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艾滋病第30年——不能后退
2011-06-09 17:42:00 来源: 人民网(北京)
对艾滋病过去30年的回顾使我们能够决定艾滋病应对的未来。
自首例艾滋病报告以来，大约6500万人受到艾滋病病毒感染——并且将近3000万人为此失去了生命。
全球在初期反应缓慢。随后，全球领袖们于2001年在联合国签署了《艾滋病承诺宣言》。这期间我们见证了目标设立、取得突破和进展。
2006年，各国承诺将实现艾滋病预防、治疗、关怀和支持的普遍可及作为目标——今天，650多万人由于接受抗逆转录病毒治疗而得以存活。用于艾滋病的投资自2001年以来增长了900%以上。预防是有成效的，将艾滋病新发感染降低了25%。
越来越好的消息纷至沓来。出现了新的艾滋病预防措施，如把治疗做为预防手段、CAPRISA凝胶——一种女性主导的杀微生物剂，以及iPreX——一种暴露前预防，都为想要保护自己和所爱的人免于感染的人们带来希望。在很多地方，固有的意识形态已经被同情和开放的对话所替代；政治领袖们在制定政策时接纳了事实依据；对倡导者、受到艾滋病病毒影响的社区以及政策决策者来说，共同计划、消除差异以及探索新领域已经不再新鲜；全球在艾滋病应对中的团结显示出了人类合作所取得的成功。
类似上述进展，我们需要更多、更多。
今天，艾滋病应对千头万绪、纷繁复杂。对预防和治疗的需求在增加，但机会也大量存在——并且，如果我们在以下五条战线继续前进，我们就能够抓住这些机会。
第一，接受以治疗为预防的好处。艾滋病病毒感染者能够在第一次即选择一种96%有效的方法，并且能够有尊严、有自信地服用和持续使用。以治疗为预防必须成为所有艾滋病病毒感染者的选择。但这并非是以900万有需求并迫切等待用治疗挽救其生命的人为代价。必须提供额外的以治疗为预防措施。
第二，感染艾滋病病毒的孕妇需要获得现有最好的治疗方案去保护她们自己和子女。31个国家仍然使用次优方案来阻断艾滋病病毒的母婴传播，但在高收入国家中，罕有婴儿生来即感染艾滋病病毒。没有任何理由不能在所有地区都实现这一目标。孩子和母亲的生命具有同样的价值，与她或他在哪里出生和成长无关。我们能够在2015年在儿童中消除艾滋病新发感染。
第三，必须存在社区对话和社会转型的空间。必须终止针对妇女和女童的暴力、跨代性行为、对同性恋的恐惧、社会性别不平等，以及将艾滋病病毒感染者、注射吸毒者和性工作者定罪。没有这些变革，艾滋病预防将只能达到部分效果。这将需要在农村和城市社区和首都的领袖们对这些问题打破沉默，坚定信念，并大胆采取行动。
第四，必须有充足的对艾滋病的投资。这应该通过一个新的共同责任方案，令每个国家，不论贫富，都投入公平的份额——没有例外，没有借口。今天延迟的投资将对未来的投资需求产生多重效应：没有哪个财政部长愿意面对那样一个前景。同时，卫生界必须在诊断和治疗方面加速创新，降低单位成本、增加有效性，并为起作用的项目投资以使投资更有价值。
最后，艾滋病应对必须与更广泛的健康和发展方案整合起来。艾滋病应对必须走出孤立，并成为实现与健康相关的千年发展目标的催化剂——特别是减少婴儿和孕产妇死亡率以及结核病。卫生保健服务绝不能停留在各自为政的阶段。
当世界领袖齐聚联合国讨论艾滋病应对的未来时，他们有机会在这五个前沿领域采取行动，并为接下来的五年设立明确目标和里程碑。这完全是3400万艾滋病病毒感染者和他们的家庭所应得的。
艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复
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| 图示∶2011年5月正式出版的《中国特色医疗金鉴》登载的刘君主任及其机构事迹 |
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AIDS, 30 years - can not turn back
2011-06-09 17:42:00 Source: People's Daily (Beijing)
AIDS review of the past 30 years enable us to determine the future of the AIDS response.
Since the first case of AIDS reported since about 6500 million people are infected with HIV - and nearly 3,000 people lost their lives for this.
Slow response in the initial world. Subsequently, the world's leaders at the United Nations in 2001 signed the "Declaration of Commitment on AIDS." During this period we have witnessed a goal setting a breakthrough and progress.
In 2006, countries pledged to implement AIDS prevention, treatment, care and support universal access target - today, more than 650 million people have been receiving antiretroviral treatment to survive. Investment for AIDS since 2001, an increase of 900% or more. Prevention is effective, will reduce new HIV infections by 25%.
More good news after another. The emergence of new HIV prevention measures, such as the treatment as a means of prevention, CAPRISA gel - a female-dominated microbicides, and iPreX - a pre-exposure prophylaxis, all you want to protect themselves and loved ones people from infection bring hope. In many places, has been sympathetic to the ideology inherent in open dialogue and replaced; political leaders in the formulation of policies accepted facts; for advocates, communities affected by HIV and policy makers, the joint planning, elimination of differences, and explore new areas is no longer fresh; global solidarity in the AIDS response shown in the success of human cooperation.
Similar to the above progress, we need more, more.
Today, the AIDS response is too complicated, complicated. The prevention and treatment demand is increasing, but the opportunities abound - and, if we move forward in the following five fronts, we can seize these opportunities.
First, the accepted treatment for the prevention benefits. HIV is able to choose one in the first 96% effective method, and to have dignity and self-confidence to take and sustainable use. The treatment for the prevention of HIV infection must be all of those choices. But this is not a demand is 9,000,000, and urgent to wait for the Treatment of the expense to save their lives. Must provide additional treatment for preventive measures.
Second, HIV-infected pregnant women need access to the best available treatment options to protect themselves and their children. 31 countries still use the second-best solution to block the mother to child transmission of HIV, but in high-income countries, very few babies born with the HIV virus. There is no reason not in all regions to achieve this goal. The lives of children and mothers have the same value, and where he or she was born and grew independent. In 2015 we were able to eliminate AIDS in children, new infections.
Third, there must be community dialogue and social transformation of space. Must end violence against women and girls, cross-generational sex, the fear of homosexuality, gender inequalities, and to people living with HIV, injecting drug users and sex workers convicted. Without these changes, part of AIDS prevention will only be able to achieve results. This will require capital of rural and urban communities and leaders to break the silence on these issues, strong faith, and bold action.
Fourthly, there must be sufficient investment in AIDS. This should be a shared responsibility through a new program, so that every country, rich or poor, have invested a fair share - no exceptions, no excuses. Today's investment will delay the investment needs of the future have multiple effects: no one willing to face as a future Treasury Secretary. Meanwhile, the health community in the diagnosis and treatment must accelerate innovation, reduce unit costs, increase effectiveness, and for the work of the project investment to make the investment more valuable.
Finally, the AIDS response must be a wider range of health and development program to integrate. AIDS response must go out of isolation, and to achieving health-related Millennium Development Goals, a catalyst - in particular, to reduce infant and maternal mortality and tuberculosis. Health services must not remain in the fragmentation stage.
When world leaders gathered at the United Nations to discuss the future of the AIDS response, they have the opportunity to take action on five fronts, and for the next five years to establish clear objectives and milestones. This is 34 million HIV infected persons and their families deserve.
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