UNICEF與夥伴召開國際會議 呼籲杜絕中西非愛滋病病毒母嬰傳播

 

UNICEF與夥伴召開國際會議 呼籲杜絕中西非愛滋病病毒母嬰傳播

巴黎,法國/香港,2011年11月16日——聯合國兒童基金會(UNICEF)與一眾致力抗擊愛滋病病毒傳播的合作機構在法國巴黎舉行一連兩日的會議,承諾動員前綫工作人員、決策者和捐款人士在中非和西非國家落實預防母嬰愛滋病病毒傳播的措施。

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.根據其中一項《千禧發展目標》訂明,在2015年前,兒童愛滋病病毒新感染個案將須大幅減少9成,同時與愛滋病相關的孕婦死亡數字亦要減半。在巴斯德研究所舉行的會議上,各方多次要求有關國家將此目標納入國家重點工作範圍。

在缺乏預防措施和治療下,超過4成新生兒會從愛滋病病毒呈陽性反應的母親身上,感染到病毒。然而,若這些婦女早在懷孕時已接受到測試,及早發現病情,再加以適切治療,將愛滋病病毒傳染給下一代的風險可大大降低至5%或以下。

非洲中、西部地區的孕婦和嬰兒死亡率一直高企,母嬰愛滋病病毒傳播率多年來亦居高不下。根據目前最新數據,雖然接受抗愛滋病病毒藥物治療的婦女比率已由2005年的近4%,大幅提升至2009年的23%,但當地的母嬰愛滋病病毒「直向」傳播預防工作,進展依然緩慢。現時,國際社會以至區內國家決策者,亦未有投入足夠的關注及向婦女提供相應的經濟援助,盡力打破當前困局,致使當地仍有不少婦女及兒童無法得到適切治療,以減低母嬰愛滋病病毒傳播的風險。

預防愛滋病病毒傳播的工作,實在刻不容緩。其他非洲國家已實行打擊愛滋病的方案和對策,並證實行之有效,遂應盡快擴展至在非洲中、西部國家。是次由聯合國兒童基金法國委員會、法國外交及歐洲事務部、法國開發署、法國國家愛滋病暨病毒性肝炎研究署、法國醫院聯會治療支援網絡、法國巴斯德研究所、聯合國愛滋病規劃署和國際藥品採購機制,多個機構及組織聯合舉辦的會議,將商討調配更龐大資源,向相關政府施壓,竭力扭轉現時不能接受的劣勢。是次會議為24個中、西非及其他國家的前綫工作人員、決策者和頂尖專家造就了一次合作良機,建設了經驗交流的平台,讓他們得以集中商討抵禦愛滋病的有效方法。

「經驗告訴我們,即使貧困國家亦能避免嬰兒在出生時感染愛滋病病毒或愛滋病。各捐助國只需下定政治決心,把資源及捐款優先投放在對抗愛滋病的項目上,便可保護兒童免受愛滋病病毒感染。」聯合國兒童基金法國委員會主席Jacques Hintzy先生表示:「所以我們實在再沒理由原地踏步。」

要有效預防母嬰愛滋病病毒傳播,就要將預防愛滋病病毒母嬰傳播的相關措施融入婦女和兒童的醫療保健計劃。孕婦產前產後的健康檢查必須加強,並把愛滋病病毒測試、婦女諮詢服務和早期嬰兒檢測納入主流服務。同時必須鼓勵父親參與檢測和預防服務。這些服務必須在全國實施,增強對最邊緣、最脆弱社區的支援。而整套策略的效率和可行性,要有專責的行動調查小組評估。

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 outbreaks 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 outbreak 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 brought 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 breastfeeding. 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 breastfed by an HIV-positive mother, infants continue to receive prophylactics and are tested again at 12 months and 18 months (and three months after breastfeeding 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.

只要投放更多資源,非洲中、西部地區將有望在2015年前加快步伐,邁向杜絕母嬰愛滋病病毒傳播及改善孕婦健康狀況的目標。

專門服務患病兒童的巴黎內克醫院Stephen White教授負責統籌是次會議,他強調:「杜絕愛滋病病毒傳播需要多方合作,包括:治療藥物、具成效的政策、研究人員、善長人翁、救助及有系統的國際支援網絡。這次會議,就志在鼓勵社會上各階層,要具備堅定的政治決心,大力推行預防母嬰愛滋病病毒直向傳播的工作。」