Tianen Yao, Christoph Benn, Jiabin Xu, Xinyu Yang, Jiajun Xu, Huaixiao Ye, Yuxin Huang, Han Chen, Wei Shen, Jinjia Zhang, Ming Xu
Debt2Health (D2H) swap is an innovative financing tool that addresses public health funding gaps in low- and middle-income countries (LMICs) facing debt distress. China, Qatar, South Korea, the United Kingdom, and Portugal are major creditors to LMICs and active global health actors, yet none have participated in D2H swaps. The study (using data from 2021) proposes a multi-dimensional assessment framework, health performance was rated as the most critical factor, followed by bilateral relations, environmental performance, political feasibility, and debt vulnerability. Using the entropy-weighted TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) method, the countries that had previously implemented D2H (Pakistan, Egypt, Cameroon and Jordan) emerged as the top recipient candidates. Comoros and Algeria stood out among the new potential candidates. According to some senior experts via AHP (Analytic Hierarchy Process), Pakistan and Egypt are China’s most desirable recipients. Furthermore, in the future, other potential D2H donor countries may invite their own experts to participate in our designed questionnaire surveys or evaluation systems to screen viable recipient nations and enhance the success of D2H. This approach establishes a robust basis for fostering diverse, equitable and mutually beneficial international cooperation, incorporating both South-South and North-South partnerships to promote global health and development.