Ukulawulwa kwezokuPhatha kwe-Trump kuphazamisa izinhloso ze-Obama-Era
Emazweni ayisishiyagalombili aseYurophu namaholo aphezulu ahlanganisa ukubuyekezwa kwamasu kazwelonke we-HIV, i-US yafika ekugcineni ekuqinisekiseni izinhloso eziningi zokuhlolisisa i-HIV , ukwelashwa nokuphathwa. Njengoba kubikwe ku-2014 International Congress kwi-Drug Therapy ku-HIV Infection eGlasgow, yiGeorgia kuphela-i-republic encane, ehlangene eMpumalanga Yurophu lapho amaphesenti angama-34 abantu abaphila ngaphansi kobuphofu-yaqhubeka kakhulu.
Ngokusho kocwaningo, amaphesenti angama-25 kuphela aseMelika anesandulela ngculaza abasebenzisa imishanguzo ye-antiretroviral (ART) bakwazi ukufeza nokugcina izinga lokufaka umgomo wokulinganisa umthamo wegciwane elingenakulinganiswa (echazwe njengamakhophi angaphansi kuka-50 / mL). Ngaphezu kwalokho, kwamaphesenti angama-66 asebenza ngokuzikhandla, anamaphesenti angu-33 kuphela kuma-ART naphezu kwemihlahlandlela kazwelonke ebiza ukwelashwa uma kutholakala ukuthi uhlolwe .
Ukubuyekezwa kohlelo lwezempilo lukazwelonke lwe- HIV aluhlolisanga nje kuphela amaphesenti abantu abahlolwe i-HIV ezweni ngalinye kodwa iphesenti elixhunyaniswe nokunakekelwa, linikezwa ukwelashwa futhi likwazi ukufeza ukucindezelwa okugcwele nokuqhubekayo kwegciwane . Ukukhethwa kwamazwe ayisishiyagalombili kwakuncike emgangeni wemininingwane etholakalayo kusukela ngo-2010 kuya ku-2012, ekhishwe ekuhlanganisweni kwemibiko kazwelonke ye-HIV, database ye- UNAIDS , izihloko ezibuyekezwa ngontanga, neminye imithombo.
Ukuphathwa kwegciwane lesandulela ngculazi kuqhuma emazweni ayisishiyagalolunye aseYurophu nasePhakeme
| Izwe | Abantu abane-HIV (is.) | Ukwanda kwesandulela ngculaza (%) | Kuthathwa nge-HIV (%) | Kuxhunywe ukunakekelwa (%) | Ku-ART (%) | Umthwalo ongenakutholakali we-Viral (%) |
| E-Australia | 33,000 | 0.2 | 75 | - | 35 | 32 |
| I-British Columbia | 11 700 | - | 71 | 67 | 51 | 35 |
| Denmark | 6,500 | 0.2 | 85 | 81 | 62 | 59 |
| EFrance | 149,900 | 0.4 | 81 | > 74 | > 60 | 52 |
| Georgia | 4,900 | 0.2 | 52 | 44 | 26 | 20 |
| Netherlands | 25,000 | 0.2 | - | 73 | 59 | 53 |
| i-United Kingdom | 98,400 | 0.3 | - | 79 | 67 | 58 |
| I-united states | 1,148,200 | 0.6 | 82 | 66 | 33 | 25 |
Isihluthulelo phakathi kwezizathu zokubonisa ukuthi abampofu be-US babonisa ukuthi yizinga eliphezulu lezinga le- HIV-okuyizona eziphakeme kunazo zonke emazweni ayisishiyagalombili, nabantu abangu-15.3 abanesifo sengculaza ngonyaka ka-100 000 Uma kuqhathaniswa, isilinganiso senani labantu abaphakathi kwaba yingxenye engaphansi kwesigamu, noma cishe 6.3 izifo ezingama-100,000.
Phakathi kwamazwe ayisishiyagalombili afakwe ekubuyekezweni, iningi labonisa ukuthi izinga lokuxilongwa nge - HIV liphakathi kwamaphesenti angu-71 namaphesenti angu-85 (ngaphandle kweGeorgia, izwe elilodwa kuphela elingenayo imali engenayo). Ngenkathi iphesenti ehlanganiswe nokunakekelwa emazweni aphezulu alingana (afana ne-US neBrithani kuphela kuphela ewela ngaphansi kwezingxenye ezingamaphesenti angu-70), ukungafani okukhulu kwabonakala lapho ukuhlolwa kwe-ART kuhlolwe, ne-US ne-Australia bebika ukuthi kuphela amaphesenti angu-33 kuphela futhi amaphesenti angu-35 e-HIV abo abanesandulela ngculaza, ngokulandelana, ayekwelashwa.
(Lokho okungafundwayo ukuthi i-US nayo inerekhodi elibi kakhulu lokugcina iziguli ekunakekeleni, ukulahlekelwa cishe isigamu ukulandela emva kokuhambela kwabo kokuqala.)
Ngesinye isikhathi ku-ART, izinombolo zibuhlungu kakhulu e-US, ezinezodwa nje kuphela ezine ezikwazi ukufeza ukucindezelwa okuphelele kwegciwane. Eqinisweni, njengamazwe onke, amazwe aseYurophu abonisa izinga eliphezulu kakhulu elingenakulinganiswa le-HIV kunelaseNyakatho Melika nase-Australia (amaphesenti angu-48 kuya kuma-27, ngokulandelana).
Ukuchazela ukungalingani
Nakuba kungekho ncazelo eyodwa yalezi zibalo, iningi liyavuma ukuthi ukungalingani ekutholeni ukunakekelwa kwe-HIV kuhlala enhliziyweni yezinkinga.
EGeorgia, isibonelo-umenzi obala kakhulu ohlwini - cishe amaphesenti angu-30 abantu abagwema izinsizakalo zezokwelapha ngenxa yezindleko eziphezulu ezingaphandle kwezindleko, ikakhulukazi izindleko zemithi yokwelapha .
Okwamanje, umthetho wokwenza umshuwalense wezempilo emphakathini ngo-1990 usuke ushiywe umshwalense wempilo yangasese, kanti amaphesenti angu-80 ezibhedlela zomphakathi athengiswe emkhakheni wangasese njengengxenye yezinhlelo zikahulumeni zikahulumeni nezenhlalakahle.
Ngokufanayo nase-US, ngaphambi kokumiswa kwe- Care Affordable Act (ACA) ngo-2014, ukufinyeleleka ekunakekeleni amaMelika anesandulela ngculaza kwakubhekwa njengampofu, kanti kuphela amaphesenti angu-17 akwazi ukufinyelela kumshuwalense wezempilo wangasese ngokuya kuma-54% abantu bonke . Futhi, kuze kube sekupheleni kuka-2013, ukuxhaswa kohlelo lukaHulumeni lwe-AIDS Drug Assistance Program (ADAP) bekuyisikhathi eside kangangokuthi ezinye iziguli kwakudingeka zilinde isikhathi eside iminyaka emihlanu ukutholakala kwezibonelelo ezifanelekayo zokukhokha izidakamizwa.
Ukuqhubeka nokuthinta ukuma kwe-US kwakungabikho kweqhinga le-HIV elisemakhaya elisemakhaya, ngomzamo wangaphambilini wezokuphatha kukaClinton ehluleka ukufaka phakathi isikhathi sokuhlangana nemigomo ethile noma imininingwane yokuthi yiziphi amahhovisi ezombusazwe ayebhekene nalezi zinhloso.
Ukusabalalisa okubanzi kwe-HIV yabantu-kanye nokuhlukahluka kombuso ka-Medicaid ukufaneleka-imizamo eqhubekayo yase-United States, okwenza ukuthi izikhulu zezempilo zomphakathi zingabikho ukusebenzisana okungahle kuhlangane nomphakathi.
I-Obama Era Inhloso Inqanyulwe Ukuphathwa Kwe-Trump
Ngomzamo wokuvuselela impendulo yombuso kulesi sifo, ukuphathwa kuka-Obama kuvuselele iSu National Strategy for HIV / AIDS Strategy for the United States (NHAS). Ngaphansi kwe-NHAS, uhulumeni wesifundazwe uhlose ukufeza imigomo emine ebalulekile ngo-2020:
- Ukwandisa iphesenti labantu abaphila negciwane lesandulela ngculaza abawazi ama-serostatus abo okungenani amaphesenti angama-90.
- Nciphise inani lokuthola izifo ezintsha okungenani amaphesenti angu-25.
- Nciphise inani lezinsizwa ezincane nabesilisa nabesifazane abesilisa nabesilisa abesilisa nabesifazane abaye bahlanganyela ekuziphatheni kwezingculazi okungenani amaphesenti ayishumi.
- Ukwandisa iphesenti labantu abasanda kutholakala abaxhunywe ukwelashwa okhethekile nge-HIV esikhathini esingangenyanga eyodwa yokuhlolwa kwegciwane lesandulela ngculaza okungenani amaphesenti angu-85.
- Ukwandisa amaphesenti abantu abane-HIV abanokutheleleka okugcinwe ekunakekelweni kwezempilo okuqondene ne-HIV okungenani amaphesenti angu-90.
Ukwandisa amaphesenti abantu abane-HIV abanokutheleleka okugcinwe ekunakekelweni kwezempilo okuqondene ne-HIV okungenani amaphesenti angu-90.
Ukwandisa amaphesenti abantu abane-HIV abanesifo esithathelwanayo okungenani ngamaphesenti angama-80.
Nakuba kulinganiselwa ukuthi izindleko ze-NHAS zizobe ziba ngu-R15 billion esikhathini esiyiminyaka emihlanu, abanye baye basikisela ukuthi ukulondolozwa ohlelweni lwezempilo lwe-US-kokubili ngenxa yezifo ezithintekayo nokufa-kungaba ngaphezulu njenge $ 18 billion.
Amathuba okuthatha leli zinga lokutshalwa kwezimali ngaphansi kwe-Trump Administration libonakala slim enikezwe inhloso ye-GOP yokubuyisa eziningi zezinhlelo ze-ACA nokuvuselela kakhulu izinhlelo zoMedicaid ezenzelwe ukuhlinzeka ngempilo emiphakathini empofu, engozini.
Ngo-Okthoba 2017, uMongameli wahamba phambili ekunciphiseni imizamo kazwelonke ye-HIV ngokusayina i-oda elihle elivumela abaqashi ukuba baphikane nokulawulwa kokuzalwa njengoba kuchazwe izidingo ze-ACA's Essential Benefit. Lo myalelo wawusekelwe ekuqinisekiseni ukuthi abaqashi kufanele bavunyelwe ukuphika ukulawulwa kokubeletha okusekelwe ezimweni zezomnotho, kodwa ngenxa yezizathu zenkolo noma "zokuziphatha".
Kuyinto enzima emizamweni yeRipublican Party ngasekupheleni kweminyaka engama-1990 ukuphika izimali ezisekelwe e-Afrika ezisekela i-HIV ezisiza abantu abagqugquzela noma yiluphi uhlobo lokuhlela umndeni, kubandakanya ukulawulwa kokubeletha noma ukukhipha isisu. Kwakuyi (futhi ihlala) ithe legumbi le -GOP imfundiso esekelwe ngokungahlali ngokuphindaphindiwe okuyi-GOP okuqhubekayo yandisa ama-HIV nezinye izifo ezithathelwana ngocansi.
Ukungaqondisi okubonakalayo kwezokuphatha kweTrump bekuye kwafakazelwa ngokwengeziwe ukuthi izinhloso ze-NHAS zisuswe ngokuphelele kwiwebhusayithi kaHIV.gov.gov.
Akukacaci ukuthi yini, uma ngabe yikuphi, ukuphathwa kweTrump kuzokwenza ukubhekana noma ukuvuma ukuthi kunenkinga yamanje emiphakathini e -Afrika yaseMelika namaGay. Ekubukekeni kwemininingwane ye-World Health Organisation ye-HIV / AIDS, i-US yafika yabafileyo ekugcineni hhayi nje kuphela emiphakathini ye-HIV ephezulu kunazo zonke emazweni aseNyakatho Melika naseYurophu kodwa futhi eyesibili isandulela-ngculaza esiphezulu-esadlula eLatvia kuphela Amaphesenti angu-0.7.
> Imithombo:
> Amasevisi Okulawula Nokuvimbela Izifo (CDC). "I-CDC Fact Sheets | I-HIV e-United States: Izinyathelo Zokunakekela." I-Atlanta, Georgia; eshicilelwe ngoJulayi 2012.
> Raymond, A .; Hill, A .; kanye nePozniak, A. "Ukungalingani okukhulu kwelashwa kwegciwane lesandulela ngculazi kuhlasela phakathi kwamazwe ayisishiyagalombili aseYurophu nalabo abahola imali ephezulu - ukuhlaziywa kwezimpahla >." I-Congress Yomhlaba Wonke Yokwelashwa Kwezidakamizwa ku-HIV Infection; I-Glasgow, eScotland; Novemba 2-6, 2014; abstract O237.
> I-World Health Organization (WHO). "Ukukhula kwegciwane lesandulela ngculazi phakathi kwabantu abadala kuya ku-49 - Idatha yezwe." I-Geneva, eSwitzerland; ibuyekezwe ngoNovemba 6, 2014.
> Yahia, B. noFrank, I. "Ukulwa ne-AIDS eMelika: Ukuhlolwa kohlelo lukazwelonke lwe-HIV / AIDS." I-American Journal of Health Public. Septemba 2011; 101 (9): e4-e8.