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The financial sustainability of the World Health Organization and the political economy of global health governance: a review of funding proposals

机译:世界卫生组织的财务可持续性和全球卫生治理的政治经济学:对供资提案的审查

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摘要

The World Health Organization (WHO) continues to experience immense financial stress. The precarious financial situation of the WHO has given rise to extensive dialogue and debate. This dialogue has generated diverse technical proposals to remedy the financial woes of the WHO and is intimately tied to existential questions about the future of the WHO in global health governance. In this paper, we review, categorize, and synthesize the proposals for financial reform of the WHO. It appears that less contentious issues, such as convening financing dialogue and establishing a health emergency programme, received consensus from member states. However, member states are reluctant to increase the assessed annual contributions to the WHO, which weakens the prospect for greater autonomy for the organisation. The WHO remains largely supported by earmarked voluntary contributions from states and non-state actors. We argue that while financial reform requires institutional changes to enhance transparency, accountability and efficiency, it is also deeply tied to the political economy of state sovereignty and ideas about the leadership role of the WHO in a crowded global health governance context.
机译:世界卫生组织(世卫组织)继续承受着巨大的财务压力。世卫组织不稳定的财务状况引起了广泛的对话和辩论。这场对话产生了各种技术建议,以弥补世卫组织的财务困境,并且与关于世卫组织在全球卫生治理中的未来的现实问题紧密相关。在本文中,我们将对WHO财务改革的建议进行审查,分类和综合。似乎不太引起争议的问题,例如召开筹资对话和制定卫生紧急计划,已获得成员国的共识。但是,成员国不愿增加对世界卫生组织的年度分摊会费,这削弱了该组织获得更大自治权的前景。世卫组织在很大程度上仍得到各州和非国家行为者的专用自愿捐款的支持。我们认为,尽管金融改革要求进行体制改革以提高透明度,问责制和效率,但它也与国家主权的政治经济学以及关于在拥挤的全球卫生治理背景下世界卫生组织的领导作用的观念息息相关。

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