Marking 10 Years of PEPFAR’s Accomplishments

紀(jì)念美國總統(tǒng)防治艾滋病緊急救援計劃走過十年成功之路

18 September 2013

2013年9月18日

At the end of the last century, the HIV/AIDS epidemic was at its height, killing scores of people in every corner of the world. Sub-Saharan Africa was struck particularly hard, with countless children orphaned and nearly an entire generation decimated. Something had to be done. To combat the epidemic, U.S. President George W. Bush launched the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003.

上世紀(jì)末，艾滋病病毒/艾滋病疫情達(dá)到高峰，在世界各地造成大量人員死亡。非洲撒哈拉以南地區(qū)的疫情尤為嚴(yán)重，無數(shù)兒童成為孤兒，幾乎整整一代人的人生毀于一旦。對此必須采取行動。為了抗擊艾滋病疫情，美國總統(tǒng)喬治·W·布什于2003年發(fā)起了“美國總統(tǒng)防治艾滋病緊急救援計劃”。

The year 2013 marks a decade of PEPFAR’s remarkable achievements in helping protect people against this deadly virus. The program has been active in 80 countries, saving at least 1 million babies from being inadvertently infected by their HIV-positive mothers and now providing antiretroviral drugs to more than 5 million patients who could not otherwise afford them.

美國總統(tǒng)防治艾滋病緊急救援計劃為幫助人們防范這種致命病毒已取得顯著成效, 2013年恰逢計劃誕生10周年。這個計劃已在80個國家得到積極實施，至少挽救了一百萬嬰兒，避免他們無意中被艾滋病毒檢測呈陽性的母親感染，同時向500多萬名無力購買藥物的患者提供抗逆轉(zhuǎn)錄病毒藥物。

Research funded by the U.S. National Institutes of Health (NIH) has provided essential guidance to PEPFAR’s treatment and prevention programs. For instance, an NIH-supported study in Haiti demonstrated that patients in resource-limited settings could comply well with complicated antiretroviral drug regimens, and a multicountry study showed that if patients began taking antiretroviral drugs as soon as possible after diagnosis, they were less likely to spread the disease to their sexual partners.

由美國國家衛(wèi)生研究院資助的研究為美國總統(tǒng)防治艾滋病緊急救援計劃的治療和預(yù)防項目發(fā)揮了重要的指導(dǎo)作用。例如，由美國國家衛(wèi)生研究院資助在海地進(jìn)行的一項研究說明，在資源有限的情況下，患者能夠很好地遵守復(fù)雜的抗逆轉(zhuǎn)錄病毒藥物療程。另一項在幾個國家進(jìn)行的研究表明，患者如果在確診后盡快開始服用抗逆轉(zhuǎn)錄病毒藥物，可降低向性伴侶傳播該病的可能性。

Many of the international scientists who were instrumental in these landmark studies were trained through the NIH’s Fogarty International Center. By training physicians and scientists who return to their countries, the Fogarty International Center helps bolster the capacity of countries to improve health care over the long term.

在這些具有里程碑意義的研究中起關(guān)鍵作用的很多外國科學(xué)家都曾接受美國國家衛(wèi)生研究院福格蒂國際中心的培訓(xùn)。這些醫(yī)生和科學(xué)家在接受培訓(xùn)后返回各自的國家工作。福格蒂國際中心通過培訓(xùn)幫助各國提高了長期醫(yī)療保健的能力。

Building Health Capacity in Africa

建設(shè)非洲的醫(yī)療保健能力

As PEPFAR began to transition from an emergency response program to a more sustainable model, its leadership focused on enabling countries to take ownership for their own HIV/AIDS programs. To support this shift, PEPFAR launched the Medical Education Partnership Initiative (MEPI) in 2010. Its objective is to increase the quality, quantity and retention of health care workers in 12 sub-Saharan countries. NIH contributes funds and helps administer MEPI through the Fogarty International Center.

隨著美國總統(tǒng)防治艾滋病緊急救援計劃開始從應(yīng)急項目轉(zhuǎn)變?yōu)楦沙掷m(xù)的模式，領(lǐng)導(dǎo)層也以促使各國自主實施本國艾滋病計劃為重點。為了支持這一轉(zhuǎn)變，美國總統(tǒng)防治艾滋病緊急救援計劃在2010年發(fā)起“醫(yī)學(xué)教育和護(hù)理教育伙伴關(guān)系行動”，目的在于提高12個撒哈拉以南國家醫(yī)務(wù)人員的質(zhì)量、數(shù)量和保留率。美國國家衛(wèi)生研究院提供資金并通過福格蒂國際中心協(xié)助管理醫(yī)學(xué)教育和護(hù)理教育伙伴關(guān)系行動。

PEPFAR and MEPI are transforming health care delivery and research capacity in many ways. Through MEPI, medical school curricula are being strengthened, incorporating electronic components such as procedure demonstration videos that enable distance learning. Institutions are upgrading their Internet connectivity, increasing access to current journal articles and building e-libraries of learning tools. They are developing programs to increase expertise in neglected areas such as emergency medicine, surgery, cancer and heart disease. Skills labs are being assembled to offer students the opportunity to practice surgeries and other procedures on lifelike models. Institutions are ramping up faculty recruitment and dramatically increasing enrollment. Finally, resources and lessons learned are being shared among the MEPI network members.

美國總統(tǒng)防治艾滋病緊急救援計劃及醫(yī)學(xué)教育和護(hù)理教育伙伴關(guān)系行動正在很多方面從根本上加強提供醫(yī)療保健和從事研究的能力。各醫(yī)學(xué)院正通過醫(yī)學(xué)教育和護(hù)理教育伙伴關(guān)系行動加強課程設(shè)置，納入有助于遠(yuǎn)程教學(xué)的程序演示視頻等電子手段。各院校正在升級因特網(wǎng)連接，擴(kuò)大查閱最新期刊文章的渠道，并建立電子圖書館作為學(xué)習(xí)工具。各院校正在制定各種項目，要求提高急救醫(yī)學(xué)、外科、癌癥和心臟疾病等被忽略領(lǐng)域的專業(yè)水平。正在籌建的技能實驗室為學(xué)生們提供機會在模擬實際操作的模型上練習(xí)做手術(shù)和其他程序。各院校正增聘教師，大幅度地提高招生人數(shù)。最后，有關(guān)的資源和獲得的經(jīng)驗正在醫(yī)學(xué)教育和護(hù)理教育伙伴關(guān)系行動網(wǎng)成員中得到分享。

Sustaining Progress Through Local Ownership

發(fā)揮當(dāng)?shù)氐淖灾餍詫崿F(xiàn)可持續(xù)進(jìn)展

Staff retention is a major challenge for many African institutions, with higher salaries elsewhere causing a brain drain. Some MEPI funds support research projects, not only to expand training and accumulate country-relevant data, but importantly as an enticement for faculty to remain in their institutions and help sustain medical capacity. Another challenge is staffing clinics in rural areas, where most of Africa’s population lives. To address this issue, MEPI grantees are nurturing rural training facilities and recruiting students from local communities who are more likely to remain in place after completing their health care studies.

對很多非洲各機構(gòu)而言，留住員工是一項重大挑戰(zhàn)，因為其他地方更高的工資造成了人才流失。醫(yī)學(xué)教育和護(hù)理教育伙伴關(guān)系行動的有些資金支持研究項目，不僅可以擴(kuò)展培訓(xùn)范圍和積累國家的相關(guān)數(shù)據(jù)，而且重要的是有助于吸引人員留在本機構(gòu)并保持醫(yī)療能力。另一項挑戰(zhàn)是在非洲大多數(shù)人口生活的農(nóng)村地區(qū)為醫(yī)療診所招收人員。為了解決這個問題，接受醫(yī)學(xué)教育和護(hù)理教育伙伴關(guān)系行動資助的有關(guān)機構(gòu)正在充實農(nóng)村培訓(xùn)設(shè)施，在當(dāng)?shù)厣鐓^(qū)招收學(xué)生，因為這些學(xué)生在完成醫(yī)療保健學(xué)業(yè)后更可能留在當(dāng)?shù)毓ぷ鳌?/p>

Since MEPI grants are made directly to African institutions, local leaders can decide how best to apply funding to meet their country’s particular needs, which enhances their sense of ownership. MEPI institutions work closely with their government ministries to ensure goals are aligned with country priorities and to foster government support.

由于醫(yī)學(xué)教育和護(hù)理教育伙伴關(guān)系行動的資助直接劃撥給非洲的有關(guān)機構(gòu)，當(dāng)?shù)仡I(lǐng)導(dǎo)人可決定如何最好地使用資金，以滿足本國獨特的需求，有助于增強他們獨立自主的責(zé)任感。參加醫(yī)學(xué)教育和護(hù)理教育伙伴關(guān)系行動的機構(gòu)與政府部委密切合作，可保證有關(guān)目標(biāo)與國家的重點規(guī)劃保持一致并有利于獲得政府支持。

Thanks to PEPFAR and MEPI, the future looks much brighter than it did a decade ago, making the prospect of an AIDS-free generation truly possible.

由于實施美國總統(tǒng)防治艾滋病緊急救援計劃及醫(yī)學(xué)教育和護(hù)理教育伙伴關(guān)系行動，未來將比10年前更加光明，完全有可能實現(xiàn)無艾滋病一代的前景。

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