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UNICEF与伙伴召开国际会议 唿吁杜绝中西非爱滋病病毒母婴传播

2011-11-16

巴黎,法国/香港,2011年11月16日——联合国儿童基金会(UNICEF)与一众致力抗击爱滋病病毒传播的合作机构在法国巴黎举行一连两日的会议,承诺动员前綫工作人员、决策者和捐款人士在中非和西非国家落实预防母婴爱滋病病毒传播的措施。

A health worker holds a bottle of antiretroviral medicine at the Princess Christian Maternity Hospital in Freetown, the capital. The medicine is being dispensed to a 15-year-old HIV-positive girl, for her seven-day-old newborn. The drug is part of a regiment of treatments and tests intended to prevent mother-to-child transmission (PMTCT) of HIV. In March 2011 in Sierra Leone, the country commemorated the ten year anniversary of the end of its civil war, which left 50,000 dead and 10,000 amputated. Although progress has been made since the wars end, Sierra Leone still ranks at the bottom of the 2010 Human Development Index. Health centres remain under-resourced, and medical care remains too expensive and inaccessible for many people. The countrys under-five mortality rate is fifth highest in the world, maternal mortality is among the worlds worst as well, and over a third of children under age five suffer stunting due to poor nutrition. According to 2008 data, only 49 per cent of the population uses improved drinking water sources, and only 13 per cent have access to improved sanitation facilities. Education systems are also deficient, with an insufficient number of schools and trained teachers. Girls face additional barriers to education, including high rates of early marriage and teen pregnancy, extra fees, and sexual abuse and exploitation in schools. UNICEF is working with the Government and partners to improve conditions for Sierra Leones children, supporting programmes that train teachers and school managers and that strengthen community-based health systems. UNICEF also supports a Government programme, launched in April 2010, that abolishes fees for primary health services for pregnant and lactating women and all children under age five.
根据其中一项《千禧发展目标》订明,在2015年前,儿童爱滋病病毒新感染个案将须大幅减少9成,同时与爱滋病相关的孕妇死亡数字亦要减半。在巴斯德研究所举行的会议上,各方多次要求有关国家将此目标纳入国家重点工作范围。

在缺乏预防措施和治疗下,超过4成新生儿会从爱滋病病毒呈阳性反应的母亲身上,感染到病毒。然而,若这些妇女早在怀孕时已接受到测试,及早发现病情,再加以适切治疗,将爱滋病病毒传染给下一代的风险可大大降低至5%或以下。

非洲中、西部地区的孕妇和婴儿死亡率一直高企,母婴爱滋病病毒传播率多年来亦居高不下。根据目前最新数据,虽然接受抗爱滋病病毒药物治疗的妇女比率已由2005年的近4%,大幅提升至2009年的23%,但当地的母婴爱滋病病毒「直向」传播预防工作,进展依然缓慢。现时,国际社会以至区内国家决策者,亦未有投入足够的关注及向妇女提供相应的经济援助,尽力打破当前困局,致使当地仍有不少妇女及儿童无法得到适切治疗,以减低母婴爱滋病病毒传播的风险。

预防爱滋病病毒传播的工作,实在刻不容缓。其他非洲国家已实行打击爱滋病的方案和对策,並证实行之有效,遂应尽快扩展至在非洲中、西部国家。是次由联合国儿童基金法国委员会、法国外交及欧洲事务部、法国开发署、法国国家爱滋病暨病毒性肝炎研究署、法国医院联会治疗支援网络、法国巴斯德研究所、联合国爱滋病规划署和国际药品采购机制,多个机构及组织联合举办的会议,将商讨调配更庞大资源,向相关政府施压,竭力扭转现时不能接受的劣势。是次会议为24个中、西非及其他国家的前綫工作人员、决策者和顶尖专家造就了一次合作良机,建设了经验交流的平台,让他们得以集中商讨抵御爱滋病的有效方法。

「经验告诉我们,即使贫困国家亦能避免婴儿在出生时感染爱滋病病毒或爱滋病。各捐助国只需下定政治决心,把资源及捐款优先投放在对抗爱滋病的项目上,便可保护儿童免受爱滋病病毒感染。」联合国儿童基金法国委员会主席Jacques Hintzy先生表示:「所以我们实在再沒理由原地踏步。」
要有效预防母婴爱滋病病毒传播,就要将预防爱滋病病毒母婴传播的相关措施融入妇女和儿童的医疗保健计划。孕妇产前产后的健康检查必须加强,並把爱滋病病毒测试、妇女谘询服务和早期婴儿检测纳入主流服务。同时必须鼓励父亲参与检测和预防服务。这些服务必须在全国实施,增强对最边缘、最脆弱社区的支援。而整套策略的效率和可行性,要有专责的行动调查小组评估。
Pregnant women listen to a midwife discuss the importance of HIV testing to prevent mother-to-child transmission (PMTCT) of the disease, at the hospital in Kani, a town in Worodougou Region. [#1 IN SEQUENCE OF FOUR] By 27 January 2011 in Côte dIvoire, some 20,000 people were internally displaced by violence that erupted after the 28 November 2010 presidential election, and an estimated 32,000 others had fled to neighbouring Liberia. Homes have been looted and burned, and many schools have remained closed since the election. The situation has been exacerbated by outeaks of yellow fever and cholera. Sixty-four cases of suspected yellow fever and 25 related deaths were reported in the districts of Béoumi, Katiola, Séguéla and Mankono, rural areas with low vaccination rates. Yellow fever, a deadly disease transmitted by mosquito, has no known cure, but vaccination provides ten years of immunity. The Ministry of Health, UNICEF and the World Health Organization (WHO) have initiated an emergency immunization campaign against the disease, targeting 840,000 people aged 9 months and older. The Global Alliance for Vaccines and Immunisation (GAVI) is providing the campaigns vaccines. Meanwhile, a cholera epidemic has been declared in Abidjan, the countrys most populous city, with seven deaths out of a reported 35 infections. UNICEF and the WHO are supporting a rapid response to that outeak as well, including the distribution of soap and chlorine and the promulgation of cholera-prevention messages. UNICEF is also responding to the mass displacement crisis by distributing blankets, sleeping mats, insecticide-treated mosquito nets, high protein biscuits, water treatment supplies, pre-school supplies and recreation equipment for children in displaced communities, and by providing family reunification services.
[RELEASE OBTAINED] Natasha Chisenga Simpasa holds her six-week-old daughter, Mutale, in the Chelstone Clinic in Lusaka, the capital. Ms. Simpasa is HIV-positive, and has ought Mutale for her first HIV test. Ms. Simpasa participated in the clinics PMTCT programme for her sons, 20-month-old Fanwick and four-year-old Masonda, both of whom are HIV-negative. She is now participating in PMTCT for Mutale. [#2 IN SEQUENCE OF NINE] In October 2010 in Zambia, the Chelstone Clinic in Lusaka continues to provide vital programmes to treat HIV-positive pregnant women and to prevent mother-to-child transmission of HIV (PMTCT). Some 95,000 Zambian children under age five are infected with HIV; the vast majority contracted the illness from an HIV-positive mother during pregnancy, delivery or eastfeeding. PMTCT programmes include HIV testing during pregnancy, antiretroviral (ARV) regimens for sick HIV-positive pregnant women, and early diagnosis and treatment for infants exposed to HIV in utero. Participating infants receive prophylactic antibiotics and ARVs in the weeks after they are born, and are administered HIV tests at six weeks. If eastfed by an HIV-positive mother, infants continue to receive prophylactics and are tested again at 12 months and 18 months (and three months after eastfeeding ceases or at any age if they fall ill). HIV-positive infants diagnosed and treated within the first 12 weeks of life are 75 per cent less likely to die from the disease. Zambia has recently made great strides in expanding PMTCT programmes. In the second quarter of 2009, ARVs were administered to approximately half of all children in need and to some 57 per cent of HIV-positive pregnant women. However, many infants still do not receive PMTCT services because their caretakers lack access to properly equipped facilities, or fear the stigma associated with HIV, or find it difficult to adhere to the structured course of required tests and services.
只要投放更多资源,非洲中、西部地区将有望在2015年前加快步伐,迈向杜绝母婴爱滋病病毒传播及改善孕妇健康状况的目标。
专门服务患病儿童的巴黎内克医院Stephen White教授负责统筹是次会议,他强调:「杜绝爱滋病病毒传播需要多方合作,包括:治疗药物、具成效的政策、研究人员、善长人翁、救助及有系统的国际支援网络。这次会议,就志在鼓励社会上各阶层,要具备坚定的政治决心,大力推行预防母婴爱滋病病毒直向传播的工作。」