美国近20年实施对外卫生援助的情况分析

Analysis of the implementation of health assistance by the US in the past 20 years

目的:分析美国实施对外卫生援助的特点,为我国开展对外卫生援助提供参考。方法:本研究基于美国国际开发署的对外援助数据库,从实施部门(横向)和实施时间(纵向)两个维度,定量分析美国实施的卫生援助,分别比较不同维度内的援助渠道、受援地区和健康领域的异同点。结果:2001—2020年,美国实施卫生援助的主要渠道是政府机构、非政府组织、多边组织以及企业渠道。美国本土机构是构成非政府组织和企业渠道的主体。主要援助地区是撒哈拉以南的非洲,主要援助的健康领域是艾滋病防控。美国国务院、国际开发署、卫生与公众服务部是三大出资机构。近三届总统任期内的卫生援助在地区(国家)、健康领域的分布上表现出了一定的一致性。结论:顶层设计上,建议我国继续强化卫生援助在对外政策中的战略定位。实施层面上,建议我国积极动员包括非政府组织、私人企业、科研机构等在内的非国家行为体参与卫生援助,同时强化卫生援助的评估与监管体系。

Objective To analyze the characteristics of the US implementation of health assistance,so as to provide references for the policy-making of China's health assistance.Methods Based on the US Agency for International Development Foreign Aid Explorer(FAE)database,this study quantitatively analyzed the health assistance provided by the US government agencies from the following two dimensions:the department in charge of implementation(horizontal)and the time of implementation(vertical),and analyzed the similarities and differences in the routes,regions and fields of health assistance within each dimension.Results From 2001 to 2020,the US implemented health assistance mainly via government agencies,Non-Governmental Organizations(NGO),multilateral organizations and enterprises.Among them,native organizations in the US were the main body of NGO and enterprise routes.The main assisted region was sub-Saharan Africa,and the main assisted health field was AIDS prevention and control.The U.S.Department of State,the Agency for International Development,and the Ministry of Health and Human Services were the three major funding agencies.Healthcare assistance during the last three presidential terms had shown a certain extent of consistency in the distribution of assisting regions and countries and health fields.Conclusions In terms of top-level policy design,it is recommended that the Chinese government continue to strengthen the strategic significance of health assistance in foreign policy.At the implementation level,it is recommended that the Chinese government actively motivate non-state agencies,including NGOs,private enterprises and research institutions,to participate in health assistance,and at the same time strengthen the evaluation and supervision system of health assistance.