Ulawulo loThuthulo lokuThatyathwa kweNkqubo yokuPhukisa ukuThatyathwa kweeNkqubo zika-Obama
Kwamazwe asibhozo aseYurophu kunye namazwe aphezulu aquka ukuhlaziywa kwamacandelo kazwelonke kaGawulayo, i-US yafika emva kokugqibela ekuqinisekiseni iinjongo ezicwangcisiweyo zokuvavanya i-HIV , unyango kunye nolawulo. Njengoko kuboniswe kwiNgqungquthela yamazwe ngama-2014 kwiNyango yamayeza e-Glasgow, iGeorgia kuphela-i-republic encinci, i-republic eMpuma Yurophu apho ama-34 ekhulwini labantu abahlala ngaphantsi kwe-intlupheko-yanda kakhulu.
Ngokwezifundo, iipesenti ezingama-25 zabantu baseMelika abane-HIV abanokunyango lwe-antiretroviral (ART) bayakwazi ukufezekisa nokugcina umgangatho wokugcina umgomo wentsholongwane engabonakaliyo (echazwe njengeikopi ezingama-50 / mL). Ngaphezu koko, kuma-66 ekhulwini ahlanganiswe ngokunyamekela, kunama-33 ekhulwini kuphela kwi-ART nangona zikhokelo zesizwe ezibiza unyango xa zixilongwa .
Ukuhlaziywa kwe- HIV kwintsholongwane kaGawulayo ayihlolisanga kuphela ipesenti yabantu abaye bavavanya i-HIV kwilizwe ngalinye kodwa ipesenti ezixhaswe kunye nokunyamekela, zinikezelwa unyango kwaye ziyakwazi ukufezekisa ngokupheleleyo ukunyanzeliswa kwegciwane . Ukukhethwa kwezizwe ezisibhozo kusekelwe kumgangatho weenkcukacha ezifumanekayo ukususela ngo-2010 ukuya ku-2012, ekhutshwe kwiinkcukacha ze-HIV ingxelo, i- UNAIDS, iinkcukacha ezifundwa ngabanye, kunye nezinye izinto.
Ukunyangwa kweNtsholongwane kaGawulayo kwi-Eight ye-Europe kunye ne-High-Revenue Countries
| Izwe | Abantu abane-HIV (ngu.). | Intsholongwane kaGawulayo (%) | Ukufumanisa i-HIV (%) | Uxhaswe kwiNkathalo (%) | Kwi-ART (%) | Umthwalo ongenakwenzeka (%) |
| Ostreliya | 33,000 | 0.2 | 75 | - | 35 | 32 |
| British Columbia | 11 700 | - | 71 | 67 | 51 | 35 |
| Dominikha | 6,500 | 0.2 | 85 | 81 | 62 | 59 |
| Fransi | 149,900 | 0.4 | 81 | > 74 | > 60 | 52 |
| Jojiya | 4,900 | 0.2 | 52 | 44 | 26 | 20 |
| elamaDatshi | 25,000 | 0.2 | - | 73 | 59 | 53 |
| iunited Kingdom | 98,400 | 0.3 | - | 79 | 67 | 58 |
| eunited States | 1,148,200 | 0.6 | 82 | 66 | 33 | 25 |
Okubalulekileyo phakathi kwezizathu ze-US ezibonisa ukuba zihluphekile zibonakaliso zentsholongwane ye- HIV yonyaka-eqinisweni, ephakamileyo kumazwe asibhozo, kunye nabantu abangama-15.3 abanesifo esisodwa kwi-100 000 (okanye malunga ne-50 000 entsha ye-HIV ehlolwayo ngonyaka). Ngokuthelekiswa, izinga lokuhlawula iziganeko lilingaphantsi kwelo nani, okanye malunga no-6.3 kwizifo ezingama-100,000.
Phakathi kwezizwe ezisibhozo ezibandakanyiweyo ekuhlaziyweni, ininzi ibonisa izinga lokuxilongwa kwe-HIV eliphakathi kwama-71 ekhulwini kunye nama-85 ekhulwini (ngaphandle kweGeorgia, ilizwe eliphela kuphela elingenalo eliphezulu). Nangona ipesenti edibaniswe nokunyamekela kumazwe aphezulu alinganayo (kunye ne-US kunye ne-British Columbia kuphela ewela ngaphantsi kwe-70%), ukungafani okukhulu kwabonwa xa ukuhlolwa kwe-ART kuhlolwa, i-US kunye ne-Australia zichaza ukuba kuphela i-33 ekhulwini kunye neepesenti ezingama-35 zentsholongwane yabo ene-HIV, ngokulandelanayo, beyonyango.
(Oko okungafundwayo ngolu hlobo kukuba i-US inayo irekhodi elibi kakhulu lokugcina izigulane ekunyamekeleni, ukulahlekelwa malunga nesiqingatha ukulandela emva kokuhambela kwabo kokuqala.)
Ngesinye kwi-ART, amanani ayenzima kakhulu kwi-US, kunye nomntu oyedwa kwi-ezine onokukwazi ukufezekisa ukunyanzeliswa kwe-viral. Enyanisweni, njengamazwe onke, amazwe aseYurophu abonakalisa izinga eliphezulu le-HIV elingabonakaliyo kuneloMntla Melika ne-Australia (ama-48 ekhulwini ukuya kuma-27 ekhulwini, ngokulandelana).
Ukucacisa ukungafani
Nangona kungekho nto ichazwe ngala manani, ininzi iyavuma ukuba ukungalingani ekufikeleleni ekunyamekelweni kweNtsholongwane kaGawulayo kuhlala kwiintliziyo zokungafani.
EGeorgia, umzekelo-owona mbi kakhulu oluhlu-uqikelelo lwangama-30 ekhulwini lwabemi lugweba iinkonzo zonyango ngenxa yeendleko eziphezulu eziphuma ngaphandle kweendleko, ngokukodwa indleko zeziyobisi zamachiza .
Okwangoku, umthetho wokwenza i-inshurensi yempilo yentlalo kwiminyaka ye-1990 ishiywe yinkxaso ye-inshurensi yempilo yabucala, ngelixa iipesenti ezingama-80 zezibhedlele zikarhulumente zithengiswa kwicandelo labucala njengenxalenye yenkqubo yezolimo kunye neenkqubo zokuhlaziywa kwezenhlalakahle.
Ngokufanayo e-US, ngaphambi kokumiselwa kwe- Career Affordable Act (ACA) ngo-2014, ukufikelela ekunyamekelweni kwabemi baseMerika abane-HIV kuye kwacatshangwa kuhlwempuzekileyo, kunye neepesenti ezingama-17 kuphela ezikwazi ukufikelela kwi-inshurensi yempilo yabucala ngokumalunga nama-54 ekhulwini labantu . Kwaye, kude kube sekupheleni konyaka ka-2013, ukuxhaswa kwe-Programme Assistance Programme (ADAP) ye-AIDS (I-ADAP) yahlala ixesha elide kangangokuthi ezinye izigulane kufuneka zilinde ixesha elide ukuya kwiminyaka emihlanu ukufumana inkxaso-mali yokuhlawula izidakamizwa ezifanelekileyo .
Ukuqhubela phambili ukuma kwe-US ukungahambi kwesicwangciso se-HIV esicacileyo sasekhaya, kunye nesilingo sangaphambili sokulawulwa kwe-Clinton ukuhluleka ukubandakanya ixesha elifanelekileyo lokudibanisa iinjongo ezithile okanye iinkcukacha malunga nokuba yeyiphi iofisi zedolophu ezijongene neenjongo ezininzi.
Ukusabalaliswa kweendawo ezahlukahlukeneyo zentsholongwane kaGawulayo-kunye nokuhlukahluka kombuso ngokumalunga nokulungelelaniswa kweMedicaid-kwandisa imizamo yaseMelika, ukushiya amaninzi amagunya ezempilo karhulumente ngaphandle kokulungelelanisa okuphambili okuya kubambanisa impendulo yesizwe.
I-Obama Era Iinjongo ezidityaniswe nguLawulo lweTrump
Ngomzamo wokuvuselela impendulo yombuso kwi-bhubhane, ulawulo luka-Obama luhlaziye iSicwangciso sawo soHlabathi se-HIV / AIDS kwi-United States (NHAS). Ngaphantsi kwe-NHAS, urhulumente wesigqeba ujonge ukufezekisa iinjongo ezine eziphambili ngo-2020:
- Ukwandisa ipesenti yabantu abaphila ne-HIV abazi i-serostatus yabo ubuncinane kwi-90 ekhulwini.
- Ukunciphisa inani lokuxilonga olutsha nge-25 ekhulwini.
- Ukunciphisa ipesenteji yabasetyhini nabasetyhini ababenokuziphatha kakubi kwe-HIV ubuncinane ngama-10 ekhulwini.
- Ukwandisa ipesenti yabantu abatsha baxilongwa abanxulumene noononophelo oluthile lwezonyango lwe-HIV ngaphakathi kwenyanga enye yokuxilongwa kwe-HIV ukuya kwi-85 ekhulwini.
- Ukwandisa ipesenti yabantu abane-HIV abanokusuleleka kosulelo olugcinwe kwiinkonzo ezithile zonyango lwe-HIV ubuncinane kwi-90 ekhulwini.
Ukwandisa ipesenti yabantu abane-HIV abanokusuleleka kosulelo olugcinwe kwiinkonzo ezithile zonyango lwe-HIV ubuncinane kwi-90 ekhulwini.
Ukwandisa ipesenti yabantu abane-HIV abanokusuleleka ukuba banesifo esingagqithisiyo.
Nangona kuqikelelwa ukuba iindleko ze-NHAS ziya kuba zigidi ezili-15 ezigidi ezili-500 kwixesha leminyaka emihlanu, abanye baye bacetyiswa ukuba ukugcinwa kwenkqubo yokunakekelwa kwezempilo yase-United States-zombini ngokutheleleka kwezifo kunye nokufa-kungathi kube njengezigidi eziyi-18 zeebhiliyoni.
Ubunzima bokuthatha eli nqanaba lotyalo-mali phantsi kolawulo lweTrump lubonakala lugqwesileyo lunikezela injongo ye-GOP yokubuyisa ezininzi iinkalo ze-ACA kunye nokubuyisela ngokutsha iiprogram zeMedicaid ezenzelwe ukubonelela ngononophelo lwempilo kubantu abahlwempuzekileyo, abasengozini.
Ngo-Oktobha 2017, uMongameli wahamba ngokuthe ngqo ekunciphiseni imizamo kazwelonke ye-HIV ngokusayina umyalelo olawulayo ovumela abaqeshi ukuba baphikise ukulawulwa kokuzalwa njengoko kuchazwe yimfuneko ye-ACA's Essential Benefit. Umyalelo wawusekelwe ekuqinisekiseni ukuba abaqeshi kufuneka bavunyelwe ukukhanyela ukulawulwa kokuzalwa ngokusekelwe kwizizathu zezoqoqosho, kodwa ngenxa yezizathu zonqulo okanye "zokuziphatha".
Ziyingozi kwiinzame zePublic Republic Party ngasekupheleni kweminyaka yama-1990 ukukhanyela imali kwizinkonzo ze-HIV ezise-Afrika ezakhuthaza nayiphina indlela yocwangciso lwezesapho, kuquka ukulawulwa kokuzalwa okanye ukukhipha isisu. Kwakuyi (kwaye ihlala) ilitye lembombo ye -GOP imfundiso engabonakaliyo ngokuphindaphindiweyo ephindaphindiweyo yokukhusela i- HIV kunye nezinye izifo ezithathelwana ngesondo.
Ukuphazamiseka okubonakalayo kolawulo lweTrump kuye kwabonakaliswa ngakumbi kukuba iinjongo ze-NHAS ziye zacinywa ngokupheleleyo kwi-website ye-HIV.gov.
Akusoloko kucacile ukuba yintoni na, ukuba kukho nantoni, ulawulo lweTrump luya kuyenza ukulungisa okanye ukuvuma ingxaki esele ikhoyo kwimimandla yaseAfrika yaseMelika kunye nabasetyhini. Ekuhlaziyweni kweNgcaciso ye-World Health Organisation ye-HIV / AIDS, i-US ifikile ekufeni kungekuphela nje kweemeko ze-HIV eziphezulu kakhulu kwilizwe lonke laseNyakatho Melika naseYurophu kodwa kwakhona okwesibini ukwanda kwesandulela-ngculaza-ngaphezu kweLatvia 0.7 ekhulwini.
> Imithombo:
> Amasebe okuLawula nokuVimbela (iCCDC). "I-CDC Fact Sheet | I-HIV e-United States: Amanyathelo okuNakekela." Atlanta, Georgia; epapashwe ngoJulayi 2012.
> Raymond, A .; Hill, A .; kunye nePozniak, A. "Ukungafani okukhulu kwe-HIV kunyango phakathi kwamazwe asibhozo aseYurophu kunye namazwe aphezulu ahlalutyo - uhlalutyo lwamabala>> . I-Congress Yomhlaba Wonke kwiNyango Yonyango kwi-HIV Infection; EGlasgow, Scotland; Novemba 2-6, 2014; O237.
> I-World Health Organization (WHO). "Ukunyuka kwe-HIV phakathi kwabantu abadala ukuya ku-49 - Idatha yelizwe." I-Geneva, eSwitzerland; hlaziywa ngoNovemba 6, 2014.
> Yahia, B. noFrank, I. "Ukulwa ne-AIDS eMelika: Ukuvavanywa kweSicwangciso seSizwe seHIV / AIDS." I-American Journal yeMpilo kaRhulumente. Septemba 2011; 101 (9): e4-e8.