近几十年来，非洲持续发生着国家间战争、部落争斗、恐怖袭击等暴力冲突事件，对当地经济、公共健康和教育等造成了严重的负面影响。理清非洲地区暴力冲突的时空变化趋势和其对于公共健康的影响，以及评估冲突事件产生的后果，有助于减缓武装冲突及其影响。在非洲武装冲突对公共健康影响方面，虽然已有研究揭示了非洲武装冲突严重影响着公共健康，但新冠疫情这一冲击的到来是否放大了暴力冲突对公共健康的负面影响，有待进一步研究。此外，非洲大陆是应对气候变化负面影响能力最弱的地区，在气候变化的背景下，暴力冲突对公共健康的影响是否具有空间溢出效应，也需要深入的探索。在缓解冲突的策略上，有研究表明外国援助在非洲国家武装冲突的发生和发展中扮演着重要角色，但其正面或负面作用仍存在着争议，并且因各国援助方式不同所起的作用也存在着很大差异。最后，近年来中国的经济援助对于非洲当地暴力冲突的影响尚未得到定量化的验证，其是否能带来缓解效应和其影响路径还不明确。
本文在已有数据集的基础上，整理了数十年非洲武装冲突事件、人口与健康、中国经济援助等数据，首先系统地分析了2000-2022年非洲52个国家武装冲突时空变化和其非洲健康负担的影响，并利用计量经济模型进一步探讨了在武装冲突国家，新冠疫情通过限制性措施和提升粮价的路径对儿童健康产生的影响，其次揭示了暴力冲突对公共健康（如疟疾）的空间溢出效应及其在不同气温和降雨场景下诱发疟疾风险的定量关系，并给出了驱动机制，最后研究了中国经济援助是否可以作为非洲武装冲突的带来缓解的一项有效策略，具体而言：
（1）基于2000-2022年涵盖了来自52个非洲国家武装冲突的ACLED（Armed Conflict Location & Event Data Project）和UCDP（Uppsala Conflict Data Program）数据库，本文利用时空分析方法，揭示了非洲暴力冲突的时空变化趋势。研究结果发现，非洲的冲突数量和死亡人数总体上呈上升趋势，特别是从2010年起，高死亡率的冲突类型如战斗、对平民的暴力和炸弹袭击从东非逐渐扩散到北非和西非。同时，两种抗议活动（抗议和暴乱）的变化最为明显，2010年前仅集中在南非地区，2010年后则迅速蔓延到整个非洲的几乎各个区域。另外，结合2000-2021年涵盖52个非洲国家的健康负担数据和暴力冲突数据，本文利用带有固定效应的面板回归模型，分析了暴力冲突与国家主要类型的健康负担之间的关系，研究结果表明，暴力冲突的加重了国家层面的健康负担加剧作用，特别是人际暴力带来的身体伤害、热带病与疟疾和营养不良三种类型的健康负担。
（2）基于2017-2020年涵盖非洲122,006起冲突事件的ACLED暴力冲突数据和包含32,623个儿童健康信息的来自DHS（Demographic and Health Survey）调查数据，利用双重差分模型，探究了新冠疫情对暴力冲突的加剧作用和对儿童健康的负面效应。研究结果表明，新冠疫情的爆发导致了冲突事件数量和死亡人数分别上升4.1%（95% CI：0.4%-7.8%）和4.6%（95% CI：0.2-9.0%）。新冠疫情加剧暴力冲突的原因不是来自病毒本身，而是来自限制性措施的实施和粮食短缺导致的价格上升。暴力冲突和疫情的协同效应进一步对儿童健康造成了负面影响，以DHS调查前12个月经历过冲突的儿童为例，如果同时经历疫情会使得儿童摄入谷物的可能性下降11.9%（95% CI：6.1%-17.8%），发育不良的几率上升8.0%（95% CI：3.7%-12.3%）。在那些收入低、没有清洁饮用水和没有完善卫生设施的家庭中，以及女童身上，儿童出现营养不良的几率更高。
（3）基于2006-2017年非洲15个国家的128,326人的DHS健康调查、历史气候和17,429起暴力冲突等数据，本文采用高维固定效应的面板回归模型，并结合一系列对于估计结果稳定性的检验（控制额外的干扰因素、加入不同的固定效应、工具变量分析等）量化了暴力冲突空间溢出效应和温度变化、降水频率变化对撒哈拉以南非洲疟疾风险的协同效应，并给出了内在影响机制。研究结果表明，暴力冲突的空间溢出效应放大了气温升高和持续降水对疟疾传播的影响，并使得更多的弱势群体暴露在恶劣外部环境中。
（4）结合2000-2017年52个非洲国家的中国援助项目数据（记录6313个项目）和暴力冲突数据，通过工具变量分析，探索了中国援助与非洲暴力冲突的关系。结果表明，中国的经济援助显著减少了援助承诺后一年的冲突死亡人数。相较于经济和生产部门的援助，民生部门如教育、医疗、卫生的援助在缓解冲突死亡方面具有更显著的影响。此外，中国的援助在有政府参与的冲突中尤为有效，并在基础设施薄弱的国家中发挥更大作用。
综上所述，本文针对非洲地区的暴力冲突这一对象展开了多角度的探索，旨在总结非洲暴力冲突的发展规律并全面评估其在不同场景下对于公共健康的威胁。较为系统探究了非洲地区暴力冲突的上升趋势和对于国家层面健康负担的加剧作用，揭示了新冠疫情与暴力冲突对于儿童营养不良的负面效应，发现了暴力冲突的溢出效应结合气温升高和持续降水对疟疾传播的加剧影响，并阐明了中国援助的投入可以作为一项有效的方式对非洲暴力冲突产生减缓效果。
 

In decades, Africa has experienced ongoing violent conflicts, including inter-state wars, tribal disputes, and terrorist attacks, that have had severe negative impacts on local economies, public health, and education. Clarifying the spatiotemporal trends of violent conflicts in Africa, their effects on public health, and evaluating the consequences of these conflicts are critical to mitigating the impacts of armed conflicts. While existing studies have shown that armed conflicts in Africa severely impact public health, further research is needed to determine whether the advent of the COVID-19 pandemic has amplified the negative effects of violent conflicts on public health. Additionally, as the region most vulnerable to the adverse impacts of climate change, it is vital to explore whether violent conflicts in Africa have spatial spillover effects on public health under the context of climate change. In terms of conflict mitigation strategies, study indicates that foreign aid plays a significant role in the occurrence and development of armed conflicts in African countries, though its positive or negative effects remain controversial, and the impacts vary greatly depending on the methods of aid provided by different countries. Finally, in recent years, the effects of China's economic assistance on local violent conflicts in Africa have not yet been quantified, and whether it can bring mitigation effects and its pathways of influence remain unclear.
Based on existing datasets, this article compiles decades of data on armed conflicts, population and health, and Chinese economic assistance in Africa. It systematically analyzes the spatiotemporal changes of armed conflicts and their impact on health burdens across 52 African countries from 2000 to 2022. Utilizing econometric models, the study further explores the impact of the COVID-19 pandemic on child health in conflict-affected countries through restrictive measures and increased food prices. It reveals the spatial spillover effects of violent conflicts on public health (e.g., malaria), quantifies the relationship between conflicts and malaria risk under various temperature and rainfall scenarios, and outlines the underlying mechanisms. Finally, the study investigates whether Chinese economic assistance can serve as an effective strategy to alleviate the impacts of armed conflicts in Africa. Specifically:
Using data from the ACLED (Armed Conflict Location & Event Data Project) and UCDP (Uppsala Conflict Data Program) databases covering 2000-2022 from 52 African countries, this paper employs spatiotemporal analysis to reveal trends in African violent conflicts. The finding indicates a consistent upward trend in both the number of conflicts and the associated fatalities, Particularly, high-fatality conflict types such as battles, violence against civilians, and explosions/remote violence have spreading from Eastern to Northern and Western Africa. Additionally, the changes in two types of protest activities (protests and riots) are most notable. Before 2010, they were primarily concentrated in the Southern African, but after 2010, they quickly spread to almost every region of the African continent. Moreover, by combining health burden data with violence conflict data across 52 African countries from 2000 to 2021, this study employed a panel regression model with fixed effects to analyze the relationship between violence conflicts and major types of health burdens. The findings indicate that violent conflicts exacerbate the health burden, particularly in the physical injuries led by interpersonal violence, tropical diseases and malaria, as well as malnutrition.
Based on the ACLED data covering 122,006 conflict events from 2017-2020 and health information of 32,623 children from the DHS (Demographic and Health Survey) data, a difference-in-differences model is used to study the exacerbating effect of the COVID-19 pandemic on violent conflicts and its negative impact on children's health. The results show that the outbreak of the pandemic led to a 4.1% increase (95% CI (confidence interval): 0.4%-7.8%) in conflict incidents and a 4.6% increase (95% CI: 0.2-9.0%) in conflict fatalities. The increase in violent conflicts is not attributed to the virus itself, but rather to the enforcement of restrictive measures and the escalating prices resulting from food shortages. Furthermore, the synergistic effects of violent conflicts and the COVID-19 pandemic have negatively impacted children's health. For example, children who experienced conflicts in the 12 months before the DHS survey and also experienced the pandemic were 11.9% less likely (95% CI: 6.1%-17.8%) to eat grains and had an 8.0% greater risk (95% CI: 3.7%-12.3%) of suffering from malnutrition. In families with low income, lacking clean drinking water and unimproved sanitation, and particularly among female children, the probability of malnutrition is even higher.
Based on DHS data from 128,326 individuals from 15 African countries between 2006 and 2017, historical climate data, and 17,429 violent conflict events, the study employs a panel regression model with high-dimensional fixed effects and a series of robustness checks (e.g., controlling for additional confounders, incorporating various fixed effects, and conducting instrumental variable analysis) to quantify the spatial spillovers of violent conflict and the synergistic effects of temperature and rainfall changes on malaria risk in sub-Saharan Africa. The analysis also provides insights into the mechanisms of these effects of conflicts. The results indicate that the spatial spillovers of violent conflict amplify the impact of rising temperatures and sustained rainfall on the transmission of malaria, exposing more vulnerable populations to harsh environments.
Combining data from 6313 China's aid projects from 2000-2017 and violent conflict data, the study explores the relationship between China's aid and African violent conflicts through instrumental variable analysis. The results show that China's economic aid significantly reduced the number of conflict fatalities in the year following the aid commitment. In comparison to aid directed towards economic and production sectors, aids invested to the sector of social infrastructure (e.g., education, healthcare, and sanitation) has a more significant impact on reducing conflict fatalities. Additionally, China's aid is particularly effective in state-based armed conflicts and plays a greater role in countries with weaker infrastructure.
In summary, this study engages in a comprehensive exploration of violent conflicts in the African region, aimed at outlining the developmental trends of these conflicts and assessing their threats to public health across various scenarios. The study systematically examines the rising trend of violent conflicts in Africa and their escalating impact on health burdens. It unveils the adverse effects of COVID-19 combined with violent conflicts on child malnutrition, identifies the spillover effects of conflicts alongside rising temperatures and persistent rainfall in exacerbating the spread of malaria, and clarifies that Chinese aid can serve as an effective means to mitigate the effects of violent conflicts in Africa.