Vadzidzisi vezano vanofananidzira kuguma kwechirwere ichi ne2030
Sangano reUnited Nations Joint Programro pamusoro peHIV / AIDS (UNAIDS) rakashuma yakajeka, zvinangwa zvitsva zvinotarisirwa kupedzisa chirwere cheAIDS pasi rose muna 2014. Chirongwa ichi, chinozivikanwa sechirongwa che 90-90-90, chinotsanangura nzira dzingapedzisira dzatangira zvinangwa zvegore ra2020:
- Kuziva 90 muzana yevanhu vanogara neHIV kuburikidza nekuwedzera kuongororwa.
- Kuisa 90 muzana yevanhu vanoonekwa vakanaka pane antiretroviral therapy .
- Kuchengetedza kuti 90 muzana yevaya vari kurapwa vanokwanisa kuwana zvisingaoneki zvehutachiona hwezvirwere zvinoratidza kupora kubudirira.
Zvinonyatsozivikanwa kuti kuburikidza nekuzadzisa huwandu hwehutachiona hwehutachiona, vanhu vane HIV vane huwandu hushoma kudarika hutachiona kune vamwe. Nokuita kudaro pasi rose, vakuru veUNAIDS vanotenda zvakasimba kuti denda racho rinogona kupera nekugumira nekutanga kwema2030.
Asi zviri nyore here sezvose izvozvo?
Kunyangwe vatsigiri vakakurumbira vechirongwa vanobvuma kuti zvinangwa izvi hazvina kumbobvira zvamboitika munhoroondo yehutano hwevanhu. Mukufema kwakafanana, zvisinei, vazhinji vanozobvumiranawo kuti kunze kwekuwedzera kwechisimba kwezvirongwa zvehutachiwana hweHIV, mawindo emukana wekutaura kuti dambudziko rose rinogona kunge rakarasika.
Icho chaiva chokwadi chekupedzisira icho chakazopedzisira chaita kuti kugadziriswa kwegadziriro ye 90-90-90 paSangano reUnited Nations High-Level rekuguma kweAIDS, rakaitwa muNew York City munaJune 2016.
Kwatiri Tiri Nhasi
Maererano nehupfumi hwesangano reNAIDS muna 2016, apo pave pave nekubudirira kunowanikwa mumakore anotungamirira kusvika kubvumirano ya 2016, kufambira mberi kwave kusina kushandiswa.
Panyaya yepamusoro, inofungidzirwa vanhu vane mamiriyoni 17 vanonzi vave vachiwana chirwere cheHIV muna 2015, inenge kaviri nhamba inotapwa muna 2011.
Pose, inenge 57 kubva muzana yeavo vane hutachiona hweHIV vanoziva maitiro avo, chiitiko chinotiswededza zvakanaka munzira yedu yekuwana kupera kwemazana makumi mapfumbamwe kubva kuzana kusvika 2020.
Pachine chikamu chiduku, hafu yevaya vakaonekwa vane HIV (46 muzana) vari kupiwa kurapwa, asi 38 muzana bedzi vanogona kuwana miviri isingaoneki yehutachiona (zvichida zvichienderana nemarapirwo emishonga uye kusagadzikana kutarisirwa). Nekushaiwa basa uye kusakwanisa kuzvipira kunopa kuvhara kukura kwezvirongwa zvepasi pose, kukwanisa kuvandudza pane izvi zviyero zvingangodaro zvinoshamisa.
Kunyangwe muUnited States, nhamba dzehurumende dziri kuwira pasi pasi pezviratidzo zvakagadzirirwa neUnited States , neCenters for Disease Control and Prevention reporting, yevamiriyoni 1.2 veAmerica vanorarama neHIV, 86 muzana vakaonekwa, 36 muzana ndevokurapa, uye makumi mapfumbamwe chete muzana ndivo vanodzvinyirirwa.
(Izvozvi nhamba dzakapikiswa muna 2016 neNew York City Dhipatimendi Rehutano uye Mental Hygiene, iyo yakatsigira yevane 819 200 vaAmerica vanorarama neHIV, 86 muzana vakanga vaongororwa, 68 muzana vakanga vachiwana kurapwa, uye 55 muzana vakange vatsva.
Kubva pane zvenyika yose, inonzi UNAIDS yakaratidza nzvimbo mbiri dzakanaka uye nzvimbo dzekutsvaga pakuzadzisa zvinangwa zve 90-90-90:
- Sangano rose, Central Europe, Western Europe, uye North America zviri nani kwazvo, uye 86 muzana yehutachiona hweHIV yakaonekwa zvakanaka, 56 muzana pakuchengetwa, uye 47 muzana vachiwana mweya usina kuonekwa.
- Munharaunda yeSharan Africa, inharaunda inokwana 67 muzana yehutachiona hwepasi pose, kubudirira kwave kuri kunakidza kune dzakawanda zvakaoma kwazvo nyika dzakashata, neBotswana, Rwanda, Malawi, Swaziland, Kenya, neLesotho zvakanaka pakufamba kwavo fast-track targets.
- Saizvozvowo, Asia, Thailand, neCambodia zviri mberi kwezvinangwa zvavo zve2020, asi China inenge yakataurira inoshamisa 91 muzana yehutachiona hwehutachiona pakati pehuwandu hwevanhu vanobatwa.
- Maererano nehutano hwekurapa, Latin America neCaribbean zvinonzi zvinoshandiswa zvakanyanya kwazvo (55 muzana), neBrazil inorayira kupfuura 80 muzana yehutachiona hweHIV yakawanikwa uye inopfuura 85 muzana inenge yakasvibiswa.
- Kusiyana neizvi, mune dzimwe nzvimbo dzeLatin America-pamwe neEastern Europe, Western Africa, Eastern Africa, uye Central Africa-kuwedzera kwehuwandu hwekuongororwa kweHIV hazvina kukonzera mhando dzakakwirira dzehutano kana kuperesa kwehutachiona. Kusvikirwa kwekutarisira uye kukanganisa kwekambani kunoramba kuchikanganisa kufambira mberi mukati mematunhu aya.
- Kunyanya kutonyanya kuipa kuEastern Europe, Russia, neCentral Asia, uko kushandiswa kwekushandisa zvinodhaka kuchiri kuendesa kutapura maitiro . Chibvumirano chekutarisira mukati mematunhu aya (kusanganisira kubata vanhu uye kukanganisa ) zvakakonzera kuwedzera kunoshamisa kwehuwandu hwehutachiona hwehuwandu hwegore.
Kukosha kwekurova Mitemo 90-90-90
Maererano nevakuru veUNAIDS, kuitira kuti vawane chinangwa che 90-90-90, mari yepasi rose inofanira kuwedzera kusvika inokwana $ 19.3 mabhiriyoni muna 2017. Mushure mekunge izvi zvichinyorwa, mari yegore ichapera kusvika madhora 18 mabhiriyoni ne2020, zvichida kuchinja kunofungidzirwa muhutachiwana hwehutachiwana.
Izvo zvinangwa zvepurogiramu zvinofanira kuzadzikiswa, zvikomborero zvingava zvakakura, sezvinoratidzwa nekuongorora kwe2016 kubva kuHarvard University Center yeAIDS Research. Maererano nekudzidza, kushandiswa kwesarudzo muSouth Africa -nyika ine hutachiona hweHIV hukuru-munyika inogona kuvhara vazhinji vanokwana 73 000 uye kufa kwemamiriyoni 1,2 kwemakore mashanu, uye 2 mamiriyoni ekutambudzwa uye kufa kwemamiriyoni maviri kwemakore gumi.
Kunyange zvazvo mutengo wekushandiswa wakakonzerwa ne $ 15,9 mabhiriyoni muSouth Africa chete, kukosha kwekugadzirisa kwechirongwa (maererano nehuwandu hwezvipatara, kufa, uye nherera dzakaberekerwa nherera) zvakaonekwa sechikonzero chekubhadhara mari yakawanda.
Kunyange zvazvo zvinangwa zvemari zvakadai sezvizvi zvingaita sezvine musoro, zvichipiwa kwenguva refu zvigaro kumagariro ehutano enyika, chokwadi chiri pachena ndechekuti mipiro yepasi rose yakaramba ichiderera gore pagore. Kubva muna 2014 kusvika muna 2015 chete, zvipo zvepasi rose zvakakundwa nemadhora anodarika mabhiriyoni kubva ku $ 8.62 mabhiriyoni kusvika ku $ 7.53 bhiriyoni.
Kunyange neU.S., iyo inoramba iine humwe hukuru hukuru hwehutachiona hweHIV, zvipo pasi peHurumende yekutonga zvakagadziriswa kubva muna 2011. Vazhinji pundits vanoratidza kuti mamiriro acho achaenderera mberi, uye vazhinji muCongress vachishevedzera "kuchinjazve" kwe mari pane kungowedzera kudhura kweAIDS.
Zvinosuwisa kuti, kuitira kuti tive nechinangwa chekutora chinangwa che 90-90-90, mupiro weUnited States unoda kuwedzera nekusvika $ 2 biliyoni mukati memakore ekubhadhara mari.
Sezvazviri ikozvino, veUnited States vakabvumirana kuenzanisa imwe dollar yezvikamu zviviri zvakapiwa nedzimwe nyika, asi kungosvika padhiri rakaoma re $ 4.3 mabhiriyoni (kana kuti chetatu cheGlobal's $ 13 billion chinangwa). Izvi chaizvoizvo zvinoshandura kuderedzwa kwedenga kubva kune $ 5 mabhiriyoni akapfuura, uye chete chikamu chezana kubva muzana kubva muzana kubva ku $ 4 bhiriyoni yeUnited States.
Kusiyana neizvi, nyika dzakawanda dzine nhamo dzakadzama dzezvematongerwo enyika dzakasimbisa zvipikirwa zvavo, neEuropean Commission, Canada, neItaly mumwe nomumwe ari kutora chibvumirano chake ne20 muzana, nepo Germany yakawedzera yavo ne 33 muzana. Kunyange Kenya, iyo imwe yeGDP inonzi 1 / 50th yeUnited States, yakaita $ 5 mamiriyoni kune zvirongwa zveHIV kunze kwemiganhu yayo yenyika.
Asi kunyange kupfuura dambudziko remadhora nemakumi, kukanganisa kwe 90-90-90 hurongwa huchaisa dambudziko rakawedzerwa pamitambo yakawanda yehutano hwenyika iyo isina nzira yekuwana mari kana hurongwa hwehupfumi kana hutsotsi hwekugadzirira kupa zvakanaka. Mishonga inongororwa inowanzoitika nguva dzose mumativi akawanda eAfrica, asi kukundikana kuchengetedza varwere mukutarisira kunodzora chero upi zvake hunoitwa kuburikidza nekuisa vanhu pane kurapa pakutanga.
Pasina mari yakawedzerwa yekugadzirisa izvi nezvimwe zvipingamupinyi zvesarudzo, vakuru veUNAIDS vanonyevera kuti mari yekukundikana ingave yakakosha-zvichiita kuti vanhu vanosvika mamiriyoni gumi nemaviri vaitapukirwe nehuwandu hwemamiriyoni gumi nemakumi maviri nemakumi maviri nemakumi maviri nemakumi manomwe vakafa.
Tinogona Kubata Nzira Yedu Kubva Munjodzi Here?
Kunyange zvazvo kufambira mberi kunoshamisa kwave kuri kupedza dambudziko reHIV rose, vatsvakurudzi veLondon School of Hygiene uye Tropical Medicine vanoratidza kuti zvinokwana 90-90-90 zvine mikana shoma yekugumisa dambudziko racho muna 2030. Nzira yacho, vanoti, uchapupu hwokuti kuwedzerwa kurapwa kunogona kuderedza hutachiona hwehutachiwana nekuderedza izvo zvinonzi "hutachiwana hwehutachiona huzhinji" -rongwa hunozivikanwa zvikuru sekurapa seSekuvhara (kana TasP ).
Maererano nekutsvakurudza, pane zvakasara zvakakosha muurongwa. Kubva pane maonero ezvakaitika kare, kuderera kukuru kwekutapukirwa kweHIV kwakaitika pakati pe 1997 na2005, makore ayo akaiswa nezviitiko zvitatu zvikuru:
- Kutanga kwemasimba makuru ekubatanidza, anozivikanwa panguva iyo seHART (kana kunyanya kushandiswa kwetachirwere chetachiona chetachiona) .
- Kuuya kwema antiretrovirals, izvo zvakaita kuti mishonga iwane mari kune dzimwe nyika dzichiri kusimukira.
- Kutanga kwemishonga inoshanda yakawanda yeHIV, yakadai sa tenofovir , pamwe chete nyore, single-pill pamwe chete kurapwa.
Zvisinei, kubvira panguva iyoyo, pakange paine kuzvininipisa kunononoka muhutachiona hwehutachiona hwepasi rese. Ichokwadi, kune dzimwe nyika makumi maviri neshanu dzakabatanidzwa muchidzidzo chacho, 102 inowanikwa gore negore kubva muna 2005 kusvika muna 2015. Pakati pavo, South Africa yakashuma kuwedzera kwevanhu vanopfuura 100 000 zvirwere zvitsva kubva muna 2014 kusvika muna 2015, zvichiwedzera kune mamiriyoni 1.8 ekutapurirwa muAfrica uye mamiriyoni 2,6 yakashuma pasi gore negore.
Panguva iyi, kupararira kweHIV (kureva kuti, chiyero chevanhu vanogara chirwere ichi) chakawedzera nezvikamu zvinokwana 0,8 kubva pagore gore gore rose kubva muna 2000, kusvika kuine mamiriyoni 38.8 kusvika 2015.
Uye apo kuwedzera kwehutachiwana kwakaderera kubva pa8,8 mamiriyoni ekufa muna 2005 kusvika 1.2 kusvika 2015, zvirwere zvinotarisana neHIV zvakakura zvikuru munyika dzakawanda. Tuberculosis (TB) inowanzoitika, inotora makumi maviri kubva muzana yevakafa pakati pevanhu vanogara neHIV (kunyanya munyika dziri kusimukira). Asi pasinei nekuti hutachiwana hwehutachiwana hwehutachiwana hwehutachiwana hwakakwira kune vanhu vane TB, HIV inowanzosiyiwa sechikonzero chekufa (kana kunyange icho chinokonzera rufu) mumatare enyika.
Vatsvakurudzi vakawedzera zvakare kuti kuwedzera kwehutachiwana hwehutano hwakakonzerwa nehupenyu hurefu kwenguva refu (chikonzero chekuwedzera kurapwa kurapwa) kuchada hurumende kugadzirisa huwandu huwandu hwevanhu vanotapukirwa neHIV. Uye pasina nzira yekuchengetedza utachiona hwehutachiwana mukati mehuwandu hwevanhu-uye kwete kwemakore mashomanana, asi kwehupenyu hwose-izvi zvose zvinongodaro kuti zvirwere zvinokonzerwa nehutachiwana huchawedzera, zvichida zvinoshamisa.
Kunyange zvazvo kune uchapupu hunogutsa hwekuti TasP inogona kuderedza hutachiona hweHIV mune huwandu hwekuwanda kwevanhu, vatsvakurudzi vanopokana kuti hatigoni kutarisira kurapwa chete kuti kugumisa chirwere chacho. Ivo vanoparidzira kuchinja kukuru munzira iyo mapurogiramu ose ari mari uye akaendeswa. Izvi zvinosanganisira kuwedzera kwemari yekubhadhara mari, kubvumira kusununguka kusununguka kwezvinhu zvinodhura zveHIV zvinodhaka, nekuisa mari mukuvandudza kwehutano hwehutano hwehutano.
Izvo zvinodawo nzira dzakagadziriswa dzekudzivirira, kusanganisira kushandiswa mukugadzirisa zvinokonzera kukuvadza kushandiswa kwevashandi vezvinodhaka, kushandiswa kwesarudzo kweHIV pre-exposure prophylaxis (PrEP) munzvimbo dzakakodzera, nekusimbiswa kwezvirongwa zvekondomu nenguva iyo kushandiswa pakati pe jaya iri pamhepo.
Pasina mishanduko iyi yekutanga, vatsvakurudzi vanopikisa, chirongwa che 90-90-90 chinogona kunge chakaita kuti pave nehuwandu hwekufa kwevanhu uye zvishoma pakuwana kushanduka kwakasimba kwehutachiona hweHIV.
> Sources:
> Carter, M. "Kupera AIDS nemakore makumi maviri nemakumi matatu nemakumi matatu (3030) pane imwe nzvimbo iri kure: kuitika kweHIV pasi rose, kurapwa kwehutachiona uye kufa kwevanhu vanofananidzira." NAM AIDSMap . August 2016.
> GBD 2015 Vashanduri veHIV. "Inofungidzira kuitika kwenyika yose, yeruwa, uye yenyika, kupararira, uye kufa kweHIV, 1980-2015: Global Burden of Disease Study 2015." The Lancet. August 2016; 3 (8): e361-e387.
> Jamieson, D. naKellerman, S. "I 90 90 90 inotonga kugumisa HIV Pandemic ne 2030: Ita rinotengeswa rinogona kubata naro here?" Journal of the International AIDS Society. 2016; 19 (1): 20917.
> United Nations Programme pamusoro peHIV / AIDS (UNAIDS). "Kuwana kwepasi pose kwakagadzirirwa kusvika kune 90-90-90." Geneva, Switzerland; July 18, 2016.
> Wallensky, R .; Borre, E ;; Bekker, L .; et al. "Maitiro Anotarisirwa Kumakemikari uye Emari Maitiro 90-90-90 muSouth Africa." Annals we Internal Medicine. Svondo 6, 2016; 165 (5): 325-333.