de Beyer J A, Preker A S, Feachem R G
World Bank, Washington, DC 20433, USA.
Soc Sci Med. 2000 Jan;50(2):169-76. doi: 10.1016/s0277-9536(99)00258-0.
During the course of the past ten years, the World Bank has become the single largest external financier of health activities in low and middle income countries and an important voice in national and international debates on health policy. This article highlights the Bank's new strategic direction in the health sector aimed at: improving health, nutrition, and population outcomes of the poor; enhancing the performance of health care systems; and securing sustainable health care financing. Millions of preventable deaths and treatable illnesses, together with health systems that are inefficient, inequitable and ineffective, have motivated expanded Bank support for the health sector in many of its client countries. The new policy directions and system-wide reforms observed in these countries are the result of both demand and supply factors. It is part of a general shift in the Bank's approach to development assistance, which sees systemic reform as a way to improve the impact and sustainability of investments in health. On the demand side, the Bank is trying to adapt to ongoing political, technological, economic, demographic, epidemiological and social pressures. On the supply side, the Bank's growing international experience and substantial financial resources are used to complement the development assistance provided by other organizations and the global effort to improve health and health systems in low and middle income countries.
在过去十年间，世界银行已成为低收入和中等收入国家卫生活动的最大单一外部融资机构，以及国家和国际卫生政策辩论中的重要声音。本文重点介绍了世行在卫生领域的新战略方向，目标是：改善穷人的健康、营养和人口状况；提高卫生保健系统的绩效；确保可持续的卫生保健融资。数百万可预防的死亡和可治疗的疾病，以及低效、不公平且无效的卫生系统，促使世行在其许多借款国扩大了对卫生领域的支持。这些国家出现的新政策方向和全系统改革是需求和供给因素共同作用的结果。这是世行发展援助方式总体转变的一部分，该转变将系统性改革视为提高卫生投资的影响力和可持续性的一种方式。在需求方面，世行正努力适应持续存在的政治、技术、经济、人口、流行病学和社会压力。在供给方面，世行不断增长的国际经验和大量财政资源被用于补充其他组织提供的发展援助，以及全球为改善低收入和中等收入国家的卫生及卫生系统所做的努力。
