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為什么在《財富》美國500強的企業(yè)里擁有全球環(huán)境戰(zhàn)略的公司多達74%，而擁有全球衛(wèi)生戰(zhàn)略的公司卻僅有9%？

原因在于私營公司與全球環(huán)保界的關(guān)系，和與全球衛(wèi)生界的關(guān)系大有不同。

通過一系列質(zhì)疑和建設性的接觸，環(huán)保人士已經(jīng)成功地讓私營企業(yè)將可持續(xù)性視為一項義務、一種機遇。相反，全球衛(wèi)生界發(fā)現(xiàn)自己甚至很難與醫(yī)療保健直接相關(guān)的企業(yè)打好交道。而在動員更大范圍內(nèi)的私營企業(yè)加入改善全球居民健康、提高幸福指數(shù)的愿景上，衛(wèi)生界基本宣告了失敗。

我們與凱瑟琳·霍爾納弗和瑞恩·莫哈德最近對《財富》美國500強公司的報告和網(wǎng)站進行了一項分析。分析表明，在如何更好地動員企業(yè)界上，全球衛(wèi)生領域的職場人士可以從氣候變化運動中尋求靈感和指導。盡管這類分析都偏向指引性而非決定性，但它表明了氣候變化運動的成功和全球衛(wèi)生運動的相對失敗。

情況并不總是這樣。2002年，美國的環(huán)保領袖警告稱，僅有少數(shù)企業(yè)會在經(jīng)營時考慮環(huán)境和社會問題。自那以后，一系列行動、法規(guī)和企業(yè)領導改變了這種態(tài)勢：如今多數(shù)大公司都有詳盡的環(huán)保戰(zhàn)略，并且會在報告中提供明確的指標。

值得一提的是，這種趨勢波及了那些破壞環(huán)境會帶來商機的領域（例如可替代能源）和被認為會加劇環(huán)境問題的領域（例如航空和能源）。如今，多數(shù)大型跨國公司都會參與環(huán)保問題并提交相關(guān)報告。

相比之下，衛(wèi)生領域的情況觸目驚心。我們研究的公司中只有4%列出了衛(wèi)生相關(guān)的目標，而有55%都承諾努力實現(xiàn)減排。如果我們在分析排除那些直接相關(guān)的公司——藥品、食品和飲料制造商和衛(wèi)生保健服務提供商——幾乎沒有其他公司認為自己需要衛(wèi)生戰(zhàn)略（6%）或衛(wèi)生影響力報告（1%）。表面上，這些公司似乎把衛(wèi)生問題看作與環(huán)境問題一樣值得關(guān)注的企業(yè)公益。但氣候變化和更廣泛的環(huán)境問題如今的商業(yè)優(yōu)先級很高，并擁有相應的戰(zhàn)略和度量標準，而全球衛(wèi)生問題并非如此。

我們需要像轉(zhuǎn)變企業(yè)的環(huán)境觀念那樣轉(zhuǎn)變它們的衛(wèi)生觀念。但實現(xiàn)這種轉(zhuǎn)變不僅要求企業(yè)的領導者改變心態(tài)，全球衛(wèi)生界的領導者也應如此。當前，全球衛(wèi)生界有許多人以高度懷疑的眼光看待私營企業(yè)。另一些人（包括我和上文提到的分析的共同作者）則認為實現(xiàn)第三個聯(lián)合國可持續(xù)發(fā)展目標（UN Sustainable Development Goal）——“確保健康的生活方式，促進各年齡段人群的福祉”——需要多方利益相關(guān)者的廣泛合作，我們亟需活力、創(chuàng)新和私營企業(yè)的資源。

全球衛(wèi)生界需要自問，動員私營企業(yè)的做法為何失敗，需要做些什么，又應當如何改變雙方的關(guān)系。我們應該更系統(tǒng)地看待環(huán)境界做了什么，從他們的方法中可以吸取什么經(jīng)驗?？梢哉f，環(huán)保人士在動員引發(fā)環(huán)境問題的企業(yè)上要主動很多，在挑戰(zhàn)它們的同時，也鼓勵它們加入到解決方案中來。而氣候界在普及衡量企業(yè)環(huán)保貢獻的指標上也發(fā)揮了作用。

與此同時，企業(yè)的領導者也應當自問，自己應該承擔怎樣的責任，在改善全球衛(wèi)生狀況上可以做些什么。大部分企業(yè)對于自身面對衛(wèi)生風險時的脆弱性只有相對初步的認識。例如，很多人不知道疾病會如何影響客戶行為、員工效率或供應鏈。更系統(tǒng)地衡量和管理衛(wèi)生風險和負擔會是一個很好的出發(fā)點。類似的，許多企業(yè)應該思考自身商業(yè)活動的衛(wèi)生影響，以及他們應該做些什么來改善經(jīng)營社區(qū)的衛(wèi)生狀況。

良好的衛(wèi)生狀況能夠大幅提升工作效率，傳染病爆發(fā)等衛(wèi)生相關(guān)的風險可能會對業(yè)務造成巨大破壞。如今人們認為改善全球環(huán)境意義重大，改善全球衛(wèi)生狀況也應該得到類似的認知。（財富中文網(wǎng)）

本文作者阿希什·K·賈阿是哈佛大學陳曾熙公共衛(wèi)生學院李國鼎全球健康教授和哈佛全球衛(wèi)生研究所主任。彼得·桑茲是哈佛全球衛(wèi)生研究所高級研究員和抗擊艾滋病、結(jié)核病和瘧疾全球基金的執(zhí)行理事。

譯者：嚴匡正

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.