战略捐助者行为和国家在卫生援助转型中的脆弱性
Wenhui Mao1, Kaci Kennedy McDade2, Osondu Ogbuoji2,3
1Center for Policy Impact in Global Health, Duke Global Health Institute, Durham, North Carolina, USA wenhui.mao@duke.edu.
BMJ global health
|November 8, 2023
概括
双边捐助者减少了对从Gavi支持中毕业的国家的援助,但战略利益可以减轻这一点. 这影响了全球卫生资金,并要求接受国家仔细规划过渡.
科学领域:
- 全球健康 全球健康
- 发展经济学 发展经济学
- 国际关系 国际关系
背景情况:
- 像Gavi (疫苗联盟) 这样的多边捐助者经常在国家达到中等收入地位 (毕业) 时撤回援助.
- 在Gavi毕业后,双边捐助者的援助模式尚未完全理解,特别是关于战略利益的援助模式.
- 在Gavi过渡后,识别那些容易受到同时融资缺口的国家至关重要.
研究的目的:
- 在接受国从Gavi毕业后分析双边捐助者的行为.
- 确定战略利益是否影响加利福尼亚之后的双边援助分配.
- 鉴定因同时援助过渡而面临金融悬崖风险的国家.
主要方法:
- 来自77个符合Gavi资格的国家 (2009-2018) 的纵向数据的观测二度分析.
- 回归模型 (OLS,Tobit,两部分) 检查了Gavi的毕业状态和支付作为解释变量.
- 控制变量包括捐赠者-接受者关系因素 (例如距离) 和接受者特征 (例如人口,收入).
主要成果:
- 在Gavi毕业后,各国获得的ODA显著减少 (总体减少310万美元,卫生减少60万美元).
- 高Gavi的ODA与双边ODA的增加相关 (0.14%更多的整体,在健康方面增加了0.16%).
- 盖维的逐步退出对健康的ODA的影响超过了ODA总额,对双边援助的长期负面影响更大;像移民和军事援助这样的战略因素影响了ODA水平.
结论:
- 双边捐助者的融资模式与Gavi的融资模式相似,可能会同时为LMICs的卫生系统创造融资缺口.
- 对双边捐助者具有战略利益的国家可以免受大量援助削减的保护.
- 调查结果为全球卫生融资政策和受援国过渡战略提供了信息.
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