Foreign aid from the United States saved millions of lives each year
In total dollars spent, the United States was the world’s largest foreign aid donor in 2023.
按美元支出总额计算，2023 年美国是世界上最大的外援国。
It gave $62 billion, about the same as the next three largest donors combined: Germany, Japan, and the United Kingdom.
它捐赠了 620 亿美元，大约相当于紧随其后的三个最大捐助国：德国、日本和英国的总和。
The chart below shows the ten largest givers.
下图显示了十大捐赠者。
The US had a huge impact on the global budget, despite giving only a small share of its income.
尽管美国只提供其收入的一小部分，但对全球预算产生了巨大影响。
Of the ten countries that gave the most in raw figures, the US gave the smallest share of its national income: 0.24% of gross national income (GNI).
在给出原始数据最多的十个国家中，美国给出的国民收入份额最小：占国民总收入 (GNI) 的 0.24%。
But because the US is so large, what America decides to contribute (or not) matters a lot.
但由于美国幅员辽阔，美国决定贡献什么（或不贡献什么）非常重要。
Many Americans, and others, understandably wonder what impact this aid has had.
可以理解的是，许多美国人和其他人想知道这项援助产生了什么影响。
Have their tax dollars made a difference?
他们的税金有影响吗？
American foreign aid has contributed in many ways, from fostering economic growth and alleviating poverty in low-income countries to boosting food production and reducing malnutrition.
美国的对外援助在许多方面做出了贡献，从促进经济增长和减轻低收入国家的贫困到提高粮食生产和减少营养不良。
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But in this article, we’ll focus on one especially tangible way to measure the outcome of foreign aid: the number of lives it has saved.
但在本文中，我们将重点关注一种衡量外援成果的特别切实的方法：援助所挽救的生命数量。
We conclude that aid programs financed by American taxpayers saved approximately three million people annually.
我们得出的结论是，由美国纳税人资助的援助计划每年拯救了大约 300 万人的生命。
As we will see, it’s hard to estimate this precisely, so our “best estimate” of three million could plausibly be closer to two or four million.
正如我们将看到的，很难准确估计这一数字，因此我们“最佳估计”的 300 万可能更接近 2 或 400 万。
This was a huge achievement that Americans can rightly be proud of.
这是美国人值得自豪的巨大成就。
As we’ll see later, it comes at a comparatively low cost: Americans tend to vastly overestimate how much is spent on foreign aid, and support rises once they learn the real figures.
正如我们稍后将看到的，它的成本相对较低：美国人往往大大高估了对外援助的支出，一旦他们了解了真实的数字，支持率就会上升。
Most of America’s foreign assistance for global health and humanitarian response came from the United States Agency for International Development (USAID) .
美国对全球卫生和人道主义应对的大部分外国援助来自美国国际开发署（USAID）。
USAID was the main American agency for delivering development assistance abroad.
美国国际开发署是美国向海外提供发展援助的主要机构。
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USAID alone had a budget of $43.8 billion, and made up around 61% of total US foreign assistance.
仅美国国际开发署的预算就达 438 亿美元，约占美国对外援助总额的 61%。
3 The rest was channeled through other agencies, such as the Department of State.
3 其余部分是通过国务院等其他机构提供的。
Most of the interventions covered in this article were funded through USAID.
本文涵盖的大部分干预措施都是通过美国国际开发署资助的。
The current US administration has dismantled USAID entirely and imposed deep cuts on many other foreign aid programs.
现任美国政府完全解散了美国国际开发署，并大幅削减了许多其他对外援助项目。
Estimating the number of lives saved by foreign aid is not straightforward.
估计外国援助挽救的生命数量并不简单。
Health data from low-income countries is often limited, and we can never directly observe what would have happened without aid.
低收入国家的健康数据往往有限，我们永远无法直接观察如果没有援助会发生什么。
In some cases, finances might come from elsewhere to fill the gap, but in others, it will go unfilled.
在某些情况下，资金可能来自其他地方来填补缺口，但在其他情况下，资金将无法填补。
That means all estimates come with considerable uncertainty, but they are precise enough to give us a sense of the impact.
这意味着所有估计都存在相当大的不确定性，但它们足够精确，足以让我们感受到影响。
The chart below is based on a recent analysis by Charles Kenny and Justin Sandefur of the Center for Global Development, in which they estimated the number of lives saved by American foreign aid.
下图基于全球发展中心的查尔斯·肯尼和贾斯汀·桑德弗最近的分析，他们在其中估计了美国对外援助挽救的生命数量。
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These figures are gross estimates.
这些数字是粗略估计。
They reflect the number of lives that US foreign aid helped to save, rather than the exact number that would have been lost if the US had not provided this support.
它们反映了美国对外援助帮助挽救的生命数量，而不是如果美国不提供这种支持就会失去的确切人数。
In some cases, other governments, charities, or communities might have stepped in to fill the gap.
在某些情况下，其他政府、慈善机构或社区可能会介入来填补这一空白。
Kenny and Sandefur focused on interventions targeting HIV/AIDS, tuberculosis, malaria, vaccines, and humanitarian assistance.
肯尼和桑德弗重点关注针对艾滋病毒/艾滋病、结核病、疟疾、疫苗和人道主义援助的干预措施。
Their estimates range from 2.3 to 5.6 million lives saved annually, with their central estimate of 3.3 million.
他们估计每年可挽救 2.3 至 560 万人的生命，中心估计为 330 万人。
The breakdown is shown in the chart.
细分情况如图表所示。
AIDS programs saved the largest number of lives: over 1.5 million per year.
艾滋病项目拯救了最多的生命：每年超过 150 万人。
Between a quarter and half a million were saved by vaccines, tuberculosis, malaria, and humanitarian response each.
疫苗、结核病、疟疾和人道主义应对措施分别挽救了 25 至 50 万人的生命。
Kenny and Sandefur’s estimates do not include lives saved from other aid programs, including improved access to clean water and sanitation , better nutrition, and family planning.
肯尼和桑德弗的估计不包括其他援助项目挽救的生命，包括改善清洁水和卫生设施的获取、更好的营养和计划生育。
We expect these to have saved lives, so the true figure might be higher.
我们预计这些措施可以挽救生命，因此真实数字可能更高。
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For these (and other) reasons, Kenny and Sandefur make it clear that these numbers are uncertain; their upper-bound estimates are more than twice their lower-bound ones.
由于这些（和其他）原因，肯尼和桑德弗明确表示这些数字是不确定的；他们的上限估计是下限估计的两倍多。
Since this was just one analysis, it’s worth comparing these results to other estimates.
由于这只是一项分析，因此值得将这些结果与其他估计进行比较。
A recent paper, published in The Lancet — which received a lot of attention — estimated that USAID averted 92 million deaths in the 21 years from 2001 to 2021.
最近发表在《柳叶刀》上的一篇引起广泛关注的论文估计，美国国际开发署在 2001 年至 2021 年的 21 年间避免了 9200 万人死亡。
6 On average, that would be approximately 46 million per decade or 4 to 5 million lives saved annually.
6 平均而言，每十年大约可拯救 4600 万人，即每年可拯救 4 至 500 万人的生命。
Several experts have flagged methodological limitations in this study, so we would not recommend basing estimates from this paper alone.
几位专家指出了这项研究的方法学局限性，因此我们不建议仅根据本文进行估计。
Still, it does give a similar figure of at least several million per year.
尽管如此，它确实给出了每年至少数百万的类似数字。
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We can also compare the estimated deaths averted from specific diseases in these aggregate analyses to studies that look at HIV, tuberculosis, or malaria individually.
我们还可以将这些汇总分析中特定疾病避免的估计死亡人数与单独研究艾滋病毒、结核病或疟疾的研究进行比较。
The US President’s Emergency Plan for AIDS Relief — better known as PEPFAR — is widely considered one of history's most successful international aid initiatives.
美国总统的艾滋病紧急救援计划（俗称“总统防治艾滋病紧急救援计划”）被广泛认为是历史上最成功的国际援助举措之一。
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Launched in 2003, PEPFAR funds testing, antiretroviral therapy , prevention, and care in dozens of low- and middle-income countries, focusing on the hardest-hit regions of Sub-Saharan Africa.
PEPFAR 于 2003 年启动，为数十个低收入和中等收入国家的检测、抗逆转录病毒治疗、预防和护理提供资金，重点关注撒哈拉以南非洲受灾最严重的地区。
In 2023 alone, over 20 million people globally received antiretroviral therapy through PEPFAR.
仅 2023 年，全球就有超过 2000 万人通过 PEPFAR 接受了抗逆转录病毒治疗。
In many of these countries, HIV/AIDS disproportionately affects women — especially young women.
在其中许多国家，艾滋病毒/艾滋病对妇女的影响尤为严重，尤其是年轻妇女。
And without treatment, the virus can be passed from mother to child during pregnancy, childbirth, or breastfeeding.
如果不进行治疗，病毒可以在怀孕、分娩或母乳喂养期间从母亲传染给孩子。
One of PEPFAR’s most transformative impacts has been interrupting this transmission chain for millions of mothers.
PEPFAR 最具变革性的影响之一就是为数百万母亲中断了这一传播链。
Millions of babies who would have been born with HIV were instead born healthy.
数以百万计原本可能携带艾滋病毒的婴儿出生时却是健康的。
This means many of the lives saved by US aid were children’s.
这意味着美国援助拯救的许多生命都是儿童。
So, how many lives has this program saved?
那么，这个计划拯救了多少人的生命呢？
The State Department administers PEPFAR and says the program has saved 25 million lives .
美国国务院负责管理总统防治艾滋病紧急救援计划 (PEPFAR)，并表示该计划已挽救了 2500 万人的生命。
9 But it’s also worth looking at independent analyses; a recent assessment finds that it has saved between 7.5 and 30 million lives.
9 但独立分析也值得一看；最近的一项评估发现，它挽救了 7.5 至 3000 万人的生命。
10 Again, this highlights how uncertain these estimates are but suggests that the State Department’s estimate of 25 million could be reasonable, as does Kenny and Sandefur’s estimate of around 1.6 million per year.
10 这再次凸显了这些估计的不确定性，但表明国务院估计的 2500 万可能是合理的，肯尼和桑德弗估计的每年约 160 万也是合理的。
The chart below shows the estimated number of deaths from HIV/AIDS and the estimated number of deaths averted by antiretroviral therapy (ART) globally.
下图显示了全球因艾滋病毒/艾滋病死亡的估计人数以及通过抗逆转录病毒治疗 (ART) 避免的估计死亡人数。
PEPFAR wasn’t the only initiative expanding access to antiretroviral treatment, but was by far the largest.
PEPFAR 并不是唯一一项扩大抗逆转录病毒治疗范围的举措，但却是迄今为止规模最大的一项。
As the global rollout of ART gained momentum, HIV/AIDS deaths, which had been rising sharply, quickly plateaued — and then began a steep decline.
随着抗逆转录病毒疗法在全球的推广势头强劲，艾滋病毒/艾滋病死亡人数急剧上升，很快就趋于稳定，然后开始急剧下降。
Republican President George W.
共和党总统乔治·W.
Bush launched PEPFAR.
布什启动了总统防治艾滋病紧急救援计划（PEPFAR）。
Reflecting later on the moral imperative behind the decision, he wrote in his memoir Decision Points :
后来，他在回忆录《决策点》中反思了这一决定背后的道德要求：
“I considered America a generous nation with a moral responsibility to do our part to help relieve poverty and despair.”
“我认为美国是一个慷慨的国家，有道德责任尽自己的一份力量来帮助缓解贫困和绝望。”
In addition to its leadership in fighting HIV/AIDS, the US has played a vital role in the global effort against malaria through the President’s Malaria Initiative and contributions to The Global Fund .
除了在抗击艾滋病毒/艾滋病方面发挥领导作用外，美国还通过总统的疟疾倡议和对全球基金的捐款，在全球抗击疟疾的努力中发挥了至关重要的作用。
Founded in 2005, this program supports malaria prevention and treatment in 27 African countries, the region hit hardest by the disease.
该计划成立于 2005 年，为 27 个非洲国家（该地区受疟疾影响最严重的国家）的疟疾预防和治疗提供支持。
It funds life-saving interventions: bednets, insecticide spraying, seasonal preventive medicine for children, and access to diagnostics and treatment.
它资助拯救生命的干预措施：蚊帐、喷洒杀虫剂、儿童季节性预防药物以及获得诊断和治疗。
These efforts have contributed to large declines in malaria deaths in recent decades.
这些努力使得近几十年来疟疾死亡人数大幅下降。
Kenny and Sandefur estimate that US foreign aid helped prevent around 293,000 malaria deaths yearly.
肯尼和桑德弗估计，美国的对外援助每年帮助避免了约 293,000 人因疟疾死亡。
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This is a reasonable central estimate given the range within the literature.
考虑到文献范围内，这是一个合理的中心估计。
Studies provide higher and lower estimates, but these typically range from around 100,000 lives to 600,000 per year.
研究提供了更高和更低的估计值，但通常范围为每年约 100,000 人到 600,000 人。
In the footnote, we’ve included some more details of these studies.
在脚注中，我们包含了这些研究的更多细节。
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A figure of around 300,000 seems credible.
30万左右的数字似乎是可信的。
Even if the true number were a few hundred thousand higher or lower, the conclusion would be the same: USAID has saved millions of lives yearly.
即使真实数字高出或低出几十万，结论也是一样的：美国国际开发署每年拯救了数百万人的生命。
We send two regular newsletters so you can stay up to date on our work and receive curated highlights from across Our World in Data.
我们定期发送两份时事通讯，以便您及时了解我们的工作并接收来自“我们的数据世界”的精选亮点。
If American aid has saved several million lives each year, it would be reasonable to assume that taking that aid away will cost lives, possibly just as many if no other interventions or resources fill the gap.
如果美国的援助每年挽救了数百万人的生命，那么我们可以合理地假设，取消援助将会导致生命损失，如果没有其他干预措施或资源填补空白，可能会造成同样多的生命损失。
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That hypothetical has become a reality this year, with the complete shutdown of USAID and cuts to other assistance programs.
随着美国国际开发署完全关闭并削减其他援助项目，这一假设今年已成为现实。
This has already had life-changing impacts on the people who would have received medicines, treatments, and humanitarian support.
这已经对那些本来可以获得药物、治疗和人道主义支持的人们产生了改变生活的影响。
In countries like Uganda, clinics have already reported shortages of life-saving medication.
在乌干达等国家，诊所已经报告救生药物短缺。
14 Programs that took decades to build are being ripped up in a matter of months.
14 个花费数十年时间构建的项目在短短几个月内就被废除。
If we think that saving these lives in other parts of the world is fundamentally a good thing and worth protecting aid budgets for — not just in the US but in other rich countries, too — then public attitudes to foreign aid matter.
如果我们认为在世界其他地区拯救这些生命从根本上来说是一件好事，并且值得保护援助预算——不仅在美国，而且在其他富裕国家也是如此——那么公众对外国援助的态度就很重要。
Political representatives tend to pursue policies that are popular among the public.
政治代表倾向于奉行受公众欢迎的政策。
Opposition to foreign aid, as a whole, is high across the American public.
总体而言，美国公众对外国援助的反对情绪很高。
There is no disputing that.
毫无疑问。
However, most Americans support giving aid for the life-saving interventions we looked at in this article.
然而，大多数美国人支持为我们在本文中讨论的挽救生命的干预措施提供援助。
When people were asked what types of aid programs they think the US government should spend money on, the share supporting health programs was extremely high.
当人们被问及他们认为美国政府应该把钱花在哪些类型的援助项目上时，支持医疗项目的比例非常高。
15 83% of respondents said that the US should give foreign aid for “providing medicine and medical supplies to developing countries”.
15 83%的受访者表示，美国应该为“向发展中国家提供药品和医疗用品”提供对外援助。
However, Americans might still support aid cuts because they think the US spends too much.
然而，美国人可能仍然支持削减援助，因为他们认为美国支出太多。
Indeed, recent survey data show that most Americans overestimate how much the US spends, often by a huge amount.
事实上，最近的调查数据显示，大多数美国人高估了美国的支出，而且往往数额巨大。
The US aid budget has been around 1% of total federal spending.
美国的援助预算约占联邦总支出的1%。
But when KFF — a policy research and polling organization — asked people what share they thought was spent on aid, 30% believed that the US spent one-third or more of its budget on aid.
但当政策研究和民意调查组织 KFF 询问人们他们认为援助支出的比例是多少时，30% 的人认为美国将其预算的三分之一或更多用于援助。
And a staggering 15% thought that it spent more than half.
令人震惊的是，有 15% 的人认为花费了一半以上。
That means they thought the US spent in a week what it actually gave for the entire year.
这意味着他们认为美国一周的支出相当于全年的实际支出。
It’s worth noting that the survey design may have nudged respondents toward higher estimates, for example, by including several high-percentage response options, but none for 1% or less.
值得注意的是，调查设计可能会促使受访者做出更高的估计，例如，通过包括几个高百分比的回答选项，但没有一个是 1% 或更少的选项。
Even so, the fact that more than half of the participants believed foreign aid accounts for over 10% of the federal budget points to a broader tendency to overestimate.
即便如此，超过一半的参与者认为外国援助占联邦预算的 10% 以上，这一事实表明存在更广泛的高估倾向。
A 2016 Ipsos survey found a similar pattern: on average, Americans believed that more than 10% of the national budget — excluding military spending — went toward foreign aid.
益普索 2016 年的一项调查发现了类似的模式：平均而言，美国人认为超过 10% 的国家预算（不包括军费开支）用于对外援助。
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Perhaps most interesting (and encouraging) is that when respondents were told that the actual number was just 1% of spending, the share of people who said the US spent “too much” on aid dropped from 58% to 34%.
也许最有趣（也是令人鼓舞）的是，当受访者被告知实际数字仅为支出的 1% 时，认为美国在援助上花费“太多”的人比例从 58% 下降到 34%。
Many Republicans, who are more skeptical of foreign assistance, also shifted to a more pro-aid position.
许多对外国援助持怀疑态度的共和党人也转向了更支持援助的立场。
It’s understandable: if you thought a third of the federal budget was being spent on foreign aid, you might be frustrated with the government’s priorities and the persistence of poverty and disease.
这是可以理解的：如果你认为联邦预算的三分之一用于对外援助，你可能会对政府的优先事项以及持续存在的贫困和疾病感到沮丧。
But that is an inaccurate picture of how much is spent and whether it provides any benefit.
但这对于花费了多少以及是否带来任何好处来说是不准确的。
Not all aid is incredibly effective, but the very best aid is, and a small share of government budgets can save millions of lives.
并非所有援助都非常有效，但最好的援助是有效的，政府预算的一小部分可以挽救数百万人的生命。
Thanks to Max Roser, Edouard Mathieu, Saloni Dattani, and Jack Ramm for their feedback and comments on this article and its visualizations.
感谢 Max Roser、Edouard Mathieu、Saloni Dattani 和 Jack Ramm 对本文及其可视化的反馈和评论。
Most countries spend less than 1% of their national income on foreign aid; even small increases could make a big difference.
大多数国家用于对外援助的支出不到国民收入的 1%；即使是很小的增加也可能产生很大的影响。
In many countries, a significant share of aid is spent domestically on hosting refugees, offering student scholarships, and administrative costs.
在许多国家，很大一部分援助用于国内收容难民、提供学生奖学金和管理费用。
Foreign aid measurement is complicated — what exactly counts as Official Development Assistance, what doesn’t, and how much is actually spent abroad?
对外援助的衡量很复杂——到底什么算是官方发展援助，什么不算，以及实际在国外花费了多少？
Karras, G.
卡拉斯，G.
(2006).
（2006）。
Foreign aid and long‐run economic growth: empirical evidence for a panel of developing countries.
外国援助和长期经济增长：一组发展中国家的经验证据。
Journal of International Development: The Journal of the Development Studies Association, 18(1), 15-28.
国际发展杂志：发展研究协会杂志，18(1), 15-28。
Ssozi, J., Asongu, S., & Amavilah, V.
Ssozi, J.、Asongu, S. 和 Amavilah, V.
H.
H.
(2019).
（2019）。
The effectiveness of development aid for agriculture in Sub-Saharan Africa.
撒哈拉以南非洲农业发展援助的有效性。
Journal of Economic Studies, 46(2), 284-305.
经济研究杂志，46(2), 284-305。
Cavalcanti, D.
卡瓦尔坎蒂，D.
M., de Sales, L.
M.，德·萨莱斯，L.
D.
D .
O.
奥。
F., da Silva, A.
F.，达席尔瓦，A.
F., Basterra, E.
F.、巴斯特拉、E.
L., Pena, D., Monti, C., ...
L.，佩纳，D.，蒙蒂，C.，...
& Rasella, D.
＆拉塞拉，D.
(2025).
（2025）。
Evaluating the impact of two decades of USAID interventions and projecting the effects of defunding on mortality up to 2030: a retrospective impact evaluation and forecasting analysis.
评估美国国际开发署二十年干预措施的影响并预测到 2030 年取消资助对死亡率的影响：回顾性影响评估和预测分析。
The Lancet.
柳叶刀。
(p.5 of the Supplementary appendix)
（补充附录第5页）
USAID spent $43.8 billion; the remainder of American aid totaled $28.1 billion.
美国国际开发署支出438亿美元；美国的剩余援助总额为 281 亿美元。
Kenny, C., & Sandefur, J.
肯尼 (Kenny, C.) 和桑德弗 (Sandefur, J.)
(2025).
（2025）。
How many lives does US foreign aid save?.
美国的对外援助拯救了多少人的生命？
Center for Global Development.
全球发展中心。
Some of the benefits of these programs could also already be captured in the lives saved from particular diseases.
这些计划的一些好处也可能已经体现在从特定疾病中挽救的生命中。
For example, better nutrition often reduces the risk of dying from malaria or tuberculosis.
例如，更好的营养通常可以降低死于疟疾或结核病的风险。
Therefore, some of the “lives saved” from these programs may already be included.
因此，这些计划所“挽救的生命”可能已经包括在内。
Kenny and Sandefur do provide some rough estimates for how many lives these could have saved, and estimate that water and sanitation could have saved 23,200 lives per year; family planning saved 8,340 women from maternal deaths per year; and 71,000 to 193,000 from nutrition per year.
肯尼和桑德弗确实对这些措施可以挽救多少生命提供了一些粗略估计，并估计水和卫生设施每年可以挽救 23,200 条生命；计划生育每年使 8,340 名妇女免于孕产妇死亡；每年 71,000 至 193,000 人来自营养。
Cavalcanti, D.
卡瓦尔坎蒂，D.
M., de Sales, L.
M.，德·萨莱斯，L.
D.
D .
O.
奥。
F., da Silva, A.
F.，达席尔瓦，A.
F., Basterra, E.
F.、巴斯特拉、E.
L., Pena, D., Monti, C., ...
L.，佩纳，D.，蒙蒂，C.，...
& Rasella, D.
＆拉塞拉，D.
(2025).
（2025）。
Evaluating the impact of two decades of USAID interventions and projecting the effects of defunding on mortality up to 2030: a retrospective impact evaluation and forecasting analysis .
评估美国国际开发署二十年干预措施的影响并预测到 2030 年取消资助对死亡率的影响：回顾性影响评估和预测分析。
The Lancet.
柳叶刀。
One concern is that it “controls” for variables — like domestic health spending — that may themselves be affected by aid.
一个担忧是，它“控制”了国内医疗支出等变量，而这些变量本身可能会受到援助的影响。
If government health budgets are reduced because aid fills the gap (a phenomenon known as “crowding out”), then controlling for that spending could lead to overestimating aid’s impact, ignoring what might have happened in its absence.
如果政府卫生预算因援助填补缺口而减少（这种现象称为“挤出”），那么控制该支出可能会导致高估援助的影响，而忽略在没有援助的情况下可能发生的情况。
Ratevosian, J., Millett, G., Honermann, B., Bennett, S., Connor, C., Bekker, L.
Ratevosian, J.、Millett, G.、Honermann, B.、Bennett, S.、Connor, C.、Bekker, L.
G., & Beyrer, C.
G.，＆拜勒，C.
(2025).
（2025）。
PEPFAR under review: what's at stake for PEPFAR's future.
PEPFAR 正在接受审查：PEPFAR 的未来面临着什么风险。
The Lancet, 405(10479), 603-605.
《柳叶刀》，405（10479），603-605。
Piper, K., Sargeant, L.
派珀，K.，萨金特，L.
L., Aitken, C., Randall, A., Tsai, B., Kasten, D., Hatfield-Dodds, Z., Scholl, K., Collier, C., & Mago, R.
L.、Aitken, C.、Randall, A.、Tsai, B.、Kasten, D.、Hatfield-Dodds, Z.、Scholl, K.、Collier, C. 和 Mago, R.
(2025).
（2025）。
A citizen review of PEPFAR effectiveness: Yesterday, today, and tomorrow .
公民对总统防治艾滋病紧急救援计划（PEPFAR）有效性的回顾：昨天、今天和明天。
Their approach compares today’s death rates to those in 2000, before PMI began.
他们的方法将今天的死亡率与 2000 年 PMI 开始之前的死亡率进行比较。
If those earlier rates had continued, around 600,000 more people would have died in 2023.
如果早期的死亡率继续下去，到 2023 年将会有大约 60 万人死亡。
Since the US accounted for nearly half of all global malaria aid in 2022, Kenny and Sandefur attribute just under half of these averted deaths to its efforts.
由于 2022 年美国提供的疟疾援助占全球疟疾援助总额的近一半，因此肯尼和桑德弗将不到一半的避免死亡归功于美国的努力。
It’s a rough method, but one that’s commonly used in the literature.
这是一种粗略的方法，但却是文献中常用的方法。
Winskill, P., Slater, H.
温斯基尔，P.，斯莱特，H.
C., Griffin, J.
C.、格里芬、J.
T., Ghani, A.
T.、加尼、A.
C., & Walker, P.
C.，＆沃克，P.
G.
G。
(2017).
（2017）。
The US President's Malaria Initiative, Plasmodium falciparum transmission and mortality: A modelling study.
美国总统的疟疾倡议，恶性疟原虫传播和死亡率：建模研究。
PLoS Medicine, 14(11), e1002448.
PLoS 医学，14(11)，e1002448。
One widely cited analysis focused on children under five — the group most vulnerable to malaria — and found that in a set of PMI-supported countries, their mortality rate dropped from 28.9 to 24.3 deaths per 1,000 person-years.
一项被广泛引用的分析主要针对五岁以下儿童（最容易感染疟疾的群体），结果发现，在一系列 PMI 支持的国家中，他们的死亡率从每 1,000 人年 28.9 人下降到 24.3 人。
Jakubowski, A., Stearns, S.
雅库博夫斯基，A.，斯特恩斯，S.
C., Kruk, M.
C.、克鲁克、M.
E., Angeles, G., & Thirumurthy, H.
E.、Angeles, G. 和 Thirumurthy, H.
(2017).
（2017）。
The US President’s Malaria Initiative and under-5 child mortality in sub-Saharan Africa: A difference-in-differences analysis.
美国总统的疟疾倡议与撒哈拉以南非洲 5 岁以下儿童死亡率：双重差分分析。
PLoS medicine, 14(6), e1002319.
PLoS 医学，14(6)，e1002319。
Using this decline, Kenny and Sandefur offer a second estimate: they apply the drop across all children under five in PMI-supported countries.
利用这一下降幅度，肯尼和桑德弗提出了第二个估计：他们将这一下降幅度应用于 PMI 支持国家的所有五岁以下儿童。
The result is a rough estimate of 600,000 lives saved each year from PMI alone.
粗略估计，仅 PMI 每年就能挽救 60 万人的生命。
Some other studies find lower figures.
其他一些研究发现数字较低。
One analysis covering 2005 to 2016 estimates that PMI saved around 940,000 lives (or 94,000 per year).
一项涵盖 2005 年至 2016 年的分析估计，PMI 挽救了约 940,000 条生命（或每年 94,000 条生命）。
Winskill, P., Slater, H.
温斯基尔，P.，斯莱特，H.
C., Griffin, J.
C.、格里芬、J.
T., Ghani, A.
T.、加尼、A.
C., & Walker, P.
C.，＆沃克，P.
G.
G。
(2017).
（2017）。
The US President's Malaria Initiative, Plasmodium falciparum transmission and mortality: A modelling study.
美国总统的疟疾倡议，恶性疟原虫传播和死亡率：建模研究。
PLoS Medicine, 14(11), e1002448.
PLoS 医学，14(11)，e1002448。
A more recent analysis projected that in 2025, PMI would prevent around 104,000 deaths across its focus countries.
最近的一项分析预测，到 2025 年，PMI 将在其重点国家中避免约 104,000 人死亡。
Symons, T.
西蒙斯，T.
L., Lubinda, J., McPhail, M., Saddler, A., van den Berg, M., Baggen, H., Berman, Y., Hafsia, S., Jayaseelen, R., Amratia, P., Browne, A., Cameron, E., Vargas-Ruiz, C., Rumisha, S.
L.、Lubinda, J.、McPhail, M.、Saddler, A.、van den Berg, M.、Baggen, H.、Berman, Y.、Hafsia, S.、Jayaseelen, R.、Amratia, P.、Browne, A.、Cameron, E.、Vargas-Ruiz, C.、Rumisha, S.
F., Golding, N., Weiss, D.
F.，戈尔丁，N.，韦斯，D.
J., & Gething, P.
J.，&格辛，P.
W.
W.
(2025).
（2025）。
Estimating the potential malaria morbidity and mortality avertable by the President’s Malaria Initiative in 2025: A geospatial modelling analysis [Preprint].
估计 2025 年总统疟疾倡议可避免的潜在疟疾发病率和死亡率：地理空间建模分析 [预印本]。
These more modest figures reflect a narrower scope.
这些较为温和的数字反映了较窄的范围。
Both studies look only at PMI, while a large chunk of US malaria funding is channeled through The Global Fund, which might explain the difference.
这两项研究都只关注 PMI，而美国的很大一部分疟疾资金是通过全球基金提供的，这或许可以解释这种差异。
In 2023, the US government provided approximately $795 million in direct bilateral funding for global malaria control through PMI (Source: Beat Malaria ).
2023年，美国政府通过PMI为全球疟疾控制提供了约7.95亿美元的直接双边资金（来源：Beat Malaria）。
The same year, it contributed $2.0 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
同年，它向全球抗击艾滋病、结核病和疟疾基金捐款20亿美元。
(Source: KFF ), which has historically disbursed 29 percent of its funds to malaria projects (Source: Global Fund ).
（来源：KFF），历来将 29% 的资金用于疟疾项目（来源：全球基金）。
Assuming this stays constant, the US contributed $580 million to tackle malaria via the Global Fund in 2023.
假设这一情况保持不变，美国将在 2023 年通过全球基金捐款 5.8 亿美元来应对疟疾。
This distinction is highlighted by Charles Kenny and Justin Sandefur in their article : “Where possible, we examine both of the questions “how many lives were saved by US financing?’ (gross lives saved) and ‘how many would have been lost absent US financing?” (net lives saved).
查尔斯·肯尼 (Charles Kenny) 和贾斯汀·桑德弗 (Justin Sandefur) 在他们的文章中强调了这一区别：“在可能的情况下，我们研究以下两个问题：‘美国的融资拯救了多少生命？’（拯救的总生命）和‘如果没有美国的融资，有多少人会失去生命？” （净挽救生命）。
The number of people who would be dead if the US hadn’t assisted isn’t necessarily all of the lives saved by that assistance because of effects including ‘crowding out’ and “crowding in”—international investments displacing or spurring more domestic support for lifesaving interventions—and market effects like generating lower prices.
如果美国没有提供援助，死亡人数不一定是援助所挽救的全部生命，因为包括“挤出”和“挤入”在内的影响（国际投资取代或刺激国内对救生干预措施的更多支持）以及市场效应（例如降低价格）。
If the US pays for 1,000 vaccine doses that save 3 lives, we’re counting those 3 lives in the “gross” calculation.
如果美国支付 1,000 剂疫苗的费用来挽救 3 条生命，我们会将这 3 条生命计入“总额”计算中。
But perhaps 300 of those vaccinations would’ve happened without US aid, so the “net” calculation only attributes 1 life saved to US aid.”
但如果没有美国的援助，其中的 300 例疫苗可能会接种，因此“净”计算仅将 1 条生命归功于美国的援助。”
Kenny, C.
肯尼，C.
(2025, July 8).
（2025 年 7 月 8 日）。
These USAID awards were saving lives.
美国国际开发署的这些奖项正在拯救生命。
Reverse the cuts or reissue them.
撤销削减或重新发行。
Center for Global Development.
全球发展中心。
Pew Research Center, May, 2025, “Majorities of Americans Support Several – But Not All – Types of Foreign Aid”.
皮尤研究中心，2025 年 5 月，“大多数美国人支持几种（但不是全部）类型的对外援助”。
Our articles and data visualizations rely on work from many different people and organizations.
我们的文章和数据可视化依赖于许多不同的人和组织的工作。
When citing this article, please also cite the underlying data sources.
引用本文时，请同时注明底层数据来源。
This article can be cited as:
这篇文章可以引用为：
We are a live site and we keep our work maintained.
我们是一个活跃的网站，我们会保持我们的工作。
So our articles are often changed, including the data.
所以我们的文章经常改，包括数据。
You can browse previous versions of this work here.
您可以在此处浏览此作品的先前版本。