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。
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.