Moucheraud Corrina, Sparkes Susan, Nakamura Yoriko, Gage Anna, Atun Rifat, Bossert Thomas J
Corrina Moucheraud (
Susan Sparkes is a health economist in the Department of Health Systems Governance and Financing at the World Health Organization, in Geneva, Switzerland.
Health Aff (Millwood). 2016 May 1;35(5):847-55. doi: 10.1377/hlthaff.2015.1445.
Launched in 2003, the US President's Emergency Plan for AIDS Relief (PEPFAR) is the largest disease-focused assistance program in the world. We analyzed PEPFAR budgets for governance and systems for the period 2004-14 to ascertain whether PEPFAR's stated emphasis on strengthening health systems has been manifested financially. The main outcome variable in our analysis, the first of its kind using these data, was the share of PEPFAR's total annual budget for a country that was designated for governance and systems. The share of planned PEPFAR funding for governance and systems increased from 14.9 percent, on average, in 2004 to 27.5 percent in 2013, but it declined in 2014 to 20.8 percent. This study shows that the size of a country's PEPFAR budget was negatively associated with the share allocated for governance and systems (compared with other budget program areas); it also shows that there was no significant relationship between budgets for governance and systems and HIV prevalence. It is crucial for the global health policy community to better understand how such investments are allocated and used for health systems strengthening.
美国总统防治艾滋病紧急救援计划（PEPFAR）于2003年启动，是全球最大的针对特定疾病的援助项目。我们分析了2004年至2014年期间PEPFAR用于治理和系统建设的预算，以确定PEPFAR所宣称的对加强卫生系统的重视在财政上是否得到体现。我们的分析中主要的结果变量（首次使用这些数据）是PEPFAR在一个国家年度总预算中指定用于治理和系统建设的份额。PEPFAR计划用于治理和系统建设的资金份额从2004年的平均14.9%增至2013年的27.5%，但在2014年降至20.8%。这项研究表明，一个国家的PEPFAR预算规模与分配给治理和系统建设的份额（与其他预算项目领域相比）呈负相关；研究还表明，治理和系统建设预算与艾滋病毒流行率之间没有显著关系。全球卫生政策界更好地了解此类投资如何分配以及如何用于加强卫生系统至关重要。
