全球愛滋病病毒應對工作取得空前進展 持續投放資源仍至關重要
2011-11-30
日内瓦／香港，2011年11月30日——在预防和治疗爱滋病病毒方面取得的全球进展，凸显了在爱滋病病毒／爱滋病领域长期持续投放资源的好处。世界衞生组织、联合国儿童基金会和联合国爱滋病规划署最新发表的《全球爱滋病病毒／爱滋病应对报告》表明，扩大爱滋病病毒服务，令过去10年间的新增感染病例下降了15%，而过去5年间的爱滋病相关死亡亦下降了22%。
报告提出了正在发挥作用的措施重点：
![[RELEASE OBTAINED] Natasha Chisenga Simpasa, holding her six-week-old daughter, Mutale, listens as a health worker explains proper dosing of Mutales prophylactic antibiotics during a consultation at the Chelstone Clinic in Lusaka, the capital. Ms. Simpasa is HIV-positive. She participated in the clinics PMTCT programme for her sons, 20-month-old Fanwick and four-year-old Masonda, both of whom are HIV-negative. She is now participating in PMTCT for Mutale. Mutale has just received her first HIV test, but the results will not be known for several weeks. [#8 IN SEQUENCE OF NINE] In October 2010 in Zambia, the Chelstone Clinic in Lusaka continues to provide vital programmes to treat HIV-positive pregnant women and to prevent mother-to-child transmission of HIV (PMTCT). Some 95,000 Zambian children under age five are infected with HIV; the vast majority contracted the illness from an HIV-positive mother during pregnancy, delivery or breastfeeding. PMTCT programmes include HIV testing during pregnancy, antiretroviral (ARV) regimens for sick HIV-positive pregnant women, and early diagnosis and treatment for infants exposed to HIV in utero. Participating infants receive prophylactic antibiotics and ARVs in the weeks after they are born, and are administered HIV tests at six weeks. If breastfed by an HIV-positive mother, infants continue to receive prophylactics and are tested again at 12 months and 18 months (and three months after breastfeeding ceases or at any age if they fall ill). HIV-positive infants diagnosed and treated within the first 12 weeks of life are 75 per cent less likely to die from the disease. Zambia has recently made great strides in expanding PMTCT programmes. In the second quarter of 2009, ARVs were administered to approximately half of all children in need and to some 57 per cent of HIV-positive pregnant women. However, many infants still do not receive PMTCT services because their caretakers lack access to properly equipped facilities, or fear the stigma associated with HIV, or find it difficult to adhere to the structured course of required tests and services.](/wp-content/uploads/2015/12/30-11-11_AIDS-response_mother-baby-300x199.jpg)
• 2010年，近一半（48%）有需要的孕妇得到预防爱滋病病毒母婴传播的有效药物。
• 抗逆转录病毒治疗不仅能够改善被感染者的健康和福祉，而且能够阻断爱滋病病毒的进一步传播。现在低收入和中等收入国家有665万人能够获得抗逆转录病毒治疗，佔符合接受治疗条件的1,420万人的47%。
报告指出，到2020年，在爱滋病病毒服务方面的投资可能带来高达港币2,652亿元（约340亿美元）的经济活动和生产率增量，大大超过抗逆转录病毒治疗规划的费用。
联合国爱滋病规划署副执行主任保罗•德莱表示：「2011年是形势逆转的一年。有了新的科学、前所未有的政治领导力和在爱滋病应对方面取得的持续进展，各国有机会抓住当前的进展，将他们的应对工作提高到新水准。各国可以通过明智投资提高效率、降低成本並改进结果。但是，若减少投放资源于爱滋病工作，迄今为止所取得的成就，仍有可能丧失。」
报告还指出了需要继续进行的工作：
![[RELEASE OBTAINED] Patients wait outside the Samfya Stage 2 Clinic, in the rural town of Samfya, in Samfya District. The clinic provides PMTCT services as well as other child and maternal health services. In October 2010 in Zambia, clinics in both urban and rural areas are providing vital programmes to treat HIV-positive pregnant women and to prevent mother-to-child transmission of HIV (PMTCT). PMTCT programmes include HIV testing during pregnancy, antiretroviral (ARV) regimens for sick HIV-positive pregnant women, and early diagnosis and treatment for infants exposed to HIV in utero. These infants receive prophylactic antibiotics and ARVs in the weeks after they are born and are administered HIV tests at six weeks. If breastfed by an HIV-positive mother, infants continue to receive prophylactics and are tested again at 12 months and 18 months (and three months after breastfeeding ceases or at any age if they fall ill). HIV-positive infants diagnosed and treated within the first 12 weeks of life are 75 per cent less likely to die from the disease. However, many infants do not receive PMTCT services because their caregivers lack access to properly equipped facilities or fear the stigma associated with HIV. Zambia has recently made great strides in expanding PMTCT programmes. In the second quarter of 2009, ARVs were administered to approximately half of all children in need and to some 57 per cent of HIV-positive pregnant women. But for PMTCT measures to be effective, infants must adhere to a long-term, structured course of tests and services. Access to PMTCT services is particularly difficult in rural areas, where poverty rates are higher and many remote communities have limited access to health clinics. UNICEF supports the expansion of these services into rural areas, including Samfya District in Luapula Province. The province has the highest child-mortality rates in the country, and Samfyas clinics face critical staff and supply shortages. However, rural areas also tend to have lower HIV infection rates, as well as greater willingness on the part of fathers to participate in PMTCT services.](/wp-content/uploads/2015/12/30-11-11_AIDS-response_clinic-300x199.jpg)
• 虽然有越来越多的证据表明各国应该关注哪些领域才能产生实效，但仍有一些国家的相关工作未能针对风险最大、最有需要的人群。在很多情况下，少女、注射吸毒者、男男性行为者、跨性別人群、性工作者、囚犯和流动人口等群体，仍无法获得爱滋病病毒预防和治疗服务。
现时，全世界15至24岁爱滋病病毒感染者大部分（64%）是女性。这一比例在撒哈拉以南非洲还更高，当地少女和年轻妇女佔所有爱滋病病毒感染年轻人的71%，主要是由于预防措施还沒有延伸到他们。
关键人群继续被边缘化。在东欧和中亚，60%以上爱滋病病毒感染者是注射吸毒者。但注射吸毒者仅佔接受抗逆转录病毒治疗者的22%。
虽然在阻止爱滋病病毒母婴传播方面，更好的服务已经成功地避免了35万例新增儿童感染，但仍有340万儿童感染爱滋病病毒，其中许多人缺乏爱滋病病毒治疗。2010年，在低收入和中等收入国家，每4名需要爱滋病病毒治疗的儿童中，只有1人获得治疗。与此相比，每2名需要治疗的成人就有1名得到治疗。
联合国儿童基金会驻日内瓦办事处主任莱拉．帕卡拉说：「虽然在成人可获得的治疗、保健和支持方面取得了进展，我们注意到在儿童方面进展缓慢。儿童爱滋病病毒干预措施的覆盖率仍然非常低。我们必须通过共同行动和公平的战略，确保全球努力不仅考虑到成人，也考虑到儿童。」
![[RELEASE OBTAINED] Two-year-old Bright smiles at his aunt Leontina Chalikosa (formerly Mwewa), in Mulebambushi Village, Samfya District. Brights mother, Yvonne, died of AIDS the previous year, and Leontina is now his primary caretaker. PMTCT services were not available when Yvonne was pregnant with Bright, and she did not learn she was HIV-positive until after his birth. Bright became ill around the time his mother died; soon after, he tested positive for HIV. As part of paediatric services at the nearby Chimembe Clinic, Bright is receiving ARVs and his health has improved, though he is currently sick with malaria. [#1 IN SEQUENCE OF FIVE] In October 2010 in Zambia, clinics in both urban and rural areas are providing vital programmes to treat HIV-positive pregnant women and to prevent mother-to-child transmission of HIV (PMTCT). PMTCT programmes include HIV testing during pregnancy, antiretroviral (ARV) regimens for sick HIV-positive pregnant women, and early diagnosis and treatment for infants exposed to HIV in utero. These infants receive prophylactic antibiotics and ARVs in the weeks after they are born and are administered HIV tests at six weeks. If breastfed by an HIV-positive mother, infants continue to receive prophylactics and are tested again at 12 months and 18 months (and three months after breastfeeding ceases or at any age if they fall ill). HIV-positive infants diagnosed and treated within the first 12 weeks of life are 75 per cent less likely to die from the disease. However, many infants do not receive PMTCT services because their caregivers lack access to properly equipped facilities or fear the stigma associated with HIV. Zambia has recently made great strides in expanding PMTCT programmes. In the second quarter of 2009, ARVs were administered to approximately half of all children in need and to some 57 per cent of HIV-positive pregnant women. But for PMTCT measures to be effective, infants must adhere to a long-term, structured course of tests and services. Access to PMTCT services is particularly difficult in rural areas, where poverty rates are higher and many remote communities have limited access to health clinics. UNICEF supports the expansion of these services into rural areas, including Samfya District in Luapula Province. The province has the highest child-mortality rates in the country, and Samfyas clinics face critical staff and supply shortages. However, rural areas also tend to have lower HIV infection rates, as well as greater willingness on the part of fathers to participate in PMTCT services.](/wp-content/uploads/2015/12/30-11-11_AIDS-response_2-300x200.jpg) |
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2010年，世界各地爱滋病病毒流行情况和地区上的应对工作各有不同，相关趋势、进展率和结果也发生了变化。
撒哈拉以南非洲地区获得抗逆转录病毒治疗的人数增加30%，是增幅最多的一年。博茨瓦纳、纳米比亚和卢旺达3国已经实现爱滋病病毒预防、治疗和保健服务的普遍覆盖（80%）。2010年底，该地区抗逆转录病毒治疗覆盖率达39%。近半感染爱滋病病毒的孕妇接受预防病毒母婴传播的治疗。21%有需要的儿童能够获得儿科爱滋病病毒治疗。该地区新增感染病例为190万，感染者人数为2,290万。该地区不同地方的进展情况差別巨大。在抗逆转录病毒治疗和预防母婴传播覆盖率方面，东部（56%）和南部（64%）非洲国家显着高于西部（30%）和中部（18%）非洲国家。
亚洲总体流行情况趋于稳定，但有些社区新增感染数量很高。亚洲480万爱滋病病毒感染者中，接近一半（49%）生活在印度。抗逆转录病毒治疗覆盖率正在增加，需要爱滋病病毒治疗的成人和儿童有39%获得了治疗。预防母婴传播服务的覆盖率相对较低（16%）。
东欧和中亚爱滋病病毒急剧增长，过去10年间新增感染增加了25%。新增感染90%以上发生在俄罗斯和乌克兰两国。该地区预防母婴传播和儿科爱滋病病毒治疗覆盖率高（分別是78%和65%）。但是，抗逆转录病毒治疗覆盖率只有23%，特別是最受影响的人群——注射吸毒者——的治疗覆盖率很低。
中东和北非地区2010年爱滋病病毒感染者人数达到最高（59,000人），比前1年增加了36%。爱滋病病毒服务覆盖率非常低：抗逆转录病毒治疗覆盖率为10%，儿科治疗覆盖率为5%，预防母婴传播覆盖率为4%。
拉丁美洲和加勒比地区总体流行情况趋于稳定，拉美有150万爱滋病病毒感染者，加勒比地区是20万。在拉丁美洲，爱滋病病毒主要存在于男男性行为者中。但在加勒比地区，妇女是最受影响的人群，佔爱滋病病毒感染者的53%。该地区成人抗逆转录病毒治疗覆盖率是63%，儿童覆盖率是39%。有效预防母婴传播治疗方案的覆盖率较高，为74%。
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• 世衞组织、联合国爱滋病规划署和联合国儿童基金会提出「消除倡议」，旨在到2015年消除新增儿童爱滋病病毒感染並确保其母亲的生存。
• 世衞组织正在就战略性使用抗逆转录病毒药物预防和治疗爱滋病制定新的指导档。
• 世衞组织「2011至2015年全球衞生部门爱滋病病毒／爱滋病战略」2011年5月获得世界衞生大会支持，该战略强调继续努力优化爱滋病病毒治疗和联合预防——使用各种不同方法降低人们感染风险——的重要性。