光想赚钱不讲卫生，大企业急需变革

为什么在《财富》美国500强的企业里拥有全球环境战略的公司多达74%，而拥有全球卫生战略的公司却仅有9%？

原因在于私营公司与全球环保界的关系，和与全球卫生界的关系大有不同。

通过一系列质疑和建设性的接触，环保人士已经成功地让私营企业将可持续性视为一项义务、一种机遇。相反，全球卫生界发现自己甚至很难与医疗保健直接相关的企业打好交道。而在动员更大范围内的私营企业加入改善全球居民健康、提高幸福指数的愿景上，卫生界基本宣告了失败。

我们与凯瑟琳·霍尔纳弗和瑞恩·莫哈德最近对《财富》美国500强公司的报告和网站进行了一项分析。分析表明，在如何更好地动员企业界上，全球卫生领域的职场人士可以从气候变化运动中寻求灵感和指导。尽管这类分析都偏向指引性而非决定性，但它表明了气候变化运动的成功和全球卫生运动的相对失败。

情况并不总是这样。2002年，美国的环保领袖警告称，仅有少数企业会在经营时考虑环境和社会问题。自那以后，一系列行动、法规和企业领导改变了这种态势：如今多数大公司都有详尽的环保战略，并且会在报告中提供明确的指标。

值得一提的是，这种趋势波及了那些破坏环境会带来商机的领域（例如可替代能源）和被认为会加剧环境问题的领域（例如航空和能源）。如今，多数大型跨国公司都会参与环保问题并提交相关报告。

相比之下，卫生领域的情况触目惊心。我们研究的公司中只有4%列出了卫生相关的目标，而有55%都承诺努力实现减排。如果我们在分析排除那些直接相关的公司——药品、食品和饮料制造商和卫生保健服务提供商——几乎没有其他公司认为自己需要卫生战略（6%）或卫生影响力报告（1%）。表面上，这些公司似乎把卫生问题看作与环境问题一样值得关注的企业公益。但气候变化和更广泛的环境问题如今的商业优先级很高，并拥有相应的战略和度量标准，而全球卫生问题并非如此。

我们需要像转变企业的环境观念那样转变它们的卫生观念。但实现这种转变不仅要求企业的领导者改变心态，全球卫生界的领导者也应如此。当前，全球卫生界有许多人以高度怀疑的眼光看待私营企业。另一些人（包括我和上文提到的分析的共同作者）则认为实现第三个联合国可持续发展目标（UN Sustainable Development Goal）——“确保健康的生活方式，促进各年龄段人群的福祉”——需要多方利益相关者的广泛合作，我们亟需活力、创新和私营企业的资源。

全球卫生界需要自问，动员私营企业的做法为何失败，需要做些什么，又应当如何改变双方的关系。我们应该更系统地看待环境界做了什么，从他们的方法中可以吸取什么经验。可以说，环保人士在动员引发环境问题的企业上要主动很多，在挑战它们的同时，也鼓励它们加入到解决方案中来。而气候界在普及衡量企业环保贡献的指标上也发挥了作用。

与此同时，企业的领导者也应当自问，自己应该承担怎样的责任，在改善全球卫生状况上可以做些什么。大部分企业对于自身面对卫生风险时的脆弱性只有相对初步的认识。例如，很多人不知道疾病会如何影响客户行为、员工效率或供应链。更系统地衡量和管理卫生风险和负担会是一个很好的出发点。类似的，许多企业应该思考自身商业活动的卫生影响，以及他们应该做些什么来改善经营社区的卫生状况。

良好的卫生状况能够大幅提升工作效率，传染病爆发等卫生相关的风险可能会对业务造成巨大破坏。如今人们认为改善全球环境意义重大，改善全球卫生状况也应该得到类似的认知。（财富中文网）

本文作者阿希什·K·贾阿是哈佛大学陈曾熙公共卫生学院李国鼎全球健康教授和哈佛全球卫生研究所主任。彼得·桑兹是哈佛全球卫生研究所高级研究员和抗击艾滋病、结核病和疟疾全球基金的执行理事。

译者：严匡正

Why is it that only 9% of the world’s Fortune 500 companies have a global health strategy, while 74% have an environmental strategy?

The answer lies in the very different relationship that the private sector has with the environmental community versus its relationship with the global health community.

Through a combination of challenge and constructive engagement, environmental activists have succeeded in getting the private sector to embrace sustainability as both an obligation and an opportunity. By contrast, the global health community often finds it hard to engage with even those companies directly involved in health care, and has largely failed to involve the broader private sector in the community’s mission to improve people’s health and well-being across the globe.

We, along with Kathryn Horneffer and Ryan Morhard, recently completed an analysis of the reports and websites of Fortune 500 companies that showed that global health professionals can look to the climate movement for inspiration and guidance on how to better engage the business community. While any such analysis is indicative rather than definitive, it shows the climate movement’s success and the global health movement’s relative failure.

It wasn’t always like this. In 2002, environmental leaders in the United Nations warned that only a small number of companies were taking environmental and social concerns into consideration for their operations. Since then, a combination of activism, regulation, and corporate leadership have transformed the picture: Most big companies now have explicit environmental strategies, with clear metrics they report on.

What’s remarkable is that this extends beyond the sectors for which harm to the environment is a business opportunity (such as alternative energy) or that are seen as contributing to the problem (such as aviation and energy). Nowadays, most large, multinational companies are engaged and reporting on environmental issues.

The contrast with health is striking. Only 4% of the companies we studied specify any kind of health goal, while 55% commit to an emissions reduction goal. If we strip out the most obvious sectors from the analysis—pharmaceuticals, food and drink manufacturers, and health care providers—hardly any other companies appear to think they need a health strategy (6%) or a health impact report (1%).On the surface, these companies appear to regard health issues as equally deserving of corporate philanthropy as environmental issues, with an equal share—32%—listing each area as a focus for corporate giving. Yet climate change and broader environmental issues are now treated like business priorities, with strategies and metrics, while global health is not.

We need to transform corporate attitudes toward global health in the same way that they’ve changed on the environment. Yet achieving this shift will require not just corporate leaders to change their mindset, but also leaders in the global health community. At the moment, many in the global health community regard the private sector with deep suspicion. Others (including us and our co-authors in the aforementioned analysis) would argue that achieving the third UN Sustainable Development Goal—to “ensure healthy lives and promote well-being for all at all ages”—will require extensive multi-stakeholder participation, and that we desperately need the dynamism, innovation, and resources of the private sector.

The global health community needs to ask itself why it has failed to engage the private sector successfully, what it needs to ask for, and how to change the relationship. We should look more systematically at what the environmental community has done, and see where we can adopt its approach. Environmentalists have arguably been much more active in engaging sectors that cause environmental problems, both challenging them and encouraging them to become part of the solution. The climate community has also been effective in gaining broad acceptance of specific metrics for measuring a company’s environmental impact.

At the same time, corporate leaders should ask themselves what their responsibility should be and what they can contribute toward improving global health. Most companies have a relatively rudimentary understanding of their vulnerability to health risks; for example, many don’t understand how diseases might impact customer behavior, staff productivity, or supply chains. Being more systematic in measuring and managing health risks and burdens would be a good starting point. Likewise, many businesses should think through the health impact of their business activities, and what they could to improve the health of the communities in which they operate.

Good health is powerful driver of productivity, while health-related risks, such as infectious disease outbreaks, can cause immense disruption to businesses. Improving the global environment is now seen as good business; so too should improving global health.

Ashish K. Jha is the K.T. Li professor of global health at the Harvard T.H. Chan School of Public Health and the director of the Harvard Global Health Institute. Peter Sands is a senior research fellow at the Harvard Global Health Institute and the executive director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria.