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2010 International AIDS conference(2010年国际艾滋病会议英文版).doc

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2010 International AIDS conference(2010年国际艾滋病会议英文版).doc

JULY19,2010PREPAREDREMARKSBYBILLGATES,COCHAIRANDTRUSTEEWATCHAVIDEOOFTHESPEECHTHANKYOU,VUYISEKA,FORTHATKINDINTRODUCTIONIALSOWANTTOTHANKPRESIDENTCLINTONFORTHEINSPIRINGMESSAGEHEDELIVEREDTHISMORNINGIT’SANHONORTOSPEAKWITHALLOFYOUTODAYASYOUSAWINTHEVIDEO,THEWORLDHASMADEAMAZINGPROGRESSINTHEFIGHTAGAINSTHIVYETWEALSOHAVETORECOGNIZETHATTHESEARETOUGHTIMESFORALLOFUSWHOAREPASSIONATEABOUTTHISCAUSEECONOMICTURBULENCEHASDRIVENUPGOVERNMENTDEFICITS,ANDSOMECOUNTRIESHAVERESPONDEDBYFREEZINGOREVENREDUCINGTHEIRINVESTMENTSINGLOBALHEALTHTHISISACHALLENGEWEALLFACEBUTITDOESNOTNEEDTODEFINEOURTIMEIAMHERETODAYBECAUSE,WHENITCOMESTOTHEFIGHTAGAINSTAIDS,IAMSTILLANOPTIMISTTHEPAST10YEARSAREATIMEOFREMARKABLEPROGRESSTODAYMORETHAN5MILLIONPEOPLEARERECEIVINGANTIRETROVIRALTREATMENT,UPFROMFEWERTHANHALFAMILLIONJUSTSIXYEARSAGOSINCE2001,THERATEOFNEWHIVINFECTIONSHASFALLEN17PERCENTTHOSEOFYOUINTHISROOMHELPEDMAKETHISPROGRESSPOSSIBLETHESCIENTISTSMADEPROGRESSONNEWTOOLSTOFIGHTTHEDISEASETHECOMMUNITYWORKERSANDCLINICIANSDROVEPREVENTIONCAMPAIGNSTHEADVOCATESARGUEDFORMOREFUNDING–ANDTHEWORLDRESPONDEDBYADDINGMONEYFORTHISCAUSEFASTERTHANANYOTHERHEALTHPROBLEMINHISTORYTHEGLOBALFUNDHASBEENAFANTASTICVEHICLEFORMAKINGSURETHISFUNDINGHELPSTHEPEOPLEWHOHAVETHEGREATESTNEEDALLOFYOUCAMETOGETHERTOOVERCOMEHUGEOBSTACLESTWODECADESAGO,THESKEPTICSSAID“WECAN’TMAKEDRUGSTOTREATAVIRUS”BUTYOUPERSISTED–ANDNOWTHEYCANTHENTHESKEPTICSSAID“WECANMAKETHEDRUGS,BUTWECAN’TMAKETHEMCHEAPENOUGH”BUTYOUKEPTPUSHING–ANDNOWTHEYDOTHENTHESKEPTICSSAID“WECANMAKETHEDRUGSCHEAPLY,BUTWEDON’TKNOWWHETHERPEOPLEWILLSTICKTOTHEREGIMEN”BUTYOUINSISTED–ANDNOWTHEYKNOWTODAYTHESKEPTICSLOOKATTHESTRUGGLINGECONOMYANDSAY“WECAN’TBEATAIDSUNLESSWECANTREATMOREPEOPLEANDWECAN’TTREATMOREPEOPLEWITHOUTMOREMONEYSOIFWEDON’TRAISEMOREMONEYFORTREATMENT,WE’LLLOSETHEFIGHTAGAINSTAIDSIT’SHOPELESS”THESKEPTICSHAVEAPOINTTHISISATOUGHECONOMICENVIRONMENTRIGHTNOWTHEREISN’TENOUGHMONEYTOSIMPLYTREATOURWAYOUTOFTHISEPIDEMICIFWEKEEPSPENDINGOURRESOURCESINEXACTLYTHESAMEWAYWEDOTODAY,WEWILLFALLFURTHERBEHINDINOURABILITYTOTREATEVERYONETHAT’SWHYIWANTTOMAKETHECASETODAYTHAT,EVENASWEADVOCATEFORMOREFUNDING,WECANDOMORETOGETTHEMOSTBENEFITFROMEACHDOLLAROFFUNDINGANDEVERYOUNCEOFEFFORTIFYOUPUSHFORANEWFOCUSONEFFICIENCY–INTREATMENTANDPREVENTION–ANDALSOPUSHTOCREATENEWPREVENTIONTOOLS,WECANDRIVEDOWNTHENUMBEROFNEWINFECTIONSDRAMATICALLYANDSTARTWRITINGTHESTORYOFTHEENDOFAIDSSCALINGUPEXISTINGTOOLSMALECIRCUMCISIONOURFIRSTTASKISTOSCALEUPTHEPREVENTIONEFFORTSTHATARECHEAP,EFFECTIVE,ANDEASYTOAPPLYSOMEOFTHESE–ESPECIALLYMALECIRCUMCISIONANDPREVENTINGMOTHERTOCHILDTRANSMISSION–ARESOCHEAP,ANDSOEFFECTIVE,THATINENDEMICCOUNTRIESITISMOREEXPENSIVENOTTOPURSUETHEMINASINGLEMONTHLASTYEAR,36,000MENINKENYAWERECIRCUMCISED,ATATOTALCOSTTOTHEGOVERNMENTOF14MILLIONIFTHESEMENHADNOTBEENCIRCUMCISED,ANDEVENTUALLYBECAMEINFECTEDWITHHIVATTHEPREVAILINGRATEFORUNCIRCUMCISEDMALESINKENYA,TREATINGTHEMWOULDHAVECOSTTHEGOVERNMENTNEARLY10TIMESASMUCHTHAT’SANASTONISHINGFINANCIALRETURN–BUTIT’SNOTJUSTSAVINGMONEY;IT’SSAVINGLIVESIHAVETOADMITWHENITCOMESTOCIRCUMCISION,IUSEDTOBEONEOFTHESKEPTICSITHOUGHT“SURE,ITREDUCESTRANSMISSIONBYNEARLY60PERCENTBUTTHERE’SNOWAYTHATLARGENUMBERSOFMENWILLSIGNUPFORIT”I’MGLADTOSAYIWASWRONGWHEREVERTHEREARECLINICSAVAILABLE,MENAREVOLUNTEERINGTOBECIRCUMCISEDINFARGREATERNUMBERSTHANIEVEREXPECTEDIWOULDLIKETOSHOWYOUASHORTVIDEOABOUTONEOFTHEM,AYOUNGMANFROMSWAZILANDLASTDECEMBER,IWENTTOSOUTHAFRICATOSEEFORMYSELFHOWENTHUSIASTICALLYMENAREEMBRACINGCIRCUMCISIONIVISITEDACLINICINTHETOWNSHIPOFORANGEFARMTHATSERVESMORETHAN750MENEVERYMONTHIMETAFEWOFTHEM,ANDTHEYWEREALLTHRILLEDABOUTGETTINGCIRCUMCISEDTHEONESWHOHADALREADYUNDERGONETHEPROCEDURESAIDITMADEITEASIERFORTHEMTOUSEACONDOMIALSOMETASURGEON–ATIRELESSYOUNGWOMANNAMEDJOSEPHINEOTCHEREDARKOSHETOLDMESHEHADPERFORMED67CIRCUMCISIONSTHATDAYIASKEDHER,“WHENDOYOUSTOP”SHESAID“WHENWEAREDONE”RIGHTINTERVENTIONFORTHERIGHTPOPULATIONMALECIRCUMCISIONISANAMAZINGADVANCEINPREVENTIONIFWEHADAVACCINETHATWASASEFFECTIVE,WEWOULDDOEVERYTHINGINOURPOWERTODELIVERITTOEVERYPERSONWHOCOULDBENEFITFROMITANDITISREACHINGMANYMEN–BUTNOTNEARLYENOUGHOFTHEMINTHEFOURYEARSSINCEWELEARNEDABOUTITSBENEFITS,ONLY150,000MENINSUBSAHARANAFRICAHAVEBEENCIRCUMCISED–OUTOF41MILLIONWHONEEDITTHAT’SINEXCUSABLECOUNTRIESNEEDTOMAKETHISAPRIORITYINTHEIRPOLICIESANDINTHEIRFUNDINGWEHAVETODOAFARBETTERJOBOFSCALINGUPINTERVENTIONSTHATAREPROVENTOWORK,ASSOONASTHEYAREPROVENTOWORKWEHAVESEENSIMILARGAPSWITHOTHERPREVENTIONEFFORTS,INCLUDINGCOUNSELINGSEXWORKERSANDOFFERINGDRUGTREATMENTANDNEEDLEEXCHANGESFORDRUGUSERSTHEREAREMANYREASONSFORTHESEFAILURESFORINSTANCE,MOREAIDFROMDONORCOUNTRIESNEEDSTOREACHTHEPEOPLEIT’SINTENDEDTOHELPBUTTHEREISONEREASONTHATESPECIALLYDESERVESOURATTENTIONMANYPREVENTIONEFFORTSARENOTTARGETINGTHECOMMUNITIESWHERETRANSMISSIONISTHEHIGHESTACCORDINGTOTHEKNOWYOUREPIDEMICREPORTPUBLISHEDTHISYEARBYUNAIDS,10PERCENTOFHIVINFECTIONSINKENYAAREDUETOSEXBETWEENMENINSOMECOASTALREGIONS,ITCOULDBEASHIGHAS20PERCENTYETMOSTDISTRICTSINKENYAHAVENOPREVENTIONPROGRAMSFORTHESEMENINRUSSIA,THEEPIDEMICISCONCENTRATEDAMONGINJECTINGDRUGUSERSINAREASWHERETHEYRECEIVEDCLEANNEEDLES,TESTING,ANDOTHERSERVI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