2010 International AIDS conference(2010年国际艾滋病会议英文版).doc2010 International AIDS conference(2010年国际艾滋病会议英文版).doc

收藏 分享

资源预览需要最新版本的Flash Player支持。
您尚未安装或版本过低,建议您

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,ANDOTHERSERVICES,THEINFECTIONRATEROSE15PERCENTOVERFIVEYEARSWHERETHEYDIDN’T,ITSKYROCKETED105PERCENTCLEARLY,THESESERVICESWORKYETRUSSIAHASGUTTEDTHEM–CUTTHEBUDGETTOZERO–ANDSHIFTEDTHEMONEYINTOPROGRAMSFORTHEGENERALPOPULATIONWHYTHEPROBLEMISNOTALACKOFDATAUNAIDSCANHELPANYENDEMICCOUNTRYANALYZEINFORMATIONTOUNDERSTANDWHICHPOPULATIONSAREATTHEGREATESTRISKTHEPROBLEMISTHATMANYCOUNTRIESARENOTUSINGTHISDATATOMAKETHEIRFUNDINGDECISIONSINSTEAD,POLITICIANSAREMAKINGTHEMBASEDONFEARANDSTIGMATHEYDON’TWANTTOASSOCIATETHEMSELVESWITHPEOPLEWHOENGAGEINBEHAVIORTHATMAKESTHEMUNCOMFORTABLEASPRESIDENTCLINTONSAIDTHISMORNING,EVERYDOLLARWASTEDPUTSALIFEATRISKIFYOU’REAFRAIDTOMATCHYOURPREVENTIONEFFORTSTOTHERIGHTPOPULATIONS,THENYOU’REWASTINGMONEY–ANDTHATCOSTSLIVESTREATMENTASPREVENTIONTHEREISONEOTHERPREVENTIONTECHNIQUEWHEREGREATEREFFICIENCYWILLMAKEABIGIMPACTANTIRETROVIRALARVTREATMENTWENOWKNOWTHATPUTTINGPEOPLEONARVSMAKESTHEMFARLESSLIKELYTOPASSTHEVIRUSONTOOTHERSTREATMENTISPREVENTIONBUTTHISRAISESACRUCIALQUESTIONHOWCANWEGETTHEMOSTPREVENTIONBENEFITFROMTHETREATMENTWE’REPROVIDINGWHENYOUHAVEAHIGHERCD4COUNTANDYOURVIRALLOADISLOW,YOUFEELHEALTHYANDAREMORESEXUALLYACTIVEASYOURCD4COUNTDROPS,YOURVIRALLOADSPIKES,ANDYOUBECOMELESSACTIVE,BUTYOUMAYBEMOREINFECTIOUSWHENSHOULDYOUSTARTTREATMENTARECENTSTUDYINVOLVINGSEVENAFRICANCOUNTRIESFOUNDANINTRIGUINGANSWERPEOPLEWITHCD4COUNTSBELOW200WERESIXTIMESMORELIKELYTHANHEALTHIERPEOPLETOTRANSMITTHEVIRUSTHISWASTRUEEVENAFTERACCOUNTINGFORTHEFACTTHATTHEYWERELESSSEXUALLYACTIVESOWHETHERYOURGOALISTOMAXIMIZETHEPREVENTIVEBENEFITSOFTREATMENTORTOSAVEASMANYLIVESASPOSSIBLE,YOUSHOULDFOCUSFIRSTONTREATINGEVERYONEWITHACD4COUNTBELOW200THISGIVESUSVITALINFORMATIONFORTHEFIGHTAGAINSTHIVITHELPSUSSEEWHEREOURTREATMENTEFFORTSCANBETARGETEDSOTHEYMAKETHEBIGGESTIMPACTFORPREVENTIONATTHESAMETIME,WEHAVETOFACEAHARSHTRUTHBECAUSEOFTHEVIRUS’SLONGLATENCYPERIOD,EXPANDINGOURPREVENTIONEFFORTSWON’TDRIVEDOWNTHENUMBEROFDEATHSFORADECADEORMOREEVENASWEACTNOWTOPREVENTFUTUREINFECTIONS,THEONLYWAYTOSAVEMORELIVESIMMEDIATELYISTOEXPANDTHENUMBEROFPEOPLERECEIVINGTREATMENTUNFORTUNATELY,THECURRENTHIGHCOSTOFTREATMENTMEANSWECANNOTTREATEVERYONEWHONEEDSITIFYOUHAVEAIDS,ANDYOUGOTOAHEALTHCLINIC,YOUSHOULDNEVERHAVETOHEARSOMEONESAY“I’MSORRYYOUCAN’THAVETHEDRUGSTHATWOULDSAVEYOURLIFEWEDON’THAVETHEMONEY”WHENFUNDINGISLIMITED,THEREARETWOWAYSTOSTOPTURNINGPEOPLEAWAYANDSTARTEXPANDINGTREATMENTYOUCANREDUCETHECOSTOFTHEDRUGS;ORYOUCANREDUCETHECOSTOFDELIVERINGTHEMTOPATIENTSTHECHEAPESTFIRSTLINEDRUGSNOWCOSTLESSTHAN100PERYEARWENEEDTOKEEPWORKINGTOREDUCETHECOSTOFTHESEANDOTHERTREATMENTDRUGS,ESPECIALLYTHEMOREEFFECTIVEREGIMESTHATCONTAINTENOFOVIRBUTUNFORTUNATELY,NONEOFTHEDRUGSARELIKELYTOGETALOTCHEAPERINTHENEXTFEWYEARSTHATLEAVESONEOPTIONFOREXPANDINGTREATMENTNOWDRIVINGDOWNTHECOSTOFDELIVERYWEARESEEINGEXCITINGEVIDENCETHATTHISISPOSSIBLEIN2006,PEPFARSTUDIEDANUMBEROFITSSITESINBOTSWANAANDREPORTEDDELIVERYCOSTSOFNEARLY1,000PERPATIENTPERYEARTWOYEARSLATER,THECOSTWASDOWNTO245INNIGERIA,ITDROPPEDFROM2,000TO280–AREDUCTIONOFNEARLY90PERCENTSOMEOFTHESESAVINGSCOMEFROMMINIMIZINGPERSONNELCOSTSASASITESEESMOREPATIENTS,THESTAFFNEEDSLESSTRAININGSOMETASKSCANBESHIFTEDFROMDOCTORSTONURSES,ORFROMNURSESTOASSISTANTSSOMECLINICSALSOCUTCOSTSBYSIMPLIFYINGTHEIRTESTINGREGIMESTHEYMAYRUNFEWERCD4COUNTSORCHECKLESSOFTENFORTOXICITYTODRIVEDOWNTHECOSTOFDELIVERINGTREATMENT,WENEEDTODOBOTHMINIMIZEPERSONNELCOSTSANDSIMPLIFYTHETESTINGREGIMESBUTTHEBESTPRACTICESAREN’TBEINGMEASUREDORSHAREDISTHEREAMOREEXPENSIVEDRUGTHATACTUALLYSAVESMONEY,BECAUSEITREQUIRESLESSMONITORINGORCANBEDELIVEREDBYLOWERPAIDSTAFFWEDON’TKNOWWENEEDTOIDENTIFYTHEMOSTEFFICIENTMODELSANDTHENMAKESUREEVERYCLINICFOLLOWSTHEMIFWECOULDLIMITTHEDELIVERYANDADMINISTRATIVECOSTSTONOMORETHANTWICETHECOSTOFTHEDRUGSTHEMSELVES,THENTHETOTALCOSTOFTREATMENTWOULDBEABOUT300PERPATIENTPERYEARFORTHESAMEAMOUNTOFMONEYWESPENDTODAY,WECOULDTREATMORETHANTWICEASMANYPEOPLEARVTREATMENTANDMALECIRCUMCISIONARETWOPOWERFUL,PROVENTOOLSFORPREVENTION,ANDWESHOULDSCALETHEMUPASQUICKLYASPOSSIBLEANOTHERSETOFINTERVENTIONS–THOSEDESIGNEDTOPERSUADEPEOPLETOCHANGERISKYBEHAVIOR–HAVEHADSUCCESSINCERTAINREGIONSWITHCERTAINPOPULATIONSFORINSTANCE,OURFOUNDATIONSUPPORTSEFFORTSININDIATOENCOURAGESEXWORKERSANDTHEIRCLIENTSTOUSECONDOMS,ANDTHERESULTSHAVEBEENIMPRESSIVENOW,ASWESCALEUPVARIOUSMETHODSOFBEHAVIORCHANGEINAFRICA,WENEEDTOMEASURETHEIRIMPACTSOWEKNOWWHICHONESMAKETHEBIGGESTDIFFERENCETHEPAYOFFOFSCALINGUPEXISTINGTOOLSCOULDBEHUGEIFWEIDENTIFYTHEMOSTEFFECTIVEPREVENTIONEFFORTS,ANDTHENEXPANDACCESSTOTHEM,WECANPREVENTMILLIONSOFDEATHSTHISISGOODNEWS–BUTITISNOTGOODENOUGHEVENIFWEDIDEVERYTHINGPOSSIBLEWITHTHETOOLSWEHAVETODAY,THEMOSTOPTIMISTICPREDICTIONSSUGGESTTHATTHEYWOULDONLYREDUCENEWINFECTIONSBYHALFMILLIONSOFPEOPLEWOULDCONTINUETOTRANSMITTHEVIRUS,ANDWEWOULDNEVERHAVEENOUGHMONEYTOTREATEVERYONEWHONEEDEDITDEVELOPINGNEWTOOLSFORTUNATELY,THEREISNOREASONTOASSUMETHATINTHEFUTUREWEWILLBELIMITEDTOFIGHTINGHIVWITHTHETOOLSWEHAVETODAYWECANDOBETTERINNOVATIONSINBASICSCIENCE,DIAGNOSTICS,COMPUTERMODELING,ANDOURUNDERSTANDINGOFTHEVIRUSITSELFWILLMAKEITPOSSIBLETOCREATENEWWEAPONSFORTHEFIGHTAGAINSTAIDS,PREVENTEVENMOREINFECTIONS,ANDSAVEE
编号:201312142348238014    类型:共享资源    大小:62.00KB    格式:DOC    上传时间:2013-12-14
  
3
关 键 词:
IS 电气 高压 110kv 220kv 550kv 800kv
  人人文库网所有资源均是用户自行上传分享,仅供网友学习交流,未经上传用户书面授权,请勿作他用。
关于本文
本文标题:2010 International AIDS conference(2010年国际艾滋病会议英文版).doc
链接地址:http://www.renrendoc.com/p-218014.html

当前资源信息

4.0
 
(2人评价)
浏览:30次
baixue100上传于2013-12-14

官方联系方式

客服手机:17625900360   
2:不支持迅雷下载,请使用浏览器下载   
3:不支持QQ浏览器下载,请用其他浏览器   
4:下载后的文档和图纸-无水印   
5:文档经过压缩,下载后原文更清晰   

精品推荐

相关阅读

人人文库
关于我们 - 网站声明 - 网站地图 - 资源地图 - 友情链接 - 网站客服客服 - 联系我们

网站客服QQ:2846424093    人人文库上传用户QQ群:460291265   

[email protected] 2016-2018  renrendoc.com 网站版权所有   南天在线技术支持

经营许可证编号:苏ICP备12009002号-5