School of Medicine, Imperial College London Faculty of Medicine, London, UK
MRC Centre for Global Infectious Disease Analysis, Imperial College London School of Public Health, London, London, UK.
BMJ Glob Health. 2021 Apr;6(4). doi: 10.1136/bmjgh-2020-003923.
There has been no systematic comparison of how the policy response to past infectious disease outbreaks and epidemics was funded. This study aims to collate and analyse funding for the Ebola epidemic and Zika outbreak between 2014 and 2019 in order to understand the shortcomings in funding reporting and suggest improvements.
Data were collected via a literature review and analysis of financial reporting databases, including both amounts donated and received. Funding information from three financial databases was analysed: Institute of Health Metrics and Evaluation's Development Assistance for Health database, the Georgetown Infectious Disease Atlas and the United Nations Financial Tracking Service. A systematic literature search strategy was devised and applied to seven databases: MEDLINE, EMBASE, HMIC, Global Health, Scopus, Web of Science and EconLit. Funding information was extracted from articles meeting the eligibility criteria and measures were taken to avoid double counting. Funding was collated, then amounts and purposes were compared within, and between, data sources.
Large differences between funding reported by different data sources, and variations in format and methodology, made it difficult to arrive at precise estimates of funding amounts and purpose. Total disbursements reported by the databases ranged from $2.5 to $3.2 billion for Ebola and $150-$180 million for Zika. Total funding reported in the literature is greater than reported in databases, suggesting that databases may either miss funding, or that literature sources overreport. Databases and literature disagreed on the main purpose of funding for socioeconomic recovery versus outbreak response. One of the few consistent findings across data sources and diseases is that the USA was the largest donor.
Implementation of several recommendations would enable more effective mapping and deployment of outbreak funding for response activities relating to COVID-19 and future epidemics.
过去针对传染病暴发和流行的政策应对措施的资金来源情况尚无系统比较。本研究旨在整理和分析 2014 年至 2019 年期间埃博拉疫情和寨卡疫情的资金情况，以了解资金报告的不足，并提出改进建议。
通过文献回顾和财务报告数据库（包括捐赠和接收金额）分析收集数据。对三个财务数据库（卫生计量与评估研究所发展援助健康数据库、乔治敦传染病地图集和联合国金融跟踪服务）中的数据进行了分析。制定并应用了一种系统文献检索策略，对 7 个数据库（MEDLINE、EMBASE、HMIC、全球卫生、Scopus、Web of Science 和 EconLit）进行了检索。从符合入选标准的文章中提取资金信息，并采取措施避免重复计数。对资金进行整理，然后比较数据源内部和之间的资金数额和用途。
不同数据源报告的资金数额存在很大差异，格式和方法也存在差异，因此难以准确估计资金数额和用途。数据库报告的埃博拉疫情总支出金额为 25 亿至 32 亿美元，寨卡疫情为 1.5 亿至 1.8 亿美元。文献报告的总资金多于数据库报告的资金，这表明数据库可能会遗漏资金，或者文献来源可能会过度报告。数据库和文献在资金的主要用途上存在分歧，即社会经济复苏与疫情应对。在疾病和资金来源方面，有一个为数不多的一致发现，即美国是最大的捐助国。
实施若干建议将能够更有效地规划和部署与 COVID-19 和未来疫情相关的应对活动的疫情资金。
