2026-04-03 10:15:32 UTC / 路透社
作者：阿穆·坎皮利、詹妮弗·里格比
2026年4月3日 美国东部时间上午10:15 | 更新于1小时前
- 概要
- 美国计划于5月30日终止现有医疗援助交付机制
- 尚未明确替代方案
- 美国国务院及消息人士警告仓促过渡存在风险
- 美国拟与非洲国家签署的卫生合作协议面临阻碍
- 美国国际开发署已向90个国家交付价值50亿美元的医疗物资，主要惠及非洲和亚洲国家
内罗毕/伦敦，4月3日（路透社）——据七位消息人士及一封内部邮件显示，美国正在彻底改变其向低收入国家提供艾滋病、疟疾等疾病医疗物资的方式，这可能在一年多时间内再次打乱救命医疗服务的供应。
此前，美国一直通过由私营承包商切莫尼克斯（Chemonics）运营的“全球卫生供应链计划——采购与供应管理”项目管理医疗捐赠。自2016年该项目成立至2024年，已向90个国家交付了价值逾50亿美元的艾滋病和疟疾相关物资，其中大部分位于撒哈拉以南非洲和亚洲地区。
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去年1月特朗普总统就职首日冻结国际援助时，该项目一度暂停，导致数百万美元的物资滞留在港口和仓库中，其中包括引发艾滋病的HIV病毒治疗药物以及经杀虫剂处理的蚊帐。在美国为救命物资发布豁免令后，大部分工作才得以重启。
然而，随着本届政府缩减并重塑对外援助政策，解散美国国际开发署（USAID）、削减预算，并将承包商管理模式改为与其他国家签订双边协议，该项目的未来一直悬而未决。
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美国援助体系剧变或加剧药品短缺
五位消息人士称，此次变革的速度可能导致部分国家的救命产品供应出现短缺或缺口，造成严重后果。
美国国务院周二在一封邮件中要求其在17个非洲国家及海地的工作人员，于5月30日前停止执行该供应计划。
邮件称，与切莫尼克斯的合同将于9月30日终止，这符合美国国际开发署所有合同的惯例——尽管该合同的官方终止日期为11月。
路透社看到了这封邮件，并经两位消息人士核实。邮件同时警告，若“过渡过程仓促或未完成，可能立即对服务连续性构成风险”。
邮件并未明确列出清晰的过渡计划，反而要求每个美国驻外办事处自行制定移交方案，并就任何风险或延长时间的需求向华盛顿汇报。
一位发言人表示，美国国务院“未向切莫尼克斯提供任何技术指令，要求其在5月30日或其他任何日期停止运营”。切莫尼克斯拒绝置评。
六位消息人士称，美国正与抗击艾滋病、结核病和疟疾全球基金（简称全球基金）洽谈，未来将使用该基金的供应平台采购和交付全球卫生项目捐赠物资。
总部位于日内瓦的全球基金每年已为这三大致命传染病管理约20亿美元的医疗产品采购和供应工作，并与项目所在国的合作伙伴组织合作。该基金还拥有供合作伙伴使用的在线采购平台。
其中两位消息人士透露，该组织与美国政府此前的讨论曾聚焦于2027年11月完成过渡。
他们表示，新的时间表并不现实——为偏远地区采购医疗产品可能需要长达一年的时间，而非目前设想的数周。
全球基金拒绝置评。美国国务院未就是否与该基金进行洽谈的具体问题作出回应，但表示将利用现有的集中采购机制，从私营制造商处以最低价格采购物资。
“美国优先”式援助
去年，特朗普政府称其全球卫生计划将优先为一线医疗物资、医护人员和技术人员提供资金，并直接与单个国家开展合作。
去年9月发布的《美国优先全球卫生战略》称，承包商是该国试图从体系中根除的“严重低效和浪费”的一部分。
但美国调整援助交付方式的速度之快已在全球范围内引发问题，包括儿童疟疾药物短缺以及艾滋病预防工作出现缺口。
美国国务院发言人表示，当前的体系是“过时发展模式下的臃肿部分”，“未将美国纳税人的利益放在首位，反而为美国大型发展企业牟取私利”。
他们称，美国政府目前已与受援国政府签署了28项双边卫生合作协议，未来将主要使用私营物流公司分发物资。
近几个月来，华盛顿承诺直接向肯尼亚、卢旺达和乌干达等国政府提供资金，并承诺增加各国的国内卫生支出。
但具体细节仍在敲定中。肯尼亚的协议因数据隐私问题面临肯尼亚活动人士的法庭挑战，而与赞比亚政府的谈判也已推迟。
由阿穆·坎皮利在内罗毕、詹妮弗·里格比在伦敦报道；乔纳森·斯坦普尔补充报道；凯文·利菲编辑
本报道符合路透社编辑准则：汤森路透信托原则。
Exclusive: US upends global supply program for malaria and HIV amid warnings of gaps
2026-04-03 10:15:32 UTC / Reuters
By Ammu Kannampilly and Jennifer Rigby
April 3, 2026 10:15 AM UTC Updated 1 hour ago
A health worker administers a dose of the RTS,S malaria vaccine, also known as Mosquirix, at the Mother and Child Hospital in Kasoa, Ghana, November 19, 2025. REUTERS/Francis Kokoroko
- US seeks to wind up health aid delivery mechanism from May 30
- No clear replacement plan in place
- State Department and sources warn of risks of rushed transition
- Planned U.S. health pacts with African nations face hurdles
- USAID had delivered $5bn in supplies to 90 countries, mainly in Africa and Asia
NAIROBI/LONDON, April 3 (Reuters) – The U.S. is upending the way it delivers medical supplies for diseases such as HIV and malaria to lower-income countries, according to seven sources and an internal email, risking a second dislocation of life-saving services in just over a year.
The U.S. has until now managed its medical donations through the Global Health Supply Chain Program – Procurement and Supply Management – run by the private contractor Chemonics. From its establishment in 2016 to 2024, it delivered a total of more than $5 billion of HIV and malaria products to 90 countries, mostly in sub-Saharan Africa and Asia.
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That program was halted when President Donald Trump froze international aid on the first day of his presidency in January last year, stranding millions of dollars of supplies in ports and warehouses – from drugs for HIV, which causes AIDS, to insecticide-treated bed nets. Much of that work restarted after the U.S. issued a waiver for products that were life-saving.
However, its future has been up in the air as the administration has reduced and reshaped foreign aid, dismantling the U.S. Agency for International Development (USAID), cutting budgets, and switching from management by contractors to bilateral agreements with other countries.
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U.S. AID UPHEAVAL LIKELY TO CAUSE MORE MEDICINE SHORTAGES
Five sources said the speed of the change could cause shortages or gaps in the provision of life-saving products in some countries, with grave impacts.
The U.S. State Department asked U.S. staff in 17 African countries and Haiti in an email on Tuesday to cease implementing the supply program by May 30.
It said the contract with Chemonics was ending on September 30, in line with all USAID awards – although its official end date is in November.
The email, seen by Reuters and verified by two sources, also said there could be “immediate risks to service continuity if (the) transition is rushed or incomplete”.
It did not lay out a clear transition plan, instead asking each U.S. country office to set out how it would implement the handover, and to inform Washington of any risks or need for more time.
A spokesperson said the State Department had “not provided any technical direction to Chemonics to cease operations by May 30 or any other date”. Chemonics declined to comment.
Six sources said the U.S. was talking to the Global Fund to Fight AIDS, Tuberculosis and Malaria about using its supply platform to procure and deliver donations of global health products in future.
The Global Fund, a Geneva-based health initiative, already manages the purchase and supply of around $2 billion a year in health products for the three deadly infectious diseases, alongside partner organisations in the countries where it works. It also has an online procurement platform used by partners.
Two of those sources said earlier discussions between the organisation and the U.S. government had focused on a November 2027 transition.
They said the new timeline was unrealistic as ordering medical products for use in hard-to-reach locations could take up to a year, rather than the matter of weeks now being envisaged.
The Global Fund declined to comment. The State Department did not respond to specific questions on whether it was talking to the Fund, but said it would use available pooling mechanisms to buy supplies at the lowest prices from private manufacturers.
AMERICA-FIRST AID
Last year, the Trump administration said its global health plans would prioritise funding front-line health supplies, health workers and technicians, and working directly with individual countries.
The America First Global Health Strategy, published in September, said contractors were part of the “significant inefficiency and waste” that it was trying to root out of the system.
But the speed of the changes to how the U.S. delivers aid has already caused problems around the world, including shortages of malaria drugs for children and gaps in HIV prevention.
The State Department spokesperson said the current system was “a bloated piece of an obsolete development model” that “does not put the American taxpayers first and instead helps to line the pockets of large U.S.-based development firms”.
They said the U.S. government had now signed 28 bilateral health pacts with recipient governments, and would mostly use private logistics firms to distribute supplies.
In recent months, Washington has pledged to provide funding directly to the governments of countries including Kenya, Rwanda and Uganda, alongside promises of increased national spending.
But details are still being hammered out. The Kenya agreement faces a court challenge by Kenyan activists over data privacy concerns, while negotiations with the Zambian government have been delayed.
Reporting by Ammu Kannampilly in Nairobi and Jennifer Rigby in London; additional reporting by Jonathan Stempel; Editing by Kevin Liffey
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