对非卫生援助是中国参与全球卫生治理的重要方式之一。2020年以来，以美国为首的西方国家炮制卫生版本的“中国威胁论”，不断抹黑中国的全球卫生参与。研究中国对非卫生援助的历史过程，不仅有助于总结中国经验，也有助于驳斥西方国家的指责，展示中国在全球卫生领域的积极作用。中国对非卫生援助历经三个历史阶段。在社会主义革命和建设时期，团结第三世界是中国对非卫生援助的政治愿景，其中包含着践行国际主义和争取国际支持的目标。在援助过程中，中国有意识地将国内的社会主义医疗卫生经验应用于非洲国家，其中包括赤脚医生、重视疾病预防、关注农村医疗需求和提倡面向大众的医学等。然而，由于受援国家缺乏合作医疗、集体经济和群众动员等社会主义制度条件，这些经验在实践过程中遇到了挑战。在改革开放和社会主义现代化建设新时期，中国开始关注卫生援助与经济发展之间相互促进的作用。在市场化改革下，卫生援助的管理权限被下放，执行过程受到市场竞争的影响，医院面临着国际责任和经济效益的抉择。为了开拓市场，各类型企业积极参与卫生援助，客观上使得援助主体多元化。随着新自由主义思潮的兴起，国际贷款机构推动非洲国家削减公共卫生开支。西方国家优先考虑卫生援助的经济效率，背离了阿拉木图会议上关于加强初级卫生保健的共识。为了应对国际形势的变化，中国坚持为受援国援建卫生基础设施、提供物资与技术援助。进入中国特色社会主义新时代以来，中国提出了人类命运共同体和人类卫生健康共同体理念，主张生命健康是基本人权，注重公共卫生体系建设和培育受援国的自主发展能力。相反，新自由主义卫生治理强调商品化和私人参与，这不仅增强了非洲受援国家对国际资本的依赖，也难以加强其公共卫生体系。中国通过中非合作论坛和“健康丝路”等平台，注重援助的公共性和监管，一定程度上遏制了全球卫生治理的新自由主义化，保障援助符合各方利益。中国对非卫生援助取得了突出成就，也形成了诸多经验，如依靠国有企业的物资保障能力、举国体制的组织动员能力、中西医结合的技术策略和因地制宜的行动方式。这些经验为推动构建人类卫生健康共同体贡献了中国智慧。
Health assistance to Africa is an important way for China to participate in global health governance. Since 2020, Western countries, led by the United States, have concocted a version of the "China threat theory" on health to discredit China‘s participation in global health. Studying the historical process of China‘s health assistance to Africa not only helps to summarize China‘s experience, but also helps to refute Western countries‘ accusations and demonstrate China‘s positive role in the global health field.China‘s health assistance to Africa has gone through three historical stages. During the period of socialist revolution and construction, solidarity with the Third World was the political vision of China‘s health assistance to Africa, which included the goal of practicing internationalism and winning international support. In the process of assistance, China has consciously applied its domestic experience of socialist health care to African countries, including barefoot doctors, emphasis on disease prevention, attention to rural medical needs and the promotion of mass-oriented medicine. However, due to the lack of socialist system conditions in recipient countries such as cooperative medical care, collective economy and mass mobilization, these experiences have met challenges in practice.In the new era of reform and opening up and socialist modernization, China began to pay attention to the mutually reinforcing role of health assistance and economic development. Under the market-oriented reform, the management authority of domestic health assistance is decentralized, and the implementation process is affected by market competition. Hospitals are faced with the choice of economic benefit and international responsibility. In order to expand the market, various types of enterprises actively participate in health assistance, which objectively makes the aid subject diversified. With neoliberalism on the rise, international lenders have pushed African countries to cut spending on public health. The priority given by Western countries to the economic efficiency of health aid is a departure from the Almaty Declaration on strengthening primary health care. In response to changes in the international situation, China has continued to build health infrastructure and provide material and technical assistance to recipient countries.Since entering a new era of socialism with Chinese characteristics, China has put forward the vision of a community with a shared future for mankind and a community of common health for mankind. China believes that life and health are basic human rights, and attaches great importance to building a public health system and fostering the independent development capacity of recipient countries. On the contrary, neoliberal health governance emphasizes commoditization and private participation, which not only increases the dependence of African recipient countries on international capital, but also makes it difficult to strengthen their public health systems. Through platforms such as the Forum on China-Africa Cooperation and the "Silk Road of Health", China attaches great importance to the public nature of aid and process supervision, which to some extent has curbed neoliberalism in health governance. Ensuring aid serves the interests of all parties.China has made outstanding achievements in its health assistance to Africa, and gained a lot of experience, such as relying on the material support capacity of state-owned enterprises, the organization and mobilization capacity of the whole nation system, the technical strategy of integrating traditional Chinese and Western medicine, and the action mode tailored to local conditions. These experiences have contributed Chinese wisdom to the building of a community of common health for mankind.
