Innovative financing for health: what is truly innovative?
Innovative financing for health: what is truly innovative?
复制标题
DOI：
10.1016/s0140-6736(12)61460-3
复制
发表时间：
2012-12-08
期刊：
影响因子：
168.9
通讯作者：
Frenk, Julio
中科院分区：
文献类型：
--
作者：
Atun, Rifat;Marie Knaul, Felicia;Frenk, Julio
2000年至2010年期间，卫生发展援助逐年增加，特别是艾滋病毒/艾滋病、结核病和疟疾，2010年达到266.6亿美元。持续的全球经济危机意味着，传统捐助方不太可能在短期内增加外部供资。因此，必须从创新筹资来源寻求新的资金，以维持在全球卫生方面取得的成果，实现卫生方面的千年发展目标，并应对非传染性疾病带来的新负担。我们使用价值链方法来概念化创新融资。在这个框架下，我们确定了三个综合创新的融资机制-GAVI，全球基金和UNITAID-已经达到了全球规模。这三种融资机制沿着创新金融价值链的每一步进行了创新--即资源动员、集中、引导、资源分配和实施--并整合这些步骤，将大量资金迅速输送到低收入和中等收入国家，以应对艾滋病毒/艾滋病、疟疾、结核病和疫苗可预防的疾病。然而，与传统来源的捐助者援助相比，从国际创新筹资来源调动的资源相对较少。相反，真实的创新是建立了新的组织形式，作为综合融资机制，将融资价值链的各个要素联系起来，以便更有效和高效地调动、汇集、分配和向低收入和中等收入国家输送财政资源，并为改进国家方案的执行和绩效创造激励措施。这些机制为今后的卫生筹资提供了平台，特别是在增加创新筹资的努力受挫的情况下。从这些机制中吸取的经验教训可用于发展和扩大国际来源的创新筹资，以满足中低收入国家的卫生需求。
Development assistance for health has increased every year between 2000 and 2010, particularly for HIV/AIDS, tuberculosis, and malaria, to reach US$26.66 billion in 2010. The continued global economic crisis means that increased external financing from traditional donors is unlikely in the near term. Hence, new funding has to be sought from innovative financing sources to sustain the gains made in global health, to achieve the health Millennium Development Goals, and to address the emerging burden from non-communicable diseases. We use the value chain approach to conceptualise innovative financing. With this framework, we identify three integrated innovative financing mechanisms-GAVI, Global Fund, and UNITAID-that have reached a global scale. These three financing mechanisms have innovated along each step of the innovative finance value chain-namely resource mobilisation, pooling, channelling, resource allocation, and implementation-and integrated these steps to channel large amounts of funding rapidly to low-income and middle-income countries to address HIV/AIDS, malaria, tuberculosis, and vaccine-preventable diseases. However, resources mobilised from international innovative financing sources are relatively modest compared with donor assistance from traditional sources. Instead, the real innovation has been establishment of new organisational forms as integrated financing mechanisms that link elements of the financing value chain to more effectively and efficiently mobilise, pool, allocate, and channel financial resources to low-income and middle-income countries and to create incentives to improve implementation and performance of national programmes. These mechanisms provide platforms for health funding in the future, especially as efforts to grow innovative financing have faltered. The lessons learnt from these mechanisms can be used to develop and expand innovative financing from international sources to address health needs in low-income and middle-income countries.