【中文标题】巨大的争议声中，国际艾滋病组织停止对华援助
【原文标题】AIDS Funds Frozen for China in Grant Dispute
【登载媒体】纽约时报
【原文作者】SHARON LaFRANIERE
【原文链接】http://www.nytimes.com/2011/05/21/world/asia/21china.html?_r=1&ref=china
一位濒死的艾滋病人在接受妻子的安抚。一家国际基金组织冻结提供给中国的对抗HIV病毒的款项。
全球抗击艾滋病、结核病和疟疾基金会冻结了向中国提供的数亿美元援助款，中国是该慈善机构最大的援助接受方之一。原因是其内部对于中国管理援助款项的方式和对草根组织参与公共健康问题的敌意所产生的巨大争论。
争论的焦点是全球医疗健康专业人士一直以来关注的问题，即中国2008年的奥运会和去年上海世博会共花费了460亿美元，还投入5860亿美元刺激本土经济，那么它是否还有资格成为艾滋病资助的受益方。
这项基金建立于2002年，主要吸纳私人和官方捐赠，目前已经遍布150个国家，其宗旨是对抗致命性最高的一些疾病。11月份，它悄悄决定停止向中国支付最大一笔艾滋病防治款项。几个星期之前，它又对基金的监管产生疑虑，因此冻结了其它疾病防治款项。
这个决定源于该基金会与中国政府之间的观念冲突，基金会的宗旨是草根组织必须从根本上介入与艾滋病一类疾病的斗争中，而中国政府对不受自身控制的民间团体持越来越不信任的态度。在此之前，一些艾滋病活动人士曾经抱怨，中国官员压制他们的公益健康活动；把得到的拨款转移给政府控制的组织手中；无法说出款项花费明细。
用来降低结核病发病率、预防和治疗人体免疫病毒传染、消除疟疾的数亿美元资金目前岌岌可危。据国际基金组织网站上的信息，从2003年开始，中国共接受了该组织5.39亿美元的资金。另有2.95亿美元正在筹划过程中，一位国际健康专家说，这让中国成为继埃塞俄比亚、印度和坦桑尼亚之后的第四大被援助国。
国际基金组织把中国排除出被援助国名单的决定，对中国政府来说是再尴尬不过的事情了。因为这表示中国政府无法满足国际组织的最低标准，这些资金本来是准备发放给更加落后的国家。对于某些资金管理不善的现象，基金组织会终止发放款项，或正式暂停放款。无限期暂停放款是比临时停止放款更加严厉的举措，后者还可以通过克服一系列重大的障碍以获得继续放款的资格。
星期五，在连续两天基金组织官员和政府代表的密集谈判之后，似乎不需要采取这些更加严厉的惩罚性措施了。全球基金组织的一位发言人Jon Liden说，中国在星期五同意了有关资金使用和监管的众多条款，“现在是向中国明确表明我们的态度的时候了，我们似乎对前进方向取得了共识。”本周，谈判进展的消息灵通人士透露，中国向国际基金组织保证，它将退还被滥用的资金。但是一些人担心，让民间社会组织参与医疗健康活动依然是一个待解决的问题。
这次会议举办的背景是有越来越多的声音出现，质疑中国是否有资格在基金组织巨额善款中受益。作为一个中等收入国家，中国的确有资格接受援助，就像泰国、印度、菲律宾和其它一些拉丁美洲国家一样。但是与那些更加贫穷的国家不同，中国等国家需要为开展资助项目所产生的成本做一定比例的贡献。
但是，中国在国际社会中的巨大成功——包括那些实力深不可测的国有企业——引起了激烈的指责和批判，国际卫生组织前首席助理总干事Jack Chow就是反对者之一。Chow博士现在是卡耐基梅隆大学的教授，他认为中国卫生部索要援助，只不过是因为中国政府想用这笔钱在国家“硬实力”机构上大肆挥霍，或者投资其它部门。
他在7月份《外交政策》中的一篇文章中写道：“中国越来越大的胃口威胁到了国际基金组织运作的大前提。”当基金组织努力挣扎获取捐助时，“如果捐款人发现如此巨大的一笔钱给到一个完全可以自己负担医疗项目的国家，他们会越来越不愿意发善心。”
他写道，中国对基金组织的捐款只有区区1600万美元，而最大捐助国美国的捐款额为55亿美元。基金组织官员已经重新审阅了款项发放的标准设定，少于预期的捐助善款让他们不得不更加谨慎地选择被援助方。
一些基金组织官员认为中国不大可能再申请到其它大额资助款项。然而，基金组织官员又坚称，有关是否符合条件的争论没有影响到暂停放款的决定。
去年年末的审计发现，中国没有按照其承诺把2.83亿美元艾滋病援助款中的35％发放到社区级组织手中，基金组织与中国政府之间的关系因此变得紧张起来。这笔款项本计划主要用于社区内的艾滋病防治工作，尤其是针对吸毒者和卖淫者的艾滋病防治。
根据一家非政府组织——全球基金观察的报告，中国实际上只把援助款中的11％发放给非政府组织。一次外部审计发现，社区组织似乎就没有出现在款项发放名单中。
有消息称，中国官员反对这样的说法，他们认为无法信任民间组织会恰当地使用国际基金组织的援助款，政府机构更值得相信。但是本周接受采访的活动人士不同意这种观点。
其中一位活动人士常昆声称，政府官员和那些由政府成立的“官方非政府组织”通常会截留一半以上的援助款。他说，他在中国西部新疆地区所领导的一个艾滋病权益组织在2005年只收到了大约3000美元的援助款。没想到后来又不得不把这笔钱原数奉还，因为当地政府解散了他的组织。
他说：“他们把我们组织的活动看作是给政府制造麻烦，他们不喜欢非政府组织，也不喜欢人们牵头组织活动。我已经为艾滋病人抗争了7年，极少见到有人拿到全球基金组织的援助款。”
河北省艾滋病组织领导人沈志齐说，他支持基金组织收回援助款的决定，因为“我真的不愿看到国际基金组织的善意被腐败的黑洞所吞噬。”但他又说并非完全赞同停止援助，因为这会伤害到草根组织。
中国政府对这类组织已经提防多年，一位高官在本周早些时候透露了些许政府的思路。中央政法委秘书长周本顺在党内刊物《求实》上发表文章，说中国必须“防止误信、误传甚至落入某些西方国家为我们设计的所谓“公民社会”的陷阱。”
原文：
A Chinese man dying of AIDS was comforted by his wife. A global fund has frozen payments to China to fight H.I.V.
BEIJING — The Global Fund to Fight AIDS, Tuberculosis and Malaria has frozen payments on hundreds of millions of dollars worth of disease-fighting grants to China, one of the charity’s biggest recipients, in a dispute over China’s management of the grants and its hostility toward involving grass-roots organizations in public health issues.
The dispute may add to a growing debate among global health experts whether China, which spent an estimated $46 billion staging the 2008 Olympic games and last year’s Shanghai Expo and financed a $586 billion economic stimulus package, should be a recipient of such aid at all.
The fund, which has expanded to 150 countries since it was founded in 2002 as a pool for public and private donations to fight the world’s worst diseases, quietly decided to hold back payments from a major AIDS grant to China in November. It froze payments from other grants to China several weeks ago because of fresh concerns over lack of monitoring of funds.
Its decisions appear rooted in a collision between the fund’s conviction that grass-roots organizations must be intrinsically involved in the fight to control diseases like AIDS, and the Chinese government’s growing suspicion of any civil-society groups that are not directly under its control. They follow complaints by some AIDS activists that Chinese officials have sought to suppress their public-health activities, have shunted grant money to groups under government control and have failed to account for how some funds were spent.
At stake are hundreds of millions of dollars for programs to reduce the incidence of tuberculosis, prevent and treat H.I.V. infections and wipe out malaria. China has received $539 million from the Global Fund since 2003, according to the fund’s Web site. An additional $295 million is in the pipeline, making China the fund’s fourth largest recipient behind Ethiopia, India and Tanzania, one global health expert said.
A decision by the Global Fund to pull out of China would be hugely embarrassing for the Chinese government because it would suggest that China was unable to meet the standards of an international organization that dispersed funds to far less sophisticated governments. The fund can terminate grants that have been mismanaged or short of that, formally suspend them. Suspension is a harsher step than halting payments and sets up a series of major obstacles to the release of additional funds.
Those more punitive measures seemed to have been averted Friday after two days of tense meetings between officials from the fund and the government. Jon Liden , a spokesman for the Global Fund, said China agreed Friday to a number of stipulations on how money would be used and monitored. “We came to a point where we needed to make clear signals to China,” he said. “We seem to share an understanding of the way forward.” This week, sources familiar with the negotiations said China pledged to the Global Fund that it would repay any funds that were misspent. But some fear that the inclusion of civil society groups in the health effort may still be an issue.
The meetings took place against the backdrop of growing questions over whether China should be allowed to benefit from the fund’s largesse. As a middle-income country, China qualifies for grants, as do Thailand, India, the Philippines and a number of Latin American countries. Unlike poorer countries, those nations are expected to contribute a certain percentage of the cost of the programs financed.
But China’s huge success in winning awards — coupled with growing evidence of the government’s deep pockets — has inspired fiery criticism, including from Jack Chow, a former first assistant director general of the World Health Organization who helped create the Global Fund. Dr. Chow, now a professor at Carnegie Mellon University, has argued that China’s Health Ministry seeks aid only because the Chinese government chooses instead to lavish funds on “hard power” agencies or to invest it in other sectors.
“China’s persistent appetite threatens to undermine the entire premise behind the Global Fund,” he wrote in the July issue of Foreign Policy. At a time when the fund is struggling for contributions, he wrote, “Donors will grow even more reluctant if they realize that substantial funds are being awarded to a country that can more than pay for its own health programs.”
China’s contributions to the fund amount to a mere $16 million, compared with $5.5 billion from the United States, the leading donor, he wrote. Fund officials have been reviewing the question of eligibility criteria, and lower-than-expected donations are now forcing them to be more selective about recipients.
Some fund officials suggest that China is not expected to apply for major new grants. Nonetheless, fund officials insist the controversy over eligibility criteria had no bearing on the fund’s decision to hold up payments.
The problems between the fund and China turned serious late last year after audits revealed that China had failed give 35 percent of a $283 million AIDS grant to community-based organizations, as it had pledged. The grant focused on community-based H.I.V. treatment and prevention, especially focusing on drug users and prostitutes.
According to a report by a nongovernment group called Global Fund Watch, China actually allocated less than 11 percent to nongovernment groups. An external audit found that community groups appeared to be left out of strategy sessions.
Chinese officials countered that many civil society groups could not be trusted to properly spend the Global Fund’s money and that government agencies were more trustworthy, sources said. But in interviews this week, activists challenged that view.
One, Chang Kun, alleged that government officials or “official NGOs” created by the government routinely pocketed more than half the grant funds. He said that an AIDS rights group that he headed in western China’s Xinjiang region had received a grant of roughly $3,000 in 2005, only to be forced to return it because the government disbanded his group.
“They view our campaigning as troublemaking. They don’t like private NGOs and people taking up organizing roles,” he said. “I have been campaigning for AIDS patients for seven years now, and I rarely see people getting any benefits from the Global Fund.”
The Hebei Province director of an AIDS support group, Shen Zhiqi, said that he supported the fund’s decision to withhold funds, because “I really don’t want to see something as well-intentioned as the Global Fund be sucked into the black hole of corruption.” But he said he did not endorse totally withdrawing financing because it would hurt grass-roots groups.
The Chinese government has been wary of such groups for years. One prominent official gave a taste of the government’s thinking earlier this week. In Qiushi, a Communist Party journal, Zhou Benshun, the secretary general of the party’s political and legislative affairs commission, wrote that China must “guard against being misled to the point of falling into the trap of so-called ‘civil society’ devised by certain Western countries.” |
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发表于 2011-6-8 13:50
