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品评校花校草，体验校园广场美国的努力促使艾滋病治疗“显著扩展”
Charlene Porter | Staff Writer |
妇女们正在乌干达接受防治艾滋病紧急救援计划资助的服务，乌干达是该计划的首批对象国之一。
华盛顿—根据2月20日发布的一份报告，历时10年的“美国总统防治艾滋病紧急救援计划”（ President's
Emergency Plan for AIDS
Relief，简称PEPFAR）为全球艾滋病患者及艾滋病病毒感染者提供的治疗护理已有“显著扩展”。
美国国家科学院（National Academy of
Sciences）医学研究所（IOM）的一个研究小组发现，防治艾滋病紧急救援计划已经“实现或超越”其多项目标，包括扩大为艾滋病病毒感染者提供治疗，为艾滋病患者提供护理以及为有可能感染艾滋病的人提供预防服务。
该计划力争为600万艾滋病病毒感染者提供抗逆转录病毒治疗（ART）。目前，该计划为大约500万人提供这种拯救生命的药物治疗。
该研究小组在华盛顿的美国国家科学院举行的介绍会上宣布了上述调查结果。研究小组成员珍妮弗·凯茨（Jennifer
Kates）表示，防治艾滋病紧急救援计划在为艾滋病患者及其家属提供护理方面已经超越其预定目标。
凯茨说，该计划的目标是让1200万人得到护理服务，而现在“已为将近1500万人提供护理支持，其中包括超过450万名”孤儿和弱势儿童。
照护儿童——在父母死于艾滋病后成为孤儿的几十万名儿童——在防治艾滋病紧急救援计划于2003年启动之时成为一项当务之急，该计划在随后的多年中为这个弱势群体“提供了前所未有的支持”。
在乔治· W ·布什（George W.
Bush）总统任期内启动的防治艾滋病紧急救援计划是有史以来由一个国家政府针对单一疾病做出的规模最大的努力。这是一个还没有经过检验的新构想，但医学研究所的报告证实了该计划取得的成果：它拯救和改善了数百万人的生命。
凯茨说：“我认为对从事艾滋病防治工作的人士至关重要的是，该计划已经验证了我们能够做到的原理。我们可以在承受着严重疫情的国家成功地扩大一项大规模行动计划。”
凯茨指出，在过去10年中的最初几年，有人对这项计划表示极大的怀疑。防治艾滋病紧急救援计划在2003年开始时的资金额度为150亿美元。如今，美国政府为艾滋病防治提供的双边援助资金已经超过370亿美元。美国政府亦为“抗击艾滋病、结核病和疟疾全球基金”（Global
Fund to Fight AIDS, Tuberculosis and Malaria）捐助逾70亿美元。
负责防治艾滋病紧急救援计划的美国全球艾滋病事务协调员埃里克·古斯比（Eric
Goosby）说：“医学研究所报告说防治艾滋病紧急救援计划在全球应对艾滋病方面发挥了变革性作用，对此我们感到非常自豪。”他说：“我们将继续发挥这一作用，与全球合作伙伴共同努力，实现无艾滋病的一代。”
在2012年世界艾滋病日（World AIDS
Day），欧巴马政府宣布力争实现无艾滋病的一代，而这项战略部分建立在更有效的预防方法之上。
纽约大学护理学院（New York University College of
Nursing）的一名委员会成员安·库尔特（Ann
Kurth）说：“这是战胜这种流行病的唯一途径。”只有加大预防工作的力度，最大限度地减少新发感染并扩大接受抗逆转录病毒治疗（ART）的人数，才能实现无艾滋病的一代。
医学研究所委员会经过4年的调查研究才发表了这份长达700页的报告。研究小组成员与实施防治艾滋病紧急救援计划的人士进行了400多次访谈，并且前往南美洲、非洲和亚洲的13个国家调查了该计划在疫区的实施情况。
在调查研究的过程中，防治艾滋病紧急救援计划也在发展演进，这项调查建议采取的几项措施已被采纳。报告说，遏制艾滋病的长期成功将取决于各国完成转变。他们不能只接受紧急援助，而是必须成为定期提供治疗、护理和预防服务的卫生医疗系统的管理者。
该报告的内容概要说明，这个进程早已展开。报告说：“防治艾滋病紧急救援计划已经改进了医疗系统的职能。它加强了实验室研究并提高了供给品和必需药品的可靠性。”
报告指出，根据防治艾滋病紧急救援计划对几十万名医护人员进行培训，是向这个方面迈出的又一步。
库尔特说，艾滋病危机的紧迫性现已略有缓解，接受防治艾滋病紧急救援计划援助的国家必须更加注重效果，例如减少感染、降低死亡人数、协助患者坚持常规治疗，以及普及艾滋病病毒检测。
古斯比说：“虽然我们的工作还远未结束，但是我们相信，美好的日子就在前头，因为我们正在与国际社会通力协作，帮助各国逆转疫情，并将艾滋病的防治工作长期坚持下去。”
Read more:
U.S. Effort Created “Remarkable Expansion” in AIDS
By Charlene Porter | Staff Writer | 20
February 2013
These women receive services from a
PEPFAR-supported clinic in Uganda, among the first nations in the
Washington — The 10-year U.S. President’s Emergency Plan for
AIDS Relief (PEPFAR) has led to a “remarkable expansion” in
services for people living with HIV/AIDS worldwide, according to a
report released February 20.
The findings of an Institute of Medicine (IOM) study panel noted
that the campaign has “met or surpassed” many of its goals to
expand treatment to people living with HIV, give care to those with
AIDS and provide prevention options to those at risk of
infection.
PEPFAR is striving to reach 6 million people with HIV
antiretroviral treatment (ART), while the current scope of the
program reaches some 5 million persons with the lifesaving
medications.
Panel members announced their conclusions at a briefing held at
the National Academy of Sciences, IOM’s parent institution, in
Washington. Panel member Jennifer Kates said PEPFAR's efforts to
care for people with AIDS and their dependents are exceeding the
The program target is to reach 12 million people with care
services, Kates said, while PEPFAR is now “supporting care for
nearly 15 million, including more than 4.5 million" orphans and
vulnerable children.
The care of children — hundreds of thousands orphaned after
their parents died of AIDS — was an urgent priority when the
program began in 2003, and PEPFAR has “provided unprecedented
support” for that vulnerable group in subsequent years.
Conceived during the administration of President George W. Bush,
PEPFAR was the largest effort ever made by a government to address
a single health problem. The concept was new and untested, but the
IOM report validates the approach and the results it has achieved:
millions of lives saved and improved.
“I think essential to those working in HIV, [PEPFAR has]
provided proof of principle that you can do this,” said Kates. “You
can successfully scale up a large program in countries with high
disease burden.”
Significant doubt existed in the early years of the last decade
that such an endeavor was possible, Kates said. PEPFAR began in
2003 as a $15 billion program, but U.S. investments in AIDS relief
have now grown to more than $37 billion in bilateral aid. The
United States has also donated more than $7 billion to the Global
Fund to Fight AIDS, Tuberculosis and Malaria.
“We are proud that the IOM stated that PEPFAR has played a
transformative role in the global response to HIV,” said Eric
Goosby, the U.S. global AIDS coordinator who oversees PEPFAR. “We
stand ready to continue to play this role as we work with our
partners across the globe to create an AIDS-free generation.”
The Obama administration announced its intent on World AIDS Day
2012 to work toward an AIDS-free generation, a strategy based in
part on more effective prevention methods.
“That’s the only way to get ahead of this epidemic,” said Ann
Kurth, a committee member from the New York University College of
Nursing. An AIDS-free generation can only be achieved when
prevention efforts are so expansive that new infections are minimal
and are exceeded by the number of new people receiving ART
The IOM committee worked four years to develop the report, which
is about 700 pages long. Panel members conducted more than 400
interviews with people working in PEPFAR activities and made trips
to 13 countries in South America, Africa and Asia to study
implementation of the programs in stricken regions.
PEPFAR was evolving while the study was in the making, so a
number of actions it recommends are already being undertaken.
Long-term success in keeping disease at bay, the report says, will
depend on countries making a transition. Rather than recipients of
emergency assistance, they must become stewards of health care
systems that routinely provide the services of treatment, care and
prevention.
A report summary indicates that process is well under way.
“Already PEPFAR has improved the function of health systems. It has
strengthened laboratories [and] bolstered the reliability of
supplies and essential medicines.”
The training of hundreds of thousands of health care workers
achieved under PEPFAR is another step in this direction, the report
Now that the urgency of the AIDS crisis has ebbed slightly,
Kurth said, countries receiving PEPFAR assistance must place a
greater focus on outcomes, such as reducing infections, reducing
deaths, helping patients adhere to a care routine and increasing
access to HIV testing.
“While our work is far from finished,” according to Goosby, “we
believe our best days lie ahead as we work with the global
community to help countries reach the tipping point in their
epidemics, and sustain their AIDS responses over time.”
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