著者

内田 孟男

出版者

JAPAN ASSOCIATION OF INTERNATIONAL RELATIONS

雑誌

国際政治 (ISSN:04542215)

巻号頁・発行日

vol.2004, no.137, pp.12-29,L6, 2004-06-19 (Released:2010-09-01)

参考文献数

56

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The prototype of the post-World War II order was formulated at the Dumbarton Oaks and Bretton Woods conferences in the summer of 1944. The United Nations system has since occupied a central place in the international collaborative framework in peace and security as well as in development and environment. The accelerated process of globalization, however, in the wake of the end of the cold war, has increasingly eroded the existing “international” order and transformed the role of the states. Non-state actors such as civil society, NGOs, the private sector, and other social forces have appeared on the global arena, to supplement if not supplant, the states in the making of a new order.Against this historical backdrop, this essay purports to examine the possible role that can and should be played by the United Nations in constructing a humane and more equitable global order. After reviewing briefly the impacts of globalization and the concepts and theories of global governance, the essay focuses on the UN's role in various phases of global public policy making, starting from the identification of global issues, consensus-building on goals and principles, deliberations and decision-making, implementation, and review and evaluation. The UN's unique status that enjoys legitimacy as the sole general and universal organization has contributed to each of these phases. A difficult phase is that of deliberation and decision-making. The decision-making in the Security Council reflects quite directly the power configuration of the permanent members and by constitution is restricted to the issues of international peace and security. The General Assembly decision-making, on the other hand, mirrors the concerns of the majority of the developing countries. The consensus arrived at by the General Assembly serves as guidelines, though not legally binding, for world society to act as well as for the UN system.The implementation of the decision is possibly the most problematic phase in the global policy making since the bulk of its actual execution has to be done by the states. This is a crucial phase of providing the global public goods. In further elaborating this phase, the essay attempts to demonstrate the relevance of the concept of global public goods in the making of global public policy within the all-inclusive perspective of global governance. Through this exercise, we may build a manageable theoretical frame on the UN's role in the new global era. It finally addresses the role of the UN Secretariat in particular the leadership and initiative in mobilizing the resources through forming and developing partnerships with NGOs, business and regional organizations. Such efforts led by the Secretary-General augur the nature of a nascent new global order.

著者

笠原 群生 内田 孟 佐々木 健吾 平田 義弘 武田 昌寛 上遠野 雅美 久保田 智美 中里 弥生 福田 晃也 阪本 靖介

出版者

一般社団法人 日本移植学会

雑誌

移植 (ISSN:05787947)

巻号頁・発行日

vol.53, no.2-3, pp.197-208, 2018 (Released:2018-11-07)

参考文献数

33

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【Purpose】 We reviewed our experience of liver transplantation in the National Center for Child Health and Development and report the results herein.【Subjects and methods】 We have handled 500 cases of liver transplantation from November 2005 through March 2018 in the National Center for Child Health and Development. Variables including indication of liver transplantation and immunological outcome were reviewed.【Results】 There were 469 living donor, 27 deceased and 4 domino liver transplantations in the study period. The indication for liver transplantation was cholestatic liver disease in 48.0%, followed by metabolic liver disease in 22.0% and acute liver failure in 12.6%. The mean age of recipients was 4.0±5.5 years and body weight was 14.9±13.3 kg. Immunosuppression consisted of tacrolimus and low-dose steroids. The incidence of acute cellular rejection was 42.0%. The 10-year patient survival was 90.2%.【Conclusion】 Satisfactory results can be achieved in the liver transplantation program in the National Center for Child Health and Development. Deceased donor liver transplantation, patients with acute liver failure and re-transplantation shows significantly lower patient survival. We conclude that liver transplantation is a safe and effective treatment modality together with proper indication and excellent management strategy. The significant factors affecting survival may be overcome by the technical and immunological refinements that have occurred in recent years.