Ulamuliro wa Trump Ukusokoneza Zolinga za Obama-Zolinga
Pa maiko asanu ndi atatu a ku Ulaya ndi omwe amapindula kwambiri, akuphatikizidwa mu njira zowononga kachilombo ka HIV, dziko la US linafika potsiriza pakuonetsetsa zolinga zambiri za kuyesa , chithandizo, ndi kayendetsedwe ka HIV . Monga momwe tafotokozera pa 2014 International Congress pa Drug Therapy ku HIV Infection ku Glasgow, Georgia yekha-dziko laling'ono lokha, lomwe lili kum'mawa kwa Ulaya komwe anthu 34 mwa anthu 100 alionse amakhala pansi pa umphaŵi-chinaipiraipirabe.
Malinga ndi kafukufukuwo, anthu 25 pa 100 aliwonse a ku America omwe ali ndi kachilombo ka HIV omwe ali ndi kachilombo ka HIV (ART) amatha kupeza ndi kusunga ndondomeko ya chiwerengero cha vutolo losaoneka. Komanso, 66 peresenti yokhudzana ndi chisamaliro, ndi 33 peresenti yokha yomwe ili pa ART ngakhale kuti pali malamulo othandiza kupeza chithandizo pa matendawa .
Kuyambiranso kwa anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi sikuwerengera kokha anthu omwe adayesedwa kachirombo ka HIV m'mayiko onse koma chiwerengero cha anthu omwe ali okhudzana ndi chisamaliro, amapatsidwa chithandizo ndipo amatha kuchiza. Kusankhidwa kwa mayiko asanu ndi atatuwa kunakhazikitsidwa ndi deta yomwe ilipo kuyambira 2010 mpaka 2012, yochokera ku mayiko osiyanasiyana a HIV, mndandanda wa UNAIDS , nkhani zowonongeka ndi anzawo, ndi zina.
Kuchiza kwa HIV kumachitika mu mayiko asanu ndi atatu a European and High-Revenue Countries
| Dziko | Anthu omwe ali ndi HIV (ali.) | Kukula kwa HIV (%) | Odziwika ndi HIV (%) | Yogwirizana ndi Kusamalira (%) | Pa ART (%) | Mtolo Wosasintha Wosatha (%) |
| Australia | 33,000 | 0.2 | 75 | - | 35 | 32 |
| British Columbia | 11,700 | - | 71 | 67 | 51 | 35 |
| Denmark | 6,500 | 0.2 | 85 | 81 | 62 | 59 |
| France | 149,900 | 0.4 | 81 | > 74 | > 60 | 52 |
| Georgia | 4,900 | 0.2 | 52 | 44 | 26 | 20 |
| Netherlands | 25,000 | 0.2 | - | 73 | 59 | 53 |
| United Kingdom | 98,400 | 0.3 | - | 79 | 67 | 58 |
| United States | 1,148,200 | 0.6 | 82 | 66 | 33 | 25 |
Chofunika kwambiri pakati pa zifukwa za kuwonetsa kwa osauka kwa US chinali chiwerengero cha anthu omwe ali ndi kachilombo ka HIV chaka ndi chaka, makamaka m'mayiko asanu ndi atatu, omwe ali ndi anthu 15.3 omwe ali ndi kachilombo ka 100,000 (kapena pafupifupi 50,000 kachilombo ka HIV chaka chilichonse). Poyerekeza, chiwerengero cha chiwerengero cha chiwerengero cha anthu oposa chiwerengerochi chinali chocheperapo theka la chiwerengerocho, kapena 6.3 matenda opitirira 100,000.
Pakati pa maiko asanu ndi atatu omwe adaphatikizidwanso, ambiri adasonyeza kuti chiwerengero cha HIV ndi chiwerengero cha HIV pakati pa 71% ndi 85 peresenti (kupatulapo Georgia, dziko lokhalo lopanda ndalama). Ngakhale kuti chiwerengero chokhudzana ndi chisamaliro m'mayiko omwe amapindula kwambiri chinali ofanana (ndi US ndi British Columbia okha akugwera pansi pa 70 peresenti), kusiyana kwakukulu kunaonekera pokhapokha ataperekedwa kwa ART, US ndi Australian akunena kuti 33 peresenti yokha ndipo 35 peresenti ya anthu omwe ali ndi kachilombo ka HIV, amatha kuchiritsidwa.
(Chimene maphunzirowa sasonyeza ndikuti US imakhalanso ndi mbiri yoipa kwambiri yosunga odwala, akusokoneza theka la kutsatira pambuyo poyendera.)
Kamodzi pa ART, chiwerengerochi chinaipiraipira kwambiri ku US, ali ndi mmodzi yekha pa anayi omwe angathe kukwanitsa kuthetsa vutoli. Ndipotu, maiko onse a ku Ulaya anawonetsa kuchuluka kwa kachilombo koyambitsa matenda a HIV kuposa a North America ndi Australia (48 peresenti ndi 27 peresenti).
Kufotokozera Zosokonekera
Ngakhale palibe tsatanetsatane wa ziwerengerozi, ambiri amavomereza kuti kusalongosoka kwa kupeza chithandizo cha kachirombo ka HIV kumakhalabe pamtima pa zopanda pake.
Mwachitsanzo, ku Georgia, omwe amachititsa kuti anthu azikhala ovuta kwambiri pazandandanda, anthu pafupifupi 30 peresenti amapewa thandizo lachipatala chifukwa cha ndalama zowonongeka, makamaka mtengo wa mankhwala osokoneza bongo .
Pakalipano, malamulo othandiza inshuwalansi yaumoyo m'zaka za m'ma 1990 akhala akusiyidwa pothandizira inshuwalansi yaumwini, ndipo 80 peresenti ya zipatala zagulitsidwa kwa anthu omwe ali payekha monga gawo la ndondomeko za zaumoyo ndi zachuma.
Mofananamo ku US, chisankhulidwe cha Affordable Care Act (ACA) chaka cha 2014, chisamaliro cha kusamalira Achimereka omwe ali ndi kachilombo ka HIV kankaonedwa kuti ndi osauka, ndipo ndi 17 peresenti yokha yomwe imatha kukhala ndi inshuwalansi ya umoyo paokha peresenti ya 54 peresenti ya anthu ambiri . Ndipo, mpaka chakumapeto kwa chaka cha 2013, boma la AIDS lidakhala lalitali kwambiri kuti adzikhala ndi nthawi yaitali kwambiri kuti odwala athe kuyembekezera zaka zisanu kuti athe kupeza ndalama zothandizira odwala .
Kuwonjezera pa kuyimirira kwa US kunali kusowa kwachinsinsi kwa HIV, mwa kuyesa koyambirira kwa kayendetsedwe ka Clinton kulephera kuikapo ndondomeko yoyenera kukwaniritsa zolinga zenizeni zomwe maofesi a federal anali nawo pazinthu zambiri.
Kufalikira kwakukulu kwa anthu omwe ali ndi kachilombo ka HIV-komanso kusiyana kwa boma ndi mkhalidwe wa Medicaid kuyenerera-kuwonjezereka kwakukulu kwa mayiko a ku United States, kusiya akuluakulu a zaumoyo ambiri kuti asagwirizanitse.
Obama Era Amaona Kutayidwa ndi Boma la Utumiki
Poyesa kulimbikitsa boma kuti liyankhe mliriwo, Obama akuyendetsa ntchito ya National HIV / AIDS Strategy ku United States (NHAS). Pansi pa NHAS, boma likulinga kukwaniritsa zolinga zinayi zofunika pofika 2020:
- Kuonjezera chiwerengero cha anthu omwe ali ndi kachilombo ka HIV omwe amadziwa kuti sterostatus ili ndi 90 peresenti.
- Pezani chiwerengero cha matenda atsopano ndi 25 peresenti.
- Kuchepetsa chiwerengero cha anyamata achichepere amuna ndi akazi omwe ali ndi kachilombo ka HIV ndi 10 peresenti.
- Kuchulukitsa chiwerengero cha anthu omwe atangoyamba kumene kupeza mankhwala okhudzana ndi chithandizo chamankhwala choyenera cha HIV m'mwezi umodzi wa kachilombo ka HIV kachepera 85 peresenti.
- Kuonjezera chiwerengero cha anthu omwe ali ndi kachilombo ka HIV omwe amasungidwa kuchipatala choyenera cha HIV mpaka 90 peresenti.
Kuonjezera chiwerengero cha anthu omwe ali ndi kachilombo ka HIV omwe amasungidwa kuchipatala choyenera cha HIV mpaka 90 peresenti.
Kuonjezera chiwerengero cha anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi omwe amalephera kupitirira 80 peresenti.
Ngakhale kuti chiwerengero cha NHAS chidzakhala ndalama zokwana madola 15 biliyoni pazaka zisanu, ena adanena kuti kusungirako njira zothandizira zaumoyo ku United States-potsata matenda opatsirana komanso imfa monga $ 18 biliyoni.
Mpata wopanga gawoli lachitukuko pansi pa Dipatimenti ya Utumiki ikuwoneka ngati yaying'ono inapereka cholinga cha GOP chobwezeretsa mbali zambiri za ACA ndikukonzanso ndondomeko za Medicaid pofuna kupereka chithandizo chaumoyo kwa anthu osawuka komanso ovuta.
Mu October 2017, Pulezidenti adapitapo patsogolo kuti asamayesetse kuika kachilombo ka HIV polemba lamulo lotsogolera lomwe limalola olemba ntchito kukana njira zothandizira kubereka monga momwe akufunira zofunikira za ACA's Essential Benefit. Lamuloli linakhazikitsidwa ponena kuti olemba ntchito ayenera kuloledwa kukana kulera, osati chifukwa chachuma, koma chifukwa chachipembedzo kapena "makhalidwe".
Zimakhala zovuta kuchitapo kanthu ndi Republican Party kumapeto kwa zaka za m'ma 1990 kukana ndalama zothandizira anthu omwe ali ndi kachirombo ka HIV omwe ali ndi Africa omwe amalimbikitsa njira iliyonse ya kulera, kuphatikizapo kubereka kapena kuchotsa mimba. Icho chinali (ndipo chiripo) mwala wapangodya wa chiphunzitso cha GOP chokhazikika mobwerezabwereza chomwe chimawongolera mobwerezabwereza chomwe nthawi zonse chimapangitsa kuchuluka kwa kachirombo ka HIV ndi matenda ena opatsirana pogonana.
Kuoneka kosakhudzidwa kwa kayendetsedwe ka Trump kwawonetsedwanso kuti ndondomeko za NHAS zakhala zikuchotsedwa pa webusaiti ya HIV.gov.
Sitikudziwa bwinobwino, ngati chili chonse, bungwe la Trump lidzachitapo kanthu kuti likhazikitse kapena kuvomereza mavuto omwe akukumana nawo m'madera ovuta kwambiri a African American ndi achiwerewere. Potsata ndondomeko ya HIV / AIDS ya World Health Organisation, a US anafa mwachindunji osati m'madera onse omwe ali ndi chiwerengero cha anthu omwe ali ndi ndalama zambiri ku North America ndi ku Ulaya, komanso kuti kachiwiri ka HIV kakula kwambiri kuposa Latvia 0,7 peresenti.
> Zotsatira:
> Zomwe Zingathetsere Kudwala ndi Kuteteza Matenda (CDC). "CDC Fact Sheet | HIV ku United States: Maphunziro a Care." Atlanta, Georgia; inasindikizidwa mwezi wa July 2012.
> Raymond, A .; Hill, A .; ndi Pozniak, A. "Kusiyana kwakukulu kwa chithandizo cha HIV kumayambira pakati pa mayiko asanu ndi atatu a ku Ulaya ndi apamwamba - kusanthula > zopuma >." Msonkhano Wadziko lonse wa mankhwala ozunguza bongo mu HIV; Glasgow, Scotland; November 2-6, 2014; O237.
> World Health Organization (WHO). "Kufalikira kwa HIV pakati pa 15 mpaka 49 akuluakulu - Dera la dziko." Geneva, Switzerland; zasinthidwa pa November 6, 2014.
> Yahia, B. ndi Frank, I. "Kumenyana ndi AIDS ku America: Kuunika kwa ndondomeko ya HIV / AIDS." Buku Lopatulika la Umoyo Wathanzi. September 2011; 101 (9): e4-e8.