Section C
International Joint Efforts Against AIDS
The uniting of the world around the AIDS epidemic is without prior example. As the number of AIDS cases around the world rapidly increases, nations are showing great focus in battling this common enemy — attacking rich and poor countries the same.
By 1989, almost every nation on earth had established a program educating its people about AIDS, according to Jonathan Mann, director of the World Health Organization's (WHO) International Program on AIDS. At that time, 143 countries had reported one or more AIDS cases.
In addition to national AIDS programs, working together internationally has begun. Through open exchanges of scientific facts as well as support of international organizations such as the World Health Organization, all nations can join efforts to fight against this life-threatening disease. According to WHO, this international effort has produced two critical developments: first, there is an amazing level of world-wide focus, using world scientists and international sharing of human and economic resources to fight AIDS. Second, the work of governments, organizations, and businesses has been followed by the very high activity of people — as singles, families, and communities.
The Influence of AIDS
The rise of Acquired immune deficiency syndrome (AIDS) around the earth has represented a major challenge to medical progress both in developed and in less-developed countries. The past forty years saw great success in the control of spreading diseases and great strides toward achieving "health for all by the year 2000" (a major WHO goal) through improved basic health care, food, cleanliness, and immunization(免疫)programs.
Yet, because of its sudden start and rapid spread, AIDS could soon wipe out this progress. By the end of 1988, more than 130,000 cases of AIDS were reported, but, because of underreporting, there may actually be more than 350,000 cases. Also, at least five million persons likely have the human Immunodeficiency Virus (HIV)(艾滋病病毒), which causes AIDS. That means as many as 400,000 new cases of AIDS could occur in the next few years — more than doubling the present total. Caring for AIDS patients could seriously stress economic resources even in richer countries.
Preventing one case of AIDS means preventing many future cases, while preventing a case of measles(麻疹)or malaria(瘧疾)in Africa would have little effect on its spreading, since those diseases are already common in many countries. Resources devoted to AIDS testing, care, and education could also be used to battle other, more-known diseases in developing countries.
Stopping the Spread
AIDS spreads only in limited ways and can be prevented through informed and mature behavior. Encouraging such behavior depends on understanding the different ways AIDS is spread around the world. AIDS spreads in three basic ways: first, through sexual intercourse(性交); second, through contact with diseased blood; and third from an HIV mother to her baby. The actual patterns of spreading of the AIDS virus change from culture to culture.
Spreading of AIDS in North America, Western Europe, Australia, New Zealand and parts of Latin America occurs most often among homosexual(同性戀)or bisexual(雙性戀)men and intravenous (IV) (靜脈內(nèi)注射的)drug users(吸毒者), most often in city areas. Heterosexual(異性之間的)spreading is low, but there is danger that the spread of AIDS from male(男性) IV-drug users to their female(女性)partners could increase the appearance of AIDS in the heterosexual population.
In sub-Saharan Africa and Latin America, particularly the Caribbean, most cases occur among heterosexuals, and spreading from mother-to-child is common. Spreading through homosexual contact and IV-drug use almost does not exist.
In Eastern Europe, Northern Africa, the eastern Mediterranean, Asia, and most of the Pacific, fewer cases of AIDS, usually among drug users, have been reported thus far. The WHO estimates that Bangkok, Thailand IV-drug users having the AIDS virus increased from less than 1 percent in August 1987 to 30 percent one year later.
Reaching Out
The WHO believes that, as AIDS becomes more common, the disease promises to unite the world to a degree never seen before. In just two years, the international plan against AIDS has grown from ideas to practice, from speeches to action. The WHO is certain that, together, we will triumph over AIDS rather than allow the disease and the fears, worries, and prejudices(偏見)which go with it to overpower us.
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國際合作與艾滋病的斗爭
全世界因艾滋病這一流行性疾病而聯(lián)合了起來,這是前所未有的。 隨著全球艾滋病患者數(shù)量的迅速增加,各國都極為關(guān)注同這一共同敵人的斗爭--因?yàn)樗瑯右u擾著富國和窮國。
據(jù)世界衛(wèi)生組織國際艾滋病項目主任喬納森·曼說,到1989年幾乎每個國家都制訂了對公民進(jìn)行艾滋病教育的計劃。 當(dāng)時有143個國家發(fā)現(xiàn)了一例或更多的艾滋病病例。
除了每個國家的艾滋病防治計劃外,國際合作也已經(jīng)開始。 通過公開交流科學(xué)資料和支持諸如世界衛(wèi)生組織這樣的國際性組織,各國就能攜手與這危及人類生命的疾病作斗爭。 世界衛(wèi)生組織認(rèn)為,這種國際努力已經(jīng)產(chǎn)生了兩個重要成果:第一,由于動員了全球的科學(xué)家以及動用了各國的人力和財力與艾滋病作斗爭,全球?qū)Π滩〉年P(guān)注達(dá)到了驚人的程度。 第二,除政府、組織和企業(yè)的努力之外,普通人民也積極參與其中--從個人、家庭到社區(qū)。
艾滋病的影響
全球艾滋病的蔓延無論在發(fā)達(dá)國家還是在欠發(fā)達(dá)國家都是對醫(yī)學(xué)進(jìn)步的重大挑戰(zhàn)。 在過去的40年中,通過改善基本醫(yī)療保健、食品、衛(wèi)生和免疫等項目,人類在控制流行病方面取得了巨大的進(jìn)步,并且朝著實(shí)現(xiàn)"2000年人人享受健康"(世界衛(wèi)生組織的一項主要目標(biāo))邁出了一大步。
然而,由于艾滋病的突然降臨和迅速蔓延,有可能使得這一進(jìn)步化為烏有。 到1988年底,共報道了13萬多例艾滋病,但由于報道不全,實(shí)際數(shù)量可能超過35萬例。 此外,至少有500萬人可能攜帶導(dǎo)致艾滋病發(fā)作的艾滋病病毒。 這就意味著在之后幾年里會有多達(dá)40萬個新的艾滋病病例--這是目前艾滋病病例的兩倍多。 照顧艾滋病病人會給經(jīng)濟(jì)資源帶來沉重的壓力,即使在富國也是如此。
預(yù)防一例艾滋病意味著為以后減少許多例艾滋病。而在非洲,預(yù)防一例麻疹或瘧疾病對于防止疾病的蔓延起不了多大作用,因?yàn)檫@些疾病在許多國家已經(jīng)是常見病。 用于艾滋病檢驗(yàn)、護(hù)理和教育的資源在發(fā)展中國家同時也可用來防治其他較常見的疾病。
抑制艾滋病蔓延
艾滋病傳播方式有限,可以通過已知的理性行為加以防范。 而提倡這類已知的理性行為取決于對艾滋病在全球范圍內(nèi)不同傳播方式的了解。 艾滋病的傳播有三種基本方式:第一,通過性交;第二,通過接觸艾滋病患者的血液;第三,經(jīng)由攜帶艾滋病毒的母親傳給嬰兒。 艾滋病的實(shí)際傳播方式又因文化的差異而有所不同。
在北美洲、西歐、澳大利亞、新西蘭和部分拉丁美洲地區(qū),艾滋病常常在同性戀或雙性戀男子之間,或采用靜脈內(nèi)注射的吸毒者之間傳播,并且往往在城市傳播。 異性之間傳播可能性不大,但艾滋病從男性靜脈注射吸毒者傳播到他們的女性伴侶,則有可能提高異性戀者艾滋病的發(fā)病率。
在靠近撒哈拉沙漠的非洲地區(qū)、拉丁美洲,尤其是在加勒比海地區(qū),大多數(shù)病例都發(fā)生在異性戀者之間,而且往往是母子之間傳播。 通過同性戀者的接觸和靜脈注射吸毒等方式的傳播幾乎不存在。
迄今為止,在東歐、北非、地中海東部地區(qū)、亞洲和太平洋大部分地區(qū),很少有有關(guān)艾滋病的報道,這些地區(qū)的艾滋病通常發(fā)生在吸毒者群體中。 世界衛(wèi)生組織估計泰國曼谷攜帶艾滋病毒的靜脈注射吸毒者從1987年8月的不到1%一年之后增加到了30%。
再接再厲
世界衛(wèi)生組織認(rèn)為隨著艾滋病越來越常見,它有可能使整個世界以前所未有的程度聯(lián)合起來。 僅僅在兩年之內(nèi),國際防治艾滋病項目便已從設(shè)想變?yōu)閷?shí)踐,從言詞變?yōu)樾袆印?世界衛(wèi)生組織相信,只要聯(lián)合起來,我們就會戰(zhàn)勝艾滋病,而不會讓艾滋病,以及隨之而來的恐懼、憂慮和偏見把我們壓倒。