美国对撒哈拉以南非洲官方卫生援助的现实考量——一项基于2001—2017年援助面板数据的实证研究

The United States official health assistance to Sub-Saharan Africa:An empirical research based on the 2001—2017 aid panel data

撒哈拉以南非洲国家是全球卫生治理中最为薄弱的地区,作为在全球治理中最具影响力的国家,美国在撒哈拉以南非洲卫生援助的供给结构中占有极为重要的地位。通过实证研究,可以发现美国将防艾卫生援助放在优先地位而且与基本卫生援助之间形成了极不平衡的结构关系。在援助分配问题上,美国的实际援助行为与其所宣扬的"利他主义"原则存在落差。受援国的政治制度、政府效率、地缘政治地位和与美国在医药领域的贸易联系对美国的卫生援助分配具有显著性的影响。由此产生的问题则是美国卫生援助投入所产生的实际效果受到制约,美国在卫生援助中所隐含的政治与经济利益考量弱化了其所宣扬的道义原则。伴随着中国参与全球卫生治理的意识与能力逐步增强,中国也将在对非卫生援助中产生更大的影响。结合美国对非卫生援助所出现的问题,中国应当以扩大基本卫生援助为中心,注重发挥卫生援助"造血功能";重视中国对非卫生援助的理念建设,增进受援国与国际社会对中国卫生援助政策的认同;完善中非卫生合作的协商制度建设,发挥政策咨询和协调共同外部立场的功能。

Sub-Saharan Africa is the weakest region in global health governance.As the most influential country in global governance,the United States plays an extremely important role in the supply structure of health assistance in sub-Saharan Africa.We conducted an empirical study to see the United States gives priority to anti-AIDS health assistance and forms a very unbalanced structural relationship with General and Basic Health Aid.The results also show that there is a gap between America’s actual aid and its professed altruism.The recipient countries’political system,government efficiency,geopolitical status and trade links with the United States in the field of medicine have significant influences on the distribution of health assistance.The resulting problems are the real impact of U.S.health assistance is limited and the political and economic considerations implicit in health aid undermine the moral principles with its professed.With China’s increased capacity and awareness of participating in global health governance,China will also have a greater impact on health assistance to Africa.Considering the problems of U.S.health aid to Africa,China should focus on expanding basic health aid and give full play to its"hematopoietic function".We should attach importance to the concept construction of China’s health aid to Africa and enhance the recognition of recipient countries and the international community on China’s health aid policy.We will improve the building of negotiation platform for China-Africa health cooperation so that it not only serves as a platform for information exchange,but also serves as a platform for policy consultation and coordination of common global health governance policy.