医学新闻精听 | 艾滋病战役的曙光

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Science and Technology 科学与技术

The fight against AIDS— HIV’s slow retreat 与艾滋病之战——HIV的缓慢退却

One of the world’s worst plagues is giving ground 抗击艾滋病：显现曙光

THE timing of the Pope’s（教皇） much-discussed change of position on the use of condoms to prevent the spread of HIV (he will now allow prostitutes（妓女，此次指男妓） to use them without fear of hellfire) was surely no coincidence（巧合）. He made it on November 21st—ten days before World AIDS Day and two before UNAIDS, the United Nations body charged with combating the epidemic, released its latest report on the state of the battle.

近期罗马教皇改变了其对于使用避孕套以防止艾滋病传播的立场（称男妓可以使用避孕套，而不必惧怕地狱之火的惩罚），引来一片议论。这个时间绝非巧合。他是本月21日向外界宣布的——恰逢世界艾滋病日前十天，也是在两天后，负责抗击艾滋病的联合国机构——联合国艾滋病规划署（UNAIDS）发布了其最新的艾滋病防治工作报告。

That report carries good news. Though some 33m people are infected, the rate of new infections is falling—down from 3.1m a year a decade ago to 2.6m in 2009. Moreover, as the map shows, the figure is falling fastest in many of the most heavily infected countries, especially those of sub-Saharan Africa and South and South-East Asia.

这份报告带来了好消息。纵使艾滋病毒感染人数已达3300万，但新增感染者的速度正在放慢——从十年前的每年感染310万人降至2009年的260万人。此外，从这张地图上可以看出，正是那些感染最严重的国家新增感染者的速度下降最快，尤其是撒哈拉以南的非洲国家以及南亚、东南亚国家。

The reason is a combination of behavioural（行为上的） change (people are losing their virginity later, are being less **promiscuous（滥交的）**and are using condoms more), a big reduction in mother-to-child transmission at birth and during breast-feeding, and the roll-out of drug treatment for those already infected.

此中原因是多方面的：包括性行为方式的改变（初次性行为年龄的推迟，滥交的减少以及越来越多地使用安全套），母婴分娩传播与哺乳传播的大幅减少，以及已感染者对毒品的戒除。

Besides prolonging（延长） life, anti-HIV drugs make those taking them less likely to pass the virus on. More than 5m people in poor and middle-income countries are now on such drugs, though Michel Sidibe, the head of UNAIDS, says another 10m could benefit. (The remainder of those infected are not yet ill enough for drugs to do them good.) The problem, as always, is money. Dr Sidibe reckons the fight needs about $25 billion a year to be fully effective. At the moment, the sum spent is around $17 billion. Not a bad fraction of the desideratum（急切的需求）, but one that will be hard to sustain in the face of the world’s economic difficulties.

抗艾滋药物除了可以延长生命，还可降低服用者将病毒向他人传播的几率。超过500万来自贫困或中等收入国家的艾滋病患者正在服用这种药物，即使这样，据联合国艾滋病规划署的负责人Michel Sidibe说，仍有超过1000万人需要这种药物。（这些人已感染病毒但还未服药，因为症状还不足以使药物发挥作用。）资金不足始终是个问题。Sidibe博士认为，抗击艾滋病每年大约需250亿美元方可全力维持。但现在最高的年支出只有约170亿美元。与总需求相比这还不算太糟，但在全球经济面临困境的当下，想维持这一水平却又是个难题。