COVID-19 期间官方发展援助的转移:指定用途、捐助方集中和贷款。

IF 7.1 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH BMJ Global Health Pub Date : 2024-11-05 DOI:10.1136/bmjgh-2024-015527
Liana Woskie, Clare Wenham
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引用次数: 0

摘要

背景:与双边援助相比,在 COVID-19 大流行爆发时,多边机构提供的援助显著增加。然而,在最需要协调一致和有效的多边应对措施的时候,COVID-19 大流行却揭示出捐助机构的格局正在发生变化,在跨国协调等基本职能方面举步维艰。虽然多边机构在超越国家优先事项和应对大流行病方面具有得天独厚的优势,但从功能上看,我们发现这些机构提供的官方发展援助(ODA)可能会越来越多地模仿双边援助的属性。我们探讨了 COVID-19 大流行之前和期间援助的三个重要但不全面的属性:(1) 专款专用;(2) 捐助者集中;(3) 援助模式:我们研究了 2010 年至 2021 年期间按 2020 年不变价格计算的官方发展援助支付情况,并根据联合国各多边机构的年均融资额绘制了指定用途的资金流入份额图。然后,我们用香农-韦纳函数和吉尼-辛普森指数这两个指标来评估市场多样性。最后,我们研究了用于支付的融资工具,并考察了长期以来所有正式捐助方提供的官方发展援助总额中的 "赠款份额":我们发现,自 2011 年以来,正规多边机构的绝对数量和市场多样性一直在增加,但同时也出现了由世界银行集团主导的市场整合,2021 年世界银行集团的市场份额达到 37%。与此同时,流入多边体系的援助资金越来越多地指定用途,而基于贷款的官方发展援助支付也在增加,这是多边机构独有的现象,但由于债务风险日益增加,这种现象也令人担忧:从理论上讲,这种合并可能会简化收入的汇集,并允许以更集体的方式来降低大流行病的风险,但与指定用途的增加相配合,有可能使集体目标(如可持续发展目标)和国家的核心任务(如追求全民医保)偏离正轨。
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Shifting official development assistance during COVID-19: earmarking, donor concentration and loans.

Context: In contrast to bilateral aid, aid disbursed from multilateral institutions increased significantly at the onset of the COVID-19 pandemic. Yet, at a time when a coherent and effective multilateral response is needed most, the COVID-19 pandemic revealed a shifting landscape of donor agencies that struggle with basic functions, such as cross-national coordination. While multilaterals are uniquely positioned to transcend national priorities and respond to pandemics, functionally we find official development assistance (ODA) from these entities may increasingly mimic the attributes of bilateral aid. We explore three important, but not comprehensive, attributes of aid leading up to and during the COVID-19 pandemic: (1) earmarking, (2) donor concentration and (3) aid modality.

Methods: We examine ODA disbursements over time in 2020 constant prices from 2010 to 2021 and plot share of inflow that is earmarked against each United Nations multilateral against their average annual financing volume. We then assess market diversity with two measures: the Shannon-Weiner Function and Gini-Simpson Index. Finally, we examine financing vehicles used to disburse and look at 'grant share' of total ODA from all formal donors over time.

Findings: We find that while the absolute number of formal multilateral actors and market diversity have been increasing since 2011, there has been a concurrent market consolidation led by the World Bank Group at 37% of market share in 2021. This coincides with an increasing prevalence of earmarking of aid inflows to the multilateral system and, unique to multilaterals but concerning given increasing debt risk, a rise in loan-based ODA disbursements.

Conclusions: In theory, this consolidation may streamline revenue pooling and allow for a more collective approach to mitigating pandemic risk but, paired with increased earmarking, has the potential to sideline both collective goals (eg, the Sustainable Development Goals) and counties' core mandates (such as the pursuit of universal health coverage).

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来源期刊
BMJ Global Health
BMJ Global Health Medicine-Health Policy
CiteScore
11.40
自引率
4.90%
发文量
429
审稿时长
18 weeks
期刊介绍: BMJ Global Health is an online Open Access journal from BMJ that focuses on publishing high-quality peer-reviewed content pertinent to individuals engaged in global health, including policy makers, funders, researchers, clinicians, and frontline healthcare workers. The journal encompasses all facets of global health, with a special emphasis on submissions addressing underfunded areas such as non-communicable diseases (NCDs). It welcomes research across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialized studies. The journal also encourages opinionated discussions on controversial topics.
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