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亚洲如何有效防治艾滋病
2009-08-12 01:50
中国日报网中国在线消息：英文《中国日报》8月12日国际言论:在亚洲，每天新增一千多个艾滋病感染者。如果我们的资源能够更多地投向有感染危险的人群及其伴侣，那么这些新增感染中很大一部分比例是可以避免的，而避免的成本仅为平均每个人不足0.5美元。
在亚洲和太平洋地区的一些国家，我们刚刚开始看到艾滋病防治取得了一些成就；但是要逆转疫情，我们做得还不够。亚洲艾滋病委员会曾经建议重新评定这个区域的艾滋病疫情。亚太地区的艾滋病防治工作需要进行改革，以使其服务于人民的利益，尤其是那些被边缘化的、缺少发言权的人们的利益。这就意味着保护性工作者、男男性行为者、跨性别人士、注射吸毒者及妇女。
我们怎样才能做到这一点呢？
首先，减少对成年人自愿性行为和使用毒品的治罪。许多国家正在修改对成年人自愿性行为（包括性工作）和使用毒品治罪的法律，法院也在竭力对不利的法律进一步做出司法解释。印度尼西亚最高法院规定，吸毒者需要关怀，而不是囚禁；尼泊尔最高法院认定，跨性别人士和男男性行为者与其他人享有同样的宪法权利；印度新德里高院在量刑中考虑了陈旧法律（如歧视男男性行为者）的不适用性，这一举动维护了上百万人的尊严；新西兰将性工作合法化，使公共卫生和公共安全两个领域都受益；澳大利亚也申明，在处理吸毒的问题上，应该同时考虑执法与公共卫生这两个目标。事实证明，我们能够废弃有碍于艾滋病有效防治的法律和政策。但是，真正的转变一定是来自人们的思想。法院和国会只能创造可能的环境；社会和社区必须改变允许侮辱和歧视的社会规范。
在印度，一个孕妇在常规的检查中被医务人员在其前额上贴上艾滋病感染者的标签。这种不人道的对待遭到了当地社区和人权活动家的强烈抗议，最终导致古吉拉特政府对此事开展调查。终结这种带有歧视性行为的决定力量正是这种社区动员。
第二，在亲密的伴侣间加强预防艾滋病传播。不利的法律和带有偏见的社会总是给妇女带来恶劣的影响。在亚洲，很多女性是通过她们的丈夫或者男性伴侣感染的艾滋病病毒，而她们的性伴侣则是通过使用毒品、与男性发生性行为或者与性工作者发生性行为而感染的。在印度，一夫多妻是造成大约90%女性艾滋病感染者感染的唯一危险因素。2008年，亚洲的成年感染者中有35%为妇女，他们当中绝大部分都有稳定的性关系。
第三，对以事实为依据的项目进行投入，包括艾滋病的预防、治疗、关怀和支持。艾滋病预防项目必须进一步扩大。政治领袖们必须将最脆弱的人群纳入到现有的艾滋病服务体系中。这些服务包括：建立针具交换项目，为吸毒人员提供口服替代治疗（孟加拉、中国、马来西亚、印度和越南在这些领域已经取得了巨大的进步），扩大抗病毒治疗的覆盖面，发放安全套，并向高危人群提供艾滋病病毒自愿咨询检测。令人振奋的是，最近几年为这些服务向全球基金提出的申请已经显著增加。然而，到2010年我们需要75亿美元用于支持各国实现这些目标，但是到2007年，我们仅获得了所需资金的10%。因此，我们必须注重资金投入的效果和公平性，特别是在现今经济危机期间。
最后，采取“将艾滋病防治与实现千年发展目标相结合”的方法。非洲的艾滋病疫情已经颠覆了社会发展所做的种种努力，然而与此不同的是，亚洲和太平洋地区有能力将社会发展和艾滋病防治整合起来。减少贫困、提高教育水平和对医疗服务的投入是这个地区可持续经济发展的基础，这正是我所提到的“将艾滋病防治与实现千年发展目标相结合”运动。
最近，我读到一位尼泊尔艾滋病感染者的经历。她叫Nisha，2004年由于无法获得艾滋病抗病毒治疗失去了丈夫。如今，她本人已经开始了艾滋病抗病毒治疗。目前她身体状况良好，重新回到了工作岗位，并且自食其力地照顾三个孩子。她的家庭开始慢慢重新接纳她，她的孩子也开始上学，在学校里，老师教授她的孩子们自我保护知识。治疗使她重获实现梦想的机会——这正是通往现实的希望。（作者为联合国艾滋病规划署（UNAIDS）执行主席米歇尔·西迪贝（Michel Sidibé 编译 周晓燕 编辑 裴培）
How to effectively fight against AIDS in Asia
2009-08-12 01:50
China News Network China's online news: the English word "China Daily" International August 12 remarks: In Asia, every day add more than 1000 HIV-infected persons. If our resources can be more dangerous infection into the crowd and their partners, then these new infections in a large part of the ratio can be avoided, and to avoid the cost of just less than an average of 0.5 U.S. dollars for each person.
In Asia and the Pacific region, some countries, we have just begun to see the AIDS prevention and control has achieved some success; but to reverse the epidemic, we did not go far enough. Asian AIDS Commission had proposed to re-assess the AIDS epidemic in the region. Asia-Pacific region, AIDS prevention and treatment need for reform in order to serve the interests of the people, especially those who have been marginalized, the lack of say in the interests of the people. This means that the protection of sex workers, MSM, transgender people, injecting drug users and women.
How can we do this?
First of all, the voluntary reduction of adult sexual behavior and drug use of the Code. Many countries in the process of amending the voluntary sexual intercourse of adults (including work) and a law criminalizing the use of drugs, the court is also sparing no efforts to make further adverse judicial interpretation of the law. Provisions of the Indonesian Supreme Court, the need to care for drug addicts rather than prison; Nepal Supreme Court held that cross-gender behavior and men and men with other people who enjoy the same constitutional rights; New Delhi, India, the High Court to take into account in sentencing the old law (such as discrimination MSM) is not the applicability of this action to safeguard the dignity of millions of people; New Zealand will be the legalization of sex work, so that two areas of public health and public safety benefit; Australia also stated that in dealing with the issue of drug abuse should consider the law enforcement and public health at the same time these two objectives. Facts have proved that we can effectively prevent and treat AIDS hinder waste laws and policies. However, real change must come from people's minds. The courts and Congress can create a possible environment; society and community must be changed to allow an insult to the social norms and discrimination.
In India, a pregnant women in the regular inspection of the medical staff were put in his forehead AIDS label. This inhumane treatment by the local communities and a strong protest against human rights activists, which eventually led to the Gujarat government to conduct investigations on the matter. The end of this discriminatory decision of having sex is the power of this community mobilization.
Secondly, to enhance intimacy between partners to prevent the spread of AIDS. Adverse legal and social is always biased to the impact of poor women. In Asia, many women through their husbands or male partners of HIV infection, and their sexual partners is through the use of drugs, have sex with men or having sex with sex workers and infection. In India, polygamy is about 90% of female AIDS infection risk factors only. In 2008, the adult infection in Asia, 35% were women, the vast majority of them have a stable sexual relationship.
Thirdly, evidence-based investment projects, including AIDS prevention, treatment, care and support. AIDS prevention project has to be further expanded. Political leaders must be the most vulnerable groups of people into the existing service system in AIDS. These services include: the establishment of needle exchange projects for drug users to provide oral replacement therapy (Bangladesh, China, Malaysia, India and Vietnam in these fields has made great progress), the expansion of antiretroviral treatment coverage, issuing of condoms to the provision of high-risk groups of HIV voluntary counseling and testing. It is heartening to note that in recent years for these services to the Global Fund has been a significant increase in applications. However, by 2010 we need 7.5 billion U.S. dollars to support countries to achieve these goals, but in 2007, we received only 10% of the funds required. Therefore, we must pay attention to the effects of capital investment and equity, especially in the current period of economic crisis.
Finally, the "AIDS prevention and control will achieve the Millennium Development Goals and the combination" approach. AIDS epidemic in Africa has made to subvert the social development efforts, however, this difference is that Asia and the Pacific have the ability to social development and integrated AIDS prevention and control. Reducing poverty and raising the educational level and the input of medical services in this region is the basis for sustainable economic development and this is what I referred to as "the AIDS prevention and the achievement of the Millennium development goals" campaign.
Recently, I read a Nepal experience of AIDS. Her name is Nisha, 2004, due to the lack of access to HIV antiretroviral therapy has lost her husband. Now, she has started anti-viral treatment of AIDS. She is currently in good health, returned to the job and earn their own living and take care of three children. Her family began to slowly re-admit her, her children started school, at school, she taught the children self-protection knowledge. Treatment to enable her to regain the opportunity to realize their dreams - this is the reality to hope. (The author is the United Nations AIDS Program (UNAIDS) Executive Chairman Michel Sidibe (Michel Sidibé editor compiler裴培ZHOU Xiao-yan)
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