Ho Calvin Wai Loon, Caals Karel
School of Law, Monash University, Melbourne, Australia.
PHG Foundation, University of Cambridge, Cambridge, UK.
Asian Bioeth Rev. 2025 Jul 16;17(3):495-514. doi: 10.1007/s41649-025-00387-9. eCollection 2025 Jul.
On 20 May 2025, the 78 World Health Assembly adopted the World Health Organization's Pandemic Agreement (PA). With the benefit of lessons learnt from the COVID-19 pandemic, the PA rightly focuses on advancing equity, but we are concerned that the PA appears to apply equity narrowly as distributive justice and neglects epistemic justice. Using infodemics and antimicrobial resistance (AMR) as examples, we argue that the PA misses epistemic architectures. We first explain why infodemics are an important public health concern that the PA seeks to address, even though it does not clearly mention them. We then explain why equity must be interpreted to include epistemic justice. Using infodemics as an example, we subsequently discuss how the epistemic architecture of the PA on infodemics will need to be set out clearly as an annex to the PA or through the adoption of an additional protocol. We note in particular that the PA could help to draw together different normative and human rights approaches and frameworks to meet the requirements of epistemic justice. A similar challenge applies to AMR as an epistemically complex phenomenon, and our argument is that a global response to AMR will require a just and equitable epistemic architecture that the PA could lay the foundation for.
2025年5月20日,第78届世界卫生大会通过了世界卫生组织的《大流行协定》(PA)。鉴于从新冠疫情中吸取的经验教训,《大流行协定》正确地将重点放在促进公平上,但我们担心该协定似乎将公平狭义地应用为分配正义,而忽视了认知正义。以信息疫情和抗菌药物耐药性(AMR)为例,我们认为《大流行协定》忽略了认知架构。我们首先解释为什么信息疫情是《大流行协定》试图解决的一个重要公共卫生问题,尽管它没有明确提及。然后我们解释为什么公平必须被解释为包括认知正义。以信息疫情为例,我们随后讨论如何将《大流行协定》关于信息疫情的认知架构作为《大流行协定》的附件或通过通过一项附加议定书来明确阐述。我们特别指出,《大流行协定》有助于整合不同的规范和人权方法及框架,以满足认知正义的要求。对于作为一种认知复杂现象的抗菌药物耐药性而言,也存在类似的挑战,我们的观点是,全球对抗菌药物耐药性的应对将需要一个公正公平的认知架构,而《大流行协定》可以为此奠定基础。