Global Program for Health, Nutrition, and Population, World Bank , Washington, DC, USA.
Global Program for Health, Nutrition, and Population, World Bank , Sydney, Australia.
Health Syst Reform. 2020 Dec 1;6(1):e1847991. doi: 10.1080/23288604.2020.1847991.
Pacific Island countries (PIC) have emerged as among the most at-risk globally from the collateral economic damage resulting from the COVID-19 pandemic, despite being largely spared its direct health effects so far. Current projections indicate that all PIC will experience an economic contraction in 2020, ranging from -1.0% in Tuvalu to -21.7% in Fiji, worse than most countries globally on average. Given that more than 80% of financing for health in the Pacific comes from domestic and external public sources, the net impact of the economic contraction on resources for health will depend on whether overall public spending can offset the decline in economic activity and how health will be prioritized in government budgets relative to other sectors. Without active reprioritization, most countries could see a slowdown or even decline in per capita levels of public spending for health in the region, risking gains made in advancing universal health coverage in recent years. If health ministries do not act quickly and in consort with other ministries (particularly ministries of finance), including by taking active steps to improve the efficient use of existing resources and other measures to mitigate the economic effects of the crisis on resources for health, it is likely that current economic circumstances will result in unplanned changes. These changes may not deliver the health outcomes that the health ministries would select themselves and may result in a reversal of hard-fought health gains.
太平洋岛国（PIC）在全球范围内受到 COVID-19 大流行带来的间接经济损失的影响的风险最高，尽管到目前为止，它们基本上没有受到直接的健康影响。目前的预测表明，所有太平洋岛国都将在 2020 年经历经济收缩，图瓦卢的收缩率为-1.0%，斐济的收缩率为-21.7%，比全球大多数国家都要糟糕。鉴于太平洋地区卫生融资的 80%以上来自国内和外部公共来源，经济收缩对卫生资源的净影响将取决于总体公共支出是否能够抵消经济活动的下降，以及卫生相对于其他部门在政府预算中的优先地位如何。如果不积极重新确定优先次序，该地区大多数国家的人均公共卫生支出可能会放缓，甚至下降，从而危及近年来在推进全民健康覆盖方面取得的成果。如果卫生部不迅速采取行动，并与其他部委（特别是财政部）合作，包括采取积极措施提高现有资源的使用效率和采取其他措施减轻危机对卫生资源的经济影响，那么目前的经济状况很可能导致计划外的变化。这些变化可能无法带来卫生部自身选择的卫生成果，并且可能导致来之不易的卫生成果发生逆转。
