Marking 10 Years of PEPFAR’s Accomplishments

纪念美国总统防治艾滋病紧急救援计划走过十年成功之路

18 September 2013

2013年9月18日

At the end of the last century, the HIV/AIDS epidemic was at its height, killing scores of people in every corner of the world. Sub-Saharan Africa was struck particularly hard, with countless children orphaned and nearly an entire generation decimated. Something had to be done. To combat the epidemic, U.S. President George W. Bush launched the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003.

上世纪末，艾滋病病毒/艾滋病疫情达到高峰，在世界各地造成大量人员死亡。非洲撒哈拉以南地区的疫情尤为严重，无数儿童成为孤儿，几乎整整一代人的人生毁于一旦。对此必须采取行动。为了抗击艾滋病疫情，美国总统乔治·W·布什于2003年发起了“美国总统防治艾滋病紧急救援计划”。

The year 2013 marks a decade of PEPFAR’s remarkable achievements in helping protect people against this deadly virus. The program has been active in 80 countries, saving at least 1 million babies from being inadvertently infected by their HIV-positive mothers and now providing antiretroviral drugs to more than 5 million patients who could not otherwise afford them.

美国总统防治艾滋病紧急救援计划为帮助人们防范这种致命病毒已取得显著成效, 2013年恰逢计划诞生10周年。这个计划已在80个国家得到积极实施，至少挽救了一百万婴儿，避免他们无意中被艾滋病毒检测呈阳性的母亲感染，同时向500多万名无力购买药物的患者提供抗逆转录病毒药物。

Research funded by the U.S. National Institutes of Health (NIH) has provided essential guidance to PEPFAR’s treatment and prevention programs. For instance, an NIH-supported study in Haiti demonstrated that patients in resource-limited settings could comply well with complicated antiretroviral drug regimens, and a multicountry study showed that if patients began taking antiretroviral drugs as soon as possible after diagnosis, they were less likely to spread the disease to their sexual partners.

由美国国家卫生研究院资助的研究为美国总统防治艾滋病紧急救援计划的治疗和预防项目发挥了重要的指导作用。例如，由美国国家卫生研究院资助在海地进行的一项研究说明，在资源有限的情况下，患者能够很好地遵守复杂的抗逆转录病毒药物疗程。另一项在几个国家进行的研究表明，患者如果在确诊后尽快开始服用抗逆转录病毒药物，可降低向性伴侣传播该病的可能性。

Many of the international scientists who were instrumental in these landmark studies were trained through the NIH’s Fogarty International Center. By training physicians and scientists who return to their countries, the Fogarty International Center helps bolster the capacity of countries to improve health care over the long term.

在这些具有里程碑意义的研究中起关键作用的很多外国科学家都曾接受美国国家卫生研究院福格蒂国际中心的培训。这些医生和科学家在接受培训后返回各自的国家工作。福格蒂国际中心通过培训帮助各国提高了长期医疗保健的能力。

Building Health Capacity in Africa

建设非洲的医疗保健能力

As PEPFAR began to transition from an emergency response program to a more sustainable model, its leadership focused on enabling countries to take ownership for their own HIV/AIDS programs. To support this shift, PEPFAR launched the Medical Education Partnership Initiative (MEPI) in 2010. Its objective is to increase the quality, quantity and retention of health care workers in 12 sub-Saharan countries. NIH contributes funds and helps administer MEPI through the Fogarty International Center.

随着美国总统防治艾滋病紧急救援计划开始从应急项目转变为更可持续的模式，领导层也以促使各国自主实施本国艾滋病计划为重点。为了支持这一转变，美国总统防治艾滋病紧急救援计划在2010年发起“医学教育和护理教育伙伴关系行动”，目的在于提高12个撒哈拉以南国家医务人员的质量、数量和保留率。美国国家卫生研究院提供资金并通过福格蒂国际中心协助管理医学教育和护理教育伙伴关系行动。

PEPFAR and MEPI are transforming health care delivery and research capacity in many ways. Through MEPI, medical school curricula are being strengthened, incorporating electronic components such as procedure demonstration videos that enable distance learning. Institutions are upgrading their Internet connectivity, increasing access to current journal articles and building e-libraries of learning tools. They are developing programs to increase expertise in neglected areas such as emergency medicine, surgery, cancer and heart disease. Skills labs are being assembled to offer students the opportunity to practice surgeries and other procedures on lifelike models. Institutions are ramping up faculty recruitment and dramatically increasing enrollment. Finally, resources and lessons learned are being shared among the MEPI network members.

美国总统防治艾滋病紧急救援计划及医学教育和护理教育伙伴关系行动正在很多方面从根本上加强提供医疗保健和从事研究的能力。各医学院正通过医学教育和护理教育伙伴关系行动加强课程设置，纳入有助于远程教学的程序演示视频等电子手段。各院校正在升级因特网连接，扩大查阅最新期刊文章的渠道，并建立电子图书馆作为学习工具。各院校正在制定各种项目，要求提高急救医学、外科、癌症和心脏疾病等被忽略领域的专业水平。正在筹建的技能实验室为学生们提供机会在模拟实际操作的模型上练习做手术和其他程序。各院校正增聘教师，大幅度地提高招生人数。最后，有关的资源和获得的经验正在医学教育和护理教育伙伴关系行动网成员中得到分享。

Sustaining Progress Through Local Ownership

发挥当地的自主性实现可持续进展

Staff retention is a major challenge for many African institutions, with higher salaries elsewhere causing a brain drain. Some MEPI funds support research projects, not only to expand training and accumulate country-relevant data, but importantly as an enticement for faculty to remain in their institutions and help sustain medical capacity. Another challenge is staffing clinics in rural areas, where most of Africa’s population lives. To address this issue, MEPI grantees are nurturing rural training facilities and recruiting students from local communities who are more likely to remain in place after completing their health care studies.

对很多非洲各机构而言，留住员工是一项重大挑战，因为其他地方更高的工资造成了人才流失。医学教育和护理教育伙伴关系行动的有些资金支持研究项目，不仅可以扩展培训范围和积累国家的相关数据，而且重要的是有助于吸引人员留在本机构并保持医疗能力。另一项挑战是在非洲大多数人口生活的农村地区为医疗诊所招收人员。为了解决这个问题，接受医学教育和护理教育伙伴关系行动资助的有关机构正在充实农村培训设施，在当地社区招收学生，因为这些学生在完成医疗保健学业后更可能留在当地工作。

Since MEPI grants are made directly to African institutions, local leaders can decide how best to apply funding to meet their country’s particular needs, which enhances their sense of ownership. MEPI institutions work closely with their government ministries to ensure goals are aligned with country priorities and to foster government support.

由于医学教育和护理教育伙伴关系行动的资助直接划拨给非洲的有关机构，当地领导人可决定如何最好地使用资金，以满足本国独特的需求，有助于增强他们独立自主的责任感。参加医学教育和护理教育伙伴关系行动的机构与政府部委密切合作，可保证有关目标与国家的重点规划保持一致并有利于获得政府支持。

Thanks to PEPFAR and MEPI, the future looks much brighter than it did a decade ago, making the prospect of an AIDS-free generation truly possible.

由于实施美国总统防治艾滋病紧急救援计划及医学教育和护理教育伙伴关系行动，未来将比10年前更加光明，完全有可能实现无艾滋病一代的前景。

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