a Public Health Emergency of International Concern for the Ebola Outbreak in the Democratic Republic of the Congo, 14 Asian J. WTO &Int'l Health L &Pol'y 287,306(2019).事实上,总干事之所以迟迟未将埃博拉疫情认定为PHEIC,很大程度上考虑了埃博拉疫情受染国家与周边国家的经济状况以及PHEIC 的认定后对当地经济可能产生的消极影响,似乎 “总干事应避免宣布一项PHEIC,因为不必要的贸易和旅行措施将随之而来。”⑱⑮ Wendy Rhymera& Rick Speareb,Countries’ response to WHO’s travel recommendations during the 2013-2016 Ebola outbreak,95 Bull World Health Organ.10,14(2017).⑯ Ali Tejpar& Steven J. Hoffman, Canada's Violation of International Law during the 2014-2016 Ebola Outbreak, 54 Can. Y.B. Int'l L. 366,375(2016).⑰ WHO,17 July 2019,Déclaration sur la réunion du Comitéd’urgence du Règlement sanitaire international (RSI) concernant la maladie à virus Ebola enRépubliquedémocratique du Congo du 17 juillet 2019,https://www.who.int/fr/news-room/detail/17-07-2019-statement-on-the-meeting-of-theinternational-health-regulations-(2005)-emergency-committee-for-ebola-virusdisease-in-the-democratic-republic-of-the-congo-on-17-july-2019,last visited 20 Feb 2020.⑱ David P. Fidler, To Declare or Not to Declare: The Controversy over Declaring a Public Health Emergency of International Concern for the Ebola Outbreak in the Democratic Republic of the Congo, 14 Asian J. WTO &Int'l Health L &Pol'y 287,306(2019).有鉴于此,很多学者对这一机制的运作抱有悲观的情绪。挪威前州流行病学家Preben Aavitsland 博士曾坦率地指出,“我们非常清楚PHEIC 声明可能带来的副作用:毫无根据的旅行和贸易限制。这可能既会阻碍响应工作,又会严重影响当地经济,从而增加社区的抵制情绪。”⑲⑲ Could an emergency declaration over Ebola make a bad situation worse?,HelenBranswell, 14 May 2019,https://www.statnews.com/2019/05/14/could-an-emergency-declaration-over-ebola-make-a-badsituation-worse/?utm_source=STAT+Newsletters&utm_campaign=6936502fd9-MR_COPY_08&utm_medium=email&utm_term=0_8cab1d7961-6936502fd9-150885145,last visited 21 Mar 2020.⑳ David P. Fidler, To Declare or Not to Declare: The Controversy over Declaring a Public Health Emergency of International Concern for the Ebola Outbreak in the Democratic Republic of the Congo, 14 Asian J. WTO &Int'l Health L &Pol'y 287,314(2019).㉑ David P. Fidler, From International Sanitary Conventions to Global Health Security: The New International Health Regulations, 4 CHINESE J.INT'L L.325,381(2005).显然,各国不应对受灾国家实施过度的旅行和贸易限制,这无疑是对那些披露自己可能暴发危险疾病的国家的一种变相惩罚,可现实却是许多国家利用PHEIC 的声明来实施这些措施。一方面,这有碍于各国为应对已发生的疾病或可察觉的疾病威胁而对国际交通实施不合理和有害限制的悠久历史。⑳⑲ Could an emergency declaration over Ebola make a bad situation worse?,HelenBranswell, 14 May 2019,https://www.statnews.com/2019/05/14/could-an-emergency-declaration-over-ebola-make-a-badsituation-worse/?utm_source=STAT+Newsletters&utm_campaign=6936502fd9-MR_COPY_08&utm_medium=email&utm_term=0_8cab1d7961-6936502fd9-150885145,last visited 21 Mar 2020.⑳ David P. Fidler, To Declare or Not to Declare: The Controversy over Declaring a Public Health Emergency of International Concern for the Ebola Outbreak in the Democratic Republic of the Congo, 14 Asian J. WTO &Int'l Health L &Pol'y 287,314(2019).㉑ David P. Fidler, From International Sanitary Conventions to Global Health Security: The New International Health Regulations, 4 CHINESE J.INT'L L.325,381(2005).另一方面,这也表明《国际卫生条例》对成员国可能采取的过度公共卫生措施缺乏一个完善的规制。
从本质上说,公共卫生安全应属于国家主权下的管辖事项。出于对成员国国内法和主权的尊重,《国际卫生条例》倾向于采取 “软性” 模式,以便在 “世卫组织行使其权威的必要性和成员国对条例侵犯其主权的合理关切之间”㉑⑲ Could an emergency declaration over Ebola make a bad situation worse?,HelenBranswell, 14 May 2019,https://www.statnews.com/2019/05/14/could-an-emergency-declaration-over-ebola-make-a-badsituation-worse/?utm_source=STAT+Newsletters&utm_campaign=6936502fd9-MR_COPY_08&utm_medium=email&utm_term=0_8cab1d7961-6936502fd9-150885145,last visited 21 Mar 2020.⑳ David P. Fidler, To Declare or Not to Declare: The Controversy over Declaring a Public Health Emergency of International Concern for the Ebola Outbreak in the Democratic Republic of the Congo, 14 Asian J. WTO &Int'l Health L &Pol'y 287,314(2019).㉑ David P. Fidler, From International Sanitary Conventions to Global Health Security: The New International Health Regulations, 4 CHINESE J.INT'L L.325,381(2005).维持条例的良好运行。世卫组织总干事就PHEIC 发布的临时建议作为指导成员国执行公共卫生措施的重要指南,其本身并不具有法律约束力。此外,就过度公共卫生措施可能引发的成员国之间的纠纷,《国际卫生条例》缺乏一个有力的争端解决机制。
临时建议是世卫组织针对每一次PHEIC 发布的具体公共卫生措施,为成员国执行额外性公共卫生措施提供了重要指导。发布临时建议是《国际卫生条例》下的一项义务性要求。对此,条例制定了非常详细的程序:临时建议由突发事件委员会提出并由总干事最终决定;临时建议可以撤销或延期,否则应在三个月后自动到期;当成员国在临时建议的范畴外执行额外性公共卫生措施而对国际交通造成明显干扰时,成员国应向世卫组织汇报此类措施的卫生依据以证明其采取措施的正当性,受此类措施影响的成员国可以与前者协商以寻求共同的解决方案。㉒㉒ 明显干扰一般是指拒绝国际旅行者、行李、货物、集装箱、交通工具、物品等入境或出境或延误入境或出境24小时以上。参见《国际卫生条例》第15、43条。㉓ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 Goettingen J. Int'l L.261,271(2016).㉔ 《国际卫生条例》第1条。㉕ 《国际卫生条例》第56条。㉖ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution, in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).㉗ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution,in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).上述有关临时建议的复杂规定似乎表明了《国际卫生条例》对其效用的期待远远超过一项建议的程度。㉓㉒ 明显干扰一般是指拒绝国际旅行者、行李、货物、集装箱、交通工具、物品等入境或出境或延误入境或出境24小时以上。参见《国际卫生条例》第15、43条。㉓ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 Goettingen J. Int'l L.261,271(2016).㉔ 《国际卫生条例》第1条。㉕ 《国际卫生条例》第56条。㉖ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution, in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).㉗ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution,in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).然而,条例将临时建议定义为 “有时间限定并建立在特定风险基础上的非约束性建议”㉔㉒ 明显干扰一般是指拒绝国际旅行者、行李、货物、集装箱、交通工具、物品等入境或出境或延误入境或出境24小时以上。参见《国际卫生条例》第15、43条。㉓ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 Goettingen J. Int'l L.261,271(2016).㉔ 《国际卫生条例》第1条。㉕ 《国际卫生条例》第56条。㉖ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution, in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).㉗ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution,in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).,排除了使临时建议发生法律效力的可能。尽管成员国出于对世卫组织权威的尊重以及政治因素的考量,往往会在保障国内卫生安全的基础上适当采纳和执行临时建议,但这显然不属于一项法律机制应有的运行方式。
《国际卫生条例》规定了争端解决机制。就成员国之间的争端而言,成员国应首先寻求通过谈判或其自行选择的任何其他和平方式解决争端,包括斡旋、调停或调解。其次,如果未能达成一致,双方可商定将争端提交世卫组织总干事,总干事应尽全力予以解决。最后,如果争端发生在同意接受强制性仲裁的成员国之间,可以进行具有约束力的仲裁。㉕㉒ 明显干扰一般是指拒绝国际旅行者、行李、货物、集装箱、交通工具、物品等入境或出境或延误入境或出境24小时以上。参见《国际卫生条例》第15、43条。㉓ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 Goettingen J. Int'l L.261,271(2016).㉔ 《国际卫生条例》第1条。㉕ 《国际卫生条例》第56条。㉖ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution, in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).㉗ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution,in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).从条例的规定上看,有关争端解决的运行机制似乎相当进步。它一方面规定了斡旋、调解等促进和平谈判的可能性,另一方面也明确了具有约束力的仲裁程序。㉖㉒ 明显干扰一般是指拒绝国际旅行者、行李、货物、集装箱、交通工具、物品等入境或出境或延误入境或出境24小时以上。参见《国际卫生条例》第15、43条。㉓ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 Goettingen J. Int'l L.261,271(2016).㉔ 《国际卫生条例》第1条。㉕ 《国际卫生条例》第56条。㉖ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution, in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).㉗ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution,in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).然而,争端解决机制的设置与实际运用尚有很大距离。由于是否接受强制仲裁的额外义务完全取决于成员国的自愿同意,争端解决机制的弱点就变得非常明显:这一 “软性” 机制没有任何行之有效的执行方式。在缺乏强制性机制迫使成员国参与争端解决的情况下,决定争端解决进程和结果的将是权力和政治影响,而并非法律规范。㉗㉒ 明显干扰一般是指拒绝国际旅行者、行李、货物、集装箱、交通工具、物品等入境或出境或延误入境或出境24小时以上。参见《国际卫生条例》第15、43条。㉓ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 Goettingen J. Int'l L.261,271(2016).㉔ 《国际卫生条例》第1条。㉕ 《国际卫生条例》第56条。㉖ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution, in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).㉗ Steven J Hoffman, Making International Law Matter:Promoting Universal Compliance through Effective Dispute Resolution,in Simon Rushton &Jeremy Youde, eds, Routledge Handbook on Global Health Security,4(Oxford: Routledge, 2014).
现如今,健康权作为人类生存和发展的基本权利,是涵盖于整个国际关系范围中的多种国际法律制度的共同目标。《国际卫生条例》要求额外性公共卫生措施对国际交通的限制和对人员的侵扰不应超过能够适当保护健康的其他合理的替代措施,包含了对经济、人权因素的价值考量。国际贸易法、国际人权法的相关规定为约束过度公共卫生措施提供了标准。与此同时,针对2014 年西非埃博拉疫情,联合国埃博拉应急特派团(UN Mission for Ebola Emergency Response, UNMEER) 的参与以及安理会的相关决议也为规范过度公共卫生措施提供了一个可行路径。
公共卫生措施的实施应该考虑对经济方面的影响。国际贸易法领域的诸多条款体现出了贸易利益与公共卫生的平衡。《关税与贸易总协定》在一般例外中赋予了成员国为保护人类、动植物的生命或健康采取必要措施的权利;《实施动植物卫生检疫措施的协议》(《SPS 协议》)确认了成员国采取卫生和植物检疫措施的权利,同时也载有防止滥用这一基本权利的若干规则。㉘㉘ 《关税贸易总协定》第20条(b),《SPS协议》第2 条第2款,第5条第6款。㉙ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.178.㉚ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.210.㉛ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.156,178.㉜ Australia - Measures Affecting Importation of Salmon, Report of the Appellate Body,WTO Doc. WT/DS18/AB/R,6 Nov.1998,para.194,India - Measures Concerning the Importation of Certain Agricultural Products,Report of the Appellate Body, WTO Doc. WT/DS430/AB/R,4 June 2015,para.5.203.国际贸易法要求公共卫生措施的实施应该在所需要的必要限度内,即符合必要性原则。根据WTO 的相关判例,评估公共卫生措施的必要性主要体现在以下几个方面:第一,利害关系的利益或价值的重要性;第二,对实现该措施的目标所作贡献的程度;第三,实施该措施对贸易的限制性。㉙㉘ 《关税贸易总协定》第20条(b),《SPS协议》第2 条第2款,第5条第6款。㉙ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.178.㉚ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.210.㉛ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.156,178.㉜ Australia - Measures Affecting Importation of Salmon, Report of the Appellate Body,WTO Doc. WT/DS18/AB/R,6 Nov.1998,para.194,India - Measures Concerning the Importation of Certain Agricultural Products,Report of the Appellate Body, WTO Doc. WT/DS430/AB/R,4 June 2015,para.5.203.WTO 认为,当所讨论的措施与所追求的目标之间存在真正的目的和手段关系时,就存在一种贡献。这并非意味着该措施一定是必不可少的,但是却要求其对实现这一目标的贡献必须是实质性的,而不仅仅是微不足道的。同时,在确定某项措施是否必要时,必须评估所有相关因素。㉚㉘ 《关税贸易总协定》第20条(b),《SPS协议》第2 条第2款,第5条第6款。㉙ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.178.㉚ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.210.㉛ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.156,178.㉜ Australia - Measures Affecting Importation of Salmon, Report of the Appellate Body,WTO Doc. WT/DS18/AB/R,6 Nov.1998,para.194,India - Measures Concerning the Importation of Certain Agricultural Products,Report of the Appellate Body, WTO Doc. WT/DS430/AB/R,4 June 2015,para.5.203.如果经过分析得出一个初步结论,认为该措施是必要的,则必须将该措施与其他可能的替代措施进行比较来确认这一结果。㉛㉘ 《关税贸易总协定》第20条(b),《SPS协议》第2 条第2款,第5条第6款。㉙ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.178.㉚ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.210.㉛ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.156,178.㉜ Australia - Measures Affecting Importation of Salmon, Report of the Appellate Body,WTO Doc. WT/DS18/AB/R,6 Nov.1998,para.194,India - Measures Concerning the Importation of Certain Agricultural Products,Report of the Appellate Body, WTO Doc. WT/DS430/AB/R,4 June 2015,para.5.203.如果后者,(i)在考虑到技术和经济可行性的情况下是合理可行的;(ii)达到成员国适当的卫生和植物检疫保护水平;以及(iii)对贸易的限制明显低于前者,则实施该措施仍不满足必要性原则的规定。㉜㉘ 《关税贸易总协定》第20条(b),《SPS协议》第2 条第2款,第5条第6款。㉙ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.178.㉚ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.210.㉛ Brazil - Measures Affecting Imports of Retreaded Tyres, Report of the Appellate Body,WTO Doc. WT/DS332/AB/R,3 December 2007,para.156,178.㉜ Australia - Measures Affecting Importation of Salmon, Report of the Appellate Body,WTO Doc. WT/DS18/AB/R,6 Nov.1998,para.194,India - Measures Concerning the Importation of Certain Agricultural Products,Report of the Appellate Body, WTO Doc. WT/DS430/AB/R,4 June 2015,para.5.203.国际贸易法中的规则与标准其实质与《国际卫生条例》针对额外性公共卫生措施的规制是一致的,上述实践可以为规范公共卫生措施提供有效参考。
公共卫生措施的实施同样应该受到人权因素的制约。《国际卫生条例》明确提及了人权保护的原则,规定条例的执行应充分尊重人的尊严、人权和基本自由。在确有公共卫生风险时,应该采取对旅行者侵扰和创伤最小的公共卫生措施,并尽量减少此类措施引起的任何不适或痛苦。与之并行不悖的是,国际人权法赋予了成员国面对紧急情况时的特殊权利。《公民权利和政治权利国际公约》(ICCPR)规定成员国可以在必要时克减其在条约下的义务,克减的程度应以紧急情势的严格需要为限,同时不得包含给予种族、肤色、性别、语言、宗教或社会出身方面的歧视。㉝㉝ 《公民权利和政治权利国际公约》第4条第1款。㉞ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.25.㉟ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.39.㊱ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.10.㊲ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.54.㊳ Juan Cianciardo, The Principle of Proportionality: The Challenges of Human Rights, 3 J. Civ. L. Stud.177,179-180(2010).换言之,成员国可以援引公共卫生风险作为限制某些权利的理由,以便使一国能够采取措施,处理对人类或个人健康的严重威胁。㉞㉝ 《公民权利和政治权利国际公约》第4条第1款。㉞ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.25.㉟ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.39.㊱ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.10.㊲ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.54.㊳ Juan Cianciardo, The Principle of Proportionality: The Challenges of Human Rights, 3 J. Civ. L. Stud.177,179-180(2010).根据锡拉库萨原则的解释,就实施措施所针对的紧急情势而言,可以包含威胁国家生命的突发公共事件,即应当属于国家生命的 “特殊、实际或迫在眉睫的危险”:或影响到整个人口和国家的全部或部分领土;或威胁到人民的人身完整、国家的政治独立或领土完整。㉟㉝ 《公民权利和政治权利国际公约》第4条第1款。㉞ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.25.㉟ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.39.㊱ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.10.㊲ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.54.㊳ Juan Cianciardo, The Principle of Proportionality: The Challenges of Human Rights, 3 J. Civ. L. Stud.177,179-180(2010).就实施措施的必要性而言,此类措施应满足以下四个条件:一是基于ICCPR 有关条款承认的限制性理由之一;二是回应公众或社会的迫切需求;三是追求合理的目标;四是与目标相称。㊱㉝ 《公民权利和政治权利国际公约》第4条第1款。㉞ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.25.㉟ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.39.㊱ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.10.㊲ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.54.㊳ Juan Cianciardo, The Principle of Proportionality: The Challenges of Human Rights, 3 J. Civ. L. Stud.177,179-180(2010).此外,任何有关必要性的评估都应基于客观考虑。每项措施应针对实际的、明确的、目前的或迫在眉睫的危险,不得仅仅因为担心潜在危险而实施。㊲㉝ 《公民权利和政治权利国际公约》第4条第1款。㉞ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.25.㉟ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.39.㊱ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.10.㊲ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.54.㊳ Juan Cianciardo, The Principle of Proportionality: The Challenges of Human Rights, 3 J. Civ. L. Stud.177,179-180(2010).显然,国际人权法的立法宗旨要求在能够达到预期目的的手段中选择对人权限制最小的手段。在效力相似时,只有对权利限制最小的规范,才能通过比例原则和必要性原则的检验。㊳㉝ 《公民权利和政治权利国际公约》第4条第1款。㉞ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.25.㉟ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.39.㊱ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.10.㊲ Siracusa Principles on the Limitation and Derogation of Provisions in the International Covenant on Civil and Political Rights, Annex, UN Doc E/CN.4/1984/4(1984),para.54.㊳ Juan Cianciardo, The Principle of Proportionality: The Challenges of Human Rights, 3 J. Civ. L. Stud.177,179-180(2010).国际人权法中的上述原则和解释为约束公共卫生措施提供了更为清晰和具体的标准。
2014 年8 月,受埃博拉疫情影响最为严重的塞拉利昂、利比里亚、几内亚三国总统联名致信联合国秘书长,希望联合国能够采取干预措施停止其他国家在疫情期间的制裁行动,通过一项全面应对埃博拉疫情的决议用于支持在疾病暴发期间受影响国家的社会和经济的协调国际对策,在采取合理预防措施的情况下维持贸易和运输联系。㊴㊴ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊵ 《2014年9月17日秘书长给大会主席和安全理事会主席的同文信》, UN Docs A/69/389-S/2014/679.㊶ Resolution 2177 (2014),UN Doc.S/RES/2177 (2014).㊷ “UN Mission for Ebola Emergency Response”,https://ebolaresponse.un.org/un-mission-ebola-emergenyresponse-unmeer,last visited 21 Mar 2020.㊸ Andra Le Roux-Kemp, International and Operational Responses to Disease Control: Beyond Ebola and Epistemological Confines, 15 Ind. Health L. Rev. 247,248(2018).㊹ Resolution 2177(2014), UN Doc.S/RES/2177(2014).㊻ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,296(2016).随后,秘书长将此信函转交联合国安理会并提请成立UNMEER, 要求UNMEER “在统一的业务框架下,发挥所有相关联合国行为体的各种能力,以加强目标统一、有效的实地领导和业务指导,从而确保迅速、有效、高效和协调地应对危机”。㊵㊴ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊵ 《2014年9月17日秘书长给大会主席和安全理事会主席的同文信》, UN Docs A/69/389-S/2014/679.㊶ Resolution 2177 (2014),UN Doc.S/RES/2177 (2014).㊷ “UN Mission for Ebola Emergency Response”,https://ebolaresponse.un.org/un-mission-ebola-emergenyresponse-unmeer,last visited 21 Mar 2020.㊸ Andra Le Roux-Kemp, International and Operational Responses to Disease Control: Beyond Ebola and Epistemological Confines, 15 Ind. Health L. Rev. 247,248(2018).㊹ Resolution 2177(2014), UN Doc.S/RES/2177(2014).㊻ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,296(2016).此后,联合国安理会通过了第2177 号决议,敦促成员国执行条例下就埃博拉疫情提出的临时建议,对针对受灾国家实行贸易和旅行限制而使受灾国孤立的不利影响表示关切,呼吁包括该区域在内的成员国取消因埃博拉疫情而施加的一般旅行和边境限制,建议航空公司和运输公司与受影响的国家和更广泛的地区保持贸易和运输联系。㊶㊴ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊵ 《2014年9月17日秘书长给大会主席和安全理事会主席的同文信》, UN Docs A/69/389-S/2014/679.㊶ Resolution 2177 (2014),UN Doc.S/RES/2177 (2014).㊷ “UN Mission for Ebola Emergency Response”,https://ebolaresponse.un.org/un-mission-ebola-emergenyresponse-unmeer,last visited 21 Mar 2020.㊸ Andra Le Roux-Kemp, International and Operational Responses to Disease Control: Beyond Ebola and Epistemological Confines, 15 Ind. Health L. Rev. 247,248(2018).㊹ Resolution 2177(2014), UN Doc.S/RES/2177(2014).㊻ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,296(2016).
联合国的上述举措是其尝试解决公共卫生问题的重要创新。UNMEER 的成立是联合国有史以来的第一个有关公共卫生的紧急任务。根据相关的原则和关键性行动的指示,UNMEER基本上实现了其扩大实地应急机制的核心目标。㊷㊴ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊵ 《2014年9月17日秘书长给大会主席和安全理事会主席的同文信》, UN Docs A/69/389-S/2014/679.㊶ Resolution 2177 (2014),UN Doc.S/RES/2177 (2014).㊷ “UN Mission for Ebola Emergency Response”,https://ebolaresponse.un.org/un-mission-ebola-emergenyresponse-unmeer,last visited 21 Mar 2020.㊸ Andra Le Roux-Kemp, International and Operational Responses to Disease Control: Beyond Ebola and Epistemological Confines, 15 Ind. Health L. Rev. 247,248(2018).㊹ Resolution 2177(2014), UN Doc.S/RES/2177(2014).㊻ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,296(2016).此外,仅以公共卫生安全为基础的安理会决议并不多见,本次决议是安理会在艾滋病问题外第二次直接处理公共卫生问题。㊸㊴ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊵ 《2014年9月17日秘书长给大会主席和安全理事会主席的同文信》, UN Docs A/69/389-S/2014/679.㊶ Resolution 2177 (2014),UN Doc.S/RES/2177 (2014).㊷ “UN Mission for Ebola Emergency Response”,https://ebolaresponse.un.org/un-mission-ebola-emergenyresponse-unmeer,last visited 21 Mar 2020.㊸ Andra Le Roux-Kemp, International and Operational Responses to Disease Control: Beyond Ebola and Epistemological Confines, 15 Ind. Health L. Rev. 247,248(2018).㊹ Resolution 2177(2014), UN Doc.S/RES/2177(2014).㊻ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,296(2016).安理会决议无疑能够通过其广泛的影响力和较强的权威更好地鼓励、呼吁、敦促各方共同应对公共卫生安全的威胁。然而遗憾的是,此次UNMEER 与安理会的行动均没有在法律层面上取得较强的执行力。一方面,针对UNMEER 的性质,《联合国宪章》下的条款并未能就其法律效力提供依据。鉴于安理会 “请秘书长协助确保联合国系统所有相关实体,包括世卫组织和联合国人道主义空运处(UNHAS),按照各自的任务规定,加快对埃博拉疫情的反应”㊹㊴ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊵ 《2014年9月17日秘书长给大会主席和安全理事会主席的同文信》, UN Docs A/69/389-S/2014/679.㊶ Resolution 2177 (2014),UN Doc.S/RES/2177 (2014).㊷ “UN Mission for Ebola Emergency Response”,https://ebolaresponse.un.org/un-mission-ebola-emergenyresponse-unmeer,last visited 21 Mar 2020.㊸ Andra Le Roux-Kemp, International and Operational Responses to Disease Control: Beyond Ebola and Epistemological Confines, 15 Ind. Health L. Rev. 247,248(2018).㊹ Resolution 2177(2014), UN Doc.S/RES/2177(2014).㊻ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,296(2016).的措辞,似乎UNMEER 的建立即是出于安理会的授权。另一方面,就安理会的职权而言,安理会认为 “非洲埃博拉疫情空前严重,对国际和平与安全构成威胁”,㊺㊴ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊵ 《2014年9月17日秘书长给大会主席和安全理事会主席的同文信》, UN Docs A/69/389-S/2014/679.㊶ Resolution 2177 (2014),UN Doc.S/RES/2177 (2014).㊷ “UN Mission for Ebola Emergency Response”,https://ebolaresponse.un.org/un-mission-ebola-emergenyresponse-unmeer,last visited 21 Mar 2020.㊸ Andra Le Roux-Kemp, International and Operational Responses to Disease Control: Beyond Ebola and Epistemological Confines, 15 Ind. Health L. Rev. 247,248(2018).㊹ Resolution 2177(2014), UN Doc.S/RES/2177(2014).㊻ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,296(2016).进而根据《联合国宪章》行使权力。然而,安理会决议本身并不能够使世卫组织的临时建议转变为具有法律约束力的文件。尽管安理会本可以根据临时建议要求成员国向受灾国家开放边界,就边境管理、贸易、旅行以及医疗卫生工作者入境等方面与受灾国家进行合作,但是前者仅仅是发布了一些建议,并未要求成员国采取具体的措施或行动。㊻㊴ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊵ 《2014年9月17日秘书长给大会主席和安全理事会主席的同文信》, UN Docs A/69/389-S/2014/679.㊶ Resolution 2177 (2014),UN Doc.S/RES/2177 (2014).㊷ “UN Mission for Ebola Emergency Response”,https://ebolaresponse.un.org/un-mission-ebola-emergenyresponse-unmeer,last visited 21 Mar 2020.㊸ Andra Le Roux-Kemp, International and Operational Responses to Disease Control: Beyond Ebola and Epistemological Confines, 15 Ind. Health L. Rev. 247,248(2018).㊹ Resolution 2177(2014), UN Doc.S/RES/2177(2014).㊻ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,296(2016).总结而言,安理会在与世卫组织的合作中仍旧缺乏协调,前者没有选择通过法律手段解决过度公共卫生措施的问题——作为安全领域的行动者,安理会最终并未在卫生治理领域额外行使职权。㊼㊼ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,299(2016).㊽ Gian Luca Burci& Jakob Quirin, Ebola, WHO, and the United Nations: Convergence of Global Public Health and International Peace and Security,https://www.asil.org/insights/volume/18/issue/25/ebola-who-andunited-nations-convergence-global-public-health-and,last visited 21 Mar 2020.㊾ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊿ [英]路易斯·亨金著:《国际法:政治与价值》,张乃根等译,中国政法大学出版社2005年版,第33页。尽管如此,安理会决议是迄今为止对传染病暴发影响全球安全的最有力认识,体现出利用《联合国宪章》干预公共卫生的概念和政治力量。㊽㊼ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,299(2016).㊽ Gian Luca Burci& Jakob Quirin, Ebola, WHO, and the United Nations: Convergence of Global Public Health and International Peace and Security,https://www.asil.org/insights/volume/18/issue/25/ebola-who-andunited-nations-convergence-global-public-health-and,last visited 21 Mar 2020.㊾ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊿ [英]路易斯·亨金著:《国际法:政治与价值》,张乃根等译,中国政法大学出版社2005年版,第33页。联合国安理会的介入为规范过度公共卫生措施提供了可行的路径,一旦过度公共卫生措施造成的恶劣影响严重威胁受灾地区的和平与安全时,安理会完全有理由采取具体行动以保障受灾国家的生命健康安全。
应对PHEIC,《国际卫生条例》赋予成员国执行额外性公共卫生措施的特权并没能终结各国实施过度公共卫生措施的历史。事实上,过度公共卫生措施并不会抵御疾病的传播反而是在灾难面前筑起了高高的围墙,使本就陷入困境的受灾国家更加孤立无援。这种 “事实上的经济制裁和贸易禁运将会恶化疾病暴发对经济造成的影响,使受灾国家为控制这一流行病所作的努力化作泡影”。㊾㊼ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,299(2016).㊽ Gian Luca Burci& Jakob Quirin, Ebola, WHO, and the United Nations: Convergence of Global Public Health and International Peace and Security,https://www.asil.org/insights/volume/18/issue/25/ebola-who-andunited-nations-convergence-global-public-health-and,last visited 21 Mar 2020.㊾ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊿ [英]路易斯·亨金著:《国际法:政治与价值》,张乃根等译,中国政法大学出版社2005年版,第33页。在全球一体化应对公共卫生安全的时代,应该适当打破国家主权神话,将其保留在必要和有价值的范围内,强化世卫组织的职权,提供一个更有力的法律框架以规制过度公共卫生措施。㊿㊼ Robert Frau, Law as an Antidote: Assessing the Potential of International Health Law Based on the Ebola-Outbreak 2014, 7 GoettingenJ.Int'l L.261,299(2016).㊽ Gian Luca Burci& Jakob Quirin, Ebola, WHO, and the United Nations: Convergence of Global Public Health and International Peace and Security,https://www.asil.org/insights/volume/18/issue/25/ebola-who-andunited-nations-convergence-global-public-health-and,last visited 21 Mar 2020.㊾ 《2014 年9月15日秘书长给安全理事会主席的信》,UN Doc.S/2014/669.㊿ [英]路易斯·亨金著:《国际法:政治与价值》,张乃根等译,中国政法大学出版社2005年版,第33页。国家应遵循法律的约束,加强对过度公共卫生措施的管制,认识到健康权的多元化内涵,积极进行信息共享,更加准确地采取科学合理的措施,担负起国际社会的责任。只有这样才能在对经济和国际交通影响最小的限度内,实现保护和促进全球公共卫生安全的美好愿景,描绘和构建出人类命运共同体的宏伟蓝图。