中国卫生发展援助的理念与实践

Ideology and practice of development assistance for health in China

新中国成立后中国卫生发展援助经历了三个发展阶段,形成了派遣援外医疗队、援建医疗卫生设施等援助形式。改革开放后,世界格局和国内的经济社会基础发生深刻变化;过去相对简单、分散的卫生援助模式对受援国卫生系统的影响有限;卫生援助管理体制分散,缺乏顶层设计,导致援助效果打折;在西方国家主导的国际规则体系下,中国的卫生制度模式、技术和产品的输出受到限制;与受援国日益增长的需求相比,我国开展卫生合作的能力有待提高。建议以"新大国观、新义利观"、"以人为本"的思想和"以援助促发展、以发展促合作、最终实现共同发展"的理念指导中国卫生发展援助;创新适应国内外经济社会发展的"立体式"援助模式;改革卫生援助管理体制,合理界定部门权责,加强信息共享与协调;将卫生发展援助与全球卫生治理结合起来,促进援助外溢效应最大化;发挥民间力量的作用,加强引导和监管。

Since the establishment of the People’s Republic of China, the development of China’s official de-velopment assistance for health has been going through three phases. To date, it has developed in many forms, inclu-ding the dispatch of medical team and the construction of health facilities. Since the market reforms, the global con-text together with the domestic socioeconomic foundations have changed; the impact of China’s relatively simple and segmented development assistance for health on the development of health systems in developing countries is limited;the effectiveness of assistance has been watered-down due to segmentation and vague management and accountability systems, as well as the lack of an overarching strategy;China’s health institutions, techniques and products suffer va-rious obstacles in their transfer to other countries where rules are dominated by western countries;compared with the increasing and multiple demands of development assistance for health from developing countries, the capacities of co-operation need to be further developed. As the paper suggests, use the “new major-country” and “new morality-in-terest” and“human oriented” concepts, as well as the ideology of“aid in order to develop, develop in order to coop-erate, so as to develop hand-in-hand” to guide China’s development assistance for health;innovate stereo-aid models to adapt to the changed foreign and domestic socioeconomic context; reform the development assistance for health management system and define rights and obligations appropriately;strengthen coordination and information sharing;link development assistance for health with global health governance to promote a maximized spillover effect;mobilize the civil society with strengthened guidance and supervision.