Financing of global health: tracking development assistance for health from 1990 to 2007
Financing of global health: tracking development assistance for health from 1990 to 2007
复制标题
DOI：
10.1016/s0140-6736(09)60881-3
复制
发表时间：
2009-06-20
期刊：
影响因子：
168.9
通讯作者：
Murray, Christopher J. L.
中科院分区：
文献类型：
--
作者：
Ravishankar, Nirmala;Gubbins, Paul;Murray, Christopher J. L.
人们普遍认识到，需要及时和可靠地了解全球卫生资源流向低收入和中等收入国家的情况。我们的目标是对1990年至2007年期间的卫生发展援助（DAH）进行全面评估。方法我们将DAH定义为来自公共和私人机构的所有卫生流动，其主要目的是向低收入和中等收入国家提供发展援助。我们使用了几个数据来源，以2007年美元为单位衡量发展中国家医疗保健的年度规模，并创建了一个综合项目数据库，以检查受援国援助的构成。研究发现，医疗保健费用从1990年的56亿美元增长到2007年的218亿美元。1990年至2007年，通过联合国机构和开发银行提供的人道主义发展援助比例有所下降，而全球抗击艾滋病、结核病和疟疾基金、全球疫苗和免疫联盟（免疫联盟）和非政府组织则成为人道主义发展援助份额不断增加的渠道。自2002年以来，由于公共资金（特别是来自美国的资金）的增加，以及私人方面，慈善捐赠和企业捐赠者的实物捐赠的增加，DAH急剧上升。2007年，在可获得项目一级信息的145亿美元发展援助中，51亿美元用于艾滋病毒/艾滋病，7亿美元用于结核病，8亿美元用于疟疾，9亿美元用于卫生部门支助。低收入和中等收入国家接受的医疗保健总费用与疾病负担呈正相关，而人均医疗保健总费用与人均国内生产总值呈负相关。这项研究记录了近年来全球卫生资源的大幅增加。虽然发展中国家卫生保健的增加导致用于艾滋病毒/艾滋病的资金增加，但全球卫生的其他领域也扩大了。在资金流入的同时，全球卫生体制格局也发生了重大变化，全球基金和免疫联盟等全球卫生倡议在动员和输送全球卫生资金方面发挥了核心作用。资助比尔及梅琳达·盖茨基金会。
Background The need for timely and reliable information about global health resource flows to low-income and middle-income countries is widely recognised. We aimed to provide a comprehensive assessment of development assistance for health (DAH) from 1990 to 2007.Methods We defined DAH as all flows for health from public and private institutions whose primary purpose is to provide development assistance to low-income and middle-income countries. We used several data sources to measure the yearly volume of DAH in 2007 US$, and created an integrated project database to examine the composition of this assistance by recipient country.Findings DAH grew from $5.6 billion in 1990 to $21.8 billion in 2007. The proportion of DAH channelled via UN agencies and development banks decreased from 1990 to 2007, whereas the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Global Alliance for Vaccines and Immunization (GAVI), and non-governmental organisations became the conduit for an increasing share of DAH. DAH has risen sharply since 2002 because of increases in public funding, especially from the USA, and on the private side, from increased philanthropic donations and in-kind contributions from corporate donors. Of the $14.5 billion DAH in 2007 for which project-level information was available, $5.1 billion was for HIV/AIDS, compared with $0.7 billion for tuberculosis, $0.8 billion for malaria, and $0.9 billion for health-sector support. Total DAH received by low-income and middle-income countries was positively correlated with burden of disease, whereas per head DAH was negatively correlated with per head gross domestic product.Interpretation This study documents the substantial rise of resources for global health in recent years. Although the rise in DAH has resulted in increased funds for HIV/AIDS, other areas of global health have also expanded. The influx of funds has been accompanied by major changes in the institutional landscape of global health, with global health initiatives such as the Global Fund and GAVI having a central role in mobilising and channelling global health funds.Funding Bill & Melinda Gates Foundation.