Kodi bungwe la UN lidzathetsa ntchito yopezera HIV?

Omwe akutsata ndondomeko amayitanitsa kutha kwa mliriwu pofika 2030

Msonkhano Wachigawo wa United Nations pa HIV / Edzi (UNAIDS) unalengeza zolinga zatsopano, zatsopano zothetsa mlili wa AIDS padziko lonse mu 2014. Njirayi, yomwe imadziwika kuti njira 90-90-90, ikufotokoza njira zomwe zingakwaniritsire zoyambirira zitatu zolinga za chaka cha 2020:

1. Kupeza 90 peresenti ya anthu omwe ali ndi kachirombo ka HIV kupyolera mu kuyesedwa kwakukulu.
2. Kuika anthu 90 peresenti ya anthu odziwika bwino pa mankhwala opatsirana pogonana .

1. Kuonetsetsa kuti 90 peresenti ya anthu omwe ali ndi chithandizochi amatha kupeza njira zosawoneka za tizilombo toyambitsa matenda.

Zimadziwika kuti pokwaniritsa njira imeneyi yachinyengo, anthu omwe ali ndi kachilombo ka HIV sangawathandize kwambiri. Pochita zimenezi padziko lonse lapansi, akuluakulu a UNAIDS amakhulupiliranso kuti mliriwu ukhoza kuthetsedwa pofika chaka cha 2030.

Koma kodi ndizophweka ngati zonsezi?

Ngakhale ochirikiza mwamphamvu kwambiri njirayi amavomereza kuti zolinga zoterezi sizinachitikepo m'mbiri ya thanzi labwino. Ambiri amavomerezanso kuti popanda kuwonjezereka kwakukulu kwa mapulogalamu a kachilombo ka HIV komwe kulipo, mwayi wopezera kuti vuto lonseli likhoza kukhala lopanda pake.

Ichi chinali chitsimikizo chomaliza chomwe chinapangitsa kuti pakhale mgwirizano wa 90-90-90 ku Msonkhano Wapamwamba wa Mayiko a Kuthetsa Edzi, womwe unachitikira ku New York City mu June 2016.

Kumene Tilili Masiku Ano

Malingana ndi lipoti la UNAIDS la 2016, pamene pakhala pali zopindulitsa zodabwitsa zomwe zaperekedwa m'zaka zomwe zatsogolera kufikira 2016, kupitako sikungakhale yunifolomu.

Pa mbali imodzi, anthu pafupifupi 17 miliyoni akupezeka kuti akulandira chithandizo cha HIV mu 2015, pafupifupi kawiri chiwerengero chonyamulidwa mu 2011.

Pafupifupi, 57 peresenti ya anthu omwe ali ndi kachilombo ka HIV amadziwika kuti ali ndi chikhalidwe chawo, zomwe zimatipangitsa kuti tipeze mayesero a 90% pofika pofika 2020.

Pa mbali imodzi, osachepera theka la omwe anapezeka ndi HIV (46 peresenti) akuchiritsidwa, koma 38 peresenti yokha amatha kupeza zovuta zomwe siziwoneke (chifukwa chokhala ndi vuto la mankhwala ndi chisamaliro chosagwirizana). Pogwiritsa ntchito ndalama zopanda malire komanso zopanda kudzipereka, zakhala zikulepheretsa kuwonjezeka kwa mapulogalamu apadziko lonse, kuthekera kwa kusintha kwa ziwerengerozi kungakhale kovuta kwambiri.

Ngakhale ku United States, chiŵerengero cha anthu chikugwera pansi pa zizindikiro zomwe bungwe la United Nations likuchita , ndi lipoti la Centers for Disease Control and Prevention reporting kuti, mwa anthu mamiliyoni 1.2 a ku America omwe ali ndi kachilombo ka HIV, 86 peresenti yapezeka, 36 peresenti ali pa chithandizo, ndipo 30 peresenti yokha ndiyo yodetsedwa.

(Chiwerengerochi chinatsutsidwa mu 2016 ndi Dipatimenti ya Zaumoyo ndi Ukhondo wa New York City, yomwe inanenapo kuti anthu 819,200 omwe amakhala ndi kachirombo ka HIV, 86 peresenti anali atapezeka, 68 peresenti anali kulandira chithandizo, ndipo 55 peresenti anali atasokonezedwa.)

Kuyambira padziko lonse lapansi, nkhani ya UNAIDS inafotokozera malo ndi malo omwe akuda nkhawa kuti akwaniritse zolinga 90-90-90:

• Zonsezi, Central Europe, Western Europe, ndi North America zikuyenda bwino kwambiri, ndipo 86 peresenti ya anthu omwe ali ndi kachilombo ka HIV amadziwika bwino, 56 peresenti ya chithandizo, ndipo 47 peresenti ikupeza mphamvu yosawerengeka ya tizilombo.
• Kumwera kwa Sahara ku Africa, dera lomwe limawerengera 67 peresenti ya matenda onse padziko lonse, kupita patsogolo kwakhala kochititsa chidwi m'mayiko ambiri ovuta kwambiri, ndi Botswana, Rwanda, Malawi, Swaziland, Kenya, ndi Lesotho pomwe akupita kukwaniritsa zolinga zofulumira.
• Chimodzimodzinso, Asia, Thailand, ndi Cambodia ali patsogolo pa zolinga zawo za 2020, pamene China yanena kale kuti 91%

• Ponena za kulandira chithandizo, Latin America ndi Caribbean zimapezeka kuti ndizofunika kwambiri (55 peresenti), ndipo Brazil imanena kuti oposa 80 peresenti ya anthu omwe ali ndi kachilombo ka HIV adapezeka ndipo opitirira 85 peresenti amatsutsidwa.
• Mosiyana ndi zimenezi, m'madera ena a Latin American-komanso Eastern Europe, Western Africa, Eastern Africa, ndi Central Africa-kuchuluka kwa kachilombo ka HIV sikunapangitse mankhwala apamwamba kapena mankhwala opatsirana. Kufikira kusamalidwa ndi kusamalidwa kwa mndandanda kumapitirizabe kuchepetsa kupita patsogolo m'madera awa.
• Zovuta kwambiri kuposa zimenezi ndi Eastern Europe, Russia, ndi Central Asia, kumene kuyiritsa mankhwala osokoneza bongo kukupitirizabe kuyambitsa matenda . Chosemphana ndi chisamaliro pakati pa madera awa (kuphatikizapo kudzipha anthu komanso kuchitidwa chiwawa ) chachititsa kuti kuwonjezeka kwakukulu kwa chiwopsezo cha pachaka.

Mtengo wa Kupha Zolinga 90-90-90

Malingana ndi akuluakulu a UNAIDS, kuti apereke zolinga za 90-90 mpaka 90, ndalama zapadziko lonse zidzawonjezeka kufika pa $ 19.3 biliyoni mu 2017. Pambuyo pazifukwazi, ndalama za pachaka zidzatha kufika pa $ 18 biliyoni ndi 2020, makamaka chifukwa cha Zosintha zowonongeka zowonongeka.

Ngati zolinga za pulojekiti ziyenera kufika, phindu likhoza kukhala lalikulu, monga umboni wa 2016 kuchokera ku Harvard University of AIDS Research. Malingana ndi kafukufukuyu, kukhazikitsidwa kwa njirayi ku South Africa -dziko lomwe lili ndi vuto lalikulu kwambiri la HIV-likhoza kuthetsa anthu opitirira 73,000 ndi kufa kwa 1.2 miliyoni pazaka zisanu, komanso milioni 2 ndi odwala mamiliyoni awiri pazaka khumi.

Ngakhale kuti ndalama zogwira ntchitoyi zinkasokoneza ndalama zokwana madola 15,9 biliyoni ku South Africa zokha, mtengo wapadera wa ndondomekoyi (malinga ndi kuchepa kwa odwala, imfa, ndi ana amasiye) anawoneka kuti akuyenera kuwononga ndalama zambiri.

Ngakhale zolinga zopezera ndalama monga izi zingawoneke ngati zomveka, podziwa kuti phindu la nthawi yayitali ku machitidwe a zaumoyo padziko lonse, choonadi chosavuta ndi chakuti zopereka zapadziko lonse zapitirira kuchepa chaka pachaka. Kuchokera 2014 mpaka 2015 yokha, zopereka zapadziko lonse zinagwera ndi madola oposa biliyoni, kuyambira $ 8.62 biliyoni mpaka $ 7.53 biliyoni.

Ngakhale a US, omwe amathandiza kwambiri kuti pakhale kachilombo koyambitsa matenda a HIV padziko lonse lapansi, zopereka zomwe boma la Obama likuchita zakhala zikuphatikizidwa kuyambira 2011. Ambiri ambiri amasonyeza kuti chikhalidwechi chidzapitirira, ndipo ambiri ku Congress akuyitanitsa "kukonzanso" ndalama osati kuchuluka kwa ndalama zonse za Edzi.

Chomvetsa chisoni n'chakuti, pofuna kuthetsa zolinga za 90-90 mpaka 90, zopereka za ku United States ziyenera kuwonjezeka ndi $ 2 biliyoni panthawi yomwe ndalama zatha.

Monga momwe zilili panopa, a US adavomereza kuti agwirizane ndi dola imodzi mwa magawo awiri omwe aperekedwa ndi mayiko ena, koma pokhazikika pa $ 4.3 biliyoni (kapena gawo limodzi mwa magawo atatu a cholinga cha Global Fund's $ 13 biliyoni). Izi zikutanthawuza kuchepetsa denga kuchokera ku madola 5 biliyoni apitawo, ndipo kuwonjezeka kwapakati pa 7 peresenti kuwonjezeka kwa ndalama za $ 4 biliyoni za US.

Mosiyana ndi zimenezi, mayiko ambiri omwe ali ndi mavuto aakulu azachuma adakwaniritsa zomwe akudzipereka, ndi European Commission, Canada, ndi Italy aliyense amapereka chikole chawo peresenti 20 peresenti, pomwe Germany yakula ndi 33 peresenti. Ngakhale Kenya, yomwe ili ndi GDP imodzi ndi 1/50 ya US, yadzipereka ndalama zokwana $ 5 miliyoni ku mapulogalamu a HIV kunja kwa malire ake.

Koma ngakhale kuposa vuto la madola ndi masentimita, zotsatira za njira 90-90-90 zidzasokoneza machitidwe ambiri azaumoyo omwe alibe njira zothandizira ndalama kapena zogwirira ntchito kapena njira zowonjezeramo kuti athandize mosamala. Mankhwala amatha kutuluka kale m'madera ambiri a Africa, pamene kulephera kusunga odwala akusamala kulipitsa phindu lililonse poika anthu pa mankhwala oyamba.

Popanda ndalama zowonjezereka kuti athetse mavutowa, akuluakulu a UNAIDS amachenjeza kuti ndalama zomwe zingalephereke zingakhale zowonjezereka, zomwe zimachititsa kuti anthu pafupifupi 17,6 miliyoni adwale matendawa ndi 2020 ndi 10.8 miliyoni.

Kodi Tingatani Kuti Tipewe Njira Yathu Kuchokera Mliri?

Ngakhale kuti kupita patsogolo kwakukulu kwakhala kulimbana ndi mliri wa HIV padziko lonse, ofufuza ku London School of Hygiene and Tropical Medicine amasonyeza kuti zolinga 90-90-90 sizikhala ndi mwayi wothetsera vutoli pofika mu 2030. Njirayi, Umboni wakuti kupititsa patsogolo chithandizo kumatha kuchepetsa matenda omwe amabwera chifukwa chochepetsera chiwerengero chomwe chimatchedwa "chiwerengero cha tizilombo toyambitsa matenda".

Malinga ndi kafukufuku, palibe kusiyana kwakukulu mu njirayi. Kuchokera ku mbiri yakale, kuchepa kwakukulu kwa kachirombo ka HIV kunachitika pakati pa 1997 ndi 2005, zaka zomwe zinalembedwa ndi zochitika zazikulu zitatu:

1. Kuyamba kwa mankhwala abwino kwambiri othandizira, omwe amadziwika pa nthawi yomwe HAART (kapena mankhwala othandiza kwambiri a antiretroviral mankhwala) .
2. Kubwera kwa ma antiretroviral, zomwe zinapangitsa kuti mankhwalawa atheke kwa mayiko osauka.
3. Kuyamba kwa mankhwala othandiza kwambiri a HIV, monga tenofovir , komanso mankhwala osakaniza a piritsi limodzi.

Komabe, kuyambira nthawi imeneyo, pangokhala kuchepa modzichepetsa pa chiwerengero cha matenda a padziko lonse. Ndipotu, m'mayiko 195 omwe akuphatikizidwapo, kuwonjezeka kwa chaka cha 2005 kufika chaka cha 2015. Kuwonjezera apo , South Africa inanena kuti kuwonjezeka kwa matenda opitirira 100,000 kuyambira 2014 mpaka 2015, kuwonjezera pa matenda oposa 1.8 miliyoni mu Africa ndi 2,6 miliyoni lipoti padziko lonse chaka chilichonse.

Pakalipano, kuchuluka kwa kachilombo ka HIV (mwachitsanzo, chiŵerengero cha anthu omwe akudwala matendawa) chawonjezeka ndi pafupifupi 0,8 peresenti pachaka pachaka kuyambira 2000, kufika pa 38.8 miliyoni pofika mu 2015.

Ndipo ngakhale chiwerengero cha anthu akufa chichepa kuchoka pa 1.8 miliyoni mchaka cha 2005 kufika pa 1.2 ndi 2015, matenda okhudzana ndi kachirombo ka HIV awonjezeka kwambiri m'mayiko ambiri. Chifuwa chachikulu (TB) ndichimodzimodzi, ndikuwerengera pafupifupi 20 peresenti ya anthu omwe ali ndi HIV (makamaka m'mayiko osauka). Komabe ngakhale kuti kachilombo koyambitsa matenda a HIV kamakhala kovuta kwambiri kwa anthu omwe ali ndi TB, nthawi zambiri kachilombo ka HIV kamaloledwa ngati chifukwa cha imfa (kapena ngakhale chifukwa chomwe chimayambitsa imfa) mu ziwerengero za dziko.

Ofufuzawo adanenanso kuti kuwonjezeka kwa chiwerengero cha matenda opatsirana kumakhala ndi moyo wautali (chifukwa cha kuchuluka kwa chithandizo cha mankhwala) kudzafuna kuti maboma aziyendetsa anthu ochuluka omwe ali ndi HIV. Ndipo popanda njira yothetsera vutoli mwa anthu-osati kwa zaka zingapo chabe, koma kwa nthawi yonse ya moyo-zonsezi ndizomwe zimakhala kuti matenda opatsirana amatha kusintha, mwinamwake modabwitsa.

Ngakhale pali umboni wokhutiritsa wakuti TasP ikhoza kuthetsa chiwerengero cha HIV m'madera ambiri, ofufuza amati sitingadalire mankhwala okha kuti athetse mliriwu. Iwo mmalo mwawo amalangiza kusintha kwakukulu mwa njira yomwe mapulogalamu onse aliri ndi ndalama ndi kuperekedwa. Izi zikuphatikizapo kuwonjezeka kwa ndalama zogwirira ntchito zapakhomo, zomwe zimapangitsa kuti ufulu wautengowu ukhale wotsika mtengo, komanso kuyendetsa patsogolo kayendedwe kathanzi.

Izi zifunanso kuthandizira njira zothandizira, kuphatikizapo ndalama zowonongeka kwa anthu ogwiritsira ntchito mankhwala osokoneza bongo, kugwiritsa ntchito njira za HIV pre-exposure prophylaxis (PrEP) m'madera oyenera, ndi kukhazikitsa mapulogalamu a kondomu nthawi yomwe ntchito wachinyamata akutha.

Ofufuzawa sakhala ndi kusintha kumeneku, amatsutsa kuti njira ya 90-90-90 idzakhala ndi zotsatira zowonjezereka za kufa komanso zochepa zowonjezereka zowonongeka kwa kachirombo ka HIV.

> Zotsatira:

> Carter, M. "Kuthetsa AIDS m'chaka cha 2030 kutalika kwake: chiwerengero cha HIV padziko lapansi, kufotokozera zachipatala komanso kufa kwa anthu." NAM AIDSMap . August 2016.

> GBD 2015 Ogwirizanitsa HIV. "Chiwerengero cha chiwerengero cha padziko lonse, chigawo, komanso chiwerengero cha anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi, m'chaka cha 1980 mpaka 201: Chiwerengero cha Mliri Wolimbana ndi Matenda ku Global 2015." Lancet. August 2016; 3 (8): e361-e387.

> Jamieson, D. ndi Kellerman, S. "90 90 90 amavomereza kuthetsa vutoli la HIV pofika 2030: Kodi kayendedwe kowonjezera kamatha kuigwira?" Journal of the International AIDS Society. 2016; 19 (1): 20917.

> United Nations Program on HIV / AIDS (UNAIDS). "Kupindula kwapadziko lonse kunachititsa kuti 90-90-90 zikhale zovuta." Geneva, Switzerland; July 18, 2016.

> Wallensky, R .; Borre, E ;; Bekker, L .; et al. "Zoyembekezeka Zotsatira za Zamakono ndi zachuma za 90-90-90 ku South Africa." Annals of Internal Medicine. September 6, 2016; 165 (5): 325-333.