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Abstract：
In recent years, the global health community has increasingly reported the problem of \'invisibility\': aspects of health and wellbeing, particularly amongst the world\'s most marginalized and impoverished people, that are systematically overlooked and ignored by people and institutions in relative positions of power. It is unclear how to realistically manage global health invisibility within bioethics and other social science disciplines and move forward. In this letter, we reflect on several case studies of invisibility experienced by people in Brazil, Malaysia, West Africa and other transnational contexts. Highlighting the complex nature of invisibility and its interconnectedness with social, political and economic issues and trends, we argue that while local and targeted interventions might provide relief and comfort locally, they will not be able to solve the underlying causes of invisibility. Building from the shared lessons of case study presentations at an Oxford-Johns Hopkins Global Infectious Disease Ethics Collaborative (GLIDE), we argue that in dealing with an intersectional issue such as invisibility, twenty-first century global health bioethics could pursue a more \'disturbing\' framework, challenging the narrow comforting solutions which take as a given the sociomaterial inequalities of the status quo. We highlight that comforting and disturbing bioethical frameworks should not be considered as opposing sides, but as two approaches working in tandem in order to achieve the internationally set global health milestones of providing better health and wellbeing for everyone. Insights from sociology, anthropology, postcolonial studies, history, feminist studies and other styles of critical reasoning have long been disturbing to grand narratives of people and their conditions. To rediscover the ethos of the WHO Alma Ata Declaration-a vision of \"health for all by the year 2000\"-these thinking tools will be necessary aids in developing cooperation and support beyond the narrow market logic that dominates the landscape of contemporary global health.
摘要：
近年来,全球卫生界越来越多地报告了“隐形”问题：健康和福祉方面，特别是在世界上最边缘化和最贫困的人群中，被处于相对权力地位的人和机构系统地忽视和忽视。目前尚不清楚如何在生物伦理学和其他社会科学学科中现实地管理全球健康隐形性并向前迈进。在这封信中,我们反思了几个巴西人经历的隐形案例研究，马来西亚,西非和其他跨国背景。突出了隐形的复杂性及其与社会的相互联系，政治和经济问题和趋势，我们认为，虽然当地和有针对性的干预措施可以在当地提供救济和安慰，他们将无法解决隐形的根本原因。从牛津-约翰霍普金斯大学全球传染病伦理学合作组织（GLIDE）的案例研究报告的共同教训中，我们认为，在处理诸如隐形之类的交叉问题时，二十一世纪的全球健康生物伦理学可以追求一个更“令人不安”的框架，挑战狭隘的安慰解决方案，这些解决方案考虑到社会对现状的不平等。我们强调，令人欣慰和令人不安的生物伦理框架不应被视为对立的一面，但作为两种方法协同工作，以实现国际设定的全球卫生里程碑，为每个人提供更好的健康和福祉。社会学的见解，人类学,后殖民研究,历史,女性主义研究和其他风格的批判性推理长期以来一直困扰着人们及其状况的宏大叙事。为了重新发现世卫组织《阿拉木图宣言》的精神——“到2000年人人享有健康”的愿景——这些思维工具将是必要的帮助，有助于发展合作和支持，超越主导当代全球健康格局的狭隘市场逻辑。
