追踪卫生发展援助,1990-2030年:历史趋势,最近的削减和前景
Angela E Apeagyei1, Catherine Bisignano2, Hans Elliott2
1Institute for Health Metrics and Evaluation, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
卫生发展援助 (DAH) 预计将大幅下降,到2025年降至384亿美元,原因是捐助者援助大幅减少. 这种趋势威胁着全球卫生成果,需要增加国内资源动员和替代性融资机制.
科学领域:
- 全球卫生融资
- 国际发展援助
- 健康经济学
背景情况:
- 卫生发展援助 (DAH) 在COVID-19大流行期间达到顶峰水平,但由于经济不确定性和竞争性财政需求,此后已下降.
- 美国和英国等国家在2025年初宣布大幅削减捐助者援助,引发了低收入和中等收入国家对卫生融资的担忧.
- 之前的评估并没有全面量化这些宣布的削减对DAH总体水平或未来发展轨迹的影响.
研究的目的:
- 估计1990年至2030年的全球卫生发展援助 (DAH).
- 量化主要捐助者宣布削减援助对DAH水平的影响.
- 根据目前的政策和潜在情景预测未来的DAH轨迹.
主要方法:
- 根据经合组织债权人报告系统,全球卫生机构 (如全球基金,Gavi) 和私人/非政府组织的数据,估计了1990-2030年的DAH.
- 使用标准化关键字标记来按来源,机构,健康重点和受理国分类支出.
- 纳入宣布的2025年预算削减和采用线性回归模型预测到2030年的捐助者特定资金目标.
主要成果:
- 在2021年达到了803亿美元的峰值,在2024年降至496亿美元,由于宣布的削减,特别是来自美国的双边援助,在2025年进一步下降至384亿美元.
- 预计全球主要卫生机构将减少对传染病和儿童疫苗的支出.
- 根据目前的政策,预测显示到2030年DAH将停滞不前,达到362亿美元,根据美国援助的变化,敏感性分析显示到2025年将达到368亿美元至40亿美元.
结论:
- 全球卫生融资格局正面临持续减少DAH的时期,这可能会扩大卫生差距.
- 减缓战略需要增加国内资源动员和替代融资机制.
- 接收国迫切需要提高效率,重新确定战略重点,加强财政性,以保持健康收益.
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