美元外交于中国或有助益
北京灵活地利用国际基金对艾滋病进行预防与治疗。这里说的就是为什么向中国注入资金也可以使世界其他国家受益。
唐安竹 贾平
Jack Chow大使最近在美国《外交政策》杂志发表的文章《吸金十亿：中国对于对外援助的胃口》中指，发展对中国的艾滋病、肺结核及疟疾的多边援助是以牺牲撒哈拉以南非洲国家（的利益）为代价的。这一说法是具有误导性的。毫无疑问,虽然中国可以而且应该投入更多的资源用于满足本国以及全球公共卫生的需求,但是，美国的发展援助,不论是通过双边或多边机制,也都不应该被看作是一方受益而同时使另一方受损的零和努力。
而且，该文章忽略了在许多方面----除了融资之外----全球基金的资金是有益于中国及世界的。在2001年，在前联合国秘书长安南提议下，全球基金于2002年1月建立，它是一家以绩效为基础的组织，其资助基于个体（国家或者其他申请者---译者）的需求及提交的项目书的质量。它也是一家以价值观为基础的组织，要求受助者具有透明的、负责任的、且具备包容性的管理机制。在每个国家的资金申请及项目实施都由选举/推选产生的一个管理委员会进行监管，委员会成员包括有政府代表、联合国机构和捐助者代表、NGO、企业、疾病感染者代表。这个委员会就是众所周知的“CCM即国家协调委员会”。
Chow大使在以下观点上是正确的，即宣称中国卫生部比较其他政府部门而言地位较弱，其最初申请国际资助的动力源于它从官僚体制内无法获得充足的资金支持。然而他的结论并不完整。正是由于治理及资源这两方面的原因，全球基金的角色对于中国而言，和任何在一个健康、稳定和治理良好的中国有利害关系的国家一样，具有特别的价值。
全球基金于2004年左右起开始资助北京，它帮助中国重建了相关的卫生体系，该体系2002-2003年SARS危机中众所周知地运转糟糕。全球基金的资源快速有效地部署了项目点，遍及中国近3000个城市和县镇（原文如此，最近的RCC艾滋病项目涉及1000余个城市----译者），这一部署绕过了官僚机制限制和政治分配过程，否则可能就会看到本来应该用于公共卫生项目的专项资金被挪作他用，特别是地方官员挪用。
这个比较流程化的体系使中国的卫生官员可以向卫生口之外的最高领导层展示在公共卫生项目中进行投资的价值和效果。尽管如此----正如Chow大使所正确指出的----治理问题是中国低效、规模庞大的卫生保健体系面临的一大挑战，对于提高监管水平的需求正在不断增长。
幸运的是，全球基金向中国政府介绍进了重要的管理规范，特别是在关于公众参与决策、透明度、责任制乃至人权保障方面的重要性，比如人体试验保护权益的国际标准等。全球基金在治理和公众参与方面的承诺对于中国长时间进行的政治改革也有做出巨大贡献的潜力。Chow大使是对的，确实，大部分的全球基金的资助被输送到了中国政府部门，而致力于艾滋病预防的草根组织的活动继续面临一连串的限制。可是，全球基金已经开始关注这一问题，它要求受援国在透明度及公众参与机构和项目管理方面要合乎一定的标准。全球基金的（CCM）最低标准要求董事会40%的成员来自私人部门（即指非政府部门-----译者），而非政府部门应在透明及良好记录的基础上选举自己的代表。（2005年，缅甸因不符合全球基金治理的要求而失去了资助）
2006年，卫生部下属的中国疾病预防控制中心协助组织了选举一名公民社会代表参与国家协调委员会（CCM）的活动，这在中国一些艾滋病非营利群体中引发了骚动。在联合国机构与总部设在日内瓦的全球基金秘书处的压力下，中国最终允许公民社会的代表自行组织、并自由选举确定民间社会组织在国家协调委员会上的代表人选。这是北京第一次容许非共产党员来组织全国性的、独立的“选举”/推选程序。国家协调委员会机制代表了中国一个罕见的例子，即在一个决策体中政府官员与公民社会处于平等地位。
自2003年SARS爆发以来，卫生部已经宣称其支持“全社会所有部门”参与促进公共卫生。甚至还拨款给草根组织实施一些AIDS预防项目。以往，政府从不提供资金供草根组织进行公共卫生工作，那在以前被认为只能是政府才能担负的职责。
诚然，变化不是一夜之间出现的。中国政府的主动介入以及鼓励公众参与和推动民主进程必然是一个长期的努力过程。尽管官员个体中，这当中包含了许多在北京的官员，越来越多地看到他们工作中涉及的公民社会的价值，但仍存在其他方面施加的强烈的、严密控制公民社会的政府压力。
全球基金代表了中国政府与国际社会间的对话（机制），而绝不仅仅是援助资金的流入。这种相互作用提供了一个难得的机会，通过民主程序推动对于诸如透明度、责任制和包容等普适价值的理解。
美国应该继续支持全球基金及其在中国的项目投入。对中国预防传染性疾病蔓延的能力的贡献，无疑是符合美国国家利益的。随着经济一体化和人民之间的愈来愈紧密的联系，改善中国的卫生体系，无论直接还是间接都会使美国受益。
最后，美国对全球基金的贡献和其对中国的持续支持，是美国对于中国意图的重要表现。尤其重要的是，在海洋主权、人权、台湾、西藏与贸易问题之后，两国处在一个双边关系高度紧张的时刻——这是美国释放欢迎中国参与国际社会、寻求接纳并最终接受国际准则(就像那些全球基金所笃信推行的那样)的信号。
（作者简介：唐安竹（Drew Thompson )是美国华盛顿智库尼克松中心中国研究部主任，Starr 资深研究员。贾平曾任中国全球基金项目国家协调委员会非政府组织类别代表，现为设在北京的中国全球基金观察项目负责人。）
Dollar Diplomacy Can Be Healthy For China
Beijing is handy at tapping into international funds for HIV/AIDS prevention and treatment. Here's why sending money to China also helps the rest of the world.
BY DREW THOMPSON AND JIA PING | AUGUST 19, 2010
Ambassador Jack Chow's recent FP article, China's Billion-Dollar Aid Appetite, is misleading in its characterization that multilateral development aid sent to China to address HIV/AIDS, tuberculosis, and malaria comes at the expense of sub-Saharan countries. Undoubtedly, while China can and should commit more of its own resources to meeting domestic as well as global public health needs, U.S. development assistance, whether bilateral or through multilateral mechanisms, should not be seen as a zero-sum endeavor where one recipient benefits at the expense of another.
Further, the article overlooks the many ways -- besides simply financial -- that Global Fund dollars are good for China and the world. Proposed by former U.N. Secretary-General Kofi Annan in 2001 and established in January 2002, the Global Fund is a performance-based organization that awards grants based on individual need and the quality of proposals that it receives. It is also a values-based organization, requiring recipients to have transparent, accountable, and inclusive governance mechanisms. Grant applications and project implementation in each nation are overseen by an elected a board of governors, drawing representatives from government, U.N. and donor agencies, NGOs, businesses, and people living with the diseases. This board is known as the "Country Coordinating Mechanism" (CCM).
Ambassador Chow is correct in asserting that China's Ministry of Health is weak in comparison to other Chinese ministries and that its initial motivation to apply for international funds was its inability to garner adequate support from its own bureaucracy. Yet his conclusion is incomplete. It is precisely for these two reasons, governance and resources, that the role of the Global Fund is particularly valuable for China, as well as for any country with a stake in a healthy, stable, and well-governed China.
Global Fund financing, which began to flow to Beijing in 2004, has helped China rebuild its health system, which failed so spectacularly during the SARS crisis in 2002-2003. Global Fund resources have been deployed quickly and efficiently to project sites in nearly 3,000 cities and counties throughout China, bypassing bureaucratic restrictions and political allocation processes that might have seen funds earmarked for health projects diverted elsewhere, particularly by local officials.
This relatively streamlined system enables health officials in China to demonstrate the value and effectiveness of investments in public health projects to top officials [KCD1] outside of the public health stovepipe. It is still true, however -- as Chow rightly points out -- that other inefficiencies and the sheer scale of China's health-care system present challenges for governance; there is a growing need for improved oversight.
Fortunately, the Global Fund introduces important regulatory norms to the Chinese government; particularly the importance of public participation in policymaking, transparency, accountability and even aspects of human rights, such as international standards protecting for protecting the rights of human test subjects. The Global Fund's commitment to governance and public participation has the potential to make a significant contribution to Chinese political reform over time. Ambassador Chow is correct that the bulk of Global Fund grants are channeled to Chinese government departments, while grassroots organizations working on HIV/AIDS preventions continue to face an array of restrictions on their activities in China. However, to begin to address this concern, the Global Fund does require that recipient countries meet standards for transparency and citizen participation in governing organizations as well as programs. The Global Fund's minimum requirements call for 40 percent of the board to come from the private sector. Non-government stakeholders should elect their own representatives in a transparent and well documented manner. (In 2005, Burma lost its grants because it did not meet the Global Fund's governance expectations.)
In 2006, the Chinese Center for Disease Control and Prevention, under the Ministry of Health organized the election of a civil society representative to the CCM, causing an uproar amongst some AIDS nonprofit groups in China. Under pressure from U.N. agencies and the Global Fund secretariat in Geneva, China eventually permitted civil-society representatives to organize themselves and hold free elections to determine who would represent them on the committee. This is the first time that Beijing has allowed non-members of the Communist Party to organize a national, independent election process. The CCM represents a rare instance in which government officials sit as equals with civil society on a decision-making body in China.
To its credit, since the aftermath of the SARS outbreak in 2003, the health ministry has been outspoken in its support for "all sectors of society" playing a role in public health efforts; it has even provided grants to grassroots organizations to implement some AIDS prevention programs. Previously, the government had never provided significant funding to grassroots groups to carry out public health work, which had previously been considered the government's exclusive responsibility.
Granted, change has not come overnight. Engaging the Chinese government and encouraging public participation and democratic processes must be viewed as a long-term endeavor. Although individual officials, including many in Beijing, increasingly see the value of involving civil society in their work, there remains intense government pressure from other quarters to tightly control civil society.
The Global Fund represents a dialogue between the Chinese government and international community, not simply a flow of aid money. The interaction provides a unique opportunity to promote the uptake of such universal values as transparency, accountability and inclusion through democratic processes.
The United States should continue to support the Global Fund and its portfolio in China. It is undoubtedly in the U.S. national interest to contribute to China's capacity to prevent the spread of infectious disease. With the relentless pace of economic integration and growth of people-to-people contacts, improving China's health system benefits Americans, both directly and indirectly.
Finally, the U.S. contribution to the Global Fund and its continued support for China is an important manifestation of U.S. intentions toward China. It is particularly important at a time of heightened tensions in the bilateral relationship -- over maritime sovereignty, human rights, Taiwan, Tibet and trade -- that the United States signals that it welcomes China's participation in the international community and seeks its acceptance and ultimately validation of international norms, such as those espoused by the Global Fund.
Drew Thompson is director of China studies and Starr senior fellow at the Nixon Center in Washington, D.C. Jia Ping is a former board member representing civil society on the China CCM and is currently director of Global Fund Watch, a watchdog NGO based in Beijing.
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贾平 首席执行官
中国全球基金观察项目
北京市朝阳区大望路SOHO现代城4-1508
电话：86-10-85897408/98
传真：8610－85897498
电子邮件：globalfundwatch@gmail.com
Jia Ping Founder & CEO
China Global Fund Watch Initiative
Add: Room 1508,4th Building,SOHO
88,JianGuo Road,Chao Yang District
Beijing,100020,China
Tel:8610-85897498
Fax:8610-85897408
Email:globalfundwatch@gmail.com
1、您收到此信息是由于您订阅了“NGO Action”listserv(非政府组织行动邮件组）。
2、要在此论坛发帖，请发电子邮件到 NGO-Action@googlegroups.com,要退订此论坛，请发邮件至 NGO-Action-unsubscribe@googlegroups.com。您也可以通过 http://groups.google.com/group/NGO-Action?hl=en 访问该论坛。
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中国全球基金观察项目
北京市朝阳区大望路SOHO现代城4-1508
电话：86-10-85897408/98
传真：8610－85897408
电子邮件：gfwatch@gmail.com
China Global Fund Watch Initiative
Add: Room 1508,4th Building,SOHO
88,JianGuo Road,Chao Yang District
Beijing,100020,China
Tel:8610-85897408/98
Fax:8610-85897408
Email:gfwatch@gmail.com
Established in Beijing in 2007, China Global Fund Watch Initiative serves as a Non-for-profit organization and think tank which involve into public participation, good governance and transparency.GF Watch also works on public health policy & legal research and access to drugs issues.
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★Archives for UNAIDS CCC http://www.HungerStrikeforAIDS.org/changkun
★Boycott Bill & Melinda Gates Foundation in China https://sites.google.com/site/boycottgatesfoundation/
★爱行马拉松俱乐部（AIDS Walk China），―"彻底实现感染者正常就医的权利"
-~----------~----~----~----~-
"China AIDS Group中国艾滋病网络"
A：论坛发帖，请发电子邮件到 chinaaidsgroup@googlegroups.com
B：退订此论坛，请发邮件至 chinaaidsgroup-unsubscribe@googlegroups.com
C：Contact: Chang Kun 13349108944 changkun2010@gmail.com
★中国艾滋病博物馆/China AIDS Museum： http://www.AIDSmuseum.cn
旗下网站：
――艾博维客 AIDS Wiki ： http://www.AIDSwiki.org
――艾博聚合（艾滋病博客群
）http://www.wanyanhai.org
――China AIDS Email Group with over 2400 members:http://chinaaidsgroup.blogspot.com
――中国艾滋病地图/China AIDS Map：http://www.AIDSmaps.org
――空腹健身运动：http://www.HungerStrikeforAIDS.org
――艾滋人权 AIDS Rights： http://www.AIDSrights.net
――为艾滋病防治努力一生：Http://www.changkun.org
★ 凡是挑�、��、非理性、�於情�性、胡�批�和�意�之言�，或是匿名人士之言�，以及所�表意�出�有不雅、粗鄙之文字等，本�件��不予以�示！
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