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发信人: Vicissitudes (命运), 信区: English
标 题: A Piece everyday
发信站: 哈工大紫丁香 (2002年07月03日21:17:00 星期三), 站内信件
Aids drugs scandal: toll soars
Only 30,000 of 30 million get treatment in Africa
Sarah Boseley, health editor
Wednesday July 3, 2002
The Guardian
Only 30,000 people out of almost 30 million now living with the death senten
ce of HIV/Aids in sub-Saharan Africa are being given the drugs that keep inf
ected men and women alive, well and working in Britain, in spite of the prom
ises of help from rich nations over the past two years.
As a devastating report from Unaids on the scale of the epidemic and its hum
an and economic cost was published yesterday, it became clear that a vast gu
lf still exists between those who will die in the absence of treatment and t
hose whose lives can be indefinitely prolonged by modern medicine.
Last year 2.2 million people died of Aids in Africa. In rich countries, wher
e 500,000 people are on anti-retroviral drugs, 25,000 died. "It is an enormo
us scandal," said Peter Piot, director general of Unaids, the joint UN progr
amme on HIV/Aids.
According to the World Health Organisation, 230,000 people in developing cou
ntries are on anti-retroviral drugs to keep HIV in check. But half of those
are in Latin America - mostly in Brazil, which has used aggressive tactics a
gainst the pharmaceutical companies to obtain the drugs cheaply, or has manu
factured its own copies.
"However you look at it, it is a tiny number on treatment," said Mohga Smith
, health policy adviser at Oxfam. "We're saying let's get serious and get ou
r act together and get treatment to people urgently."
The UN report warns that the epidemic has hardly begun, and offers shocking
ev idence of rising infection and death. "Contrary to expectations, there is
no sign that it is levelling off," Dr Piot said.
The latest count in the report suggests 40 million people are living with HI
V. Within the next 20 years 70 million people will die unless drastic action
is taken.
In Botswana almost 40% of adults are HIV positive. Among pregnant women HIV
prevalence has risen from 38.5% in 1997 to 44.9% in 2001. Among 25- to 29-ye
ar-old pregnant women, 55.6% have HIV.
It is a story repeated elsewhere in Africa, and the report also reveals stee
p rises in HIV infections in central Asia and eastern Europe. Diagnoses of H
IV infection have been doubling every year in the Russian federation since 1
998, and 83,000 new cases were reported last year. The real figure is expect
ed to be four times as high.
A separate report from Unaids last week warned that HIV prevalence in China
could rise from 1.5 million to 10 million by 2010 if more prevention and edu
cation efforts are not made.
Dr Piot said promising developments included the engagement of African polit
ical leaders and an increase in funding from the paltry $800m (£523m) the w
est gave in 1999. But he added: "I think the rest is all pretty bad news."
Britain is far from immune from the epidemic, which is not only spreading fa
ster than many feared but has the capacity to change its direc tion. Angus N
icoll, director of the communicable disease surveillance centre at Britain's
public health laboratory service, said there were an estimated 33,500 peopl
e with HIV in Britain, of whom around 9,400 are undiagnosed. What was once l
argely confined to the homosexual community is now spreading faster within t
he heterosexual population.
"There is no sign that the problem is diminishing -in fact, the truth is com
pletely the opposite," Dr Nicoll said.
"There is strong evidence that unsafe sex is on the increase, with the lates
t national survey of sexual attitudes and lifestyles showing an increase in
numbers of sexual partners, lower age at first sexual intercourse, increasin
g levels of heterosexual anal sex and payment for sex. All of these are know
n to be associated with HIV transmission."
If there is complacency in Britain and other rich countries it has come larg
ely from the knowledge that Aids is no longer a death sentence in the west,
because of the availability of drug treatments. But in poor countries, HIV l
eads inexorably to Aids, destroying families and creating 14 million orphans
so far, the report says.
The court victory of the South African government over drug companies two ye
ars ago raised hopes that poor countries would be able to buy quantities of
cheap drugs. But, says Médecins sans Frontières, the prices are still too
high. At the international Aids conference in Barcelona next week, it will b
e calling for the price of a three-drug cocktail - already down from $1,500
a year to about $300 - to fall to $50.
In the wake of the South African court case, Unaids set up a scheme to suppl
y discounted drugs to African countries. Yesterday's report reveals that the
scheme has so far enabled only 22,000 extra people in 11 countries to get d
rugs. Critics say the discount prices are too high and are only available fo
r a limited selection of drugs.
--
I do not believe vicissitudes.
Then, who am I?
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