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      雙語:撒哈拉以南非洲:我們需要立刻行動起來
      發布時間:2021年10月29日     發布人: nanyuzi
      來源: 國際貨幣基金組織
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      Sub-Saharan Africa: We Need to Act Now

      撒哈拉以南非洲:我們需要立刻行動起來

       

      By Kristalina Georgieva and Abebe Aemro Selassie

      克里斯塔利娜·格奧爾基耶娃 阿貝貝·埃姆羅·塞拉西

       

      28 July 2021

      2021年7月28日

       

      Sub-Saharan Africa is in the grips of a third wave of COVID-19 infections that threatens to be even more brutal than the two that came before.

      撒哈拉以南非洲正在經歷第三波疫情,這波疫情可能比之前的兩波更為嚴重。

       

      This is yet more evidence of a dangerous divergence in the global economy. One track for countries with good access to vaccines, where strong recoveries are taking hold. And another for those countries that are still waiting and at risk of falling further behind.

      這是全球經濟出現危險分化的又一證據。疫苗充足的國家正在經歷日趨穩固的經濟復蘇,而仍在等待疫苗的國家可能會落后得更遠。

       

      The growth of infections in sub-Saharan Africa is now the fastest in the world, with an explosive trajectory that is outpacing the record set in the second wave. At this pace, this new wave will likely surpass previous peaks in a matter of days – and in some countries, infections are already more than double, or even triple, their January peaks. The latest (delta) variant – reportedly 60 percent more transmissible than earlier variants – has been detected in 14 countries. When the pandemic first hit, quick action by policymakers helped prevent infection rates seen elsewhere around the world. But it pushed already strained local health systems to the breaking point. Only six months after the initial crisis, the region experienced a second wave that swiftly outpaced the scale and speed of the first. Now, another six months on, sub-Saharan Africa faces its third devastating wave. The only way for the region to break free from this vicious pandemic cycle is to swiftly implement a widespread vaccination program.

      從全球范圍看,撒哈拉以南非洲感染人數的增長速度目前是最快的,病例呈爆發式增長,超過了第二波疫情的創記錄水平。按照當前的傳播速度,數天之內,新一波疫情就可能超過之前的感染人數峰值——在一些國家,感染病例已經達到今年1月峰值水平的兩倍甚至三倍。14個國家已經發現了最新的德爾塔變異病毒株——據報道其比早先的變異病毒株傳染性強60%。疫情最初暴發時,政策制定者的迅速行動使撒哈拉以南非洲避免了其他地區出現的高感染率。但當地醫療衛生體系也由此不堪重負。最初的危機暴發之后僅六個月,撒哈拉以南非洲經歷了第二波疫情,其規模和速度很快超過了第一波疫情?,F在又過了六個月,該地區正受到第三波疫情的嚴重沖擊。撒哈拉以南非洲地區擺脫這種惡性循環的唯一途徑就是迅速實施廣泛的疫苗接種計劃。

       

      A still-vulnerable region

      撒哈拉以南非洲地區依然脆弱

       

      The sheer speed of this third wave highlights the difficulty policymakers in sub?Saharan Africa face in heading off a crisis once it gets under way. In Namibia, for example, new cases reached the previous January peak within only two weeks, and tripled another two weeks later. For many countries, by the time a new surge is identified, it may already be too late.

      第三波疫情傳播速度極快,這突出表明,一旦疫情蔓延開來,撒哈拉以南非洲地區的政策制定者擊退危機就面臨相當大的難度。例如,在納米比亞,新病例在僅僅兩周之內就達到1月份的峰值水平,兩周之后則增至三倍。對于許多國家來說,確定發生新一波疫情時,可能已經為時太晚。

       

      And the options employed during previous waves may no longer be feasible. The re-imposition of containment measures would likely come at too high an economic and social cost, and is simply unsustainable – and unenforceable – over a prolonged period. Looking back, most sub-Saharan African countries entered the second wave in a more difficult economic position than the first, with shrinking fiscal resources to protect the vulnerable, additional millions thrown into poverty, and depleted household balance sheets. While some countries have taken steps to improve preparedness, unfortunately, very few have had sufficient resources – or time – to strengthen public health systems. And, now, the scale of the current wave is once again threatening to overwhelm local health systems. News reports across the region point to overwhelmed hospitals. The sick are dying while waiting for a bed. Non-emergency surgeries have been canceled to preserve space for COVID-19 patients. And military hospitals have been opened for civilian use. Oxygen has become a key constraint, with supply already failing to keep up with the demand for critically-ill patients. The region’s scarce health workers continue to be at risk.

      前兩波疫情期間采取的方案可能不再可行。重新實施防疫措施的經濟和社會成本可能太高,并且長期來看不可持續、無法執行?;剡^頭看,第二波疫情襲來時,大多數撒哈拉以南非洲國家的經濟狀況比第一波疫情暴發時要困難得多,保護脆弱群體的財政資源不斷減少,又有數百萬人陷入貧困,家庭資產負債狀況急劇惡化。盡管一些國家已經采取措施提高危機防范能力,但很少有國家擁有充足的資源或充裕的時間來加強公共醫療衛生體系。當前這波疫情規模之大,再次使當地醫療衛生體系不堪重負。該地區的新聞報道普遍顯示,各地的醫院已經人滿為患。病人因等不到床位而面臨死亡;為了給新冠病人留出位置,非急救手術被取消;軍隊醫院已向民眾開放。氧氣成為一個關鍵的制約因素,其供給已經跟不上危重病人的需求。撒哈拉以南非洲地區稀缺的醫護人員繼續面臨風險。

       

      The risks of leaving Africa behind

      非洲可能被落在后面

       

      The vaccine rollout in sub-Saharan Africa remains the slowest in the world. Less than 1 adult in every hundred is fully vaccinated, compared to an average of over 30 in more advanced economies. This means even most essential frontline workers continue to work unprotected. In this context, some of the world’s more fortunate countries have stockpiled enough vaccines to cover their populations many times over.

      撒哈拉以南非洲的疫苗普及速度在全球仍是最緩慢的。每100名成人中還不到1人完全接種了疫苗,而在更為發達的經濟體則平均超過30人。接種率如此之低,意味著最關鍵的一線工作人員仍沒有得到有效防護,與此同時,世界上一些更富裕的國家已經儲備了足以為本國人口接種多次的疫苗劑量。

       

      Without significant, upfront, international assistance – and without an effective region-wide vaccination effort – the near-term future of sub-Saharan Africa will be one of repeated waves of infection, which will exact an ever-increasing toll on the lives and livelihoods of the region’s most vulnerable, while also paralyzing investment, productivity, and growth. In short, without help the region risks being left further and further behind. And the longer the pandemic is left to ravage Africa, the more likely it is that ever more dangerous variants of the disease will emerge. Vaccination is not simply an issue of local lives and livelihoods. It is also a global public good. For every country – everywhere – the most durable vaccine effort is one that covers everyone, in every country. What can be done to speed up the vaccine effort? IMF staff has put forward a global proposal that targets vaccinating at least 40 percent of the total population of all countries by end-2021, and at least 60 percent by the first half of 2022. Africa is expected to receive 30 percent vaccination coverage through COVAX and another 30 percent coverage through the African Vaccine Acquisition Task Team (AVATT), established by the African Union under the leadership of President Cyril Ramaphosa.

      如果不先行提供大規模國際援助——不在整個撒哈拉以南非洲地區范圍內開展有效的疫苗接種工作,那么該地區近期內將會經歷數波疫情,而這將對該地區最脆弱民眾的生命和生計帶來越來越大的沖擊,同時也會導致投資、生產率和經濟增長陷入癱瘓。簡而言之,如果得不到幫助,撒哈拉以南非洲地區將面臨越來越落后的風險。疫情在非洲肆虐時間越長,該地區就越有可能出現更危險的變異毒株。疫苗接種不僅僅是關乎當地生命和生計的問題,同時其也是一項全球公共產品。對于每個國家、世界每個角落,為實現最持久的復蘇,需要在全球范圍內開展疫苗接種行動,覆蓋到每個國家的每一個人。如何能夠加快疫苗接種?IMF提出了一項全球建議,目標是到2021年底,所有國家接種疫苗的人口比例至少達到40%,2022年上半年至少達到60%。非洲的疫苗接種需求預計有30%將通過新冠肺炎疫苗實施計劃(COVAX)來滿足,另有30%將通過非洲聯盟成立的非洲疫苗采購工作組(AVATT,西里爾·拉馬福薩總統領導)來滿足。

       

      We see seven key steps to ensure these vaccination targets are met:

      為確保實現上述疫苗接種目標,我們認為需要采取七項關鍵措施:

       

      First, it is essential to deliver vaccines to sub?Saharan Africa as soon as possible. Given that much of the global supply of vaccines for 2021 has already been bought up, many countries will be forced to wait until 2022 to get them. So, the fastest way to get vaccines to sub?Saharan Africa is for advanced economies to share their stockpiles bilaterally or through multilateral initiatives. COVAX has already received pledges for over half a billion doses. But these need to turn into actual deliveries as soon as possible to make a difference. Indeed, the goal should be to get a quarter of a billion doses to the region by September. Second, vaccine manufacturers should speed up supply to Africa for the rest of this year. Advanced economies with vaccine manufacturing capabilities should encourage their manufacturers to do so, especially when demand at home is falling short of supply. Third, AVATT should be fully financed to ensure coverage of 30 percent of the African Union population. This requires an estimated $2 billion, that would for example allow AVATT to execute its optional contract of 180 million doses with J&J. Fourth, remove cross-border export restrictions on raw materials and finished vaccines. This includes ensuring that the Aspen facility in South Africa – a key supplier to AVATT – is operational at full capacity, and resuming exports from the Serum Institute of India to COVAX. African vaccination plans rely heavily on these two facilities. Fifth, financing of at least $2.5 billion and upfront planning will also be critical to ensure health systems can deliver shots-in-arm promptly as vaccine supply ramps up. Many countries in the region, including eSwatini, Ghana, Kenya, Namibia, and Rwanda, have quickly and effectively administered their limited supplies. These countries, along with others in the region, have had to place their vaccine campaigns on hold as they wait for the arrival of the new supplies that they have recently procured at comparatively high cost or the donated supplies from other countries’ stockpiles. It is these shortages – rather than the ability to administer shots – that has so far been the biggest constraint. But when supply picks up, health systems must be prepared to vaccinate as many people as possible. And this is doable as the experience in many developing countries show – the likes of Seychelles, Mongolia, Bhutan, and Maldives impressively scaled-up vaccinations quickly once their vaccine supplies arrived. Alongside vaccination efforts, countries must also ensure that their public health systems are able to handle an influx of cases. This includes accelerating the acquisition of vital COVID-19 health tools, including therapeutics, oxygen, and personal protective equipment. No matter what the speed of vaccinations, these supplies are needed now to help save lives. This will require urgent grant financing to pre-emptively procure and deliver a minimum package of critical COVID-19 Health Tools to address the rising health and economic costs arising from the surge in cases driven by the delta variant.

      第一,必須盡快向撒哈拉以南非洲國家提供疫苗。鑒于2021年全球大部分疫苗供給已被訂購完畢,許多國家可能不得不等到2022年。因此,使撒哈拉以南非洲能夠盡快獲得疫苗的途徑是,發達經濟體通過雙邊或多邊渠道分享其疫苗儲備。COVAX已經收到超過5億劑的捐贈承諾。但需要盡快落實這些承諾才能真正起到作用。事實上,目標應該是在今年9月之前向撒哈拉以南非洲地區提供2.5億劑疫苗。第二,在今年剩下的時間里,疫苗生產商應加快向非洲供給疫苗。具備疫苗生產能力的發達經濟體應鼓勵其生產商這樣做,特別是在國內需求不足的情況下更應如此。第三,AVATT應得到充分的資金支持,以確保非洲聯盟國家人口的30%獲得疫苗接種。這方面的資金需求估計為20億美元,這些資金將使AVATT能夠執行其與強生公司簽訂的1.8億劑疫苗的可選合同。第四,應取消對疫苗生產原材料和疫苗制成品的跨境出口限制,包括確保南非的Aspen生產廠(AVATT的主要供應商之一)滿負荷運轉,并恢復印度血清研究所向COVAX的出口。非洲疫苗接種計劃高度依賴這兩個生產基地。第五,必須安排至少25億美元的資金并做出前期規劃,以確保醫療衛生體系在疫苗供給增加后能夠落實接種工作。該地區的許多國家(包括斯威士蘭、加納、肯尼亞、納米比亞和盧旺達)已經迅速有效地為人們接種了有效數量的疫苗。這些國家以及該地區其他國家不得不暫時停止接種工作,等待新的疫苗供給。新疫苗要么是它們最近以相對較高成本采購的,要么是其他國家從其庫存中捐贈的。到目前為止,最大的制約因素是疫苗供給的短缺,而不是實施接種的能力。但當疫苗供給增加時,醫療衛生體系必須做好準備為盡可能多的人接種疫苗。許多發展中國家的經驗表明,這是可以做到的——塞舌爾、蒙古、不丹和馬爾代夫等國都在獲得疫苗之后迅速擴大了接種工作。在加強疫苗接種的同時,各國還必須確保本國醫療衛生體系能夠應付感染病例大幅增加的情況。這包括,加快必要防疫物資的采購,包括治療用品、氧氣和個人防護設備。無論疫苗接種速度如何,現在都需要這些防疫物資來挽救人們的生命。為此,目前迫切需要提供贈款融資,預先采購和發放最低數量的防疫物資,解決德爾塔變異病毒感染病例激增引起的越來越大的健康和經濟代價。

       

      Finally, the magnitude of the region’s financing needs requires a coordinated effort on the part of the international community. Few countries have the fiscal space to finance this effort on their own, considering the region’s already elevated debt levels and already pressing spending needs. Most of the international community’s financial assistance will need to come in the form of grants or concessional loans. With our colleagues from the World Bank, WHO, WTO, and others, the IMF has formed a special task force to ensure that countries get the resources and vaccines they need.

      最后,鑒于撒哈拉以南非洲地區的融資需求規模巨大,國際社會需要采取協調一致的行動。很少有國家具備足夠的財政空間來自行解決這些資金需求,因為該地區的債務水平已經很高,并且面臨已經十分緊迫的支出需求。國際社會的大部分資金援助將需要以贈款或優惠貸款的形式提供。IMF在與世界銀行、世界衛生組織、世界貿易組織和其他機構合作基礎上,成立了一個特別工作組,確保非洲國家能獲得所需的資源和疫苗。

       

      As always, Africa can count on the IMF. We remain deeply committed to all countries in the region. We’ve ramped up our lending to sub?Saharan Africa – last year it was more than 13 times our annual average – and support to increase our access limits will allow us to scale up our zero-interest lending capacity. And the unprecedented $650 billion new SDR allocation, far and away the largest in the Fund’s history, once approved will make $23 billion available to member countries in sub?Saharan Africa.

      IMF將一如既往地為非洲提供幫助。我們仍堅定地支持該地區的所有國家。我們已經擴大了對撒哈拉以南非洲的貸款——去年,我們向該地區提供的貸款是年均水平的13倍多。提高貸款限額的工作獲得了有力支持,這將使我們能夠擴大零息貸款能力。6500億美元的特別提款權新一輪分配將是IMF歷史上空前的、規模最大的一次分配,一經批準,將為撒哈拉以南非洲成員國家提供230億美元的可用資金。

       

      Yet the gravity and urgency of the situation requires the global community working together. We all have a stake in this. So, in all countries – advanced and emerging alike – we can reclaim our physical and economic health from the pandemic. And so that sub?Saharan Africa can resume its path toward a more prosperous future.

      當前形勢嚴峻而緊迫,國際社會必須攜手努力。這關乎所有各方的利益。只有同舟共濟,包括發達經濟體和新興經濟體在內的所有國家才能從疫情中恢復經濟健康和活力,撒哈拉以南非洲國家也才能繼續邁向更加繁榮的未來。

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