JUNE 2016
GLOBAL HEALTH SECTOR STRATEGY ON
HIV 2016–2021 TOWARDS ENDING AIDS
GLOBAL HEALTH SECTOR STRATEGY ON
HIV 2016–2021 TOWARDS ENDING AIDS
04
GLOBAL HEALTH SECTOR STRATEGY ON HIV, 2016–2021
WHO/HIV/2016.05 © World Health Organization 2016 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/copyright_form/en/index. html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The definitive versions of the global health sector strategies on HIV, viral hepatitis and sexually transmitted infections, for the period 2016–2021, can be found in the official records of the Sixty-ninth World Health Assembly (document WHA69/2016/REC/1). Design and layout by 400.co.uk Printed by the WHO Document Production Services, Geneva, Switzerland.
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CONTENTS
01 02 03 04 05
Why the world must step up the HIV response quickly Framing the strategy Vision, goal and targets Strategic directions and priority actions Strategy implementation: partnerships, accountability, monitoring and evaluation and costing
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18 22 26 50
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GLOBAL HEALTH SECTOR STRATEGY ON HIV, 2016–2021
INTRODUCTION AND CONTEXT
The international community has committed to ending the AIDS epidemic as a public health threat by 2030 – an ambitious target of the 2030 Agenda for Sustainable Development adopted by the United Nations General Assembly in September 2015.1 Interim targets have been established for 2020. This strategy describes the health sector contribution towards the achievement of these targets. It outlines both what countries need to do and what WHO will do. If implemented, these fast-track actions by countries and by WHO will accelerate and intensify the HIV response in order for the “end of AIDS” to become a reality.
1 United Nations General Assembly resolution 70/1 – Transforming our world: The 2030 Agenda for Sustainable Development, see http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E (accessed 15 March 2016).
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T
he strategy builds on the extraordinary public health achievements made in the global HIV response since WHO launched the Special Programme on AIDS in 1986.2 It continues the momentum generated by the Millennium Development Goals and the universal access commitments.3 Recently, the Global health sector strategy on HIV/ AIDS 2011–20154 has galvanized global and country action that has helped halt and reverse the AIDS epidemic. During that period, HIV treatment coverage was expanded rapidly with well over 17 million people living with HIV on antiretroviral therapy by the end of 2015; new HIV infections and deaths declined; dozens of countries moved towards the elimination of mother-to-child transmission of HIV; and HIV responses have been embedded in broader health and development programmes. However, there is no room for complacency. Much has changed since 2011, with new opportunities to exploit and many new challenges to overcome. Ending the AIDS epidemic will require rapid acceleration of the response over the next five years and then sustained action through to 2030 and beyond. This can only be achieved through renewed political commitment, additional resources, and technical and programmatic innovations.
The strategy positions the health sector response to HIV as being critical to the achievement of universal health coverage – one of the key health targets of the Sustainable Development Goals. The strategy promotes a people-centred approach, grounded in principles of human rights and health equity. It will contribute to a radical decline in new HIV infections and HIVrelated deaths, while also improving the health and well-being of all people living with HIV. It will guide efforts to accelerate and focus HIV prevention, enable people to know their HIV status, provide antiretroviral therapy and comprehensive long-term care to all people living with HIV, and challenge pervasive HIV-related stigmatization and discrimination.
PEOPLE LIVING WITH HIV ON ANTIRETROVIRAL THERAPY BY THE END OF 2015
17m
2 In March 1987, WHO published the “Special Programme on AIDS: strategies and structure projected needs”, which is available at: http://apps.who.int/iris/bitstream/10665/62299/1/WHO_SPA_GEN_87.1.pdf (accessed 15 March 2016). In addition, the Global Programme on AIDS 1987–1995 published its “Final Report with Emphasis on 1994–1995 Biennium”, available at: http://apps.who.int/ iris/bitstream/10665/65955/1/WHO_ASD_97.1.pdf (accessed 15 March 2016). 3 United Nations General Assembly resolution 65/277 — Political Declaration on HIV and AIDS: Intensifying Our Efforts to Eliminate HIV and AIDS http://www.unaids.org/sites/default/files/sub_landing/files/20110610_UN_A-RES-65-277_en.pdf (accessed 15 March 2016). 4 The global health sector strategy on HIV/AIDS 2011–2015 is available at: http://apps.who.int/iris/ bitstream/10665/44606/1/9789241501651_eng.pdf (accessed 15 March 2016).
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GLOBAL HEALTH SECTOR STRATEGY ON HIV, 2016–2021
Broad partnerships and strong linkages with other health and development issues must be emphasized in the next phase of the response. This strategy is fully aligned with the post-2015 health and development agenda and targets. It provides the health sector contribution to a broader multisectoral response as outlined in the UNAIDS strategy for 2016–2021.5 It is also aligned with other relevant global health strategies and plans, including those for sexually transmitted infections, tuberculosis, viral hepatitis, sexual and reproductive health, maternal and child health, blood safety, mental health, noncommunicable diseases and integrated people-centred health services. It has been informed by the extraordinary efforts of many countries, recognizing that countries and communities are central to the response. It takes into consideration the HIV and broader health strategies of key development partners, including the Global Fund to fight AIDS, Tuberculosis and Malaria, and the United States President’s Emergency Plan for AIDS Relief.6 Full implementation of the strategy will contribute to the achievement of other Sustainable Development Goals – it will prevent and relieve poverty, reduce inequities, promote gender equality, enhance productivity and tackle exclusion, stigmatization and discrimination.
The strategy outlines a vision, goals and actions for the global health sector response, including five strategic directions: strengthening and focusing national HIV programmes and plans through sound strategic information and good governance; defining a package of essential HIV services and high-impact interventions along the HIV services continuum; adapting and delivering the HIV services continuum for different populations and locations to maximize quality and achieve equitable coverage; implementing systems to fully fund the continuum of HIV services and to minimize the risk of financial hardship for those requiring the services; and embracing innovation to drive rapid progress (see Figure 1).
01 – State-sponsored educational programme on the prevention of mother-to-child transmission of HIV, Nigeria.
5 UNAIDS Strategy 2016–2021, see http://www.unaids.org/en/resources/documents/2015/UNAIDS_PCB37_15-18 (accessed 15 March 2016). 6 For more information on the United States President’s Emergency Plan for AIDS Relief, see http://www.pepfar.gov/about/strategy/ (accessed 15 March 2016).
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OUTLINE OF THE STRATEGY The strategy has five major components:
01 02 03 04 05
Setting the scene – reviews the current status of HIV epidemics and responses, identifies opportunities and challenges for the future, and argues the case for adequate investment in the health sector response to HIV; Framing the strategy – describes the three organizing frameworks for the strategy (universal health coverage, the continuum of HIV services and the public health approach); Presenting a global vision and setting global goals and targets – presents a set of impact and service coverage targets for 2020 and 2030 to drive the response; Recommending priority actions – recommends fast-track actions to be taken by both countries and WHO under each of five strategic directions; Guiding implementation – outlines key elements of strategy implementation, including strategic partnerships, monitoring and evaluation, and costing.
01 WHY THE WORLD MUST STEP UP THE HIV RESPONSE QUICKLY
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The enormous investments in the HIV response over the past 15 years are paying off. Large declines in HIV-related deaths in the past decade attest to the commitment, resources and innovations that have already been directed at the global HIV epidemic. Fewer people are dying of HIV-related causes, with an estimated 1.1 million (range of 940 000 – 1.3 million) deaths in 2015 , down 43 % from 2003 the date that treatment targets were first set, largely the result of increased access to antiretroviral therapy. In 2015, new HIV infections were estimated at 2.1 million (range of 1.8 million–2.4 million).7, 8
THE CHALLENGES Despite major progress in the response, HIV epidemics continue to pose serious public health threats in all regions. Shadowing the gains are important challenges. Not enough and not fast enough – Current coverage of services is inadequate and the rate of expansion is too slow to achieve global targets. The full benefits of effective HIV interventions and services are not being realized. Globally, 17 million of the 37 million people living with HIV at the end of 2014 did not know their HIV status and 22 million were not accessing antiretroviral therapy.8 Major inequities persist and populations are being left behind – Success in the global HIV response is distributed unevenly and inequitably. While HIV incidence is declining overall, it is increasing in some countries and regions. Adolescent girls and young women in sub-Saharan Africa are being infected at twice the rate as that of boys and men of the same age. Progress is not sufficient or quick enough, and is not reaching many of the populations most at risk for HIV infection. In addition, there are substantial disparities in access to treatment and care, with boys and men lagging behind in many countries. Human rights violations, along with widespread gender-based violence and stigmatization and discrimination, continue to hinder access to health services, particularly for children, adolescents, young women and key populations.9
REDUCTION ON HIVRELATED DEATHS SINCE 2003
43%
Middle-income countries require specific focus – An estimated 70% of people living with HIV worldwide are in middle-income countries and global success will also be determined by whether efforts in these countries accelerate or stall. With changing donor priorities, expanding equitable and sustainable health financing systems is particularly critical for middle-income countries. At the same time, low-income countries will continue to rely on external development assistance to ensure that essential HIV services are funded adequately.
7 Most data presented in the strategy are drawn from routine country reports, World Health Organization and Joint United Nations Programme on HIV/AIDS reporting systems, such as the Global AIDS Response Reporting (GARPR) system. 8 Global AIDS Update 2016, UNAIDS http://www.unaids.org/en/resources/documents/2016/Global-AIDS-update-2016 (accessed 23 June 2016) 9 The present strategy on HIV uses the definition of “key populations” presented in the UNAIDS Strategy 2016–2021, available at http://www.unaids.org/en/resources/documents/2015/UNAIDS_PCB37_15-18 (accessed 15 March 2016): “Key populations, or key populations at higher risk, are groups of people who are more likely to be exposed to HIV or to transmit it and whose engagement is critical to a successful HIV response. In all countries, key populations include people living with HIV. In most settings, men who have sex with men, transgender people, people who inject drugs, sex workers and their clients and prisoners are at higher risk of exposure to HIV than other groups. However, each country should define the specific populations that are key to their epidemic and response based on the epidemiological and social context.”
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GLOBAL HEALTH SECTOR STRATEGY ON HIV, 2016–2021
Figure 1. Outline of the global health sector strategy on HIV, 2016-2021
VISION
Zero new HIV infections, zero HIV-related deaths and zero HIV-related discrimination in a world where people living with HIV are able to live long and healthy lives.
GOAL
End of the AIDS epidemic as a public health threat by 2030.
2020 TARGETS
Reduce new HIV infections to less than 500 000; zero new infections among infants. Reduce HIV-related deaths to below 500 000. 90% people living with HIV tested; 90% treated; 90% virally suppressed.
FRAMEWORKS FOR ACTION
Universal health coverage,the continuum of services; and, a public health approach.
MONITORING AND EVALUATION
The three dimensions of universal health coverage STRATEGIC DIRECTION 1 Information for focused action The “who” and “where” STRATEGIC DIRECTION 2 Interventions for impact The “what” STRATEGIC DIRECTION 3 Delivering for equity The “how” STRATEGIC DIRECTION 4 Financing for sustainability The financing STRATEGIC DIRECTION 5 Innovation for acceleration The future
STRATEGY IMPLEMENTATION
Leadership, Partnership, Accountability, Monitoring & Evaluation
COUNTRY ACTION
COUNTRY PARTNER ACTION
WHO ACTION HQ, REGIONS AND COUNTRIES
GLOBAL PARTNER ACTION
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Fragile communities and mobile populations – The world is facing an increasingly complex series of challenges. Conflict, natural disasters, economic crises and climate change can trigger humanitarian emergencies, which destroy local health systems, displace communities and force increasing numbers of people into migration with interrupted or poor access to health services. Insufficiently targeted interventions and services – National HIV responses often fail to focus interventions on the populations and locations most in need, thereby increasing inefficiencies and undermining their impact. Ensuring and maintaining quality – Rapid expansion of HIV programmes without ensuring the quality of services risks undermining programme effectiveness, wasting precious resources and contributing to negative public health outcomes, such as the emergence of drug resistant strains of HIV. Assuring the quality of prevention, diagnostic and treatment commodities is essential as demand and use increases. Increasing burden of coinfections and other comorbidities – AIDS deaths are declining with expanding access to antiretroviral therapy, however, investments in treatment are being challenged by increasing morbidity and mortality associated with coinfections, such as hepatitis B and hepatitis C, and other comorbidities, including cancers, cardiovascular disease, diabetes and other noncommunicable diseases, and mental health and substance use disorders. Despite a scale-up in antiretroviral therapy, and improvements in the prevention and management of HIV and tuberculosis coinfection, tuberculosis is still the leading cause of hospitalization of adults and children living with HIV, and remains the leading cause of HIV-related deaths.
Doing more of the same is not enough – The global epidemic has reached a point where a steady-state response – that is, maintaining coverage at current levels or gradual expansion – will soon see a rebound in new HIV infections and HIV-related deaths. Proceeding at the current pace will not be enough to end an epidemic that is constantly evolving. New HIV infections will increase and more people will require HIV treatment and care. The costs of prevention, care and treatment will continue to expand. By the end of 2015, the number of people living with HIV had reached an estimated 33.3 million (range of 30.9 million– 36.1 million) worldwide. The world is faced with a dilemma: “business as usual” will see the HIV response lose steam and slide back. The actions outlined in this strategy will avoid that outcome. They involve accelerating the development and implementation of comprehensive, high-impact HIV prevention and treatment interventions, using rights-based and people-centred approaches, identifying sustainable financing for HIV programmes into the future and ensuring progressive integration of the HIV response into broader health programmes and services.
PEOPLE LIVING WITH HIV BY THE END OF 2015
33.3m
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GLOBAL HEALTH SECTOR STRATEGY ON HIV, 2016–2021
READY FOR A MAJOR LEAP FORWARD There are enormous opportunities for capitalizing on the progress made over the past 15 years, to catapult the response to a new trajectory towards the elimination of the AIDS epidemic. The health sector must show leadership as the response moves forward. CRITICAL AREAS FOR FAST-TRACK ACTION
Ensuring all people living with HIV know their status: New HIV testing approaches, including self- and community-based testing, and new quality-assured testing technologies, promise to identify and link greater numbers of people living with HIV to early treatment and care, maximizing HIV prevention potential and treatment effectiveness. The strategic focusing of HIV testing services will be critical in reaching those most at risk and diagnosing people early. Expanding quality treatment for all people living with HIV: Filling the treatment gap, expanding from 17 million people to all people who are living with HIV, must be a priority and will massively curtail new infections and deaths. However, the initiation of antiretroviral therapy for everyone living with HIV will require an unprecedented effort from countries and partners. Specific attention must be given to addressing the greatest inequities in access to treatment – to reach those left behind: infants, children, adolescent girls and boys, men and key populations. The quality of medicines and services must be assured. Strategies to maximize treatment adherence and retention in care will be essential to fully realize the potential of treatment. Keeping people healthy and alive through person-centred and holistic care: The broad health needs of the millions of people living with HIV, including those on lifelong antiretroviral therapy, must be addressed. Linkages between HIV services and those for tuberculosis, viral hepatitis and other major health issues are significantly reducing morbidity and mortality. Strengthening those linkages, including with noncommunicable disease services, will ensure holistic and integrated person-centred care, boosting the overall impact of programmes. Joint HIV and tuberculosis programming in countries with the highest burden of tuberculosis and HIV coinfection further strengthens integration, enhancing access to life-saving interventions, while maximizing efficient use of resources. Using a chronic care model for HIV treatment and care offers opportunities for addressing broader health needs, particularly noncommunicable diseases, and mental health and substance use disorders. Palliative care remains a critical component of a comprehensive health sector response, helping to ensure dignity and comfort for people in managing their pain and other symptoms.
We must build on the existing momentum of the HIV response, to benefit from the solid base of comprehensive national progammes and to exploit renewed political commitment. More, however, is required. There are six areas where new commitments, resources and intensified efforts will be essential for the attainment of the 2020 and 2030 targets. Bolstering combination prevention with new tools: The HIV prevention effects of antiretroviral drugs, including antiretroviral therapy are well recognized. The game-changing potential of pre-exposure prophylaxis – using antiretroviral drugs to prevent HIV infection – has been confirmed. Strategically combining antiretroviral therapy with pre-exposure prophylaxis, as part of combination HIV prevention, could almost eliminate HIV transmission to HIV-negative sexual and drug-using partners. There is great scope to capitalize further on the preventive power of voluntary medical male circumcision. Innovations that close in on the 80% coverage target for voluntary medical male circumcision in designated “priority” countries would dramatically curtail new infections in some of the world’s largest HIV epidemics. Male and female condoms, in combination with lubricants, must continue to be the mainstay of prevention programmes. However, the full benefits of consistent condom use are yet to be realized. Innovations in condom programming could catapult the HIV response forward. The development of an effective topical microbicide and HIV vaccine would be powerful additions to an increasingly robust HIV prevention intervention portfolio.
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Reaching and protecting those most vulnerable and at risk: The HIV response can no longer ignore those populations most affected and left behind. Effective HIV prevention and empowerment interventions must reach girls and young women – a group which continues to be the most vulnerable and affected in many communities, particularly in the high-burden epidemics of subSaharan Africa. Major new and focused investments will be required to strengthen community-based services to: provide appropriate interventions for adolescents; tackle effectively gender-based violence, also related to harmful alcohol use; reduce the vulnerability of girls and young women; bring men and boys into treatment; reach key populations (notably men who have sex with men, people who inject drugs, sex workers, transgender people and prisoners); expand harm reduction programmes for people who use drugs; and deliver services to mobile and displaced populations. More has to be done to overturn laws and change policies that marginalize and stigmatize populations, promote risk behaviours, create access barriers to effective services and perpetuate these inequities and inequalities. Reducing costs and improving efficiencies: In a resource-constrained environment with competing development priorities, an unprecedented scale-up in HIV services by 2020 can only be achieved by making radical savings through reduced prices of key medicines and other commodities and increased efficiencies in service delivery, along with a more rational allocation of resources.
HUGE BENEFITS FORESEEN
An immediate, fast-tracked global response that achieves the targets set out in this strategy will effectively end the epidemic as a global public health threat (see Figures 2 and 3). Modelling undertaken by UNAIDS shows that, in combination with high-impact prevention packages and a strengthened commitment to protect human rights, an accelerated testing and treatment effort would:10 • Reduce new adult HIV infections from 2.1 million
in 2010 to 500 000 in 2020; • Avert 28 million HIV infections between 2015 and 2030; • Avert almost 6 million infections in children by 2030; • Avert 21 million AIDS-related deaths between 2015
and 2030; • Avoid US$ 24 000 million of additional costs for HIV treatment; • Enable countries to reap a 15-fold return on their HIV investments. Further investments in HIV responses have the potential to significantly impact on other health targets of the Sustainable Development Goal on health (Goal 3), including those related to maternal and child health, tuberculosis, viral hepatitis, noncommunicable diseases and mental health, substance use disorders, sexual and reproductive health, and universal health coverage.
10 Understanding fast-track: accelerating action to end the AIDS epidemic by 2030, see http://www.unaids.org/sites/default/files/ media_asset/201506_JC2743_Understanding_FastTrack_en.pdf (accessed 15 March 2016).
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GLOBAL HEALTH SECTOR STRATEGY ON HIV, 2016–2021
Figure 2. Projections for decline in new HIV infections
2.5 FAST TRACK 2
0 NEW INFECTIONS AMONG INFANTS
NEW INFECTIONS (IN MILLIONS)
1.5
75% 1
REDUCTION IN NEW INFECTIONS INCLUDING KEY POPULATIONS FROM 2010 TO 2020 PAST TRENDS IN NEW HIV INFECTIONS PROJECTED NEW HIV INFECTIONS – MAINTAINING THE 2014 LEVEL OF SERVICES 2030 PROJECTED NEW HIV INFECTIONS – FAST-TRACK APPROACH
0.5
2010
2015
2020 YEAR
2025
Figure 3. Projections for decline in HIV-related deaths
2.5 FAST TRACK 2 DEATHS (IN MILLIONS) REDUCE HIV RELATED DEATHS BELOW 1.5
500.000 BY 2020
1
PAST TRENDS IN AIDS-RELATED DEATHS PROJECTED AIDSRELATED DEATHS – MAINTAINING THE 2014 LEVEL OF SERVICES PROJECTED AIDSRELATED DEATHS – FAST-TRACK APPROACH
0.5
2010
2015
2020 YEAR
2025
2030
Source: UNAIDS, 20162021 Strategy, see: http://www.unaids.org/sites/default/files/media_ asset/20151027_ UNAIDS_PCB37_15_18_EN_rev1.pdf (accessed 15 March 2016).
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BUILDING AN INVESTMENT CASE
Investment cases need to: • Define and provide a budget for the packages of
Most of the tools required to reach the fast-track targets are in hand, and several potentially vital upgrades and innovations are imminent. Using them to full effect, however, will require a rapid augmentation of existing investments in the HIV response, and focusing resources on both the most effective services and interventions, and on the populations and geographical locations where HIV transmission and burden are greatest. Resources mobilized from all sources for HIV programmes in lowand middle-income countries increased by an additional US$ 250 million from 2012 to reach US$ 19 100 million in 2013 and then increased again to an estimated US$ 21 007 million in 2015. The rising trend was due mainly to greater domestic investments, which comprised about 57% of the total in 2014. Nevertheless, investments in HIV will need to grow to US$ 31 900 million in 2020 and US$ 29 300 million in 2030 if long-term control of the epidemic is to be achieved. Many countries have gained significant experience and expertise in designing and implementing high coverage, high-quality and comprehensive HIV services that have had a major impact on HIV vulnerability, incidence, morbidity and mortality, and the quality of lives of people living with HIV. There are many opportunities for countries to “leap-frog” their own HIV responses, learning from other countries so that they can rapidly adapt and implement the most effective policies, services and interventions. With limited available resources, countries need to plan carefully, setting ambitious but realistic country targets, and develop strong investment cases. The investment case should provide justification for an adequate allocation of domestic resources, facilitate the mobilization of external resources and help identify global partners who would support efforts.
• • • • •
interventions and services required, based on the country context; Argue for the most cost-effective interventions; Identify the populations and locations most affected and where resources should be focused; Define the most efficient and equitable models of service delivery; Outline the most appropriate allocation of resources across the different levels of the health system; and Identify potential and reliable sources of funding.
Refocused actions, innovations that can boost impact and a renewed commitment to investment are required throughout the six years of this strategy. The strategy builds a case for such investment: it identifies five strategic directions to focus the actions of country programmes and WHO, and outlines the priority interventions and innovations that can achieve the greatest impact.
02 FRAMING THE STRATEGY
03
The HIV strategy is one of a series of three, related health sector strategies for the period 2016–2020, which include a strategy to end the epidemic of viral hepatitis and one to end the epidemic of sexually transmitted infections. The strategies use a common structure, drawing on three organizing frameworks: universal health coverage; the continuum of health services; and the public health approach. All three strategies are designed to contribute to the attainment of the Sustainable Development Goal on health (Goal 3). The HIV strategy describes how the health sector response to HIV can contribute to the achievement of the “ending AIDS” target, universal health coverage, and other key health and development targets. The HIV strategy is also aligned with other relevant health strategies, notably the End TB Strategy,11 the UNAIDS strategy (mentioned previously), and other HIV strategies (those of key partners, and those that are sectoral and multisectoral in nature). 11 End TB Strategy, see http://www.who.int/tb/strategy/en/ (accessed 15 March 2016).
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THE SUSTAINABLE DEVELOPMENT GOALS – PROVIDING DIRECTION The Sustainable Development Goals provide an ambitious and far-reaching development agenda for the period 2016–2030. Health is a major goal in this post-2015 agenda, reflecting its central role in alleviating poverty and facilitating development. The health-related Sustainable Development Goal (Goal 3) addresses a range of health challenges critical for development, notably target 3.3 on communicable diseases, which includes ending the AIDS epidemic.12 Efforts to end AIDS will also impact on other health targets, including on reducing maternal mortality (target 3.1), preventing deaths of newborns and children under the age of 5 years (target 3.2), reducing mortality from noncommunicable diseases and promoting mental health (target 3.4), preventing and treating substance use disorders (target 3.5), sexual and reproductive health (target 3.7), achieving universal health coverage (target 3.8), access to affordable medicines and vaccines (target 3.b) and health financing and health workforce (target 3.c). In addition to its impact on Goal 3, ending the AIDS epidemic will contribute to ending poverty (Goal 1), ending hunger (Goal 2), achieving gender equality and empowering women and girls (Goal 5), reducing inequality in access to services and commodities (Goal 10), promoting inclusive societies that promote non-discrimination (Goal 16), and financing and capacity building for implementation (Goal 17).
UNIVERSAL HEALTH COVERAGE – AN OVERARCHING FRAMEWORK At the global level, 150 million people experience financial catastrophe and 100 million people suffer impoverishment every year as a result of out-of-pocket health expenses. The Sustainable Development Goals focus on the importance of ensuring financial security and health equity and universal health coverage provides a framework for addressing them. Universal health coverage (see Figure 4) is achieved when all people receive the health services required, which are of sufficient quality to make a difference, without those people incurring financial hardship. It comprises three major, interlinked objectives: improving the range, quality and availability of essential health services (covering the range of services needed); improving the equitable and optimal uptake of services in relation to need (covering the populations in need of services); and reducing costs and providing financial protection for those who need the services (covering the costs of services). As resources, efficiencies and capacities increase, the range of services provided can be expanded, the quality can be improved, and more populations can be covered with less direct costs to those who need the services – a progressive realization of universal health coverage.
Figure 4. The three dimensions of universal health coverage
REDUCE COST SHARING AND FEES
DIRECT COSTS PROPORTION OF THE COSTS COVERED
EXTEND TO NON-COVERED CURRENT COVERAGE
INCLUDE OTHER SERVICES
SERVICES WHICH SERVICES ARE COVERED? POPULATION WHO IS COVERED?
12 United Nations General Assembly resolution 70/1 – Transforming our world: the 2030 Agenda for Sustainable Development, see http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E (accessed 15 March 2016).
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GLOBAL HEALTH SECTOR STRATEGY ON HIV, 2016–2021
THE CONTINUUM OF HIV SERVICES – AN ORGANIZING FRAMEWORK Universal health coverage provides an overarching framework for the strategy while the continuum, or cascade, of HIV services provides an organizing framework for implementation. Countries need to implement high impact, evidence-based interventions along the entirety of the continuum of services for HIV vulnerability and risk reduction, prevention, diagnosis, treatment and chronic care (see Figure 5), focusing on populations and geographic locations where most HIV transmission is occurring and which are experiencing the greatest HIV burden. The continuum of services will need to be adapted and monitored for different populations, settings and epidemic types, while ensuring that common comorbidities such as tuberculosis and viral hepatitis are also well addressed. The strategy defines the essential services and interventions along the continuum, and it recommends ways for assuring and improving the quality of services and programmes. As people move along the HIV services continuum, there is a loss to follow up, with this “leakage” creating a retention cascade (see Figure 5). The objective is to engage individuals as early as possible along the continuum, retain them in care, and minimize any leakages along the cascade.
Figure 5. The continuum of HIV services and retention cascade
HIV -
HIV CASCADE
HIV HIV HIV -
HIV +
HIV +
HIV +
HIV +
ALL PEOPLE
PEOPLE REACHED BY PREVENTION ACTIVITIES
PEOPLE TESTED
AWARE OF STATUS
ENROLLED IN CARE
ON TREATMENT
RETAINED ON TREATMENT
VIRAL LOAD SUPPESSED
ACCESSING CHRONIC CARE
CONTINUUM OF SERVICES
PREVENTION
TESTING
LINK TO CARE
TREATMENT
CHRONIC CARE
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A PUBLIC HEALTH APPROACH The strategy is rooted in a public health approach that is concerned with preventing disease, promoting health, and prolonging life among the population as a whole. It aims to ensure the widest possible access to high-quality services at the population level, based on simplified and standardized interventions and services that can readily be taken to scale, including in resourcelimited settings. A public health approach aims to achieve health equity and promote gender equality, to engage communities and to leverage public and private sectors in the response. It promotes the principle of health in all policies through, where necessary, legal, regulatory and policy reforms. It aims to strengthen integration and linkages between HIV and other services, improving both impact and efficiency. The strategy builds on the many ways in which HIV responses have helped strengthen health systems in many countries, leading to better quality services. Those responses have pioneered financing models and strategies for reducing the prices of commodities and the financial risks to individuals and communities. HIV responses have catalysed breakthroughs in science and technology and proven that it is feasible to rapidly scale-up clinical and public health programmes in challenging settings. They have driven transformations in the way health services are delivered, through decentralized and linked services, task shifting, and stronger intersectoral collaboration. Benefits are also apparent in enhanced systems for the provision of chronic care and for strengthening adherence to and retention on lifelong treatments, as well as improved systems concerned with monitoring and evaluation, and procurement and distribution. Crucially, they have capitalized on the advantages of engaging communities in designing, implementing and monitoring HIV programmes, and have highlighted their roles in strengthening governance and accountability.
03 VISION, GOAL AND TARGETS
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The strategy outlines a global vision, a global goal and a set of global targets, all of which are fully aligned with the vision, goal and targets of the multisectoral UNAIDS strategy and the Sustainable Development Goals.
VISION The vision: Zero new HIV infections, zero HIV-related deaths and zero HIV-related discrimination in a world where people living with HIV are able to live long and healthy lives.
GOAL The goal: To end the AIDS epidemic as a public health threat by 2030, within the context of ensuring healthy lives and promoting well-being for all at all ages.
GLOBAL TARGETS FOR 2020 Global targets: Countries have an opportunity to take a decisive leap towards ending their AIDS epidemics – if they act swiftly and with enough resolve to reach ambitious targets for 2020. These targets apply to everyone: children, adolescents and adults; rich and poor; women and men; and all key populations. Tracking new HIV infections is the leading indicator to measure progress towards the overall goal of ending the AIDS epidemic as a public health threat by 2030.
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HIV-related deaths: • reduce global HIV-related deaths to below 500 000; • reduce tuberculosis deaths among people living
Financial sustainability: • overall financial investments for the AIDS response
with HIV by 75%; • reduce hepatitis B and C deaths among people coinfected with HIV by 10%, in line with mortality targets for all people with chronic hepatitis B and C infection.
in low- and middle-income countries reach at least US$ 26 billion, with a continued increase from the current levels of domestic public sources; • ensure all countries have integrated essential HIV services into national health financing arrangements.
Innovation: • increase research into and development of HIV-related
Testing and treatment: • ensure that 90% of people living with HIV know
their HIV status; • ensure that 90% of people diagnosed with HIV receive antiretroviral therapy; • ensure that 90% of people living with HIV, and who are on treatment, achieve viral load suppression.
vaccines and medicines for use in treatment and prevention; • provision of access by 90% of countries to integrated health services covering HIV, tuberculosis, hepatitis B and C, reproductive health and sexually transmitted infections.
Prevention: • reduce new HIV infections to below 500 000; • zero new infections among infants.
Discrimination: • zero HIV-related discriminatory laws, regulations and
policies, and zero HIV-related discrimination in all settings, especially health settings; • 90% of people living with HIV and key populations report no discrimination in the health sector.
500 000* *GLOBAL TARGETS FOR 2020
REDUCE NEW HIV INFECTIONS TO BELOW
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05 – Demonstration of a female condom, Myanmar
COUNTRY TARGETS FOR 2020 Countries should develop, as soon as practicable, ambitious national goals and targets for 2020 and beyond, which ideally would be guided by global goals and targets. Such goals and targets should take into consideration the country context, including the nature and dynamics of country HIV epidemics, populations affected, structure and capacity of the health care and community systems, and resources that can be mobilized. Targets should be feasible and based on the best possible data available on the HIV situation, trends and responses, and monitored through a set of standard and measurable indicators. The targets should apply to everyone.
04 STRATEGIC DIRECTIONS AND PRIORITY ACTIONS
To achieve the 2020 and 2030 targets, action is required in five areas, referred to as “strategic directions”. Under each of the strategic directions, specific actions need to be taken by countries, WHO and partners. This strategy outlines the priority actions to be taken by countries and WHO. The proposed actions are intended to guide country efforts, with countries selecting and implementing those actions that are most appropriate to their HIV epidemics and country contexts, considering national jurisdictions and legislation. It aims to maximize the synergies between HIV and other health areas, and to align the health sector response with other global health and development strategies, plans and targets.
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STRATEGIC DIRECTIONS The five strategic directions that guide priority actions by countries and by WHO are presented below: Strategic direction 1: Information for focused action (know your epidemic and response). Strategic direction 2: Interventions for impact (covering the range of services needed). Strategic direction 3: Delivering for equity (covering the populations in need of services). Strategic direction 4: Financing for sustainability (covering the financial costs of services). Strategic direction 5: Innovation for acceleration (looking towards the future).
Figure 6. The five strategic directions of the global health sector strategy on HIV, 2016–2021
VISION, GOAL AND TARGETS
FRAMEWORKS FOR ACTION
Universal health coverage,the continuum of services; and, a public health approach.
The three dimensions of universal health coverage STRATEGIC DIRECTION 1 Information for focused action The “who” and “where” STRATEGIC DIRECTION 2 Interventions for impact The “what” STRATEGIC DIRECTION 3 Delivering for equity The “how” STRATEGIC DIRECTION 4 Financing for sustainability The financing STRATEGIC DIRECTION 5 Innovation for acceleration The future
STRATEGY IMPLEMENTATION
Leadership, Partnership, Accountability, Monitoring & Evaluation
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Each of the strategic directions addresses a specific set of questions: STRATEGIC DIRECTION 1 WHAT IS THE SITUATION? –
STRATEGIC DIRECTION 4 HOW CAN THE COSTS OF DELIVERING THE PACKAGE OF SERVICES BE COVERED? –
Focuses on the need to understand the HIV epidemic and response as a basis for advocacy, political commitment, national planning, resource mobilization and allocation, implementation, and programme improvement. STRATEGIC DIRECTION 2 WHAT SERVICES SHOULD BE DELIVERED? –
Addresses the third dimension of universal health coverage by identifying sustainable and innovative models for financing HIV responses, approaches for reducing costs and financial protection systems so that people can access the services they need without incurring financial hardship. STRATEGIC DIRECTION 5 HOW CAN THE TRAJECTORY OF THE RESPONSE BE CHANGED? –
Addresses the first dimension of universal health coverage by describing the essential package of high-impact interventions that need to be delivered along the continuum of HIV services to reach country and global targets, and which should be considered for inclusion in national health benefit packages. STRATEGIC DIRECTION 3 HOW CAN THESE SERVICES BE DELIVERED? –
Identifies those areas where there are major gaps in knowledge and technologies, where innovation is required to shift the trajectory of the HIV response so that actions can be accelerated and the 2020 and 2030 targets achieved.
Addresses the second dimension of universal health coverage by identifying the best methods and approaches for delivering the continuum of HIV services to different populations and in different locations, so as to achieve equity, maximize impact and ensure quality.
STRATEGIC DIRECTION 1: INFORMATION FOR FOCUSED ACTION Knowing your HIV epidemic and response in order to implement a tailored response The global HIV response has matured over the past 30 years, supported by unprecedented financial investments and public health and technical innovations. Nevertheless, major service gaps exist, inequities in access persist and resource constraints are becoming more pressing. The success of the next phase of the response will depend on more efficient, tailored and sustained action informed by country realities and quality data. High-quality “granular” data – disaggregated by sex, age and other population characteristics, across the different levels of the health care system – make it possible to focus HIV services more precisely and effectively, and to deploy or adapt services to reach greater numbers of people in need. Greater community and stakeholder involvement in collecting and analysing the data has the potential to improve the quality and effective use of the information. The rigorous application of ethical standards in gathering and using data is important so as not to compromise the confidentiality and safety of individuals and communities. With limited resources available, countries need to use these data to build strong investment cases, to argue for fair allocation of domestic resources and to mobilize external resources.
THE SUCCESS OF THE NEXT PHASE OF THE RESPONSE WILL DEPEND ON MORE EFFICIENT, TAILORED AND SUSTAINED ACTION INFORMED BY COUNTRY REALITIES AND QUALITY DATA.
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UNDERSTANDING THE EPIDEMIC AND THE RESPONSE – DATA FOR DECISIONS
A robust and flexible strategic information system is the cornerstone for advocacy, national strategic planning, and ensuring accountability for the best and fairest use of resources. Such HIV information systems must be integrated within the broader national health information system.
They are also the ones more likely to have limited access to critical HIV services. In many settings, some populations fall outside the routine HIV surveillance system, often because they are less likely to access health services. These include adolescents, men and mobile populations. Migration and population movements within and between countries can significantly influence the dynamics of local HIV epidemics, highlighting the importance of including mobile populations in national HIV strategies, plans, efforts and activities.
UNDERSTANDING THE EPIDEMIC – THE “WHO” AND THE “WHERE”
HIV information systems must be capable of: identifying the locations where and among whom new HIV infections are occurring; determining the major modes of HIV transmission and risk behaviours; estimating the size of populations at risk and affected; monitoring the health consequences of HIV epidemics, including common HIV coinfections and other comorbidities; and ascertaining the social, legal and economic conditions that increase the vulnerability of populations. In the most affected region, sub-Saharan Africa, adolescent girls and young women continue to experience the greatest burden of HIV, with HIV incidence and prevalence among young women more than twice as high as among young men. Those disproportionately affected by HIV epidemics in all regions, including in high-burden settings, have been identified as: men who have sex with men, people who inject drugs, sex workers, transgender people and prisoners.
MONITORING AND UNDERSTANDING THE RESPONSE
Monitoring and understanding the HIV response at country and global levels is critical for informing more strategic investments in HIV programmes, and for maximizing their effectiveness, responsiveness and cost–effectiveness. Quality data are required to measure service access, service uptake, populations covered, quality and acceptability along the entire continuum of HIV services. This ensures that gaps and deficiencies are identified, which in turn ensures that remedial actions can be implemented. With the aim of gauging the health sector response along the continuum of HIV services, WHO guidelines recommends for countries to consider the adoption of 50 national indicators where appropriate, of which 10 are identified for global monitoring (see Figure 7).
Figure 7. Key indicators for monitoring the HIV response across the continuum of HIV services and including the HIV care cascade KNOW YOUR EPIDEMIC Epidemic pattern by key population, age, sex and geography
INPUTS Health system inputs and financing
OUTPUTS AND OUTCOMES HIV services continuum
EVALUATE IMPACT Reduce incidence, deaths and inequities Assess outcomes at all stages of the cascade CHRONIC CARE
PREVENTION
TESTING
LINK TO CARE
TREATMENT
1) PEOPLE WITH HIV Number and % of people living with HIV (PLHIV)
2) DOMESTIC FINANCE % of HIV response financed domestically
3) PREVENTION OF KEY POPULATIONS % of condom use among key populations or needles per PWID
4) KNOWING HIV STATUS % of PLHIV who have been diagnosed
5) LINKAGE TO CARE Number and % in HIV care (including ART)
6) CURRENTLY ON ART % on ART
8) VIRAL SUPPRESSION % on ART virally suppressed
9) HIV DEATHS Number and ratio of HIVrelated deaths
7) ART RETENTION % retained and surviving on ART “ART” refers to antiretroviral therapy – “PWID” refers to people who inject drugs
10) NEW INFECTIONS Number and % of new HIV infections
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INFORMATION FOR ACTION FAST-TRACK ACTIONS FOR COUNTRIES Build a comprehensive strategic information system to provide quality and timely data, using standardized indicators and methodologies, guided by WHO and UNAIDS guidelines. Increase the “granularity” of data, appropriately disaggregated to the district, community and facility levels by age, sex, population and location to better understand subnational epidemics, assess performance along the continuum of HIV services and guide more focused investments and services. ink and integrate HIV strategic information L systems with broader health information systems and identify opportunities for integrated strategic information platforms. FAST-TRACK ACTIONS FOR WHO Provide global leadership, in cooperation with UNAIDS, in HIV surveillance and monitoring the health sector response. et standards and provide updated guidance and S operational tools for data collection, analysis and reporting, including the WHO and UNAIDS guidelines for second generation HIV surveillance and the WHO consolidated strategic information guidelines. Provide technical support to countries for the adaptation and implementation of WHO and UNAIDS HIV strategic information guidelines and tools for strengthening national, district and facility data systems. Support the analysis of health services cascades in key countries to guide quality improvement. Report annually on the health sector response to HIV and progress towards the 2020 and 2030 HIV targets.
GOVERNANCE, NATIONAL STRATEGIC PLANNING AND ACCOUNTABILITY
GOVERNANCE AND ACCOUNTABILITY FAST-TRACK ACTIONS FOR COUNTRIES eview and, where necessary, reform national HIV R governance structures to ensure that HIV is “taken out of isolation” by promoting appropriate linkages and integration of HIV services within the broader national health programme and coordinating the HIV response across relevant sectors. Set national targets and milestones for 2020 and 2030, based on global targets for eliminating AIDS as a public health threat. Review and update the national HIV strategy to reflect the new national HIV targets and priorities and develop a costed implementation plan to operationalize the strategy. Strengthen programme accountability by regularly reporting on national HIV programme implementation, financing, performance and impact, including progress towards the 2020 and 2030 targets. FAST-TRACK ACTIONS FOR WHO Develop and update guidance on national HIV strategic planning, prioritization and costing, with a focus on achieving 2020 and 2030 targets. Provide technical support to countries to undertake regular HIV programme and impact reviews to monitor progress towards national and global HIV targets and to improve country implementation.
National HIV governing structures, such as national HIV programmes, HIV commissions and country coordination mechanisms, play a critical role in advocating for an effective response, national strategic planning and resource allocation, promoting policy coherence, coordinating roles and actions across different stakeholders, aligning the HIV response with broader health programmes and ensuring that an enabling environment is in place. National government leadership is essential for achieving coherence and coordination, although the importance of decentralized decision-making, where appropriate, should also be recognized. Data generated from the national HIV strategic information system are critical for informing the national HIV strategy and implementation plan and other HIV-related efforts and activities. The strategy should define national targets that are aligned with global targets and actions required to reach these targets. The strategy should outline critical policy, legal and structural measures that need to be taken to enable and enhance the HIV response. The linkages need to be clearly shown between the HIV health strategy and other related strategies, including: sectoral HIV strategies; other relevant strategies specific to diseases and risk factors, such as those for tuberculosis and sexual and reproductive health; and broader national health and development strategies.
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STRATEGIC DIRECTION 2: INTERVENTIONS FOR IMPACT People should receive the full range of HIV services they need Achievement of the prevention, testing and treatment targets for 2020 requires a robust health system that is able to engage and retain people along the entire continuum of HIV prevention and care services. It must ensure that people: can access effective HIV prevention services; are tested, receive and understand their HIV diagnosis; are referred to appropriate HIV prevention services or enrolled in care; are initiated early on antiretroviral therapy if diagnosed HIV positive; are retained on effective treatment to achieve sustained viral suppression; are moved to alternative antiretroviral regimens if treatment fails; and can access chronic and palliative care, including prevention and management of major coinfections and other comorbidities. DEFINING AN ESSENTIAL BENEFIT PACKAGE FOR HIV
Each country should review its package of essential HIV services in light of changing epidemics, new knowledge and innovations, and define a set of essential HIV interventions, services, medicines and commodities to be included in its national health benefit package. The benefit package should be covered in whole, or in part, through public funding so as to minimize out-ofpocket payments, ensure access to services for all who need them and cover the entire continuum of HIV services. Selection of essential interventions and services should be through a transparent process, involving key stakeholders, considering the following criteria: effectiveness, cost, cost– effectiveness, acceptability, feasibility, relevance, demand and ethics. The package should be regularly reviewed to ensure that the selected interventions reflect changes in the country epidemic and context, advances in technologies and service delivery approaches and evidence of impact or harm. Combinations of interventions should be specifically considered, recognizing that some interventions will only be effective, or achieve maximum impact, if they are delivered in combination with other interventions. WHO guidelines make recommendations on the selection and use of interventions along the full continuum of HIV services, summarize the evidence of effectiveness of different interventions and services, and provide guidance on how such interventions might be applied in different contexts.
07 – Volunteer at a prison needleexchange programme, Moldova.
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THE HIV PREVENTION LANDSCAPE IS CHANGING DRAMATICALLY AND RAPIDLY WITH THE INTRODUCTION OF NEW TECHNOLOGIES AND APPROACHES
and rapidly with the introduction of new technologies and approaches, most notably the use of antiretroviral drugs to prevent HIV transmission and acquisition. Combination HIV prevention will continue to rely on long-standing and highly effective interventions, including male and female condoms, behaviour change communication, harm reduction for people who use drugs and universal precautions in health care settings. However, even if these interventions were widely accepted and taken to scale, the world would still fall short of the 2020 target. The strategic use of antiretroviral drugs and the expansion of voluntary medical male circumcision for HIV prevention have the potential to change the course of the HIV response. To achieve the prevention target HIV prevention programmes will require a focused and combination approach, using high-impact interventions to reduce vulnerability and prevent sexual transmission, transmission through injecting drug use, transmission in health care settings, and mother-to-child transmission. The following high-impact interventions should be included in a comprehensive HIV prevention package: Male and female condoms and lubricants: Despite their effectiveness and their central role in the prevention of HIV and other sexually transmitted infections, the acceptability and uptake of these interventions remain low. Opportunities to realize the potential of such critical interventions include: reducing the cost of female condoms; revitalizing condom marketing approaches; and expanding distribution through diverse services and marketing outlets. Harm reduction for people who inject drugs: The comprehensive package of harm reduction interventions is defined in the WHO Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations.13,14 Sterile needle and syringe programmes, opioid substitution therapy for opioid users, and risk reduction communication are highimpact interventions within this broader harm reduction package. Needle and syringe programmes substantially and cost-effectively reduce HIV transmission among people who inject drugs. Opioid substitution therapy is highly effective in reducing injecting behaviours that put opioid-dependent people at risk of HIV infection. These services need to reach high coverage to have a public health impact. Special attention is required for cocaine and amphetamine-type stimulant users, for which opioid substitution therapy is not effective, and for non-injecting drug users where sexual transmission risk may be high.
REDUCING HIV VULNERABILITY AND HIV TRANSMISSION AND ACQUISITION
Reducing new HIV infections by 75% by the end of 2020 as compared with 2010 will require major reductions in vulnerability and risk behaviour, new approaches to delivering effective prevention interventions to those who need them, and new prevention technologies. Some populations are particularly vulnerable to HIV infection because of their high exposure to HIV and/ or their inability to avoid risks or to use effective HIV prevention interventions. As mentioned, factors that increase HIV vulnerability in certain locations and populations, notably among girls and young women in sub-Saharan Africa, include gender inequality, gender-based and sexual violence, and stigmatization and discrimination. For other populations, vulnerability may be associated with their living conditions, such as men living in remote mining communities and in detention or with their inability to access services, such as migrants and displaced populations. Evidence-based and comprehensive prevention frameworks are most effective when there is a strategic combination of behavioural, biomedical and structural approaches that includes primary prevention methods that reach HIVnegative people and a focus on working with people living with HIV as important partners in prevention by placing an emphasis on positive health, dignity and prevention. The HIV prevention landscape is changing dramatically
13 Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations, see http://www.who.int/hiv/pub/ guidelines/keypopulations/en/ (accessed 18 March 2016). 14 WHO’s comprehensive package for the prevention, treatment and care of HIV among people who inject drugs includes the following interventions: needle and syringe programmes; opioid substitution therapy and other drug dependence treatment; HIV testing and counselling; antiretroviral therapy; prevention and treatment of sexually transmitted infections; condom programmes for people who inject drugs and their sexual partners; targeted information, education and communication for people who inject drugs and their sexual partners; vaccination, diagnosis and treatment of viral hepatitis; prevention, diagnosis and treatment of tuberculosis; and prevention and management of overdose.
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Antiretroviral-based prevention : Antiretroviral drugs have great potential to prevent HIV transmission and acquisition, including through pre-exposure prophylaxis and post-exposure prophylaxis, by preventing mother-tochild transmission, and through antiretroviral therapy that achieves viral suppression. Pre-exposure prophylaxis should be considered as an additional, powerful HIV prevention tool for individuals who are at high risk of HIV acquisition; post-exposure prophylaxis should be made available for people who have had a significant exposure to HIV. Guidance on the use of pre-exposure prophylaxis, post-exposure prophylaxis and antiretroviral therapy for HIV prevention is provided in the WHO Consolidated guidelines on the use of antiretroviral therapy for treating and preventing HIV infection.15 Countries should establish appropriate criteria for risk assessment, develop models of service delivery and decide on the most strategic combination of antiretroviral and other prevention approaches based on their country context. Particular attention should be given to testing for HIV before people start pre-exposure prophylaxis in order to minimize the risk of the emergence of HIV drug resistance. HIV drug-resistance surveillance should be extended to cover pre-exposure prophylaxis services if they are introduced. Prevention of HIV infection in infants: In 2014, only 62% of the estimated 1.5 million pregnant women living with HIV received antiretroviral therapy through “Option B+”. Although elimination of mother-to-child transmission is feasible, HIV transmission rates remain unacceptably high – in excess of 10% in many countries. Since 2011, the Global Plan: towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive16 has helped accelerate elimination efforts. Similarly, countries are increasingly active in working towards the elimination of congenital syphilis in infants. Despite gains, achievement of the dual elimination target for 2020 will require intensified efforts for many countries. Critical elements of this elimination strategy are lifelong antiretroviral therapy for all pregnant and breastfeeding women living with HIV; early infant diagnosis; and infant prophylaxis and treatment.
Voluntary medical male circumcision: It is estimated that, in high HIV-prevalence countries in sub-Saharan Africa, circumcising 80% of men aged 15–49 years who have not already been circumcised would prevent 3.3 million HIV infections by 2025, generating savings of US$ 16 500 million. To achieve this coverage, accelerated scale-up is needed through innovative approaches, such as the use of safe male circumcision devices that enable the procedure to be performed by mid-level health care workers, and targeted campaigns to increase demand for circumcision among populations with low circumcision rates and significant exposure to HIV. Injection and blood safety: Although reliable data are lacking, it is likely that unsafe medical injections and blood transfusions account for significant numbers of new HIV infections. Safe medical injections and blood supplies, along with universal precautions, are central to a well-functioning health system. The launch of the WHO injection safety policy in 2015 has focused greater attention on the issue and promotes a transition to the use of safetyengineered injection devices for therapeutic injections and vaccinations that prevent reuse and sharps injuries. Behaviour change interventions: A range of behavioural interventions can provide information and skills that support primary prevention and risk reduction, address factors that increase risk behaviours, promote transitions to less risky behaviours, prevent HIV transmission, and increase the uptake of effective prevention services. Behaviour change messages and communication approaches can have the desired impact if they are targeted, specific to particular population groups and settings, and linked to increased access to prevention commodities, such as condoms and sterile injecting equipment. Adolescent girls and young women in sub-Saharan Africa require specific attention, given their vulnerability and the very high HIV incidence witnessed in some communities. Prevention and management of gender-based and sexual violence: It is widely recognized that women and girls are particularly vulnerable to gender-based and sexual violence; however, boys, men and transgender people are also vulnerable. Structural interventions, such as addressing gender inequities and antisocial behaviour, harmful use of alcohol and other major risk factors, are required to prevent violence. The health sector also has an important role in providing care to those who have experienced such violence, including post-rape care and provision of post-exposure prophylaxis.
15 Consolidated guidelines on the use of antiretroviral therapy for treating and preventing HIV infection, see http://www.who.int/hiv/ pub/guidelines/en/ (accessed 18 March 2016). 16 Global Plan: towards the elimination of new HIV infections among children and keeping their mothers alive, see http://www.unaids. org/en/resources/documents/2011/20110609_JC2137_Global-Plan-Elimination-HIV-Children_en.pdf (accessed 22 March 2016).
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HIV PREVENTION FAST-TRACK ACTIONS FOR COUNTRIES Prioritize high-impact prevention interventions, including for male and female condom programming, injection and blood safety, and behaviour change communication. Maximize the prevention benefits of antiretroviral drugs by scaling up antiretroviral therapy coverage for all people living with HIV and implementing a strategic combination of pre-exposure prophylaxis and post-exposure prophylaxis with other prevention interventions. Eliminate HIV and congenital syphilis in infants by setting national targets and providing lifelong antiretroviral therapy for pregnant and breastfeeding women, expanding early infant diagnosis and providing immediate antiretroviral therapy for all infants diagnosed with HIV. mplement, to scale, a comprehensive package I of harm reduction interventions tailored to and appropriate for the local drug-using patterns and country context. Priority should be given to the highimpact interventions, where appropriate, including the provision of sterile injecting equipment, opioid substitution therapy, risk reduction information and drug dependence treatment. rioritize combination HIV prevention to P adolescents, girls and young women, and male sexual partners, particularly in high-burden settings in sub-Saharan Africa, using interventions that aim to reduce both vulnerability and risk behaviours, including gender-based and sexual violence and sexual risk behaviour associated with alcohol and other drug use. FAST-TRACK ACTIONS FOR WHO Advocate for and support expansion of new prevention technologies and approaches in the context of combination prevention, including implementation of early antiretroviral therapy, pre-exposure prophylaxis and post-exposure prophylaxis, and, in priority countries, voluntary medical male circumcision. Provide guidance on combination HIV prevention, rapidly integrating new, evidence-based health sector interventions into HIV prevention packages for different epidemic contexts, with particular attention to female and male adolescents, girls, women and key populations (including young key populations). upport increased commitment, resources and S actions to eliminate HIV infections in children, working in cooperation with UNICEF. Validate the elimination of mother-to-child transmission of HIV and syphilis in countries. Reinforce country implementation of WHO standards and policies on existing prevention interventions, including quality male and female condom and lubricant programmes, and injection and blood safety.
08 – HIV prevention counselling with men who have sex with men, Indonesia.
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EXPANDING HIV TESTING
Achieving the target of 90% of people with HIV knowing their HIV status by 2020 will demand wider use of effective and new HIV testing approaches, strategies and technologies, while at the same time ensuring the quality of testing and ethical testing practices. Testing services need to target those populations, settings and locations where HIV risk and transmission is highest. Testing should be consensual, confidential and accompanied by appropriate information and counselling. HIV testing is the first step in enabling people with HIV to know their HIV status and to be linked to HIV prevention, treatment and care services. Late diagnosis can compromise efforts to ensure long-term effectiveness of treatment and lessen the potential impact on prevention. It is estimated that, globally, about half of people living with HIV currently do not know their HIV status. HIV testing also offers an opportunity, in parallel, to screen for other infections and health conditions, including sexually transmitted infections, tuberculosis and viral hepatitis, which is likely to contribute significantly to reducing comorbidity and mortality. Early diagnosis of HIV in infants born to women living with HIV is critical to ensure the timely initiation of life-saving antiretroviral therapy, and yet, in 2013, fewer than 50% of exposed infants were tested.
Selection of the most appropriate combination of HIV testing approaches and strategies will depend on HIV epidemic dynamics, the populations affected and the local health system. New and targeted approaches provide opportunities to rapidly expand the coverage, quality and yield of testing services, for example, the routine offer of testing to all key populations in primary care and clinical settings including tuberculosis services, couples testing, community-based testing, self-testing and the use of lay testers, along with testing technologies that may be used at point-of-care. When resources are limited, testing should be targeted where yields will be greatest while maintaining equity. Expanding testing coverage requires specific attention to ensuring the quality of the diagnostics and testing services to minimize the risk of misdiagnosis of HIV status. Comprehensive guidance on HIV testing approaches and strategies is presented in the WHO Consolidated guidelines on HIV testing services.
HIV TESTING FAST-TRACK ACTIONS FOR COUNTRIES iversify testing approaches and services by combining provider-initiated and community-based testing, D promoting decentralization of services and utilizing HIV testing services to test for other infections and health conditions. Focus testing services to reach populations and settings where the HIV burden is greatest and to achieve equity. Prioritize the expanded coverage of early infant diagnosis technologies. Ensure that HIV testing services meet ethical and quality standards. FAST-TRACK ACTIONS FOR WHO Regularly update consolidated guidance on HIV testing and testing for common coinfections, rapidly integrating guidance on new testing approaches, strategies and diagnostics. Support countries to implement quality assurance programmes for testing, guided by data on misdiagnosis and misclassification. Support expansion of paediatric HIV testing through updated guidance and technical support to countries, including early infant diagnosis and testing in low-prevalence settings.
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EXPANDING ANTIRETROVIRAL THERAPY, MANAGING COMORBIDITIES AND PROVIDING CHRONIC CARE
The target of having 90% of people with HIV on antiretroviral therapy by 2020 will require acceleration in the scale-up of antiretroviral therapy and improved retention in care. Achievement of the target of viral suppression of 90% of people on antiretroviral therapy will require major improvements in treatment adherence, robust and well-tolerated antiretroviral therapy regimens and effective HIV drug-resistance surveillance and toxicity monitoring systems to minimize treatment failure. WHO guidelines on the use of antiretroviral drugs provide a means of achieving the 90% coverage target and help simplify treatment initiation protocols by recommending that anyone diagnosed with HIV should begin antiretroviral therapy as soon as possible following diagnosis. Countries should develop national treatment plans that provide a road map for expanding access to antiretroviral therapy through differentiated care that ensures rapid and equitable access to treatment, particularly for people at an advanced stage of HIV-related disease. The global target of having 15 million people on treatment was achieved in early 2015. Nevertheless, this represents only about 40% of people living with HIV, all of whom should have access to treatment. The situation is particularly poor for children living with HIV, only 32% of whom were receiving antiretroviral therapy in 2014. Similarly, people from key populations tend to have very poor access to antiretroviral therapy. In addition, as more asymptomatic people are treated with antiretroviral drugs, viral load testing to assess treatment effectiveness and prevent the emergence of HIV drug resistance will be important. HIV drug resistance surveillance at the population level is essential for monitoring the quality of treatment programmes and the selection of treatment regimens. Access to second- and third-line antiretroviral therapy regimens continues to be severely limited in most low- and middle-income countries, highlighting the importance of preventing first-line treatment failure. As coverage of antiretroviral therapy expands, people living with HIV are also experiencing a broad range of other health issues, including those related to HIV infection and HIV treatment, non-HIV-related coinfections and comorbidities, and ageing – all of which require comprehensive care and management.
Expand antiretroviral therapy coverage: Safe, simple, affordable and well-tolerated first-line antiretroviral regimens, using one tablet a day fixed-dose combinations, enable rapid and sustainable scale-up of antiretroviral therapy for adults. Continuous assessment of evidence on treatment efficacy and toxicity, with regular updates of WHO consolidated antiretroviral guidelines will ensure that the latest scientific evidence, new medicines and technologies, and country experiences in treatment scale-up can inform national treatment guidelines and protocols. The lack of early infant diagnosis, fixed-dose antiretroviral combinations and palatable antiretroviral formulations pose particular barriers to paediatric treatment scale-up. To maximize treatment outcomes, antiretroviral therapy should be started as early as possible for both adults and children, highlighting the need for early diagnosis and effective linkages to treatment for those testing HIV positive. Prevent and manage HIV and tuberculosis coinfection: Effective tuberculosis and HIV co-management has resulted in a decline in the number of people dying from HIV-associated tuberculosis by a third between 2004 and 2014. However, tuberculosis continues to be the major cause of morbidity among people living with HIV and is estimated to account for around a third of HIV-related deaths. More than half of the cases of HIV-associated tuberculosis are undetected, undermining access to lifesaving antiretroviral therapy. Intensified implementation and uptake of key interventions, including systematic tuberculosis screening among people living with HIV, isoniazid preventive therapy, as well as HIV testing of all people with diagnosed or presumed tuberculosis, timely initiation of antiretroviral therapy, and co-trimoxazole prophylaxis, will be required to further reduce tuberculosis-related morbidity and mortality. Prevent and manage HIV and viral hepatitis coinfection: Chronic hepatitis B infection and chronic hepatitis C infection are growing causes of morbidity and mortality among people living with HIV in a range of countries. HIV and hepatitis C virus coinfection rates are highest among people who inject drugs, affecting all regions. HIV has a profound impact on hepatitis B virus and hepatitis C virus infection, resulting in higher rates of chronic hepatitis infection, accelerated fibrosis progression with increased risk of cirrhosis and hepatocellular carcinoma, and higher liver-related mortality. Integrated management of HIV and viral hepatitis infection should be provided, with early diagnosis and treatment of both HIV infection and viral hepatitis infection based on WHO guidelines on HIV, hepatitis B virus and hepatitis C virus treatment.
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Address other HIV coinfections : The prevalence and impact of other coinfections, both opportunistic and non-opportunistic, among people living with HIV varies by country and population, requiring tailored responses. If not addressed, they have the potential to compromise gains made through the expansion of antiretroviral therapy. Prevention, early detection and treatment of common coinfections, such as candidiasis, cryptococcus, human papilloma virus and other sexually transmitted infections, malaria and Pneumocystis pneumonia require specific attention. Prevent and manage HIV drug resistance: Preventing and managing the emergence of HIV drug resistance will be crucial as the world moves towards wider and earlier use of HIV medicines for both HIV treatment and prevention. Addressing HIV drug resistance is critical for achieving viral suppression, addressing treatment failure, and preventing the need to move to more expensive and toxic second- and third-line antiretroviral therapy regimens. HIV drug-resistance surveillance and monitoring of early warning indicators should be integrated into national HIV treatment services, quality improvement efforts and broader health information systems, including those for antimicrobial resistance.
Provide person-centred chronic care for people living with HIV: Simple and effective care interventions can improve the general health and well-being of people living with HIV, including factors such as adequate nutrition, access to safe water and sanitation, and palliative care. People living with HIV are at increased risk of developing a range of noncommunicable diseases as a consequence of their HIV infection or related to side-effects of their treatment or ageing, including cardiovascular disease, diabetes, chronic lung disease and various cancers. Common mental health comorbidities include depression, anxiety, dementia and other cognitive disorders. Chronic HIV care services should include interventions across the continuum of care, including screening for, monitoring and managing the most common health risks and comorbidities experienced by people living with HIV. The increasing burden of cervical cancer among women living with HIV, associated with human papillomavirus infection, requires specific attention, particularly given the availability of effective human papillomavirus vaccine, screening and treatment. Effective pain management, palliative care and end-of-life care are also essential interventions to be included in HIV services.
TREATMENT AND CARE FAST-TRACK ACTIONS FOR COUNTRIES Regularly review and update national HIV treatment and care guidelines and protocols, including guidance on the prevention and management of common comorbidities. evelop and update treatment plans to ensure continuity of treatment, differentiated care, as well as D timely transitioning from old to new treatment regimens and approaches. Implement strategies to minimize HIV drug resistance and use the data to inform national antiretroviral policies and guidelines. Provide general and chronic care services, make available the WHO Package of essential noncommunicable disease interventions for primary care,17 provide community and home-based care, and ensure access to opioid medicines for the management of pain and end-of-life care. FAST-TRACK ACTIONS FOR WHO Review and report on the major causes of, and trends in, morbidity and mortality among people living with HIV, disaggregated by geographic region, population and gender. Provide updated consolidated guidelines on the use of antiretroviral drugs for HIV treatment and prevention and the prevention and management of common comorbidities that will guide rapid and sustainable treatment scale-up to all people living with HIV. Provide guidance on differentiated care for people presenting at different stages of HIV infection and disease. rovide assistance to countries to develop and implement national HIV treatment guidelines, plans and P protocols based on the WHO global guidelines. Provide guidance on HIV drug resistance surveillance, prevention and management and regularly report on global HIV drug-resistance prevalence and trends.
17 Package of essential noncommunicable (PEN) disease interventions for primary health care in low-resource settings, see http://www.who.int/cardiovascular_diseases/publications/pen2010/en/ (22 March 2016).
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STRATEGIC DIRECTION 3: DELIVERY FOR EQUITY All people should receive the services they need, which are of sufficient quality to have an impact Achievement of the 2020 HIV targets will require a robust and flexible health system that includes: a strong health information system; efficient service delivery models; a sufficient and well-trained workforce; reliable access to essential medical products and technologies; adequate health financing; and strong leadership and governance. HIV interventions are most effective when they occur in appropriate social, legal, policy and institutional environments that encourage and enable people to access and use services, which, in themselves, are free of stigmatization and discrimination. Such interventions therefore need to be grounded in an enabling environment that promotes health equity and human rights, and that features well-supported health and community systems. HIV is an area of public health in which major inequities exist in terms of vulnerability and risk, service access, and health and social outcomes. Countries need to strike a balance between focusing their HIV responses for maximum impact and ensuring that no one is left behind, particularly children and adolescents, girls and women, key populations, and people living in remote areas. Priority should be given to reaching populations and locations in greatest need and overcoming major inequities.
COUNTRIES NEED TO STRIKE A BALANCE BETWEEN FOCUSING THEIR HIV RESPONSES FOR MAXIMUM IMPACT AND ENSURING THAT NO ONE IS LEFT BEHIND
ADAPTING THE HIV SERVICES CONTINUUM FOR DIFFERENT POPULATIONS AND LOCATIONS
HIV interventions and the continuum of HIV services need to be adapted for different populations and locations, to reach those most affected and to ensure that no one is left behind. WHO guidelines, and implementation tools developed with partners, define essential packages of HIV interventions and service delivery models for different populations and settings, including specific packages for adolescents, women and girls, people who use drugs, sex workers, men who have sex with men, transgender people and prisoners. Decentralization: Different levels of the health system have different roles to play in delivering HIV and related services. The strategic decentralization, integration and linking of services provide opportunities to increase access, coverage, acceptability and quality. Decentralizing services can strengthen community engagement and may improve access to services, care-seeking behaviour and retention in care.
Differentiated care: As national guidelines evolve towards providing antiretroviral therapy to all people with HIV regardless of clinical and immunological status, HIV services will be challenged to manage an increasing number of patients on treatment and an increasingly diverse set of patient needs. Differentiated care involves the provision of different care packages to patients on antiretroviral therapy based on the stage of their HIV disease, their stability on treatment and their specific care needs. Patients who are stable on treatment, for example, may be moved to community-based care, enabling overburdened clinical care settings to focus on patients who are unwell either because they are unstable on antiretroviral therapy or because they present to the clinic with an advanced stage of HIV disease or major comorbidities.
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Person-centred and integrated care: People living with HIV and affected communities experience a broad range of health risks and problems; therefore, HIV and related services need to identify and deliver appropriate interventions in order to address commonly occurring conditions. With the effectiveness of antiretroviral therapy and ageing populations of people living with HIV, HIV services will need to evolve to provide comprehensive chronic care that includes the management of noncommunicable diseases. Greater integration, linking and coordination of HIV services with those for other relevant health areas (including for sexually transmitted infections, broader sexual and reproductive health, substance use disorders, hepatitis, tuberculosis, blood safety, noncommunicable diseases and genderbased violence) has the potential to reduce costs, improve efficiencies and lead to better outcomes. Appropriate models of integration and linkage will depend on the country context and health system, and should be informed by operational research. Joint planning should occur for cross-cutting areas such as health information systems and monitoring and evaluation, laboratory and diagnostic services, human resource planning and capacity building, procurement and supply chain management, and resource mobilization. Linking HIV and tuberculosis services: The strategic linking and integration of HIV and tuberculosis services and programmes provide a good model for integration. WHO guidelines for national programmes on collaborative tuberculosis and HIV activities identify 12 collaborative activities for implementation to integrate tuberculosis and HIV services. Uptake of indicators from the WHO publication, A guide to monitoring and evaluation for collaborative TB/ HIV activities (2015 revision),18 helps countries identify and reduce weak linkages within the care cascade. The introduction of electronic reporting and web-based systems with unique patient identifiers to be used by both programmes can facilitate smooth interoperability and enhanced patient follow-up. Community engagement and community-based services: The meaningful involvement of the community, particularly people living with HIV, is essential for the delivery of effective HIV and broader health services, especially in settings and among populations affected by stigmatization, discrimination and marginalization. Engagement of communities at all levels bolsters advocacy efforts, policy coherence and programme coordination, strengthens accountability and can address factors that affect access, uptake, performance and outcomes of HIV responses. Community organizations and networks play
a key role in delivering services to people who are not reached by government services, generating strategic information that might not be available through national HIV information systems and promoting and protecting human rights. Developing community capacities through adequate training and supervision helps improve the quality of community-based services and programmes. National HIV programmes should facilitate predictable funding of community organizations and adequate remuneration for services provided. Addressing the needs of special settings: There are specific settings where HIV vulnerability and risk are high and where access to basic HIV services might be severely compromised, such as in prisons and detention centres, refugee camps and settings of humanitarian concern. Services provided to individuals in such settings should be equivalent to those available to the broader community. Particular challenges exist for mobile and displaced populations, including those affected by conflict, natural disasters and economic migration. Members of such population groups are dislocated from their communities, support networks and regular health services, the effect of which may be interruptions in the continuity of their prevention, treatment and care. For example, they may not be able to access or utilize local HIV and other health services because of lack of necessary documentation or high costs of the services with no form of financial protection, such as health insurance. Ensuring the quality of interventions and services: Rapid expansion of programmes to improve coverage should neither compromise the quality of services nor contribute to inequities in access to services and health outcomes. Countries should monitor the integrity of their continuum of HIV services to determine where improvements can be made. Services should be organized to minimize “leakages” and maximize retention and adherence. Major challenges include: acceptability and uptake of effective prevention interventions; targeting HIV testing and counselling to achieve greatest yield; ensuring quality of testing to minimize incorrect diagnosis; linking people diagnosed to appropriate prevention and treatment services as early as possible; ensuring adherence to and continuity of treatment; providing chronic care to prevent and manage comorbidities, including tuberculosis and viral hepatitis; and monitoring treatment outcomes, including antiretroviral toxicity and viral suppression in order to ensure timely switching to second- and thirdline treatment and to prevent the emergence of HIV drug resistance.
18 A guide to monitoring and evaluation for collaborative TB/HIV activities: 2015 revision, see http://www.who.int/tb/publications/monitoring-evaluation-collaborative-tb-hiv/en/ (accessed 22 March 2016).
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Quality of care can be optimized by ensuring that HIV services, including testing and laboratory services adhere to national and international norms and standards, are continuously monitored and improved, and are made more acceptable and accessible to patients’ needs and preferences. Indicators and mechanisms for monitoring the quality of services should address such issues as waiting lists, facility waiting times, frequency of visits, and competencies and supervision of health care workers. Ultimately, the quality of HIV interventions must be measured by their ability to improve people’s health and well-being.
ADAPTING SERVICES FAST-TRACK ACTIONS FOR COUNTRIES Set national norms and standards across the HIV service continuum based on international guidelines and other standards and monitor their implementation. Define and implement tailored HIV intervention packages for specific populations and locations, ensuring services are relevant, acceptable and accessible to populations most affected. Provide differentiated care by providing tailored intervention packages to individuals at different stages of HIV disease and with different treatment needs. Adapt service delivery models to strengthen integration and linkages with other health areas and to achieve equity, with a particular focus on reaching adolescents, young women, men and key populations. Enable effective engagement of and capacity building of communities and ensure that legal and regulatory frameworks facilitate stronger collaboration and partnerships with community groups and between the public and private sectors. Integrate HIV into national emergency plans to ensure the continuity of essential HIV services during emergencies and in settings of humanitarian concern, with a particular focus on preventing treatment interruptions. Provide training to essential emergency and health service staff based on the Inter-Agency Standing Committee Task Force on HIV/AIDS in Emergency Setting’s Guidelines for HIV/AIDS interventions in emergency settings.19 Provide equitable services in closed settings, including implementing the comprehensive package of HIV interventions for prisoners and prison settings as developed by WHO and the United Nations Office on Drugs and Crime. FAST-TRACK ACTIONS FOR WHO Provide updated guidance on essential HIV packages, differentiated care and service delivery models for specific populations and specific settings, including for adolescents, mobile populations, populations in humanitarian settings (WHO in cooperation with UNHCR). Prisoners (WHO in cooperation with the United Nations Office on Drugs and Crime) and key populations. Support countries in their effort to adapt their HIV services continuum, based on an analysis of their situation, with a particular focus on improving treatment adherence and retention in care. Provide technical support to countries for implementing the WHO policy on collaborative TB/HIV activities20 and A guide to monitoring and evaluation for collaborative TB/HIV activities.21 Provide guidance on community-based services and community engagement and involve civil society in the development and implementation of WHO policies and guidance. Provide technical assistance to countries and partners to undertake timely health needs assessments in settings of humanitarian concern and among fragile communities.
19 Guidelines for HIV/AIDS interventions in emergency settings, see http://www.who.int/3by5/publications/documents/en/iasc_ guidelines.pdf (accessed 22 March 2016). 20 WHO policy on collaborative TB/HIV activities: guidelines for national programmes and other stakeholders, see http://apps.who.int/ iris/bitstream/10665/44789/1/9789241503006_eng.pdf?ua=1 (accessed 22 March 2016).). 21 A guide to monitoring and evaluation for collaborative TB/HIV activities, see http://www.unaids.org/sites/default/files/media_ asset/2015_guide_monitoring_evaluation_collaborative_TB-HIV_activities_en.pdf (accessed 22 March 2016).).
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STRENGTHENING HUMAN RESOURCES FOR HEALTH
The expansion of HIV services to achieve the HIV targets for 2020 and 2030 will place unprecedented demands on the health workforce. Different cadres of health care workers will be required to perform different roles across the full continuum of HIV services. New models of service delivery for meeting more ambitious targets will require strengthening the health workforce, reviewing the roles and tasks of health workers and their deployment across different services. In addition to the provision of routine HIV services, there will be an increasing need for health workers to be competent in delivering services to specific populations, including key populations, and in providing chronic care for people living with HIV. A comprehensive national health workforce plan should address the needs of the overall health system, along with what is required to deliver the full HIV service continuum.
Task-shifting is increasingly being used as part of broader human resources reforms to improve service accessibility, efficiency and quality. Such approaches have already enabled rapid scale-up of HIV testing, treatment and other services in low-resource settings and will play an increasingly important role in expanding the capacity of health care systems. Within the context of task-shifting and task-sharing, supportive mechanisms need to be put in place, including mentoring and supervision, to ensure the quality of services. Peer-support workers can provide valuable services and can help link the community and health services, and in turn should receive regular training, mentoring, supervision and appropriate compensation for their work. Given the risk of HIV transmission in health care settings, health workers should be protected by comprehensive occupational health and safety programmes, which promote universal precautions, access to prevention commodities such as condoms, post-exposure prophylaxis following significant exposure to HIV, confidential HIV testing, and treatment and care for health workers living with HIV.
HUMAN RESOURCES FAST-TRACK ACTIONS FOR COUNTRIES Develop, monitor implementation and regularly update a national HIV health workforce plan that is part of a broader health workforce plan, and aligned with the national health plan and priorities. Develop the capacity of the health workforce by defining core competencies for different roles in the provision of comprehensive HIV services, providing relevant training and introducing appropriate accreditation and certification processes. Identify opportunities for task-shifting to extend the capacity of the health workforce, and apply an appropriate training system and regulatory framework including for community health workers. Promote the retention of health workers through appropriate incentives, in particular ensuring adequate wages for all health workers, including for community health and lay workers. FAST-TRACK ACTIONS FOR WHO Advocate for training of health workers to focus on the delivery of people-centred care that addresses discrimination in the health sector, including discrimination against key populations. Provide guidance on task-shifting across the full continuum of HIV services, including on the use of lay providers for the delivery of specific services, such as HIV testing, support for pre-exposure prophylaxis and antiretroviral therapy delivery, and prevention and management of common comorbidities.
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SECURING THE SUPPLY OF GOOD QUALITY AND AFFORDABLE MEDICINES, DIAGNOSTICS AND COMMODITIES
The rapid expansion in coverage of HIV prevention, diagnosis and treatment interventions is dependent on the availability and secure supply of affordable and high-quality HIV medicines, diagnostics and other commodities. Inferior quality and interrupted supplies of essential HIV commodities, whether it be condoms, injecting equipment, male circumcision devices, diagnostics, medicines or other commodities, impede programme expansion and risk prevention and treatment failure, including the emergence of HIV drug resistance. The accurate forecasting of country and global needs of all HIV commodities is required to inform the readiness and capacity of manufacturers to meet expected needs and to ensure the continuity of supplies. Local manufacturing capacity should be considered, with the potential to reduce prices, guarantee supply and promote national ownership. National HIV and broader health plans and budgets should address procurement and supply chain management needs. Medicines, diagnostics and other commodities constitute a major component of national HIV programme costs. Selecting the right products of sufficient quality is critical for achieving the best outcomes at an affordable price. WHO offers a range of guidance for countries to facilitate the selection process, including guidelines on the use of antiretroviral drugs for HIV treatment and prevention, the WHO list of essential medicines, testing strategies, and the WHO list of prequalified products.
To ensure their long-term secure supply, the procurement and supply management of HIV commodities should be integrated into the broader national procurement and supply management system. The demand for affordable HIV treatment has resulted in comprehensive price reduction strategies for HIV medicines that may be applied to other medicines, diagnostics and health commodities. Strategies include fostering generic competition, including through, where appropriate, voluntary licences that include pro-access terms and conditions such as those negotiated by the Medicines Patent Pool, and applying, as appropriate, the use of the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and in accordance with the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property, including compulsory licences and filing patent oppositions, differential pricing and direct price negotiations with manufacturers, as well as local manufacturing. WHO maintains databases on the prices of HIV medicines and diagnostics, and collaborates with the Medicines Patent Pool,22 which maintains a database on patent status to help countries achieve the best possible prices for these commodities. There are also many opportunities to spend less on the procurement of HIV medicines, diagnostics and commodities, and improve efficiencies in supply management, such as bulk procurement with staggered deliveries for short shelf-life commodities, advance purchasing and improved forecasting in order to avoid wastage through expired products.
09 – Preparing to take antiretroviral medicine, Uganda.
22 The Medicines Patent Pool is a public-health oriented voluntary licensing mechanism , see http://www.medicinespatentpool.org/ (accessed 22 March 2016).
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SECURING SUPPLY FAST-TRACK ACTIONS FOR COUNTRIES Strengthen the national HIV procurement and supply management structures and processes by ensuring that they are integrated into the broader national procurement and supply management system. Ensure the procurement of quality-assured HIV medicines, diagnostics, condoms, male circumcision devices and other HIV-related commodities, including through the use of WHO prequalification. Plan and implement an HIV medicines and commodities access strategy to reduce prices of HIV medicines, diagnostics and other commodities, including through the use of the provisions in the Agreement on TradeRelated Aspects of Intellectual Property Rights regarding flexibilities to protect public health. Safeguard and expand availability of WHO-prequalified generic products through the expansion of licence agreements and expedition of registration at national level. FAST-TRACK ACTIONS FOR WHO Forecast demand for, access to and uptake of medicines, diagnostics and other commodities for HIV and major comorbidities, and use this information to advocate for adequate manufacturing capacity of producers, including, where appropriate, in suitable low- and middle-income settings. Promote the WHO prequalification programme to allow fast-track registration of priority medicines and commodities, and to safeguard and expand availability of quality-assured medicines and diagnostics. rovide guidance on HIV product selection by national programmes, donors and implementing agencies P through the generation and dissemination of strategic information on prices and manufacturers of HIV medicines, diagnostics and other commodities. Provide technical support to countries to forecast the need for essential HIV commodities, include them in their national procurement and supply management plans and develop a strategy for negotiating price reductions with manufacturers. Support regulatory authorities in pre-market assessment and registration of new HIV medicines and diagnostics, with post-market surveillance. Provide technical support to countries to develop comprehensive price reduction strategies in order to ensure access to essential HIV medicines, diagnostics and commodities.
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CREATING AND SUSTAINING AN ENABLING ENVIRONMENT
ENABLING ENVIRONMENT FAST-TRACK ACTIONS FOR COUNTRIES Reform policies, laws and regulations that hinder equitable access to HIV-related services, especially for key populations and other vulnerable groups. End policies and practices that reinforce stigmatization and discrimination (especially in health care settings), particularly for people living with HIV and key populations. Create institutional and community environments that make it safe for people to access HIV services without fear of discrimination, involving communities in the planning and delivery of services to improve their reach, quality and effectiveness. Address gender inequality by integrating evidence-based interventions into national HIV plans and strategies. FAST-TRACK ACTIONS FOR WHO Advocate for the use of public health evidence to shape pro-health laws and actions based on medical ethics, human rights and public health principles. Develop and promote WHO policies and guidelines that explicitly address gender inequality, gender-based violence, stigmatization and discrimination, human rights, key populations, and public health alternatives to criminalization. Develop, update and implement guidance and implementation tools on the prevention and management of gender-based violence and the inclusion of structural barriers to accessing essential HIV services for different populations, including children, adolescents and key populations.
An effective HIV response requires a supportive social, legal and policy environment that encourages and enables people to access and use services. Reaching diverse populations in many different settings requires strong, well-supported health and community systems and an enabling environment that promotes health equity, gender equality and human rights. Policies, laws and regulations: The health sector has a major obligation to ensure that policies, laws and regulations, including those in other sectors, are pro-health and support national HIV responses. When properly enforced, laws and policies that eliminate gender inequality and protect and promote human rights can reduce vulnerability to and risk of HIV infection, expand access to health services and enhance their reach, quality and effectiveness – especially for key populations. An array of barriers, nevertheless, continues to prevent certain populations from accessing and using effective interventions and services, such as age of consent laws for adolescents, lack of social protection for migrants and displaced populations, and the criminalization of some populations and behaviours (such as drug use, sex work and sex between men). HIV programmes have an important role in monitoring policies, laws and regulations in other sectors to determine their possible implications for the HIV and broader health response, and where barriers exist to advocate for appropriate reviews and reforms to ensure pro-health outcomes.
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STRATEGIC DIRECTION 4: FINANCING FOR SUSTAINABILITY All people should receive the services they need without experiencing financial hardship INCREASING INVESTMENTS THROUGH INNOVATIVE FINANCING AND NEW FUNDING APPROACHES
INCREASING HIV FUNDING NEEDS TO BE PART OF THE BROADER EFFORTS IN PLACE TO INCREASE OVERALL INVESTMENTS IN HEALTH
Existing international and domestic funding commitments are not enough to achieve the 2020 and 2030 targets outlined in this strategy. New sources of funding will be required, not only to fund a sustainable scale-up of HIV-related interventions and services, but also to fill funding gaps resulting from shifting donor priorities. The HIV response has already stimulated innovation in health system financing, at global and country levels, such as the use of levies on airline tickets and mobile telephones, and through income taxes. Further innovation will be required to generate the resources required for a sustained response. Increasing HIV funding needs to be part of the broader efforts in place to increase overall investments in health, in order to ensure that all priority health services can be scaled up towards universal health coverage. Public, domestic funding is central to funding essential and sustainable health services, including those for HIV. UNAIDS has set 2020 targets for domestic funding of HIV programmes, including 12% domestic funding for programmes in low-income countries, 45% for lowermiddle income countries and 95% for upper middleincome countries. Public spending on health can be increased either by raising more tax revenues (increasing the government’s fiscal capacity) or by allocating a greater share of overall government funds to health (giving health a greater priority in the public budget). Health ministries need to actively engage with ministries of finance on issues related to budgets, public financial management systems, and fiscal space concerns. HIV investment cases should be used to advocate for and negotiate a fair allocation of public resources for HIV. Most low-income and lower middle-income countries will continue to rely on external and private sector funding for their HIV services and interventions through to 2020 and beyond. It is important that revenue flows from such sources are fully aligned with national HIV priorities, programmes and plans that are in turn embedded in a coherent national health plan. Stability and predictability of these flows are essential in order to minimize the risk of service interruption.
Implementing fast-track actions to end the AIDS epidemic by 2030 will require major new global investments, increasing from US$ 21 700 million in 2015 to US$ 32 000 million in 2020. By front-loading investments, the full continuum of HIV interventions and services can be rapidly taken to scale. Financing for a sustainable HIV response requires action in three areas: Revenue raising to pay for HIV interventions and services, with an emphasis on improving domestic tax collection (including both general revenues and compulsory health insurance contributions) supplemented by external sources, such as donor grants and private revenues; Financial risk protection and pooling, including establishing equitable mechanisms to pool funds across the health system to ensure adequate coverage of the continuum of HIV services that reduces financial barriers to services while providing financial risk protection; Improving efficiency in the use of health system resources to enable greater effective coverage of HIV services, including by reducing the costs of HIV medicines, diagnostics and other commodities and by reducing duplication of underlying subsystems with other programmes and the wider health system, such as strategic information, human resources, and procurement and supply management. Systematic use of cost studies and programme and financial data should inform programmatic priorities. The national health financing system should address HIV along with all other national priority health needs, avoiding fragmented funding channels and aiming to achieve health equity.
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ADDRESSING FINANCIAL BARRIERS TO ACCESS AND PROVIDE FINANCIAL RISK PROTECTION
REDUCING PRICES AND COSTS AND IMPROVING EFFICIENCIES
Health financing systems that minimize out-of-pocket payments for all essential health services increase access to these services and prevent impoverishment. To minimize catastrophic health payments, out-of-pocket spending should be limited to less than 15–20% of total health spending. Essential HIV interventions, across the continuum of HIV services, should be included in the national health benefit package and be provided free of charge. In addition, the provision of supportive arrangements (such as decentralizing services or offering transport vouchers) to minimize the indirect costs for people using services can improve service uptake and impact. User fees result in inequities in access to HIV treatment, undermine service use, contribute to poor treatment adherence, increase risks of treatment failure, and constitute unnecessary financial burdens on households. Financial risk protection and access to needed services for people living with HIV and other affected populations will depend on a broader robust and fair national health financing system. Public financing systems for health, involving predominant reliance on revenues raised from general taxation and/or payroll taxes for compulsory health insurance are the most equitable and efficient systems. Such prepayment mechanisms should be based on ability to pay, with broad pooling of the revenues to enable benefits to be provided to those in need, including those who cannot afford to contribute to the system.
Fiscal pressures require that countries select the most effective HIV interventions and approaches, target those activities according to the populations and settings where they will have greatest impact, reduce the prices of medicines and other health commodities, and increase the efficiency of services. Programmes that can demonstrate “value for money” and efficiency gains are better positioned to argue for fair allocation of resources and external financial support. There are various opportunities to improve efficiencies and reduce costs. Good programme management can improve the efficient flow, allocation and utilization of resources from national budgets or external sources to service delivery. This includes better coordination of donor funding and alignment with national plans and the broader health system, pooling of resources, performance-based funding and increased accountability at all levels and across all stakeholders, including implementers and funders. Improved selection, procurement and supply of affordable medicines diagnostics and other health commodities can reduce the cost of services and eliminate waste. These approaches are described under Strategic direction 3. More efficient and high-quality service delivery can result in major savings and improved health outcomes. Strategic direction 3 already considers opportunities for improving service delivery models, including through service integration and linkages, decentralization, task-shifting and the use of lay health providers and community systems strengthening. Assuring the quality of services is essential for improving efficiencies – good quality services will result in greater health gains for every dollar spent. Good treatment adherence and retention in care, for example, will minimize treatment failure, reduce hospitalization, and lessen the need to switch to more expensive second- and third-line treatments. The coordination of HIV interventions and services with other health programmes and the overall health system will reduce inefficiencies, and, as a result, will maximize intended results.
10 – Promoting HIV awareness with homeless people, Bangladesh.
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FINANCING FOR SUSTAINABILITY FAST-TRACK ACTIONS FOR COUNTRIES Develop a robust HIV investment case to advocate for adequate allocation of domestic resources and to mobilize external funding support. Estimate national HIV resource needs and, where necessary, develop plans to transition from external to public domestic funding of HIV services, with a particular focus on protecting essential services most reliant on external funding in order to avoid service interruption. Reduce financial barriers, including phasing out direct, out-of-pocket payments for accessing HIV and other health services. Provide universal protection against health-related financial risk, covering all populations, and identify the most appropriate way for achieving such protection, including public compulsory health financing systems. Monitor health expenditures and costs and costeffectiveness of HIV services through the national monitoring and evaluation system in order to identify opportunities for cost reduction and saving. Strengthen coordination with other health programmes including identifying opportunities to consolidate underlying health systems, such as those for strategic information, human resources, and procurement and supply management. FAST-TRACK ACTIONS FOR WHO stimate and regularly review resource needs E (in cooperation with UNAIDS) to achieve the 2020 and 2030 targets. Advocate for full funding of the HIV response by building political commitment for sustained national financing and by promoting strategic financing partnerships, including with the Global Fund to fight AIDS, Tuberculosis and Malaria, UNITAID, the United States President’s Emergency Plan for AIDS Relief, the Bill & Melinda Gates Foundation and others. Support countries to develop national HIV investment cases and financial transition plans to move from external to domestic HIV funding. Provide guidance and tools for assessing and monitoring health service costs and cost– effectiveness and support countries to adopt WHO’s Health Accounts Country Platform.23 Advocate for countries to include essential HIV intervention and services into national health benefit packages and remove financial barriers to accessing HIV services and commodities.
ASSURING THE QUALITY OF SERVICES IS ESSENTIAL FOR IMPROVING EFFICIENCIES – GOOD QUALITY SERVICES WILL RESULT IN GREATER HEALTH GAINS FOR EVERY DOLLAR SPENT
23 For more information on WHO’s health accounts country platform approach, see http://www.who.int/health-accounts/platform_ approach/en/ (accessed 22 March 2016).
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STRATEGIC DIRECTION 5: INNOVATION FOR ACCELERATION Changing the trajectory of the response to achieve ambitious targets Research and innovation provide the tools and knowledge that can change the trajectory of the HIV response, improve efficiency and quality, achieve equity and maximize impact. It is unlikely that the HIV targets set for 2020 and 2030 will be achieved if countries rely only on existing HIV knowledge, technologies and service delivery approaches. Innovation is not only required to develop new technologies and approaches, but also to use existing tools more efficiently and to adapt them for different populations, settings or purposes. Interventions that have been developed and established in one region may require “re-engineering” to be effective elsewhere, such as the concept of task-shifting developed in high prevalence settings of southern Africa being adapted as a novel approach in eastern Europe or Asia. Harm reduction programmes developed for opioid users will require innovative approaches to make them relevant for cocaine users. The rapid transfer of knowledge can help countries to “leapfrog” their HIV responses, learning from the experiences of others to quickly identify and adapt the most promising interventions and approaches. Operational research can guide HIV service improvements to ensure investments are maximized. WHO supports HIV research in four main areas: building capacity of health research systems; convening partners around priority-setting for research; setting norms and standards for good research practice; and facilitating the translation of evidence into affordable health technologies and evidence-informed policy. While having a very limited direct role in research and product development, WHO works closely with research and development partners and manufacturers to ensure that essential new HIV technologies are available and affordable to countries as soon as possible. Given the critical role of partners in innovation, this Strategic Direction describes key areas for innovation that will require joint effort by countries, WHO and other partners. Given the 15-year time horizon for achieving the 2030 targets, short-, medium- and long-term research priorities should be considered. This strategy focuses on the short- and medium-term priorities. OPTIMIZING HIV PREVENTION
Recent innovations in prevention technologies have dramatically strengthened the HIV prevention portfolio, including the use of antiretroviral drugs for preventing HIV transmission and acquisition, and the expansion of medical male circumcision for prevention of HIV acquisition. More extensive use of these opportunities and further innovations – some already in the pipeline – will increase impact. To fully realize the potential of pre-exposure prophylaxis of HIV infection will require improved formulations, delivery systems and service delivery models, including topical and long-acting injectable formulations. Innovations in male and female condom design and medical male circumcision devices should aim to improve acceptability and uptake. HIV vaccine research and efforts to find a functional cure in people living with HIV will continue to be a key component of the HIV research agenda. New information and communication technologies should be exploited to deliver effective prevention interventions through eHealth, using web-based and mobile-based applications.
OPTIMIZING HIV TESTING AND DIAGNOSTICS
New and improved diagnostics technologies and testing approaches will lead to earlier and more accurate HIV diagnosis, and strengthened patient monitoring. There are several opportunities for innovation. New developments in HIV self-testing have the potential to expand HIV testing dramatically, but will need to ensure quality and adequate linkages to confirmatory testing and broader HIV services. Simple, affordable and reliable point-of care diagnostics for HIV diagnosis, including early infant diagnosis, and patient monitoring, particularly for viral load measurement, will enable HIV testing and patient monitoring to be taken to communities and remote areas. The development of polyvalent or integrated diagnostic platforms for the combined diagnosis of HIV and coinfections, such as tuberculosis, viral hepatitis and syphilis, has the potential to increase service efficiencies and improve patient care.
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OPTIMIZING HIV MEDICINES AND TREATMENT REGIMENS
OPTIMIZING SERVICE DELIVERY
Despite major advances in the safety, potency and acceptability of antiretroviral drugs and regimens, there are still areas where innovations and improvements are required. Whereas much progress has been made in the development of simple and effective first-line antiretroviral therapy regimens and formulations, innovation is required to develop simple and robust fixed-dose second-line and third-line regimens. Research on optimal doses of antiretroviral drugs should aim to inform effective regimens while minimizing toxicity and drug–drug interactions and reducing costs. Much innovation is still required on developing suitable antiretroviral formulations and harmonized regimens, including simple and palatable formulations for infants and children, regimens for adolescents to improve acceptability and adherence, and long-acting oral and injectable formulations to improve adherence and viral suppression. At the same time, there is the need to develop more effective drugs and regimens for the prevention and management of major coinfections and other comorbidities.
Much of the success of a rapid scale-up of antiretroviral therapy can be attributed to the adoption of a public health approach to HIV treatment and care, which promotes the use of simplified and standardized regimens, protocols and approaches, makes efficient use of the different levels of health services and engages fully with communities. Similarly, many of the HIV prevention successes can be attributed to innovations in health services and the strengthening of community systems, so that those populations most vulnerable and at risk can be reached with effective interventions. However, as HIV programmes mature, they need to be adapted to meet new challenges, expand their reach and impact, and enhance equity. A careful balance is required, whereby services are tailored to specific settings and populations, while at the same time maintaining a certain level of simplicity and standardization to allow for large-scale, efficient and sustainable expansion. Experience from a scale-up of antiretroviral therapy has highlighted the need to consider differentiated HIV treatment and care to respond to the different treatment needs of people living with HIV (depending on their age, the stage of HIV disease, their response to treatment, the presence of comorbidities and other health conditions, and local contexts). Particular focus needs to be given to the development of innovative services to reach, engage and retain in care a number of populations and to deliver specific packages of interventions. Innovative combination prevention packages are urgently needed to tackle the high HIV incidence in some populations of adolescent girls and young women particularly in sub-Saharan Africa, and to increase the engagement of boys and men in both prevention and treatment services. Poor treatment adherence, low rates of retention in care and increasing mortality among adolescents living with HIV require priority attention. Low coverage of voluntary medical male circumcision in adolescent boys and older men needs to be addressed.
11 – Families in Ethiopia have come together to address HIV-related stigma.
05 STRATEGY IMPLEMENTATION: PARTNERSHIPS, ACCOUNTABILITY, MONITORING AND EVALUATION AND COSTING
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Effective implementation of the strategy depends on concerted action from all stakeholders in the health sector response to HIV. Success requires strong partnerships to ensure policy and programme coherence. Within the health sector, linkages across different disease-specific and cross-cutting programmes need to be established and strengthened.
COLLABORATION WITH PARTNERS WHO has an important convening role in bringing together different constituencies, sectors and organizations in support of a coordinated and coherent health sector response to HIV. In addition to working with the ministries of health of Member States, the WHO Secretariat works closely with other key partners, including: Multilateral and bilateral donor and development agencies, funds and foundations : WHO has developed joint HIV workplans and other collaborative arrangements with a range of major HIV donor agencies, including the Global Fund to fight AIDS, Tuberculosis and Malaria; UNITAID; and the United States President’s Emergency Plan for AIDS Relief. Civil society: WHO has established a Civil Society Reference Group on HIV, which brings together representatives from a broad range of HIV-related civil society constituencies and networks. The Reference Group advises WHO on its HIV policies and programme of work, and facilitates dissemination and implementation of WHO policies and guidance. Civil society is represented in all WHO technical working groups, including those involved in the development of WHO policies, guidelines and tools. A range of civil society organizations have official relations with WHO, enabling them to attend as observers various WHO governing body meetings, including the World Health Assembly. UNAIDS and partner United Nations agencies: WHO, as a cosponsor of UNAIDS, depends on the broader United Nations system to provide a comprehensive multisectoral HIV response. The ten other UNAIDS cosponsors, along with the UNAIDS secretariat, contribute to the health sector response to HIV, guided by the UNAIDS “division of labour” which outlines key areas of responsibilities across the UNAIDS family. Technical partners: WHO has established a Strategic and Technical Advisory Committee on HIV, which comprises a range of technical experts from national HIV programmes, implementing organizations, research institutes and civil society to advise the Director-General on the Organization’s HIV policies and programme of work. Technical partners play a critical role in WHO working groups that are responsible for developing WHO policies and guidelines.
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GLOBAL AND COUNTRY ACCOUNTABILITY Accountability mechanisms that function well and are transparent and that have strong civil society participation are vital, given the range of partners and stakeholders that is needed for an effective HIV response. Important building blocks include nurturing strong leadership and governance and involve: full engagement with all relevant stakeholders; setting clear national targets that reflect, where appropriate, the Sustainable Development Goals, including the goals and targets of this strategy, and other global commitments; using appropriate indicators on the availability, coverage, quality and impact of interventions to track progress; and establishing transparent and inclusive assessment and reporting processes. Several instruments already exist for measuring progress (including for creating an enabling environment). Consistent monitoring and regular reporting on progress at country and global levels are vital for strengthening accountability.
13 – Prenatal check-up, Latin America and the Caribbean.
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MONITORING, EVALUATING AND REPORTING Implementation of the strategy will be monitored at four levels, using existing mechanisms: • Monitoring and reporting progress towards global MONITORING AND REPORTING PROGRESS TOWARDS GLOBAL GOALS AND TARGETS
goals and targets; • Monitoring and evaluating the response at regional and country levels; • Applying WHO’s framework for results-based management; • Applying the UNAIDS accountability framework.
At the global level, regular reviews will assess progress on the various commitments and targets. These reviews will build on data received from countries through various existing monitoring and evaluation mechanisms and procedures, such as the Global AIDS Progress Reporting and complemented by additional data where necessary. WHO has identified a set of ten core global indicators, which are organized along the continuum of HIV services, and which should be used for monitoring and reporting on the progress of the health sector response to HIV (see Figure 7). Progress at global and regional levels in moving towards the targets set out in this strategy will be regularly assessed. Benchmarking – or comparisons between and within countries – will also be used to assess performance in reaching targets. The strategy is designed to be sufficiently flexible to incorporate additional priorities or fill gaps in the health sector response to HIV that may be identified. To that end, WHO will continue to work with its partners to provide support to countries for the harmonized and standardized collection of core indicators, based on WHO’s Consolidated strategic information guidelines for HIV in the health sector,24 and in the preparation of global and regional reports. Regular reporting of the data is proposed. WHO will implement a monitoring and accountability framework for the strategy in consultation with stakeholders. It will also monitor and share data on the uptake of its guidelines on HIV, as well as on progress in implementation of the strategy, to highlight barriers and promote best practices.
BENCHMARKING – OR COMPARISONS BETWEEN AND WITHIN COUNTRIES – WILL ALSO BE USED TO ASSESS PERFORMANCE IN REACHING TARGETS
MONITORING AND EVALUATING THE RESPONSE AT COUNTRY LEVEL
Progress in implementing the health sector response to HIV should be assessed with indicators on availability, coverage outcome and impact, taking into consideration other relevant recommendations for monitoring implementation. The WHO Consolidated Strategic Information Guidelines recommends a standardized core set of 50 national indicators that countries may use to monitor and report on their national HIV programmes and overall national HIV responses. Progress towards the HIV-related Sustainable Development Goals will be tracked and reported.
Indicators for monitoring the strengthening of health systems derive from a common platform for monitoring and evaluating national health strategies coordinated by WHO. Instruments are also available for measuring progress in implementing policy, legal and structural measures for enhancing the HIV response.
24 Consolidated strategic information guidelines for HIV in the health sector, see http://who.int/hiv/pub/guidelines/strategic-information-guidelines/en/ (accessed 22 March 2016).
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WHO’S FRAMEWORK FOR RESULTS-BASED MANAGEMENT
THE UNAIDS ACCOUNTABILITY FRAMEWORK
WHO’s Twelfth General Programme of Work 2014– 2019,25 provides the high-level strategic vision for the work of WHO, and outlines six areas of work. Most activities related to HIV fall under Category 1 on communicable diseases. However, other important HIV-related activities fall under other categories, notably, Category 2 on noncommunicable diseases (including substance use, mental health and chronic care), Category 3 on promoting health through the life course (including maternal, adolescent and child health, and sexual and reproductive health) and Category 4 (including access to medicines and diagnostics, integrated service delivery, strategic information and human resources). Under Category 1, HIV and viral hepatitis have their own area of work for which biennial workplans are developed along with a set of agreed outcomes and budget. This strategy covers three biennia (2016–2017, 2018–2019 and 2020–2021). Workplan implementation is monitored through progress reports at the end of each biennium. Mid-term biennium reviews will be undertaken to facilitate implementation.
WHO’s HIV work is reflected in the budget and workplan of the UNAIDS unified budget, results and accountability framework,26 which entails a single framework for 2016–2021 that promotes joint planning and budgeting across the 11 cosponsors and the UNAIDS secretariat. Detailed workplans and budgets are developed for two-year periods, for the period of this strategy starting with 2016–2017. Each cosponsor is responsible for implementing a set of broad activities related to their organizational mandate and the UNAIDS Technical Support Division of Labour. The UNAIDS Unified Budget, Results and Accountability Framework is accompanied by a performance-monitoring framework, which defines indicators against which progress in implementation of the budget and work plan is measured. Annual progress reports are submitted to the UNAIDS Programme Coordinating Board.
14 – HIV training for maternal and child health assistants, Sierra Leone.
25 Twelfth General Programme of Work 2014–2019: not merely the absence of disease, see http://www.who.int/about/resources_ planning/twelfth-gpw/en/ (accessed 22 March 2016). 26 At the 37th meeting of the UNAIDS Programme Coordinating Board (Geneva, 26–28 October 2015), the framework was presented, entitled: UNAIDS unified budget, results and accountability framework 2016–2021, see http://www.unaids.org/sites/default/files/ media_asset/20151103_UNAIDS_UBRAF_PCB37_15-19_EN.pdf (accessed 22 March 2016)..
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COST OF IMPLEMENTING THE STRATEGY The Global health sector strategy on HIV, 2016–2021, describes the health sector contribution to the goal of ending AIDS as a public health threat by 2030. The costing of implementation of the strategy has been undertaken based on the costing of the UNAIDS 2016– 2021 Strategy, which used specific targets and unit costs for the interventions included in the strategy. Data for the costing are drawn from demographic estimates prepared by the United Nations Population Division, national household surveys (Demographic and Health Surveys and AIDS Indicator Survey),27 UNAIDS estimates of the burden of HIV by country, and country reports through the Global AIDS Response Progress Reporting system.28 The costs are calculated for 120 lowand middle-income countries across the six WHO regions. Unit costs are based on reviews of costing studies and have been reviewed by experts from a range of countries. An expert panel provided estimates of future costs of antiretroviral therapy. Those estimates assume some continued decline in antiretroviral prices and reductions in both laboratory costs (as testing regimens are simplified) and in service delivery costs, as some patients are transferred to community care. Future coverage targets are from the UNAIDS 2016–2021 Strategy. The total costs of the present strategy are estimated to rise from about US$ 20 000 million in 2016 to almost US$ 22 000 million in 2020 and to US$ 21 000 million in 2021 (see Figure 8). Antiretroviral therapy requires the largest amount of resources, about 47% of the total; programme enablers represent the next largest component at 13%; HIV testing services are next at 9%; followed by condom programmes at 8%. More than one third of all resources are required for four countries (in order of burden): South Africa, Nigeria, Brazil and China. Over half of all resources required for low- and middle-income countries are needed in the African Region (55%).29 The next largest regions are the Americas Region at 16%, the Western Pacific Region at 13% and the South-East Asia Region at 8%. In the European Region, 5% of resources are needed, and 4% are needed in the Eastern Mediterranean Region. About one quarter of resources are needed in low-income countries, about one quarter in lower middle-income countries, and just under one half in upper middle-income countries.
Figure 8. Costs by intervention and year (in US$) CONDOMS PEOPLE WHO INJECT DRUGS (OST) BEHAVIOUR CHANGE COMMUNICATION PREVENTION OF MOTHERTO-CHILD TRANSMISSION VOLUNTARY MEDICAL MALE CIRCUMCISION POST-EXPOSURE PROPHYLAXIS PRE-EXPOSURE PROPHYLAXIS TESTING $10,000 PRE-TREATMENT TREATMENT (ART) $5,000 PROGRAMME ENABLERS SOCIAL ENABLERS $2013 2014 2015 2016 2017 YEARS 2018 2019 2020 2021 HEALTH SYSTEMS
$25,000
$20,000 (IN MILLIONS)
$15,000
27 The DHS Program: demographic and health surveys, see http://dhsprogram.com/What-We-Do/Survey-Types/DHS.cfm (accessed 22 March 2016). 28 Global AIDS Response Progress Reporting, see http://www.unaids.org/en/dataanalysis/knowyourresponse/ globalaidsprogressreporting (accessed 22 March 2016). 29 The regions refer to the six WHO regions, with data covering 120 low- and middle-income countries.
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Photo credits
01 – © 2014 Kunle Ajayi, Courtesy of Photoshare; Location: Lagos, Nigeria
02 – HIV conference, Latin America and the Caribbean. © WHO/PAHO
03 – A blood sample is prepared for HIV testing from a seven month old child, Cambodia. © 2011 David Snyder for the CDC Foundation, Courtesy of Photoshare; Location: Seireisophon, Cambodia
04 – © WHO
05 – © UNAIDS
06 – © WHO/PAHO
07 – © UNAIDS
08 – © 2015 Aulia Human, Courtesy of Photoshare Location: DKI Jakarta Indonesia
09 – © UNAIDS
10 – © 2014 M Ponir Hossain, Courtesy of Photoshare Location: Dhaka Bangladesh
11 – © UNAIDS
12 – © WHO/PAHO
13 – © WHO/PAHO
14 – © Abbie Trayler-Smith/Panos/H4+
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For more information, contact: World Health Organization Department of HIV/AIDS 20, avenue Appia 1211 Geneva 27 Switzerland E-mail: hiv-aids@who.int www.who.int/hiv WHO/HIV/2016.05
JUNE 2016
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1700ݚ ಚՑᏃޗᄔܕጚ ਾ།ૠೣᎡޗ፧ன
ܸijıIJĶ೧ˈݒ ࢥġ
2 ၩໍᏠፈIJĺĹĸ೧Ĵኟߙ؝ம ȖՑᏃ࿅׳ढ़˖ ዸకञੌࢬኁكᅍชȗ ˈ ૰ᏋũŵŵűĻİİŢűűŴįŸũŰįŪůŵİŪųŪŴİġţŪŵŴŵųŦŢŮİIJıķķĶİķijijĺĺİIJİŘʼnŐŠŔőłŠ ňņŏŠĹĸįIJįűťŧঠถ ˄ijıIJķ೧ĴኟIJĶ๊ߺၳ˅ ȃ ۨိˈ ภฉՑᏃࣙढ़ۃ ˄IJĺĹĸĮIJĺĺĶ೧˅ ߙ؝ம ȖᏥ፮֫ࡻ ˄ف፱IJĺĺĵĮIJĺĺĶ೧˅ ȗ ˈ ૰ᏋũŵŵűĻİİ ŢűűŴįŸũŰįŪůŵİŪųŪŴİţŪŵŴŵųŦŢŮİIJıķķĶİķĶĺĶĶİIJİŘʼnŐŠłŔŅŠġĺĸįIJįűťŧঠถ ˄ijıIJķ೧ĴኟIJĶ๊ߺၳ˅ ȃ 3 ठ࣭ܐঐķĶİijĸĸखિሊˈ Ȗ࣋ՑᏃޗञՑᏃܿጹ፧ᅠᆗȗ ˈ ũŵŵűĻİİŸŸŸįŖŏłŊŅŔįŰųŨİŴŪŵŦŴİťŦŧŢŶŭŵİŧŪŭŦŴİġŴŶţŠŭŢůťŪůŨİŧŪŭŦŴİijıIJIJıķIJıŠŖŏŠłĮ œņŔĮķĶĮijĸĸŠŦůįűťŧ ˄ijıIJķ೧ĴኟIJĶ๊ߺၳ˅ ȃ 4 ȖijıIJIJĮijıIJĶ೧ภฉၩໍؠՑᏃޗİՑᏃዸకȗ ૰ᏋũŵŵűĻİİŢűűŴįŸũŰįŪůŵİŪųŪŴİţŪŵŴŵųŦŢŮİIJıķķĶİĵĵķıķİIJİġĺĸĹĺijĵIJĶıIJķĶIJŠŦůŨįűťŧঠถ ˄ijıIJķ೧Ĵ ኟIJĶ๊ߺၳ˅ ȃ
08
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
ϨцᇯැϡЎϣ႒ݫ䩟 ۓછ݆מԁԷјਛТфтࣁ ՜֣ϡܲጷϡׁӑଏԮڍф઼ܷ࠾ڍ䦚 ϸ࣮ږଯस ଈԁњёਛТфтࣁ৷ࡄߵ۵ࡣԟҪϣঊ䩟 ܋оϦ ਛТח՟ЋѸܲጷϡቄח՟цᇯැؑઌϡ֞ӑ䩟 Ғ࠾ׁмዐ༸࠴ਢឱ 䩛81$,'6䩜 ёږଯ ؚЇላׁԷјԚԮϡҪܧਛТږଯфڋਢ䩟 Ѕӛ5䦚 د၉ᇎߵԛتҀท䦙 ֲಚ࠴䦙 ࠴ఽԛႣ䦙 ԛфТᜊ ࣉ䦙 ෂਛТ䦙 ߱ญԥҪ䦙 ظؘਛТ䦙 ۘتทԛᅔ࠴ фйϪЋӆϡᆨׁਛТࠖע䦚 ؚՄѴϦܙЄмрϡо ֞ӑ䩟 ڶЋмрфघ߇ϥцᇯැϡಚК䦚 ؚԗዐ༸࠴ ఽфԮඡтࣁׁӑଏѸܲጷϡਛТږଯรՊߎഒ ࣻ䩟 ԝҒ䩟 Ҫܧଝዐ༸࠴䦙 ֲಚ࠴ф⟉ᅔऴؖйߵѤм ւࢅዐ༸࠴ࠤାષᎨڋਢ 6䦚 ږଯसଈϡҪӌӥැԗϩ ࡾӊӥѴԷјН۟فтࣁ۵ࡣ䩭 বࣃфثᆢ䦙 ँվ Ϥכҳ䦙 ՖԛԆכҳ䦙 ٤ҙТݘҨ䩟 йߵٕݸثᕷ䦙 ᇉӜ٩ф᥋؇䦚
ږଯसଈมϦҪܧਛТח՟цᇯැϡ݁䦙 ۵ࡣ фҲ҃䩟 د၉ٚϬږଯҤז䩭 ֡РԟϡږଯҞ֥ф મϮԑ䩟 ӸמфԮڀмрዐ༸࠴ఽ࣮۵фڋਢ䩮 ء ӡϣࠇዐ༸࠴ఽऴӆࠖעфҙؙড়Ҩݾবᇯැ䩟 ᖝܕ ዐ༸࠴ఽࠖעϡ۟ۂРࡄ䩮 ఱцϤӎϪळфсѢ䩟 ݆ ݱф٤పዐ༸࠴ఽࠖעϡ۟ۂРࡄ䩟 йԅЏзҙڱ ֝фӥѴԍכ۵ࡣ䩮 ӥැࢅڍ࣮ٿ䩟 йҪӌࡾޝ ዐ༸࠴ఽࠖעϡ۟ۂРࡄ䩟 ԗؑϴࠖעϡϪळӌை ॒ࠖϡըছઁ۠зࠍ䩮 ࡷفݒЈ䩟 йԐ҃ьݬՖࣁ 䩛ԋ֘䩜 䦚
01 – ೞ๊ᆊጹࡃፀڕዴቼ ढ़ˈ ኁ߷ՑᏃޗವሣۈ؆ȃ
5 Ȗठ࣭ՑᏃࣙढ़༡ዸక ˄ijıIJķĮijıijIJ˅ ȗ ˈ ਈũŵŵűĻİİŸŸŸįŖŏłŊŅŔįŰųŨİŦůİųŦŴŰŶųŤŦŴİťŰŤŶŮŦůŵŴİijıIJĶİŖŏłŊŅŔŠġőńŃĴĸŠIJĶĮIJĹ ˄ijıIJķ೧ĴኟIJĶ๊ ߺၳ˅ ȃ 6 ࣭࣋ᏓՑᏃাઑኋढ़ܿᄪႩˈ ਈũŵŵűĻİİŸŸŸįűŦűŧŢųįŨŰŷİŢţŰŶŵİŴŵųŢŵŦŨźİ ˄ijıIJķ೧ĴኟIJĶ๊ߺၳ˅ ȃ
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
09
ዸకؾ՝ᇋ
ዸకؾ՝֡ଭႎࢋ᎐ᇋᏠ˖ࠍؠڈ
01 02 03 04 05
ࠧ䩭 Ҙઈዐ༸࠴ఽᐭєфцᇯැϡѴ૮䩟 ࡧԆ۔ϱϡҜ߁ф खږ䩟 ٤оזਛТח՟ዐ༸࠴ఽцᇯැйࣘдޝۄϡ ԑࣝ䩮 ږଯᕴବ䩭 ᆡږଯϡѧϬॵᕴବ 䩛Ҫࣉھ۵ࡣ䦙 ዐ༸࠴ఽ ࠖעϡ۟ۂРࡄйߵԍਛТҤఱ䩜 䩮 Ҫ݁ܧ䦙 Ҫܧ۵ࡣфࡢՄ۵ࡣ䩭 ೀཾЋԐ҃цᇯැґޕঞϡӌזёфёϡϣڍ ࠶ؙড়Ҩфࠖע۵ࡣ䩮 ހҲ҃ࠃ৷䩭 ࠃ৷ٿмфԒ֎ਛТॵ࣠ࣝٚϬږଯҤ זдԆಈԼϡ ь֡ݬѬҲ҃䩮 ӥැ܋䩭 มږଯӥැϡԮඡϴঈ䩟 د၉ږଯׁӑଏԮڍ䦙 ฮ࠻ф ߯ຽ䩟 йߵюӆд䦚
01 ภฉၓटሥ ଓཨৠූՑᏃޗ ሥޭ܈
02
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
11
ࣰบIJĶ೧ඓৱሥޭՑᏃޗቱܿધܐခᏁᇲᏗᄌȃ ࣰบIJı೧ ହՑᏃޗዉܿڈཏ၁เ༮࠰ܐਠˈ ጝቪጦޭภฉՑᏃޗᄵ ၳ࿏ᏮڏܿڵഐȂ ခܿᏁኑᇵঽتถܿۑᄧ܈ࠍܿȃ ᎐ᇋቈ ኚହኚܿเঠܾமૠೣᎡޗ፧னঐˈ ՑᏃޗཏ၁เ༮ਂ ຬˈ ijıIJĶ೧ՑᏃޗཏ၁เ༮ኙၓIJIJıွเ ˄ĺĵွ Į IJĴıွ˅ ˈ ijııĴ೧ ˄ 7 ࡘ೧༈۫ฬށம፧ன಼˅ ਂຬமĵĴĦ ȃ ijijıIJĶ೧ˈ ՑᏃޗᄧߙࡥำ 8 ஂၓijIJıွஂ ˄IJĹıွஂ Į ijĵıွஂ˅ȃ
ዸ ߊ܉ϨцᇯැҤӌԼЏϦԳϽՖࣁ䩟 Ԕϥ䩟 ዐ༸࠴ఽ ᐭєകߓ۟цٿсพюԳϡԍਛТᙈ䦚 ैϽϡ खږѯюϲྤϼϦംؙ䦚 ϤޢЄॸϤޢь䩭 ۵ӓϡࠖע࣑ࣻϤ߿ޢ䩟 ᓛࣁ ֏ݬЇЪߝ䩟 ԡйӥѴҪܧ۵ࡣ䦚 ϩϡዐ༸࠴ఽݾ বᇯැфࠖעക۔ԼЏҪחҝ䦚 ϨҪݚܧӜዐ ༸࠴ఽҀทٷЅ䩟 ϩݚϪϨёёઃകϤҌ༿І ӱϡዐ༸࠴ఽ૮ୂ䩟 ݚӜѪ֚ԅЏଝဵఽ࠴࠹׆ ඎ8䦚 ҰϴϡϤכҳߓ۟ࡖϨфϪळҩ۲䩭 Ҫܧዐ༸࠴ఽ цᇯැϡюۋϡдϥϤ႗䦙 Ϥכҳϡ䦚 ॎѼዐ ༸࠴ఽт࠴ଛԪݱՄϼЃϩӛЎઁ䩟 ԔϨחдмрф с߇Ϩϼڢ䦚 ϨྺՀࠁй۪ۘರ䩟 ۔юёվѽфё ڴѽԛϡҀทଛϥӎёූվԲфԲԛϡҖහ䦚 Ֆࣁ ЬϩࣘдڈႭݬсߵϽחдዐ༸࠴ఽҀทըছзҙ ϡϪळ䦚 ֔ױ䩟 ϨԅЏඎфࣇԑҤӌ䩟 ЇࡖϨԚӾϽ ϡጊቕ䦚 ϨܙЄмр䩟 վԲфԲԛЁҩ۲Ϧ䦚 ༽୍Ϫ йߵܲጷࡖϨϡԛԆફҨ䦙 ᇉӜ٩ф᥋؇കϨႛዢ ԅԼਛТࠖע䩟 දԷϥոু䦙 ݙվё䦙 ёڴѽԛфԳѢ Ϫळ9䦚
ᏋijııĴ೧ᇵହˈ ՑᏃޗ ዉܿڈཏ၁เ༮ਂຬம
43%
ȃ
ЅҳּՊмрؑϴئԆԮڀ䩭 ҪԒ֎ऎϡዐ༸࠴ఽ Ҁท֧ٷӊЅҳּՊмр䩟 ҪܧϡюۋЇԼݸӊϨϸ ԈмрϡझҨϥӸݬХϥ߾ᣝ䦚 ڦаዊࡾٷϡހԳ ѢϡԸ٩䩟 ᇓϽԍכфН۟فϡਛТቻޝՄڍцЅҳ ּՊмрґߞදԷԳϴ䦚 ӎЗ䩟 ࠍּՊмрԗߓ۟࣊༌ ֔חтࣁᎨࡾ䩟 й৭خऴӆϡዐ༸࠴ఽࠖעЌԅЏࣘ ߿ϡؖޝ䦚
7 ׁዸకؾ՝ྈቂܿ༮દܐହᏋ࣭য়Ȃ ၩໍᏠፈञठ࣭ՑᏃޗİՑᏃठࣙढ़ށඓ֫ࡻႼˈ ஂภฉՑᏃሥޭ֫ࡻႼȃ 8 ijıııĮijıIJĶ೧ภฉၩໍؠሥޭՑᏃ˖ޗ ፱ݞ߾፷تถᄧሰ܈ȃ ਈũŵŵűĻİİŢűűŴįŸũŰįŪůŵİŪųŪŴİţŪŵŴŵųŦŢŮİġIJıķķĶİIJĺĹıķĶİIJİĺĸĹĺijĵIJĶıĺĹijĵŠ ŦůŨįűťŧ ˄ijıIJķ೧ĴኟIJĶ๊ߺၳ˅ ȃ 9 ׁՑᏃޗዸకؾ՝ᆛቂமठ࣭ՑᏃࣙढ़༡ijıIJķĮijıijIJ೧ዸక፩ቂܿ Ȑ፱ݞเฯȑ ށሆˈ ਈũŵŵűĻİİŸŸŸįġŶůŢŪťŴįŰųŨİŦůİųŦŴŰŶųŤŦŴİ ťŰŤŶŮŦůŵŴİijıIJĶİŖŏłŊŅŔŠőńŃĴĸŠIJĶĮIJĹ ˄ijıIJķ೧ĴኟIJĶ๊ߺၳ˅ ˖ Ȑ፱ݞเฯডࡴ၌เฯፑܿ૰ঐਾۂডۈ؆ՑᏃܿޗเฯˈ ጝᄎเฯ ܿدቪޭ࢙ڈዴՑᏃޗሥޭᏮসၓ፱ᇋȃ ྈ࣭য়፩ˈ ፱ݞเฯૂ֡ଭՑᏃࡥޗำጚȃ ༮ଝˈ ್್ᄹᄵၓጚȂ קᄹጚȂ ᎙ືޗ൰ጚȂ ᄹᏮጚঽඝࢾŜᇵঽซ߯ŞਾۂՑᏃࠞܿޗნࡴඝྊเฯȃ ܦࢋ࣭য়ሥܬށ།ՑᏃޗᄵၳ࿏ሯჳᏥᆒ፱ܿ࿅ށ เฯˈ ࣋ޭـሥܬᇵᄵᅪञ຺ঐଝၓনھȃ ȑ
12
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
ဇIJįġijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗ ዸకؾ՝ᇋ
ን˖
ภႇՑᏃޗᄧߙࡥำˈ ႇՑᏃޗყ࣋ཏ၁ˈ ՑᏃࡥޗำጚ།ච༄ˈ ࢮ٣༊ȃ
಼˖
ܸijıĴı೧፮ੌՑᏃᄵጝᇜ࢞ࢥၩໍ၉ᄗȃ
ijıijı೧ܿન࿒಼˖
ՑᏃޗᄧߙࡥำஂ༮ਠፚĶıွஂᇵ˗ ႇሣߒᄧߙࡥำஂȃ ՑᏃޗყ࣋ ཏ၁เ༮ਠፚĶıွเᇵȃ ĺıˁܿՑᏃࡥޗำጚܾܸ৹˗ك ĺıˁܿՑᏃࡥޗ ำጚঠܾ፧ன˗ ĺıˁܿՑᏃࡥޗำጚᇷ፟᎘ޗȃ
ᄵވଙ৩˖
ภಐࡇ˗ ဵጶஏᅝܿ࠵ႚ˗ ᇵঽ࢞ࢥၩໍߴጦȃ
৭ ك ञ ൹ ২
ภಐࡇܿࢋߴಅ ዸకߴჹIJ ۶፱ݞ ᄵܿވᄪႩ Ȑटเ ȑ ቪ Ȑटۃȑ ዸకߴჹij ٛໍሯჳܿ ࡞ኁ܈ Ȑȑġ ዸకߴჹĴ ࢞൶ݓ ࿎࢜࠵ႚ ȐᏭߟȑ ዸకߴჹĵ ڮᏁ۶ ૰ڕઌᄹ ȐڮᏁȑ ዸకߴჹĶ ዴۑᄧˈ ৠଓዴ Ȑၝହȑ
ዸకܿ˖
ܷȂ ঞ֎࣋ႼȂ ၳውȂ ৭كቪ൹২
࣭য়ᄵވ
࣭য়ঞ֎ܿᄵވ
ၩᏠፈᄵ˖ވ ᏓؠȂ ฏቱञ࣭য়
ภฉঞ֎ܿᄵވ
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
13
ୟघ߇фԵ҃Ϫळ䩭 ҪԒ֎Ԝӌைքϱքߒϡख ږ䦚 ৳߷䦙 ІѼᇻߛ䦙 Ү௸ҜфӤԃԸ٩НකтϪѬ Ұॶࠤା૮ୂ䩟 वӾсϡਛТՄڍ䩟 घ߇Եڒӛ䩟 ྋٍѸЄϪळናԵ҃䩟 ҩЅआڈѪ֚ԅЏਛТࠖע䦚 ݾবᇯැфࠖעϡఱцԛϤ߿䩭 мрዐ༸࠴ఽцᇯ ැ܊܊Ѫ֚ԗݾবᇯැओЅӊзؑϴϡϪळфсѢ䩟 ࣔঊԷѸӸѪфؙড়ҨЎઁ䦚 ৭خф֝ڱفۅ䩭 Ⴍݬᇓצዐ༸࠴ఽਢґϤע࢙خ ࠖ֝ڱ䩟 जНЌഡߛڋਢϡϩԛф٭عնਯϡޝ䩟 ࣔঊԍਛТݘТӌֲҝ䩟 ԝҒ䩟 ዐ༸࠴ఽ಄ԛ䦚 ڦаؑؒфٍѓϡҶӸ䩟 ࢙خবࣃ䦙 ᒎआфඎѓԘϡ ۠֝ڱԮԳϴ䦚 ׁҀทфԷјׁೋϡҶӸ䩭 ዐ༸࠴Ӛ༆ଛӹѸ ЄϪבիଝဵఽ࠴࠹׆ඎґЎઁ䩟 Ѽњ䩟 цඎϡۄ ۥޝӊׁҀทԮ࠾ϡт࠴ଛфӚ༆ଛϼڢґ໑Ϻ ڱ䩟 ԝҒ䩟 ᒬࡿႣ䦙 ᴙࡿႣߵჩೋ䦙 К߱܉ᅔ࠴䦙 ਫ਼၎࠴фԷјۘتทԛᅔ࠴йߵظؘਛТᅔථфڱ ٍѓᅣዢҳׁೋ䦚 ߊ܉ଝဵఽ࠴࠹׆ඎϡথϨ ᇓϽ䩟 ዐ༸࠴ఽԁֲಚ࠴ׁҀทϡবࣃфସءЏϺ Ϧۨ䩟 Ԕϥ䩟 ֲಚ࠴കѼϥҀทዐ༸࠴ఽϡюϪф ոু֙ࡨඎϡҰϴ֍ӹфዐ༸࠴ఽԚԮӚ༆ϡҰϴ ֍ӹ䦚
ђϥѸЄс҂ӎ҈ϡѨєϥϤޢϡ䩭 ҪܧᐭєӔҮт ࣁϺϣϬڝѢ䩟 س䩟 ಢݮড় 䩛س䩟 ԗӌفۅϨӾ ӓһ܌ཱྀڈכᇓϽ䩜 ԗ Ъьӌைዐ༸࠴ఽ ЈтҀท фዐ༸࠴ఽԚԮӚ༆ϡބഇ䦚 йӾӓϡ ֏ݬጞՖϥ Ϥ߿йֲټϸϣϤआࠟ Ըϡᐭєϡ䦚 ዐ༸ ࠴ ఽ Јт ҀทԗҶӸ䩟 ϿϩѸЄϪؑϴዐ༸࠴ఽඎфࣇԑ䩟 বࣃ䦙 ࣇԑфඎϡюӆԗߓ۟ϼڢ䦚 Ϻё݄䩟 ҪԒ֎ዐ༸࠴ఽၧհٷւّऎЋݚϪ 䩛ݚϪ ݚϪ䩜 䦚 ҪԒ֎ӌைϡϣϬᕝ॒ϥ䩟 䦧ϣܷؕଓ䦨䩟 जዐ༸࠴ఽ цᇯැԗЧ҃Ҩф܌䦚 ږଯसଈЅ٤оϡҲ҃ԗ ೬ݪϸ҈ϡֲҝ䦚 Ҳ҃ԗӸݬэтфӥැҪӌ䦙 ҙؙড় Ҩϡዐ༸࠴ఽবࣃфඎݾবᇯැ䩟 ٍѓಀԳ۱䦙 й ϪЋӆϡҤ֚䩟 Ћዐ༸࠴ఽਢࡧԆࡢϩН۟فԛϡ ؖޝϱ䩟 ৭خዐ༸࠴ఽцᇯැཱྀ๎܌ՊѸܲጷϡ ਛТڋਢфࠖע䦚
3670ݚϪ
ijıIJĶ೧ݒՑᏃޗ ᄔܕጚᏓ༮ၓ
14
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
ၓࠀኛᏭऔᎳֻ
ܐܿት૰ᇵࠍڣቂࣰบໟႎ೧ྈถܾܿዴˈ ۰ߑሥޭ܈፮ੌՑᏃሀܿᄧܻࣟȃ ཱུᎼ ሥޭ܈ჹထˈ ၩໍؠכᅐዴڵܷஉȃ
ଓཨܻᄵ࣋ܿވਉቱ
৭خӛϩዐ༸࠴ఽҀทٷϦثІӱ૮ୂ䩭 Јࡿϡዐ༸ ࠴ఽഠ࠻Ѳݫ 䩛د၉ІϢഠ࠻фघ߇ഠ࠻Ϩֵ䩜 фϩ ࢙خ֝ڱϡЈഠ࠻भ䩟 ЌࡧԆоѸЄϡዐ༸࠴ఽҀ ทٷ䩟 ٍԷבիՉඎфࣇԑ䩟 зϽࡳ֏ст༯ዐ ༸࠴ఽবࣃᇯැϡၘҨфඎϡҝ䦚 ዐ༸࠴ఽഠ࠻ ࠖעϡږଯԳѢцӊҙըছϪळфՉᒎआ۠ ԮԳϴ䦚 זӛϩዐ༸࠴ఽၧհٷՖϣ܌٤పҙ֝ڱඎ䩭 ۓછ ԳѢᇞਤඎઑט䩟 זӛϩዐ༸࠴ఽၧհٷ٤పඎ 䩛۵ӓђϩݚϪԅЏඎ䩜 䩟 झҨϽๆँվЈтҀ ทфӚ༆Ϫّ䦚 Ԕϥ䩟 ೩҃ఱцϣܷዐ༸࠴ఽҀทٷ ϡଝဵఽ࠴࠹׆ඎؑϴٿϬмрфׁӑଏо ӓӛ۔ϩϡझҨ䦚 ۓછئԆԮڀϡϥ䩟 ϴݸثඎҤ ӌࡖϨϡзϽϤכҳ䩟 س䩟 ъԈҩ۲ϡϪळ䩟 ԝҒ䩟 ᆯո䦙 ոু䦙 ݙվё䦙 ԲԛфԳѢϪळ䦚 ф ࠖעϡۓ֝ڱછЏϺ࢙خ䦚 ҒܼحϺзҙϡඎ࣊Ԫ ԛфࣇԑفخଛԗϥ݄т༯ඎၘҨϡԮඡ䦚 ֡РйϪЋӆϡҪӌࣇԑ䩟 ٍϪळࣉفخф҅Ҩ䩭 ّйڋݚښϡዐ༸࠴ఽҀทٷ 䩛د၉ъԈټТבիଝ ဵఽ࠴࠹׆ඎϡϪ䩜 ϡܲጷϡਛТؑؒۓછЏϺٶ ߿䦚 ԗዐ༸࠴ఽࠖעԁֲಚ࠴䦙 ࠴ఽԛႣߵԷјԳ ϽਛТ՜֣ϡࠖעԚֲׁ䩟 ЌϽๆ֏ઁࠍт࠴ଛфӚ ༆ଛ䦚 Ӹמϸ҈ϡֲׁ 䩛د၉ԁۘتทԛᅔ࠴ࠖעϡ ֲׁ䩜 Н৭خᆨׁ䦙 Ҫӌ䦙 йϪЋӆϡࣇԑ䩟 Ҷמਢ ϡݱՄؙড়Ҩ䦚 Ϩֲಚ࠴ԁዐ༸࠴ఽׁҀทз Գϡмр䩟 ዐ༸࠴ఽԁֲಚ࠴࠾ׁਢՖϣ܌ӸמϦ ׁݱ䩟 ٍѸЄϪבիϦЌቡષТܞϡݾবᇯැ䩟 з Ͻࡳ֏٤ҙϦޝϡٍѓଛ䦚 ԗӗࣇࣨথܴؽѓ ӊዐ༸࠴ఽඎфࣇԑ䩟 ЋݸثѸܲጷϡਛТؑؒ٤ పϦҜ߁䩟 දԷϥۘتทԛᅔ࠴йߵظؘਛТᅔථф ٍڱѓᅣዢ䦚 ಪ֥ඎകѼϥਛТח՟ᆨׁцᇯ ැϡԳϴॵюחд䩟 ϩࡾӊ࢙خϪळϨࡽڔࡕעфԷ јೋ૮Зفخಀфস䦚
ϢЙۓછཟዐ༸࠴ఽцᇯැӾӓϡۤӳ䩟 Ԫܲጷ ϡмрڋਢϡಢऴኜф۟فϡूઌൖЅի೯䦚 Ѽґ䩟 ؑϴϡХϤঝӊױ䦚 ϨࡏϬ֩Ѕ䩟 Јϡઌൖ䦙 ޝфӸϽҨ֏ԗϥӥѴёфё۵ࡣӛۓϤ Нվϡ䦚 ೖಿԗবࣃᇯැԁЈ֞ࡢԚֲׁ䩭 ଝဵఽ࠴࠹׆ 䩛د၉ଝဵఽ࠴࠹׆ඎϨֵ䩜 цዐ༸࠴ఽϡবࣃ ҝӔԅЏԍڶ䦚 בකӓবࣃԛᇯැӛࡢϩϡۨԸ ղۜजϡၘҨ 䩛س䩟 ۱ѓଝဵࣃఽ࠴࠹׆ঝҀท ዐ༸࠴ఽ䩜 ӔҮҩ৭ڶ䦚 ԗଝဵఽ࠴࠹׆ඎԁבකӓ বࣃԛᇯැՖҲږଯԛϡֲׁ䩟 ӑЋዐ༸࠴ఽॵ ׁবࣃᇯැϡϣחд䩟 ЌӪল۽ङዐ༸࠴ఽזዐ༸࠴ ఽംԛϡԛଏຖфఽଏຖت䦚 ԲԛІܷ݁ࢲޔدभϡবࣃӑѓЇϩϩЪϽϡҽН Ӹй۱ѓ䦚 Ϩ܋ӡϡ䦧ހ䦨мр䩟 ࡷЈᇯٍԲԛІ݁ ܷࢲޔدभϡଛײבϦϸϣ۵ࡣ䩟 ЌϽ֝ᚤँ ҪܧзԳϡዐ༸࠴ఽᐭєϡЈтҀท䦚 ۓછԗԲԛфѽԛԥҪࠇۂӎ්า፣ߓ۟ӑЋবࣃ ਢϡݒᔉ䦚 ϤР䩟 ߙٍفѓԥҪࠇϡϮ۔࣑؝Ҫחӥ Ѵ䦚 ԥҪࠇਢϡࡷЈНԗዐ༸࠴ఽцᇯැזӓԐ Ֆ䦚 ୳ءϩϡח৹ጶ፣фዐ༸࠴ఽᐭြԗюЋя ೯מϽϡዐ༸࠴ఽবࣃݾবᇯැϡϩҨਤࣘ䦚
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
15
фࣇخзୟфըছзҙϡϪळ䩭 ዐ༸࠴ఽц ᇯැϤЌӗಃଯъԈիؙড়зԳфҩ۲ϡϪ ळ䦚 ϩϡዐ༸࠴ఽবࣃᇯැфᔼݾবᇯැۓછ վѽфёڴѽԛ䩟 ϨЪЄмр䩟 ԧЙϣׯϥз ୟфիؙড়зԳϡϪ䩟 දԷϥϨᐭєԳϡྺՀࠁ й۪ۘರ䦚 ЋӸמऴӊघ߇ϡࠖע䩟 ؑϴϽথϡЈ ҶфԳѢޝۄ䩟 ѓӊݙזվё٤పӾϡݾবᇯැ䩮 ϩсݸثԛԆફҨ䩟 د၉؝ԑ₱ࣔܦঊϡԛԆફҨ ՜֣䩮 ઁࠍվѽфёڴѽԛϡୟԛ䩮 ٍԲԛЏϺ ඎ䩮 ԳѢϪळ 䩛දԷϥԲԲԛҲЋٷ䦙 ڀथఽԘ ٷ䦙 ԛ֞ӑٷ䦙 Ըԛٷф୍䩜 䩮 ЋఽԘٍѓٷᓛࣁँ ߛਢ䩮 ЋԵ҃ϪטфѪрНஓϡϪळ٤పࠖע䦚 Ћ Ϧᘪએф๒ԗϪळࢉ٩фᇉӜ٩䦙 ࡾԐҙըছҲ Ћ䦙 ႛዢԅԼϩࠖעϡಬዓ䦙 ෨۟ϼϤԍכфϤ כҳϡ֚ಋфू೫䩟 Хؑϴ҂ѸЄ֞ӑ䦚 ઁࠍюӆф٤ҙଛ䩭 ϨޝիࡳфтࣁԳѢԚૠს ϡєୂЎ䩟 ϴϨёҏӓԗዐ༸࠴ఽࠖעᇓϽ۠ ӓӛ۔ϩϡথ䩟 ђЌ֡РઁࠍԮඡфԷјݘ Ԙϡ٣۴䩟 ٤ҙࠖעଛ䩟 Ѹׁԑсдࡈޝ䩟 йڝ ऎϽ֝ؖޝ䦚
૰ኁਈܿધܐᄌሇ
ಈԼߵЗ䦙 ьݬϡҪܧцᇯැ䩟 ӥѴږଯसଈЅޕӡ ϡࡢՄ۵ࡣ䩟 ԗϩсֲټᐭєϸϣҪܧԍਛТᙈ 䩛ԋ֘ф֘䩜 䦚 ࠾ׁмዐ༸࠴ਢឱӛࠃ߹ϡথܴЛ Ҵ䩟 ԗҙؙড়ҨϡবࣃᇯැҤଈԁӸמϪࣇخઌൖ Ԛֲׁ䩟 ٍഠ࠻фඎ֞ӑӸь䩟 जНԗ10䩭 • юϪዐ༸࠴ఽЈтҀทԪёϡݚຎЎઁ۠ • • • •
ёϡݚຎ䩮 Ϩё೬ݚݪຎዐ༸࠴ఽҀท䩮 Ϩёҏӓ೬ݚݪຎոুҀท䩮 Ϩёҽ೬ݚݪຎዐ༸࠴ԚԮӚ༆䩮 Ћዐ༸࠴ఽඎڝᏼѤׄϡ֔юӆ䩮
• ٍٿмцዐ༸࠴ఽϡޝۄԅЏٚහϡҘۏ䦚
цዐ༸࠴ఽцᇯැϡՖϣޝۄ܌ϩНЌц 䦭Н۟ف тࣁ۵ࡣ䦮 ЅϡԷјࣉ۵ࡣ 䩛䦧۵ࡣ䦨䩜 ݘТԳϽؙ ড়䩟 ԝҒ䩟 ԁෂਛТ䦙 ֲಚ࠴䦙 ࠴ఽԛႣ䦙 ۘتทԛ ᅔ࠴фظؘਛТ䦙 ٍڱѓᅣዢ䦙 ԛԁТᜊࣉ䦙 Ҫھ ࣉҳϩԮϡ۵ࡣ䦚
10 ம੍ଓཨܻ˖ ৠཨᄵˈވ ጴถܸijıĴı೧ᄂڼՑᏃᄵၳ࿏ȃ ਈũŵŵűĻİİŸŸŸįŶůŢŪťŴįŰųŨİŴŪŵŦŴİťŦŧŢŶŭŵİŧŪŭŦŴİŮŦťŪŢŠġŢŴŴŦŵİijıIJĶıķŠŋńijĸĵĴŠ ŖůťŦųŴŵŢůťŪůŨŠŇŢŴŵŕųŢŤŬŠŦůįűťŧ ˄ijıIJķ೧ĴኟIJĶ๊ߺၳ˅ ȃ
16
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
ဇij˖ ՑᏃޗᄧߙࡥำਠኁك
2.5 ଓཨܻ 2 ᄧ ߙ ࡥ ำ 1.5 ༮ ܠ ၤ Ļ վ ွ ˄ġġġġġġġġġġġġġġġġġġġġ˅
0 ሣߒᄧߙࡥำ
75% ਠ ijıIJı೧ፚijıijı೧ ᄧߙࡥำ˄ࣽ፱ ݞเฯ˅ ᇵ၄ՑᏃޗ ᄧߙࡥำฎ ၕڕijıIJĵ೧࠵ႚ ༽൶ܿଝኁ ᄧߙࡥำ༮಼ ኁՑᏃޗᄧߙ ࡥำ༮಼ȊȊଓཨ ܻ
1
0.5
2010
2015
2020 ೧ࠔ
2025
2030
ဇĴ˖ ՑᏃޗყ࣋ཏ၁ਠኁك
2.5 ଓཨܻ 2 ཏ ၁ ༮ 1.5 ˄ġġġġġġġġġġġġġġġġġġġġ˅ ܠ ၤ Ļ վ ွ ਠ݈ՑᏃޗ ყ࣋ཏ၁༮ ܸijıijı೧ਠፚ ᇵ
500.000
1 ᇵ၄ՑᏃཏ၁ ฎ 0.5 ኁՑᏃཏ၁ ༮಼ȊȊၕڕijıIJĵ೧ ࠵ႚ༽൶ ኁՑᏃཏ၁ ༮಼ȊȊଓཨܻ
2010
2015
2020 ೧ࠔ
2025
2030
ହኑ˖ ठ࣭ՑᏃࣙढ़༡ˈ ijıIJķĮijıijIJ೧ዸకˈ ਈũŵŵűĻİİŸŸŸįŖŏłŊŅŔįŰųŨİŴŪŵŦŴİťŦŧŢŶŭŵİŧŪŭŦŴİŮŦťŪŢŠŢŴŴŦŵİġ ijıIJĶIJıijĸŠŖŏłŊŅŔŠőńŃĴĸŠIJĶŠIJĹŠņŏŠųŦŷIJįűťŧ ˄ijıIJķ೧ĴኟIJĶ๊ߺၳ˅ ȃ
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
17
ਓஅခᏁ୲દ
ޝۄԑࣝ䩭 • ࣠ࣝмє䩟 ءӡф٤పݾؑۓবᇯැфࠖעϡ • • • • •
ӥѴь֡ݬѬࡣ܋ӛؑۓϡ֞ࡢϽחдЁӔϨീ䩟 ྋ ϨᆠᖿϡϥၘݾϨϡԳϽڢٛфࡷЈ䦚 ϴਘԷࣘд т༯ӑѓ䩟 जؑϴႭݬᇓϽцዐ༸࠴ఽцᇯැϡѴ ϩޝۄ䩟 ԗޝओЅ۠зϩϡࠖעфݾবᇯැ䩟 й ߵዐ༸࠴ఽتз൬фзԳϡϪळԁс䦚 Ԫӛ ϩϱЋЅࠍּՊмрϡዐ༸࠴ఽਢ҃ϡޝԪ ёҶӸϦᏼѤׄ䩟 ϨёܼϺ ᏼѤׄ䩟 ব ڋϨёНӐҶӸ۠ᏼѤׄ䦚 ϸϣϼۤࠌڢҰ ϴϥۥӊмֵޝۄҶӸ䩟 ϨёऎϺւϡ䦚 ߊ܉Ғױ䩟 цዐ༸࠴ఽϡۓޝۄછϨёҶӸ۠ ᏼѤׄ䩟 ϨёҶӸ۠ ᏼѤׄ 䩛ҒҝцᐭєӥѴ ӗସء䩜 䦚 Ϩڋޕфӥැҙଛ䦙 ҙ֝ڱфҪӌϡዐ༸࠴ఽע ࠖҤӌ䩟 ܙЄмрڄۯϦϽ֝Үࡑф֠भ䩟 цዐ ༸࠴ఽϡୟԛ䦙 тТଛ䦙 т࠴ଛфӚ༆ଛ䩟 йߵዐ ༸࠴ఽҀทٷϡТ҅ݘ֝ڱТϦԳϽؙড়䦚 ٿмЁϩ Ͻ֝ҜϿٍԷዐ༸࠴ఽцᇯැݘТٟቸ䩟 זԷјм рѺܠЌႭݱ݆ݬфӥැзϩϡू೫䦙 ࠖעфݾব ᇯැ䦚 ۥӊНЏϺϡޝϩࡳ䩟 ٿмؑϴ௩࢛ਢ䩟 ޕӡᒩ໘ ґѴӥϡӆмࡢՄ۵ࡣ䩟 מ߹ࠃϽϡޝۄԑࣝ䦚 ޝۄ ԑࣝЋࣘддࡈмֵޝфՖ҃ޝח֔٤ప ԜӾϡԑۥ䩟 ࡧࡾݨԆНفݒϡҪׁܧӑଏ䦚
বڲ䩮 Ұצзࡢюӆ೯ϡݾবᇯැ䩮 ৭ӡзիؙড়ϡϪळфсѢйߵԳѢ٤పϡ ޝ䩮 ءӡзϩфԍכϡࠖע٤పথܴ䩮 มϨਛТՄৢٿڍӌҏҽзׁԑϡޝдࡈ䩮 ࡧԆၘϨфНۻϡؖޝϱ䦚
ϨږଯसଈӛዧϡࡏёЅ䩟 ؑϴԳЈుဖϡҲ҃ф ࡷЈ䩟 йҶӸؙড়ҨфԳൾޝۄઌൖ䦚 ږଯसଈЋϼ߹ࠃޝۄϦԑࣝ䩟 ࡧԆомԆਢф Ԓ֎ਛТॵϡҲ҃ᄬԳϡٚϬږଯҤז䩟 มϦ ЌݘТзϽؙড়ҨϡԳѢݾবᇯැфࡷЈ䦚
02 ዸకଙ৩
03
ՑᏃޗዸకؾ՝ჵႼளዸకؾ՝ፇᇜˈ ௐိჵijıIJķĮ ijıijı೧ၩໍؠ፮ੌޗᄹࡣᆚሀዸకؾ՝ञ፮ੌᄹۈ؆ࡥ ำዸకؾ՝ȃ ຢ༧ዸకؾ՝تቂமࢥܿੌࢬˈ அᏚࢋᏠ ፈଙ৩˖ ภಐࡇ಼Ȃ ၩໍ࠵ႚܿஏᅝࣰڋȂ ࢞ࢥၩໍ ߴጦȃ ჵዸకؾ՝ޕၓம֔᎓ო Ȗ૰ڕᅝߙዴ಼ȗ ፩ܿ ಼ ˄ Ȑ಼Ĵȑ ˅ ȃ ՑᏃޗዸకؾ՝ٜ༧மၩໍؠܿՑ Ꮓޗሥޭ܈ट᎓ო Ȑ፮ੌՑᏃȑ Ȃ ภಐࡇ ञඝྊ፱ᇋܿၩໍቪߙዴ಼ȃ ྋቪඝྊყ࣋ၩໍዸక֦ڕ 11 ᇜˈ ˈ Ȗᄂੌڼजዸకȗ Ȃ ठ࣭ՑᏃࣙढ़༡ዸక ˄ຢၭዕ࿎ঽ˅ ˈ ᇵঽඝྊՑᏃޗዸక ˄࣋ਉठᏮঞ֎ܿዸ కȂ ؠञؠዸక˅ ȃ
11 Ȗᄂੌڼजዸకȗ ˈ ਈũŵŵűĻİİŸŸŸįŸũŰįŪůŵİŵţİŴŵųŢŵŦŨźİŦůİ ˄ijıIJķ೧ĴኟIJĶ๊ߺၳ˅ ȃ
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
19
ቈ Ȗ૰ڕᅝߙዴ಼ȗ ፟ߴށჹ
ᇵภಐࡇ಼ၓᏓ࿒ଙ৩
䦭Н۟فтࣁ۵ࡣ䦮 ЋёءӡϦϣڤᒩ໘䦙 ٹϡтࣁ৷ࡄ䦚 ࣉϥϸڤњё৷ࡄЅϡϣϬҰ ϴ۵ࡣ䩟 ՄѴϦؚцँվᆢфՖтࣁӛт༯ϡಚК ӑѓ䦚 ԁࣉԚԮϡН۟فтࣁ۵ࡣ 䩛۵ࡣ䩜 ϥఱцӊ тࣁґߞ۠ԮԳϴϡϣ࠶ڍਛТҤӌϡखږ䩟 දԷϥ Ԯӊتทԛᅔ࠴ϡ۵ࡣ䩟 ԷЅϲدଭϦֲټዐ༸࠴ ᐭє12䦚 Ћֲټዐ༸࠴ӛоϡझҨЇϿцԷјࣉ ۵ࡣݘТؙড়䩟 ԝҒ䩟 ઁࠍ຺ݘӚ༆ଛ 䩛۵ࡣ䩜 䦙 ࣃঝЈТոфٚۗйЎոুӚ༆ 䩛۵ࡣ䩜 䦙 ઁࠍۘت ทԛᅔ࠴Ӛ༆ଛфՖࣉظؘ 䩛۵ࡣ䩜 䦙 বࣃф ඎٍڱѓᅣዢ 䩛۵ࡣ䩜 䦙 ԛфТᜊࣉ 䩛۵ࡣ䩜 䦙 ӥѴҪࣉھ 䩛۵ࡣ䩜 䦙 ԅԼҮ௸ϡфᐭြ 䩛۵ࡣE䩜 䦙 ЋࣉቻޝфਛТϪҨޝ 䩛۵ࡣF䩜 䦚 ङц۵ࡣϡؙড়Ҩҏ֔䩟 ֲټዐ༸࠴ᐭєХԗϩࡾӊ ۽ङᆢ 䩛۵ࡣ䩜 䦙 ֲଚᙬਜ 䩛۵ࡣ䩜 䦙 ӥѴҖԛכҳ ߵЋѽфѽיᔼ 䩛۵ࡣ䩜 䦙 ँվࠖעфݘԘԅԼಬ ዓϡϤכҳ 䩛۵ࡣ䩜 䦙 ՖዋࣔѪ᥋؇ϡبدԛघϿ 䩛۵ࡣ䩜 䦙 ЋӥැቻޝфЌҨࠃޕ 䩛۵ࡣ䩜 䦚
ϨҪܧ䩟 ӹІࣨඎ٭ѓࣔঊҟёᏼϪҮࣄࠖᇻ ԡфᏼϪ໑իᆢ䦚 䦭Н۟فтࣁ۵ࡣ䦮аՒӊ৭خ ࠖ ԥҪфࣉԍכԛϡԳϴԛ䩟 Ҫࣉ ھ ۵ ࡣजЋݸثϸԈ՜֣ءӡϦᕴବ䦚 ӾھЁЌЏϺӛ ؑϴϡਛТࠖעЗ䩟 ϲЌӥѴҪࣉھ۵ࡣ 䩛ԋ ֘䩜 䩟 ґϸԈࠖעϡ߿֝ڱйٍєୂۨ䩟 ٍϪळϤϿ ထՊ॒ࠖ䦚 ҪࣉھҰϴۥѧϬԚૠԮ࠾ϡ۵ ࡣพю䩭 ᇓϽऴӆࣉࠖעϡࣻ䦙 ٤ڢऴӆࣉࠖע ϡ֝ڱ䦙 ҶӸऴӆࣉࠖעϡНЏԛ 䩛ӛؑϴϡע ࠖ䩜 䩮 ٤ҙࠖעϡԍכԛфԚцӊؑؒґߞзϡಈѓ ଛ 䩛ؑϴࠖעϡϪळ䩜 䩮 ઁࠍюӆфЋؑϴࠖעϡ Ϫळ٤పࠖࣇخ 䩛ࠖעϡюӆ䩜 䦚 ڦаޝϡҶӸ䦙 ଛфЌҨϡ٤ڢ䩟 ӛ٤పϡࠖע ࣻЏйᇓϽ䩟 ֝ڱϩӛۨ䩟 ЌѸЄϪळ䩟 ઁॸ ࠍؑϴٷϡבׯюӆ䩟 ཱྀ܌ӥѴҪࣉھ۵ࡣ䦚
ဇĵ˖ ภಐࡇܿࢋߴಅ
ਠ݈ྈࠍྜܿ ׁڈঽࠈቂ
ፊਾࠈቂ ࡇܿࠈቂஂġ
ࡇเฯ ಼ࡇ߭ၐ
֡ଭඝྊ࠵ႚ
࠵ႚ ࡇುᄎ࠵ႚ˛
เฯ ġġࡇುᄎเฯ˛
12 ठ࣭ܐঐĸıİIJखિሊ˖ Ȗ࡙קၻ౦ܿ˖ ijıĴı೧૰ڕᅝߙዴሊڋȗ ˈ ਈũŵŵűĻİİŸŸŸįŶůįŰųŨİŨŢİŴŦŢųŤũİŷŪŦŸŠġťŰŤįŢŴűŀŴźŮţŰŭľłİ œņŔİĸıİIJħōŢůŨľņ ˄ijıIJķ೧ĴኟIJĶ๊ߺၳ˅ ȃ
20
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
ਖՑᏃ࠵ޗႚܿஏᅝࣰڋ ᏮၓᏠፈଙ৩ Ҫࣉھ۵ࡣЋږଯसଈஔ߹ϦւՄᕴବ䩟 ዐ༸࠴ ఽࠖעϡ۟ۂРࡄۂڈ၌РࡄजЋӥැءӡϦॵᕴ ବ䦚 ٿмϨݱϬࠖעϡ۟ۂРࡄЅӥැࡢϩҙؙড় Ҩ䦙 й࢙ࣝЋऴኜϡݾবᇯැ䩟 ѓйઁࠍዐ༸࠴ఽୟ ԛфըছ䦙 বࣃ䦙 ᒎआ䦙 ඎфӗࣇࣨ 䩛ԋ֘䩜 䩟 ԗԳ ѢӵϨዐ༸࠴ఽتз൬фзԳϡϪळфс䦚 ࣝ࣠ϤӎϡϪळ䦙 ޕැфᐭє҇ण䩟 ݆ݱфฮ࠻ע ࠖϡ۟ۂРࡄ䩟 ৭ֲخಚ࠴ф࠴ఽԛႣҳԋׁ ೋ՜֣ЇЏϺમϮϡݸث䦚 ږଯसଈءӡϦ۟ۂР ࡄЅӛدଭϡऴӆࠖעфݾবᇯැ䩟 Ћ࢙خф٤ҙ ࠖעԁਢϡ֝ڱ٤పϦࠃ৷䦚 ϨϪळੜؕዐ༸࠴ఽ ࠖעϡ۟ۂРࡄཱྀב܌իࠖעЗ䩟 ϿоѴԵ䩟 䦧ᇄо ߃юϦفۅଛۂ၌ँվѴࢣ䦨 䩛ԋ֘䩜 䦚 Է۵ϡϥٍϬ ϪߊՉՖՊࠖעϡ۟ۂРࡄ䩟 ߈خϨࣇԑРࡄЅ䩟 з Ͻࡳ֏сँվۂ၌РࡄЅϡᇄо䦚
ဇĶ˖ ဵጶஏᅝܿՑᏃ࠵ޗႚञၕڕఋ࿊ৃੌࢬ
Ց Ꮓ ޗ ߷ ፧ ࠵ ႚ ܿ ࿊ ৃ ੌ ࢬ
HIV HIV HIV HIV -
HIV +
HIV +
HIV +
HIV +
ྈเ
ဵ ጶ ஏ ᅝ ܿ ࠵ ႚ
ኁ߷ঝވ ࡇܿ เฯ
ਾ། ৹ܿك เฯ
ம੍Ꮛে Ꭻଝܿ เฯ
ৠᇞன ढ़ܿ เฯ
ਾ། ፧னܿ เฯ
ၕڕ ፧னܿ เฯ
ޗ ܾܸᇷ፟ܿ เฯ
ਾ།٣ඓ ᇞ॓࠵ႚܿ เฯ
ኁ߷
৹ك
ᇞன ვਾ
፧ன
٣ඓ ᇞ॓
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
21
࢞ࢥ ၩໍߴጦ ږଯसଈယ࣠ӊϣ࣮ԍਛТҤఱ䩟 س䩟 Ԯڀӊবࣃᅔ ࠴䦙 Ֆࣉф෨ӗϪטႏܞ䦚 ؚᙲϨ৭ھخЌзܲ ጷсԅЏҙ֝ڱϡࠖע䩟 йҮРߣ٩фࡣކ٩ϡݾব ᇯැфࠖעЋऴኜ䩟 ԔٍسϨޝϩࡳϡޕැЅЇډ ӊՖҲথ٩䦚 ԍਛТҤఱϡ۵ϡϥӥѴࣉϡԍ כԛфՖԛԆכҳ䩟 ٍघ߇܀ԁԷЅ䩟 ԗԍфॹ ח՟ϡҨ֝ѓӊцᇯැ䩮 ϨۓϴЗ䩟 ֡Р֚ಋ䦙 ฮ܉ фू೫ۨཪ䩟 Ϩू࣮ٿ೫Ѕዋࣔࣉ֍ज䩮 ঊҨӊӸמ ዐ༸࠴ఽԚԮࠖעԁԷјࠖעϡׁݱфԮ࠾䩟 ҶӸؙ ড়Ҩф٤ҙଛ䦚 ϸ࣮ږଯसଈϥऴӊ߲ܙࡾݨЄмрӸמਛТՄڍԪ ґ٤పѸࠖעڱހϡዐ༸࠴ఽцᇯැ䦚 ϸԈцᇯ ැэࡷϦቻޝথܴфږଯ䩟 йઁࠍݘԘ٣۴фϬϪߵघ ߇ϡࠖըছ䦚 ዐ༸࠴ఽцᇯැྗ٩Ϧ॓Ѻфभϼ ϡ߷䩟 ࢙ҴϦϨࣘٶखږϡࢲ॒ЅႭݬᇓϽைࢭф ԍਛТڋਢϥНҲϡ䦚 ֡Рд્фԮ࠾ϡࠖע䦙 ࠖڗ ׆фѸמϽϡቄח՟ׁӑ䩟 Ԑ҃ϦਛТࠖע٤పথ ܴϡ׆Ը䦚 ϨҶמϡՄڍЅ䩟 ц٤పӗࣇࣨф٤ҙټ Тඎϡ࣊ԪԛԁفخଛϡϮ؝ЇЪҴࣸ䩟 ۨՖϡฮ ࠻ф߯ຽ䦙 ಈकфдࡈࢅڍЇϥҒױ䦚 Գϴϡϥ䩟 ؚЙ ۱ѓϦٍघ߇܀ԁڋޕ䦙 ӥැфฮ࠻ዐ༸࠴ఽਢϡ ۤހ䩟 ᙪࣸϦؚЙϨӸמԑф՜ૺҤӌϡӑѓ䦚
03 ንȂ ಼ञ ન࿒಼
04
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
23
ዸకؾ՝ٜ༧மภฉንȂ ภฉ಼ञᇜႼளภฉፑ ˈ ૂቪठ࣭ՑᏃࣙढ़༡ؠዸకञ Ȗ૰ڕᅝ ߙዴ಼ȗ ፩ܿንȂ ಼ञፑᇜȃ
ን ን˖ ภႇՑᏃޗᄧߙࡥำˈ ႇՑᏃޗყ࣋ཏ၁ˈ ՑᏃࡥޗำጚ །ච༄ˈ ࢮ٣༊ȃ
಼ ಼˖ ܸijıĴı೧፮ੌՑᏃᄵ ጝᇜ࢞ࢥၩໍ၉ᄗˈ ุ೧ேާܿ ྈเࣰޕຢܿໍঝˈ ۶ྊ౦ܿ࠸ᮚȃ
ijıijı೧ภฉન࿒಼ ภฉન࿒಼˖ ࣮࣭য়ᅻཨتถᄵވᏚࢮિᄩ ოijıijı೧ऻၙ಼ˈ ખ૰ᇵ၄፮ੌՑᏃᄵၳ࿏ܿߴ ჹశڵᇜ؞ܐȃ ጝᄎ಼ቂࢋเ˖ ߒȂ ຬ೧ञ ڈเ˗ ࡐเञฅเ˗ ഉᄹञ್ᄹ˗ ᇵঽྈ፱ݞเฯȃ ᏐՑᏃޗᄧߙࡥำቂळܸijıĴı೧፮ੌՑᏃ ᄵጝᇜ࢞ࢥၩໍ၉ᄗܿᏓ಼ოଝܿ᎐ᇋዴ ፑȃ
24
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
ዐ༸࠴ఽԚԮӚ༆䩭 • Ҫܧዐ༸࠴ఽԚԮӚ༆Ϫّઁ۠ݚϪйЎ䩮 • ዐ༸࠴ఽҀทٷӚӊֲಚ࠴Ϫّँվ䩮 • ੜؕӛ৭ӡϡઁࠍӛϩߝԛᒬႣфᴙႣҀทٷ
ؖޝН۟فԛ䩭 • ࠍּՊࠍּՊфЅҳּՊмрዐ༸࠴цޝۄւ
Ӛ༆ଛ۵ࡣ䩟 ԗዐ༸࠴ఽׁҀทٷӚӊᒬႣф ᴙႣϪّँվ䦚
ܼϺᏼѤׄйϼ䩟 ԷЅмֵԍޝۄһכϨ Ѵϩऴኜϼ۟فҶӸ䩮 • ৭خӛϩмрԗᆨׁዐ༸࠴ఽऴӆࠖעรՊӆм ਛТపޝԥٕ䦚
ഠ࠻фඎ䩭 • ৭ خϡዐ༸࠴ఽҀทٷҌѬІѝӔҀทዐ༸
ࡷЈ䩭 • ӸϽѓӊඎфবࣃϡዐ༸࠴ఽԚԮᐭြф
࠴ఽ䩮 • ৭خӔ৭ᒎϡ ዐ༸࠴ఽҀทבٷիଝဵ࠹׆ ࠴ఽඎ䩮 • ৭خဪءԜבիඎϡ ዐ༸࠴ఽҀทٷϡ࠴ ఽ՚֝䦚
ϡ୳тҨ֏䩮 • ϡмр٤పد၉ዐ༸࠴ఽ䦙 ֲಚ࠴䦙 ᒬႣфᴙ Ⴃ䦙 ТᜊࣉфԛتҀทҳᆨׁਛТࠖע䦚
বࣃ䩭 • ዐ༸࠴ఽЈтҀท࠴ຎّઁ۠ݚຎйЎ䩮 • ѪᆯոЈтҀท࠴ຎ䦚
᥋؇䩭 • ЬϩԮӊዐ༸࠴ఽϡ᥋؇ԛ֚ಋ䦙 ֺຎфू೫䩟 Ϩ
ӛϩࢲ॒Ѕ䦙 ئԆϥਛТޕැЅዐ༸࠴ఽҀทٷϤ ի᥋؇䩮 • ϡዐ༸࠴ఽҀทٷфԳѢϪळݍۏЬϩϨਛТ ח՟իϺ᥋؇䦚
ਖՑᏃޗᄧߙࡥำஂ༮ਠፚ
500 000 ຎйЎ* *ijıijı೧ภฉન࿒಼
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05 – ಄ݤዴഉᄹ ภ࿄
ijıijı೧࣭য়ન࿒಼ мрзϮؕ܀Ҫܧ۵ࡣфࡢՄ۵ࡣ䩟 ߊьءӡӆмёф ёҏњϡᒩ໘۵ࡣфࡢՄ۵ࡣ䦚 мрϡ۵ࡣфࡢՄ۵ࡣߎ ഒϺӆммє䦙 ӆмዐ༸࠴ఽԵҲϡԛڱф҃ݮ䦙 իؙড়Ϫळ䦙 ਛТࢅڍخфघ߇ࢅڍϡֲพфЌҨйߵНй݆҃ϡޝ䦚 ࡢ Մ۵ࡣࡢНҲԛ䩟 ऴӊዐ༸࠴ఽєୂ䦙 ࠌۤфц೫ϡзН Џّࣝ䩟 цؕϣࠇݱН႗֝ϡࡣࡣ܋ކйฮ࠻䦚 ࡢՄ۵ࡣ ӾѓӊҟϬϪ䦚
04 ዸకߴჹቪ ፱ݞᄵވ
ၓოijıijı೧ञijıĴı೧ܿન࿒಼ˈ ᅍᇋ ႎࢋቱ ˄ু Ȑዸకߴჹȑ ˅ تถᄵވȃ ᇜዸకߴჹˈ ࢌ࣭Ȃ ၩໍᏠፈ ञठᏮঞ֎ᅍتถ࿅ܿށᄵވȃ ዸకؾ ՝࡚༧ம࣭য়ञၩໍᏠፈሥتถܿ ቄᄵވȃ ਓሊتถܿᄵވሃፑܷ࣭ য়Ꮾڵഇஉˈ ࢎદׁ࣭࣏ܿჄฝञߟࣙˈ ᅤዎञᏥ࠲ठׁ࣭ଝञᏥۃ ୲ׁ࣭ՑᏃޗᄵၳ࿏ܿᄵވȃ ಼ܿ Ꮵܐქݓޡ࿎ࡴՑᏃޗቪඝྊၩໍ ቱܿᄒᄌሥˈ ၩໍؠܿሥޭ܈ቪ ඝྊภฉञߙዴዸకȂ ढ़ञ಼֦ ڕᇜȃ
06
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ዸకߴჹ ᇵၓ࣭য়ञၩໍᏠፈܿቄ ᄵވ࿎࢜ፑሞܿႎࢋዸకߴჹ˖ ږଯҤז䩭 ՖԳѢҲ҃ϡҞ֥ 䩛Ϧثӆмᐭєфцᇯැ䩜 䦚 ږଯҤז䩭 ݘТؙড়ϡݾবᇯැ 䩛ӛؑࣻࠖע䩜 䦚 ږଯҤז䩭 ԍכс٤పࠖע 䩛ؑϴࠖעϡϪळ䩜 䦚 ږଯҤז䩭 ቻޝՖН۟فԛ 䩛ࠖעюӆ䩜 䦚 ږଯҤז䩭 эࣁࡷЈ䩟 ӸьՖࣁ 䩛ࣁֳ۔ϱ䩜 䦚
ဇķįġijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸకܿ ႎࢋዸకߴჹ
ንȂ ಼ञન࿒಼
ᄵވଙ৩˖
ภಐࡇ˗ ဵጶஏᅝܿ࠵ႚ˗ ᇵঽ࢞ࢥၩໍߴጦȃ
ภಐࡇܿࢋߴಅ ዸకߴჹIJ ۶፱ݞ ᄵܿވᄪႩ Ȑटเ ȑ ቪ Ȑटۃȑ ዸకߴჹij ٛໍሯჳܿ ࡞ኁ܈ Ȑȑ ዸకߴჹĴ ࢞൶ݓ ࿎࢜࠵ႚ ȐᏭߟȑ ዸకߴჹĵ ڮᏁ۶ ૰ڕઌᄹġ ġ ȐڮᏁȑ ዸకߴჹĶ ዴۑᄧˈ ৠଓዴ Ȑၝହȑ
ዸకܿ˖
ܷȂ ঞ֎࣋ႼȂ ၳውȂ ৭كቪ൹২
28
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
ҟϣږଯҤזఱцϣॵئӡϡ՜֣䩭 ዸకߴჹIJ˖ ოᎫȃ
ዸకߴჹĵ˖ ࡇྈ࿎࢜࠵ႚׁܿڈȃ
ԳѢԮڀцዐ༸࠴ఽᐭєфцᇯැϡϦث䩟 ӑЋୌ ت䦙 ूઌൖ䦙 мрਢ䦙 ҃ޝфдࡈ䦙 ӥැфۨ Ֆਢϡऴኜ䦚 ዸకߴჹij˖ ሥ࿎࢜ܿ࠵ႚȃ
ఱцҪࣉھ۵ࡣϡҷѧϬ֏ۅ䩟 ࡧԆЋዐ༸࠴ ఽцᇯැቻᇯؖޝϡН۟فфࡷЈথܴ䦙 ઁࠍюӆ ϡҤ֚фࠖࣇخՄڍ䩟 ٍھЌϨϤထՊ॒ࠖ ϡєୂЎԅЏӛؑࠖע䦚 ዸకߴჹĶ˖ ࡙קሥޭ܈ܻܿࣟȃ
ఱцҪࣉھ۵ࡣϡҷϣϬ֏ۅ䩟 ᆡϨዐ༸࠴ ఽࠖעϡ۟ۂРࡄЅؑ٤పϡϣॵࡢϩҙؙড়Ҩϡऴ ӆݾবᇯැ䩟 ۵ϡϥܼϺмрфҪࡣ܋ܧ䩟 ߎഒรՊ мрਛТ۱Ҥଈ䦚 ዸకߴჹĴ˖ ࿎࢜࠵ႚܿߴȃ
ࡧԆϨҌࡧфभҤӌࡖϨҰϴઑטϡ֩䩟 س䩟 ؑ ϴࡷЈйۨԸዐ༸࠴ఽцᇯැϡፊѬ䩟 ԪґӸьҲ ҃֏ݬ䩟 ӥѴёфёϡࡢՄ۵ࡣ䦚
ఱцҪࣉھ۵ࡣϡҷԏϬ֏ۅ䩟 ࡧԆЋϤӎϪळ фϨϤӎсѢ٤పዐ༸࠴ఽࠖעϡ۟ۂРࡄϡзҤ ֚фಬዓ䩟 йӥѴԍכ䩟 зϽࡳ֏ст༯ؙড়Ҩф৭خ ֝ڱ䦚
ዸకߴჹIJ˖ ۶፱ݞᄵܿވᄪႩ ம੍ׁ࣭ܿՑᏃޗሀञሥޭ܈ˈ ᇵ ເށ፟ܿሥޭ܈ Ҫܧዐ༸࠴ఽцᇯැҮРѧёӔࠌю়䩟 ԅЏϦ ӓӛ۔ϩϡۄؖޝՊ䦙 ԍਛТфभࡷЈفݒ䦚 ߊ ܉Ғױ䩟 ԳϽϡࠖעઑטകѼࡖϨ䩟 ԅԼಬዓࡖϨϤ ԍכ䩟 ޝऎଚЇքϱքࠤྋ䦚 цᇯැϨЎϣ႒ݫ ϡюۋԗԼݸӊऴӊٿммєфҙّࣝ֝ڱϡѸҙ 䦙 ϩఱцԛфڜفϡҲ҃䦚 ҙ֝ڱϡ䦧ཇ֏䦨ّࣝ 䩛س䩟 ϨਛТࣨඎࢅڍϡϤӎৢ ӌ䩟 ੜԛԆ䦙 ёූфԷјϪئטдण䩜 Ќٍዐ༸࠴ ఽࠖעѸކؘфҙ䩟 НחឱڈՖҲ݆ݱ䩟 йѸ ЄϩؑؒϡϪळ䦚 घ߇ф۱೯ԚԮٷѸЄс܀ԁّࣝ ּओфдЌ٤ҙҞ֥ϡ֝ڱфٍѓଛ䦚 Ϩಈओф ٍѓّࣝЗ䩟 ௬Ҳ۴ϡѬख़ࡣ۠ކԮԳϴ䩟 йݪ ߵϬϪԁघ߇ϡфԥҪ䦚 ۥӊޝϩࡳ䩟 ٿм ۱ѓϸԈّࣝࠃ߹ϩҨϡޝۄԑࣝ䩟 йԼԍכдࡈ мֵޝф҃ޝח֔䦚
ᇜੂާሥޭᏮ࢙ڈቪࠨ ถિࠨࢎદ࣭য়ৗଝ ञࡴ፣༮દتถᄌȂ ጦޭᄹञڕઌܿᄵވȃ
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ம੍ሀञሥޭ܈ȊȊቂિܿـ༮દ
מϽ䦙 ࢽ҅ϡږଯҞ֥ࢅڍϥୌت䦙 мрږଯਢф৭ ޝخзфзԍٍכѓϡऴ䦚 ዐ༸࠴ఽҞ֥ࢅڍ ۓછ๎ՊѸܲጷϡмрਛТҞ֥ࢅڍ䦚
༸࠴ఽࠖעϡϪ䦚 ϨЪЄޕැЅ䩟 חдϪळҏӛйҩ ᇄϨϡዐ༸࠴ఽฮସՄڍҏ֔䩟 ܊܊ϥӹЋјЙ ԡйԅЏਛТࠖע䦚 ϸԷЅد၉Ϧݙվё䦙 ԲԛфԵ҃ Ϫט䦚 ϨмֵфмԁмҏҽϡናфϪטԵ҃ϿࣸЯؙ ড়Ӿсዐ༸࠴ఽᐭєϡ҃ݮ䩟 ᙪࣸоԗԵ҃ϪטรՊ мрዐ༸࠴ఽږଯ䦙 ڋਢ䦙 झҨф҅҃ϡԳϴԛ䦚
ம੍ሀञሥޭ܈ȊȊޭჺञݞݓ
ዐ༸࠴ఽҞ֥ۓࢅڍછЌޢ䩭 ࡧԆዐ༸࠴ఽЈтҀท ϡсѢфϪळ䩮 ৭ӡዐ༸࠴ఽϡҰϴتথܴфըছ ҲЋ䩮 ব࠻ըছϪळфիؙড়Ϫळϡথ䩮 ฮ࠻ዐ༸࠴ ఽᐭєӛࣔঊϡਛТҤӌϡњҝ䩟 د၉ԋϡዐ༸࠴ఽ ׁҀทфԷјׁೋ䩮 ৭ӡϿҶӸϪळୟԛϡघ Ͽ䦙 ֚ಋфҮ௸૮ୂ䦚 Ϩիؙড়зϽϡс߇䦡䦡ྺՀࠁй۪ۘರ䦡䦡۔юё վѽфёڴѽԛߓ۟ઌիазਭԳϡዐ༸࠴ఽ䩟 ёڴѽԛϡዐ༸࠴ఽтТଛфථ࠴ଛϥёڴԲԛϡҖ හйϼ䦚 Ϩӛϩс߇ 䩛د၉ਭԳϡޕැ䩜 իϺዐ༸ ࠴ఽ࡙Ͻؙড়ϡϪळϥ䩭 ԲԲԛҲЋٷ䦙 ڀथఽԘٷ䦙 ԛ֞ӑٷ䦙 Ըԛٷф୍䦚 јЙЇϥࢹԡԅЏԮඡϡዐ
৭૿ञம੍ሥޭ܈
ฮସфϦثӆмфҪܧϡዐ༸࠴ఽцᇯැЌٍԚԮ ږଯޝۄѸҴ䩟 зϽࡳ֏с٤ҙԷϩԛ䦙 ড়ЌҨ фюӆ೯䦚 ؑϴҙ֝ڱϡّࣝ֝ڋዐ༸࠴ఽࠖעϡ ۟ۂРࡄϡԅԼಬዓ䦙 ಈѓଛ䦙 ӛϪळ䦙 ֝ڱфН בի֏䩟 й৭خцઑטфϤ߿ϡࡧԆ䩟 ߓґ৭خЌಈԼ ਤષᇯැ䦚 Ћ႗֝ਛТח՟Ϩዐ༸࠴ఽࠖעϡ۟ۂР ࡄЅϡцᇯැ䩟 Ԓ֎ਛТॵϡࠃ۪܋৷ٿмߎഒ ϨӾϡєୂЎಈѓ࣮мрࡣ܋ 䩛ԷЅ࣮ϥѓӊҪ ܧฮସ䩜 䩛ԋ֘䩜 䦚
ဇĸ˖ ቂ৭كဵጶஏᅝܿՑᏃ࠵ޗႚࣰڋ፩ՑᏃޗሥޭᏮ ञتቂՑᏃޗᇞ॓࿊ৃੌࢬܿ࣋ਉፑ
ம੍ ׁ࣭ሀ ሀಠ ˄፱ݞเฯȂ ೧ேȂ ᄹ׳ञݓቱ˅
ခ ၩໍႼ ခञڮᏁ
ٛڵञ࣮ڈ ဵጶஏᅝܿՑᏃ࠵ޗ
൹ࢳሯჳஉ ਠ݈ߙໍఋȂ ཏ၁ఋञ࢞൶ ൹ࢳ࿊ৃ ࢌੂާ࣮ܿڈ
ኁ߷
৹ك
ᇞன ვਾ
፧ன
٣ඓ ᇞ॓
ĩIJĪġՑᏃޗ ࡥำጚ
ĩijĪġ࣭ڵᏁ ቈׁ࣭ڵᏁܿ ՑᏃޗ ሥޭ܈ վࠍ
ĩĴĪġ፱ݞเฯ ኁ߷܈ ፱ݞเฯቂ ภ࿄վࠍড ࢋܠ᎙ືޗ൰ጚ ቂጦဂ༮
ĩĵĪġፃᄅ ՑᏃޗᎫଝ ᇲฬጪՑᏃޗ ࡥำጚվࠍ
ĩĶĪġᇞனვਾ ਾ།ՑᏃޗ ᇞ॓˄ࣽૠೣᎡ ޗ፧ன˅ ༮ञվࠍ
ĩķĪġܬਾ། ૠೣᎡ ޗ፧னਾ། ૠೣᎡޗ፧ன վࠍ
ĩĹĪġޗᇷ፟ ਾ།ૠೣᎡ ޗ፧னጚ ޗᇷ፟ఋĦ
ĩĺĪġՑᏃޗ ཏ၁ ՑᏃޗყ࣋ ཏ၁༮ञఋ
ȐłœŕȑġųŦŧŦųŴġŵŰġŢůŵŪųŦŵųŰŷŪųŢŭġŵũŦųŢűźġġ–ġȐőŘŊŅȑġųŦŧŦųŴġŵŰġűŦŰűŭŦġŸũŰġŪůūŦŤŵġťųŶŨŴ
ĩĸĪġૠೣᎡ ޗ፧ன ֦ڕఋ ૠೣᎡޗ ፧ன֦ڕఋञ ܃ঝఋĦ
ĩIJıĪġᄧߙࡥำ ՑᏃޗᄧߙ ࡥำ༮ञվࠍ
30
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
࣭য়ଓཨܻᄵވ ၓዴᄵވ࿎࢜ᄪႩˈ ࿎࢜ቄ፣Ȃ ঽܿ༮દˈ ቂᎳ फ़ፑञߴߟˈ ਾ།ၩໍᏠፈञठ࣭ՑᏃࣙढ़ ༡ፑೌܿፑሞȃ ࿎ࡴ༮દ Ȑஆޡȑ ˈ ՙ೧ேȂ ᄹ׳Ȃ เଁञ੍ࠍݞݓፚݓ ฏȂ ຺ฏञົˈ औݓம੍ߴݓሀˈ ൹ࢳՑᏃ࠵ޗ ႚஏᅝࣰܿڋᄌˈ ፑܷጦޭᄹܿခᏁञ࠵ႚȃ ਖՑᏃޗዸకᄪႩႼஏਾञ๏ࣖ߱ܿၩໍᄪ ႩႼˈ ၓᏒठዸకᄪႩ൶ྕ׳ትȃ
ၩໍᏠፈଓཨܻᄵވ ߙংภฉܷᏮቂˈ ቪठ࣭ՑᏃࣙढ़༡ठᏮˈ ጦޭ ՑᏃޗ৭كञၩໍؠሥޭ܈৭૿ȃ ົށᎳञᄧፑܷኊዏቪከᏮનˈ ቂ༮દ়تȂ ࠍ႟ञ֫ˈ ֡ଭ ȖၩໍᏠፈञठ࣭ՑᏃࣙढ़ ༡ܗߗݕՑᏃޗ৭كፑೌȗ ञ ȖၩໍᏠፈᏒठዸ కᄪႩፑೌȗ ȃ ၓࢌ࣭࿎࢜༦ፀˈڕ ᇵሥञၩໍᏠፈञ ठ࣭ՑᏃࣙढ़༡ܿዸకᄪႩፑೌञનˈ ቂৠූ࣭ য়Ȃ ݓฏञົܿ༮દႼ˗ ၓ፱࣭ݞয়ܿၩໍ࠵ႚஏ ࠍڋࣰۋ႟࿎࢜ፀˈڕ ፑܷ፣ܿ࿎໐ȃ ߙ؝೧ˈࡻ֫ޡ ֫ၩໍؠܿՑᏃޗሥޭ܈ञ ijıijı೧Ȃ ijıĴı೧ՑᏃޗન࿒಼ܿዴȃ
፧୲ቪၳው
࣭য়ଓཨܻᄵވ ൹ࢳञޭ࣭য়ՑᏃޗ፧୲ੌࢬᄵכᇋ࡙ܿࢄˈ ۶ ՑᏃ࠵ޗႚቪ࣭ࣖ߱ܿয়ၩໍࣙढ़ܿ࣋ञጶठˈ ᄒ ݲყ࣋ؠܿՑᏃޗሥޭ܈ˈ ᇵฬ֦ՑᏃޗ ־ Ȑࢉ୰ȑ ȃ ົށijıijı೧ञijıĴı೧࣭ܿয়ન࿒಼ञ୴ˈֱڋ নھၓ ፮ੌՑᏃጝᇜ࢞ࢥၩໍ၉ᄗྈົܿށภฉન࿒಼ȃ ൹ࢳञᄧ࣭য়ՑᏃޗዸకˈ ߫ሲ࣭ڵয়ՑᏃޗᄧፑ ञቄ፱ˈݞ ׁ፟ڈࣰ੶ށजིܿढ़ˈ ඝન ૰غᏮᄹȃ ৠූࣙढ़ၳውˈ ށඓ֫ࡻ࣭য়ՑᏃࣙޗढ़ܿȂ ڮ ᏁȂ ᄌञሯჳஉˈ ֡ଭijıijı೧ञijıĴı೧ન࿒಼ܿ ዴȃ ၩໍᏠፈଓཨܻᄵވ ፟ށञᄧፑܷኊዏˈ ጦޭ࣭য়ՑᏃޗዸకࣙढ़Ȃ ቄ གᅗञࠍׁڈ႟ˈ ፱࣋ݞ᎙ijıijı೧ञijıĴı೧ન࿒಼ܿ ዴȃ ၓࢌ࣭࿎࢜༦ፀˈڕ ᇵፍᄵ٢ࣙՑᏃࣙޗढ़ञ൹ࢳሯ ჳஉˈ צ৭࣭كয়ञภฉՑᏃޗન࿒಼ܿዴˈ ࡙ ນ࣭য়ܿଝȃ
мрዐ༸࠴ఽԑֲพ 䩛ԝҒ䩟 мрዐ༸࠴ఽਢ䦙 ዐ༸࠴ఽణϿфмр݆Ҝء䩜 цዋࣔҙц ᇯැ䦙 мрږଯਢфޝдࡈ䦙 Ֆू೫ۂᖝԛ䦙 ݆۱೯ԚԮٷϡࡠաфҲ҃䦙 ٍዐ༸࠴ఽцᇯ ැԁѸܲጷϡਛТਢفخϣঊ䦙 ৭ިࡢخϩ۱ࢲ ॒ࡢϩԳϴӑѓ䦚 мрूϡ֩ࣔҨцӥѴۂᖝԛ ф݆ԛ۠ԮԳϴ䩟 ԔϨӾϡЗԃ䩟 ЇڶНд્ ݸ೫ϡҺॶ䦚 мрዐ༸࠴ఽږଯҞ֥ࢅڍТюϡّࣝϥмрዐ ༸࠴ఽږଯфӥැڋਢйߵԁዐ༸࠴ఽϩԮϡԷј झҨф҅҃ϡҞ֥ऴኜ䦚 ږଯޕӡԁҪࡣ܋ܧф ЋۓױછಈԼϡҲ҃ԚϣঊϡмрࡢՄ۵ࡣ䦚 ږଯ ܋оЋюфҶמዐ༸࠴ఽцᇯැґؑۓϡԮ ඡू೫䦙 ֚ಋфֲพԛᇯැ䦚 Ϩዐ༸࠴ఽਛТږଯԁԷјԚԮږଯҏҽ߹ࠃ ֜ᎋϡԮ࠾䩟 њدٷ၉ח՟ዐ༸࠴ఽږଯ䦙 ԷјԚ Ԯϡఱцئӡᅔ࠴фئӡըছӹঈϡږଯ 䩛ԝҒ䩟 Ԯӊֲಚ࠴䦙 ԛߵТᜊࣉ䩜 䩟 йߵѸܲጷϡмр ࣉфтࣁږଯ䦚
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ዸకߴჹij˖ġ ٛໍሯჳܿ࡞ኁ܈ ಐ፳ሥঠܾྈᅍᇋܿᇜ෧ՑᏃ࠵ޗႚ ЋӥѴёবࣃ䦙 ഠ࠻фඎࡣ܋䩟 ۓછࠃ߹מϽϡ ਛТՄڍ䩟 Ќٍ܀ھԁф߈خϨዐ༸࠴ఽবࣃфࣇ ԑϡҪРࡄЅ䦚 ۓؚછ৭ھخЌԅЏϩϡዐ༸࠴ ఽবࣃࠖע䩮 ԅЏഠ࠻䦙 ᒎआҌ༿ዐ༸࠴ఽᒎआֲ ҝ䩮 ׆ೀ۠Ԛϡዐ༸࠴ఽবࣃבڈࠖעիࣇԑ䩮 ߊՉ э״ଝဵఽ࠴࠹׆ඎ 䩛Ғҝ৭ᒎЋዐ༸࠴ఽݵԛ䩜 䩮 ߙفϩϡඎйӥѴ۟فϡ࠴ఽဪء䩮 ۠׆Էјଝ ဵఽ࠴࠹׆ඎ֚ 䩛Ғҝඎਠ䩜 䩮 ЌԅЏӗࣨ ࣇфಪ֥ඎ䩟 د၉ࣃঝфସءԳϽׁҀทߵԷјׁ ೋ䦚 ፟ށՑᏃޗনׁ࠸ߴ՝
ٿмࣝ࣠ᐭєԸ٩䦙 ЈҌࡧфࡷЈ䩟 ߯ຽዐ༸࠴ఽ ऴӆࠖעҤଈ䩟 ӡϣࠇऴӆϡዐ༸࠴ఽݾবᇯැ䦙 ע ࠖ䦙 фݘԘ䩟 ԗԷรՊмрਛТ۱Ҥଈ䦚 ۱ ҤଈҪחڈחдоІԍؖޝ䩟 ԪґзϽࡳ֏ઁࠍІ ٭ѓ䩟 ৭خӛϩؑϴٷЁЌԅЏࠖע䩟 ॸዧݱϬ ዐ༸࠴ఽࠖעϡ۟ۂРࡄ䦚 ᣩשऴӆݾবᇯැфࠖע З䩟 ಈѓਧҴϡԵࡄ䩟 ٍԮඡ۱೯ԚԮ܀ٷԁԷЅ䩟 ֝ߎЎ࠶ࡣކ䩭 ϩԛ䦙 юӆ䦙 юӆ೯䦙 Нבի֏䦙 НҲԛ䦙 ԚԮԛ䦙 ؑؒфѬख़䦚 цҤଈՖҲӡ߯ ຽ䩟 ৭خӛࡺשϡݾবᇯැЌྱބомֵᐭєфмє ϡԸ٩䦙 भфࠖע٤పҤܴϡՖ܌䩟 йߵԮӊؙড়Ҩ ߛ؍ڈϡ࢙ࣝ䦚 ॵׁݾবᇯැછҮРئԆϡߎഒ䩟 Ҵ৭ חдݾবᇯැђϩԁԷјݾবᇯැֲׁٍѓҥЌт༯ ҨڈӥѴзϽؙড়Ҩ䦚 Ԓ֎ਛТॵϡ۪܋Ћᣩשфٍѓዐ༸࠴ఽ۟ۂࠖע РࡄЅϡݾবᇯැ٤పϦࠃ৷䩟 ւֲϦԮӊݾ҇ٿবᇯ ැфࠖעϡϩԛϡ࢙ࣝ䩟 ЋҒحϨϤӎࢲ॒Ѕؽ ѓϸԈݾবᇯැ٤పϦ܋䦚
07 – ಣߔဪፗንጚ৭ቻዴጦဂਦ ४ढ़ȃ
32
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цᇯැϡՖࡄ䦚 ЋӥѴবࣃᇯැࡣ܋䩟 ዐ༸࠴ఽবࣃ ਢؑϴϩఱцԛϡॵׁҤ֚䩟 ۱ѓҙؙড়Ҩϡݾব ᇯැ䩟 ઁࠍୟԛфࣃঝԛت䦙 ڀथఽԘت䦙 ਛ Тࣨඎޕැتфআᆯت䦚
ཱུᎼتቂᄧ༦ ञᄧߴߟˈ ՑᏃޗ ኁ߷Ꭻଝ ᅻཨߙໍધק
ԗЎ࠶ҙؙড়ҨϡݾবᇯැรՊዐ༸࠴ఽᆨׁব ࣃਢ䩭 ԲԛфѽԛԥҪࠇߵ්า፣䩭 ߊ܉ԷϩԛϨবࣃ ዐ༸࠴ఽйߵԷјԛتҀทҤӌт༯ϡԮඡӑѓ䩟 ԔϸणݾবᇯැϡНבի֏фಈѓଛകѼϤҙ䦚 ϴт ༯ϸϣԳϴݾবᇯැϡၘҨ䩟 НઁࠍѽԛԥҪࠇϡю ӆ䩟 ᇚߒԥҪࠇॹએҤܴϡ҅Ҩ䩟 йߵ֡РЄׄࠖע фએତᓀѬᇓϽએ֝䦚 ЋڀथఽԘँٷվߛ؍䩭 䦭Ԓ֎ਛТॵఱцԳѢ Ϫळϡዐ༸࠴ఽবࣃ䦙 ᒎआ䦙 ඎфࣇԑϡᆨׁ܋ 13 14 , Ћँվءߛ؍ӡϦҪӌϡݾবᇯැҤଈ䦚 Ѫጶ ۪䦮 ఱӳԁڀथॆڋਢ䦙 ०әणٍѓٷ०әण༗ ڊඎ֚䩟 йߵЌઁࠍըছϡےԵЁϥܲጷँߛҤଈЅ ࡢϩҙؙড়Ҩϡݾবᇯැ䦚 ఱӳԁڀथॆਢϽๆ䦙 Ү௸сँվϦዐ༸࠴ఽϨڀथఽԘٷҏҽϡت䦚 ० әण༗ڊඎ֚ϩँվϦٍ०әण࣊༌ٷӌ ைዐ༸࠴ఽҀทըছϡڀथҲЋ䦚 ЋϦцԍਛТݘ Тؙড়䩟 ٤ҙϸԈࠖעϡଛ䦚 ц०әण༗ ڊඎ֚ѪϡН१ӹфԥۘјܞणࣳ፣ٍѓٷ䩟 й ߵԛتըছࢹҙϡۘڀथఽԘٍѓٷ䩟 ۓછѯئ ቕԮڀ䦚 ऴӊଝဵఽ࠴࠹׆ϡবࣃᇯැ䩭 ଝဵఽ࠴࠹׆ Ϩবࣃዐ༸࠴ఽϡتфԅԼҤӌࡢϩैϽၘҨ䩟 د၉ӥҲבකӓবࣃԛᇯැфבකњবࣃԛ ᇯැ䦙 বࣃআᆯت䩟 йߵ֡Рଝဵఽ࠴࠹׆ඎ ӥѴ࠴ఽဪء䦚 цዐ༸࠴ఽҀทըছҙϡϬϪ䩟 ߎ ഒԗבකӓবࣃԛᇯැӑЋปӸϡ䦙 ϩҨϡዐ༸ ࠴ఽবࣃ֞ࡢ䩮 цϽ֝בකዐ༸࠴ఽϡϪळ䩟 जЋ Է٤పבකњবࣃԛᇯැ䦚 䦭Ԓ֎ਛТॵԮӊ ٍѓଝဵఽ࠴࠹׆ඎфবࣃዐ༸࠴ఽҀทϡᆨׁ ۪܋䦮 Ћԗבකӓবࣃԛᇯැ䦙 בකњবࣃԛ ᇯැфଝဵఽ࠴࠹׆ඎѓӊবࣃዐ༸࠴ఽ٤ పϦ܋䦚 ٿмءӡӾϡըছ߯ຽࡣކ䩟 этע ࠖ٤పথܴ䩟 ࣝ࣠мє䩟 ԗଝဵఽ࠴࠹׆ԁԷ јবࣃҤ֚ՖҲзࡢϩږଯҺॶϡॵׁ䦚 ئԆԳ؇ Ϩэ״ಈԼבකӓবࣃԛᇯැҏӓഠ࠻ዐ༸࠴ ఽ䩟 й۬ߊ֝ઁࠍтТዐ༸࠴ఽ಄ԛϡըছ䦚 Ғҝ٤పבකӓবࣃࠖע䩟 Ї؎ఱцࠖע࣮ױՖҲ ዐ༸࠴ఽ಄ԛฮ࠻䦚
ਂຬՑᏃޗყ࣋ܿ۽ᄹᇵঽՑᏃۈܿ؆ञࡥำ
ЋϨёё݄ҏӓԗዐ༸࠴ఽЈтҀทࢹёઁ ࠍ䩟 ؑϴϽๆઁࠍୟԛфँվҙըছҲЋ䩟 ֡ РЈϡಬዓ䩟 ؑזϴٷ٤పϩϡবࣃݾবᇯැфЈ ࡿবࣃभ䦚 ۥӊԁዐ༸࠴ఽבකࠏфڈѪ֚೬ݪըছٍڈѓ ϩϡዐ༸࠴ఽবࣃᇯැ䩟 חдϪळئԆډبҀทዐ ༸࠴ఽ䦚 Ғϼҹӛ䩟 ࣔঊࡆԈсѢфϪळϡዐ༸࠴ఽ ୟԛҶӸϡӹঈد၉ԛԆϤכҳ䦙 ऴӊԛԆϡફҨ фԛફҨ䦙 ᇉӜ٩ф᥋؇䩟 දԷϥцྺՀࠁй۪ۘರϡ վѽфёڴѽԛґߞ䦚 ԷјϪळϡୟԛНЌԁԷТ ֺ҅խϩԮ䩟 ԝҒ䩟 Т҅Ϩണቁ߇ڈҩᤗᤔϡԲԛ䩟 ڈϥѪ֚ԅЏࠖעϡԵ҃ϪטфԵڒӛϡϪळ䦚 Ћٍᆨׁိ࢙বࣃᕴବт༯зѓ䩟 Ԫږଯࡠ֏ ಈԼҲЋѺ䦙 ТࣨѺфֲพԛᆨׁҤ֚䩟 د၉ఱцዐ ༸࠴ఽംԛٷಈԼऴӆবࣃᇯැ䩟 ڀԳԁዐ༸࠴ఽҀ ทׁٷӑ䩟 ԗԷӑЋবࣃ֩ЅԳϴϡׁӑଏ䩟 ࡙ۯ Գ؇ࣉࣇۅфಀэࣁবࣃ֞ӑ䦚 ዐ༸࠴ఽবࣃ ᇯැϡ۴ӹЈभфҤ֚ϡՊґࣸЯ䦙 ႭݬсԸ ٩䩟 зϪڀ۵ϡϥ۱ѓଝဵఽ࠴࠹׆বࣃዐ༸ ࠴ఽϡتфԅԼ䦚 ዐ༸࠴ఽॵׁবࣃᇯැԗߓ۟࣊ ۻӗфҙϡݾব䩟 ԝҒ䩟 ԲԛфѽԛԥҪࠇ䩟 ٤ዋ ۨԸҲЋ䩟 ЋఽԘٍѓߛ؍ࠍઁٷ䩟 йߵਛТࣨඎޕැ Ѕϡ֡ѓবࣃᇯැ䦚 Ѽґ䩟 ۬سϼݾবᇯැԅЏܲጷ בիф࣏юথ䩟 ҪԒ֎കѼѪܼ֚ϺёϡࡢՄ ۵ࡣ䦚 ږଯԛсٍѓଝဵఽ࠴࠹׆䩟 ԐܲԲԛІ݁ ܷࢲޔدभйবࣃዐ༸࠴ఽ䩟 ϩНЌۨԸዐ༸࠴ఽ
13 Ȗጦޭ፱ݞเฯܿՑᏃޗኁ߷Ȃ ጪިȂ ፧னञ॓୲ܿᏒठፑೌȗ ˈ ਈũŵŵűĻİİŸŸŸįŸũŰįŪůŵİũŪŷİűŶţİŨŶŪťŦŭŪůŦŴİġŬŦźűŰűŶŭŢŵŪŰůŴİŦůİ ˄ijıIJķ೧ĴኟIJĶ ๊ߺၳ˅ ȃ 14 ၩᏠፈኁ߷Ȃ ጪިȂ ፧னञ॓୲᎙ືႥޗጚՑᏃޗᏒठߴ՝֡ଭᇵ܈˖ ጦဂञ᎙ືධࣙढ़˗ Շᇊ႘࿓ܗனߟᇵঽඝྊᇊ႘ᇡ ፧ன˗ ՑᏃޗ৹كञᏀᅲ˗ ૠೣᎡޗ፧ன˗ ኁ߷ञ፧னᄹۈ؆ࡥำ˗ ჹ᎙ືޗ൰ጚঽඝᄹ֎ః࿎࢜ภ࿄ࣙढ़˗ ჹ᎙ືႥޗጚঽඝ ᄹ֎ః࿎࢜࣋ᄪႩञቼቪඝਦ˗ ਾ፯ޗᄹࡣᆚሀಆˈ ጪިञ፧னޗᄹࡣᆚ˗ ኁ߷Ȃ ጪިञ፧னੌज˗ ኁ߷ञ࣏୲Ⴅࣰޗ ၳ࿏ȃ
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
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ऴӊଝဵఽ࠴࠹׆ϡবࣃᇯැ䩭 ଝဵఽ࠴࠹׆ Ϩবࣃዐ༸࠴ఽϡتфԅԼҤӌࡢϩैϽၘҨ䩟 د၉ӥҲבකӓবࣃԛᇯැфבකњবࣃԛ ᇯැ䦙 বࣃআᆯت䩟 йߵ֡Рଝဵఽ࠴࠹׆ඎӥ Ѵ࠴ఽဪء䦚 цዐ༸࠴ఽҀทըছҙϡϬϪ䩟 ߎഒԗ בකӓবࣃԛᇯැӑЋปӸϡ䦙 ϩҨϡዐ༸࠴ఽ বࣃ֞ࡢ䩮 цϽ֝בකዐ༸࠴ఽϡϪळ䩟 जЋԷ٤ప בකњবࣃԛᇯැ䦚 䦭Ԓ֎ਛТॵԮӊٍѓଝ ဵఽ࠴࠹׆ඎфবࣃዐ༸࠴ఽҀทϡᆨׁ۪܋䦮16 Ћԗבකӓবࣃԛᇯැ䦙 בකњবࣃԛᇯැ фଝဵఽ࠴࠹׆ඎѓӊবࣃዐ༸࠴ఽ٤పϦ܋䦚 ٿмءӡӾϡըছ߯ຽࡣކ䩟 этࠖע٤పথܴ䩟 ࣝ࣠мє䩟 ԗଝဵఽ࠴࠹׆ԁԷјবࣃҤ֚Ֆ ҲзࡢϩږଯҺॶϡॵׁ䦚 ئԆԳ؇Ϩэ״ಈԼב කӓবࣃԛᇯැҏӓഠ࠻ዐ༸࠴ఽ䩟 й۬ߊ֝ઁ ࠍтТዐ༸࠴ఽ಄ԛϡըছ䦚 Ғҝ٤పבකӓ বࣃࠖע䩟 Ї؎ఱцࠖע࣮ױՖҲዐ༸࠴ఽ಄ ԛฮ࠻䦚 ࣃঝᆯոҀทዐ༸࠴ఽ䩭 ё䩟 ϨϽऎݚӜҀทϦ ዐ༸࠴ఽϡ຺Ѕ䩟 ђϩ֡Р䦧%ඎ֚䦨בիଝဵ ఽ࠴࠹׆ඎ䦚 ߊ۽܉ङআᆯتϥНҲϡ䩟 Ԕዐ༸࠴ ఽتଛകѼЪҙ䦡䦡ϨܙЄмрӔսР䦚 І ёйϱ䩟 䦭ԮӊϨёҏӓ۽ङոুዐ༸࠴ఽЈтҀ ทߵفۅআ֬ТܞϡҪڋܧਢ䦮 ӔӸьϦ۽ङ۵ࡣϡ Ֆ֏䦚 ӎ҈䩟 ٿмЇϨքϱք࡙ۯс۽ङᆯոϳႰఽ Ҁท䦚 ॎѼӔϩю䩟 ԔϴӥѴёϡҖϬ۽ङ۵ࡣ ХؑϴٿмӸמҨ֏䦚 ۽ङږଯϡԮඡϴঈϥЋӛϩ Ҁทዐ༸࠴ఽϡ຺фᱳဧѽټТ٤పଝဵ࠹׆ ࠴ఽඎ䦙 ᆯոՉᒎआ䩟 йߵᆯոবࣃԛᇯැф ඎ䦚
ԲԛІܷ݁ࢲޔدभ䩭 ࣝຽڋ䩟 ϨྺՀࠁй۪ۘರዐ༸ ࠴ఽථ࠴ଛҙϡмр䩟 Ћϡ࣑۔ӥҲܷࢲޔدभϡ ۗԲԛӥҲܷࢲޔدभНϨёҏӓবࣃݚ ຎዐ༸࠴ఽҀท䩟 ЌڝऎᏼѤׄ䦚 ЋϦܼϺϸϣ ଛ䩟 ֡РࡷЈಬዓ䩟 ӸݬᇓϽথ䩟 ԝҒ䩟 ٍѓԥ ҪϡԲԛܷࢲޔدभިޕ䩟 ٍѲभЌۥЅٛࣨࠖ֞ӑٷ ӑ䩟 эࣁϩఱцԛϡ҅҃䩟 йҶӸܷࢲޔدଛࠍфዐ ༸࠴ఽבකଛҙϡϪळцܷࢲޔدभϡؑؒ䦚 ڀथф߱ญԥҪ䩭 ߊ܉ઑྩНّࣝۻ䩟 ԔϤԥҪϡࣨඎ ڀथф߱ϩНЌϥ߃юϽ֝ዐ༸࠴ఽЈтҀทϡ֍ ӹ䦚 ԥҪϡࣨѺڀथф߱ญప䩟 Ӹϼ֡ѓবࣃᇯැ䩟 ϥ׆ؽમϮϡਛТՄڍϡಚК䦚 Ԓ֎ਛТॵϨ ётϡڀथԥҪू೫цϸϣ՜֣ѯϦѸЄԮڀ䩟 ՖٍזѓհԥҪڋޕϡڀथඎфᐭြިޕ҇ב 䩛ЌࣃঝԳߒٍѓфᑯॆ؍䩜 РᏟ䦚 ЌۨԸҲЋϡݾবᇯැ䩭 ҲЋݾবᇯැЌ٤పҞ֥ф Ќ䩟 ѓӊفݒऴӆবࣃᇯැфઁࠍըছ䩟 ؝ԑъԈࡾ ӗըছҲЋϡӹঈ䩟 ՖಈԼࠍըছҲЋ䩟 ࣃঝዐ༸࠴ ఽت䩟 ٤ҙϩবࣃࠖעϡಈѓଛ䦚 ӾЌۨԸҲЋϡ ల֥фےԵҤܴࡢϩҴ৭ϡ۵ࡣ䩟 ఱцϡϥئӡϪळ фޕැ䩟 ЌࣔঊবࣃݘԘ 䩛ԝҒ䩟 ԥҪࠇфѪጶڀथ ިޕ䩜 ϡٍѓٷҶӸ䩟 ϲЌݘТবϡؙড়Ҩ䦚 ӹԷ ୟԛфחдघ߇ϡዐ༸࠴ఽтТଛ࡙ҙ䩟 ྺՀࠁй۪ ۘರϡ۔юёվѽфёڴѽԛԗؑϴئԆϡԮڀ䦚 ࣃঝфସءऴӊԛԆϡફҨԁԛફҨ䩭 ϪЙӔҮ૦ৄڶ ࡧϺ䩟 ѽԛදԷډب໑իԛԆфԛફҨ䩮 Ѽґ䩟 վԲ䦙 Բ ԛфԸԛٷЇЪୟ䦚 ಈѓֲพԛϡݾবᇯැ 䩛ԝ Ғ䩟 ఱцԛԆϤכҳфބघϿҲЋ䩟 ϩߛٍѓؘܦйߵ ԷјԳϽըছӹঈ䩜 ࣃঝફҨ䦚 Ћ໑իϼફҨϡϪळ ٤పࣇԑ 䩛د၉מફњࣇԑф٤పבකњবࣃԛ ᇯැ䩜 䩟 ਛТח՟ЇࡢϩԳϴӑѓ䦚
15 Ȗ࣋ቂૠೣᎡޗ፧னञኁ߷ՑᏃࡥޗำܿᏒठፑೌȗ ˈ ਈũŵŵűĻİİŸŸŸįŸũŰįŪůŵİũŪŷİűŶţİŨŶŪťŦŭŪůŦŴİŦůİ ˄ijıIJķ೧ĴኟIJĹ๊ߺၳ˅ ȃ 16 Ȗ࣋ᄂߒڼՑᏃޗᄧߙࡥำঽၕڕವ෮ໍಛܿภฉढ़ȗ ˈ ਈũŵŵűĻİİŸŸŸįŶůŢŪťŴįŰųŨİŦůİųŦŴŰŶųŤŦŴİťŰŤŶŮŦůŵŴİġijıIJIJİijıIJIJıķıĺŠŋńijIJĴĸŠ ňŭŰţŢŭĮőŭŢůĮņŭŪŮŪůŢŵŪŰůĮʼnŊŗĮńũŪŭťųŦůŠŦůįűťŧ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ
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࣭য়ଓཨܻᄵވ ፱تݞቂࡴሯჳஉܿኁ߷࡞ኁ܈ˈ ֡ଭ್ᄹञഉᄹ ภ࿄ࣙढ़Ȃ ᎙ືञᅭᇛภˈ ᇵঽ࡙קᄵၓܿਦȃ ᏥܐქߙޡংૠೣᎡޗᇊ႘ܿኁ߷࢙ᄌˈ ࿎ࡴૠೣ Ꭱޗ፧னޭྈՑᏃࡥޗำጚܿࡇఋˈ ਖਾۂ ኁ߷ᄹᇊ႘܈ञਾॄۂኁ߷ᄹᇊ႘܈ቪඝྊኁ߷ ࡞ኁ܈ᄵዸకᄹܿੌठȃ ᄂڼሣߒࡥำՑᏃޗञ࿙ౖˈޗ ົ࣭ށয়ન࿒಼ ˈ ၓክඓञؙඓഉᄹ࿎࢜፮ໍૠೣᎡޗ፧னˈ ࿎ࡴሣߒዄඓጪިఋˈ ၓྈՑᏃޗฬጪሣߒ࿎࢜ঽ ܿૠೣᎡޗ፧னȃ ਂࣷ࡞ኁ܈Ꮢठߴ՝ਖඝࣙಠफ़ˈ ጦޭञ ܬሥޭׁޗݓ൰ቂಠञׁ࣭ન࿒ଝȃ ሥᎺت ถࡴሯჳஉܿ࡞ኁ܈ˈ ֡ଭ࿎࢜ႇૃ᎙ືົֻȂ Շ ᇊ႘࿓ܗனߟȂ ਠ݈ࠞნܿᄪႩञޗ൰ᇡ፧னၓ ፱ݞȃ ቄتቂጦޭຬ೧Ȃ ຬഉञ೧ഉᄹᇵঽ್ᄹᄹ֎ః ܿՑᏃޗᏠठኁ߷܈ˈ ቇඝࣱଲᇵೌ߾፷ܿ ࡴࡏܞ०፩ˈ تቂ࡞ኁ܈ਠ݈۽ᄹञਂຬࡴࠞნ ᄵၓˈ ֡ଭনᄹ֬ܿ׳உቪᄹ֬உᇵঽᅔએञႥޗ ፇॄ۰ܿࡴࠞნܿᄹᄵၓȃ
ၩໍᏠፈଓཨܻᄵވ ٪ܷञፀڕဣዴᄧᄲኁ߷༦ঽߴߟˈ ᇵᏠठኁ߷܈ ၓ࿎ˈ ֡ଭૠೣᎡޗᇊ႘ዄඓ፧னȂ ਾۂ ኁ߷ᄹᇊ႘܈ञਾॄۂኁ߷ᄹᇊ႘܈ˈ ፱࣭ݞ য়ᄵ್ᄹᏋን֡൝०෧༦ȃ ࿎࢜࣋ՑᏃޗᏠठኁ߷܈ܿፑሞˈ ᅻཨਖᄧᄲ ܿȂ নጽદܿၩໍؠ࡞ኁ܈ೆጦޭࢌ፯ሀֶ ܿኁ߷ՑᏃࣙޗढ़ˈ ቇඝ࣋᎙್ഉຬ೧Ȃ ഉᄹञ ፱ݞเฯ ˄֡ଭ೧፱ݞเฯ˅ ȃ ፀڕፕᄂߒڼࡥำՑᏃܿޗᄧዓڏഐȂ Ꮑኑञᄵ ˈވ ቪठ࣭ߒনਜ਼ঐ ˄ŖŏŊńņŇ˅ ठᏮˈ ฬไࢌ࣭ᄂ ڼՑᏃޗञౖޗವሣۈำȃ ූफ़ࢌ࣭ޭၩໍᏠፈ࣋ოኁ߷࡞ኁ܈ܿᎳ ञጹܿـፍᄵˈ ֡ଭቄ፣್ܿᄹञഉᄹภ࿄ঽज़ৎ ࣙढ़Ȃ ᎙ືञᅭᇛภȃ
08 – ሠޡೞႠᆊჹ್್ᄹᄵၓ ጚ࿎࢜ኁ߷ՑᏃޗᏀᅲ࠵ႚ
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ՑᏃޗ৹ك
ЋӥѴϨёҏӓϩ ϡዐ༸࠴ఽҀทٷҌ༿Է ዐ༸࠴ఽ૮ୂ䩟 Ѹܲጷсٍѓϩ䦙 Јࡿϡዐ༸࠴ఽ ഠ࠻Ѳݫ䦙 ږଯфभ䩟 ӎЗ䩟 ৭خഠ࠻֝ڱфׁল Ѭख़ϡഠ࠻ӑ䦚 ഠ࠻ࠖעఱцዐ༸࠴ఽըছзҙ фتз൬ϡϪळ䦙 ޕැфсѢ䦚 ഠ࠻ӾϥІ݁䦙 خ ઼ϡ䩟 ިࡈԚϡҞ֥фᆈฐ䦚 ዐ༸࠴ఽഠ࠻ϥٍዐ༸࠴ఽҀทٷҌ༿Іӱዐ༸࠴ఽ ૮ୂф׆ೀ۠ዐ༸࠴ఽবࣃ䦙 ඎфࣇԑࠖעϡҷϣ ܌䦚 ԉᒎआϿवЋ৭خඎϡӗϩԛґоϡ झҨ䩟 ࠍઁবࣃᇯැϡၘϨҝ䦚 ࣝຽڋ䩟 Ҫܧऎٻ ّዐ༸࠴ఽҀทٷ۵ӓ࣑۔Ҍ༿Էዐ༸࠴ఽ૮ୂ䦚 ዐ ༸࠴ఽഠ࠻ӎЗЇЋᣩݓԷјҀทфࣉ૮ୂ٤పϦ ҜϿ䩟 ԝҒ䩟 ԛتҀท䦙 ֲಚ࠴ф࠴ఽԛႣ䩟 Їܙ Ќ࡙ϽँࡾݨվׁೋфઁࠍӚ༆ଛ䦚 цѽԛዐ༸࠴ ఽҀทٷᅇЎϡᆯոՖҲՉዐ༸࠴ఽᒎआϥ৭سخ З೩҃ЌቡષТܞϡଝဵఽ࠴࠹׆ඎϡԮඡ䩟 ґϨ ё䩟 ϩױըছϡᆯոђϩϤϺՖҲϦഠ࠻䦚
ҒࡺשحзӾϡዐ༸࠴ఽഠ࠻Ѳݫԁږଯॵׁ䩟 Լ ݸӊዐ༸࠴ఽᐭєϡ҃ݮ䦙 իؙড়ϪळфӾсਛТՄ ڍ䦚 Јࡿ䦙 ࡢϩఱцԛϡѲݫЋႭݬ٤ҙഠ࠻ࠖע ଛ䦙 ֝ڱфҝ٤పϦҜ߁䩟 ຎҒ䩟 Ћӛϩ؝ӊऴӆ ࣇԑфைࢭޕැϡԳѢϪळ٤పഠ࠻䩟 د၉ֲಚ ࠴ࠖע䦙 ਜ਼ഀഠ࠻䦙 घ߇ഠ࠻䦙 ІϢഠ࠻фٍѓۘ֠ ഠ࠻ٷ䩟 йߵНϨࣇԑѢٍѓϡഠ࠻भ䦚 Ғҝޝϩ ࡳ䩟 जϨ࢙خԍכϡӓ٤Ў䩟 ٍഠ࠻ࠖעओЅϨю зϽϡחд䦚 Ћ٤ҙഠ࠻ଛ䩟 ئԆڀԳцᒎ आфഠ࠻֝ڱࠖעϡ࢙خ䩟 йзϽࡳ֏ઁࠍዐ༸࠴ఽ ૮ୂҩணᒎϡըছ䦚 Ԯӊዐ༸࠴ఽഠ࠻Ҥ֚фږଯϡ ᆨׁ۪܋НԋԒ֎ਛТॵ䦭ዐ༸࠴ఽഠ࠻ࠖעᆨׁ ۪܋䦮 䦚
࣭য়ଓཨܻᄵވ ਖ৹ߴكञ࠵ႚᆼफ़ˈ ਖ࿎࢜ጚߙඩܿ৹كञন຺ฏܿ৹كყੌठˈ ۶࠵ႚܿࠍफ़ˈ ቂՑᏃޗ৹ك ࠵ႚ৹كඝྊࡥำञᎫଝȃ ৹࠵كႚྈف፱ܿเฯञົՑᏃܞࡏޗᏥ፱ܿˈ ሥ֦ጽ࢞൶ȃ ፱ݞဣዴሣߒዄඓጪި༦ܿࡇ߭ၐȃ ၩໍᏠፈଓཨܻᄵވ ށඓᄧ࣋ՑᏃޗ৹كञ٢ਈठࡥำܿᏒठፑܷኊዏˈ ଓཨጶठ࣋ᄧ৹ߟߴكȂ ዸకञጪިܿፑܷኊዏȃ ጦޭႜጪञႜࠍ༮દˈ ፀޭ࣭ࢌڕ৹ك፣֦ጽࣙढ़ȃ ၓဣዴߒ૭ՑᏃޗ৹ك࿎࢜ፀˈڕ ၓࢌ࣭࿎࢜Ꮵᄧܿፑܷኊዏञ༦ፀˈڕ ֡ଭ݈५ఋ०፩ܿሣߒዄඓ ጪިञ৹كȃ
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ମܐૠೣᎡޗ፧னˈ ૿፟ठጻञ࿎࢜٣ඓᇞ॓
ЋӥѴϨёҏӓϩ ϡዐ༸࠴ఽҀทٷԅЏଝ ဵఽ࠴࠹׆ඎ䩟 ؑϴӸьᇓϽଝဵఽ࠴࠹׆ඎϡ থф٤ҙࣇԑفخଛ䦚 ϴٍ ϡଝဵఽ࠴࠹׆ ඎٷӥѴ࠴ఽဪء䩟 ϲۓછϽๆ٤ҙඎ࣊Ԫԛ䩟 ಈѓ ಢ䦙 ಄ի֏ҙϡଝဵఽ࠴࠹׆ඎҤଈйߵϩϡ ዐ༸࠴ఽ಄ԛฮ࠻фఽԛฮ࠻ࢅڍ䩟 зϽࡳ֏сઁ ࠍඎਠଛ䦚 Ԓਛॵଝဵٍఽ࠴࠹׆ѓ۪܋ ٤పϦӥѴ ଛϡբዓ䩟 ϩࡾӊߣ٩ඎ೩҃ ࡄ䩟 ࠃ৷Ϩ৭ᒎњזس߹ዐ༸࠴ఽҀทٷ٤పଝဵ ఽ࠴࠹׆ඎ䦚 мрءӡӆмඎڋਢ䩟 ٤పଝဵ׆ ࠹࠴ఽඎࠖעᇓࣁբ۶֘䩟 ֡Рई٩ࠖע䩟 ৭خႭ ݬфԍכԅЏඎ䩟 දԷϥ৭خԁዐ༸࠴ఽϩԮϡ࠴ ԳٷԅЏඎ䦚 ўݚϪԅЏඎϸϣҪࡣ܋ܧӔӊёё२ԟ ю䩟 ԔϸђڊԣϦऎϡዐ༸࠴ఽҀทٷ䩟 ґӛϩϡ ϪЁϩҜϿЏϺඎ䦚 Ϩոুዐ༸࠴ఽҀทٷЅ䩟 єୂදԷ࣌ᔡ䦡䦡ђϩϨёԅЏଝဵ࠴࠹׆ ఽඎ䦚 ӎ҈䩟 ԳѢϪळЇ࡙܊܊ԡԅЏଝဵ࠴࠹׆ ఽඎ䦚 ֔ױ䩟 ۥӊѸЄѪೋ૮ϡϪϨٍѓଝဵ࠴࠹׆ ఽඎ䩟 ӹױ䩟 ѓй߯ຽඎۋфࣃঝዐ༸࠴ఽݘТ ಄ԛϡ࠴ఽ֝ഠ࠻ࡢϩԳϴҺॶ䦚 цϪळϡዐ༸࠴ ఽ಄ԛϡฮ࠻ϥฮସඎҤଈ֝ڱфࡺשඎ֚ϡԮ ඡ䦚 ϨϽחдЅࠍּՊмр䩟 ԅЏҷԏфҷѧ۶ଝဵ׆ ࠹࠴ఽඎ֚ϡಬዓകѼۘϩࡳ䩟 ᙪࣸоࣃঝҷ ϣ۶ඎਠϡԳϴԛ䦚 ڦаଝဵఽ࠴࠹׆ඎϡࣻᇓϽ䩟 ዐ༸࠴ఽҀ ทٷЇӌைаԷјϣ࠶ڍਛТ՜֣䩟 د၉ԁዐ༸࠴ఽ Ҁทфዐ༸࠴ఽඎԚԮϡ䦙 ԁዐ༸࠴ఽѪԮϡׁ Ҁทфׁೋ䩟 йߵҡූ٩䩟 ϸϣܷЁؑϴҪӌϡࣇԑ фସء䦚
ᇓϽଝဵఽ࠴࠹׆ඎϡࣻ䩭 ԥҪ䦙 ߣ䦙 Ү௸ ф಄ի֏ҙϡҷϣ۶ଝဵఽ࠴࠹׆ඎ֚ಈѓϣ ϳϣཇϡӡ፣֝ॵׁ䩟 ЌႭݬ䦙 Н۟فсᇓϽюϪ ଝဵఽ࠴׆ඎϡথ䦚 цඎфఽԛϡ࢙ࣝՖҲف ۟߯ຽ䩟 ӡѸЈԒ֎ਛТॵԮӊଝဵఽ࠴࠹׆ ඎᆨׁ۪܋䩟 ЌўЈϡ॓Ѻ࢙ࣝ䦙 Ј䦙 Јभйߵ ٿмϨᇓϽඎথҤӌϡҮࡑюЋмрඎ۪܋ фࡄϡҞ֥ऴኜ䦚 ઑྩᆯոՉᒎआ䦙 ӡ፣֝ϡ ଝဵఽ࠴࠹׆ඎҤଈфНטϡଝဵఽ࠴࠹׆ ء፣䩟 ٍո॓ඎϡথ٩ӌைئԆϡᅣዢ䦚 ЋзϽ ࡳ֏ст༯ඎҝ䩟 юϪфոুЁߊՉэ״ଝဵ ఽ࠴࠹׆ඎ䩟 ϸЇᙪࣸоцՉᒎआфԗዐ༸࠴ఽ ഠ࠻ֲҝᅲݵԛϡϪळߊьࣨඎᨘבϡۓϴԛ䦚 ࣃঝфସءዐ༸࠴ఽԁֲಚ࠴ׁҀท䩭 цֲಚ࠴ԁ ዐ༸࠴ఽӥҲҙϡӎସء䩟 ӔҮٍёҽ ԁዐ༸࠴ఽԚԮϡֲಚ࠴ϡӚ༆ଛЎઁϦѧдҏϣ䦚 Ԕϥ䩟 ֲಚ࠴കѼϥዐ༸࠴ఽҀทٷт࠴ଛϡҰϴ֍ ӹ䩟 ࣔঊऎѧдҏϣϡዐ༸࠴ఽԚԮӚ༆䦚 ԁዐ༸ ࠴ఽԚԮϡֲಚ࠴ଈຎϩّٻйϼ۔ҩтѴ䩟 ႛዢϦ ϪळԅЏЌቡષТܞϡଝဵఽ࠴࠹׆ඎ䦚 ЋՖϣ܌ ઁࠍֲಚ࠴ԚԮт࠴ଛфӚ༆ଛ䩟 ؑϴӸמӥැфಈ ѓԮඡݾবᇯැ䩟 د၉Ϩዐ༸࠴ఽҀทٷЅՖҲࢅڍ ԛϡֲಚ࠴ᣩݓ䦙 ଘ㍡বࣃԛඎ䩟 йߵцӛϩ৭ ᒎڈԐӡֲಚ࠴ථٷՖҲዐ༸࠴ఽഠ࠻䦙 ߵЗ೩҃ଝ ဵఽ࠴࠹׆ඎ䩟 йߵߒҤЈൖҴবࣃԛᇯැ䦚 ࣃঝфସءዐ༸࠴ఽԁ࠴ఽԛႣׁҀท䩭 ϨܙЄ мр䩟 ߝԛᒬࡿфᴙࡿႣҀทя೯юЋዐ༸࠴ఽҀ ทٷт࠴ଛфӚ༆ଛϡ֍ӹ䦚 ዐ༸࠴ఽԁᴙࡿႣ࠴ ఽׁҀทϡԝຎϨڀथఽԘٷЅзҙ䩟 ӛϩ߇ᄘ ϥҒױ䦚 ዐ༸࠴ఽцᒬࡿфᴙࡿႣ࠴ఽҀทࡢϩٹ ؙড়䩟 ࣔঊߝԛႣҀทଛϼڢ䩟 Ӹьኂۅ٩Ֆࡄ䩟 ҶӸႣఐ٩фႣჩϡըছ䩟 ߃юѸҙϡႣෙԚԮӚ ༆ଛ䦚 цዐ༸࠴ఽԁ࠴ఽԛႣҀทՖҲᆨׁସ ء䩟 ࣠ࣝԒ֎ਛТॵԮӊዐ༸࠴ఽ䦙 ᒬࡿфᴙࡿႣ ࠴ఽඎϡ۪܋䩟 цዐ༸࠴ఽҀทф࠴ఽԛႣҀ ทӥැՉᒎआфඎ䦚
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ݸثԷјዐ༸࠴ఽׁҀท䩭 ዐ༸࠴ఽҀทٷϡԷј ׁҀท 䩛ᨦҜԛۘڈᨦҜԛ䩜 ϡථ࠴ଛфؙড়ӹмԆ фϪळґϤӎ䩟 ؑϴಈԼ֝ӱӡءϡцᇯැ䦚 Ғҝ ϤЌݸثϸԈ՜֣䩟 जНЌߵ֡РᇓϽଝဵ࠴࠹׆ ఽඎԼЏϡюҝ䦚 цবࣃ䦙 ՉтѴфඎԋϡ ׁҀทѯئԆϡԮڀ䩟 ԝҒ䩟 ݉ጶ䦙 ܧጶ䦙 Ϫဧӳ૮ᢺ࠴ఽфߵԷјԛتҀท䦙 ⟉ᅔф༶າ ༶䦚 বࣃф܉ԑዐ༸࠴ఽ಄ԛ䩭 ڦаҪԒ֎ԗዐ༸࠴ఽ Ѹܲጷ䦙 ѸՉсѓӊඎфবࣃዐ༸࠴ఽ䩟 ࣃঝф ସءዐ༸࠴ఽݘТ಄ԛԗ۠ԮԳϴ䦚 ݸثዐ༸࠴ఽ ಄ԛцӥѴ࠴ఽဪء䦙 ݸثඎਠфࣃঝҩྋ׆ זѸᒰਯфఽԛѸҙϡҷԏߵҷѧ۶ଝဵఽ࠴࠹׆ ඎ֚ࡢϩԳϴҺॶ䦚 ԗዐ༸࠴ఽ಄ԛฮ࠻фц Չবࡣ܋ϡฮସ 䩛د၉ఱцଝТঈଝԛϡฮସ䩜 รՊмрዐ༸࠴ఽඎࠖע䦙 ֝ڱ٤ڋڢਢфѸܲጷ ϡਛТҞ֥ࢅڍ䦚
Ћዐ༸࠴ఽҀทٷ٤పඎфԮЕϡӗࣇࣨ䩭 ߣ ґϩϡࣇԑݾবᇯැЌۨዐ༸࠴ఽҀทٷϡݱՄ ࣉф┴䩟 د၉ࣘ߿ϡॹޚ䦙 ԥҪϡѓһфਛТޕ ැ䦙 ಪ֥ඎ֚ҳ䦚 ۥӊዐ༸࠴ఽҀทڈԁඎϡైӑѓ фҡූ٩ϩԮ䩟 ዐ༸࠴ఽҀท∿ٷථϣتۘ࠶ڍทԛ ᅔ࠴ϡըছя೯ҶӸ䩟 ԝҒ䩟 К߱܉ᅔ࠴䦙 ਫ਼၎࠴䦙 ߝԛ ༶חᅔ࠴ф҇ٿჩೋ䦚 ԋϡظؘਛТׁೋد၉ဪ ఛ䦙 ဖഒ䦙 စഗфԷјڶҌᅣዢ䦚 ӗዐ༸࠴ఽࣇԑע ࠖዧࣇԑ۟ۂРࡄϡݾবᇯැ䩟 ԝҒ䩟 ᣩݓ䦙 ฮ࠻ фସءዐ༸࠴ఽҀทٷзԋϡࣉըছфׁೋ䦚 ѽԛዐ༸࠴ఽҀทٷӌைϡя೯ਭԳϡϥԁϪဧ ӳᢺ࠴ఽҀทϩԮϡжჩ䩟 йئԆϡԮڀ䩟 දԷ ϥϴ٤పϩϡϪဧӳᢺ࠴ఽᐭြ䦙 ᣩݓфඎ䦚 ϩ ϡࡕڔସء䦙 ಪ֥ඎ֚фைࣇټԑЇϥӾรՊዐ༸ ࠴ఽࠖעϡۓϴݾবᇯැ䦚
࣭য়ଓཨܻᄵވ ށඓ൹ࢳञᄧ࣭য়ՑᏃޗ፧னञ॓୲ፑೌञࣙˈڋ ֡ଭ࣋߷ፒञ૿፟٢ਈठጻܿፑܷኊዏȃ ፟ށञᄧ፧னढ़ˈ ᇵฬ֦፧னܿஏᅝᄹȂ ُልफ़॓୲ञঽ۰னߟჹᄧனߟঽߴࣰޢȃ ዸకˈ Ꮵܐქޡਠ݈ՑᏃޗೊᇊᄹˈ ਖ༮દᏮၓ࣭য়ૠೣᎡޗᇊ႘ጹـञፑሞܿᄪႩনھȃ ፧னञ࣋Փˈ ࿎࢜ၩໍᏠፈጦޭনׁ॓୲ܿ፱ᇋ߾ۈำᄹি࡞ኁ܈ߴ՝17ˈ ࿎຺࢜ฏञয়॓୲ˈ ฬ֦เฯ૰ঠถՇᇊ႘ᇵ૿፟࿈ञ፮॓୲ȃ ၩໍᏠፈଓཨܻᄵވ ൹ࢳञߙ؝ՑᏃࡥޗำܿ᎐ᇋኊሓȂ ฎȂ ߙఋञཏ၁ఋ֫ࡻˈ ՙݓቱȂ เଁञᄹࠍ׳ȃġ ࿎࢜ᏥᄧܿᏒठፑೌˈ ጦޭቂૠೣᎡޗ፧னञኁ߷ՑᏃˈޗ ᇵঽ٢ਈठጻܿ߷ፒञ૿፟ˈ ሞܷᅻ ཨञ૰ڕᅝݓਖ፧னࣙಠମܐፚྈՑᏃࡥޗำጚˈ ၓጦޭۃՑᏃࡥޗำञিܿੂާܿเฯ ُልफ़॓୲࿎࢜ፑሞȃ ᄒ᎓ࢌ࣭፟ށञ࣭য়ՑᏃޗ፧னፑೌȂ ढ़ञࣙˈڋ ᇵၩໍᏠፈܿภฉፑೌၓনھȃ ࿎࢜ՑᏃޗೊᇊᄹ৭كȂ ኁ߷ञ૿፟ፑೌˈ ӡтԮӊҪܧዐ༸࠴ఽ಄ԛݘТଛфࠌۤϡݍۏ䦚
17 ȖጦޭᏁኑޥฦܿົ፩࿎࢜নׁ॓୲ܿ፱ᇋ߾ۈำᄹি࡞ኁ܈ߴ՝ȗ ˈ ਈũŵŵűĻİİŸŸŸįŸũŰįŪůŵİŤŢųťŪŰŷŢŴŤŶŭŢųŠġťŪŴŦŢŴŦŴİűŶţŭŪŤŢŵŪŰůŴİ űŦůijıIJıİŦůİ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ
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ዸకߴჹĴ˖ġ ࢞൶ݓ࿎࢜࠵ႚ ྈเฯૂሥঠܾྈᅍᇋܿ࠵ႚ෩࠵ႚ፣ ֦ጽٛໍሯჳȃ ЋӥѴёዐ༸࠴ఽࡢՄ۵ࡣ䩟 ۓછࡢިಢ䦙 ࢽ ҅ϡਛТՄڍ䩟 ՄڍЅد၉מϽϡਛТҞ֥ࢅڍ䦙 ҙϡࠖע٤పথܴ䦙 ࣘ߿фਖϩঈϡࠬ֞ግ䦙 ԅԼऴӆࣨඎݘԘфभϡНۻಬዓ䦙 ࣘ߿ϡਛТቻ ޝϱ䦙 מϩҨϡ֩ࣔфԑ䦚 ࡖϨӊӾϡघϿ䦙 ֚ ಋ䦙 ू೫фՄ॒ࢲءЅ䩟 Ќೖಿ䦙 ࡾݨϪЙԅЏфٍѓ ࠖע䩟 ݪӊᇉӜ٩ф᥋؇䩟 ϸЗϡዐ༸࠴ఽݾবᇯැ ҥϥзϩϡ䦚 ӹױ䩟 ݾবᇯැؑϴϡϥϣϬϩ۱ϡ ࢲ॒䩟 س䩟 ՖਛТԍכфϪ䩟 ࡢϩݒනમϮϡਛ Тфघ߇Մڍ䦚 ዐ༸࠴ఽϥԍਛТϡϣϬ֩䩟 Ϩୟԛфըছ䦙 ࠖעԅԼಬዓ䦙 ࣉфघϿюҝҤӌࡖϨԳϽϡϤԍ כ䦚 ٿмϨԮڀዐ༸࠴ఽцᇯැйӥѴзϽؙড় ԁ৭خѪϪҩ۲ 䩛දԷϥոুфݙվё䦙 ѽԛ䦙 Գ ѢϪळфТ҅Ϩണс߇ϡϪळ䩜 ҏҽܼюכ႗䦚 ԗԳѢӵϨзؑϴϡϪळфсѢ䦙 ݸثҰϴϡϤ כҳ䦚
࣭য়ᅍᇋ፱ݞዴ નᏥܐᄌ࣮ܿՑᏃޗ ሥޭᏮቪฬ֦ᇦ௪ ใटเፇৱ֦ڕ൶ळ
ุՑᏃ࠵ޗႚܿஏᅝࣰڋሥܿเฯञݞݓ
ዐ༸࠴ఽݾবᇯැфዐ༸࠴ఽࠖעϡ۟ۂРࡄછ ϤӎϡϪळфсѢ䩟 йիؙড়з൬ٷ䩟 ৭خϤо Ѵᇄ䦚 Ԓ֎ਛТॵϡ۪܋фԁׁӑଏэтϡӥ ැ֞ࡢءӡϦЋϤӎϪळфޕැ٤పዐ༸࠴ఽݾবᇯ ැфࠖעϡऴӆҤଈ䩟 د၉ఱцݙվё䦙 ѽԛ䦙 ఽԘٍ ѓٷ䦙 ԛ֞ӑٷ䦙 ԲԲԛҲЋٷ䦙 Ըԛٷф୍ϡئӡ Ҥଈ䦚 д્٩䩭 ਛТՄڍϡٿϬৢӌц٤పዐ༸࠴ఽߵԚԮ ࡢࠖעϩϤӎϡӑѓ䦚 ږଯԛсԗࠖעд્䦙 ׁݱфԮ ࠾䩟 НҶӸԅԼಬዓфࣻ䩟 ٤ҙНבի֏фڱ ֝䦚 д્ࠖעЌӸמघ߇ϡ܀ԁ䩟 ۨࠖעԅԼಬዓф ؒࣨҲЋ䩟 ٤ҙࣇԑفخଛ䦚
ई٩ࣇԑ䩭 мр۪܋ϡࠟԸҤזϥ䩟 Ϥ܉ዐ༸࠴ఽ Ҁทٷϡைࢭфݪᐭ૮ݮҒح䩟 זӛϩዐ༸࠴ఽ Ҁทٷ٤పଝဵఽ࠴࠹׆ඎ䩟 ԔϸۤۓЋዐ༸࠴ఽ ࠖעհϱखږ䩟 בիඎϡථٷԗքϱքЄ䩟 ථؑٷ ؒЇԗя೯Є҈٩䦚 ई٩ࣇԑ܋ϡϥ䩟 ࣠ࣝථٷϡ ዐ༸࠴ఽᅔ࠴႒ݫ䦙 ඎϡಢӡԛߵԷࡢՄϡࣇԑؑ ؒ䩟 בזիଝဵఽ࠴࠹׆ඎϡථٷ٤పϤӎϡࡈ ࠇࣇԑࠖע䦚 ຎҒ䩟 ԜϨבիඎϡєୂಢӡϡථٷ НЌҩ۠׆घ߇ࣇԑ䩟 ϸ҈䩟 РԳϡைࢭࣇԑޕ ැϲНйԳѢ؝ԑଝဵఽ࠴࠹׆ඎҝϤಢӡڈ ዐ༸࠴ఽᅔ࠴ӔՖՊԉڈථϩԳϽׁೋϡԡ ථٷ䦚
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йϪЋӆϡᆨׁࣇԑ䩭 ዐ༸࠴ఽҀทٷфիؙড়घ߇ ϴӌைϣ࠶ڍਛТըছф՜֣䩮 ӹױ䩟 ዐ༸࠴ఽߵԚԮ ࡧࠖעԆф٤పԚϡݾবᇯැ䩟 йцҮтТ ϡ૮ୂ䦚 პӊଝဵఽ࠴࠹׆ඎϡۋфዐ༸࠴ఽҀ ทٷϡҡූ٩䩟 ዐ༸࠴ఽۓࠖעછϤआтࣁ䩟 й٤పد ၉ۘتทԛᅔ࠴ସءϨֵϡҪӌӗࣇࣨ䦚 ԗዐ༸࠴ ఽࠖעԁԷјԚԮਛТ֩ 䩛ԝҒ䩟 ԛتҀท䦙 ԛԁ Тᜊࣉ䦙 ٍڱѓᅣዢ䦙 Ⴃ䦙 ֲಚ࠴䦙 ߱ญԥҪ䦙 ۘ تทԛᅔ࠴фԛԆફҨ䩜 ϡࠖעѸϮсׁݱ䦙 Ԯ࠾ф ݆䩟 Нઁࠍюӆ䦙 ٤ҙଛфԼЏѸҝ䦚 Ӿϡݱ ׁфԮ࠾থܴԼݸӊмєфਛТՄڍ䩟 ߹ࠃॸϨН ӑԛ୳ૢϡऴኜϼ䦚 Ϩےᑭ֩ՖҲ࠾ׁਢ䩟 ԝ Ғ䩟 ਛТҞ֥ࢅڍ䦙 ฮ࠻ф߯ຽ䦙 ӥࡑॣфᒎआࠖע䦙 ϪҨޝਢфЌҨࠃޕ䦙 ಈकфప܉ԑ䦙 ҃ޝ 䦚 ԗዐ༸࠴ఽࠖעԁֲಚ࠴ࠖעԚ࠾䩭 ዐ༸࠴ఽࠖעԁֲ ಚ࠴ࠖעфਢϡږଯԛԮ࠾фׁݱ٤పϦϣ҇મϮ ϡׁݱথܴ䦚 Ԓ֎ਛТॵԮӊмрֲಚ࠴ԁዐ༸࠴ ఽӎਢ۪܋৭ӡϦԏ࣮ѓйֲׁݱಚ࠴фዐ༸ ࠴ఽࠖעϡਢ䦚 ಈѓϡࡣ܋ϱІԒ֎ਛТॵтϡ 䦭ֲಚ࠴ዐ༸࠴ఽӎਢฮ࠻ф߯ຽ۪܋䦮 䩛 18 ёؗ䩜 䩟 ϩࡾӊٿмࡧԆфँվࣇԑۂ၌Рࡄֵϡ ୟࢲڝ䦚 Պӈжݍۏфऴӊӽ౩ϡࢅڍ䩟 ϨԷЅٍ ѓݼϣѪԏϡථࡧٷԆڷ䩟 Н٤ҙૠӑԛфцථٷ йٰՖ䦚 घ߇܀ԁфऴӊघ߇ϡࠖע䩭 घ߇䦡䦡දԷϥዐ༸࠴ ఽҀทٷ䦡 䦡ϡ܀ԁц٤పϩϡዐ༸࠴ఽфѸܲ ጷϡਛТ۠ࠖעԮԳϴ䩟 ئԆϥϨիϺᇉӜ٩䦙 ᥋؇ф ࢉ٩ؙড়ϡޕැфϪळ䦚 घ߇Ϩৢٿҋϼϡ܀ԁЋ ୌتҨ֏䦙 ू೫ۂᖝԛфਢ݆٤పϦݒන䩟 ҶמϦ ՜ૺҜء䩟 Ќݸثዐ༸࠴ఽцᇯැϡԅԼಬዓ䦙 ಈѓ ଛ䦙 ၾфюҝҳ՜֣䦚 घ߇ॵфӽ౩ϨйЎҤӌЌ
т༯Ԯඡӑѓ䩭 Ћू۔ࠖעϡϪळ٤పࠖע䩟 Т юмрዐ༸࠴ఽҞ֥ࢅڍѪ֚٤పϡږଯҞ֥䩟 Ֆ фࣇخϪ䦚 ֡Рࣘдഷਖфᒾࣔ䩟 этघ߇ϡЌҨ䩟 ϩࡾӊ٤ڢघ߇ࠖעфਢϡ֝ڱ䦚 мрዐ༸࠴ఽ ਢՖЋघ߇ॵ٤పНব࠻ϡؖޝфЋӛ٤పע ࠖޢ߿ݒϡۏᗐ䦚 ئݸثቕޕැϡؑؒ䩭 ϨϣԈئቕޕැ䩟 ዐ༸࠴ఽୟ ԛфըছЪҙ䩟 ґԅԼऴӆዐ༸࠴ఽࠖעϡಬዓԳ իࡳ䩟 ԝҒ䩟 ฮደ䦙 ᤗᤔЅК䦙 ԡॹھфիϺϪѬҰॶ Ԯܷϡޕැ䦚 ϨϸԈޕැЅ䩟 ЋϬϪ٤పϡࠖעҳӎ ӊϨѸܲጷϡघ߇НйԅЏϡࠖע䦚 Ե҃ϪטфѪрН ஓϡϪळදԷࡢϩखږ䩟 ԝҒ䩟 ի৳߷䦙 ІѼᇻߛфҮ ௸ؙھড়ϡϪळ䦚 ϸԈळՄڒІѝϡघ߇䦙 فݒӽ ౩фϡਛТࠖע䩟 њҝϲϥјЙϡবࣃ䦙 ඎфࣇ ԑРࡄНЌҩЅआ䦚 ຎҒ䩟 ۥӊઑվۓϴϡҹխ䩟 ۥڈ ӊ٭ࠖעѓҙґઑྩࣉخছҳࠖࣇخ䩟 јЙНЌѪ ֚ԅЏٍڈѓӆсዐ༸࠴ఽߵԷјਛТࠖע䦚 ৭ݾخবᇯැфࠖעϡ֝ڱ䩭 ϨЋ٤ҙଛґႭݬ ᓛࣁЗ䩟 ૽Ϥᔮᓙ֝ڱࠖע䩟 ЇϤНࡾӗϨԅԼࠖע фਛТюҝҤӌϡϤԍכ䦚 ٿмฮସዐ༸࠴ఽࠖע ϡ۟ۂРࡄϡԟݱԛ䩟 ৭ӡϥਦؑϴӸйۨՖ䦚 ࠖע ϩӛॵ䩟 зϽࡳ֏сँվ䦧ᇄ䦨䦙 ٤ҙفخଛф࣊Ԫ ԛ䦚 Ұϴखدږ၉䩭 ϩবࣃݾবᇯැϡНבի֏фಈ ѓଛ䩮 ఱцዐ༸࠴ఽഠ࠻фᆈฐ䩟 йӥѴзϽּ೯䩮 ৭ خഠ࠻֝ڱ䩟 йзϽࡳ֏ँվணᒎ䩮 ߊՉԗ৭ᒎϪळ׆ ೀ۠Ԛϡবࣃфඎࠖע䩮 ৭خඎϡ࣊Ԫԛфف ۟ԛ䩮 ٤పӗࣇࣨ䩟 йࣃঝфସׁءೋ 䩛د၉ֲಚ ࠴ф࠴ఽԛႣ䩜 䩮 ฮ࠻ඎֲҝ 䩛د၉ଝဵఽ࠴࠹׆ ఽԛф࠴ఽဪء䩜 䩟 й৭ߵخЗ۠׆ҷԏфҷѧ ۶ඎ䩟 ࣃॸঝዐ༸࠴ఽݘТ಄ԛ䦚
18 ȖੌजİՑᏃޗᄒࣙढ़৭كञ൹ࢳፑೌȗ ˄ijıIJĶ೧˅ ˈ ਈũŵŵűĻİİŸŸŸįŸũŰįŪůŵİŵţİűŶţŭŪŤŢŵŪŰůŴİŮŰůŪŵŰųŪůŨĮġŦŷŢŭŶŢŵŪŰůĮŤŰŭŭŢţŰųŢŵŪŷŦĮŵţĮũŪŷİ Ŧůİ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ
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ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
۟فฮ࠻фۨՖዐ༸࠴ఽࠖע 䩛د၉ላׁмрфмক ԁࡣކϡഠ࠻фӥࡑॣࠖע䩜 䩟 ٍԷѸډӊבի ॸථٷϡؑؒфണϮ䩟 ϲЌހ٩ࣇԑ֝ڱ䦚 ѓӊฮ ସ֝ڱࠖעϡࡣ܋фҜݸثءҳԃӜ䦙 ޕැҳۉ Зҽ䦙 බ՜ࠏଛ䦙 ਛТࣨඎϪϡЌҨфᒾࣔҳ՜֣䦚 ዐ ༸࠴ఽݾবᇯැϡ֝ڱзۥټԷ٤ࣉھڢф ┴ϡЌҨϱ႗֝䦚
࣭য়ଓཨܻᄵވ ົ࣭ށয়ࣙ߭ञᎳˈ ጦޭՑᏃ࠵ޗႚܿஏᅝࣰˈڋ ন ࣭ৗፑೌञඝྊᎳˈ ޭଝᄵ৭૿ȃ ፟ށञເށ፟ܿՑᏃ࡞ޗኁ܈ߴ՝ˈ ጦޭ࿅ށเ ฯञˈݞݓ ฬ֦࠵ႚޭ།ሯჳᏥᆒ፱ܿเฯߑᆗყ࣋Ȃ ૰ਾ །Ȃ ૰ঠܾȃ ࿎ُ࢜ልफ़॓୲ˈ ჹۃՑᏃޗিާੂञ፧ னᅍชܿเ࿎࢜ເށᏭܿ࡞ኁߴ՝ȃ ݲጶ࠵ႚˈ ᇵৠූቪඝྊၩໍቱܿጶठञ࣋ო࢞൶ˈ ቇඝ࣋᎙ޭຬ೧Ȃ ೧ഉᄹȂ ್ᄹञ፱ݞเฯܿࡇȃ ຺ฏᄌدቪᄵஉਓົˈ ฬ֦ߟఊञ৭࣏ଙ৩ ৠූቪ຺ฏฯ࿒ञ࢞அঽཌሩؠܿᄒᏮञठᏮঞ֎࣋ Ⴜȃ ਖՑᏃޗೆ࣭য়ሥাढ़ˈ ฬ֦নׁՑᏃ࠵ޗႚ াଝञ།ܸเܻ᎐ሆ࣋෧ܿົ፩ᅝˈ ቇඝሥ߷ፒ ፧ன፩ިȃ ࢎદࢬৱ٢ົၘঐՑᏃޗİՑᏃሥা ᏮᄆᏠܿ Ȗ࣋াᎫྙՑᏃޗİՑᏃ࡞ኁ܈ܿፑ 19 ೌȗ ˈ ޭכᇋܿሥাञၩໍ࠵ႚᄵ഻ᅸȃ ࠙ົט፩࿎࢜࢞൶ܿ࠵ႚˈ ֡ଭፍᄵቈၩໍᏠፈञ ठ࣭ޗ൰ቪ߯Ꮶ֑࢞༃፟࣋ܿށซ߯ञ৭ቻົܿՑᏃ ࡞ޗኁ܈Ꮢठࣙढ़ȃ
ၩໍᏠፈଓཨܻᄵވ ࿎࢜࣋ጦޭ࿅ށเฯञ࿅ົށܿনׁՑᏃࣙޗढ़Ȃ ُ ልफ़॓୲ञ࠵ႚ࿎࢜ಠܿᏥᄧፑೌˈ ଓˈ ጦޭຬ೧Ȃ ވเฯȂ ۃเܻ᎐ሆົܿเฯ ˄ၩໍᏠፈቪठ࣭ ಐ༡ ˄Ŗŏʼnńœ˅ ठᏮ˅ Ȃ ซ߯ ˄ၩໍᏠፈቪठ࣭ޗ൰ቪ ߯Ꮶ֑࢞༃ठᏮ˅ ञ፱ݞเฯȃ ၓݲጶඝՑᏃ࠵ޗႚܿஏᅝࣰڋ࿎࢜ፀˈڕ ଓᇵޭࢌ࣭ ᄳܿࠍ႟ၓনˈھ ቇඝ࣋᎙࿎ࡴ፧னᇡ۰ᄹञ॓୲֦ڕఋȃ ၓࢌ࣭࿎࢜༦ፀˈڕ ଓፀڕඝၩໍᏠፈ Ȗੌजİ ՑᏃޗᄒᏮঝވጹـȗ20ᇵঽ ȖੌजİՑᏃޗᄒᏮঝވ 21 ৭كञ൹ࢳፑሞȗ ȃ ࿎຺࢜࣋ฏ࠵ႚञ຺ฏدቪܿፑܷኊዏˈ ಐৱတ࿒دቪ ፟ށञፍᄵၩໍᏠፈܿጹـञፑܷኊዏȃ ၓࢌ࣭ञठᏮঞ֎࿎࢜༦ኋ᎓ˈ ᇵޭਾ།เܻ᎐ሆ࣋෧ܿ ົञ۽຺ฏঽᄵᅍช൹ࢳȃ
19 Ȗ࣋াᎫྙՑᏃޗİՑᏃ࡞ኁ܈ܿፑೌȗ ˈ ਈũŵŵűĻİİŸŸŸįŸũŰįŪůŵİĴţźĶİűŶţŭŪŤŢŵŪŰůŴİťŰŤŶŮŦůŵŴİŦůİġŪŢŴŤŠŨŶŪťŦŭŪůŦŴįűťŧ ˄ijıIJķ೧Ĵኟ ijij๊ߺၳ˅ ȃ 20 ၩໍᏠፈ ȖੌजİՑᏃޗᄒᏮঝވጹ˖ـ ࣭࣋য়ࣙढ़ঽඝྊሇყ࣋ߴܿፑೌȗ ˈ ਈũŵŵűĻİİŢűűŴįŸũŰįŪůŵİġŪųŪŴİ ţŪŵŴŵųŦŢŮİIJıķķĶİĵĵĸĹĺİIJİĺĸĹĺijĵIJĶıĴııķŠŦůŨįűťŧŀŶŢľIJ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ 21 ȖੌजİՑᏃޗᄒߴ՝৭كञ൹ࢳፑሞȗ ˈ ਈũŵŵűĻİİŸŸŸįŖŏłŊŅŔįŰųŨİŴŪŵŦŴİťŦŧŢŶŭŵİŧŪŭŦŴİŮŦťŪŢŠŢŴŴŦŵİijıIJĶŠġŨŶŪťŦŠŮŰůŪŵŰųŪůŨŠŦŷŢŭŶŢŵŪŰůŠ ŤŰŭŭŢţŰųŢŵŪŷŦŠŕŃĮՑᏃޗŠŢŤŵŪŷŪŵŪŦŴŠŦůįűťŧ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
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เஉᏁኑ
ЋӥѴёфёϡዐ༸࠴ఽࡢՄ۵ࡣ䩟 ؑϴᓛ ࣁዐ༸࠴ఽࠖע䩟 ϸԗцਛТϪҨޝพюӓӛ۔ϩ ϡؑؒ䩟 ؑϴࣨ҇ٿඎਛТ֞ӑٷϨዐ༸࠴ఽࠖעϡ ۟ۂРࡄЅт༯Ϥӎϡӑѓ䦚 ЋӥѴѸᒩϽϡࡣ܋䩟 ؑϴಈѓЈϡࠖע٤పথܴ䩟 ϸؑϴӸמਛТϪҨޝ 䩟 цਛТ֞ӑٷϡӑѓфࠖڗйߵϨϤӎࠖעЅϡ חឱՖҲ߯ຽ䦚 ङ٤పϡዐ༸࠴ఽࠖעй֔䩟 Х ϿքϱքЄсؑϴਛТ֞ӑٷЌਸ਼ڗЋئӡϪळد၉ ЋԳѢϪळ٤పࠖעфЋዐ༸࠴ఽҀทٷ٤పӗࣨ ࣇ䦚 ҪӌϡмрਛТϪҨڋޝਢݱݸثϬਛТՄڍ ϡؑؒ䩟 د၉Ϩዐ༸࠴ఽࠖעϡ۟ۂРࡄЅӛݘТϡ ؑؒ䦚 ϨѸܲጷϡϪҨۨޝཪЅ䩟 ׆ࠖڗҩքϱքЄс ѓӊ٤ҙࠖעϡНԅЏԛ䦙 ଛф֝ڱ䦚 ϸ҇Ҥٍ֚ዐ
༸࠴ఽഠ࠻䦙 ඎфԷјࠖעЌϨޝիࡳϡޕැЅ Ⴍݬথ٩䩟 ԗцਛТࣨඎՄڍЌҨϡ٤ڢт༯я೯ Գϴϡӑѓ䦚 ϨӥҲ׆ࠖڗфࠖڗдЗ䩟 ࣔ܋фฮ ᒾҳفݒҜۓءછϺ֧䩟 й৭ࠖעخϡ֝ڱ䦚 ӎଏفݒ ֞ӑٷЌ٤పϩ٣ߚϡࠖע䩟 ϩࡾӊघ߇ԁਛТࠖעϡ Ԯ࠾䩟 ӹױ䩟 ԅЏӡϡഷਖ䦙 ࣔ܋䦙 ฮᒾфӾϡ֞ ӑᗐబ䦚 ۥӊϨਛТࣨඎޕැЅࡖϨዐ༸࠴ఽتըছ䩟 ਛТ ֞ӑٷЏϺҪӌϡੲࣉфԥҪڋਢϡࣇخ䩟 Ֆ֡ѓবࣃф٤పবࣃݘԘ 䩛ԝҒ䩟 ԥҪࠇ䩜 䦙 Ͻ֝ב කዐ༸࠴ఽњϡבකњবࣃԛᇯැ䦙 ዐ༸࠴ఽخ ઼ഠ࠻䩟 ЋҀทዐ༸࠴ఽϡਛТ֞ӑٷ٤పඎф ࣇԑ䦚
࣭য়ଓཨܻᄵވ ፟ށȂ ށඓᄧ࣭য়ՑᏃޗၩໍเஉᏁኑढ़৭૿ඝፍᄵଝˈ ਖඝᏮၓࣖ߱ܿၩໍเஉᏁኑढ़ܿ ᇜˈࠍؠ ቪ࣭য়ၩໍढ़ञ፱ڕ֦ݞᇜȃ ഻ᆻၩໍเஉᏁኑܿஉˈ ށ࿎࢜ՑᏃޗᏒठ࠵ႚࢌ፯ၤሥનֻܿजᄩஉˈ ࿎࢜ყ഻࣋ᅸˈ ሞ ܿܬਅށञไጽڋȃ ၓใႚᎡᇧግܸትˈ ᇵဣዴၩໍเஉᏁኑܿஉˈ ከቂ ˄֡ଭጦޭ຺ฏၩໍᏮጚܿ˅ ܿܬ഻ᅸ࿒Ⴜञ ৭࣏ଙ৩ȃ ࿎ࡴၩໍᏮጚ֦ܿڕఋˈ ቂܿܬ፟ˈ ቇඝᇋฬ֦ྈၩໍᏮጚ ˄֡ଭ຺ฏၩໍञ߾ᇖᏮ ጚ˅ ༆ܸᏚ߇ܿᏁȃ ၩໍᏠፈଓཨܻᄵވ ࿎٪ޭၩໍᏮጚᄵ഻ᅸˈ ف፱टᄵᇵเၓׁܿ॓୲ˈ ᇵ੍િ܃ၩໍؠܿච༄ ˄֡ଭޭ፱ݞ เฯܿච༄˅ ȃ ࿎࢜࣋ใႚᎡᇧܿፑܷኊዏˈ ጦޭՑᏃ࠵ޗႚܿஏᅝࣰˈڋ ˈ ࣋ቂ߾ᇖ࿎࢜ጚ࿎࢜࿅࠵ށႚ ܿፑܷኊዏˈ ֡ଭՑᏃޗ৹كȂ ਾۂኁ߷ᄹᇊ႘܈ፀڕञૠೣᎡޗ፧னˈ ᇵঽኁ߷ञ૿፟٢ਈठ ጻȃ
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֦ጽቄ፣Ȃ ੶ܿᇊ႘Ȃ ጪިનञٛ൰࢜ሥ
ႭݬᇓϽዐ༸࠴ఽবࣃ䦙 ᒎआфඎݾবᇯැϡ ࣻ䩟 ԼݸӊҮ௸䦙 ڱހϡዐ༸࠴ఽ䦙 ᒎआ֞ࡢф ԷјݘԘϡНЏԛфԥҪప䦚 ऴӆዐ༸࠴ఽݘԘڱ ֝ࠍЎфआప䩟 ԝҒ䩟 ԥҪࠇ䦙 ڀथިޕ䦙 Բԛࢲޔد ܷभިޕ䦙 ᒎआ֞ࡢ䦙 ڈԷјݘԘ䩟 ԗᏲዢਢᓛ ࣁ䦙 ըছবࣃ䩟 ࣔঊඎਠ 䩛د၉ዐ༸࠴ఽݘТ಄ ԛ䩜 䦚 ކ৭ব࠻мрфҪܧцӛϩዐ༸࠴ఽݘԘϡؑؒ䩟 й۬࠱߃ءϩިфϩЌҨ߿ٶবؒؑڋ䩟 ৭۟فخ ప䦚 ߎഒӆс߃ءЌҨ䩟 ӹԷϩНЌઁࠍ٣۴䦙 خ ᅣపфՖӆмϡІҰ䦚 мрዐ༸࠴ఽфѸܲጷ ϡਛТڋਢфবݸثڲಈकфప܉ԑؑؒ䦚 ԗ䦙 ᒎआ֞ࡢфԷјݘԘӑЋмрዐ༸࠴ఽਢ ϡюӆϡҰϴॵюחд䦚 ࡣܼ֝ڱࡺשϡԜ৭ݘԘϥй ׁԑϡ٣۴ӥѴзюҝϡԮඡ䦚 Ԓ֎ਛТॵЋٿ м٤పϦϣ࠶ڍϩ۱ӊᣩשԵࡄϡ܋䩟 ԝҒ䩟 Ԯӊԗ ଝဵఽ࠴࠹׆ѓӊዐ༸࠴ఽඎфবࣃϡ۪܋䦙 Ԓ֎ਛТॵऴӆ֜䦙 ഠ࠻ږଯ䩟 йߵԒ֎ਛТ ॵׁ۴ݘԘ֜䦚
Ћ৭خӗԥҪప䩟 ዐ༸࠴ఽݘԘಈकфప܉ԑ ҩรՊѸܲጷϡмрಈकфప܉ԑՄڍ䦚 ц٣۴ ׁԑϡዐ༸࠴ఽඎϡؑؒࣔঊϦዐ༸࠴ఽϡ Ҫӌઁ٣೫ଯ䩟 ϸ҈ϡ೫ଯЇНѓӊԷј䦙 ᒎआ ֞ࡢфਛТݘԘ䦚 ೫ଯد၉Ֆညءს䩟 ຎҒᳬ є֡РІ݁ܙН࠶ҴۥԘ֠۱ဩҜءҳঠᔃϡ ԅЏֺխфֺܝ䩟 ࣠ࣝԍਛТ䦙 ࡷЈфҌࡧݘҪ ږܧଯфҲ҃ڋਢ䩟 ᳬє۱ѓ 䦭ԁᆒډϩԮϡҌࡧݘ ӡ䦮ЅԮӊࢽ҅ԛϡֺࣇۅܝԍࣉ䩟 د၉מ ܙءНфިଈ֠۱৷䦙 ईԆӡ٣фԁבׯ࠱߃ء৷ ٣䩟 йߵӆс߃ء䦚 Ԓ֎ਛТॵࣇۅዐ༸࠴ఽ фᒎआ֞ࡢ٣۴ّࣝᆟ䩟 ԁԘ֠۱ဩॵ22ׁӑ䩟 њ ֠ࣇۅٷ۱૮ّࣝݮᆟ䩟 йٿࡾݨмԅЏϸԈݘԘϡ з٣۴䦚 ХϩЪЄҜϿНڝዐ༸࠴ఽ䦙 ᒎआ֞ࡢфݘԘ ϡಈक٭䩟 ٤ҙప܉ԑଛ䩟 ԝҒ䩟 ಈѓےӮ٤ ప䩟 ֝ಈकߦڱخϡݘԘ䩟 ٤ӓಈकфۨՖব࠻ ކ৭֏䩟 й೬ݪӹݘԘРࣔঊϡ٭ع䦚
09 – ႃ࡞܌เᎳֻ࠵ቂૠೣᎡ ޗᇊ႘ȃ
22 ᇊ൰ڗ࢞ࢥၩໍቱܿᇜჵᏋንᅒ૰፟ˈ ਈũŵŵűĻİİŸŸŸįŮŦťŪŤŪůŦŴűŢŵŦůŵűŰŰŭįŰųŨİ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
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࣭য়ଓཨܻᄵވ ৠූ࣭য়ՑᏃࢭتޗञ࢜ሥ࣏୲ܿੌࢬञˈڋ ฬ֦ਖඝೆ࣭ࣖ߱ܿয়ࢭتञ࢜ሥ࣏୲࿒Ⴜȃ ฬ֦ࢭت፣֦ጽܿՑᏃޗᇊ႘Ȃ ጪިનȂ ภ࿄Ȃ ್ᄹ֡൝०෧༦ົֻঽඝྊՑᏃޗყ࣋ٛ൰ˈ ֡ଭቂ ၩໍᏠፈܿᏁࢆኁໆȃ ࣙढ़ञՑᏃޗᇊ႘ञٛ൰ࢭዸకˈ ᇵਠ݈ՑᏃޗᇊ႘Ȃ ጪިનञඝྊٛ൰ܿ২ࢆˈ ֡ଭቂ Ȗቪᇸ ࣋ܿፃٛฝᄒށȗ ፩࣋ௌঝᄹܿକၕ॓࢞፳ȃ ၕ॓ञဣዴࣰၩໍᏠፈኁໆܿ߹፟ᇊܿ૰ঠܾᄹˈ ဣዴᅒ૰ᄒሊञৠཨ࣭য়ᇜৃܿ᎙قȃ ၩໍᏠፈଓཨܻᄵވ ኁكᅍชȂ ՑᏃޗञ፱ܐठጻܿᇊ႘Ȃ ጪިનঽඝྊٛ൰ܿঠถဉञتቂఋˈ ቂყ࣋ᄪႩࢷໍٛຟ નֻڣᏚܿ፟ዉஉˈ ֡ଭᎺࢷ݈༆ञ፩݃༆࣭য়ܿໍٛຟનֻڣᏚܿ፟ዉஉȃ ထࣖၩໍᏠፈܿᏁࢆኁໆࣙढ़ˈ ᇵצ፱ݞᇊ႘ञٛ൰ঠܾଓཨܻ᎙ˈق ၕ॓ञဣዴ፣֦ጽܿᇊ႘ञ ጪިનܿ૰ঠܾᄹȃ ၓՑᏃޗٛ൰ܿᅤ࿎࢜ፑܷኊዏˈ ጦޭ࣭য়ढ़Ȃ ᎓ጚञࢬˈ ໍڈञߙ࣋؝ՑᏃޗᇊ႘Ȃ ጪިન ञඝྊٛ൰ܿ২ࢆঽ፟ዉຟܿᄪႩȃ ၓࢌ࣭࿎࢜༦ፀˈڕ ᇵኁޭكনׁՑᏃޗٛ൰ܿᅍชˈ ਖඝೆ࣭য়ࢭتञ࢜ሥ࣏୲ढ़ˈ ၓቪ፟ዉຟሊ২ ፟ށዸకȃ ၓ৭࣏ࢬ࿎࢜ፀˈڕ ጦޭຢ༁൹ࢳȂ ᄧᄲՑᏃޗᇊ႘ञጪިનܿ᎙قȂ ຢ༁ॄ৭كȃ ჹ࣭য়࿎࢜༦ፀˈڕ ፟ށภಅਠ২ـకˈ ฬ֦ঠܾনׁܿՑᏃޗᇊ൰Ȃ ጪިનञຟ൰ȃ
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ۑਓञၕ॓०
࣭য়ଓཨܻᄵވ ࡙ࢄጹـȂ ߟఊञࣙˈށ ඝᏟՒ൶݃ঠܾՑᏃޗყ࣋ ࠵ႚˈ ࿅׳ޭ፱ݞเฯञඝྊ۽ฯ࿒ܿᏟՒȃ ፮ੌঐৠરႄಚफ़ञච༄ܿጹـቪᏭߟˈ ˄࿅׳ၩໍ ᇞனົ፩˅ ˈ ቇඝጦޭՑᏃࡥޗำጚञ፱ݞเฯܿ ጹـቪᏭߟȃ ۑਓ፟ޡञ຺ฏ०ˈ ಐ፳ภݓঠܾՑᏃ࠵ޗႚ ߑႇᅍܞᄩච༄ˈ ຺ฏدቪࣙढ़ञ࿎࢜࠵ႚˈ ᇵ࿎ࡴࡇ ఋȂ ፣ञᄌᄹȃ ੍િᄹ׳൶݃ˈ ਖনጽદܿ࡞ኁ܈ೆ࣭য়ՑᏃ ࣙޗढ़ञዸకȃ ၩໍᏠፈଓཨܻᄵވ ٪ܷቂ࢞ࢥၩໍጽદˈ ᄳڈၩໍ෩ᇵᇞனܻܽȂ เฝञ࢞ࢥၩໍኊዏၓনߟܿھఊञࣙढ़ȃ ፟ށञထࣖၩໍᏠፈܿყ࣋ጹـञፑೌˈ ಖฬጦޭ ᄹ׳൶݃Ȃ নᄹ֬ܿ׳உȂ ႄಚफ़ञච༄Ȃ เฝȂ ፱ݞ เฯञ࢞ࢥၩໍቱ࿓ށܗᏦ܈ȃ ፟ށȂ ᄧञყ࣋ፑܷኊዏञનˈ ߷ፒञ૿፟ নᄹ֬ܿ׳உˈ ᄂڼเฯ ˄֡ଭߒȂ ຬ೧ञ፱ ݞเฯ˅ ঠܾনׁՑᏃ࠵ޗႚྈಅܿੌࢬᄹጊ Ւȃ
ϩϡዐ༸࠴ఽцᇯැؑϴفݒԛϡघ Ͽ䦙 ֚ಋфू೫ࢲ॒ೖಿھٍЌԅЏф ٍѓࠖע䦚 ЋϤӎޕැЅϡ҇ٿϪळ䩟 ؑ ϴמϽфࡢϩમϮݒනϡਛТԁघ߇Մڍ䩟 йߵϣϬՖਛТԍכ䦙 ԛԆכҳфϪϡ મϮࢲ॒䦚 ू೫䦙 ֚ಋфӡ䩭 ਛТח՟ϡҰϴૺڗҏϣ ϥ৭ूخ೫䦙 ֚ಋфӡ 䩛د၉Էјח՟ϡϨ ֵ䩜 ϩ۱ӊਛТفݒॸмрϡዐ༸࠴ఽ цᇯැ䦚 Ғҝ௬ҲЏӾ䩟 Ќ۽ङԛԆϤכҳ фࣇخ䦙 ՖϪϡ֚ಋфू೫ϲНйઁࠍ ዐ༸࠴ఽҀทϡୟԛфըছ䩟 ᓛஞਛТע ࠖϡԅԼಬዓ䩟 ٤ҙԷଛ䦙 ֝ڱфϩ ԛ䦡䦡දԷϥЋԳѢϪळ䦚 ߊ܉Ғױ䩟 ϩϣ࠶ڍᅣዢകߓ۟ਘࡆԈϪळ Ѫ֚ԅЏфٍѓϩϡݾবᇯැфࠖע䩟 ԝ Ғ䩟 ఱцݙվёϡܙНёූ֚䩟 цԵ҃Ϫטф ѪрНஓٷઑྩघϿࣇخ䩟 йߵԗחдϪळ фҲЋՊ഻ 䩛ຎҒ䩟 ٍѓఽԘ䦙 ԛ֞ӑфԲԲ ԛҲЋ䩜 䦚 ዐ༸࠴ఽਢӛࡢϩϡԳϴӑѓ ϥ䩟 ฮᒾԷјח՟ϡू೫䦙 ֚ಋфӡ䩟 ৭ӡ ԷНЌцዐ༸࠴ఽфѸܲጷϡਛТцᇯැ ݘТϡؙড়䩟 ϨࡖϨᅣዢҏ؝䩟 ዋࣔՖҲԚ ϡ߯ຽфۨཪ䩟 й৭ֲخҝӊਛТϩ۱䦚
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ዸకߴჹĵ˖ġ ڮᏁ۶૰ڕᅝᄹ ྈเฯૂሥঠܾྈᅍᇋܿ࠵ႚ෩ႇᅐფ اႚବ ࣰۑᄧᄲڮᏁञᄧᄲڮᏁ֑ߟዓৠခᏁ
Ꮾ߱ࣖڵഇஉˈ ዓৠᏓ࿒ၩໍခᏁˈ ᇜ؞ᏚՑᏃޗ ቱᏁਜ਼ᅍช
Ѵϩϡмকфмֵؖޝઌൖ࣑Ϥ߿йӥѴږଯसଈӛ ޕӡϡёфёϡࡢՄ۵ࡣ䦚 കؑϴЈϡؖޝ ϱ䩟 ѓӊН۟فсᇓϽዐ༸࠴ఽԚԮݾবᇯැфע ࠖϡথ䩟 йߵᇞਤӹዊࡾٷϡԳѢ׆ґࣔঊϡޝ ؖઑט䦚 ዐ༸࠴ఽцᇯැࢫಿϦҪܧфмрৢӌϡਛ ТՄڍቻࡷޝЈ䩟 ԝҒ䩟 цҜܯ䦙 ҃ӈҦᇃфӛЏ ᇃ䦚 ЋԅЏН۟فцᇯැؑۓϡޝ䩟 ХؑϴՖϣ܌ ϡࡷЈ䦚 ҶӸዐ༸࠴ఽቻޝӑЋҶӸҪӌਛТޝۄϡѸܲጷ झҨϡϣחд䩟 й৭خӛϩԳѢਛТࠖעЌӌזҪھ ࣉ۵ࡣӥѴথ٩䦚 ԍфмֵቻޝϥۓϴфН ۟فϡਛТࠖעϡಚК䩟 د၉ዐ༸࠴ఽԚԮࠖעϨֵ䦚 ࠾ׁмዐ༸࠴ਢឱޕӡϦёϡዐ༸࠴ఽਢ мֵቻޝ۵ࡣ䩟 ԝҒ䩟 ਢЅϡмֵቻޝԝຎϨࠍּՊ мрܼϺ䩟 ϨЅҳണЎּՊмрܼϺ䩟 ϨЅҳ ണϼּՊмрܼϺ 䦚 ҶӸԍਛТݒоН֡Рቻ ओѸЄᇃּ 䩛٤ҙूϡूЌҨ䩜 ڈԗूؖޝϡ ѸϽڤдࡈѯਛТ 䩛٤ҙਛТϨԍবڲЅϡހ с֧䩜 䦚 ਛТח՟܀࡙ۯԁूחϨবڲ䦙 ԍࠖ ܉ԑՄڍфूҽߎഒҤӌϡ՜֣䦚 ۱ѓዐ༸࠴ ఽޝۄԑࣝ䩟 ዋࣔф࠱ԗԍޝԍכсдࡈѯዐ ༸࠴ఽ䦚 ϨϽחдࠍּՊфЅҳണЎּՊмр䩟 ዐ༸࠴ఽࠖע фݾবᇯැԗߓ۟࣊༌֔חфॹח՟ϡؖޝ䩟 ׯϺ ёߵйњ䦚 ϱІϼϱϡּՊԵۓછԟҪላׁ ᢊՊмрਛТڋਢϡмрዐ༸࠴ఽԳѢ䦙 ਢфڋਢ䦚 ּՊԵϡಢӡԛфНব࠻ԛцзϽࡳ֏ઁࠍࠖעЅआ ըছ۠ԮԳϴ䦚
Ћӥැь֡ݬѬҲ҃䩟 ԪґЌϨёӓֲټዐ༸࠴ ᐭє䩟 ؑϴҪܧЈҶϽ֝ޝۄ䦡 䦡Ԫёϡᏼ ѤׄҶӸ۠ёϡᏼѤׄ䦚 ֡РϽ֝ӓޝۄ䩟 ዐ༸࠴ఽݾবᇯැфࠖעϡ۟ۂРࡄНႭݬӥѴ থ٩䦚 ЋН۟فϡዐ༸࠴ఽцᇯැቻᇯؖޝ䩟 ؑϴϨѧϬ ֩ಈԼҲ҃䩭 ҶӸּՊ䩟 йݒዐ༸࠴ఽݾবᇯැфࠖעϡ٭ѓ䩟 ԳѢϥۨмֵּᇃ 䩛د၉ ϣ ડּ Պфࣨءמඎخ ছ٭䩜 䩟 ᔅҏй֔חϱ 䩛ԝҒ䩟 ዊࡾٷჇܝфϪ ּՊ䩜 䩮 ࠖըছخᅣфࢅؖޝቻ䩟 د၉ࠃ߹ԍכϡҜء䩟 ԗਛ ТՄڍϡؖޝओЅ䩟 ৭ࣘخдዐ༸࠴ఽࠖעϡۂ ۟Рࡄ䩟 ઁࠍࠖעӛӌைϡؖޝᅣዢ䩟 ٤పࠖըছ خᅣ䩮 ٤ҙଛ䩟 ϨԗਛТՄڍϡޝѓӊᇓϽዐ༸࠴ఽࠖע ϡϩࣻЗ䩟 ઁࠍዐ༸࠴ఽ䦙 ᒎआ֞ࡢфԷ јݘԘϡюӆ䩟 ँվԚԮжࢅڍԁԷјڋਢйߵѸܲጷ ϡਛТՄڍϡԳߒ䩟 ԝҒ䩟 ږଯҞ֥䦙 ϪҨޝ䦙 ಈकф ప܉ԑ䦚 ϩࢅڍсٍѓюӆ୳ૢйߵਢфࠖ ّࣝࡾ৭ӡਢԳѢ䦚 мрਛТቻޝՄݸثڍዐ༸࠴ఽߵԷјмрԳѢ ਛТؑؒ䩟 ೬ݪജ્ϡؖޝᓀѬ䩟 ঊҨӊӥѴਛТ ԍכ䦚
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੍િঠܾञ࿎࢜اႚࠞნ֦॓ྈಅܿᏁਜ਼ጊՒ
ਠ݈২ࢆञˈׁڈ ࿎ࡴᄌఋ
ਛТቻޝՄڍЌзϽࡳ֏ँվӛϩऴӆਛТࠖעϡІ ٭ѓ䩟 ҶӸࠖעϡԅԼಬዓфࣃঝᆢ٩䦚 Ћߊ֝ઁ ࠍैਛТэݒ䩟 І٭ѓءࡳϨਛТݒоւϡ 䦚 ዐ༸࠴ఽࠖעϡ۟ۂРࡄЅϡዐ༸࠴ఽऴӆݾবᇯැ รՊмрਛТ۱Ҥଈ䩟 ٭ݪॸ٤ప䦚 ֔ױ䩟 ٤ప ᔅࡾԥٕ 䩛ԝҒ䩟 д્٩ڈࠖע٤పؖڊ֡ےᄳ䩜 䩟 ߊ֝ ઁࠍٍࠖעѓٷϡҽבюӆ䩟 ЇЌ٤ҙࠖעಈѓଛф ؙড়Ҩ䦚 цٍѓ٭ּٷԗࣔঊዐ༸࠴ఽඎԅԼಬዓ ݘТϤԍכ䩟 वࠖעϡٍѓ䩟 ઁࠍඎ࣊Ԫԛ䩟 ҶӸ ඎਠϡըছ䩟 цр࣏юϤۓϴϡࠖ䦚 Ћዐ༸࠴ఽҀทߵٷԷјիؙড়Ϫळ٤పࠖըছخ ࣇфӛؑࠖעϡԅԼಬዓ䩟 ϴ࣊ۻѸܲጷфמϽ䦙 ԍ כϡмрਛТቻޝՄڍ䦚 ѓӊਛТϡԍቻޝՄڍ䩟 Ұ ϴ࣊ۻԪϣડᇃּфޝ֞ڈᇃּ 䩛ѓӊءמԛࣨඎخ ছ䩜 ቻओϡּՊ䩟 ϥзԍכфϩϡࢅڍ䦚 ϸ҇ব٭ Ҝ߹ࠃءϨݒЌҨϡऴኜϼ䩟 ԗּՊܲጷओЅ䩟 й ۬Ќߵӛϩؑϴٷ 䩛د၉Ѫ֚ࢅڍזᣯ٭ϡϪळ䩜 䦚
ؖޝҤӌϡय़Ҩٍٿмۓછࡺשзϩϡዐ༸࠴ఽ ݾবᇯැфҤܴ䩟 ఱцзЌݘТؙড়ҨϡϪळфޕ ැ䩟 ઁࠍߵԷјਛТݘԘϡ٣۴䩟 ॸ٤ҙࠖע ଛ䦚 Ќ࢙Ҵ䦧ϩӛߚ䦨ф٤ҙଛϡਢѸϩ۱ӊ ԼԍכдࡈޝфԅЏ֔فݒؖޝח䦚 ϩ҇ٿҜϿ Нй٤ҙଛфઁࠍюӆ䩭 મϮϡ࣮۵܉ԑЌՖϱІмрবח֔ڈڲϱϡ ޝϩсԵ҃фдࡈ۠ԚԮࠖע䩟 ѓӊԚԮע ࠖ䦚 ԝҒ䩟 ѸϮс݆ዊࡾؖޝ䩟 ԁмрڋਢфѸܲጷ ϡਛТՄفخڍϣঊ䩟 ԗޝओЅ䩟 ࣠ࣝၾቻओޝ ؖ䩟 ӸמϨৢٿӌфӛϩ۱೯ԚԮҤ 䩛د၉ӥැٷф оٷޝ䩜 ϡ՜ૺ䦚 ۨՖц٣۴ׁԑϡ䦙 ᒎआ֞ࡢߵԷјਛТݘԘϡ ᣩש䦙 ಈकфప䩟 Ќઁࠍࠖעюӆфᖯࠀ٭ع䦚 ࡢ ՄҤ֚Ғ䦧ږଯҤז䦨ӛ䦚 Ѹϩфҙ֝ڱϡࠖע٤పЌݘТϽֲ֝٤ҙ ਛТю䦚 䦧ږଯҤז䦨ߎ֝ϦНۨՖࠖע٤పথܴϡ Ҝ߁䩟 ԝҒ䩟 ԗׁݱࠖע䦙 Ԯ࠾䦙 д્٩䩟 ӥැ׆ࠖڗ 䩟 ٍѓۘ֠ਛТ٤పٷйߵҶמघ߇Մڍ䦚 ৭خ ֝ڱࠖעц٤ҙଛ۠ԮԳϴ䩟 ڱހϡࠖעԗЋӛՐ ٭ҟϣѤׄհϱѸϽϡਛТּ೯䦚 ຎҒ䩟 મϮϡඎ ࣊ԪԛфࣇԑفخଛЌзϽࡳ֏сઁࠍඎਠଛ䩟 ँվ֙ࡨඎфઁࠍ׆ೀ۠Ѹᒰਯϡҷԏ䦙 ѧ۶ඎ ϡۓϴԛ䦚 ዐ༸࠴ఽݾবᇯැфࠖעԁԷјਛТڋਢ фݱϬਛТՄڍϡ݆䩟 ЌँվଛࠍЎϡєୂ䩟 Ԫ ґԗবڋюҝзϽ٩䦚
10 – ჹႇয়૰ࣜጚਝ੍ՑᏃޗ ˄౮ৠ ଲ࣭˅ ȃ
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47
࣭য়ଓཨܻᄵވ ਓஅූܿܐՑᏃޗခᏁ୲દˈ ᇵ٪ܷޭ࣭Ꮑኑܿڣ ᏚࠍിञވိؠᏁਜ਼ፀڕȃ ኁ࣭كয়ՑᏃޗᏁኑᅍชˈ ፟כށᇋܿढ़ˈ Ց Ꮓ࠵ޗႚޭိؠᏁਜ਼ܿᅍชჹ࢞ࢥञ࣭Ꮑਜ਼ࣰˈޢ ቇඝ᎙ሃ֦॓ᏥᇡိؠᏁਜ਼ܿনׁ࠵ႚˈ ᇵןಁ࠵ ႚ፩ިȃ ਂຬᏁਜ਼ጊՒˈ ֡ଭᎉ؞࿁ྚၓՑᏃޗঽඝྊၩໍ࠵ ႚፊਾञᏋࡋࠈቂȃ ࿎࢜ඎܿၩໍاႚࠞნ֦॓ˈ ࡇྈเฯˈ ׳ ო಼֦॓ܿܿᏥߴ ˄֡ଭ࢞ࢥූ፟ᄹၩໍڮᏁ ࿒Ⴜ˅ ȃ ৭كၩໍፀڵञׁڈঽՑᏃ࠵ޗႚׁܿڈᄌሇˈ ࣰ ࣭য়৭كञ൹ࢳ࿒Ⴜᄵˈ ᇵ׳ਠׁ݈ڈञٛໍੌ ܿትȃ ৠූቪඝྊၩໍढ़ܿᄒˈݲ ֡ଭ׳ትˈ ጶठყ࣋ ၩໍ࿒Ⴜ ˄ˈ ዸకᄪႩȂ เஉᏁኑȂ ࢭتञ࢜ሥ࣏ ୲˅ ȃ
ၩໍᏠፈଓཨܻᄵވ ኁكञށඓ൹ࢳᏁኑᅍช ˄ቪठ࣭ՑᏃࣙढ़༡ठ Ꮾ˅ ˈ ოijıijı೧ञijıĴı೧ܿન࿒಼ȃ ٪ܷޭՑᏃޗሥޭ܈ܿภ߇Ꮑ᎓ˈ ڮᏁ۶૰ڕᅝ ᄹ࣭ܿয়Ꮑ᎓ਓஅጹ፧ڏഐˈ ۶ዸకڮᏁठᏮঞ֎࣋ Ⴜˈ ˈ ቪภฉૠՑᏃȂ ੌजञഌিনਜ਼Ȃ ࣭Ꮣ ՑᏃাઑኋढ़Ȃ ߔञౖஹۡ܌নਜ਼ঐ݃ȃ ፀ࣭ࢌڕਓஅ࣭য়ՑᏃޗခᏁ୲દञاႚࣰޢढ़ˈ ۰ိؠᏁਜ਼ହኑჹ࣭ՑᏃڮޗᏁࣰޢȃ ၓ൹ࢳञ৭كၩໍ࠵ႚׁڈ࿎࢜ፑܷኊዏञનˈ ᇵঽ ׁڈᄌሇનˈ ፀت࣭ࢌڕቂၩໍᏠፈ Ȗၩໍजི 23 ࣭য়൶ྕȗ ȃ ٪ܷࢌ࣭ਖՑᏃޗনׁ࡞ኁ܈ञ࠵ႚೆ࣭য়ၩ ໍ࠸ߴ՝ˈ ᄂڼঠܾՑᏃ࠵ޗႚञٛ൰ྈಅܿ Ꮑਜ਼ጊՒȃ
֦ጊ࠵ႚ፣ޭ࿎ࡴᄌሇ সၓ፱ᇋȊȊ࿎࢜டऔܿ࠵ႚ ਖ࿎ࡴၩໍခᏁᄌሇ
23 ࣋ၩໍᏠፈܿၩໍजི࣭য়൶ྕܿᄪႩˈ ਈũŵŵűĻİİŸŸŸįŸũŰįŪůŵİũŦŢŭŵũĮŢŤŤŰŶůŵŴİűŭŢŵŧŰųŮŠŢűűųŰŢŤũİŦůİ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ
48
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
ዸకߴჹĶ˖ġ ዴۑᄧˈ ৠଓዴ ࡙קሥޭ܈ܻܿࣟᇵოऻၙ಼ ୳ૢфࡷЈЌ٤ప֞ࡢфҌࡧ䩟 ۨԸዐ༸࠴ఽцᇯ ැϡፊѬ䩟 ٤ҙଛф֝ڱ䩟 ӥѴԍכфԗؙড়ҨзϽ ٩䦚 Ғҝٿм࣊ۻѴϩϡዐ༸࠴ఽҌࡧ䦙 भфע ࠖ٤పҤܴ䩟 जϤНЌӥѴёфёϡዐ༸࠴ ఽࡢՄ۵ࡣ䦚 этЈभфಬዓؑϴࡷЈ䩟 Ѹϩс۱ѓѴϩ֞ࡢ䦙 ٍԷ҇ٿϪळ䦙 ޕැڈѓಬЇؑϴࡷЈ䦚 ϨϣϬс ߇этфءӡϡݾবᇯැНЌؑϴ䦧ԳЈڋޕ䦨ҥЌϨ ԷјсҤт༯ۋ䦚 ԝҒ䩟 Ϩ۪ۘחರҙථ࠴ଛࢲ॒Ў этϡ䦧׆ࠖڗ䦨цևଡڈರґߞϲϥϣ҇ЈҤ֚䩟 ؑϴՖҲ݆ݱ䦚 Ћ०әणٍѓءٷӡϡ䦧ँվߛ؍䦨 ҤଈЇؑϴಈѓࡷЈϡҤܴ䩟 ҥЌٍԷцН१ӹٍѓ ٷѸϩҺॶ䦚 Ҍࡧϡьتݬϩࡾӊٿмዐ༸࠴ఽ цᇯැݘТ䦧ٟቸ䦨䩟 პјϪϡҮࡑ䩟 ႭࡧݬԆф݆ݱ зϩӓಬϡݾবᇯැфҤܴ䦚 цНӑԛϡ୳ૢЌЋ ዐ༸࠴ఽࠖעϡۨ٤ప܋䩟 ԪґзϽࡳ֏с۱ѓ ޝۄ䦚 Ԓ֎ਛТॵЋףϬҰϴ֩ϡዐ༸࠴ఽ୳ૢ٤పݒ ف䩟 дԆϥ䩭 ࠃޕਛТ୳ૢՄڍϡЌҨ䦙 ኗओԳѢޕැ رϡׁӑଏՖҲ୳ૢ䦙 ءӡમϮ୳тӑϡ фࡣކ䦙 Ֆԗ࢙ࣝ׆٩ю٣۴ׁԑϡਛТभфй ࢙ࣝЋऴኜϡू೫䦚 ॎѼϨ୳ૢфݘԘэтҤӌϡׯ בӑѓЪϩࡳ䩟 ԔԒ֎ਛТॵНԁ୳ૢфэтׁӑ ଏ䦙 Т઼ׁܷ࠱ݘӑ䩟 й৭ٿخмЌԅЏфЈϡዐ ༸࠴ఽऴӆभ䦚 ۥӊׁӑଏцࡷЈࡢϩԳϴӑѓ䩟 ږଯҤ܋זоϦؑ ϴٿм䦙 Ԓ֎ਛТॵߵԷјׁӑଏӎझҨϡԮඡ ࡷЈ֩䦚 ӥѴёϡࡢՄ۵ࡣԗቄքٚёϡЗ ҽ䩟 ӹױ䩟 ۓછߎഒߦ䦙 Ѕфӗϡ୳ૢԳѢ䦚 ږ ଯसଈԳѢԮڀϡϥߦфЅϡԳѢ䦚 ቄफ़ՑᏃޗኁ߷܈
ײϱϨবࣃभҤӌԼЏϡࡷЈ࡙ϽҶמϦዐ༸࠴ ఽবࣃᇯැॵׁ䩟 ԝҒ䩟 ٍѓଝဵఽ࠴࠹׆বࣃ ዐ༸࠴ఽϡتфҀท䦙 ᓛࣁԲԛܷࢲޔدभйࣃঝ Ҁทዐ༸࠴ఽ䦚 ѸܲጷсؽѓϸԈҜ߁фՖϣࡷ܌Ј 䩛חдӔҮϨቻިЅ䩜 ԗҶӸԚԮؙড়Ҩ䦚 Ћࣘдт༯בකӓবࣃዐ༸࠴ఽҀทᇯැϡၘҨ䩟 ؑ ϴۨՖࡈҤ䦙 ٤పࢅڍфࠖע٤పথܴ䩟 د၉֔ѓф ӗఱ፣ࡈҤ䦚 цԲԛфѽԛԥҪࠇڋޕ䦙 Բԛޔد ࢲܷभިޕϡࡷЈঊҨӊ٤ҙНבի֏фಈѓଛ䦚 ЋଷۋװЌԛჷዐ༸࠴ఽҀทٷґՖҲϡዐ༸࠴ ఽᐭြ୳ૢфझҨԗߓ۟ӑЋዐ༸࠴ఽ୳ૢ৷ࡄЅ ϡԮඡॵюחд䦚 ۱ѓЈࡿϡҞ֡भ䩟 ٍѓऴӊ ӽ౩ϡѲҜѓࡄਡ䩟 ֡РӈжਛТࠖעخ٤పϩ ϡবࣃݾবᇯැ䦚
ቄफ़ՑᏃޗ৹كञጪި
ЈࡿфҮРۨϡᒎआभ䦙 ഠ࠻Ҥ֚Нٍዐ༸࠴ ఽЏϺѸՉфކ৭ϡᒎआ䩟 Ӹמцථٷϡฮ࠻䦚 ϨϸҤӌЇϩϣԈࡷЈϡҜ߁䦚 ዐ༸࠴ఽІϢഠ࠻֩ ϡЈтࣁНϽๆᓛࣁዐ༸࠴ఽഠ࠻䩟 Ԕകؑϴ৭ ֝ڱخ䩟 ԁ৭࢙ՆࡑфѸܲጷϡዐ༸࠴ఽࠖעՖҲ ࣘдϡԮ࠾䦚 ߣ䦙 Ү௸фНۻϡࣇԑѢዐ༸࠴ఽᒎ आ䦡䦡د၉ᆯոՉᒎआ䦙 ථٷฮ࠻ 䩛දԷϥ࠴ఽ֝ ߯ຽ䩜 䦡䦡ٍዐ༸࠴ఽฮ࠻фථٷฮ࠻Ϩघ߇фണ с߇ЇЌԟю䦚 Ћዐ༸࠴ఽߵׁҀท 䩛ԝҒ䩟 ֲಚ ࠴䦙 ࠴ఽԛႣфႰఽ䩜 этϡЄ٣ڈओюᒎआݡכ ԗ٤ҙࠖעଛфۨථࣇٷԑ䦚
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49
ቄफ़ՑᏃޗᇊ႘ञ፧ன፟
ቄफ़࠵ႚ࿎࢜ಠ
ߊ܉Ϩଝဵఽ࠴࠹׆фҜءϡԥҪԛ䦙 ۋфН בի֏ҤӌԼЏϦԳϽՖࣁ䩟 ԔകѼϩϣԈ֩ؑϴ ࡷЈфۨՖ䦚 Ϩэтߣ䦙 ҙϡҷϣ۶ଝဵఽ࠴࠹׆ ඎҜءфࡈҤҤӌЇԼЏϦЪϽϡՖ܌䩟 ԔХؑϴՖ ҲࡷЈ䩟 йэтߣ۬䦙 ಢϡӡ፣֝ҷԏ䦙 ѧ۶ඎ֚䦚 Ԯӊଝဵఽ࠴࠹׆з፣֝ϡ୳ૢЋϩඎ֚ ٤పҞ֥ऴኜ䩟 зϽࡳ֏сઁࠍఽԛфԚૠӑѓ䩟 ࠍઁюӆ䦚 Ћэт௱ϡଝဵࡈఽ࠴࠹׆Ҥф ࢅϣඎ֚䩟 ؑϴՖҲϽ֝ࡷЈ䩟 ԝҒ䩟 ఱцᆯոфոু ϡߣ䦙 НטϡࡈҤ䩟 ఱцݙվёϡѯҤଈ 䩛й٤ҙ Нבի֏ф࣊Ԫԛ䩜 䩟 йߵӗעטфڀथء፣ 䩛й٤ ҙ࣊Ԫԛфۨ࠴ఽဪء䩜 䦚 ӎЗ䩟 ХؑϴэтѸϩ ϡфඎ֚䩟 йࣃঝфସءԳϽׁҀทфԷјׁ ೋ䦚
ଝဵఽ࠴࠹׆ඎႭݬӥѴথ٩䩟 Ͻחдϴஓۋӊ цዐ༸࠴ఽඎфࣇԑಈԼϦԍਛТҤఱ䦡䦡٤ዋ ٍѓߣ٩䦙 ࡣކ٩ϡҜء䦙 Ҥଈф֚ފ䩟 ϩ۱ѓٿϬ ৢӌϡਛТࠖעфٍघ߇ࣘд܀ԁ䦚 ӎ҈䩟 ዐ༸࠴ఽব ࣃᇯැϡюۋЇϽחдஓۋӊਛТࡷࠖעЈфӸמघ ߇Մڍ䩟 ԪґٍϩϡݾবᇯැЌзୟфըছ зҙϡϪळ䦚 ۥӊዐ༸࠴ఽਢӔࠌю়䩟 ӹױ䩟 ۓછՖҲ݆ݱ䩟 й цЈϡखږ䩟 ᇓϽࣻфؙড়Ҩ䩟 Ҷמԍכԛ䦚 ܼϺϣ҇ᅮዌϡכ႗䩟 ЋئӡޕැфϪळ֝ӱӡء ࠖע䩟 ӎЗ䩟 فخϣӡࡄ֏ϡߣ٩фࡣކ٩䩟 й۱ӊ ᇓϽথ䦙 ٤ҙଛфՖҲН۟فϡᓛࣁ䦚 Ԫଝဵ׆ ࠹࠴ఽඎথ٩ЏоϡҮࡑᙪࣸоߎഒዐ༸࠴ఽ ඎߵࣇԑई٩ϡۓϴ䩟 йцዐ༸࠴ఽҀทٷϡϤ ӎඎؑؒ 䩛ԼݸӊԷёූ䦙 ዐ༸࠴ఽᅔ࠴႒ݫ䦙 ц ඎϡބ䦙 ׁೋфԷјࣉ૮ୂϡࡖϨ䩟 йߵӾс ࢲ॒䩜 䦚 ؑϴئԆԮڀϡϥцࡷЈࡿࠖעϡэт䩟 йϪळ䩟 ٍԷ܀ԁф߈خϨࣇԑࢲڝЅ䩟 ٤పئӡϡݾবᇯ ැҤଈ䦚 ۵ӓྋܷؑϴࡷЈࡿॵׁবࣃҤଈ䩟 й۔ݸث юёվѽфёڴѽԛϡҙтТଛ 䩛දԷϥϨྺՀࠁй ۪ۘರ䩜 䩟 ٍѸЄԲԛ܀ԁবࣃᇯැфඎࠖע䦚 ݙվ ёዐ༸࠴ఽҀทٷϡඎ࣊Ԫԛୟ䦙 ࣇԑفخଛࠍ䦙 Ӛ ༆ଛϼڢ䩟 ؑϴѯԳѢԮڀ䦚 ۔юёվԲфёӗԲԛ ϡІܷ݁ࢲޔدभଛࠍ䩟 Їؑϴݸث䦚
11 – Ո߆ᆊয়ࢥሥޭՑᏃޗ ܕହܿڛၳ࿏ȃ
05 ዸక˖ ठᏮঞ֎࣋ႼȂ ၳውȂ ৭كञ൹ࢳȂ ࠍׁڈ႟
12
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51
ዸకܿᄌᇡྈሇყ࣋ߴၩໍؠՑᏃ ޗሥޭ܈፩تถᄒݲᇜܿᄵވȃ ࢙ڈᅍᇋූܿܐठᏮ ঞ֎࣋Ⴜˈ ᇵฬ֦ጹـञࣙढ़ܿᇜᄹȃ ၩໍؠˈؠ ᅍᇋਓஅञৠූিढ़ञਦهढ़ፇৱܿ࣋ȃ
ቪठᏮঞ֎ᄒᏮ Ԓ֎ਛТॵцኗओϤӎ֎Ԇ䦙 ח՟фॵفݒ݆ϣ ঊϡਛТח՟ዐ༸࠴ఽцᇯැࡢϩԳϴӑѓ䦚 ङԁ ٿϿмϡਛТח՟ׁӑҏ֔䩟 Ԓ֎ਛТॵ੶؝ڪХ ԁԷјԮඡׁӑଏ઼ׁܷӑ䩟 د၉䩭 ЄфהዊࡾٷфэтҜพ䦙 ऴؖфऴؖϿ䩭 Ԓ֎ ਛТॵӔԁϣ࠶ڍҰϴϡዐ༸࠴ఽዊࡾҜพࠃ߹Ϧ ዐ༸࠴ఽ࠾ׁ֞ӑڋਢфԷјӑԥٕ䩟 ԝҒ䩟 Ҫܧଝ ዐ༸࠴䦙 ֲಚ࠴ф⟉ᅔऴؖ䦙 ࠾ׁммকԘಈकҜء 䩛81,7$,'䩜 䦙 Ѥмւࢅዐ༸࠴ࠤାષᎨڋਢ䦚 ھҽࣕՄ䩭 Ԓ֎ਛТॵю߹Ϧዐ༸࠴ఽھҽࣕՄઈ՜ Щॵ 䩛&LYLO 6RFLHW\ 5HIHUHQFH *URXS RQ +,9䩜 䩟 ཹओϦ ϱІ҇ٿዐ༸࠴ఽԚԮھҽࣕՄфӽ౩ϡڊԣ䦚 ઈ՜ ЩॵЋԒ֎ਛТॵϡዐ༸࠴ఽू೫ф֞ӑҤଈ٤ప ࠃ৷䩟 ՖԒ֎ਛТॵू೫ф֍ࣔ܋जϡتԁ௬ Ҳ䦚 ϨԒ֎ਛТॵϡӛϩभ֞ӑЩॵЅЁϩھҽ ࣕՄϡڊԣ䩟 د၉ءӡԒ֎ਛТॵϡू೫䦙 ۪܋ф֞ ࡢ䦚 ЄϬھҽघϿॵԁԒ֎ਛТॵࠃ߹ϦܥҤԮ ڍ䩟 ԪґЌӑЋൌ䩟 ܀ӸԒ֎ਛТॵٿԑѨҜพ Ͽ৷ 䩛د၉Ԓ֎ਛТϽϿ䩜 䦚 ࠾ׁмዐ༸࠴ਢឱߵ࠾ׁмଏҜพ䩭 ӑЋ࠾ׁм ዐ༸࠴ਢឱϡӎтвҤ䩟 Ԓ֎ਛТॵ࣊ۻѸܲ ጷϡ࠾ׁмՄڍ䩟 ٤పҪӌϡቄח՟ዐ༸࠴ఽцᇯ ැ䦚 ࠾ׁмዐ༸࠴ਢឱϡԷјϬӎтвҤۂӎ ࠾ׁмዐ༸࠴ਢឱ੶؝ڪ䩟 ੜؕ࠾ׁмዐ༸࠴ਢ ឱϡ䦧д֞䦨 䩛Ϩ࠾ׁмዐ༸࠴ਢឱϡϽрֵਢдٿ ϬԮඡૺ߇ڗ䩜 䩟 ࡾҨਛТח՟ϡዐ༸࠴ఽцᇯැ䦚 भׁӑଏ䩭 Ԓ֎ਛТॵю߹Ϧዐ༸࠴ఽږଯф भᆈฐణϿ䩟 ۥϱІмрዐ༸࠴ఽਢ䦙 ӥැॵ䦙 ୳ૢҜพфھҽࣕՄϡभ֠рॵю䩟 ЋւݾѨϲӆ ॵϡዐ༸࠴ఽू೫ф֞ӑڋਢ٤పࠃ৷䦚 ϨԒ֎ਛ Тॵૺءӡӆॵू೫ф֍ࣔ܋जϡ֞ӑЩॵЅ䩟 भׁӑଏࡢϩԳϴӑѓ䦚
52
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ภฉञ࣭য়ၳው
ϩϡዐ༸࠴ఽцᇯැؑϴϣׁ࠶ڍӑଏф۱೯ ԚԮҤ䩟 ӹױ䩟 ׆ؽમϮ䦙 ਧҴ䦙 ࡢϩמϽھҽࣕՄ܀ ԁϡ՜ૺҜ۠ءԮԳϴ䦚 ԷЅϡԳϴॵюחдϥഷޚ מϩҨϡ֩ࣔҨфԑЌҨ䩟 ᇎߵ䩭 ӛϩԚԮϡ۱೯Ԛ ԮҤࣘд܀ԁ䩮 ޕӡ֜ᎋ䦙 ЌӾՄѴН۟فтࣁ۵ࡣ 䩛د၉ӆږଯसଈϡ࣮ٿ۵ࡣфࡢՄ۵ࡣ䩜 ߵԷјҪܧ ઌൖϡмрࡣ܋䩮 ಈѓӾϡݾবᇯැНԅЏԛ䦙 ଛ䦙 ֝ڱфؙড়Ҩࡣ܋йٰᏈՖࣁ䩮 ࠃ߹ਧҴ䦙 بدԛ ϡ߯ຽфཹۏԵࡄ䦚 ۵ӓӔࡢިחд֞ࡢ䩟 Нѓ႗֝Ֆ ࣁ 䩛د၉ࡷࠃϩ۱ࢲ॒䩜 䦚 ЋϦӸמ՜ૺ䩟 ۓછцмрф ҪৢܧӌϡՖࣁՖҲ۟فฮ࠻фӡۏཹ䦚
13 – ٛ৹ي ˄ଲݺ፷ञৠ ݓฏ˅ ȃ
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53
৭كȂ ൹ࢳञ֫ࡻ
ԗؽѓѴϩҜء䩟 ϨףϬৢӌฮ࠻ږଯӥැєୂ䩭 • ฮ࠻фݍۏҪܧ۵ࡣфࡢՄ۵ࡣϡՖࣁ䩮 • ฮ࠻ф߯ຽ߇фмрৢӌϡцᇯැ䩮 • ԗԒ֎ਛТॵϡᕴବؽѓӊюҝ܉ԑ䩮 • ؽѓ࠾ׁмዐ༸࠴ਢឱϡ՜ૺᕴବ䦚
৭كञ֫ࡻภฉ಼ञન࿒಼ܿዴ
ϨҪৢܧӌ䩟 ӡᅮݓԗ߯ຽ҇ٿઌൖфࡢՄ۵ࡣϡ Ֆࣁ䩟 Էऴኜϥ۱ѓѴϩฮ࠻ф߯ຽҜءфࡄਡԅЏ ϡٿмّࣝ 䩛ԝҒҪܧዐ༸࠴ࣃՖ֏ݍۏ䩜 䩟 Ϩۓ ϴЗйԷјّࣝӑЋਤࣘ䦚 Ԓ֎ਛТॵ৭ӡϦϬಚ КҪࡣ܋ܧ䩟 ੜዐ༸࠴ఽ۟ۂࠖעРࡄϡॅਡٕ࠶䩟 ѓ ӊฮ࠻фݍۏਛТח՟ዐ༸࠴ఽцᇯැϡՖࣁ 䩛ԋ ֘䩜 䦚 ӡ߯ຽږଯसଈӛޕӡࡣ܋ϨҪܧф߇ৢӌԼ ЏϡՖࣁ䩟 ԗࡣᒢ 䩛мрҏҽфмрֵחϡԝࢹ䩜 ѓ ӊ߯ຽࡣ܋ϡӥѴၾ䦚 ږଯࡢڋޕϩࣘдϡࢽ҅ԛ䩟 йรՊѸЄހѨ࣮ڈᇞਤਛТח՟ዐ༸࠴ఽцᇯ ැЅНйࡧԆϡઑט䦚 Ћױ䩟 Ԓ֎ਛТॵԗߓ۟ԁׁ ӑଏׁӑ䩟 ࣠ࣝԒ֎ਛТॵ䦭ਛТח՟ዐ༸࠴ఽ ᆨׁږଯҞ֥۪܋䦮24䩟 Ϩ൜ءҪܧф߇ݍۏϡРࡄ Ѕ䩟 Ћٿмࢅϣ٩фࡣކ٩сಈओಚКࡣ܋٤పفݒ䦚 Ԯӊӡّࣝۏཹϡࠃ৷ӔҮ٤о䦚
२ਖনᎳܿনھຢ ডࣰ࣭ቪ࣭ፇৱᇵঽ ᇜ࣭ؠᄵˈ ൹ࢳન࿒಼ܿოଝ
Ԓ֎ਛТॵԗцԁ۱೯ԚԮҤ࠱ϡږଯӥැฮ࠻ ф՜ૺᕴବ䩟 ԗฮ࠻фдұԮӊԷዐ༸࠴ఽ۪܋ಈѓ ଛϡّࣝ䩟 йߵԮӊږଯӥැՖࣁϡّࣝ䩟 й߷оᅣዢ фԐܲз҂֚䦚
৭كञ൹ࢳ࣭য়لಅܿሥޭ܈
цਛТח՟ዐ༸࠴ఽцᇯැϡӥැՖࣁՖҲ߯ຽ З䩟 ಈѓНԅЏԛ䦙 ଛ䦙 юҝфؙড়Ҩҳࡣ܋䩟 ߎഒԮӊӥැєୂฮ࠻ϡԷјԚԮࠃ৷䦚 Ԓ֎ਛТॵ 䦭ᆨׁږଯҞ֥۪܋䦮 ԐեϦٚϬࡣކ٩ಚКмр ࡣ܋䩟 Нѓӊٿмฮ࠻фݍۏӆмዐ༸࠴ఽਢфмр ዐ༸࠴ఽݱՄцᇯැ䦚 ٰᏈфݍۏϨԁዐ༸࠴ఽ ԚԮϡН۟فтࣁ۵ࡣҤӌӛԼЏϡՖࣁ䦚
ѓӊฮ࠻ਛТՄۨڍϡࡣ܋ៗТІԒ֎ਛТॵࢅ ቻϡмрਛТږଯฮ࠻ф߯ຽ֡ѓݡכ䩟 Ї٤పѓӊ ႗֝ӥැՖࣁϡ֞ࡢ䩟 ԝҒ䩟 ЋҶמዐ༸࠴ఽцᇯැ ґಈԼϡू೫䦙 ֚ಋфֲพԛᇯැ䦚
24 ȖၩໍؠՑᏃޗᏒठዸకᄪႩፑೌȗ ˈ ਈũŵŵűĻİİŸũŰįŪůŵİũŪŷİűŶţİŨŶŪťŦŭŪůŦŴİŴŵųŢŵŦŨŪŤĮŪůŧŰųŮŢŵŪŰůĮŨŶŪťŦŭŪůŦŴİŦůİ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ
54
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ၩໍᏠፈ୲࣏࣮ڈଙ৩
ठ࣭ՑᏃࣙढ़༡ၳውଙ৩
Ԓ֎ਛТॵ 䦭 ёҷԏϬ֞ӑւਢ䦮25Ћ ӆॵϡ֞ӑءӡϦҙৢӌږଯ݁䩟 มϦࡏϬ֩ ϡ֞ӑ䦚 ԁዐ༸࠴ఽԚԮϡϽחд֞ӑЁஓՊϦԮӊ تท࠴ϡҷϣणԆ䦚 Ԕϥ䩟 ԷјԳϴϡዐ༸࠴ఽԚԮ֞ ӑҩஓՊϦԷјणԆ䩟 ئԆϥԮӊۘتทԛᅔ࠴ϡҷԏ णԆ 䩛د၉ٍڱѓ䦙 ࣉظؘфӗࣇࣨ䩜 䦙 ԮӊТܞ ҪࡄՖࣉϡҷѧणԆ 䩛د၉຺ݘ䦙 ݙվёфոু ࣉ䦙 ԛфТᜊࣉ䩜 䩟 йߵҷףणԆ 䩛د၉фᒎआ ֞ࡢԅԼಬዓ䦙 ٤పᆨׁࠖע䦙 ږଯҞ֥фϪҨޝ䩜 䦚 ϨҷϣणԆЅ䩟 ዐ༸࠴ఽф࠴ఽԛႣࡢϩݼϡ֩ 䩟 ЋءױӡϦҖё֞ӑڋਢфϣॵ࠱ӡϡюҝф বڲ䦚 ӆږଯसଈዧѧϬהё֏ 䩛ё䦙 ё䦙 ё䩜 䦚 ֡РᅮݓϨҟϬהё֏ֲଚЗ٤ے ϡՖࣁݍۏ䩟 ฮ࠻֞ӑڋਢϡӥැєୂ䦚 ԗՖҲהё֏ Ѕᅮݓ䩟 йࡾэࣁӥැ֞ӑ䦚
Ԓ֎ਛТॵϡዐ༸࠴ఽ֞ӑՄѴϨ࠾ׁмዐ༸࠴ ਢឱࢅϣবڲ䦙 юҝф՜ૺᕴବϡবڲф֞ӑڋ 26 ਢЅ 䩟 ӹױ䩟 ؑϴЋёءӡϣϬݼϡᕴ ବ䩟 йՖϣϬӎтвҤф࠾ׁмዐ༸࠴ਢឱ ੶؝ڪϡ࠾ׁਢфবڲ䦚 ࢛ϡ֞ӑڋਢфবڲੜ ؕהё֏ءӡ䩟 ӆږଯዧϡ႒ݫϥԪёэ ״䦚 ҟϣϬӎтвҤЁૺӥැԁԷॵࠖڗф࠾ ׁмዐ༸࠴ਢឱभفݒд֞ԚԮϡϣॵ֞ӑ䦚 ࠾ ׁмዐ༸࠴ਢឱࢅϣবڲ䦙 юҝф՜ૺᕴବଏϩၾ ฮ࠻ᕴବ䩟 Ћ႗֝বڲф֞ӑڋਢϡӥැՖ֏ޕӡ Ϧࡣ܋䦚 ё֏Ֆ֏ݍۏછ٤ׁ࠾۠ےмዐ༸࠴ਢឱ ਢ݆ణϿ䦚
14 – ၓክٛञߒᇞႚ࠽᎓เ࿎ ࢜ՑᏃޗ഻ᅸ ˄ଲ՟˅ ȃ
25 ȖijıIJĵĮijıIJĺ೧ݕໟߗࢋᏮᏓࣙढ़˖ ౚিȗ ˈ ਈũŵŵűĻİİŸŸŸįŸũŰįŪůŵİŢţŰŶŵİųŦŴŰŶųŤŦŴŠűŭŢůůŪůŨİġŵŸŦŭŧŵũĮŨűŸİŦůİ ˄ijıIJķ೧Ĵኟijij๊ ߺၳ˅ ȃ 26 ݕໟठ࣭ՑᏃࣙढ़༡ࣙढ़ᄒၘݲঐঐሊ ˄ijıIJĶ೧IJıኟijķĮijĹ๊๊ဪઢᄵ˅ ࢞ࡘ؝ଙ৩ਖඝށಚၓijıIJķĮijıijIJ೧ठ࣭ ՑᏃࣙढ़༡ᇜኁིȂ ࣮ڈञၳውଙ৩ˈ ਈũŵŵűĻİİŸŸŸįŖŏłŊŅŔįŰųŨİŴŪŵŦŴİťŦŧŢŶŭŵİŧŪŭŦŴİġŮŦťŪŢŠŢŴŴŦŵİijıIJĶIJIJıĴŠŖŏłŊŅŔŠŖŃœłŇŠőńŃĴĸŠIJĶĮ IJĺŠņŏįűťŧ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
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ዸకׁڈ
ёҪܧਛТח՟ዐ༸࠴ఽږଯसଈ܋оϦਛ Тח՟ЋܼюϨёҏӓ䦧ֲټዐ༸࠴䦨۵ࡣઌ ϡ֞ӑ䦚 Ϩ࠾ׁмዐ༸࠴ਢឱёږଯϡю ӆдϡऴኜϼ䩟 ӆږଯϡӥැюӆдӔԟю䩟 ԷЅ ٍѓϦԮӊږଯЅӛد၉ϡݾবᇯැϡئӡࡣ܋ф ֧юӆ䦚 ѓӊюӆдϡّࣝϱІ࠾ׁмϪޅטϡϪטব࠻ ّࣝ䦙 мрр݆ݓ 䩛ϪטԁਛТ݆ݓфዐ༸࠴݆ࡣ܋ ݓ27䦙 ࠾ׁмዐ༸࠴ਢឱԮӊٿмዐ༸࠴ఽϡব ࠻ّࣝ䦙 Ҫܧዐ༸࠴цᇯැՖࣁݍۏ28ࢅڍЅϡмԆ ݍۏ䩟 ੜؕԒ֎ਛТॵϡࡏϬ߇䩟 ڲڋϦϨϬ ЅࠍּՊмрϡюӆ䦚 ֧юӆϥऴӊцюӆдϡ߯ຽ䩟 ҮРϱІЄϬм рϡ֠рϡᅮಚ䦚 ֠рЩॵϲଝဵఽ࠴࠹׆ඎϡ۔ ϱюӆՖҲϦব࠻䩟 ӡଝဵఽ࠴࠹׆ϡ٣۴ߓ ۟Ўઁ䩟 ӥࡑॣюӆ 䩛ӹഠ࠻Ҝߣء٩䩜 фࠖע٤పю ӆඩઁࠍ䦡䦡ӹחд࠴Ϫ۠׆घ߇ࣇԑ䦚 ۔ϱଛ ϡࡣ܋ϱІё࠾ׁмዐ༸࠴ਢឱږଯ䦚
ږଯसଈϡւюӆবڋԗԪёऎᏼѤׄҶӸ۠ ёײᏼѤׄ䩟 ҏњ䩟 ϨёЎઁ۠ऎᏼѤ ׄ 䩛ԋ֘䩜 䦚 ଝဵఽ࠴࠹׆ඎӛٍѓϡޝԝз ҙ䩟 ऎЋւ֝ϡ䩮 ਢюٷҋҏ䩟 䩮 Ӑҋϥ ዐ༸࠴ఽഠ࠻ࠖע䩟 䩮 ԥҪࠇਢ䦚 ϩףϬмрԗ ٍѓѧдҏϣй ϼϡޝ 䩛ੜٕ ਡ䩜 䩟 дԆϥ䩭 ۪ۘ䦙 ৸я۱䦙 ࣬՝фЅм䦚ۘರ߇ ࠍּՊфЅҳּՊмрӛؑޝւϣٻйϼ 29 䩛䩜 䦚 ؑؒҷԏϽϡ߇ϥѤರ߇䩟 䩟 Էҋ ϥ՝ѿכଥ߇ 䩛䩜 фև۪߇ 䩛䩜 䦚 ଡರ ߇䩟 ևсЅ߇䦚 ࠍּՊмрؑϴऎף дҏϣϡޝ䩟 ЅҳണЎּՊмрؑϴऎףдҏϣϡޝ 䩟 ЅҳണϼּՊмрؑϴײԏдҏϣϡޝ䦚
ဇĹ˖ ׁڈ ˄ՙ࡞ኁ܈ञ೧ࠔ˅ ˄ܠၤ˖ ኇ˅
ภ࿄ $25,000 ᎙ືޗ൰ጚ ࡙קᄵၓܿਦ $20,000 ˄ġġġġġġġġġ˅ ವሣۈ؆ኁ߷܈ ್ᄹᏋን֡൝०෧༦ ਾॄۂኁ߷ᄹᇊ႘܈ ਾۂኁ߷ᄹᇊ႘ ৹ك $10,000 ፧ன ፧ன $5,000 ࣙढ़۶ڈጚ ຺ঐ۶ڈጚ $2013 2014 2015 2016 2017 ೧ࠔ 2018 2019 2020 2021 ၩໍ࿒Ⴜ վ $15,000 ွ
27 ŅʼnŔढ़ˈ ਈũŵŵűĻİİťũŴűųŰŨųŢŮįŤŰŮİŘũŢŵĮŘŦĮŅŰİŔŶųŷŦźĮŕźűŦŴİŅʼnŔįŤŧŮ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ 28 ȖภฉՑᏃሥޭ܈ዴ֫ࡻȗ ˈ ਈũŵŵűĻİİŸŸŸįŶůŢŪťŴįŰųŨİŦůİťŢŵŢŢůŢŭźŴŪŴİŬůŰŸźŰŶųųŦŴűŰůŴŦİŨŭŰţŢŭŢŪťŴűųŰŨųŦŴŴųŦűŰųŵŪůŨ ˄ijıIJķ೧Ĵኟijij๊ߺၳ˅ ȃ 29 Ȑฏቱȑ ፑၩໍᏠፈܿࢋฏቱˈ ༮દࡇIJijıࢋ݈༆ञ፩݃༆࣭য়ȃ
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ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
Photo credits
01 – © 2014 Kunle Ajayi, Courtesy of Photoshare; Location: Lagos, Nigeria
02 – ଲݺ፷ञৠݓฏՑᏃޗঐሊȃ © WHO/PAHO
03 – ၓĸኟேߒڨᅭ৹كՑᏃޗ ˄৺උዪ˅ © 2011 David Snyder for the CDC Foundation, Courtesy of Photoshare; Location: Seireisophon, Cambodia
04 – © WHO
05 – © UNAIDS
06 – © WHO/PAHO
07 – © UNAIDS
08 – © 2015 Aulia Human, Courtesy of Photoshare Location: DKI Jakarta Indonesia
09 – © UNAIDS
10 – © 2014 M Ponir Hossain, Courtesy of Photoshare Location: Dhaka Bangladesh
11 – © UNAIDS
12 – © WHO/PAHO
13 – © WHO/PAHO
14 – © Abbie Trayler-Smith/Panos/H4+
ijıIJķĮijıijIJ೧ภฉၩໍؠՑᏃޗዸక
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ቺঠܾᄪႩˈ ขనၩໍᏠፈ World Health Organization Department of HIV/AIDS 20, avenue Appia 1211 Geneva 27 Switzerland E-mail: hiv-aids@who.int www.who.int/hiv WHO/HIV/2016.05
ﻳﻮﻧﻴﻮ ٢٠١٦
ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي،
٢٠٢١–٢٠١٦
ﺻﻮب وﺿﻊ ﺣﺪ ﻟﻤﺮض اﻷﻳﺪز
ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي،
٢٠٢١–٢٠١٦
ﺻﻮب وﺿﻊ ﺣﺪ ﻟﻤﺮض اﻷﻳﺪز
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
٠٤
WHO/HIV/2016.06 © World Health Organization 2016 ﺟﻤﻴﻊ اﻟﺤﻘﻮق ﻣﺤﻔﻮﻇﺔ .وﻳﻤﻜﻦ اﻟﺤﺼﻮل ﻋﻠﻰ ﻣﻨﺸﻮرات ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ )اﻟﻤﻨﻈﻤﺔ( ﻣﻦ ﻋﻠﻰ ﻣﻮﻗﻊ اﻟﻤﻨﻈﻤﺔ اﻹﻟﻜﺘﺮوﻧﻲ ) (www.who.intأو ﺷﺮاؤﻫﺎ ﻣﻦ ﻗﺴﻢ اﻟﻄﺒﺎﻋﺔ واﻟﻨﺸﺮ ،ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ) Switzerland ،1211 Geneva 27 ،20 Avenue Appiaﻫﺎﺗﻒ رﻗﻢ+٤١ ٢٢ ٧٩١ ٣٢٦٤ :؛ ﻓﺎﻛﺲ رﻗﻢ+٤١ ٢٢ ٧٩١ ٤٨٥٧ :؛ ﻋﻨﻮان اﻟﺒﺮﻳﺪ اﻹﻟﻜﺘﺮوﻧﻲ.(bookorders@who.int : وﻳﻨﺒﻐﻲ ﺗﻮﺟﻴﻪ ﻃﻠﺒﺎت اﻟﺤﺼﻮل ﻋﻠﻰ إذن ﺑﺎﺳﺘﻨﺴﺎخ ﻣﻨﺸﻮرات اﻟﻤﻨﻈﻤﺔ أو ﺗﺮﺟﻤﺘﻬﺎ -ﺳﻮاء ﻛﺎن ذﻟﻚ ﻟﺒﻴﻌﻬﺎ أو ﻟﺘﻮزﻳﻌﻬﺎ ﻷﻏﺮاض ﻏﻴﺮ ﺗﺠﺎرﻳﺔ -إﻟﻰ ﻗﺴﻢ اﻟﻄﺒﺎﻋﺔ واﻟﻨﺸﺮ ﻋﺒﺮ ﻣﻮﻗﻊ اﻟﻤﻨﻈﻤﺔ اﻹﻟﻜﺘﺮوﻧﻲ ).(www.who.int/about/licensing/copyright_form/en/index. html ﺗﻌﺒﺮ اﻟﺘﺴﻤﻴﺎت اﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ اﻟﻤﺎدة اﻟﻮاردة ﻓﻲ ﻫﺬا اﻟﻤﻨﺸﻮر وﻻ ﻃﺮﻳﻘﺔ ﻋﺮﺿﻬﺎ ﻋﻦ رأي وﻻ ّ اﻟﻤﻨﻈﻤﺔ إﻃﻼﻗﺎً ﺑﺸﺄن اﻟﻮﺿﻊ اﻟﻘﺎﻧﻮﻧﻲ ﻷي ﺑﻠﺪ أو إﻗﻠﻴﻢ أو ﻣﺪﻳﻨﺔ أو ﻣﻨﻄﻘﺔ ،أو ﻟﺴﻠﻄﺎت أي ﻣﻨﻬﺎ ،أو ﺑﺸﺄن ﺗﻌﻴﻴﻦ ﺣﺪودﻫﺎ أو ﺗﺨﻮﻣﻬﺎ ،وﺗﺸﻜﻞ اﻟﺨﻄﻮط اﻟﻤﻨﻘﻮﻃﺔ ﻋﻠﻰ اﻟﺨﺮاﺋﻂ ﺧﻄﻮﻃﺎً ﺣﺪودﻳﺔ ﺗﻘﺮﻳﺒﻴﺔ ﻗﺪ ﻻ ﻳﻮﺟﺪ ﺑﻌﺪ اﺗﻔﺎق ﻛﺎﻣﻞ ﻋﻠﻴﻬﺎ. وﻻ ﻳﻌﻨﻲ ذﻛﺮ ﺷﺮﻛﺎت ﺑﻌﻴﻨﻬﺎ أو ﻣﻨﺘﺠﺎت ﺟﻬﺎت ﺻﺎﻧﻌﺔ ﻣﻌﻴﻨﺔ أﻧﻬﺎ ﺗﺤﻈﻰ ﺿﻤﻨﺎً ﺑﺘﺄﻳﻴﺪ اﻟﻤﻨﻈﻤﺔ أو أﻧﻬﺎ ﺗﻔﻀﻴﻼ ﻟﻬﺎ ﻋﻠﻰ ﻏﻴﺮﻫﺎ ﻣﻦ اﻟﺸﺮﻛﺎت واﻟﻤﻨﺘﺠﺎت اﻟﺘﻲ ﺗﻤﺎﺛﻠﻬﺎ وﻟﻢ ﻳﺮد ذﻛﺮﻫﺎ .وﺑﺎﺳﺘﺜﻨﺎء ﺣﺎﻻت ﺗﺰﻛﻴﻬﺎ ً ﻤﻴﺰ ﺑﺬﻛﺮ اﻷﺣﺮف اﻟﻜﺒﻴﺮة اﻻﺳﺘﻬﻼﻟﻴﺔ ﻣﻦ اﻟﺨﻄﺄ واﻟﺴﻬﻮ ﻓﺈن أﺳﻤﺎء اﻟﻤﻨﺘﺠﺎت اﻟﻤﺴﺠﻠﺔ اﻟﻤﻠﻜﻴﺔ ﺗُ ّ أﺳﻤﺎﺋﻬﺎ )ﻓﻲ اﻟﻨﺺ اﻹﻧﻜﻠﻴﺰي(. وﻗﺪ اﺗﺨﺬت اﻟﻤﻨﻈﻤﺔ ﻛﻞ اﻻﺣﺘﻴﺎﻃﺎت اﻟﻤﻌﻘﻮﻟﺔ ﻟﻠﺘﺤﻘﻖ ﻣﻦ ﺻﺤﺔ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻮاردة ﻓﻲ ﻫﺬا اﻟﻤﻨﺸﻮر ،ﻋﻠﻰ أن ﻫﺬه اﻟﻤﺎدة اﻟﻤﻨﺸﻮرة ﺗﻮزع ﻣﻦ دون أي ﺿﻤﺎن ﻣﻬﻤﺎ ﻛﺎن ﻧﻮﻋﻪ ،ﺻﺮﻳﺤﺎً ﻛﺎن أم ﺿﻤﻨﻴﺎً . وﺗﻘﻊ ﻣﺴﺆوﻟﻴﺔ ﺗﻔﺴﻴﺮ ﻋﺮض اﻟﻮرﻗﺔ واﺳﺘﻌﻤﺎﻟﻬﺎ ﻋﻠﻰ اﻟﻘﺎرئ ﺣﺼﺮاً ،وﻻ ﺗﺘﺤﻤﻞ اﻟﻤﻨﻈﻤﺔ ﺑﺄي ﺣﺎل ﻣﻦ اﻷﺣﻮال اﻟﻤﺴﺆوﻟﻴﺔ ﻋﻦ اﻷﺿﺮار اﻟﺘﻲ ﺗﺘﺮﺗﺐ ﻋﻠﻰ اﺳﺘﻌﻤﺎل ﻫﺬه اﻟﻤﺎدة. وﻳﻤﻜﻦ اﻻﻃﻼع ﻋﻠﻰ اﻹﺻﺪارات اﻟﻨﻬﺎﺋﻴﺔ ﻣﻦ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ ﺑﺸﺄن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ واﻟﻌﺪوى اﻟﻤﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎً ﻟﻠﻔﺘﺮة ٢٠٢١-٢٠١٦ﻓﻲ اﻟﺴﺠﻼت اﻟﺮﺳﻤﻴﺔ ﻟﺠﻤﻌﻴﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﺘﺎﺳﻌﺔ واﻟﺴﺘﻴﻦ )اﻟﻮﺛﻴﻘﺔ ج ص ع /٢٠١٦/٦٩ﺳﺠﻼت.(١/ اﻟﺘﺼﻤﻴﻢ واﻟﻌﺮض ﻣﻦ إﻋﺪاد ﻫﻴﺌﺔ 400.co.uk ﻃ ِﺒﻌﺖ ﻓﻲ ﺧﺪﻣﺎت ﻧﺸﺮ اﻟﻮﺛﺎﺋﻖ ﺑﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ،ﺟﻨﻴﻒ ،ﺳﻮﻳﺴﺮا. ُ
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻟﻤﺤﺘﻮﻳﺎت
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ﻟﻤﺎذا ﻳﺠﺐ ﻋﻠﻰ اﻟﻌﺎﻟﻢ اﻹﺳﺮاع ﻓﻲ ﺗﺴﺮﻳﻊ وﺗﻴﺮة اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺻﻴﺎﻏﺔ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﺮؤﻳﺔ واﻟﻬﺪف واﻟﻐﺎﻳﺎت اﻟﺘﻮﺟﻬﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ واﻹﺟﺮاءات ذات اﻷوﻟﻮﻳﺔ ﱡ ﺗﻨﻔﻴﺬ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ :اﻟﺸﺮاﻛﺎت واﻟﻤﺴﺎءﻟﺔ واﻟﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ وﺗﻘﺪﻳﺮ اﻟﺘﻜﺎﻟﻴﻒ
٠١ ٠٢ ٠٣ ٠٤ ٠٥
١٨ ٢٢ ٢٦ ٥٠
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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اﻟﻤﻘﺪﻣﺔ واﻟﺴﻴﺎق
اﻟﺘﺰم اﻟﻤﺠﺘﻤﻊ اﻟﺪوﻟﻲ ﺑﺈﻧﻬﺎء وﺑﺎء اﻷﻳﺪز ﺑﺎﻋﺘﺒﺎره أﺣﺪ اﻟﺘﻬﺪﻳﺪات اﻟﺘﻲ ﺗﺤﺪق ﺑﺎﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﺑﺤﻠﻮل ﻋﺎم ،٢٠٣٠وﻫﻮ ﻏﺎﻳﺔ ﻃﻤﻮﺣﺔ ﺗﺒﻨﺘﻬﺎ ﺧﻄﺔ اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ ﻟﻌﺎم ٢٠٣٠اﻟﺘﻲ اﻋﺘﻤﺪﺗﻬﺎ اﻟﺠﻤﻌﻴﺔ اﻟﻌﺎﻣﺔ ﻟﻸﻣﻢ اﻟﻤﺘﺤﺪة ﻓﻲ أﻳﻠﻮل /ﺳﺒﺘﻤﺒﺮ ١ ،٢٠١٥ﻣﻊ وﺿﻊ ﻏﺎﻳﺎت ﻣﺮﺣﻠﻴﺔ ﻟﻌﺎم .٢٠٢٠وﺗﺼﻒ ﻣﺴﻮدة ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻣﺴﺎﻫﻤﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻣﻦ أﺟﻞ ﺗﺤﻘﻴﻖ ﺗﻮﺿﺢ ﻣﺎ ﻋﻠﻰ اﻟﺒﻠﺪان أن ﺗﻔﻌﻠﻪ وﻣﺎ ﻫﺬه اﻟﻐﺎﻳﺎت ،إذ ﱢ ﻋﻠﻰ اﻟﻤﻨﻈﻤﺔ أن ﺗﻔﻌﻠﻪ .ﻓﺈذا ﺳﻠﻜﺖ اﻟﺒﻠﺪان واﻟﻤﻨﻈﻤﺔ ً ﺳﺮﻳﻌﺔ ﻓﻲ ﺗﻨﻔﻴﺬ ﻫﺬه اﻹﺟﺮاءات ﻓﺈﻧﻬﺎ ﻣﺴﺎرات ﺳﺘﺴﺮع اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ّ وﺗﻜﺜﻔﻬﺎ ﻟﻜﻲ ﺗﺼﺒﺢ ”ﻧﻬﺎﻳﺔ اﻷﻳﺪز“ ﺣﻘﻴﻘﺔ واﻗﻌﺔ.
١ﻗﺮار اﻟﺠﻤﻌﻴﺔ اﻟﻌﺎﻣﺔ ﻟﻸﻣﻢ اﻟﻤﺘﺤﺪة – ١/٧٠ﺗﺤﻮﻳﻞ ﻋﺎﻟﻤﻨﺎ :ﺧﻄﺔ اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ ﻟﻌﺎم ،٢٠٣٠اﻧﻈﺮ: ) http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=Eﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس .(٢٠١٦
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
وﺗﻀﻊ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ ﻣﻮﻗﻊ ﺑﺎﻟﻎ اﻷﻫﻤﻴﺔ ﻟﺘﺤﻘﻴﻖ اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ ،وﻫﻲ إﺣﺪى اﻟﻐﺎﻳﺎت اﻟﺼﺤﻴﺔ اﻷﺳﺎﺳﻴﺔ ﻷﻫﺪاف اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ .ﻛﻤﺎ ﺗﺸﺠﻊ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﺗﺒﻨﱢ ﻲ ﻧﻬﺞ ﻳﺮﻛﱢ ﺰ ﻋﻠﻰ اﻟﻨﺎس ،وﻫﻮ ﻧﻬﺞ راﺳﺦ اﻟﺠﺬور ﻓﻲ ﻣﺒﺎدئ ﺣﻘﻮق اﻟﺼﺤﻲ ،إﻟﻰ ﺟﺎﻧﺐ إﺳﻬﺎﻣﻬﺎ ﻓﻲ إﺣﺪاث ﺗﺮاﺟﻊ اﻹﻧﺴﺎن واﻹﻧﺼﺎف ّ ﻛﺒﻴﺮ ﻓﻲ أﻋﺪاد اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻮﻓﻴﺎت ذات اﻟﻌﻼﻗﺔ ﺑﻪ ،وﻓﻲ ﺗﺤﺴﻴﻦ ﺻﺤﺔ وﻋﺎﻓﻴﺔ ﺟﻤﻴﻊ وﺳﺘﻘﺪم اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻫﺬا اﻟﻔﻴﺮوس. ﱢ اﻟﺘﻮﺟﻴﻪ ﻟﻠﺠﻬﻮد اﻟﺮاﻣﻴﺔ إﻟﻰ ﺗﺴﺮﻳﻊ وﺗﻴﺮة ﺟﻬﻮد اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﺮﻛﻴﺰﻫﺎ ،وﺳﺘﻤﻜّ ﻦ اﻟﻨﺎس ﻣﻦ ﻣﻌﺮﻓﺔ ﺣﺎﻟﺘﻬﻢ ﻣﻦ ﺣﻴﺚ إﺻﺎﺑﺘﻬﻢ أو ﻋﺪم إﺻﺎﺑﺘﻬﻢ ﺑﺎﻟﻔﻴﺮوس، وﺳﺘﻮﻓﺮ ﻋﻼﺟﺎً ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ورﻋﺎﻳﺔ ﺷﺎﻣﻠﺔ ﻃﻮﻳﻠﺔ اﻟﻤﺪى ﻟﺠﻤﻴﻊ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ اﻟﻔﻴﺮوس، وﺗﺘﺼﺪى ﻻﻧﺘﺸﺎر اﻟﻮﺻﻢ واﻟﺘﻤﻴﻴﺰ ﺑﺴﺒﺐ اﻹﺻﺎﺑﺔ ﺑﺎﻟﻔﻴﺮوس.
١٧م ١٧ﻣﻠﻴﻮن ﺷﺨﺺ ﻣﻦ اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ اﻟﻔﻴﺮوس اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﺑﻨﻬﺎﻳﺔ ﻋﺎم ٢٠١٥
وﺗﺴﺘﻨﺪ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ إﻟﻰ إﻧﺠﺎزات ﻏﻴﺮ ﻋﺎدﻳﺔ ﻟﻠﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﺗﺤﻘﻘﺖ ﻓﻲ اﻻﺳﺘﺠﺎﺑﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻨﺬ أن أﻃﻠﻘﺖ اﻟﻤﻨﻈﻤﺔ اﻟﺒﺮﻧﺎﻣﺞ اﻟﺨﺎص ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ﻓﻲ ﻋﺎم ٢،١٩٨٦وﻳﺘﻮاﺻﻞ اﻟﺰﺧﻢ اﻟﺬي ﺗﻤﺨﻀﺖ ﻋﻨﻪ اﻷﻫﺪاف اﻹﻧﻤﺎﺋﻴﺔ ﻟﻸﻟﻔﻴﺔ واﻻﻟﺘﺰاﻣﺎت اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻟﺘﻐﻄﻴﺔ ﻓﻌﻠﺖ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ اﻟﺸﺎﻣﻠﺔ ٣.وﻗﺪ ﱠ ٤ ﺑﺸﺄن ﻣﺮض اﻷﻳﺪز واﻟﻌﺪوى ﺑﻔﻴﺮوﺳﻪ ﻓﻲ اﻟﻔﺘﺮة ٢٠١٥–٢٠١١ ﻓﻲ اﻵوﻧﺔ اﻷﺧﻴﺮة اﻟﻌﻤﻞ ﻋﻠﻰ اﻟﺼﻌﻴﺪﻳﻦ اﻟﻌﺎﻟﻤﻲ واﻟﻘﻄﺮي، ﻣﻤﺎ ﺳﺎﻋﺪ ﻋﻠﻰ وﻗﻒ اﻧﺘﺸﺎر وﺑﺎء اﻷﻳﺪز وﺑﺪء اﻧﺤﺴﺎره .وﺧﻼل ﺗﻠﻚ اﻟﻔﺘﺮة ،ﺗﻮﺳﻌﺖ اﻟﺘﻐﻄﻴﺔ ﺑﻤﻌﺎﻟﺠﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﻮﺳﻌﺎً ﺳﺮﻳﻌﺎً ،إذ ﺗﻠﻘﻰ ﻣﺎ ﻳﺰﻳﺪ ﻋﻠﻰ ١٧ﻣﻠﻴﻮن ﺷﺨﺺ ﻣﻦ اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ اﻟﻔﻴﺮوس اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﺑﻨﻬﺎﻳﺔ ﻋﺎم ،٢٠١٥وﺗﺮاﺟﻌﺖ أﻋﺪاد اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﺎﻟﻔﻴﺮوس واﻟﻮﻓﻴﺎت اﻟﻨﺎﺗﺠﺔ ﻋﻨﻪ ،وﺣﻘﻖ ﻋﺸﺮات اﻟﺒﻠﺪان ﺗﻘﺪﻣﺎً ﻓﻲ ﻃﺮﻳﻘﻬﺎ ﻧﺤﻮ اﻟﻘﻀﺎء ﻋﻠﻰ اﻧﺘﻘﺎل اﻟﻔﻴﺮوس ﻣﻦ اﻷم إﻟﻰ اﻟﻄﻔﻞُ ، ﺟﺖ در َ وأ ِ أﻧﺸﻄﺔ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻠﻔﻴﺮوس ﻓﻲ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ واﻹﻧﻤﺎﺋﻴﺔ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً .إﻻ أﻧﻪ ﻻ ﻣﺠﺎل ﻟﻠﻘﻨﺎﻋﺔ ﺑﻤﺎ ﺗﺤﻘﻖ؛ إذ ﺗﻐﻴﺮت أﺷﻴﺎء ﻛﺜﻴﺮة ﻣﻨﺬ ﻋﺎم ،٢٠١١ﻓﺒﺮزت ﻓﺮص ﺟﺪﻳﺪة ﻳﺠﺐ اﻏﺘﻨﺎﻣﻬﺎ ،وﺑﺮزت ﺗﺤﺪﻳﺎت ﺟﺪﻳﺪة ﻛﺜﻴﺮة ﻳﻠﺰم اﻟﺘﻐﻠﺐ ﻋﻠﻴﻬﺎ .وﺳﻴﺘﻄﻠﺐ اﻟﻘﻀﺎء ﻋﻠﻰ وﺑﺎء اﻷﻳﺪز ﺗﺴﺮﻳﻌﺎً ﻛﺒﻴﺮاً ﻟﻮﺗﻴﺮة اﻻﺳﺘﺠﺎﺑﺔ ﻋﻠﻰ ﻣﺪى اﻟﺴﻨﻮات ﻣﺘﻮاﺻﻼ ﺣﺘﻰ ﻋﺎم ٢٠٣٠وﻣﺎ ﺑﻌﺪه .وﻻ ﻋﻤﻼ اﻟﺨﻤﺲ اﻟﻤﻘﺒﻠﺔ ﺛﻢ ً ً ﻳﻤﻜﻦ ﺗﺤﻘﻴﻖ ﻫﺬا إﻻ ﻣﻦ ﺧﻼل ﺗﺠﺪﻳﺪ اﻻﻟﺘﺰام اﻟﺴﻴﺎﺳﻲ ،وﺗﻮﻓﻴﺮ ﻣﻮارد إﺿﺎﻓﻴﺔ ،واﺑﺘﻜﺎرات ﺗﻘﻨﻴﺔ وﺑﺮﻣﺠﻴﺔ.
ﻓﻲ آذار /ﻣﺎرس ،١٩٨٧ﻧﺸﺮت اﻟﻤﻨﻈﻤﺔ ”اﻟﺒﺮﻧﺎﻣﺞ اﻟﺨﺎص ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز :اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت واﻟﺒﻨﻴﺔ اﻟﻬﻴﻜﻠﻴﺔ :اﻟﺤﺎﺟﺎت اﻟﻤﺘﻮﻗﻌﺔ“ ،وﻫﻮ ﻣﺘﺎح ﻋﻠﻰ: ) http://apps.who.int/iris/bitstream/10665/62299/1/WHO_SPA_GEN_87.1.pdfﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس .(٢٠١٦ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ذﻟﻚ ،ﻓﻘﺪ ﻧﺸﺮ اﻟﺒﺮﻧﺎﻣﺞ اﻟﻌﺎﻟﻤﻲ ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ١٩٩٥–١٩٨٧ﺗﻘﺮﻳﺮاً ﺑﻌﻨﻮان ”اﻟﺘﻘﺮﻳﺮ اﻟﻨﻬﺎﺋﻲ ﻣﻊ ﺗﺄﻛﻴﺪ ﻋﻠﻰ اﻟﺜﻨﺎﺋﻴﺔ “١٩٩٥–١٩٩٤اﻟﻤﺘﺎح ﻋﻠﻰhttp://apps.who.int/iris/bitstream/10665/65955/1/WHO_ASD_97.1.pdf : )ﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس .(٢٠١٦ ﻗﺮار اﻟﺠﻤﻌﻴﺔ اﻟﻌﺎﻣﺔ ﻟﻸﻣﻢ اﻟﻤﺘﺤﺪة - ٢٧٧/٦٥اﻹﻋﻼن اﻟﺴﻴﺎﺳﻲ ﺑﺸﺄن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻷﻳﺪز :ﺗﻜﺜﻴﻒ ﺟﻬﻮدﻧﺎ ﻣﻦ أﺟﻞ اﻟﻘﻀﺎء ﻋﻠﻰ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻷﻳﺪز ) http://www.unaids.org/sites/default/files/sub_landing/files/20110610_UN_A-RES-65-277_en.pdfﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس .(٢٠١٦ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ ﺑﺸﺄن اﻷﻳﺪز واﻟﻌﺪوى ﺑﻔﻴﺮوﺳﻪ ﻓﻲ اﻟﻔﺘﺮة ٢٠١٥–٢٠١١ﻣﺘﺎﺣﺔ ﻋﻠﻰhttp://apps.who.int/iris/bitstream/10665/44606/1/9789241501651_eng.pdf : )ﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس .(٢٠١٦
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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ﻓﻬﻲ ﺳﺘﻤﻨﻊ اﻟﻔﻘﺮ وﺗﺨﻔﻒ وﻃﺄﺗﻪ ،وﺗﺤﺪ ﻣﻦ اﻹﺟﺤﺎف ﻓﻲ إﺗﺎﺣﺔ اﻟﺨﺪﻣﺎت ،وﺗﺸﺠﻊ اﻟﻤﺴﺎواة ﺑﻴﻦ اﻟﺠﻨﺴﻴﻦ ،وﺗﻌﺰز اﻹﻧﺘﺎﺟﻴﺔ، وﺗﺘﺼﺪى ﻟﻺﻗﺼﺎء واﻟﻮﺻﻢ واﻟﺘﻤﻴﻴﺰ. ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻋﻠﻰ رؤﻳﺔ وأﻫﺪاف وإﺟﺮاءات وﺗﻨﺺ ّ ﺟﻬﺎت ﻮﱡ ﻟﻼﺳﺘﺠﺎﺑﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ ،وﺗﺸﻤﻞ ﺧﻤﺴﺔ ﺗَ َ اﺳﺘﺮاﺗﻴﺠﻴﺔ ،وﻫﻲ :ﺗﻌﺰﻳﺰ وﺗﺮﻛﻴﺰ اﻟﺒﺮاﻣﺞ واﻟﺨﻄﻂ اﻟﻮﻃﻨﻴﺔ اﻟﻤﻌﻨﻴﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻦ ﺧﻼل اﻟﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﺴﻠﻴﻤﺔ واﻟﺘﺼﺮﻳﻒ اﻟﺴﺪﻳﺪ ﻟﻠﺸﺆون؛ ﺗﺤﺪﻳﺪ ﺣﺰﻣﺔ ﻣﻦ اﻟﺨﺪﻣﺎت اﻷﺳﺎﺳﻴﺔ واﻟﺘﺪﺧﻼت اﻟﻌﺎﻟﻴﺔ اﻟﺘﺄﺛﻴﺮ ﻓﻲ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻋﻠﻰ اﻣﺘﺪاد اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي؛ ﺗﻜﻴﻴﻒ وﺗﻘﺪﻳﻢ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻤﺨﺘﻠﻒ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻮاﻗﻊ اﻟﺠﻐﺮاﻓﻴﺔ ،ﻟﺒﻠﻮغ أﻋﻠﻰ ﻣﺴﺘﻮى ﻣﻦ اﻟﺠﻮدة وﺗﺤﻘﻴﻖ اﻟﺘﻐﻄﻴﺔ اﻟﻌﺎدﻟﺔ؛ ﺗﻨﻔﻴﺬ ﻧﻈﻢ اﻟﺘﻤﻮﻳﻞ اﻟﻜﺎﻣﻞ ﻟﻠﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻟﻠﺘﻘﻠﻴﻞ إﻟﻰ أدﻧﻰ ﺣﺪ ﻣﻦ ﻣﺨﺎﻃﺮ ﺗﻌﺮض ﻣﻦ ﻳﺤﺘﺎﺟﻮن إﻟﻰ اﻟﺨﺪﻣﺎت ﻟﻠﻀﻮاﺋﻖ اﻟﻤﺎﻟﻴﺔ؛ ﺗﺸﺠﻴﻊ اﻻﺑﺘﻜﺎر ﻟﺪﻓﻊ ﻋﺠﻠﺔ اﻟﺘﻘﺪم )اﻧﻈﺮ اﻟﺸﻜﻞ .(١
وﻻﺑﺪ ﻣﻦ اﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ اﻟﺸﺮاﻛﺎت اﻟﻮاﺳﻌﺔ اﻟﻨﻄﺎق واﻟﺮواﺑﻂ اﻟﻘﻮﻳﺔ ﻣﻊ اﻟﻘﻀﺎﻳﺎ اﻟﺼﺤﻴﺔ واﻹﻧﻤﺎﺋﻴﺔ اﻷﺧﺮى ﻓﻲ اﻟﻤﺮﺣﻠﺔ اﻟﺘﺎﻟﻴﺔ ﻣﻦ اﻻﺳﺘﺠﺎﺑﺔ .وﺗﺘﺴﻖ ﻣﺴﻮدة ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﺗﺴﺎﻗﺎً ﺗﺎﻣﺎً ﻣﻊ ﺧﻄﺔ اﻟﺼﺤﺔ واﻟﺘﻨﻤﻴﺔ وﻏﺎﻳﺎﺗﻬﺎ ﻟﻤﺎ ﺑﻌﺪ ﻋﺎم .٢٠١٥ وﺗﻘﺪم اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ أﻳﻀﺎً ﻣﺴﺎﻫﻤﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻓﻲ اﺳﺘﺠﺎﺑﺔ أوﺳﻊ ﻧﻄﺎﻗﺎً وﺿﻤﻦ ﻗﻄﺎﻋﺎت ﻣﺘﻌﺪدة ﻋﻠﻰ اﻟﻨﺤﻮ اﻟﺬي َﺑ ﱠﻴﻨﺘﻪ اﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ﻓﻲ اﻟﻔﺘﺮة ٥٫٢٠٢١–٢٠١٦ﻛﻤﺎ ﺗﺘﺴﻖ أﻳﻀﺎً ﻣﻊ اﺳﺘﺮاﺗﻴﺠﻴﺎت وﺧﻄﻂ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻷﺧﺮى ذات اﻟﻌﻼﻗﺔ ،ﺑﻤﺎ ﻓﻴﻬﺎ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت واﻟﺨﻄﻂ اﻟﻤﻌﻨﻴﺔ ﺑﺎﻷﻣﺮاض اﻟﻤﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎً واﻟﺴﻞ واﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ واﻟﺼﺤﺔ اﻟﺠﻨﺴﻴﺔ واﻹﻧﺠﺎﺑﻴﺔ وﺻﺤﺔ اﻷم واﻟﻄﻔﻞ وﻣﺄﻣﻮﻧﻴﺔ اﻟﺪم واﻟﺼﺤﺔ اﻟﻨﻔﺴﻴﺔ واﻷﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ واﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻟﻤﺘﻜﺎﻣﻠﺔ اﻟﺘﻲ ﺗُ َﺮﻛّ ﺰ ﻋﻠﻰ اﻟﻨﺎس .وﻗﺪ اﺳﺘﻤﺪت اﻟﻤﺴﻮدة اﻟﺘﻮﺟﻴﻬﺎت ﻣﻦ اﻟﺠﻬﻮد ﻏﻴﺮ اﻟﻌﺎدﻳﺔ اﻟﺘﻲ ﺑﺬﻟﺘﻬﺎ ﺑﻠﺪان ﻛﺜﻴﺮة إﻗﺮاراً ﻣﻨﻬﺎ ﺑﺄن اﻟﺒﻠﺪان واﻟﻤﺠﺘﻤﻌﺎت اﻟﻤﺤﻠﻴﺔ ﻋﻨﺼﺮان ﻣﺤﻮرﻳﺎن ﻓﻲ اﻻﺳﺘﺠﺎﺑﺔ .وﻗﺪ أﺧﺬت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻓﻲ اﻋﺘﺒﺎرﻫﺎ اﺳﺘﺮاﺗﻴﺠﻴﺎت ﻣﻜﺎﻓﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﺼﺤﻴﺔ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً اﻟﺘﻲ وﺿﻌﻬﺎ ﺷﺮﻛﺎء اﻟﺘﻨﻤﻴﺔ اﻟﺮﺋﻴﺴﻴﻮن ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺼﻨﺪوق اﻟﻌﺎﻟﻤﻲ ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز واﻟﺴﻞ واﻟﻤﻼرﻳﺎ وﺧﻄﺔ رﺋﻴﺲ اﻟﻮﻻﻳﺎت اﻟﻤﺘﺤﺪة اﻟﻄﺎرﺋﺔ ﻟﻠﻤﺴﺎﻋﺪة ﻓﻲ ﻣﺠﺎل ﻣﻜﺎﻓﺤﺔ اﻷﻳﺪز ٦.وﺳﻴﺴﻬﻢ اﻟﺘﻨﻔﻴﺬ اﻟﻜﺎﻣﻞ ﻟﻤﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻓﻲ ﺗﺤﻘﻴﻖ أﻫﺪاف اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ،
– ٠١اﻟﺒﺮﻧﺎﻣﺞ اﻟﺘﺜﻘﻴﻔﻲ اﻟﺬي ﺗﺮﻋﺎه اﻟﺪوﻟﺔ ﺑﺸﺄن اﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻧﺘﻘﺎل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻦ اﻷم إﻟﻰ اﻟﻄﻔﻞ ،ﻧﻴﺠﻴﺮﻳﺎ.
اﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ﻓﻲ اﻟﻔﺘﺮة ،٢٠٢١–٢٠١٦اﻧﻈﺮ: http://www.unaids.org/en/resources/documents/2015/ UNAIDS_PCB37_15-18 )ﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس .(٢٠١٦ ﻟﻠﻤﺰﻳﺪ ﻣﻦ اﻟﻤﻌﻠﻮﻣﺎت ﻋﻦ ﺧﻄﺔ رﺋﻴﺲ اﻟﻮﻻﻳﺎت اﻟﻤﺘﺤﺪة اﻟﻄﺎرﺋﺔ ﻟﻠﻤﺴﺎﻋﺪة ﻓﻲ ﻣﺠﺎل ﻣﻜﺎﻓﺤﺔ اﻷﻳﺪز ،اﻧﻈﺮhttp://www.pepfar.gov/about/strategy/ : )ﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس .(٢٠١٦
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻹﻃﺎر اﻟﻌﺎم ﻟﻤﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻣﻜﻮﻧﺎت رﺋﻴﺴﻴﺔ ،وﻫﻲ: ﺗﺸﺘﻤﻞ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻋﻠﻰ ﺧﻤﺴﺔ ﱢ
ﺗﻘﻴﻴﻢ ﻋﺎم ﻟﻠﻮﺿﻊ – ﻳﺴﺘﻌﺮض اﻟﻮﺿﻊ اﻟﻘﺎﺋﻢ ﻷوﺑﺌﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وأﻧﺸﻄﺔ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻬﺎ ،وﻳﺤﺪد اﻟﻔﺮص واﻟﺘﺤﺪﻳﺎت اﻟﺘﻲ ﻗﺪ ﺗﻈﻬﺮ ﻓﻲ اﻟﻤﺴﺘﻘﺒﻞ، وﻳﻨﺎﻗﺶ ﺿﺮورة اﻻﺳﺘﺜﻤﺎر اﻟﻜﺎﻓﻲ ﻓﻲ أﻧﺸﻄﺔ اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي؛ ﺻﻴﺎﻏﺔ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ – ﻳﺼﻒ اﻷﻃﺮ اﻟﺘﻨﻈﻴﻤﻴﺔ اﻟﺜﻼﺛﺔ ﻟﻼﺳﺘﺮاﺗﻴﺠﻴﺔ )اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ، واﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻧﻬﺞ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ(؛ ﺗﻘﺪﻳﻢ رؤﻳﺔ ﻋﺎﻟﻤﻴﺔ ووﺿﻊ أﻫﺪاف وﻏﺎﻳﺎت ﻋﺎﻟﻤﻴﺔ – ﺑﺘﻘﺪﻳﻢ ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻟﻐﺎﻳﺎت اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻷﺛﺮ وﺗﻐﻄﻴﺔ اﻟﺨﺪﻣﺔ ﻟﻌﺎﻣﻲ ٢٠٢٠و ٢٠٣٠ﻟﺪﻓﻊ ﻋﺠﻠﺔ أﻧﺸﻄﺔ اﻻﺳﺘﺠﺎﺑﺔ؛ اﻟﺘﻮﺻﻴﺔ ﺑﺎﻹﺟﺮاءات ذات اﻷوﻟﻮﻳﺔ – وﻓﻴﻪ ﺗﻮﺻﻴﺔ ﺑﺎﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ اﻟﺘﻲ ﺳﺘﺘﺨﺬﻫﺎ اﻟﺒﻠﺪان اﻟﺘﻮﺟﻬﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ وﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺿﻤﻦ ﻛﻞ واﺣﺪ ﻣﻦ ﱡ اﻟﺨﻤﺴﺔ؛ ﺗﻮﺟﻴﻪ اﻟﺘﻨﻔﻴﺬ – وﻓﻴﻪ ﺷﺮح ﻟﻠﻌﻨﺎﺻﺮ اﻟﺮﺋﻴﺴﻴﺔ ﻓﻲ ﺗﻨﻔﻴﺬ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺸﺮاﻛﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ واﻟﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ وﺗﻘﺪﻳﺮ اﻟﺘﻜﺎﻟﻴﻒ.
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ﻟﻤﺎذا ﻳﺠﺐ ﻋﻠﻰ اﻟﻌﺎﻟﻢ اﻹﺳﺮاع ﻓﻲ ﺗﺴﺮﻳﻊ وﺗﻴﺮة اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
ﺑﺪأت اﻻﺳﺘﺜﻤﺎرات اﻟﻬﺎﺋﻠﺔ ﻓﻲ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻋﻠﻰ ﻣﺪى اﻟﺨﻤﺴﺔ ﻋﺸﺮ ﻋﺎﻣﺎً اﻟﻤﺎﺿﻴﺔ ﺗﺆﺗﻲ ﺛﻤﺎرﻫﺎ ،ﺣﻴﺚ ﺗﺸﻬﺪ اﻻﻧﺨﻔﺎﺿﺎت اﻟﻜﺒﻴﺮة ﻓﻲ اﻹﺻﺎﺑﺎت اﻟﺠﺪﻳﺪة ﺑﺎﻟﻔﻴﺮوس اﻟﻤﺬﻛﻮر واﻟﻮﻓﻴﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﻪ ﺧﻼل اﻟﻌﻘﺪ اﻟﻤﺎﺿﻲ ﻬﺖ ﺑﺎﻟﻔﻌﻞ إﻟﻰ ﻣﻜﺎﻓﺤﺔ وﺑﺎء ﻓﻴﺮوس ﺟَ وﱢ ﻋﻠﻰ اﻻﻟﺘﺰاﻣﺎت واﻟﻤﻮارد واﻻﺑﺘﻜﺎرات اﻟﺘﻲ ُ اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻌﺎﻟﻤﻲ .وﻳﺘﻮاﺻﻞ ﺗﺮاﺟﻊ ﻋﺪد اﻷﺷﺨﺎص اﻟﺬﻳﻦ ﻳﻤﻮﺗﻮن ﻣﻦ ﺟﺮاء أﺳﺒﺎب ﻣﺮﺗﺒﻄﺔ ﺑﺎﻟﻔﻴﺮوس ،ﻓﻘﺪ أﺷﺎرت اﻟﺘﻘﺪﻳﺮات ﻓﻲ ﻋﺎم ٥١٠٢إﻟﻰ وﻗﻮع ١٫١ﻣﻠﻴﻮن ﻋﻤﺎ ﻛﺎن وﻓﺎة )اﻟﻨﻄﺎق ٠٤٩ ٠٠٠وﻓﺎة – ٣٫١ﻣﻠﻴﻮن وﻓﺎة( ،أي ﺑﺎﻧﺨﻔﺎض ﻧﺴﺒﺘﻪ ّ ٪٣٤ ﺪدت ﻓﻴﻪ ﻷول ﻣﺮة اﻟﻐﺎﻳﺎت اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻟﻌﻼج، ﺣﱢ ﻋﻠﻴﻪ ﻓﻲ ﻋﺎم ،٣٠٠٢وﻫﻮ اﻟﺘﺎرﻳﺦ اﻟﺬي ُ ﺮد ذﻟﻚ ﺑﺸﻜﻞ ﻛﺒﻴﺮ إﻟﻰ زﻳﺎدة إﺗﺎﺣﺔ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ .ﻛﻤﺎ وﻳ ّ ُ أﺷﺎرت اﻟﺘﻘﺪﻳﺮات ﻓﻲ ﻋﺎم ٥١٠٢إﻟﻰ أن اﻹﺻﺎﺑﺎت اﻟﺠﺪﻳﺪة ﺑﻌﺪوى اﻟﻔﻴﺮوس ﺑﻠﻐﺖ ١٫٢ ٨،٧ ﻣﻠﻴﻮن إﺻﺎﺑﺔ )اﻟﻨﻄﺎق ٤٫٢ – ٨٫١ﻣﻠﻴﻮن ﺣﺎﻟﺔ(
اﻟﺘﺤﺪﻳﺎت
ﻓﻲ اﻟﻮﻓﻴﺎت اﻟﻨﺎﺟﻤﺔ ﻋﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻨﺬ ﻋﺎم ٢٠٠٣
٪٤٣ اﻧﺨﻔﺎض ﺑﻨﺴﺒﺔ
ﻋﻠﻰ اﻟﺮﻏﻢ ﻣﻦ اﻟﺘﻘﺪم اﻟﻜﺒﻴﺮ ﻓﻲ اﻻﺳﺘﺠﺎﺑﺔ ،ﻣﺎزاﻟﺖ أوﺑﺌﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﻤﺜﻞ ﻣﺸﻜﻼت ﻛﺒﺮى ﺗﻮاﺟﻪ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﻓﻲ ﺟﻤﻴﻊ اﻷﻗﺎﻟﻴﻢ ،وﻫﻲ ﺗﺤﺪﻳﺎت ﻫﺎﻣﺔ ﺗﻠﻘﻲ ﺑﻈﻼﻟﻬﺎ ﻋﻠﻰ اﻟﻤﻜﺎﺳﺐ اﻟﺘﻲ ﺗﺤﻘﻘﺖ. ﺟﻬﻮد ﻏﻴﺮ ﻛﺎﻓﻴﺔ وﺑﻄﻴﺌﺔ – ﺗﻌﺘﺒﺮ اﻟﺘﻐﻄﻴﺔ ﺑﺎﻟﺨﺪﻣﺎت اﻟﺤﺎﻟﻴﺔ ﻏﻴﺮ ﻛﺎﻓﻴﺔ ،وﻣﻌﺪل ﺗﻮﺳﻴﻊ ﻧﻄﺎﻗﻬﺎ ﻳﺴﻴﺮ ﺑﻮﺗﻴﺮة أﺑﻄﺄ ﻣﻦ أن ﻳﺤﻘﻖ اﻟﻐﺎﻳﺎت اﻟﻌﺎﻟﻤﻴﺔ ،ﻛﻤﺎ أن اﻟﻤﻨﺎﻓﻊ اﻟﻜﺎﻣﻠﺔ ﻟﺘﺪﺧﻼت وﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻢ ﺗﺘﺤﻘﻖ ﺑﻌﺪ .ﻓﻌﻠﻰ ﻣﺴﺘﻮى اﻟﻌﺎﻟﻢ ،وﻣﻦ أﺻﻞ ٣٧ﻣﻠﻴﻮن ﺷﺨﺺ ﻣﺘﻌﺎﻳﺶ ﻣﻊ اﻟﻔﻴﺮوس ﻓﻲ ﻧﻬﺎﻳﺔ ﻋﺎم ،٢٠١٤ﻛﺎن ﻫﻨﺎك ١٧ﻣﻠﻴﻮن ﺷﺨﺺ ﻳﺠﻬﻠﻮن إﺻﺎﺑﺘﻬﻢ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،و ٢٢ﻣﻠﻴﻮن ﺷﺨﺺ ﻻ ﻳﺤﺼﻠﻮن ٨ ﻋﻠﻰ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ. اﺳﺘﻤﺮار ﺟﻮاﻧﺐ ﺿﺨﻤﺔ ﻣﻦ اﻹﺟﺤﺎف وﻣﻦ إﻫﻤﺎل اﻟﻨﺎس – ﻳﺘﻮزع اﻟﻨﺠﺎح اﻟﺬي ﺗﺤﻘﻖ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﻮزﻳﻌﺎً ﻳﻔﺘﻘﺪ إﻟﻰ اﻟﻌﺪل وإﻟﻰ اﻹﻧﺼﺎف ،ﻓﻔﻲ ﺣﻴﻦ أن ﺣﺪوث ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي آﺧﺬ ﺑﺎﻟﺘﺮاﺟﻊ ﺑﻮﺟﻪ ﻋﺎم ،ﻓﺈﻧﻪ ﻳﺘﺰاﻳﺪ ﻓﻲ ﺑﻌﺾ اﻟﺒﻠﺪان واﻷﻗﺎﻟﻴﻢ ،ﺣﻴﺚ ﻳﺒﻠﻎ ﻣﻌﺪل إﺻﺎﺑﺔ اﻟﻤﺮاﻫﻘﺎت واﻟﺸﺎﺑﺎت ﻓﻲ أﻓﺮﻳﻘﻴﺎ ﺟﻨﻮب اﻟﺼﺤﺮاء اﻟﻜﺒﺮى ﺿﻌﻒ ﻣﻌﺪل إﺻﺎﺑﺔ اﻟﺼﺒﻴﺎن واﻟﺮﺟﺎل اﻟﺬﻳﻦ ﻳﺴﺎووﻧﻬﻦ ﻓﻲ اﻷﻋﻤﺎر ،ﺛﻢ إن اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻏﻴﺮ ﻛﺎف أو ﻏﻴﺮ ﺳﺮﻳﻊ ﺑﻤﺎ ﻳﻜﻔﻲ ،إذ ﻻ ﻳﺼﻞ إﻟﻰ ﻛﺜﻴﺮ ﻣﻦ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻷﺷﺪ ﺗﻌﺮﺿﺎً ﻟﻤﺨﺎﻃﺮ اﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ذﻟﻚ ،ﻫﻨﺎك ﺗﻔﺎوﺗﺎت ﻛﺒﻴﺮة ﻓﻲ ﻣﺪى إﺗﺎﺣﺔ اﻟﻌﻼج واﻟﺮﻋﺎﻳﺔ ،ﺣﻴﺚ ﻳﻨﺨﻔﺾ ﻣﺴﺘﻮاﻫﺎ ﺑﺎﻟﻨﺴﺒﺔ إﻟﻰ اﻟﺼﺒﻴﺎن واﻟﺮﺟﺎل ﻓﻲ ﺑﻠﺪان ﻛﺜﻴﺮة .وﻣﺎزاﻟﺖ اﻧﺘﻬﺎﻛﺎت ﺣﻘﻮق اﻹﻧﺴﺎن ،ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ﺗﻔﺸﻲ اﻟﻌﻨﻒ اﻟﻘﺎﺋﻢ ﻋﻠﻰ ﻧﻮع اﻟﺠﻨﺲ واﻟﻮﺻﻢ واﻟﺘﻤﻴﻴﺰ ،ﻳﺤﻮﻻن دون إﺗﺎﺣﺔ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ،وﺧﺼﻮﺻﺎً ﻟﻸﻃﻔﺎل واﻟﻤﺮاﻫﻘﻴﻦ واﻟﺸﺎﺑﺎت واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ ٩ اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ. َ
ﺗﺘﻄﻠﺐ اﻟﺒﻠﺪان اﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ ﺗﺮﻛﻴﺰاً ﺧﺎﺻﺎً – ﺗﺸﻴﺮ اﻟﺘﻘﺪﻳﺮات إﻟﻰ أن ﻫﻨﺎك ﻧﺤﻮ ٪٧٠ﻣﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺣﻮل اﻟﻌﺎﻟﻢ ﻣﻮﺟﻮدون ﻓﻲ اﻟﺒﻠﺪان اﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ ،وﺳﻴﺘﺤﺪد اﻟﻨﺠﺎح اﻟﻌﺎﻟﻤﻲ أﻳﻀﺎً ﺑﻤﺪى ﺗﻮﻗﻔﻬﺎ. ﺗﺴﺎرع وﺗﻴﺮة اﻟﺠﻬﻮد اﻟﻤﺒﺬوﻟﺔ ﻓﻲ ﻫﺬه اﻟﺒﻠﺪان أو ّ وﻓﻲ ﻇﻞ ﺗﻐﻴﺮ اﻷوﻟﻮﻳﺎت ﻟﺪى اﻟﺠﻬﺎت اﻟﻤﺎﻧﺤﺔ أﺻﺒﺢ ﻟﺘﻮﺳﻴﻊ ﻧﻈﻢ ﺗﻤﻮﻳﻞ اﻟﺼﺤﺔ اﻟﻌﺎدﻟﺔ واﻟﻤﺴﺘﺪاﻣﺔ أﻫﻤﻴﺔ ﺧﺎﺻﺔ ﻟﻠﺒﻠﺪان اﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ .وﻓﻲ اﻟﻮﻗﺖ ﻧﻔﺴﻪ ،ﺳﺘﻮاﺻﻞ اﻟﺒﻠﺪان اﻟﻤﻨﺨﻔﻀﺔ اﻟﺪﺧﻞ اﻋﺘﻤﺎدﻫﺎ ﻋﻠﻰ اﻟﻤﺴﺎﻋﺪة اﻹﻧﻤﺎﺋﻴﺔ اﻟﺨﺎرﺟﻴﺔ ﻟﻀﻤﺎن ﺣﺼﻮل ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻀﺮورﻳﺔ ﻋﻠﻰ اﻟﺘﻤﻮﻳﻞ اﻟﻜﺎﻓﻲ.
ﺗﻌﺘﻤﺪ ﻣﻌﻈﻢ اﻟﺒﻴﺎﻧﺎت اﻟﺘﻲ ﻳﺘﻢ ﻋﺮﺿﻬﺎ ﻓﻲ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻋﻠﻰ اﻟﺘﻘﺎرﻳﺮ اﻟﻘﻄﺮﻳﺔ اﻟﺪورﻳﺔ ،وﻧﻈﻢ اﻟﺘﺒﻠﻴﻎ اﻟﺨﺎﺻﺔ ﺑﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ و ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز واﻟﻌﺪوى ﺑﻔﻴﺮوﺳﻪ ﻣﻦ ﻗﺒﻴﻞ اﻟﻨﻈﺎم اﻟﻌﺎﻟﻤﻲ ﻟﻠﺘﺒﻠﻴﻎ ﺑﺎﻻﺳﺘﺠﺎﺑﺔ ﻟﻤﺮض اﻷﻳﺪز. )Global AIDS Update 2016, UNAIDS http://www.unaids.org/en/resources/documents/2016/Global-AIDS-update-2016 (accessed 23 June 2016 ﺗﺴﺘﺨﺪم اﻟﻤﺴﻮدة اﻟﺤﺎﻟﻴﺔ ﻟﻼﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﻌﺮﻳﻒ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻷﺳﺎﺳﻴﺔ ﻋﻠﻰ اﻟﻮﺟﻪ اﻟﺬي ﻋﺮﺿﺘﻪ اﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ،٢٠٢١-٢٠١٦اﻟﻤﺘﺎﺣﺔ ﻋﻠﻰ ) http://www.unaids.org/en/resources/documents/2015/UNAIDS_PCB37_15-18ﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس ” :(٢٠١٦اﻟﻤﺠﻤﻮﻋﺎت اﻷﺳﺎﺳﻴﺔ أو اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﻌﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ ﻫﻲ ﻣﺠﻤﻮﻋﺎت ﻣﻦ اﻟﻨﺎس اﻟﺬﻳﻦ ﻳﻐﻠﺐ أن ﻳﺘﻌﺮﺿﻮا أﻛﺜﺮ ﻣﻦ ﻏﻴﺮﻫﻢ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي أو ﻟﻨﻘﻠﻪ ،واﻟﺬﻳﻦ ﺗﻌﺘﺒﺮ ﻣﺸﺎرﻛﺘﻬﻢ ﺣﺎﺳﻤﺔ ﻟﻨﺠﺎح اﻻﺳﺘﺠﺎﺑﺔ ﻟﻠﻔﻴﺮوس ،وﻓﻲ ﺟﻤﻴﻊ اﻟﺒﻠﺪان ﺗﺘﻀﻤﻦ ﱠ اﻟﻤﻌﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻷﻳﺪز ،وﻓﻲ ﻣﻌﻈﻢ اﻟﻤﻮاﻗﻊ ﻳﺘﻌﺮض اﻟﺮﺟﺎل اﻟﺬﻳﻦ ﻳﻤﺎرﺳﻮن اﻟﺠﻨﺲ ﻣﻊ اﻟﺮﺟﺎل واﻷﺷﺨﺎص اﻟﻤﺘﺤﻮﻟﻮن ﺟﻨﺴﻴﺎً واﻷﺷﺨﺎص اﻟﺬﻳﻦ ﻳﺘﻌﺎﻃﻮن اﻟﻤﺨﺪرات اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ ﱠ ﺣﻘﻨﺎً واﻟﻌﺎﻣﻠﻮن ﻓﻲ اﻟﺠﻨﺲ واﻟﺰﺑﺎﺋﻦ اﻟﺬﻳﻦ ﻳﺘﺮددون ﻋﻠﻴﻬﻢ ،واﻟﻤﺴﺎﺟﻴﻦ ﻟﻤﺨﺎﻃﺮ أﻛﺜﺮ ﻣﻦ ﻏﻴﺮﻫﻢ ﻟﻺﺻﺎﺑﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،إﻻ أﻧﻪ ﻳﻨﺒﻐﻲ ﻋﻠﻰ ﻛﻞ ﺑﻠﺪ ﻋﻠﻰ ﺣﺪة أن ﻳﻀﻊ ﺗﻌﺮﻳﻔﺎً ﻟﻠﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺤﺪدة اﻟﺘﻲ ﺗﻌﺘﺒﺮ أﺳﺎﺳﻴﺔ ﻓﻲ اﻟﻮﺑﺎء ﻓﻴﻬﺎ واﻟﺘﻲ ﻳﺘﻢ اﻻﺳﺘﺠﺎﺑﺔ اﺳﺘﻨﺎداً إﻟﻰ اﻟﺴﻴﺎق اﻻﺟﺘﻤﺎﻋﻲ واﻟﻮﺑﺎﺋﻲ“.
٧ ٨ ٩
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
١٢
اﻟﺸﻜﻞ .١إﻃﺎر اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ ﺑﺸﺄن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي٢٠٢١-٢٠١٦ ،
اﻧﻌﺪام ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻧﻌﺪام اﻟﻮﻓﻴﺎت اﻟﻨﺎﺟﻤﺔ ﻋﻨﻪ، واﻧﻌﺪام اﻟﺘﻤﻴﻴﺰ اﻟﻤﺘﻌﻠﻖ ﺑﻪ ،ﻓﻲ ﻋﺎﻟﻢ ﻳﺘﻴﺢ ﻟﻸﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ اﻟﻔﻴﺮوس أن ﻳﻨﻌﻤﻮا ﺑﺤﻴﺎة ﻃﻮﻳﻠﺔ وﻳﺘﻤﺘﻌﻮا ﺑﺎﻟﺼﺤﺔ.
اﻟﺮؤﻳﺔ
اﻟﻘﻀﺎء ﻋﻠﻰ وﺑﺎء اﻷﻳﺪز ﻛﺨﻄﺮ ﻳﻬﺪد اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﺑﺤﻠﻮل ﻋﺎم .٢٠٣٠
اﻟﻬﺪف
ﺧﻔﺾ ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة إﻟﻰ أﻗﻞ ﻣﻦ ٥٠٠ ٠٠٠؛ واﻧﻌﺪام ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻴﻦ اﻷﻃﻔﺎل .وﺧﻔﺾ ﻋﺪد اﻟﻮﻓﻴﺎت اﻟﻨﺎﺟﻤﺔ ﻋﻦ اﻟﻔﻴﺮوس إﻟﻰ أﻗﻞ ﻣﻦ .٥٠٠ ٠٠٠وﺧﻀﻮع ٪٩٠ ﻣﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ اﻟﻔﻴﺮوس ﻟﻼﺧﺘﺒﺎر؛ وﻋﻼج ٪٩٠ﻣﻦ اﻟﻤﺮﺿﻰ؛ وﺣﺪوث اﻟﻜﺒﺖ اﻟﻔﻴﺮوﺳﻲ ﻟﺪى ٪٩٠ﻣﻨﻬﻢ.
ﻏﺎﻳﺎت ﻋﺎم ٢٠٢٠
اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ ،وﺳﻠﺴﻠﺔ اﻟﺨﺪﻣﺎت ،وﻧﻬﺞ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ.
ُأﻃﺮ اﻟﻌﻤﻞ
اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٥ اﻻﺑﺘﻜﺎر ﻣﻦ أﺟﻞ ﺗﺴﺮﻳﻊ وﺗﻴﺮة اﻟﺨﺪﻣﺎت ”اﻟﻤﺴﺘﻘﺒﻞ“
اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٤ اﻟﺘﻤﻮﻳﻞ ﻷﻏﺮاض اﻻﺳﺘﺪاﻣﺔ ”اﻟﺘﻤﻮﻳﻞ“
اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٣ ﺗﻮﻓﻴﺮ اﻟﺨﺪﻣﺎت ﻟﻀﻤﺎن اﻹﻧﺼﺎف ”ﻛﻴﻒ“
اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٢ اﻟﺘﺪﺧﻼت اﻟﺮاﻣﻴﺔ إﻟﻰ إﺣﺪاث اﻷﺛﺮ ”ﻣﺎذا“
اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ١ ﺗﻮﻓﻴﺮ اﻟﻤﻌﻠﻮﻣﺎت ﻻﺗﺨﺎذ إﺟﺮاءات ﻣﺮﻛﺰة ”ﻣﻦ“ و“أﻳﻦ“
اﻟﻘﻴﺎدة واﻟﺸﺮاﻛﺔ واﻟﻤﺴﺎءﻟﺔ واﻟﺘﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ
ﺗﻨﻔﻴﺬ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ:
اﻟﻘﻄﺮﻳﻴﻦ ﻋﻤﻞ اﻟﺸﺮﻛﺎء ُ
اﻟﻘﻄﺮي اﻟﻌﻤﻞ ُ
ﻋﻤﻞ اﻟﺸﺮﻛﺎء اﻟﺪوﻟﻴﻴﻦ
ﻋﻤﻞ اﻟﻤﻘﺮ اﻟﺮﺋﻴﺴﻲ ﻟﻠﻤﻨﻈﻤﺔ وﻣﻜﺎﺗﺒﻬﺎ اﻹﻗﻠﻴﻤﻴﺔ واﻟﻘﻄﺮﻳﺔ ُ
اﻟﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ
اﻷﺑﻌﺎد اﻟﺜﻼﺛﺔ ﻟﻠﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ
١٣
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻟﺒﺸﺮي وﺗﺪﺑﻴﺮﻫﺎ اﻟﻌﻼﺟﻲ ،ﻣﺎزال اﻟﺴﻞ ﻫﻮ اﻟﺴﺒﺐ اﻟﺮﺋﻴﺴﻲ ﻟﺪﺧﻮل اﻟﻤﺴﺘﺸﻔﻴﺎت ﺑﻴﻦ اﻟﺒﺎﻟﻐﻴﻦ واﻷﻃﻔﺎل اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻳﻈﻞ ﻫﻮ اﻟﺴﺒﺐ اﻟﺮﺋﻴﺴﻲ ﻟﻠﻮﻓﻴﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. زﻳﺎدة اﻟﻌﻤﻞ ﻓﻲ ﻣﺠﺎل واﺣﺪ ﻻ ﻳﻜﻔﻲ – ﺑﻠﻎ اﻟﻮﺑﺎء اﻟﻌﺎﻟﻤﻲ ﻧﻘﻄﺔ اﻻﺳﺘﺠﺎﺑﺔ اﻟﺜﺎﺑﺘﺔ ،واﻟﺘﻲ ﺗﻌﻨﻲ أن اﻟﺘﻮﺳﻊ اﻟﺘﺪرﻳﺠﻲ اﻹﺑﻘﺎء ﻋﻠﻰ اﻟﺘﻐﻄﻴﺔ ﻋﻨﺪ ﻣﺴﺘﻮﻳﺎﺗﻬﺎ اﻟﺤﺎﻟﻴﺔ أو ّ ﻓﻴﻬﺎ ﺳﻴﺆدي ﺳﺮﻳﻌﺎً إﻟﻰ ﻋﻮدة اﻻرﺗﻔﺎع ﻓﻲ ﻣﺴﺘﻮﻳﺎت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻮﻓﻴﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﻪ. وﻟﻦ ﻳﻜﻮن اﻟﺴﻴﺮ ﺑﺎﻟﻮﺗﻴﺮة اﻟﺤﺎﻟﻴﺔ ﻛﺎﻓﻴﺎً ﻟﻠﻘﻀﺎء ﻋﻠﻰ وﺑﺎء ﻳﺘﻄﻮر ﺑﺎﺳﺘﻤﺮار ،وﺳﺘﺰداد ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﺳﻴﺰداد ﻋﺪد اﻷﺷﺨﺎص اﻟﺬﻳﻦ ﺳﻴﺤﺘﺎﺟﻮن إﻟﻰ اﻟﻌﻼج واﻟﺮﻋﺎﻳﺔ ،وﺳﻴﺘﻮاﺻﻞ ارﺗﻔﺎع ﺗﻜﺎﻟﻴﻒ اﻟﻮﻗﺎﻳﺔ واﻟﺮﻋﺎﻳﺔ واﻟﻌﻼج .ﻓﺒﺤﻠﻮل ﻧﻬﺎﻳﺔ ﻋﺎم ،٥١٠٢ﻛﺎن ﻋﺪد اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ اﻟﻔﻴﺮوس ﻗﺪ ﺑﻠﻎ ﻣﺎ ﻳﻘﺪر ﺑﻨﺤﻮ ٧٫٦٣ﻣﻠﻴﻮن ﺷﺨﺺ )اﻟﻨﻄﺎق ٨٫٩٣ﻣﻠﻴﻮن – ٠٫٤٣ﻣﻠﻴﻮن( ﻓﻲ ﺟﻤﻴﻊ أﻧﺤﺎء اﻟﻌﺎﻟﻢ. وﻳﻮاﺟﻪ اﻟﻌﺎﻟﻢ ﻣﻌﻀﻠﺔ” :اﻻﺳﺘﻤﺮار ﻓﻲ اﻟﻌﻤﻞ ﻋﻠﻰ ﻣﺎ ﻫﻮ ﻋﻠﻴﻪ“ ﺳﻴﺆدي إﻟﻰ ﻓﻘﺪان اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺰﺧﻤﻬﺎ ﺑﻞ وﺗﺮاﺟﻌﻬﺎ .إﻻ أن اﻹﺟﺮاءات اﻟﻤﺒﻴﻨﺔ ﻓﻲ ﻫﺬه اﻟﻤﺴﻮدة ﺳﺘﺘﻔﺎدى ﺗﻠﻚ اﻟﺤﺼﻴﻠﺔ ،ﻓﻬﻲ ﺗﺘﻀﻤﻦ ﺗﺴﺮﻳﻊ وﺗﻴﺮة اﻟﻌﻤﻞ ﻓﻲ ﺗﺪﺧﻼت ﺷﺎﻣﻠﺔ ﻋﺎﻟﻴﺔ اﻷﺛﺮ وﺗﻄﻮﻳﺮﻫﺎ وﺗﻨﻔﻴﺬﻫﺎ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻋﻼﺟﻪ ،واﺗﺒﺎع ﻧﻬﻮج ﺗﺮﺗﻜﺰ ﻋﻠﻰ اﻟﺤﻘﻮق وﻋﻠﻰ اﻟﻨﺎس ،وﺗﺤﺪﻳﺪ ﺗﻤﻮﻳﻞ ﻣﺴﺘﺪام ﻟﺒﺮاﻣﺞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ اﻟﻤﺴﺘﻘﺒﻞ ،وﺿﻤﺎن اﻟﺘﻜﺎﻣﻞ واﻟﺪﻣﺞ اﻟﺘﺪرﻳﺠﻲ ﻟﻼﺳﺘﺠﺎﺑﺔ ﻟﻠﻔﻴﺮوس ﻓﻲ ﺑﺮاﻣﺞ اﻟﺼﺤﺔ وﺧﺪﻣﺎﺗﻬﺎ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً .
اﻟﻤﺠﺘﻤﻌﺎت اﻟﻬﺸﺔ واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺘﻨﻘﻠﺔ – ﻳﻮاﺟﻪ اﻟﻌﺎﻟﻢ ﺳﻠﺴﻠﺔ ﻣﺘﺰاﻳﺪة اﻟﺘﻌﻘﻴﺪ ﻣﻦ اﻟﺘﺤﺪﻳﺎت ،ﺣﻴﺚ ﻳﻤﻜﻦ أن ﻳﺘﺴﺒﺐ اﻟﺼﺮاع واﻟﻜﻮارث اﻟﻄﺒﻴﻌﻴﺔ واﻷزﻣﺎت اﻻﻗﺘﺼﺎدﻳﺔ وﺗﻐﻴﺮ اﻟﻤﻨﺎخ ﻓﻲ وﻗﻮع ﺣﺎﻻت ﻃﻮارئ إﻧﺴﺎﻧﻴﺔ ﺗﺪﻣﺮ ﻧﻈﻢ اﻟﺼﺤﺔ اﻟﻤﺤﻠﻴﺔ وﺗﺸﺮد اﻟﻤﺠﺘﻤﻌﺎت وﺗﺠﺒﺮ أﻋﺪاداً ﻣﺘﺰاﻳﺪة ﻣﻦ اﻟﻨﺎس ﻋﻠﻰ اﻟﻬﺠﺮة ،ﻣﻊ اﻧﻘﻄﺎع اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ أو ﺗﺪﻧﻲ ﺗﻮاﻓﺮﻫﺎ. ﻋﺪم ﺗﻮﺟﻴﻪ اﻟﺘﺪﺧﻼت واﻟﺨﺪﻣﺎت ﺗﻮﺟﻴﻬﺎً ﻛﺎﻓﻴﺎً – ﻏﺎﻟﺒﺎً ﻣﺎ ﺗﺨﻔﻖ أﻧﺸﻄﺔ اﻻﺳﺘﺠﺎﺑﺔ اﻟﻮﻃﻨﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ ﺗﺮﻛﻴﺰ ﺗﺪﺧﻼﺗﻬﺎ ﻋﻠﻰ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻮاﻗﻊ اﻟﺠﻐﺮاﻓﻴﺔ اﻟﺘﻲ ﻫﻲ ﻓﻲ أﺷﺪ اﻟﺤﺎﺟﺔ إﻟﻴﻬﺎ ،ﻣﻤﺎ ﻳﺰﻳﺪ ﺑﺎﻟﺘﺎﻟﻲ أوﺟﻪ ﻋﺪم ﻛﻔﺎءﺗﻬﺎ وﻳﻘﻠﻞ ﻣﻦ أﺛﺮﻫﺎ. ﻳﻌﺮض اﻟﺘﻮﺳﻊ اﻟﺴﺮﻳﻊ ﻓﻲ ﺑﺮاﻣﺞ ﺿﻤﺎن اﻟﺠﻮدة واﻟﺤﻔﺎظ ﻋﻠﻴﻬﺎ – ّ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻊ إﻫﻤﺎل ﺿﻤﺎن ﺟﻮدة اﻟﺨﺪﻣﺎت ﻟﻤﺨﺎﻃﺮ ﺗﻘﻮﻳﺾ ﻓﻌﺎﻟﻴﺔ ﻫﺬه اﻟﺒﺮاﻣﺞ وﺗﺒﺪﻳﺪ اﻟﻤﻮارد اﻟﺜﻤﻴﻨﺔ واﻟﻤﺴﺎﻫﻤﺔ ﻓﻲ اﻟﺤﺼﺎﺋﻞ اﻟﺴﻠﺒﻴﺔ ﻟﻠﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ،ﻣﺜﻞ ﻇﻬﻮر ﺳﻼﻻت ﻣﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. ﻓﻀﻤﺎن ﺟﻮدة ﺳﻠﻊ اﻟﻮﻗﺎﻳﺔ واﻟﺘﺸﺨﻴﺺ واﻟﻌﻼج ﻓﻲ ﻇﻞ ﺗﺰاﻳﺪ أﺳﺎﺳﻲ. اﻟﻄﻠﺐ واﻻﺳﺘﺨﺪام أﻣﺮ ّ ازدﻳﺎد ﻋﺐء ﺣﺎﻻت اﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ واﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ اﻷﺧﺮى – ﺗﺸﻬﺪ اﻟﻮﻓﻴﺎت ﻧﺘﻴﺠﺔ اﻹﺻﺎﺑﺔ ﺑﺎﻷﻳﺪز اﻧﺨﻔﺎﺿﺎً ﻓﻲ ﻇﻞ ﺗﻮﺳﻴﻊ ﻣﺪى اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،ﻟﻜﻦ اﻻﺳﺘﺜﻤﺎرات ﻓﻲ اﻟﻌﻼج ﺗﻮاﺟﻪ ﺗﺤﺪﻳﺎت ﺗﺰاﻳﺪ ﻣﻌﺪﻻت اﻟﻤﺮاﺿﺔ واﻟﻮﻓﻴﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ، ﻛﺎﻟﺘﻬﺎب اﻟﻜﺒﺪ Bواﻟﺘﻬﺎب اﻟﻜﺒﺪ ،Cواﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ اﻷﺧﺮى ،ﺑﻤﺎ ﻓﻴﻬﺎ اﻟﺴﺮﻃﺎن وأﻣﺮاض اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ واﻟﺴﻜﺮي واﻷﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ اﻷﺧﺮى واﻟﺼﺤﺔ اﻟﻨﻔﺴﻴﺔ )اﻟﻌﻘﻠﻴﺔ( وﺗﻌﺎﻃﻲ ﻣﻮاد اﻹدﻣﺎن .وﻋﻠﻰ اﻟﺮﻏﻢ ﻣﻦ اﻟﺘﻮﺳﻊ ﻓﻲ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،وﻣﺠﺎﻻت اﻟﺘﺤﺴﻦ ﻓﻲ اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻋﺪوى اﻟﺴﻞ اﻟﻤﺼﺎﺣﺒﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ
ﻓﺒﺤﻠﻮل ﻧﻬﺎﻳﺔ ﻋﺎم ،٢٠١٥ﻛﺎن ﻋﺪد اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ اﻟﻔﻴﺮوس ﻗﺪ ﺑﻠﻎ ﻣﺎ ﻳﻘﺪر ﺑﻨﺤﻮ
٧,٦٣ﻣﻠﻴﻮن ﺷﺨﺺ
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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اﻻﺳﺘﻌﺪاد ﻟﻘﻔﺰة ﻛﺒﻴﺮة إﻟﻰ اﻷﻣﺎم اﻟﻤﻴﻜﺮوﺑﺎت وﻟﻘﺎح ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،إﺿﺎﻓﺘﻴﻦ ﻣﻠﻒ ﺗﺘﺰاﻳﺪ ﻗﻮﺗﻪ ﺑﻤﺎ ﻳﺘﻀﻤﻨﻪ ﻣﻦ ﺗﺪﺧﻼت ﺗﻨﻀﻤﺎن إﻟﻰ ﻓﻌﺎﻟﺘﻴﻦ ّ ّ اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. ﺿﻤﺎن ﻣﻌﺮﻓﺔ ﺟﻤﻴﻊ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺤﺎﻟﺘﻬﻢ ﻣﻦ ﺣﻴﺚ اﻹﺻﺎﺑﺔ: إن اﻟﻨﻬﻮج اﻟﺠﺪﻳﺪة اﻟﻤﺘﺒﻌﺔ ﻓﻲ اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻻﺧﺘﺒﺎر اﻟﺬاﺗﻲ واﻻﺧﺘﺒﺎر اﻟﺬي ﻳﺮﺗﻜﺰ ﻋﻠﻰ اﻟﻤﺠﺘﻤﻊ ،واﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎت اﻟﺠﺪﻳﺪة اﻟﻤﻀﻤﻮﻧﺔ اﻟﺠﻮدة ،ﱢ ﺗﺒﺸﺮ ﺑﺎﻟﺘﻌﺮف ﻋﻠﻰ ﻣﺰﻳﺪ ﻣﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ورﺑﻄﻬﻢ ﺑﺎﻟﻌﻼج واﻟﺮﻋﺎﻳﺔ اﻟﻤﺒﻜﺮﻳﻦ ،ﻣﻤﺎ ﻳﺰﻳﺪ إﻣﻜﺎﻧﻴﺎت اﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻟﻔﻴﺮوس وﻓﻌﺎﻟﻴﺔ ﻋﻼﺟﻪ إﻟﻰ اﻟﺤﺪ اﻷﻗﺼﻰ .وﺳﻴﻜﻮن ﻟﻠﺘﺮﻛﻴﺰ اﻻﺳﺘﺮاﺗﻴﺠﻲ ﻋﻠﻰ ﺧﺪﻣﺎت اﺧﺘﺒﺎر اﻟﻔﻴﺮوس أﻫﻤﻴﺔ ﺣﺎﺳﻤﺔ ﻓﻲ اﻟﻮﺻﻮل إﻟﻰ ﻣﻦ ﻫﻢ أﺷﺪ ﺗﻌﺮﺿﺎً ﻟﻠﻤﺨﺎﻃﺮ ،وﺗﺸﺨﻴﺺ اﻟﻨﺎس ﻣﺒﻜﺮاً . اﻟﺘﻮﺳﻊ ﻓﻲ اﻟﻌﻼج اﻟﺠﻴﺪ اﻟﻨﻮﻋﻴﺔ ﻟﺠﻤﻴﻊ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي :ﻳﺠﺐ أن ﻳﻜﻮن ﺳﺪ اﻟﻔﺠﻮة ﻓﻲ اﻟﻌﻼج ،واﻟﺘﻮﺳﻊ ﻣﻦ ١٧ﻣﻠﻴﻮن ﺷﺨﺺ إﻟﻰ ﺟﻤﻴﻊ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻣﻦ اﻷوﻟﻮﻳﺎت ،وﻫﺬا ﻣﻦ ﺷﺄﻧﻪ أن ﻳﺤﻮل دون ﺣﺪوث ﺣﺎﻻت ﻣﻦ اﻟﻌﺪوى اﻟﺠﺪﻳﺪة وﻣﻦ اﻟﻮﻓﻴﺎت ﺑﻘﺪر ﻫﺎﺋﻞ ،ﻟﻜﻦ اﻟﺒﺪء ﻓﻲ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﺠﻤﻴﻊ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺳﻴﺘﻄﻠﺐ ﻣﻦ اﻟﺒﻠﺪان واﻟﺸﺮﻛﺎء ﺑﺬل ﺟﻬﺪ ﻏﻴﺮ ﻣﺴﺒﻮق .وﻳﺠﺐ إﻋﺎرة اﻫﺘﻤﺎم ﺧﺎص ﻟﻠﺘﺼﺪي ﻷﺷﺪ ﺟﻮاﻧﺐ اﻟﺘﻔﺎوت ﻓﻲ إﺗﺎﺣﺔ اﻟﻌﻼج ﺑﺤﻴﺚ رﺿﻊ وأﻃﻔﺎل ﻳﺼﻞ اﻟﻌﻼج إﻟﻰ ﻣﻦ ﺗﻌﺮﺿﻮا ﻟﻺﻫﻤﺎل ،ﻣﻦ ّ وﻣﺮاﻫﻘﺎت وﻣﺮاﻫﻘﻴﻦ ورﺟﺎل وﻣﺠﻤﻮﻋﺎت ﺳﻜﺎﻧﻴﺔ رﺋﻴﺴﻴﺔ ﻣﻌﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ .وﻻﺑﺪ ﻣﻦ ﺿﻤﺎن ﺟﻮدة اﻷدوﻳﺔ واﻟﺨﺪﻣﺎت. ﻛﻤﺎ ﻳﻠﺰم وﺟﻮد اﺳﺘﺮاﺗﻴﺠﻴﺎت ﻟﻠﻮﺻﻮل إﻟﻰ أﻗﺼﻰ اﻟﺘﺰام ﺑﺎﻟﻌﻼج واﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﺮﺿﻰ ﻓﻲ اﻟﺮﻋﺎﻳﺔ ﻟﺘﺤﻘﻴﻖ إﻣﻜﺎﻧﻴﺎت اﻟﻌﻼج ﻛﺎﻣﻠﺔ. اﻟﺤﻔﺎظ ﻋﻠﻰ ﺻﺤﺔ اﻟﻨﺎس وأرواﺣﻬﻢ ﻣﻦ ﺧﻼل اﻟﺮﻋﺎﻳﺔ اﻟﺘﻲ ﺗﺮﻛﱢ ﺰ ﻋﻠﻰ اﻷﺷﺨﺎص واﻟﺮﻋﺎﻳﺔ اﻟﺸﻤﻮﻟﻴﺔ :ﻻﺑﺪ ﻣﻦ ﺗﻠﺒﻴﺔ اﻻﺣﺘﻴﺎﺟﺎت اﻟﺼﺤﻴﺔ اﻟﻌﺎﻣﺔ ﻟﺪى ﻣﻼﻳﻴﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻣﻦ ﺑﻴﻨﻬﻢ أوﻟﺌﻚ اﻟﺬﻳﻦ ﻳﺘﻠﻘﻮن ﻋﻼﺟﺎً ﻣﺪى اﻟﺤﻴﺎة ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ .وﺗﺆدي اﻟﺮواﺑﻂ ﺑﻴﻦ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺧﺪﻣﺎت اﻟﺴﻞ واﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ واﻟﻘﻀﺎﻳﺎ اﻟﺼﺤﻴﺔ اﻟﻜﺒﺮى اﻷﺧﺮى إﻟﻰ ﺗﻘﻠﻴﺺ ﻣﻌﺪﻻت اﻟﻤﺮاﺿﺔ واﻟﻮﻓﻴﺎت ﺗﻘﻠﻴﺼﺎً ﻣﻠﺤﻮﻇﺎً .وإن ﺗﻘﻮﻳﺔ ﺗﻠﻚ اﻟﺮواﺑﻂ ،ﺑﻤﺎ ﻓﻴﻬﺎ اﻟﺮواﺑﻂ ﻣﻊ ﺧﺪﻣﺎت اﻷﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ، ﺳﺘﻀﻤﻦ ﺗﻮاﻓﺮ رﻋﺎﻳﺔ ﺷﻤﻮﻟﻴﺔ وﻣﺘﻜﺎﻣﻠﺔ ﺗﺮﻛﱢ ﺰ ﻋﻠﻰ اﻷﺷﺨﺎص، ﻣﻤﺎ ﻳﻌﺰﱢ ز اﻷﺛﺮ اﻟﻜﻠﻲ ﻟﻠﺒﺮاﻣﺞ .ﺛﻢ إن اﻹﻋﺪاد اﻟﻤﺸﺘﺮك ﻟﺒﺮاﻣﺞ ﻣﻜﺎﻓﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺴﻞ ﻓﻲ اﻟﺒﻠﺪان اﻟﺘﻲ ﺗﺸﻬﺪ أﻋﻠﻰ أﻋﺒﺎء ﻋﺪوى اﻟﺴﻞ اﻟﻤﺼﺎﺣﺒﺔ ﻟﻌﺪوى ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻳﺴﺎﻋﺪ ﻋﻠﻰ ﺗﻌﺰﻳﺰ اﻟﻤﺰﻳﺪ ﻣﻦ اﻟﺘﻜﺎﻣﻞ ،وﻳﺰﻳﺪ ﻣﻦ ﻓﺮص اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺘﺪﺧﻼت اﻟﻤﻨﻘﺬة ﻟﻸرواح ،وﻳﺤﻘﻖ
ﻫﻨﺎك ﻓﺮص ﻫﺎﺋﻠﺔ ﻟﻼﺳﺘﻔﺎدة ﻣﻦ اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻋﻠﻰ ﻣﺪى ١٥ ﻋﺎﻣﺎً ﻣﻀﺖ ﻟﺪﻓﻊ اﻻﺳﺘﺠﺎﺑﺔ إﻟﻰ ﻣﺴﺎر ﺟﺪﻳﺪ ﻧﺤﻮ اﻟﻘﻀﺎء ﻋﻠﻰ وﺑﺎء اﻷﻳﺪز .وﻣﻦ اﻟﻀﺮوري أن ﻳﻀﻄﻠﻊ ﻗﻄﺎع اﻟﺼﺤﺔ ﺑﺪور ﻗﻴﺎدي ﻣﻊ اﻟﺘﻘﺪم ﻓﻲ اﻻﺳﺘﺠﺎﺑﺔ. ﻣﺠﺎﻻت ﺑﺎﻟﻐﺔ اﻷﻫﻤﻴﺔ ﻟﻺﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ
ﻳﺠﺐ أن ﻧﻨﻄﻠﻖ ﻣﻦ اﻟﺰﺧﻢ اﻟﺬي ﺗﺸﻬﺪه اﻻﺳﺘﺠﺎﺑﺔ اﻟﺤﺎﻟﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻜﻲ ﻧﺴﺘﻔﻴﺪ ﻣﻦ اﻟﻘﺎﻋﺪة اﻟﻤﺘﻴﻨﺔ اﻟﻤﺘﺠﺪد. ﻣﻦ اﻟﺒﺮاﻣﺞ اﻟﻮﻃﻨﻴﺔ اﻟﺸﺎﻣﻠﺔ وﻧﺴﺘﻐﻞ اﻻﻟﺘﺰام اﻟﺴﻴﺎﺳﻲ ﱢ ﻟﻜﻦ اﻷﻣﺮ ﻳﺤﺘﺎج إﻟﻰ ﻣﺎ ﻫﻮ أﻛﺜﺮ ﻣﻦ ذﻟﻚ .ﻓﻬﻨﺎك ﺳﺘﺔ ﻣﺠﺎﻻت ﺳﺘﺘﻄﻠﺐ اﻟﺘﺰاﻣﺎت وﻣﻮارد ﺟﺪﻳﺪة وﺟﻬﻮداً ﻣﻜﺜﻔﺔ ﻟﺒﻠﻮغ اﻟﻐﺎﻳﺎت اﻟﻤﺤﺪدة ﻟﻌﺎﻣﻲ ٢٠٢٠و.٢٠٣٠ ﺗﺪﻋﻴﻢ اﻟﻮﺳﺎﺋﻞ اﻟﻤﺸﺘﺮﻛﺔ ﻟﻠﻮﻗﺎﻳﺔ ﺑﺄدوات ﺟﺪﻳﺪة: ﻫﻨﺎك إدراك ﺗﺎم ﺑﻤﺎ ﻟﻠﻌﻘﺎﻗﻴﺮ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ، وﻣﻦ ﺿﻤﻨﻬﺎ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،ﻣﻦ آﺛﺎر ﻓﻲ اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻛﻤﺎ ﺗﺄﻛﺪت اﻹﻣﻜﺎﻧﻴﺔ اﻟﻬﺎﺋﻠﺔ اﻟﺘﻲ ﺗﻨﻄﻮي ﻋﻠﻴﻬﺎ اﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﻗﺒﻞ اﻟﺘﻌﺮض ،ﺑﺎﺳﺘﺨﺪام اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﻋﺪوى ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﻳﻤﻜﻦ ﻟﻠﺠﻤﻊ ﺑﻄﺮﻳﻘﺔ اﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﻴﻦ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ واﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﻗﺒﻞ اﻟﺘﻌﺮض ،ﻓﻲ إﻃﺎر اﻟﻮﺳﺎﺋﻞ اﻟﻤﺸﺘﺮﻛﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،أن ﻳﻘﻀﻲ ﺗﻘﺮﻳﺒﺎً ﻋﻠﻰ اﻧﺘﻘﺎل اﻟﻔﻴﺮوس إﻟﻰ اﻟﺸﺮﻛﺎء ﻓﻲ ﻣﻤﺎرﺳﺔ اﻟﺠﻨﺲ وﻓﻲ ﺗﻌﺎﻃﻲ اﻟﻤﺨﺪرات اﻟﺴﻠﺒﻴﻴﻦ ﻟﻠﻔﻴﺮوس. وﻫﻨﺎك ﻣﺠﺎل رﺣﺐ ﻟﺘﺤﻘﻴﻖ اﻟﻤﺰﻳﺪ ﻣﻦ اﻻﺳﺘﻔﺎدة ﻣﻦ اﻟﻘﺪرة اﻟﻮﻗﺎﺋﻴﺔ ﻟﻠﺨﺘﺎن اﻟﻄﺒﻲ اﻟﻄﻮﻋﻲ ﻟﺪى اﻟﺬﻛﻮر .إن اﻻﺑﺘﻜﺎرات اﻟﺘﻲ ﺗﻘﺘﺮب ﻣﻦ ﺗﺤﻘﻴﻖ ﻏﺎﻳﺔ اﻟﺘﻐﻄﻴﺔ ﺑﻨﺴﺒﺔ ٪٨٠ﻟﻠﺨﺘﺎن اﻟﻄﺒﻲ اﻟﻄﻮﻋﻲ ﻟﺪى اﻟﺬﻛﻮر ﻓﻲ اﻟﺒﻠﺪان اﻟﺘﻲ ﺗﻢ ﺗﻌﻴﻴﻨﻬﺎ ﻋﻠﻰ أﻧﻬﺎ ”ذات أوﻟﻮﻳﺔ“ ﺳﻮف ﺗﺴﺎﻋﺪ ﻋﻠﻰ ﺣﺪوث اﻧﺨﻔﺎض ﺷﺪﻳﺪ ﻓﻲ اﻹﺻﺎﺑﺎت اﻟﺠﺪﻳﺪة ﻓﻲ ﺑﻌﺾ اﻷﻣﺎﻛﻦ اﻟﺘﻲ ﺗﺸﻬﺪ أﻋﻠﻰ ﻣﻌﺪﻻت اﻻﻧﺘﺸﺎر ﻷوﺑﺌﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ اﻟﻌﺎﻟﻢ. ﻳﺠﺐ أن ﺗﻈﻞ اﻟﻌﻮازل اﻟﺬﻛﺮﻳﺔ واﻷﻧﺜﻮﻳﺔ ،وﻣﺸﺎرﻛﺘﻬﺎ ﻣﻊ اﻟﻤﺰَ ﻟﱢ ﻘﺎت ،اﻟﺪﻋﺎﻣﺔ اﻷﺳﺎﺳﻴﺔ ﻟﺒﺮاﻣﺞ اﻟﻮﻗﺎﻳﺔ ،ﻟﻜﻦ اﻟﻔﻮاﺋﺪ اﻟﻜﺎﻣﻠﺔ ُ ﻣﻦ وراء اﻻﺳﺘﺨﺪام اﻟﻤﺘﺴﻖ ﻟﻠﻌﻮازل ﻟﻢ ﺗﺘﺤﻘﻖ ﺑﻌﺪ ،ﺣﻴﺚ ﻳﻤﻜﻦ ﻟﻼﺑﺘﻜﺎرات ﻓﻲ إﻋﺪاد ﺑﺮاﻣﺞ اﻟﺘﺮوﻳﺞ ﻻﺳﺘﺨﺪام اﻟﻌﻮازل أن ﺗﻌﻄﻲ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي دﻓﻌﺔ ﻗﻮﻳﺔ إﻟﻰ اﻟﻔﻌﺎﻟﺔ ﻓﻲ إﺑﺎدة اﻷﻣﺎم .وﺳﻴﻜﻮن ﺗﻄﻮﻳﺮ اﻟﻤﺒﻴﺪات اﻟﻤﻮﺿﻌﻴﺔ ّ
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻟﻤﻨﺎﻓﻊ اﻟﻬﺎﺋﻠﺔ اﻟﻤﺮﺗﻘﺒﺔ
ﺗﺤﻘﻖ إن اﻻﺳﺘﺠﺎﺑﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﻔﻮرﻳﺔ ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ اﻟﺘﻲ ﱢ اﻟﻐﺎﻳﺎت اﻟﻮاردة ﻓﻲ ﻣﺴﻮدة ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﺳﺘﺆدي إﻟﻰ إﻧﻬﺎء اﻟﻮﺑﺎء ﺑﺎﻋﺘﺒﺎره أﺣﺪ اﻟﺘﻬﺪﻳﺪات ﻟﻠﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﻋﻠﻰ اﻟﺼﻌﻴﺪ وﺗﻮﺿﺢ اﻟﻨﻤﺎذج اﻟﺘﻲ وﺿﻌﻬﺎ ﱢ اﻟﻌﺎﻟﻤﻲ )اﻧﻈﺮ اﻟﺸﻜﻠﻴﻦ ٢و.(٣ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ،أن ﺑﺬل اﻟﺠﻬﻮد ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻼﺧﺘﺒﺎر واﻟﻌﻼج ،ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ﺣﺰم ﺗﺪﺧﻼت ﻋﺎﻟﻴﺔ اﻷﺛﺮ وﺗﻘﻮﻳﺔ اﻻﻟﺘﺰام ﺑﺤﻤﺎﻳﺔ ﺣﻘﻮق اﻹﻧﺴﺎن ،ﺳﻮف ﻳﺆدي ١٠ إﻟﻰ: • ﺧﻔﺾ ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻴﻦ اﻟﺒﺎﻟﻐﻴﻦ ﻣﻦ ٢٫١ﻣﻠﻴﻮن ﻓﻲ ﻋﺎم ٢٠١٠إﻟﻰ ٥٠٠ ٠٠٠ﻓﻲ ﻋﺎم ٢٠٢٠؛ • ﺗﻔﺎدي ﺣﺪوث ٢٨ﻣﻠﻴﻮن ﻋﺪوى ﺑﺎﻟﻔﻴﺮوس ﺑﻴﻦ ﻋﺎﻣﻲ ٢٠١٥ و٢٠٣٠؛ ﺗﻔﺎدي ﻧﺤﻮ ٦ﻣﻼﻳﻴﻦ ﻋﺪوى ﺑﻴﻦ اﻷﻃﻔﺎل ﺑﺤﻠﻮل ﻋﺎم ٢٠٣٠؛ ﺗﻔﺎدي ٢١ﻣﻠﻴﻮن ﺣﺎﻟﺔ وﻓﺎة ﻣﺮﺗﺒﻄﺔ ﺑﺎﻷﻳﺪز ﺑﻴﻦ ﻋﺎﻣﻲ ٢٠١٥ و٢٠٣٠؛ ﺗﻔﺎدي إﻧﻔﺎق ٢٤ ٠٠٠ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ ﻣﻦ اﻟﺘﻜﺎﻟﻴﻒ اﻹﺿﺎﻓﻴﺔ ﻋﻠﻰ ﻋﻼج ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي؛ ﺗﻤﻜﻴﻦ اﻟﺒﻠﺪان ﻣﻦ ﺟﻨﻲ ﻋﺎﺋﺪ ﻳﺒﻠﻎ ١٥ﺿﻌﻔﺎً ﻻﺳﺘﺜﻤﺎراﺗﻬﺎ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. • • • •
ﻓﻲ اﻟﻮﻗﺖ ﻧﻔﺴﻪ أﻗﺼﻰ ﻛﻔﺎءة ﻓﻲ اﺳﺘﺨﺪام اﻟﻤﻮارد .وﻳﺘﻴﺢ اﺳﺘﺨﺪام ﻧﻤﻮذج ﻣﻌﺎﻟﺠﺔ اﻟﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ ﻓﻲ ﻋﻼج اﻟﻤﺼﺎﺑﻴﻦ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ورﻋﺎﻳﺘﻬﻢ ﻓﺮﺻﺎً ﻟﺘﻠﺒﻴﺔ اﻟﺤﺎﺟﺎت اﻟﺼﺤﻴﺔ اﻷﻋﻢ وﺧﺼﻮﺻﺎً اﻷﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ واﻟﺼﺤﺔ اﻟﻨﻔﺴﻴﺔ )اﻟﻌﻘﻠﻴﺔ( واﺿﻄﺮاﺑﺎت ﺗﻌﺎﻃﻲ ﻣﻮاد اﻹدﻣﺎن .وﺗﻈﻞ اﻟﺮﻋﺎﻳﺔ اﻟﻤﻠﻄﻔﺔ ﻣﻜﻮﻧﺎً ﺣﺎﺳﻤﺎً ﻣﻦ ﻣﻜﻮﻧﺎت أي اﺳﺘﺠﺎﺑﺔ ﺷﺎﻣﻠﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ ،ﻣﻤﺎ ﻳﺴﺎﻋﺪ ﻋﻠﻰ ﺣﻔﻆ ﻛﺮاﻣﺔ اﻟﻨﺎس وﺿﻤﺎن راﺣﺘﻬﻢ ﻓﻲ اﻟﺘﺪﺑﻴﺮ اﻟﻌﻼﺟﻲ ﻵﻻﻣﻬﻢ وﻟﻸﻋﺮاض اﻷﺧﺮى اﻟﺘﻲ ﻳﻌﺎﻧﻮن ﻣﻨﻬﺎ. ﺗﻌﺮﺿﺎً ﻟﻺﺻﺎﺑﺔ وﻟﻠﻤﺨﺎﻃﺮ اﻟﻮﺻﻮل إﻟﻰ ﻣﻦ ﻫﻢ أﺷﺪ ﱡ وﺣﻤﺎﻳﺘﻬﻢ :ﻟﻦ ﺗﺘﺠﺎﻫﻞ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻌﺪ اﻟﻴﻮم اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻷﺷﺪ ﺗﻀﺮراً واﻷﻛﺜﺮ ﻣﻌﺎﻧﺎة ﻣﻦ اﻹﻫﻤﺎل .ﻓﻴﺠﺐ أن ﺗﺼﻞ ﺗﺪﺧﻼت اﻟﻮﻗﺎﻳﺔ اﻟﻔﻌﺎﻟﺔ ﻣﻦ اﻟﻔﻴﺮوس وﺗﺪﺧﻼت اﻟﺘﻤﻜﻴﻦ إﻟﻰ اﻟﻔﺘﻴﺎت واﻟﺸﺎﺑﺎت ،اﻟﻼﺗﻲ ﺗﻌﺮﺿﺎً ﻟﻺﺻﺎﺑﺔ واﻷﻛﺜﺮ ﺗﻀﺮراً ﻳﺸﻜﻠﻦ ﻓﺌﺔ ﻣﺎزاﻟﺖ ﻫﻲ اﻷﺷﺪ ّ ﻓﻲ ﻣﺠﺘﻤﻌﺎت ﻛﺜﻴﺮة ،وﺧﺼﻮﺻﺎً ﻓﻲ أﻓﺮﻳﻘﻴﺎ ﺟﻨﻮب اﻟﺼﺤﺮاء اﻟﻜﺒﺮى اﻟﺘﻲ ﺗﺮزح ﺗﺤﺖ ﻋﺐء ﺛﻘﻴﻞ ﻣﻦ اﻷوﺑﺌﺔ .وﺳﺘﻜﻮن ﻫﻨﺎك ﺣﺎﺟﺔ إﻟﻰ اﺳﺘﺜﻤﺎرات ﺟﺪﻳﺪة وﻣﺮﻛﱠ ﺰة ﻛﺒﻴﺮة ﻟﺘﻘﻮﻳﺔ اﻟﺨﺪﻣﺎت اﻟﻤﺠﺘﻤﻌﻴﺔ ﻣﻦ أﺟﻞ ﺗﻮﻓﻴﺮ اﻟﺘﺪﺧﻼت اﻟﻤﻼﺋﻤﺔ ﻟﻠﻤﺮاﻫﻘﻴﻦ؛ واﻟﺘﺼﺪي ﺑﻔﻌﺎﻟﻴﺔ ﻟﻠﻌﻨﻒ اﻟﻘﺎﺋﻢ ﻋﻠﻰ ﻧﻮع اﻟﺠﻨﺲ ،واﻟﺬي ﺗﻌﺮض ﻳﺘﻌﻠﻖ أﻳﻀﺎً ﺑﺘﻌﺎﻃﻲ اﻟﻜﺤﻮل ﻋﻠﻰ ﻧﺤﻮ ﺿﺎر؛ واﻟﺤﺪ ﻣﻦ ﱡ اﻟﻔﺘﻴﺎت واﻟﺸﺎﺑﺎت ﻟﻺﺻﺎﺑﺔ؛ وإدﺧﺎل اﻟﺮﺟﺎل واﻟﻔﺘﻴﺎن ﻓﻲ ﺑﺮاﻣﺞ اﻟﻤﻌ ﱠﺮﺿﺔ اﻟﻌﻼج؛ واﻟﻮﺻﻮل إﻟﻰ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ َ ﻟﻠﻤﺨﺎﻃﺮ )وﻻﺳﻴﻤﺎ اﻟﺮﺟﺎل اﻟﺬﻳﻦ ﻳﻤﺎرﺳﻮن اﻟﺠﻨﺲ ﻣﻊ اﻟﺮﺟﺎل، واﻟﻤﺘﺤﻮﻟﻮن وﻣﺘﻌﺎﻃﻮ اﻟﻤﺨﺪرات ﺣﻘﻨﺎً ،واﻟﻌﺎﻣﻠﻮن ﻓﻲ اﻟﺠﻨﺲ، ﱢ ﺟﻨﺴﻴﺎً ،واﻟﺴﺠﻨﺎء(؛ وﺗﻮﺳﻴﻊ ﻧﻄﺎق ﺑﺮاﻣﺞ ﺗﻘﻠﻴﺺ اﻷﺿﺮار ﻟﺘﺸﻤﻞ ﻣﺘﻌﺎﻃﻲ اﻟﻤﺨﺪرات؛ وﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ﻟﻠﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺘﻨﻘﻠﺔ واﻟﻨﺎزﺣﻴﻦ .وﻻﺑﺪ ﻣﻦ ﺑﺬل اﻟﻤﺰﻳﺪ ﻣﻦ اﻟﺠﻬﺪ ﻹﻟﻐﺎء ﺗﺴﺒﺐ ﺗﻬﻤﻴﺶ اﻟﻤﺠﻤﻮﻋﺎت اﻟﻘﻮاﻧﻴﻦ وﺗﻐﻴﻴﺮ اﻟﺴﻴﺎﺳﺎت اﻟﺘﻲ ﱢ وﺗﺸﺠﻊ اﻟﺴﻠﻮﻛﻴﺎت اﻟﺨﻄﺮة، اﻟﺴﻜﺎﻧﻴﺔ وﺗﻠﺤﻖ ﺑﻬﺎ اﻟﻮﺻﻤﺔ، ﱢ وﺗﺨﻠﻖ ﻋﻮاﺋﻖ أﻣﺎم اﻟﺨﺪﻣﺎت اﻟﻔﻌﺎﻟﺔ ،وﺗُ ﻀﻔﻲ ﻋﻠﻰ ﻫﺬه اﻟﺘﻔﺎوﺗﺎت واﻟﺘﺒﺎﻳﻨﺎت ﻃﺎﺑﻊ اﻻﺳﺘﺪاﻣﺔ. ﺧﻔﺾ اﻟﺘﻜﺎﻟﻴﻒ وﺗﺤﺴﻴﻦ أوﺟﻪ اﻟﻜﻔﺎءة :إن ﺗﻮﺳﻴﻊ ﻏﻴﺮ ﻣﺴﺒﻮق ﻓﻲ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺤﻠﻮل ﻋﺎم ٢٠٢٠ﻓﻲ ﺑﻴﺌﺔ ﻣﺤﺪودة اﻟﻤﻮارد وﺗﺘﻨﺎﻓﺲ ﻓﻴﻬﺎ اﻷوﻟﻮﻳﺎت ﻳﺘﺤﻘﻖ إﻻ ﺑﺈﻧﺠﺎز وﻓﻮرات ﻛﺒﻴﺮة ﻣﻦ ﺧﻼل ﱠ اﻹﻧﻤﺎﺋﻴﺔ ﻻ ﻳﻤﻜﻦ أن ﺧﻔﺾ أﺳﻌﺎر اﻷدوﻳﺔ اﻷﺳﺎﺳﻴﺔ واﻟﺴﻠﻊ اﻷﺧﺮى وزﻳﺎدة أوﺟﻪ اﻟﻜﻔﺎءة ﻓﻲ ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ﺗﺮﺷﻴﺪ أﻛﺜﺮ ﻓﻲ ﺗﺨﺼﻴﺺ اﻟﻤﻮارد.
وﻳﻤﻜﻦ ﻟﻼﺳﺘﺜﻤﺎرات اﻹﺿﺎﻓﻴﺔ ﻓﻲ أﻧﺸﻄﺔ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس ﺗﺤﻘﻖ أﺛﺮاً ﻛﺒﻴﺮاً ﻓﻲ اﻟﻐﺎﻳﺎت اﻟﺼﺤﻴﺔ اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي أن ﱢ اﻷﺧﺮى ﻟﻬﺪف اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ اﻟﻤﻌﻨﻲ ﺑﺎﻟﺼﺤﺔ )اﻟﻬﺪف ،(٣ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﻐﺎﻳﺎت اﻟﻤﺘﻌﻠﻘﺔ ﺑﺼﺤﺔ اﻷﻣﻬﺎت واﻷﻃﻔﺎل، واﻟﺴﻞ ،واﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ ،واﻷﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ واﻟﺼﺤﺔ اﻟﻨﻔﺴﻴﺔ ،واﺿﻄﺮاﺑﺎت ﺗﻌﺎﻃﻲ ﻣﻮاد اﻹدﻣﺎن ،واﻟﺼﺤﺔ اﻟﺠﻨﺴﻴﺔ واﻹﻧﺠﺎﺑﻴﺔ ،واﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ.
١٠ﻓﻬﻢ اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ :ﺗﺴﺮﻳﻊ وﺗﻴﺮة اﻟﻌﻤﻞ ﻟﻠﻘﻀﺎء ﻋﻠﻰ وﺑﺎء اﻷﻳﺪز ﺑﺤﻠﻮل ﻋﺎم ،٢٠٣٠اﻧﻈﺮ اﻟﺮاﺑﻂ: http://www.unaids.org/sites/default/files/media_asset/201506_JC2743_Understanding_FastTrack_ en.pdf )ﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس (.٢٠١٦
٢٠٢١–٢٠١٦ ˛اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ
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ﺗﻮﻗﻌﺎت اﻻﻧﺨﻔﺎض ﻓﻲ اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي:٢ اﻟﺸﻜﻞ
Ǩȓǫ
Ĵřŀ ŶŴİőŤēěǘĔĨŧēİőŬē ŒńĴŤē ŮżĖ ęİŻİĥŤē
ěēıěēĆēĴĤǞē ŒŻĴĹŤēijĔĹũŤē
ĚʼnĝĭũŤēěĔűĔĥĜǘē łĭŻĔũżŘ ƻĔŝĖĔĸ ęİŻİĥŤēěĔĖĔŀǞē ĵŵőŤēķŴĴżŘŶŴİőĖ źĴĽėŤēŽŐĔŭũŤē ęİŻİĥŤēěĔĖĔŀǞē ŶŴİőĖĚőŜŵĝũŤē ŽŐĔŭũŤēĵŵőŤēķŴĴżŘ ūŵŀijĔňčŽŘźĴĽėŤē ŮŨŧİŝ ǁ ũŤēŶŵĝĹŨ ƿ ǨǦǧǪŧĔŐŽŘěĔŨİĬ ęİŻİĥŤēěĔĖĔŀǞē ŶŴİőĖĚőŜŵĝũŤē ŽŐĔŭũŤēĵŵőŤēķŴĴżŘ ĦŲŬ±źĴĽėŤē ĚőŻĴĹŤēěēijĔĹũŤē
ǧȓǫ Ȓǭǫ ĚėĹŭĖņřĬ ęİŻİĥŤēŶŴİőŤēěǘĔĨįİŐņřĬ ŮżĖŢŤıŽŘĔũĖȒǭǫĚėĹŭĖ ̿ſĐĴŤēĚżŬĔšĹŤēěĔŐŵũĥũŤē ǨǦǧǦŧĔŐŮŨĴňĔĭũťŤĚńĴǍ őũŤē ƾ ǨǦǨǦŧĔŐŹŤč
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Ǧȓǫ
ǨǦǩǦ
ǨǦǨǫ
ǨǦǨǦ ĚŭĹŤē
ǨǦǧǫ
ǨǦǧǦ
ﺗﻮﻗﻌﺎت اﻻﻧﺨﻔﺎض ﻓﻲ اﻟﻮﻓﻴﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي:٣ اﻟﺸﻜﻞ
Ǩȓǫ ěēıěēĆēĴĤǞē ŒŻĴĹŤēijĔĹũŤē
ķŴĴżřĖĚʼnėĜĴũŤē ŹŤčźĴĽėŤēŽŐĔŭũŤēĵŵőŤē
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ǫǦǦ ǦǦǦ ǧȓǫ ŮżŻǙũŤĔĖ ěĔżŘŵŤē ǨǦǨǦŧĔŐţŵťĩĖ
ŮŨŦŜĉ
ƻĔŝĖĔĸĚʼnĝĭũŤēěĔűĔĥĜǘē ěĔżŘŵŤēłĭŻĔũżŘ ĵİŻǜēŮŐĚũĤĔŭŤē ŮŨĚőŜŵĝũŤēěĔżŘŵŤē ūŵŀĵİŻǜēĆēĴĤ ŮŨŧİŝ ǁ ũŤēŶŵĝĹŨ ƿ ǨǦǧǪŧĔŐŽŘěĔŨİĬ ŮŨĚőŜŵĝũŤēěĔżŘŵŤē ĦŲŬĵİŻǜēĆēĴĤ ĚőŻĴĹŤēěēijĔĹũŤē
ǧ
Ǧȓǫ
ǨǦǩǦ
ǨǦǨǫ
ǨǦǨǦ ĚŭĹŤē
ǨǦǧǫ
ǨǦǧǦ
: ﻋﻠﻰ٢٠٢١-٢٠١٦ اﻧﻈﺮ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ، ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز:اﻟﻤﺼﺪر http://www.unaids.org/sites/default/files/media_asset/20151027_UNAIDS_PCB37_15_18_EN_rev1.pdf .(٢٠١٦ ﻣﺎرس/ آذار١٥ )ﺗﻢ اﻻﻃﻼع ﻓﻲ
( ŮżŻǙũŤĔĖ ęİŻİĥŤē ŶŴİőŤē ěǘĔĨ įİŐ
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻟﻘﻄﺮي ،وﺻﻴﺎﻏﺔ ﻣﺒﺮرات ﻗﻮﻳﺔ ﻟﻼﺳﺘﺜﻤﺎر .وﻳﻨﺒﻐﻲ أن ﺗﺘﻀﻤﻦ ﻳﺴﻮغ ﺗﺨﺼﻴﺺ ﻣﻮارد ﻣﺤﻠﻴﺔ ﻛﺎﻓﻴﺔ ،وﺗﻴﺴﻴﺮ ﻣﺒﺮرات اﻻﺳﺘﺜﻤﺎر ﻣﺎ ّ ﺣﺸﺪ اﻟﻤﻮارد اﻟﺨﺎرﺟﻴﺔ ،واﻟﻤﺴﺎﻋﺪة ﻋﻠﻰ ﺗﺤﺪﻳﺪ اﻟﺸﺮﻛﺎء اﻟﻌﺎﻟﻤﻴﻴﻦ اﻟﺬﻳﻦ ﺳﻴﺴﺎﻧﺪون اﻟﺠﻬﻮد. وﻳﺠﺐ أن ﺗﺘﻀﻤﻦ ﻣﺒﺮرات اﻻﺳﺘﺜﻤﺎر ﻣﺎ ﻳﻠﻲ: • ﺗﺤﺪﻳﺪ ﺣﺰم اﻟﺘﺪﺧﻼت واﻟﺨﺪﻣﺎت اﻟﻤﻄﻠﻮﺑﺔ وﺗﻮﻓﻴﺮ ﻣﻴﺰاﻧﻴﺔ ﻟﻬﺎ اﺳﺘﻨﺎداً إﻟﻰ اﻟﺴﻴﺎق اﻟﻘﻄﺮي؛ • اﻟﺪﻋﻮة إﻟﻰ اﻟﺘﺪﺧﻼت ذات اﻟﻤﺮدود اﻷﻋﻠﻰ؛ • ﺗﺤﺪﻳﺪ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻮاﻗﻊ اﻟﺠﻐﺮاﻓﻴﺔ اﻷﻛﺜﺮ ﺗﻀﺮراً واﻷﻣﺎﻛﻦ اﻟﺘﻲ ﻳﻨﺒﻐﻲ أن ﺗﺮﻛﱠ ﺰ ﻓﻴﻬﺎ اﻟﻤﻮارد؛ • ﺗﺤﺪﻳﺪ اﻟﻨﻤﺎذج اﻷﻛﺜﺮ ﻛﻔﺎءة وإﻧﺼﺎﻓﺎً ﻓﻲ ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت؛ • ﺗﻮﺿﻴﺢ اﻟﺘﺨﺼﻴﺺ اﻷﻧﺴﺐ ﻟﻠﻤﻮارد ﻋﺒﺮ ﻣﺨﺘﻠﻒ ﻣﺴﺘﻮﻳﺎت اﻟﻨﻈﺎم اﻟﺼﺤﻲ؛ • ﺗﺤﺪﻳﺪ ﻣﺼﺎدر اﻟﺘﻤﻮﻳﻞ اﻟﻤﺤﺘﻤﻠﺔ واﻟﻤﻮﺛﻮﻗﺔ. وﻫﻨﺎك ﺣﺎﺟﺔ إﻟﻰ اﻹﺟﺮاءات واﻟﺘﺪﺧﻼت اﻟﺘﻲ ﻳﻌﺎد ﺗﺮﻛﻴﺰﻫﺎ واﻟﺘﻲ ﻣﺘﺠﺪد ﺑﺎﻻﺳﺘﺜﻤﺎر ،وذﻟﻚ ﻃﻮال ﻳﻤﻜﻨﻬﺎ ﺗﻌﺰﻳﺰ اﻷﺛﺮ ،وإﻟﻰ اﻟﺘﺰام ﱢ اﻟﺴﻨﻮات اﻟﺴﺖ اﻟﺘﻲ ﺗﻐﻄﻴﻬﺎ ﻣﺴﻮدة ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ. ﻣﺒﺮرات ﻟﻬﺬا اﻻﺳﺘﺜﻤﺎر ،ﺣﻴﺚ ﺗﺤﺪد وﺗﻘﺪم ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﱢ ﺗﻮﺟﻬﺎت اﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﺘﺮﻛﱢ ﺰ ﻋﻠﻴﻬﺎ إﺟﺮاءات اﻟﺒﺮاﻣﺞ اﻟﻘﻄﺮﻳﺔ ﺧﻤﺴﺔ ﱡ وﺑﺮاﻣﺞ ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ،ﻛﻤﺎ ﺗﺒﻴﻦ اﻟﺘﺪﺧﻼت واﻻﺑﺘﻜﺎرات ذات اﻷوﻟﻮﻳﺔ اﻟﺘﻲ ﻳﻤﻜﻨﻬﺎ ﺗﺤﻘﻴﻖ أﻋﻈﻢ اﻷﺛﺮ.
ﺻﻴﺎﻏﺔ ﻣﺒﺮرات اﻻﺳﺘﺜﻤﺎر
إن ﻣﻌﻈﻢ اﻷدوات اﻟﻤﻄﻠﻮﺑﺔ ﻟﺘﺤﻘﻴﻖ اﻟﻐﺎﻳﺎت ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻓﻲ ﻣﺘﻨﺎول أﻳﺪﻳﻨﺎ ،وﻫﻨﺎك اﻟﻌﺪﻳﺪ ﻣﻦ اﻟﺘﺤﺪﻳﺜﺎت واﻻﺑﺘﻜﺎرات اﻟﻮﺷﻴﻜﺔ اﻟﻈﻬﻮر واﻟﺘﻲ ﻗﺪ ﺗﻜﻮن ﺑﺎﻟﻐﺔ اﻷﻫﻤﻴﺔ .ﺑﻴﺪ أن اﻻﺳﺘﻔﺎدة ﻣﻦ أﻗﺼﻰ ﻗﺪر ﻣﻤﻜﻦ ﻣﻦ ﻓﻌﺎﻟﻴﺘﻬﺎ ﻳﺘﻄﻠﺐ اﻟﺘﻌﺰﻳﺰ اﻟﺴﺮﻳﻊ ﻓﻲ اﻻﺳﺘﺜﻤﺎرات اﻟﻤﺘﻮاﻓﺮة ﺣﺎﻟﻴﺎً ﻓﻲ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﺗﺮﻛﻴﺰ اﻟﻤﻮارد ﻋﻠﻰ ﻛﻞ ﻣﻦ اﻟﺨﺪﻣﺎت واﻟﺘﺪﺧﻼت اﻷﻛﺜﺮ ﻓﻌﺎﻟﻴﺔ وﻋﻠﻰ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻮاﻗﻊ اﻟﺠﻐﺮاﻓﻴﺔ اﻟﺘﻲ ﺗﺸﻬﺪ أﻋﻠﻰ ﻣﻌﺪﻻت ﺳﺮﻳﺎن اﻟﻔﻴﺮوس وﺗﻌﺎﻧﻲ ﻣﻦ ﺣﺸﺪت ﻣﻦ ﺟﻤﻴﻊ اﻟﻤﺼﺎدر أﻋﻠﻰ ﻋﺐء ﻟﻪ .وازدادت اﻟﻤﻮارد اﻟﺘﻲ ُ ﻟﺒﺮاﻣﺞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ اﻟﺒﻠﺪان اﻟﻤﻨﺨﻔﻀﺔ واﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ ﺑﻤﻘﺪار ٢٥٠ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ إﺿﺎﻓﻲ ﻋﻦ ﻣﺴﺘﻮاﻫﺎ اﻟﺬي ﻛﺎﻧﺖ ﻋﻠﻴﻪ ﻓﻲ ﻋﺎم ٢٠١٢ﻟﺘﺼﻞ إﻟﻰ ١٩ ١٠٠ ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ ﻓﻲ ﻋﺎم ،٢٠١٣ﺛﻢ ازدادت ﻣﺮة ﺛﺎﻧﻴﺔ إﻟﻰ ﺣﻮاﻟﻲ ٢١ ٠٠٧ﻣﻼﻳﻴﻦ دوﻻر أﻣﺮﻳﻜﻲ ﻓﻲ ﻋﺎم .٢٠١٥وﺟﺎءت ﻫﺬه اﻻﺗﺠﺎﻫﺎت ﻓﻲ اﻟﺰﻳﺎدة ﻓﻲ اﻟﻤﻘﺎم اﻷول ﻧﺘﻴﺠﺔ ازدﻳﺎد اﻻﺳﺘﺜﻤﺎرات اﻟﻤﺤﻠﻴﺔ اﻟﺘﻲ ﺷﻜﻠﺖ ٪٥٧ﻣﻦ إﺟﻤﺎﻟﻲ اﻟﻤﻮارد ﻓﻲ ﻋﺎم .٢٠١٤ وﻣﻊ ذﻟﻚ ،ﻓﺴﻮف ﻳﺘﻌﻴﻦ زﻳﺎدة اﻻﺳﺘﺜﻤﺎرات اﻟﻤﻮﺟﻬﺔ إﻟﻰ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻟﻰ ٣١٩٠٠ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ ﻓﻲ ﻋﺎم ،٢٠٢٠وإﻟﻰ ٢٩ ٣٠٠ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ ﻓﻲ ﻋﺎم ٢٠٣٠ إذا أرﻳﺪ ﺗﺤﻘﻴﻖ ﻣﻜﺎﻓﺤﺔ اﻟﻮﺑﺎء ﻋﻠﻰ اﻟﻤﺪى اﻟﻄﻮﻳﻞ. ﻟﻘﺪ اﻛﺘﺴﺒﺖ ﺑﻠﺪان ﻛﺜﻴﺮة ﺧﺒﺮة واﺳﻌﺔ ﻓﻲ ﺗﺼﻤﻴﻢ وﺗﻨﻔﻴﺬ ﺧﺪﻣﺎت ﻋﺎﻟﻴﺔ اﻟﺘﻐﻄﻴﺔ وﻋﺎﻟﻴﺔ اﻟﺠﻮدة وﺷﺎﻣﻠﺔ ﻓﻲ ﻣﺠﺎل اﻟﺘﻌﺮض ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻛﺎن ﻟﻬﺎ أﺛﺮ ﻛﺒﻴﺮ ﻋﻠﻰ ﱡ ﻟﻤﺨﺎﻃﺮ اﻟﻌﺪوى ﺑﺎﻟﻔﻴﺮوس ،وﻋﻠﻰ ﻣﻌﺪﻻت ﺣﺪوﺛﻪ ،وﻣﻌﺪﻻت اﻟﻤﺮاﺿﺔ واﻟﻮﻓﻴﺎت اﻟﻨﺎﺗﺠﺔ ﻋﻨﻪ ،وﻧﻮﻋﻴﺔ وﺟﻮدة ﺣﻴﺎة اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻌﻪ .وﻫﻨﺎك ﻓﺮص ﻛﺜﻴﺮة أﻣﺎم اﻟﺒﻠﺪان ﻟﺘﺤﻘﻴﻖ ﻗﻔﺰة ﻛﺒﻴﺮة ﻓﻲ أﻧﺸﻄﺔ اﺳﺘﺠﺎﺑﺘﻬﺎ ﻟﻠﻔﻴﺮوس واﻟﺘﻌﻠﻢ ﻣﻦ اﻟﺒﻠﺪان اﻷﺧﺮى ﺑﺤﻴﺚ ﻳﺘﺴﻨﻰ ﻟﻬﺎ ﺗﻜﻴﻴﻒ اﻟﺴﻴﺎﺳﺎت واﻟﺨﺪﻣﺎت واﻟﺘﺪﺧﻼت اﻷﺷﺪ ﻓﻌﺎﻟﻴﺔ وﺗﻨﻔﻴﺬﻫﺎ ﺑﺴﺮﻋﺔ. وﻓﻲ ﻇﻞ ﻣﺤﺪودﻳﺔ اﻟﻤﻮارد اﻟﻤﺘﺎﺣﺔ ،ﺗﺤﺘﺎج اﻟﺒﻠﺪان إﻟﻰ اﻟﺘﺨﻄﻴﻂ ﺑﻌﻨﺎﻳﺔ ﺑﺤﻴﺚ ﺗﻀﻊ ﻏﺎﻳﺎت ﻃﻤﻮﺣﺔ ﻟﻜﻨﻬﺎ واﻗﻌﻴﺔ ﻋﻠﻰ اﻟﺼﻌﻴﺪ
ﺻﻴﺎﻏﺔ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ
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ﺗﻌﺘﺒﺮ ﻣﺴﻮدة اﺳﺘﺮاﺗﻴﺠﻴﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺣﻠﻘﺔ ﻓﻲ ﺳﻠﺴﻠﺔ ﺗﺘﺄﻟﻒ ﻣﻦ ﺛﻼث اﺳﺘﺮاﺗﻴﺠﻴﺎت ،وﺗﺘﻌﻠﻖ ﺑﻘﻄﺎع اﻟﺼﺤﺔ ﻓﻲ اﻟﻔﺘﺮة ،٢٠٢٠–٢٠١٦واﻟﺘﻲ ﺗﺘﻀﻤﻦ ﻣﺴﻮدة اﺳﺘﺮاﺗﻴﺠﻴﺔ ﻹﻧﻬﺎء وﺑﺎء اﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ واﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﻠﻘﻀﺎء ﻋﻠﻰ وﺑﺎء اﻟﻌﺪوى اﻟﻤﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎً . ﻫﻴﻜﻼ ﻣﺸﺘﺮﻛﺎً ،ﻟﺘﻌﺘﻤﺪ ﻋﻠﻰ ﺛﻼﺛﺔ أﻃﺮ ﺗﻨﻈﻴﻤﻴﺔ ،وﻫﻲ: وﺗﺴﺘﺨﺪم ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت ً اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ ،واﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﻠﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ،وﻧﻬﺞ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ .وﻗﺪ ﻤﻤﺖ ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﺜﻼث ﺟﻤﻴﻌﻬﺎ ﻟﻠﻤﺴﺎﻫﻤﺔ ﻓﻲ ﺑﻠﻮغ ﻫﺪف اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ ﺻﱢ ُ اﻟﻤﻌﻨﻲ ﺑﺎﻟﺼﺤﺔ )اﻟﻬﺪف .(٣وﺗﺼﻒ ﻣﺴﻮدة اﺳﺘﺮاﺗﻴﺠﻴﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻄﺮﻳﻘﺔ اﻟﺘﻲ ﻳﻤﻜﻦ أن ﺗﺴﻬﻢ ﺑﻬﺎ اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ ﺗﺤﻘﻴﻖ ﻏﺎﻳﺔ ”إﻧﻬﺎء اﻷﻳﺪز“ واﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ وﻏﻴﺮﻫﻤﺎ ﻣﻦ اﻟﻐﺎﻳﺎت اﻟﺼﺤﻴﺔ واﻹﻧﻤﺎﺋﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ .ﻛﻤﺎ ﺗﺘﺴﻖ ﻣﺴﻮدة اﺳﺘﺮاﺗﻴﺠﻴﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻊ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﺼﺤﻴﺔ اﻷﺧﺮى ذات اﻟﺼﻠﺔ ،وأﺑﺮزﻫﺎ اﺳﺘﺮاﺗﻴﺠﻴﺔ إﻧﻬﺎء اﻟﺴﻞ ١١،واﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز )ﺳﺎﻟﻔﺔ اﻟﺬﻛﺮ( ،واﺳﺘﺮاﺗﻴﺠﻴﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻷﺧﺮى )اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻟﺸﺮﻛﺎء اﻟﺮﺋﻴﺴﻴﻴﻦ واﻻﺳﺘﺮاﺗﻴﺠﻴﺎت ذات اﻟﻄﺒﻴﻌﺔ اﻟﻘﻄﺎﻋﻴﺔ وﻣﺘﻌﺪدة اﻟﻘﻄﺎﻋﺎت(. ١١اﺳﺘﺮاﺗﻴﺠﻴﺔ إﻧﻬﺎء )دﺣﺮ( اﻟﺴﻞ ،اﻧﻈﺮ) http://www.who.int/tb/strategy/en/ :ﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس .(٢٠١٦
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ - إﻃﺎر ﺟﺎﻣﻊ ﻋﻠﻰ اﻟﻤﺴﺘﻮى اﻟﻌﺎﻟﻤﻲ ،ﻳﺼﺎب ١٥٠ﻣﻠﻴﻮن ﺷﺨﺺ ﺑﻜﺎرﺛﺔ ﻣﺎﻟﻴﺔ وﻳﻌﺎﻧﻲ ١٠٠ﻣﻠﻴﻮن ﺷﺨﺺ ﻛﻞ ﻋﺎم ﻣﻦ اﻟﻔﻘﺮ ﺑﺴﺒﺐ ﻧﻔﻘﺎت اﻟﻌﻼج اﻟﺘﻲ ﻳﺪﻓﻌﻬﺎ اﻷﻓﺮاد ﻣﺒﺎﺷﺮة ﻣﻦ ﺟﻴﻮﺑﻬﻢ .وﺗﺮﻛﱢ ﺰ أﻫﺪاف اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ ﻋﻠﻰ أﻫﻤﻴﺔ ﺿﻤﺎن اﻷﻣﻦ اﻟﻤﺎﻟﻲ واﻹﻧﺼﺎف ﻓﻲ ﻣﺠﺎل اﻟﺼﺤﺔ ،وﺗﻮﻓﺮ اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ إﻃﺎراً ﻟﺘﻠﺒﻴﺘﻬﻤﺎ .وﺗﺘﺤﻘﻖ اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ )اﻧﻈﺮ اﻟﺸﻜﻞ (٤ ﻋﻨﺪﻣﺎ ﻳﺤﺼﻞ ﺟﻤﻴﻊ اﻟﻨﺎس ﻋﻠﻰ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻟﺘﻲ ﻳﺤﺘﺎﺟﻮن إﻟﻴﻬﺎ ،وﺗﻜﻮن ﻫﺬه اﻟﺨﺪﻣﺎت ذات ﺟﻮدة ﻛﺎﻓﻴﺔ ﻹﺣﺪاث ﺗﺄﺛﻴﺮ إﻳﺠﺎﺑﻲ ،دون ﻣﻌﺎﻧﺎة أوﻟﺌﻚ اﻟﻨﺎس ﻟﺼﻌﻮﺑﺎت ﻣﺎﻟﻴﺔ .وﻫﻲ ﺗﺸﺘﻤﻞ ﻋﻠﻰ ﺛﻼث ﻏﺎﻳﺎت ﻣﺘﺮاﺑﻄﺔ :ﺗﺤﺴﻴﻦ ﻧﻄﺎق اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻟﻀﺮورﻳﺔ وﺟﻮدﺗﻬﺎ وﺗﻮاﻓﺮﻫﺎ )ﺗﻐﻄﻴﺔ ﻧﻄﺎق اﻟﺨﺪﻣﺎت اﻟﺘﻲ ﻳﺤﺘﺎج اﻟﻨﺎس إﻟﻴﻬﺎ( ،وﺗﺤﺴﻴﻦ اﻻﻧﺘﻔﺎع اﻟﻤﻨﺼﻒ واﻷﻣﺜﻞ ﺑﺎﻟﺨﺪﻣﺎت اﺳﺘﻨﺎداً إﻟﻰ اﻟﺤﺎﺟﺔ )ﺗﻐﻄﻴﺔ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺤﺘﺎﺟﺔ إﻟﻰ اﻟﺨﺪﻣﺎت( ،وﺧﻔﺾ اﻟﺘﻜﺎﻟﻴﻒ وﺗﻮﻓﻴﺮ اﻟﺤﻤﺎﻳﺔ اﻟﻤﺎﻟﻴﺔ ﻟﻤﻦ ﻳﺤﺘﺎﺟﻮن إﻟﻰ اﻟﺨﺪﻣﺎت )ﺗﻐﻄﻴﺔ ﺗﻜﺎﻟﻴﻒ اﻟﺨﺪﻣﺎت(. وﻣﻊ ازدﻳﺎد اﻟﻤﻮارد وﺗﻮﺳﻊ ﺟﻮاﻧﺐ اﻟﻜﻔﺎءة واﻟﻘﺪرات ،ﻳﻤﻜﻦ اﻟﻤﻘﺪﻣﺔ ،وﺗﺤﺴﻴﻦ ﺟﻮدﺗﻬﺎ ،وﺗﻐﻄﻴﺔ ﺗﻮﺳﻴﻊ ﻧﻄﺎق اﻟﺨﺪﻣﺎت ﱠ اﻟﻤﺰﻳﺪ ﻣﻦ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ ،ﻣﻊ ﺗﺤﻤﻴﻞ ﻗﺪر أﻗﻞ ﻣﻦ اﻟﺘﻜﺎﻟﻴﻒ اﻟﻤﺒﺎﺷﺮة ﻋﻠﻰ ﻣﻦ ﻳﺤﺘﺎﺟﻮن إﻟﻰ اﻟﺨﺪﻣﺎت ،ﻣﻤﺎ ﻳﻌﻨﻲ ﺗﺤﻘﻴﻖ اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ ﺗﺪرﻳﺠﻴﺎً .
أﻫﺪاف اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ – ﺗﻘﺪﻳﻢ اﻟﺘﻮﺟﻴﻪ ﺗﺘﻀﻤﻦ أﻫﺪاف اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ ﺧﻄﺔ إﻧﻤﺎﺋﻴﺔ ﻃﻤﻮﺣﺔ وﺷﺎﻣﻠﺔ ﻟﻠﻔﺘﺮة ،٢٠٣٠ –٢٠١٦وﺗﺸﻜﻞ اﻟﺼﺤﺔ أﺣﺪ اﻷﻫﺪاف اﻟﺮﺋﻴﺴﻴﺔ ﻓﻲ ﺧﻄﺔ ﻣﺎ ﺑﻌﺪ ﻋﺎم ،٢٠١٥ﻣﻤﺎ ﻳﻌﻜﺲ دورﻫﺎ اﻟﻤﺤﻮري ﻓﻲ ﺗﺨﻔﻴﻒ ﺣﺪة اﻟﻔﻘﺮ وﺗﻴﺴﻴﺮ اﻟﺘﻨﻤﻴﺔ .وﻳﺘﺼﺪى اﻟﻬﺪف اﻟﻤﺘﻌﻠﻖ ﺑﺎﻟﺼﺤﺔ ﻣﻦ أﻫﺪاف اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ )اﻟﻬﺪف (٣ﻟﻤﺠﻤﻮﻋﺔ ﻣﻦ اﻟﺘﺤﺪﻳﺎت اﻟﺼﺤﻴﺔ اﻟﺒﺎﻟﻐﺔ اﻷﻫﻤﻴﺔ ﻟﻠﺘﻨﻤﻴﺔ ،وأﺑﺮزﻫﺎ اﻟﻐﺎﻳﺔ ٣-٣اﻟﻤﺘﻌﻠﻘﺔ ١٢ ﺑﺎﻷﻣﺮاض اﻟﺴﺎرﻳﺔ ،وﻫﻮ ﻣﺎ ﻳﺸﻤﻞ إﻧﻬﺎء )دﺣﺮ( وﺑﺎء اﻷﻳﺪز. وﺳﻮف ﺗﺆﺛﺮ اﻟﺠﻬﻮد اﻟﺮاﻣﻴﺔ إﻟﻰ إﻧﻬﺎء اﻷﻳﺪز أﻳﻀﺎً ﻓﻲ اﻟﻐﺎﻳﺎت اﻟﺼﺤﻴﺔ اﻷﺧﺮى ،وﻣﻦ ﺿﻤﻨﻬﺎ ﺧﻔﺾ ﻣﻌﺪل وﻓﻴﺎت اﻷﻣﻮﻣﺔ )اﻟﻐﺎﻳﺔ (١-٣واﻟﻮﻗﺎﻳﺔ ﻣﻦ وﻓﻴﺎت ﺣﺪﻳﺜﻲ اﻟﻮﻻدة واﻷﻃﻔﺎل دون اﻟﺨﺎﻣﺴﺔ ﻣﻦ اﻟﻌﻤﺮ )اﻟﻐﺎﻳﺔ (٢-٣وﺧﻔﺾ ﻣﻌﺪل اﻟﻮﻓﻴﺎت اﻟﻨﺎﺟﻤﺔ ﻋﻦ اﻷﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ وﺗﻌﺰﻳﺰ اﻟﺼﺤﺔ اﻟﻨﻔﺴﻴﺔ )اﻟﻐﺎﻳﺔ (٤-٣ واﻟﻮﻗﺎﻳﺔ ﻣﻦ اﺿﻄﺮاﺑﺎت ﺗﻌﺎﻃﻲ ﻣﻮاد اﻹدﻣﺎن وﻋﻼﺟﻬﺎ )اﻟﻐﺎﻳﺔ (٥-٣واﻟﺼﺤﺔ اﻟﺠﻨﺴﻴﺔ واﻹﻧﺠﺎﺑﻴﺔ )اﻟﻐﺎﻳﺔ (٧-٣وﺗﺤﻘﻴﻖ اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ )اﻟﻐﺎﻳﺔ (٨-٣وإﺗﺎﺣﺔ أدوﻳﺔ وﻟﻘﺎﺣﺎت ﻣﻴﺴﻮرة اﻟﺘﻜﻠﻔﺔ )اﻟﻐﺎﻳﺔ -٣ب( واﻟﺘﻤﻮﻳﻞ اﻟﺼﺤﻲ واﻟﻘﻮى اﻟﻌﺎﻣﻠﺔ اﻟﺼﺤﻴﺔ )اﻟﻐﺎﻳﺔ -٣ج( .وﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ أﺛﺮه ﻋﻠﻰ اﻟﻬﺪف ،٣ﺳﻴﺴﻬﻢ إﻧﻬﺎء وﺑﺎء اﻷﻳﺪز ﻓﻲ إﻧﻬﺎء اﻟﻔﻘﺮ )اﻟﻬﺪف (١وإﻧﻬﺎء اﻟﺠﻮع )اﻟﻬﺪف (٢وﺗﺤﻘﻴﻖ اﻟﻤﺴﺎواة ﺑﻴﻦ اﻟﺠﻨﺴﻴﻦ وﺗﻤﻜﻴﻦ اﻟﻨﺴﺎء واﻟﻔﺘﻴﺎت )اﻟﻬﺪف (٥واﻟﺤﺪ ﻣﻦ ﻋﺪم اﻟﻤﺴﺎواة ﻓﻲ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺨﺪﻣﺎت واﻟﺴﻠﻊ )اﻟﻬﺪف (١٠وﺗﺸﺠﻴﻊ اﻟﻤﺠﺘﻤﻌﺎت اﻟﺸﺎﻣﻠﺔ ﻟﻠﺠﻤﻴﻊ اﻟﺘﻲ ﺗﺸﺠﻊ ﻋﺪم اﻟﺘﻤﻴﻴﺰ )اﻟﻬﺪف (١٦واﻟﺘﻤﻮﻳﻞ وﺑﻨﺎء اﻟﻘﺪرات ﻣﻦ أﺟﻞ اﻟﺘﻨﻔﻴﺬ )اﻟﻬﺪف .(١٧
اﻟﺸﻜﻞ :٤اﻷﺑﻌﺎد اﻟﺜﻼﺛﺔ ﻟﻠﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ
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ěĔŨİĭŤē ěĔŨİĭŤēĔŨ ȗĚżʼnŕĝŤĔĖĚŤŵũĽũŤē
ūĔšĹŤē ȗĚżʼnŕĝŤĔĖţŵũĽũŤēŮŨ
١٢ﻗﺮار اﻟﺠﻤﻌﻴﺔ اﻟﻌﺎﻣﺔ ﻟﻸﻣﻢ اﻟﻤﺘﺤﺪة – ١/٧٠ﺗﺤﻮﻳﻞ ﻋﺎﻟﻤﻨﺎ :ﺧﻄﺔ اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ ﻟﻌﺎم ،٢٠٣٠اﻧﻈﺮ: ) http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=Eﺗﻢ اﻻﻃﻼع ﻓﻲ ١٥آذار /ﻣﺎرس .(٢٠١٦
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي — اﻹﻃﺎر اﻟﺘﻨﻈﻴﻤﻲ وﻳﺠﺐ ﺗﻜﻴﻴﻒ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﻠﺨﺪﻣﺎت ورﺻﺪﻫﺎ ﻟﺘﻼﺋﻢ ﻣﺨﺘﻠﻒ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﺒﻴﺌﺎت وأﻧﻮاع اﻷوﺑﺌﺔ ،وﻓﻲ اﻟﻮﻗﺖ ﻧﻔﺴﻪ ﺿﻤﺎن اﻟﺘﺼﺪي اﻟﺠﻴﺪ ﻟﻸﻣﺮاض اﻟﻤﺘﺮاﻓﻘﺔ اﻟﺸﺎﺋﻌﺔ ،ﻛﺎﻟﺴﻞ واﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ أﻳﻀﺎً .وﺗﺤﺪد ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﺨﺪﻣﺎت واﻟﺘﺪﺧﻼت اﻷﺳﺎﺳﻴﺔ ﻋﻠﻰ اﻣﺘﺪاد ﻫﺬه اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ،وﺗﻮﺻﻲ ﺑﺎﺗﺒﺎع ﺳﺒﻞ ﺗﻀﻤﻦ ﺟﻮدة اﻟﺨﺪﻣﺎت ﺗﺤﺮك اﻟﻨﺎس ﺿﻤﻦ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ واﻟﺒﺮاﻣﺞ وﺗﺤﺴﻴﻨﻬﺎ .وﻣﻊ ﱡ ﻟﺴﻠﺴﻠﺔ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻳﺤﺪث ﻧﻘﺺ ﻻﺑﺪ ﻣﻦ ﻣﺘﺎﺑﻌﺘﻪ؛ ﻷن ﻫﺬا اﻟﺘﺴﺮب ﻳﺘﺴﺒﺐ ﻓﻲ ﺣﺪوث ﺗﺴﻠﺴﻞ اﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﺮﺿﻰ )اﻧﻈﺮ اﻟﺸﻜﻞ .(٥وﻳﺘﻤﺜﻞ اﻟﻬﺪف ﻓﻲ إﺷﺮاك اﻷﻓﺮاد ﻓﻲ أﻗﺮب وﻗﺖ ﻣﻤﻜﻦ ﻋﻠﻰ اﻣﺘﺪاد ﻫﺬه اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ،واﻻﺣﺘﻔﺎظ ﺑﻬﻢ ﻓﻲ اﻟﺮﻋﺎﻳﺔ ،وإﻧﻘﺎص اﻟﺘﺴﺮﺑﺎت إﻟﻰ أﻗﻞ ﻗﺪر ﻣﻤﻜﻦ ﻋﻠﻰ اﻣﺘﺪاد اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﻠﺮﻋﺎﻳﺔ. ﺗﻮﻓﺮ اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ إﻃﺎراً ﺟﺎﻣﻌﺎً ﻟﻤﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ،ﻓﻲ ﺣﻴﻦ ﺗﻮﻓﺮ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ أو اﻟﻤﺘﺴﻠﺴﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻃﺎراً ﺗﻨﻈﻴﻤﻴﺎً ﻟﻠﺘﻨﻔﻴﺬ. ﺑﺎﻟﺒﻴﻨﺎت ﻓﻲ وﻋﻠﻰ اﻟﺒﻠﺪان ﺗﻨﻔﻴﺬ ﺗﺪﺧﻼت ﻋﺎﻟﻴﺔ اﻷﺛﺮ ﻣﺴﻨﺪة ّ اﻟﻨﻄﺎق اﻟﻜﺎﻣﻞ ﻟﺴﻠﺴﻠﺔ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي، واﻟﺘﻲ ﺗﺸﻤﻞ ﺗﺨﻔﻴﻒ ﺳﺮﻋﺔ اﻟﺘﺄﺛﺮ ﺑﺎﻟﻔﻴﺮوس واﻟﺘﻌﺮض ﻟﻠﻤﺨﺎﻃﺮ، واﻟﻮﻗﺎﻳﺔ ،واﻟﺘﺸﺨﻴﺺ ،واﻟﻌﻼج ،ورﻋﺎﻳﺔ اﻟﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ )اﻧﻈﺮ اﻟﺸﻜﻞ ،(٥ﻣﻊ اﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻮاﻗﻊ اﻟﺠﻐﺮاﻓﻴﺔ اﻟﺘﻲ ﻳﺤﺪث ﻓﻴﻬﺎ أﻋﻠﻰ ﻣﻌﺪل ﻻﻧﺘﻘﺎل اﻟﻔﻴﺮوس وﺗﻌﺎﻧﻲ ﻣﻦ أﻋﻠﻰ ﻋﺐء ﻟﻪ.
اﻟﺸﻜﻞ :٥اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﺴﻠﺴﻞ اﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﺮﺿﻰ ﻓﻲ اﻟﺮﻋﺎﻳﺔ
ķŴĴżŘŦŨĔĨ ĵŵőŤēķŴĴżŘŦŨĔĨĴżŔ źĴĽėŤēŽŐĔŭũŤēĵŵőŤē źĴĽėŤēŽŐĔŭũŤē
ķŴĴżŘŦŨĔĨ ĵŵőŤēķŴĴżŘŦŨĔĨĴżŔ źĴĽėŤēŽŐĔŭũŤēĵŵőŤē źĴĽėŤēŽŐĔŭũŤē
ķŴĴżŘŦŨĔĨ ĵŵőŤēķŴĴżŘŦŨĔĨĴżŔ źĴĽėŤēŽŐĔŭũŤēĵŵőŤē źĴĽėŤēŽŐĔŭũŤē
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
ﻧﻬﺞ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﺗﺴﺘﻨﺪ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ إﻟﻰ اﻟﺴﺒﻞ اﻟﻜﺜﻴﺮة اﻟﺘﻲ ﺳﺎﻋﺪت ﺑﻬﺎ أﻧﺸﻄﺔ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻋﻠﻰ ﺗﻌﺰﻳﺰ اﻟﻨﻈﻢ اﻟﺼﺤﻴﺔ ﻓﻲ ﺑﻠﺪان ﻛﺜﻴﺮة ﻋﻠﻰ ﻧﺤﻮ أدى إﻟﻰ اﻻرﺗﻘﺎء ﺑﺠﻮدة اﻟﺨﺪﻣﺎت .وﻗﺎﻣﺖ ﺗﻠﻚ اﻻﺳﺘﺠﺎﺑﺎت ﺑﺎﺑﺘﻜﺎر راﺋﺪ ﻟﻠﻨﻤﺎذج اﻟﻤﺎﻟﻴﺔ وﻻﺳﺘﺮاﺗﻴﺠﻴﺎت ﺧﻔﺾ أﺳﻌﺎر اﻟﺴﻠﻊ واﻟﻤﺨﺎﻃﺮ اﻟﻤﺎﻟﻴﺔ اﻟﺘﻲ ﻳﺘﻌﺮض ﻟﻬﺎ اﻷﻓﺮاد واﻟﻤﺠﺘﻤﻌﺎت ،وﻗﺪ ﺣﻔﺰت ﺗﺪاﺑﻴﺮ اﻟﺘﺼﺪي ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﺘﻮﺻﻞ إﻟﻰ اﻛﺘﺸﺎﻓﺎت ﻋﻠﻤﻴﺔ وﺗﻜﻨﻮﻟﻮﺟﻴﺔ ﻛﺒﻴﺮة وأﺛﺒﺘﺖ أن ﻣﻦ اﻟﻤﻤﻜﻦ ﺗﻮﺳﻴﻊ اﻟﺒﺮاﻣﺞ اﻟﺴﺮﻳﺮﻳﺔ وﺑﺮاﻣﺞ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﺑﺴﺮﻋﺔ ﻓﻲ اﻷوﺿﺎع اﻟﺘﻲ ﺗﻨﻄﻮي ﻋﻠﻰ ﺗﺤﺪﻳﺎت. ﻛﻤﺎ ﻛﺎﻧﺖ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﻤﺜﺎﺑﺔ اﻟﺪاﻓﻊ وراء ﺣﺪوث ﺗﺤﻮﻻت ﻓﻲ أﺳﻠﻮب ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ،وذﻟﻚ ﻣﻦ ﺧﻼل اﻟﺨﺪﻣﺎت اﻟﻼﻣﺮﻛﺰﻳﺔ واﻟﻤﺘﺮاﺑﻄﺔ ،وإﻋﺎدة ﺗﻮزﻳﻊ اﻟﻤﻬﺎم ،وﺗﻘﻮﻳﺔ اﻟﺘﻌﺎون ﺑﻴﻦ اﻟﻘﻄﺎﻋﺎت .وﺗﺘﺠﻠﻰ ﻓﻮاﺋﺪﻫﺎ أﻳﻀﺎً ﻓﻲ ﺗﺤﺴﻴﻦ ﻧﻈﻢ ﺗﻮﻓﻴﺮ رﻋﺎﻳﺔ اﻟﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ وزﻳﺎدة اﻻﻟﺘﺰام ﺑﺎﻟﻌﻼﺟﺎت اﻟﺘﻲ ﺗﺴﺘﻤﺮ ﻓﻀﻼ ﻋﻦ ﺗﺤﺴﻴﻦ اﻟﻨﻈﻢ ﻣﺪى اﻟﺤﻴﺎة واﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﺮﺿﻰ ﻓﻴﻬﺎ، ً اﻟﻤﻌﻨﻴﺔ ﺑﺎﻟﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ ،واﻟﺸﺮاء ،واﻟﺘﻮزﻳﻊ .واﻷﻣﺮ اﻷﻛﺜﺮ أﻫﻤﻴﺔ أﻧﻬﺎ ﺳﺎﻋﺪت ﻋﻠﻰ اﻻﺳﺘﻔﺎدة ﻣﻦ ﻣﺰاﻳﺎ إﺷﺮاك اﻟﻤﺠﺘﻤﻌﺎت ﻓﻲ ﺗﺼﻤﻴﻢ ﺑﺮاﻣﺞ ﻣﻜﺎﻓﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﻨﻔﻴﺬﻫﺎ ورﺻﺪﻫﺎ ،وﺳﻠﻄﺖ اﻟﻀﻮء ﻋﻠﻰ أدوارﻫﺎ ﻓﻲ ﺗﻘﻮﻳﺔ ﻛﻞ ﻣﻦ اﻟﺘﺼﺮﻳﻒ اﻟﺴﺪﻳﺪ ﻟﻠﺸﺆون واﻟﻤﺴﺎءﻟﺔ. ﺗﺴﺘﻨﺪ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ إﻟﻰ ﻧﻬﺞ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ اﻟﺬي ُﻳﻌﻨﻰ ﺑﺎﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻟﻤﺮض ،وﺗﻌﺰﻳﺰ اﻟﺼﺤﺔ ،وإﻃﺎﻟﺔ أﻋﻤﺎر اﻟﺴﻜﺎن إﺟﻤﺎﻻ .وﻫﻲ ﺗﻬﺪف إﻟﻰ ﺿﻤﺎن اﻟﺘﻮﺳﻊ إﻟﻰ أﻗﺼﻰ ﺣﺪ ﻣﻤﻜﻦ ﻓﻲ ً إﺗﺎﺣﺔ ﺧﺪﻣﺎت ﻋﺎﻟﻴﺔ اﻟﺠﻮدة ﻋﻠﻰ ﻣﺴﺘﻮى اﻟﺴﻜﺎن ،وذﻟﻚ اﺳﺘﻨﺎداً إﻟﻰ ﺗﺪﺧﻼت وﺧﺪﻣﺎت ﻣﺒﺴﻄﺔ وﻣﻮﺣﺪة ﻳﻤﻜﻦ ﺗﻮﺳﻴﻊ ﻧﻄﺎﻗﻬﺎ ﺑﺴﻬﻮﻟﺔ ،ﻟﺘﺸﻤﻞ ﺣﺘﻰ اﻷﻣﺎﻛﻦ اﻟﺘﻲ ﺗﻌﺎﻧﻲ ﻣﻦ ﻗﻠﺔ اﻟﻤﻮارد. وﻳﻬﺪف ﻧﻬﺞ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ إﻟﻰ ﺗﺤﻘﻴﻖ اﻹﻧﺼﺎف اﻟﺼﺤﻲ وﺗﻌﺰﻳﺰ اﻟﻤﺴﺎواة ﺑﻴﻦ اﻟﺠﻨﺴﻴﻦ وإﺷﺮاك اﻟﻤﺠﺘﻤﻌﺎت واﻻﺳﺘﻔﺎدة ﻣﻦ اﻟﻘﻄﺎﻋﻴﻦ اﻟﻌﺎم واﻟﺨﺎص ﻓﻲ اﻻﺳﺘﺠﺎﺑﺔ ،وﻳﻌﺰز ﻣﺒﺪأ إدراج اﻟﺼﺤﺔ ﻓﻲ ﺟﻤﻴﻊ اﻟﺴﻴﺎﺳﺎت ﻣﻦ ﺧﻼل إﺻﻼﺣﺎت ﺗﺘﻨﺎول اﻟﻘﻮاﻧﻴﻦ واﻹﺟﺮاءات اﻟﺘﻨﻈﻴﻤﻴﺔ واﻟﺴﻴﺎﺳﺎت ﻋﻨﺪ اﻟﻠﺰوم .ﻛﻤﺎ ﻳﻬﺪف ﻧﻬﺞ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ إﻟﻰ ﺗﻘﻮﻳﺔ اﻟﺘﻜﺎﻣﻞ واﻟﺮواﺑﻂ ﺑﻴﻦ ﺧﺪﻣﺎت ﻛﻼ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺨﺪﻣﺎت اﻷﺧﺮى ،ﻣﻤﺎ ﻳﺤﺴﻦ ً ﻣﻦ اﻷﺛﺮ واﻟﻜﻔﺎءة.
اﻟﺮؤﻳﺔ واﻟﻬﺪف واﻟﻐﺎﻳﺎت
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
ﺗﻨﺺ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻋﻠﻰ رؤﻳﺔ ﻋﺎﻟﻤﻴﺔ وﻋﻠﻰ ﻫﺪف ﻋﺎﻟﻤﻲ وﻋﻠﻰ ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻟﻐﺎﻳﺎت اﻟﻌﺎﻟﻤﻴﺔ ،وﻛﻠﻬﺎ ﻳﺘﺴﻖ ﺗﻤﺎﻣﺎً ﻣﻊ رؤﻳﺔ وﻫﺪف وﻏﺎﻳﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﻤﺘﻌﺪدة اﻟﻘﻄﺎﻋﺎت ﻟﺒﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز وأﻫﺪاف اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ.
اﻟﻬﺪف اﻟﻬﺪف :إﻧﻬﺎء وﺑﺎء ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺎﻋﺘﺒﺎره أﺣﺪ اﻟﺘﻬﺪﻳﺪات اﻟﺘﻲ ﺗﺤﺪق ﺑﺎﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﺑﺤﻠﻮل ﻋﺎم ،٢٠٣٠وذﻟﻚ ﻓﻲ ﺳﻴﺎق ﻳﻀﻤﻦ ﺗﻤﺘﻊ اﻟﺠﻤﻴﻊ ﺑﺼﺤﺔ وﺑﻌﺎﻓﻴﺔ ﻓﻲ ﻛﻞ اﻷﻋﻤﺎر.
اﻟﺮؤﻳﺔ اﻟﺮؤﻳﺔ :اﻧﻌﺪام ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻧﻌﺪام اﻟﻮﻓﻴﺎت اﻟﻨﺎﺟﻤﺔ ﻋﻨﻪ ،واﻧﻌﺪام اﻟﺘﻤﻴﻴﺰ اﻟﻤﺘﻌﻠﻖ ﺑﻪ ،ﻓﻲ ﻋﺎﻟﻢ ﻳﺘﻴﺢ ﻟﻸﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻫﺬا اﻟﻔﻴﺮوس أن ﻳﻨﻌﻤﻮا ﺑﺤﻴﺎة ﻃﻮﻳﻠﺔ وأن ﻳﺘﻤﺘﻌﻮا ﺑﺎﻟﺼﺤﺔ.
اﻟﻐﺎﻳﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻌﺎم ٢٠٢٠ اﻟﻐﺎﻳﺎت اﻟﻌﺎﻟﻤﻴﺔ :إن اﻟﻔﺮﺻﺔ ﺳﺎﻧﺤﺔ أﻣﺎم اﻟﺒﻠﺪان ﻛﻲ ﺗﻘﻔﺰ ﻗﻔﺰة ﺣﺎﺳﻤﺔ ﻹﻧﻬﺎء أوﺑﺌﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﺘﻲ ﺗﺸﻬﺪﻫﺎ ،إذا ﻣﺎ ﻋﻤﻠﺖ ﺑﺴﺮﻋﺔ وﺑﺎﻟﻌﺰم اﻟﺬي ﻳﻜﻔﻲ ﻟﺒﻠﻮغ ﻣﺠﻤﻮﻋﺔ اﻟﻐﺎﻳﺎت اﻟﻄﻤﻮﺣﺔ اﻟﻤﺤﺪدة ﻟﻌﺎم .٢٠٢٠وﺗﻨﻄﺒﻖ ﻫﺬه اﻟﻐﺎﻳﺎت ﻋﻠﻰ اﻟﺠﻤﻴﻊ :اﻷﻃﻔﺎل واﻟﻤﺮاﻫﻘﻴﻦ واﻟﺒﺎﻟﻐﻴﻦ؛ اﻷﻏﻨﻴﺎء واﻟﻔﻘﺮاء؛ اﻟﻨﺴﺎء واﻟﺮﺟﺎل؛ ﺟﻤﻴﻊ اﻟﻤﺠﻤﻮﻋﺎت اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ .وﻳﻌﺘﺒﺮ ﺗﺘﺒﻊ ﺣﺎﻻت اﻟﻌﺪوى اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ َ اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻦ اﻟﻤﺆﺷﺮات اﻟﻤﻬﻤﺔ ﻓﻲ ﻗﻴﺎس اﻟﺘﻘﺪم ﺻﻮب ﺗﺤﻘﻴﻖ ﻫﺪف اﻟﻘﻀﺎء ﻋﻠﻰ وﺑﺎء اﻷﻳﺪز ﺑﻮﺻﻔﻪ ﻣﻦ ﺗﻬﺪﻳﺪات اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﺑﺤﻠﻮل ﻋﺎم .٢٠٣٠
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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اﺳﺘﺪاﻣﺔ اﻟﺘﻤﻮﻳﻞ: • وﺻﻮل إﺟﻤﺎﻟﻲ اﻻﺳﺘﺜﻤﺎرات اﻟﻤﺎﻟﻴﺔ ﻓﻲ اﻟﺘﺼﺪي ﻟﻸﻳﺪز ﻓﻲ اﻟﺒﻠﺪان اﻟﻤﻨﺨﻔﻀﺔ اﻟﺪﺧﻞ واﻟﺒﻠﺪان اﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ ﻟﻤﺎ ﻻ ﻳﻘﻞ ﻋﻦ ٣٠ﻣﻠﻴﺎر دوﻻر أﻣﺮﻳﻜﻲ ،ﻣﻊ ازدﻳﺎد ﻣﺘﻮاﺻﻞ ﻣﻦ اﻟﻤﺴﺘﻮﻳﺎت اﻟﺤﺎﻟﻴﺔ ﻟﻠﻤﻮارد اﻟﻌﻤﻮﻣﻴﺔ اﻟﻤﺤﻠﻴﺔ؛ • ﺿﻤﺎن إدﻣﺎج ﺟﻤﻴﻊ اﻟﺒﻠﺪان ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻷﺳﺎﺳﻴﺔ ﻓﻲ اﻟﺘﺮﺗﻴﺒﺎت اﻟﻮﻃﻨﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ اﻟﺼﺤﻲ.
اﻟﻮﻓﻴﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي: • ﺧﻔﺾ ﻋﺪد اﻟﻮﻓﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ اﻟﻤﺮﺗﺒﻄﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻟﻰ أﻗﻞ ﻣﻦ ٥٠٠ ٠٠٠؛ • ﺧﻔﺾ ﻋﺪد اﻟﻮﻓﻴﺎت اﻟﻨﺎﺟﻤﺔ ﻋﻦ اﻟﺴﻞ ﺑﻴﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻨﺴﺒﺔ ٪٧٥؛ • ﺧﻔﺾ ﻋﺪد اﻟﻮﻓﻴﺎت اﻟﻨﺎﺟﻤﺔ ﻋﻦ اﻟﺘﻬﺎب اﻟﻜﺒﺪ Bو Cﺑﻴﻦ اﻷﺷﺨﺎص اﻟﻤﺼﺎﺑﻴﻦ ﺑﻌﺪوى ﻣﺼﺎﺣﺒﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻨﺴﺒﺔ ،٪١٠وذﻟﻚ اﺗﺴﺎﻗﺎً ﻣﻊ اﻟﻐﺎﻳﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻟﻮﻓﻴﺎت ﺑﻴﻦ ﺟﻤﻴﻊ اﻟﻤﺼﺎﺑﻴﻦ ﺑﻌﺪوى ﻣﺰﻣﻨﺔ ﺑﺎﻟﺘﻬﺎب اﻟﻜﺒﺪ B و.C
اﻻﺑﺘﻜﺎر: • زﻳﺎدة اﻟﺒﺤﻮث ﻓﻲ ﻣﺠﺎل ﺗﻄﻮﻳﺮ اﻟﻠﻘﺎﺣﺎت واﻷدوﻳﺔ ذات اﻟﺼﻠﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وزﻳﺎدة ﺗﻄﻮﻳﺮﻫﺎ ﻻﺳﺘﺨﺪاﻣﻬﺎ ﻓﻲ اﻟﻌﻼج واﻟﻮﻗﺎﻳﺔ؛ • ﺗﻮﻓﻴﺮ ٪٩٠ﻣﻦ اﻟﺒﻠﺪان اﻟﺤﺼﻮل ﻋﻠﻰ ﺧﺪﻣﺎت ﺻﺤﻴﺔ ﻣﺘﻜﺎﻣﻠﺔ ﺗﺸﻤﻞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺴﻞ واﻟﺘﻬﺎب اﻟﻜﺒﺪ Bو Cواﻟﺼﺤﺔ اﻹﻧﺠﺎﺑﻴﺔ واﻷﻣﺮاض اﻟﻤﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎً .
إﺟﺮاء اﻻﺧﺘﺒﺎرات واﻟﻌﻼج: • ﺿﻤﺎن ﻣﻌﺮﻓﺔ ٪٩٠ﻣﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺤﺎﻟﺘﻬﻢ ﻣﻦ ﺣﻴﺚ اﻹﺻﺎﺑﺔ ﺑﺎﻟﻔﻴﺮوس؛ • ﺿﻤﺎن ﺗﻠﻘﻲ ٪٩٠ﻣﻤﻦ ﺗﻢ ﺗﺸﺨﻴﺺ إﺻﺎﺑﺘﻬﻢ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻋﻼﺟﺎً ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ؛ • ﺿﻤﺎن أن ٪٩٠ﻣﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز ﻤﻞ اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻟﺬﻳﻦ ﻳﺘﻠﻘﻮن اﻟﻌﻼج ،ﻳﺤﻘﻘﻮن ﻛﺒﺘﺎً ِ ﻟﻠﺤ ْ اﻟﻔﻴﺮوﺳﻲ. ّ
اﻟﻮﻗﺎﻳﺔ: • ﺧﻔﺾ ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻟﻰ أﻗﻞ ﻣﻦ ٥٠٠ ٠٠٠؛ • اﻧﻌﺪام ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻴﻦ اﻟﺮﺿﻊ.
اﻟﺘﻤﻴﻴﺰ: • اﻧﻌﺪام اﻟﻘﻮاﻧﻴﻦ اﻟﺘﻤﻴﻴﺰﻳﺔ ذات اﻟﺼﻠﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻧﻌﺪام اﻟﺘﻤﻴﻴﺰ اﻟﻤﺘﻌﻠﻖ ﺑﺎﻟﻔﻴﺮوس ﻓﻲ ﺟﻤﻴﻊ اﻷوﺳﺎط ،وﺧﺼﻮﺻﺎً ﻓﻲ ﻣﻮاﻗﻊ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ؛ • إﺑﻼغ ٪٩٠ﻣﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻌ ﱠﺮﺿﺔ اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ َ ﻟﻠﻤﺨﺎﻃﺮ ﻋﻦ ﻋﺪم ﺗﻌﺮﺿﻬﻢ ﻟﻠﺘﻤﻴﻴﺰ ﻓﻲ ﻗﻄﺎع اﻟﺼﺤﺔ.
ﺧﻔﺾ ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻟﻰ أﻗﻞ ﻣﻦ
*٥٠٠ ٠٠٠ *اﻟﻐﺎﻳﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻌﺎم ٢٠٢٠
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
– ٠٥ﺑﻴﺎن ﻛﻴﻔﻴﺔ اﺳﺘﺨﺪام اﻟﻌﻮازل اﻷﻧﺜﻮﻳﺔ – ﻣﻴﺎﻧﻤﺎر
اﻟﻐﺎﻳﺎت ﻋﻠﻰ اﻟﻤﺴﺘﻮى اﻟﻘﻄﺮي ﻟﻌﺎم ٢٠٢٠ ﺗﻄﻮر وﺑﺄﻗﺼﻰ ﺳﺮﻋﺔ ﻣﻤﻜﻨﺔ ﻏﺎﻳﺎت وأﻫﺪاﻓﺎً وﻃﻨﻴﺔ ﻋﻠﻰ اﻟﺒﻠﺪان أن ﱢ ﻟﻌﺎم ٢٠٢٠وﻣﺎ ﺑﻌﺪه ﻣﺴﺘﺮﺷﺪة ﻓﻲ اﻟﺤﺎﻻت اﻟﻤﺜﻠﻰ ﺑﺎﻟﻐﺎﻳﺎت واﻷﻫﺪاف اﻟﻌﺎﻟﻤﻴﺔ ،وأن ﺗﺄﺧﺬ ﻫﺬه اﻷﻫﺪاف واﻟﻐﺎﻳﺎت ﻓﻲ اﻋﺘﺒﺎرﻫﺎ اﻟﺴﻴﺎق اﻟﻘﻄﺮي واﻟﺬي ﻳﺸﻤﻞ ﻃﺒﻴﻌﺔ دﻳﻨﺎﻣﻴﻜﻴﺔ أوﺑﺌﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ ﻈﻢ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﻘﻄﺮ واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺘﻀﺮرة وﺑﻨﻴﺔ وﻗﺪرات ﻧُ ُ واﻟﻤﺠﺘﻤﻊ واﻟﻤﻮارد اﻟﺘﻲ ﻳﻤﻜﻦ ﺣﺸﺪﻫﺎ .وﻳﻨﺒﻐﻲ أن ﺗﻜﻮن اﻟﻐﺎﻳﺎت ﻣﻤﻜﻨﺔ اﻟﺒﻴﻨﺎت اﻟﺘﻲ ﻳﻤﻜﻦ أن ﺗﺘﻮاﻓﺮ ﺣﻮل وﺿﻊ اﻟﺘﺤﻘﻴﻖ وأن ﺗﺴﺘﻨﺪ إﻟﻰ أﻓﻀﻞ ﱢ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﺗﺠﺎﻫﺎﺗﻪ واﻻﺳﺘﺠﺎﺑﺔ ﻟﻪ ،ورﺻﺪه ﻣﻦ ﺧﻼل ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻟﻤﻌﺎﻳﻴﺮ واﻟﻤﺆﺷﺮات اﻟﺘﻲ ﻳﻤﻜﻦ ﻗﻴﺎﺳﻬﺎ .وﻳﻨﺒﻐﻲ أن ﺗﻨﻄﺒﻖ اﻟﻐﺎﻳﺎت ﻋﻠﻰ اﻟﺠﻤﻴﻊ.
اﻟﺘﻮﺟﻬﺎت ﱡ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ واﻹﺟﺮاءات ذات اﻷوﻟﻮﻳﺔ
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ﻟﺘﺤﻘﻴﻖ اﻟﻐﺎﻳﺎت اﻟﻤﺤﺪدة ﻟﻌﺎﻣﻲ ٢٠٢٠و ،٢٠٣٠ﻻﺑﺪ ﻣﻦ اﺗﺨﺎذ إﺟﺮاءات ﻓﻲ ﺧﻤﺴﺔ ﻣﺠﺎﻻت ﺗﻌﺮف ﺑﺎﺳﻢ ﺟﻪ ﻣﻦ “ ﻮﱡ اﻟﺘﻮﺟﻬﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ” .وﺿﻤﻦ ﻛﻞ ﺗَ َ ﱡ دة ﺪَ ﺤﱠ ﻣَ اﻟﺘﻮﺟﻬﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻫﺬه ﻫﻨﺎك إﺟﺮاءات ُ ﱡ ﻋﻠﻰ اﻟﺒﻠﺪان وﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ واﻟﺸﺮﻛﺎء أن وﺗﻮﺿﺢ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻹﺟﺮاءات ذات ﱢ ﺗﺘﺨﺬﻫﺎ. اﻷوﻟﻮﻳﺔ اﻟﺘﻲ ﻳﻨﺒﻐﻲ أن ﺗﺘﺨﺬﻫﺎ اﻟﺒﻠﺪان وﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ،واﻟﻤﻘﺼﻮد ﻣﻦ اﻹﺟﺮاءات اﻟﻤﻘﺘَ َﺮﺣﺔ ﺗﻮﺟﻴﻪ اﻟﺠﻬﻮد اﻟﺘﻲ ﻳﺒﺬﻟﻬﺎ اﻟﺒﻠﺪ ،ﻓﺎﺧﺘﻴﺎر اﻟﺒﻠﺪان ﻟﻬﺬه اﻹﺟﺮاءات اﻷﻛﺜﺮ ﻣﻼﺋﻤﺔ ﻷوﺑﺌﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﻘﻄﺮي ،ﻳﺄﺧﺬ ﺑﺎﻻﻋﺘﺒﺎر اﻟﺘﺸﺮﻳﻌﺎت اﻟﺒﺸﺮي وﻟﻠﺴﻴﺎق ُ واﻟﻘﻮاﻧﻴﻦ اﻟﻮﻃﻨﻴﺔ .ﻛﻤﺎ أن اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﺗﻬﺪف إﻟﻰ ﺗﺤﻘﻴﻖ أﻛﺒﺮ ﻗﺪر ﻣﻦ اﻟﺘﺂزر ﺑﻴﻦ أﻧﺸﻄﺔ ﻣﻜﺎﻓﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻤﺠﺎﻻت اﻟﺼﺤﻴﺔ اﻷﺧﺮى، وإﻟﻰ اﻟﻤﻮاءﻣﺔ ﺑﻴﻦ اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ وﺑﻴﻦ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت واﻟﺨﻄﻂ واﻷﻫﺪاف اﻟﺼﺤﻴﺔ واﻹﻧﻤﺎﺋﻴﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻷﺧﺮى.
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ﱡ اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ :١ ﱡ ﻣ َﺮﻛﱠ ﺰة) :اﻋﺮف اﻟﻮﺑﺎء اﻟﺬي ﺗﺘﻌﺮض ﻟﻪ إﺟﺮاءات ﻻﺗﺨﺎذ اﻟﻤﻌﻠﻮﻣﺎت ﺗﻮﻓﻴﺮ ُ واﺳﺘﺠﺐ ﻟﻪ(. اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ :٢ ﱡ اﻟﺘﺪﺧﻼت اﻟﺮاﻣﻴﺔ إﻟﻰ إﺣﺪاث اﻷﺛﺮ )اﻟﺘﻐﻄﻴﺔ ﺑﻄﺎﺋﻔﺔ ﻣﻦ اﻟﺨﺪﻣﺎت اﻟﻼزﻣﺔ(. اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ :٣ ﱡ ﺗــﻮﻓﻴﺮ اﻟﺨــﺪﻣﺎت ﻟﻀــﻤﺎن اﻹﻧﺼــﺎف )ﺗﻐﻄﻴﺔ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺘﻲ ﺗﺤﺘﺎج إﻟﻰ اﻟﺨﺪﻣﺎت( اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ :٤ ﱡ اﻟﺘﻤﻮﻳﻞ ﻷﻏﺮاض اﻻﺳﺘﺪاﻣﺔ )ﺗﻐﻄﻴﺔ ﺗﻜﺎﻟﻴﻒ اﻟﺨﺪﻣﺎت(. اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ :٥ ﱡ اﻻﺑﺘﻜﺎر ﻣﻦ أﺟﻞ ﺗﺴﺮﻳﻊ وﺗﻴﺮة اﻟﺨﺪﻣﺎت )اﻟﺘﻄﻠﻊ إﻟﻰ اﻟﻤﺴﺘﻘﺒﻞ(. اﻟﺸﻜﻞ :٦اﻟﺘﻮﺟﻬﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﺨﻤﺴﺔ ﻟﻤﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ ﺑﺸﺄن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي٢٠٢١-٢٠١٦ ،
اﻟﺘﻮﺟﻬﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﺨﻤﺴﺔ وﻓﻴﻤﺎ ﻳﻠﻲ ﱡ اﻟﺘﻲ ﺗﺴﺘﻬﺪي ﺑﻬﺎ اﻹﺟﺮاءات ذات اﻷوﻟﻮﻳﺔ اﻟﺘﻲ ﺳﺘﺘﺨﺬﻫﺎ اﻟﺒﻠﺪان وﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ:
اﻟﺮؤﻳﺔ واﻟﻬﺪف واﻟﻐﺎﻳﺎت
اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ؛ واﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﻠﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ، وﻧﻬﺞ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ
أﻃﺮ اﻟﻌﻤﻞ:
اﻷﺑﻌﺎد اﻟﺜﻼﺛﺔ ﻟﻠﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٥ اﻻﺑﺘﻜﺎر ﻣﻦ أﺟﻞ ﺗﺴﺮﻳﻊ وﺗﻴﺮة اﻟﺨﺪﻣﺎت اﻟﻤﺴﺘﻘﺒﻞ اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٤ اﻟﺘﻤﻮﻳﻞ ﻷﻏﺮاض اﻻﺳﺘﺪاﻣﺔ اﻟﺘﻤﻮﻳﻞ اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٣ ﺗﻮﻓﻴﺮ اﻟﺨﺪﻣﺎت ﻟﻀﻤﺎن اﻹﻧﺼﺎف ”ﻛﻴﻒ“ اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٢ اﻟﺘﺪﺧﻼت اﻟﺮاﻣﻴﺔ إﻟﻰ إﺣﺪاث اﻷﺛﺮ ”ﻣﺎذا“ اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ١ ﺗﻮﻓﻴﺮ اﻟﻤﻌﻠﻮﻣﺎت ﻻﺗﺨﺎذ إﺟﺮاءات ﻣﺮﻛﺰة ”ﻣﻦ“ و“أﻳﻦ“
اﻟﻘﻴﺎدة واﻟﺸﺮاﻛﺔ واﻟﻤﺴﺎءﻟﺔ واﻟﺘﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ
ﺗﻨﻔﻴﺬ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ:
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
٢٨
ﻳﺘﺼﺪى ﻟﻠﺒﻌﺪ اﻟﺜﺎﻧﻲ ﻣﻦ أﺑﻌﺎد اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ ﺑﺘﺤﺪﻳﺪ أﻓﻀﻞ اﻟﺴﺒﻞ واﻟﻨﻬﺞ ﻟﺘﻘﺪﻳﻢ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻣﻦ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻤﺨﺘﻠﻒ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ وﻓﻲ ﻣﺨﺘﻠﻒ اﻟﻤﻮاﻗﻊ اﻟﺠﻐﺮاﻓﻴﺔ ،ﻣﻦ أﺟﻞ ﺗﺤﻘﻴﻖ اﻹﻧﺼﺎف واﻟﻮﺻﻮل إﻟﻰ أﻛﺒﺮ أﺛﺮ ﻣﻤﻜﻦ وﺿﻤﺎن اﻟﺠﻮدة. اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٤ ﱡ ﻛﻴﻒ ﻳﻤﻜﻦ ﺗﻐﻄﻴﺔ ﺗﻜﺎﻟﻴﻒ ﺗﻘﺪﻳﻢ ﺣﺰﻣﺔ اﻟﺨﺪﻣﺎت؟ – ﻳﺘﺼﺪى ﻟﻠﺒﻌﺪ اﻟﺜﺎﻟﺚ ﻣﻦ أﺑﻌﺎد اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ ﺑﺘﺤﺪﻳﺪ ﻧﻤﺎذج ﻣﺴﺘﺪاﻣﺔ واﺑﺘﻜﺎرﻳﺔ ﻟﺘﻤﻮﻳﻞ أﻧﺸﻄﺔ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻧﻬﺞ ﻟﺨﻔﺾ اﻟﺘﻜﺎﻟﻴﻒ وﻧﻈﻢ ﺣﻤﺎﻳﺔ ﻣﺎﻟﻴﺔ ﺑﺤﻴﺚ ﻳﺘﺴﻨﻰ ﻟﻠﻨﺎس اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺨﺪﻣﺎت اﻟﺘﻲ ﻳﺤﺘﺎﺟﻮن إﻟﻴﻬﺎ دون اﻟﻤﻌﺎﻧﺎة ﻣﻦ ﻣﺼﺎﻋﺐ ﻣﺎﻟﻴﺔ. اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٥ ﱡ ﻛﻴﻒ ﻳﻤﻜﻦ ﺗﻐﻴﻴﺮ ﻣﺴﺎر اﻻﺳﺘﺠﺎﺑﺔ؟ – ﻳﺤﺪد اﻟﻤﺠﺎﻻت اﻟﺘﻲ ﺑﻬﺎ ﺛﻐﺮات ﻛﺒﻴﺮة ﻓﻲ اﻟﻤﻌﺮﻓﺔ وﻓﻲ اﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎت ،وﺣﻴﺚ ﻳﻠﺰم اﻻﺑﺘﻜﺎر ﻟﺘﺤﻮﻳﻞ ﻣﺴﺎر اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺤﻴﺚ ﻳﺘﺴﻨﻰ ﺗﺴﺮﻳﻊ اﻹﺟﺮاءات وﺗﺤﻘﻴﻖ اﻟﻐﺎﻳﺎت اﻟﻤﺤﺪدة ﻟﻌﺎﻣﻲ ٢٠٢٠و.٢٠٣٠
اﻟﺘﻮﺟﻬﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻣﺠﻤﻮﻋﺔ ﻣﺤﺪدة ﻣﻦ ﺗﻮﺟﻪ ﻣﻦ ﱡ ﻳﺘﻨﺎول ﻛﻞ ﱡ اﻷﺳﺌﻠﺔ: اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ١ ﱡ ﻣﺎ ﻫﻮ اﻟﻮﺿﻊ؟ – ﻳﺮﻛﺰ ﻋﻠﻰ اﻟﺤﺎﺟﺔ إﻟﻰ ﻓﻬﻢ وﺑﺎء ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻻﺳﺘﺠﺎﺑﺔ ﻟﻪ ﺑﺎﻋﺘﺒﺎرﻫﻤﺎ اﻷﺳﺎس ﻟﻠﺘﻮﻋﻴﺔ وﻟﻼﻟﺘﺰام اﻟﺴﻴﺎﺳﻲ واﻟﺘﺨﻄﻴﻂ اﻟﻮﻃﻨﻲ وﺣﺸﺪ اﻟﻤﻮارد وﺗﺨﺼﻴﺼﻬﺎ ،واﻟﺘﻨﻔﻴﺬ، وﺗﺤﺴﻴﻦ اﻟﺒﺮاﻣﺞ. اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٢ ﱡ ﻣﺎ ﻫﻲ اﻟﺨﺪﻣﺎت اﻟﺘﻲ ﻳﻨﺒﻐﻲ ﺗﻘﺪﻳﻤﻬﺎ؟ – ﻳﺘﺼﺪى ﻟﻠﺒﻌﺪ اﻷول ﻣﻦ أﺑﻌﺎد اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ ﺑﻮﺻﻒ اﻟﺤﺰﻣﺔ اﻟﻀﺮورﻳﺔ ﻣﻦ اﻟﺘﺪﺧﻼت اﻟﻌﺎﻟﻴﺔ اﻷﺛﺮ اﻟﺘﻲ ﻳﺠﺐ ﺗﻘﺪﻳﻤﻬﺎ ﻋﻠﻰ اﻣﺘﺪاد اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻣﻦ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺒﻠﻮغ اﻟﻐﺎﻳﺎت اﻟﻘﻄﺮﻳﺔ واﻟﻌﺎﻟﻤﻴﺔ ،واﻟﺘﻲ ﻳﻨﺒﻐﻲ أن ُﻳﻨﻈﺮ ﻓﻲ إدراﺟﻬﺎ ﻓﻲ ﺣﺰم اﻟﻔﻮاﺋﺪ اﻟﺼﺤﻴﺔ اﻟﻮﻃﻨﻴﺔ. اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٣ ﱡ ﻛﻴﻒ ﻳﻤﻜﻦ ﺗﻘﺪﻳﻢ ﻫﺬه اﻟﺨﺪﻣﺎت؟ –
اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ :١ ﱡ ﻣ َﺮﻛﱠ ﺰة ﺗﻮﻓﻴﺮ اﻟﻤﻌﻠﻮﻣﺎت ﻻﺗﺨﺎذ إﺟﺮاءات ُ ﻟﻘﺪ ﻧﻀﺠﺖ اﻻﺳﺘﺠﺎﺑﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻋﻠﻰ ﻣﺪى اﻟﺜﻼﺛﻴﻦ ﻋﺎﻣﺎً اﻟﻤﺎﺿﻴﺔ ،ﻣﺪﻋﻮﻣﺔ ﺑﻤﺴﺘﻮى ﻏﻴﺮ ﻣﺴﺒﻮق ﻣﻦ اﻻﺳﺘﺜﻤﺎرات اﻟﻤﺎﻟﻴﺔ واﻻﺑﺘﻜﺎرات اﻟﺘﻘﻨﻴﺔ وﻣﻦ اﻟﻌﻤﻞ ﻓﻲ ﻣﺠﺎل اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ .وﻋﻠﻰ اﻟﺮﻏﻢ ﻣﻦ ذﻟﻚ ،ﻓﺈن ﻫﻨﺎك ﺛﻐﺮات ﻛﺒﻴﺮة ﻓﻲ اﻟﺨﺪﻣﺎت ،واﺳﺘﻤﺮت ﺟﻮاﻧﺐ اﻟﺘﻔﺎوت ﻓﻲ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺨﺪﻣﺎت وأﺻﺒﺤﺖ ﻣﺤﺪودﻳﺔ اﻟﻤﻮارد ﺿﺎﻏﻄﺔ أﻛﺜﺮ ﻣﻦ ذي ﻗﺒﻞ .وﺳﻴﺘﻮﻗﻒ ﻧﺠﺎح اﻟﻤﺮﺣﻠﺔ اﻟﺘﺎﻟﻴﺔ ﻣﻦ اﻻﺳﺘﺠﺎﺑﺔ ﻋﻠﻰ اﺗﺨﺎذ إﺟﺮاءات أﻛﺜﺮ ﻛﻔﺎءة وﻣﺼﻤﻤﺔ ﺧﺼﻴﺼﺎً وﻣﺴﺘﺪاﻣﺔ ﺗﺴﺘﺮﺷﺪ ﺑﻮاﻗﻊ اﻟﺒﻠﺪان وﺑﺒﻴﺎﻧﺎت ﻋﺎﻟﻴﺔ اﻟﺠﻮدة. ﺼﻨﱠ ﻔﺔ ﺣﺴﺐ اﻟﺠﻨﺲ اﻟﻤ َ اﻟﻤ َ ﺼﻠﺔ“ اﻟﻌﺎﻟﻴﺔ اﻟﺠﻮدة ُ - ﻔﱠ إن اﻟﺒﻴﺎﻧﺎت ” ُ واﻟﻌﻤﺮ واﻟﺨﺼﺎﺋﺺ اﻟﺴﻜﺎﻧﻴﺔ اﻷﺧﺮى ﻋﺒﺮ ﻣﺨﺘﻠﻒ ﻣﺴﺘﻮﻳﺎت ﻧﻈﺎم اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ -ﺗﻤﻜّ ﻦ ﻣﻦ ﺗﺮﻛﻴﺰ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻋﻠﻰ ﻧﺤﻮ أدق وأﺷﺪ ﻓﻌﺎﻟﻴﺔ ،وﺗﺘﻴﺢ ﻧﺸﺮ اﻟﺨﺪﻣﺎت أو ﺗﻜﻴﻴﻔﻬﺎ ﻟﻠﻮﺻﻮل إﻟﻰ أﻋﺪاد أﻛﺒﺮ ﻣﻦ اﻷﺷﺨﺎص اﻟﺬﻳﻦ ﻳﺤﺘﺎﺟﻮن إﻟﻴﻬﺎ .وﻳﻤﻜﻦ ﻟﺰﻳﺎدة إﺷﺮاك اﻟﻤﺠﺘﻤﻌﺎت وأﺻﺤﺎب اﻟﻤﺼﻠﺤﺔ ﻓﻲ ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت وﺗﺤﻠﻴﻠﻬﺎ أن ﺗﺆدي إﻟﻰ ﺗﺤﺴﻴﻦ ﺟﻮدة اﻟﻤﻌﻠﻮﻣﺎت وﻓﻌﺎﻟﻴﺔ اﺳﺘﺨﺪاﻣﻬﺎ .وﻳﻌﺘﺒﺮ اﻟﺘﻄﺒﻴﻖ اﻟﺼﺎرم ﻟﻠﻤﻌﺎﻳﻴﺮ اﻷﺧﻼﻗﻴﺔ ﻓﻲ ﺟﻤﻊ اﻟﺒﻴﺎﻧﺎت أﻣﺮاً ﺑﺎﻟﻎ اﻷﻫﻤﻴﺔ ﻟﻜﻲ ﻳﺘﻢ ﺳ ﱢﺮ ﱠﻳﺘﻬﺎ ودون ﺗﻌﺮﻳﺾ ﺳﻼﻣﺔ اﻷﻓﺮاد اﺳﺘﺨﺪاﻣﻬﺎ دون اﻧﺘﻬﺎك ِ واﻟﻤﺠﺘﻤﻌﺎت ﻟﻠﻤﺨﺎﻃﺮ .وﻓﻲ ﻇﻞ ﻣﺤﺪودﻳﺔ اﻟﻤﻮارد اﻟﻤﺘﺎﺣﺔ، ﻳﺘﻌﻴﻦ ﻋﻠﻰ اﻟﺒﻠﺪان اﺳﺘﺨﺪام ﻫﺬه اﻟﺒﻴﺎﻧﺎت ﻟﺼﻴﺎﻏﺔ ﻣﺒﺮرات ﻗﻮﻳﺔ ﻟﻼﺳﺘﺜﻤﺎر ،وﻟﻠﻤﻄﺎﻟﺒﺔ ﺑﺘﺨﺼﻴﺺ ﻣﻮارد ﻣﺤﻠﻴﺔ ﻛﺎﻓﻴﺔ ،وﻟﺤﺸﺪ اﻟﻤﻮارد اﻟﺨﺎرﺟﻴﺔ.
ﻣﻌﺮﻓﺔ وﺑﺎء ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﺬي ﺗﺘﻌﺮض ﻟﻪ واﻻﺳﺘﺠﺎﺑﺔ ﻟﻪ ﻣﻦ أﺟﻞ ﺗﻨﻔﻴﺬ اﺳﺘﺠﺎﺑﺔ ﻣﺼﻤﻤﺔ ﻟﺘﻼﺋﻤﻪ
وﺳﻴﺘﻮﻗﻒ ﻧﺠﺎح اﻟﻤﺮﺣﻠﺔ اﻟﺘﺎﻟﻴﺔ ﻣﻦ اﻻﺳﺘﺠﺎﺑﺔ ﻋﻠﻰ اﺗﺨﺎذ إﺟﺮاءات أﻛﺜﺮ ﻛﻔﺎءة وﻣﺼﻤﻤﺔ ﺧﺼﻴﺼﺎً وﻣﺴﺘﺪاﻣﺔ ﺗﺴﺘﺮﺷﺪ ﺑﻮاﻗﻊ اﻟﺒﻠﺪان وﺑﺒﻴﺎﻧﺎت ﻋﺎﻟﻴﺔ اﻟﺠﻮدة.
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
واﻟﺴﺠﻨﺎء .وﻫﻢ اﻟﺬﻳﻦ ﻻ ﺗﺘﺎح ﻟﻬﻢ اﻟﺨﺪﻣﺎت اﻟﺒﺎﻟﻐﺔ اﻷﻫﻤﻴﺔ اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻹﺻﺎﺑﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻻ ﺑﻘﺪر ﻣﺤﺪود ﻟﻠﻐﺎﻳﺔ .وﻓﻲ أﻣﺎﻛﻦ ﻋﺪﻳﺪة ،ﻻ ﺗﻨﺪرج ﺑﻌﺾ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ ﻓﻲ ﻧﻈﺎم اﻟﺘﺮﺻﺪ اﻟﺮوﺗﻴﻨﻲ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻳﺮﺟﻊ ذﻟﻚ ﻓﻲ اﻟﻐﺎﻟﺐ إﻟﻰ ﻗﻠﺔ اﺣﺘﻤﺎل ﺣﺼﻮﻟﻬﺎ ﻋﻠﻰ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ،وﻣﻦ ﺿﻤﻨﻬﺎ اﻟﻤﺮاﻫﻘﻮن واﻟﺮﺟﺎل واﻟﺴﻜﺎن اﻟﻤﺘﻨﻘﻠﻮن .وﻳﻤﻜﻦ أن ﺗﺆﺛﺮ اﻟﻬﺠﺮة وﺗﺤﺮﻛﺎت اﻟﺴﻜﺎن داﺧﻞ اﻟﺒﻠﺪان وﻓﻴﻤﺎ ﺑﻴﻨﻬﺎ ﺗﺄﺛﻴﺮاً ﻛﺒﻴﺮاً ﻋﻠﻰ دﻳﻨﺎﻣﻴﺎت اﻷوﺑﺌﺔ اﻟﻤﺤﻠﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻣﻤﺎ ﻳﺒﺮز أﻫﻤﻴﺔ إدراج اﻟﺴﻜﺎن اﻟﻤﺘﻨﻘﻠﻴﻦ ﻓﻲ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت واﻟﺨﻄﻂ واﻟﺠﻬﻮد واﻹﺟﺮاءات اﻟﻮﻃﻨﻴﺔ اﻟﻤﻌﻨﻴﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. رﺻﺪ اﻻﺳﺘﺠﺎﺑﺔ وﻓﻬﻤﻬﺎ
ﻓﻬﻢ اﻟﻮﺑﺎء واﻻﺳﺘﺠﺎﺑﺔ ﻟﻪ – ﺗﻮﻓﻴﺮ اﻟﺒﻴﺎﻧﺎت ﻣﻦ أﺟﻞ اﺗﺨﺎذ اﻟﻘﺮارات
إن وﺟﻮد ﻧﻈﺎم ﺳﻠﻴﻢ وﻣﺮن ﻟﻠﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻫﻮ ﺣﺠﺮ اﻟﺰاوﻳﺔ ﻓﻲ اﻟﺪﻋﻮة واﻟﺘﺨﻄﻴﻂ اﻻﺳﺘﺮاﺗﻴﺠﻲ اﻟﻮﻃﻨﻲ وﺿﻤﺎن اﻟﻤﺴﺎءﻟﺔ ﻣﻦ أﺟﻞ اﺳﺘﺨﺪام اﻟﻤﻮارد ﻋﻠﻰ اﻟﻨﺤﻮ اﻷﻓﻀﻞ واﻷﻛﺜﺮ ﻋﺪﻻ .وﻳﺠﺐ دﻣﺞ ﻧﻈﻢ ﻣﻌﻠﻮﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ً ﻫﺬه ﻓﻲ اﻟﻨﻈﺎم اﻟﻮﻃﻨﻲ اﻷوﺳﻊ ﻟﻠﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ. ﻓﻬﻢ اﻟﻮﺑﺎء – ”ﻣﻦ“ و“أﻳﻦ“
ﻳﻌﺘﺒﺮ رﺻﺪ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻓﻬﻤﻬﺎ ﻋﻠﻰ اﻟﻤﺴﺘﻮﻳﻴﻦ اﻟﻘﻄﺮي واﻟﻌﺎﻟﻤﻲ ﺑﺎﻟﻎ اﻷﻫﻤﻴﺔ ﻟﻼﺳﺘﻔﺎدة ﻣﻦ اﻟﻤﺰﻳﺪ ﻣﻦ اﻻﺳﺘﺜﻤﺎرات اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻓﻲ ﺑﺮاﻣﺞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻟﻠﻮﺻﻮل ﺑﻔﻌﺎﻟﻴﺘﻬﺎ وﻗﺪرﺗﻬﺎ ﻋﻠﻰ اﻻﺳﺘﺠﺎﺑﺔ وﻣﺮدودﻳﺘﻬﺎ إﻟﻰ أﻗﺼﻰ ﻣﺴﺘﻮى .وﻻﺑﺪ ﻣﻦ وﺟﻮد ﺑﻴﺎﻧﺎت ﺟﻴﺪة اﻟﻨﻮﻋﻴﺔ ﻟﻘﻴﺎس ﺗﻮاﻓﺮ اﻟﺨﺪﻣﺎت واﻹﻗﺒﺎل ﻋﻠﻴﻬﺎ واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺸﻤﻮﻟﺔ ﺑﺎﻟﺘﻐﻄﻴﺔ ،واﻟﺠﻮدة واﻟﻤﻘﺒﻮﻟﻴﺔ ﻋﻠﻰ اﻣﺘﺪاد اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺄﻛﻤﻠﻬﺎ .وﻳﻀﻤﻦ ﻫﺬا ﺗﺤﺪﻳﺪ اﻟﻔﺠﻮات وأوﺟﻪ اﻟﻘﺼﻮر ،ﻣﻤﺎ ﻳﻀﻤﻦ ﺑﺪوره إﻣﻜﺎﻧﻴﺔ ﺗﻨﻔﻴﺬ إﺟﺮاءات ﺗﺼﺤﻴﺤﻴﺔ .وﺣﺘﻰ ﻳﺘﺴﻨﻰ ﻗﻴﺎس اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻋﻠﻰ اﻣﺘﺪاد اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺄﻛﻤﻠﻬﺎ ،ﻓﺈن اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺗﻮﺻﻲ اﻟﺒﻠﺪان ﺑﺎﻟﻨﻈﺮ ﻓﻲ اﻋﺘﻤﺎد ٥٠ﻣﺆﺷﺮاً وﻃﻨﻴﺎً ﺣﻴﻨﻤﺎ ﻳﻜﻮن ذﻟﻚ ﻣﻼﺋﻤﺎً ،وﻗﺪ ﺗﻢ ﺗﺤﺪﻳﺪ ١٠ ﻣﺆﺷﺮات ﻣﻦ ﺑﻴﻨﻬﺎ ﻟﻠﺮﺻﺪ ﻋﻠﻰ اﻟﺼﻌﻴﺪ اﻟﻌﺎﻟﻤﻲ )اﻧﻈﺮ اﻟﺸﻜﻞ .(٧
ﻈﻢ ﻣﻌﻠﻮﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻳﺠﺐ أن ﺗﻜﻮن ﻧُ ُ ﻗﺎدرة ﻋﻠﻰ :ﺗﺤﺪﻳﺪ أﻣﺎﻛﻦ ﺣﺪوث اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻷﺷﺨﺎص اﻟﺬﻳﻦ ﺗﺤﺪث ﺑﻴﻨﻬﻢ؛ وﺗﺤﺪﻳﺪ اﻷﻧﻤﺎط اﻟﺮﺋﻴﺴﻴﺔ ﻟﺴﺮﻳﺎن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺴﻠﻮﻛﻴﺎت اﻟﻤﻌﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ اﻟﺨﻄﺮة؛ وﺗﻘﺪﻳﺮ ﺣﺠﻢ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ ﱠ واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺘﻀﺮرة؛ ورﺻﺪ اﻟﻌﻮاﻗﺐ اﻟﺼﺤﻴﺔ ﻷوﺑﺌﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺣﺎﻻت اﻟﻌﺪوى اﻟﺸﺎﺋﻌﺔ اﻟﻤﺼﺎﺣﺒﺔ ﻟﻠﻔﻴﺮوس واﻻﻋﺘﻼﻻت اﻟﻤﺸﺘﺮﻛﺔ اﻷﺧﺮى؛ واﻟﺘﻌﺮف ﻋﻠﻰ اﻟﻈﺮوف اﻻﺟﺘﻤﺎﻋﻴﺔ واﻟﻘﺎﻧﻮﻧﻴﺔ واﻻﻗﺘﺼﺎدﻳﺔ اﻟﺘﻲ ﺗﺰﻳﺪ ﻣﻦ ﺗﺄﺛﺮ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ ﺑﺎﻟﻌﺪوى. وﻣﺎزاﻟﺖ اﻟﻤﺮاﻫﻘﺎت واﻟﺸﺎﺑﺎت ﻳﻌﺎﻧﻴﻦ ﻣﻦ اﻟﻌﺐء اﻷﻛﺒﺮ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ ﻣﻨﻄﻘﺔ أﻓﺮﻳﻘﻴﺎ ﺟﻨﻮب اﻟﺼﺤﺮاء اﻟﻜﺒﺮى ،وﻫﻲ اﻟﻤﻨﻄﻘﺔ اﻷﺷﺪ ﺗﻀﺮراً ﻣﻨﻪ ،ﺣﻴﺚ ﻳﺒﻠﻎ ﻣﻌﺪل اﻹﺻﺎﺑﺔ ﺑﺎﻟﻔﻴﺮوس واﻧﺘﺸﺎره ﺑﻴﻦ اﻟﻨﺴﺎء اﻟﺸﺎﺑﺎت أﻛﺜﺮ ﻣﻦ ﺿﻌﻒ ﻣﻌﺪﻟﻪ ﺑﻴﻦ اﻟﺸﺒﺎب .ﻛﻤﺎ أن اﻟﺬﻳﻦ ﻳﺘﺄﺛﺮون ﻋﻠﻰ ﻧﺤﻮ ﻏﻴﺮ ﻣﺘﻨﺎﺳﺐ ﺑﺄوﺑﺌﺔ اﻟﻔﻴﺮوس ﻓﻲ ﺟﻤﻴﻊ اﻷﻗﺎﻟﻴﻢ ﺗﻢ ﺗﺤﺪﻳﺪﻫﻢ ﻋﻠﻰ أﻧﻬﻢ اﻟﺮﺟﺎل اﻟﺬﻳﻦ ﻳﻤﺎرﺳﻮن اﻟﺠﻨﺲ ﻣﻊ اﻟﺮﺟﺎل ،واﻷﺷﺨﺎص اﻟﺬﻳﻦ ﻳﺘﻌﺎﻃﻮن اﻟﻤﺨﺪرات ﺣﻘﻨﺎً ،واﻟﻌﺎﻣﻠﻴﻦ ﻓﻲ اﻟﺠﻨﺲ ،واﻟﻤﺘﺤﻮﻟﻮن ﺟﻨﺴﻴﺎً ،
اﻟ ﺸ ﻜ ﻞ :٧اﻟ ﻤ ﺆﺷ ﺮات اﻟ ﺮﺋ ﻴ ﺴ ﻴ ﺔ ﻟ ﺮﺻ ﺪ اﻻﺳ ﺘ ﺠ ﺎﺑ ﺔ ﻟ ﻔ ﻴ ﺮوس اﻟ ﻌ ﻮز اﻟ ﻤ ﻨ ﺎﻋ ﻲ اﻟ ﺒ ﺸ ﺮي ﻋ ﻠ ﻰ اﻣ ﺘ ﺪاد اﻟ ﺴ ﻠ ﺴ ﻠ ﺔ اﻟ ﻜ ﺎﻣ ﻠ ﺔ ﻟ ﺨ ﺪﻣ ﺎت اﻟ ﻔ ﻴ ﺮوس ﺑ ﻤ ﺎ ﻓ ﻲ ذﻟ ﻚ ﺗ ﺴ ﻠ ﺴ ﻞ رﻋ ﺎﻳ ﺔ اﻟ ﻤ ﺮﺿ ﻰ
ĴĠǜē ŪżżŝĜ ŦĐĔŁĩŤēŴ ěĔĤĴĭũŤē ğŴİĩŤēěǘİőŨŮŨİĩŤē ěĔĜŴĔřĝŤēŴ ěĔżŘŵŤēŴ ŒżũĤ ŽŘ ŦĐĔŁĩŤē ŪżżŝĜ ̝ŝōē ŦĨēĴŨ ĚŻĔŐĴŤē ĚŭŨĶũŤē ģǙőŤē ŊĖĴŤē ĚŻĔŐĴŤĔĖ ijĔėĝĬǘē ĚŻĔŜŵŤē
ěĔŨİĭŤ ĚťŨĔšŤē ̝ŝōē źĴĽėŤēŽŐĔŭũŤēĵŵőŤēķŴĴżŘ
ěǙĬİũŤē ěǙĬİŨ ŦŻŵũĜŴ ŽĩŁŤēŧĔōŭŤē
ĆĔĖŵŤē ĚŘĴőŨ ĚŐŵũĥũŤēĘĹĨŽĐĔĖŵŤēŊũŭŤē ĚńĴőũŤē̿ſĐĴŤēĚżŬĔšĹŤē ĺŭĥŤēŏŵŬŴĴũőŤēŴĴňĔĭũťŤ ĚżŘēĴŕĥŤē ĚŝʼnŭũŤēŴ
ūŵŝťĝŻŮŻIJŤē Ǭ ěĔŐŵũĥũŤēĚŻĔŜŴ ǩķŴĴżřĖĚĖĔŀǞēĚŤĔĨĚŘĴőŨ Ǫ ĞėšŤē Ǯ ŊĖĴŤē ǫ ěĔżŘŵŤē ǯ ģǙőŤē ƻĔżŤĔĨ ̿ſĐĴŤē ĚżŬĔšĹŤē ŽĸŴĴżřŤē źĴĽėŤēŽŐĔŭũŤēĵŵőŤē ĚŻĔŐĴŤĔĖ ŮŐĚĥĜĔŭŤēěĔżŘŵŤēįİŐ ĴňĔĭũťŤ ĚńĴőũŤē Ǎ ūŵŝťĝŻŮũŤȒŴįİŐ ĚŻĴŝŲŝŤēěĔĸŴĴżřŤēěēįĔŅũĖ ģǙőŤēŽŝťĝŨŮŨȒ ŽŐĔŭũŤēĵŵőŤēķŴĴżŘ ŒŨŮżĽŻĔőĝũŤēȒ ģǙőŤēŽŝťĝũŤȒ ěĔżŘŵŤēĚėĹŬŴźĴĽėŤē ěēįĔŅũĖ ŪŲĝĖĔŀǞĚŻĔŐĴŤē ŪĜŮŻIJŤēķŴĴżřŤē ŮżĖţĵēŵőŤēŧēİĭĝĸǘȒ ěēįĔŅũĖ ųĖĚʼnėĜĴũŤē ĚŻĴŝŲŝŤēěĔĸŴĴżřŤē ĵŵőŤēķŴĴżřĖ ŪŲŁżĭĽĜ ĚżŬĔšĹŤēěĔŐŵũĥũŤē ĚŻĴŝŲŝŤēěĔĸŴĴżřŤē ŪŲŻİŤŞŝĩĜŮŻIJŤē ģǙőŤēŢŤıŽŘĔũĖ źĴĽėŤēŽŐĔŭũŤē ĚńĴǍ őũŤē̿ſĐĴŤē ƾ ŽĸŴĴżřŤēĞėšŤē ĚŻĴŝŲŝŤēěĔĸŴĴżřŤēěēįĔŅũĖ ŦšŤĴĖǞēŴĉĴňĔĭũťŤ Ĕƻ ŭŝĨěēijİĭũťŤŇĔőĝŨ ŽŝťĝũĖŋĔřĝĨǘē ǭ ęİŻİĥŤēěĔĖĔŀǞē ǧǦ ěĔĸŴĴżřŤēěēįĔŅũĖģǙőŤē ĚŻĴŝŲŝŤē ĚĖĔŀǞēěǘĔĩŤȒŴįİŐ ĵŵőŤēķŴĴżřĖęİŻİĥŤē ŋĔřĝĨǘēŪĜŮũŤȒ źĴĽėŤēŽŐĔŭũŤē İżŜŹťŐēŵŝĖŴŪŲĖ “ART” refers to antiretroviral therapy – “PWID” refers to people who inject drugs ěēįĔŅũĖģǙőŤēŪŲżŝťĝŤęĔżĩŤē ĚŻĴŝŲŝŤēěĔĸŴĴżřŤē ŦŻŵũĝŤē Ǩ ŽťĩũŤ ē ķŴĴżřĖŮżĖĔŁũŤēįİŐ ķŴĴżřŤĚĖĔĥĝĸǘēŮŨȒ źĴĽėŤēŽŐĔŭũŤēĵŵőŤē źĴĽėŤēŽŐĔŭũŤēĵŵőŤē Ĕƻ żťĬēįţŵũŨ ŒŨŮżĽŻĔőĝũŤēŮŨȒŴ ķŴĴżřŤē ŮżĽŻĔőĝũŤē ǧ ķŴĴżřŤē ŒŨ
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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ﺗﻮﻓﻴﺮ اﻟﻤﻌﻠﻮﻣﺎت ﻻﺗﺨﺎذ اﻹﺟﺮاءات اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺗﻮﻓﻴﺮ ﻗﻴﺎدة ﻋﺎﻟﻤﻴﺔ ،ﺑﺎﻟﺘﻌﺎون ﻣﻊ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﺗﺮﺻﺪ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ورﺻﺪ ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ،ﻓﻲ ّ اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ. ﻣﺤﺪﺛﺔ وأدوات ﺗﺸﻐﻴﻠﻴﺔ ﻟﺠﻤﻊ وﺿﻊ ﻣﻌﺎﻳﻴﺮ وﺗﻘﺪﻳﻢ إرﺷﺎدات ﱠ اﻟﺒﻴﺎﻧﺎت وﺗﺤﻠﻴﻠﻬﺎ واﻹﺑﻼغ ﻋﻨﻬﺎ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ ﻟﻠﻤﻨﻈﻤﺔ وﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ﻟﻠﺠﻴﻞ اﻟﺜﺎﻧﻲ ﻣﻦ ﻋﻤﻠﻴﺔ ﺗﺮﺻﺪ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻣﺒﺎدئ ﻤﻌﺔ ﺑﺸﺄن اﻟﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ. ﺠﱠ اﻟﻤ َ اﻟﻤﻨﻈﻤﺔ اﻟﺘﻮﺟﻴﻬﻴﺔ ُ ﺗﻘﺪﻳﻢ اﻟﺪﻋﻢ اﻟﺘﻘﻨﻲ ﻟﻠﺒﻠﺪان ﻟﺘﻜﻴﻴﻒ وﺗﻨﻔﻴﺬ اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ واﻷدوات اﻟﺨﺎﺻﺔ ﺑﺎﻟﻤﻨﻈﻤﺔ وﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ﺑﺸﺄن اﻟﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﺘﻌﺰﻳﺰ ﻧﻈﻢ اﻟﺒﻴﺎﻧﺎت ﻋﻠﻰ اﻟﻤﺴﺘﻮى اﻟﻮﻃﻨﻲ واﻟﻤﻨﺎﻃﻖ واﻟﻤﻨﺸﺂت اﻟﺼﺤﻴﺔ ،وﻣﺴﺎﻧﺪة ﺗﺤﻠﻴﻞ ﺗﺴﻠﺴﻼت اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﻓﻲ اﻟﺒﻠﺪان اﻟﺮﺋﻴﺴﻴﺔ ﻟﻜﻲ ﺴﺘَ ْﺮ َ ﺷﺪ ﺑﻬﺎ ﻓﻲ ﺗﺤﺴﻴﻦ اﻟﺠﻮدة. ُﻳ ْ اﻹﺑﻼغ ﺳﻨﻮﻳﺎً ﻋﻦ اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﻤﺤﺪدة ﻟﻌﺎﻣﻲ ٢٠٢٠ ﺤ َﺮز ﺻﻮب ﺑﻠﻮغ اﻟﻐﺎﻳﺎت ﱠ اﻟﻤ ْ اﻟﺒﺸﺮي واﻟﺘﻘﺪم ُ و.٢٠٣٠ اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﺒﻠﺪان ﺑﻨﺎء ﻧﻈﺎم ﺷﺎﻣﻞ ﻟﻠﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﺘﻮﻓﻴﺮ ﺑﻴﺎﻧﺎت رﻓﻴﻌﺔ اﻟﺠﻮدة وﻓﻲ اﻟﻮﻗﺖ اﻟﻤﻨﺎﺳﺐ ﺑﺎﺳﺘﺨﺪام ﻣﺆﺷﺮات ﻣﻌﻴﺎرﻳﺔ ﺣﺪة ،ﻣﻊ اﻻﺳﺘﺮﺷﺎد ﺑﺎﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ ﻟﻤﻨﻈﻤﺔ ﻮﱠ ﻣَ وﻣﻨﻬﺠﻴﺎت ُ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ وﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز. زﻳﺎدة اﻟﺘﻔﺼﻴﻞ ﻓﻲ اﻟﺒﻴﺎﻧﺎت ،وﺗﺼﻨﻴﻔﻬﺎ وﻓﻖ ﻣﺎ ﻫﻮ ﻣﻼﺋﻢ ﻋﻠﻰ ﻣﺴﺘﻮﻳﺎت اﻟﻤﻨﺎﻃﻖ واﻟﻤﺠﺘﻤﻌﺎت اﻟﻤﺤﻠﻴﺔ واﻟﻤﻨﺸﺂت اﻟﻄﺒﻴﺔ ﺣﺴﺐ اﻟﻌﻤﺮ واﻟﺠﻨﺲ واﻟﻤﺠﻤﻮﻋﺔ اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻮﻗﻊ اﻟﺠﻐﺮاﻓﻲ ﻣﻦ أﺟﻞ ﺗﺤﺴﻴﻦ ﻓﻬﻢ اﻷوﺑﺌﺔ اﻟﺘﻲ ﺗﺤﺪث ﻓﻲ ﺟﺰء ﻣﻦ اﻟﺒﻼد )دون اﻟﻮﻃﻨﻴﺔ( وﺗﻘﻴﻴﻢ اﻷداء ﻋﻠﻰ اﻣﺘﺪاد اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤ َﺮﻛﱠ ﺰة. اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﻮﺟﻴﻪ اﻟﻤﺰﻳﺪ ﻣﻦ اﻻﺳﺘﺜﻤﺎرات واﻟﺨﺪﻣﺎت ُ رﺑﻂ ﻧﻈﻢ اﻟﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ودﻣﺠﻬﺎ ﻓﻲ اﻟﻨﻈﻢ اﻟﻮﻃﻨﻴﺔ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً ﻟﻠﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ ﻣﻨﺼﺎت( ﻣﺘﻜﺎﻣﻠﺔ واﻟﺘﻌﺮف ﻋﻠﻰ ﻓﺮص إﻗﺎﻣﺔ ﻣﻮاﻗﻊ إﻟﻜﺘﺮوﻧﻴﺔ ) ّ ﻟﻠﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ.
ﺗﺼﺮﻳﻒ اﻟﺸﺆون واﻟﻤﺴﺎءﻟﺔ اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﺒﻠﺪان اﺳﺘﻌﺮاض اﻟﻬﻴﺎﻛﻞ اﻟﻮﻃﻨﻴﺔ ﻹدارة ﺷﺆون ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وإﺻﻼﺣﻬﺎ ﻋﻨﺪ اﻟﻠﺰوم ﻟﻀﻤﺎن ”اﻟﻘﻀﺎء ﻋﻠﻰ ﻋﺰﻟﺔ“ اﻷﻧﺸﻄﺔ اﻟﻤﻌﻨﻴﺔ ﺑﺎﻟﻔﻴﺮوس ﺑﺘﻌﺰﻳﺰ اﻟﺮواﺑﻂ اﻟﻤﻼﺋﻤﺔ ودﻣﺞ اﻟﺨﺪﻣﺎت اﻟﻤﻌﻨﻴﺔ ﺑﺎﻟﻔﻴﺮوس داﺧﻞ ﺑﺮﻧﺎﻣﺞ اﻟﺼﺤﺔ اﻟﻮﻃﻨﻲ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً وﺗﻨﺴﻴﻖ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻠﻔﻴﺮوس ﻋﺒﺮ اﻟﻘﻄﺎﻋﺎت ذات اﻟﻌﻼﻗﺔ. وﺿﻊ ﻏﺎﻳﺎت وﻣﻌﺎﻟﻢ وﻃﻨﻴﺔ ﻟﻌﺎﻣﻲ ٢٠٢٠و ٢٠٣٠اﺳﺘﻨﺎداً إﻟﻰ اﻟﻐﺎﻳﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻠﻘﻀﺎء ﻋﻠﻰ اﻷﻳﺪز ﺑﺎﻋﺘﺒﺎره أﺣﺪ اﻟﺘﻬﺪﻳﺪات ﻟﻠﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ. ﻣﺮاﺟﻌﺔ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﻮﻃﻨﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﻮﺿﺢ اﻟﻐﺎﻳﺎت واﻷوﻟﻮﻳﺎت اﻟﻮﻃﻨﻴﺔ اﻟﺠﺪﻳﺪة ﺑﺸﺄن وﺗﺤﺪﻳﺜﻬﺎ ﻟﻜﻲ ﱢ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ووﺿﻊ ﺧﻄﺔ ﻣﺤﺴﻮﺑﺔ اﻟﺘﻜﺎﻟﻴﻒ ﻟﺘﻨﻔﻴﺬ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ. ﺗﻘﻮﻳﺔ اﻟﻤﺴﺎءﻟﺔ ﻋﻦ اﻟﺒﺮاﻣﺞ ﺑﺮﻓﻊ اﻟﺘﻘﺎرﻳﺮ اﻟﻤﻨﺘﻈﻤﺔ ﻋﻦ ﺗﻨﻔﻴﺬ اﻟﺒﺮﻧﺎﻣﺞ اﻟﻮﻃﻨﻲ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﻤﻮﻳﻠﻪ وأداﺋﻪ وأﺛﺮه ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺘﻘﺪم ﺻﻮب اﻟﻐﺎﻳﺎت اﻟﻤﺤﺪدة ﻟﻌﺎﻣﻲ ٢٠٢٠و.٢٠٣٠ اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ وﺿﻊ وﺗﺤﺪﻳﺚ اﻹرﺷﺎدات ﺣﻮل اﻟﺘﺨﻄﻴﻂ اﻻﺳﺘﺮاﺗﻴﺠﻲ اﻟﻮﻃﻨﻲ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﺤﺪﻳﺪ اﻷوﻟﻮﻳﺎت واﻟﺘﻜﺎﻟﻴﻒ ،ﻣﻊ اﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺗﺤﻘﻴﻖ اﻟﻐﺎﻳﺎت اﻟﻤﺤﺪدة ﻟﻌﺎﻣﻲ ٢٠٢٠و.٢٠٣٠ ﺗﻘﺪﻳﻢ اﻟﺪﻋﻢ اﻟﺘﻘﻨﻲ ﻟﻠﺒﻠﺪان ﻹﺟﺮاء ﻣﺮاﺟﻌﺎت دورﻳﺔ ﻟﺒﺮﻧﺎﻣﺞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻷﺛﺮه ،ورﺻﺪ اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﺻﻮب اﻟﻐﺎﻳﺎت اﻟﻮﻃﻨﻴﺔ واﻟﻌﺎﻟﻤﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﺗﺤﺴﻴﻦ اﻟﺘﻨﻔﻴﺬ ﻋﻠﻰ اﻟﺼﻌﻴﺪ اﻟﻘﻄﺮي.
ﺗﺼﺮﻳﻒ اﻟﺸﺆون واﻟﺘﺨﻄﻴﻂ اﻻﺳﺘﺮاﺗﻴﺠﻲ اﻟﻮﻃﻨﻲ واﻟﻤﺴﺎءﻟﺔ
إن اﻟﻬﻴﺎﻛﻞ اﻟﻮﻃﻨﻴﺔ ﻹدارة ﺷﺆون ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻛﺎﻟﺒﺮاﻣﺞ اﻟﻮﻃﻨﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻟﺠﺎن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وآﻟﻴﺎت اﻟﺘﻨﺴﻴﻖ اﻟﻮﻃﻨﻴﺔ ،ﺗﺆدي دوراً ﺑﺎﻟﻎ اﻷﻫﻤﻴﺔ ﻓﻲ اﻟﺪﻋﻮة إﻟﻰ اﺳﺘﺠﺎﺑﺔ ﻓﻌﺎﻟﺔ ،وﻓﻲ اﻟﺘﺨﻄﻴﻂ اﻻﺳﺘﺮاﺗﻴﺠﻲ وﻓﻲ ﺗﺨﺼﻴﺺ اﻟﻤﻮارد ﻋﻠﻰ اﻟﻤﺴﺘﻮى اﻟﻮﻃﻨﻲ ،وﻓﻲ دﻋﻢ اﺗﺴﺎق اﻟﺴﻴﺎﺳﺎت، وﺗﻨﺴﻴﻖ اﻷدوار واﻹﺟﺮاءات اﻟﺘﻲ ﻳﺆدﻳﻬﺎ ﻣﺨﺘﻠﻒ أﺻﺤﺎب اﻟﻤﺼﻠﺤﺔ ،واﻟﻤﻮاءﻣﺔ ﺑﻴﻦ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺑﻴﻦ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً وﺿﻤﺎن ﺗﻬﻴﺌﺔ اﻟﻤﻨﺎخ اﻟﻤﻼﺋﻢ .وﺗﻌﺘﺒﺮ اﻟﻘﻴﺎدة اﻟﺤﻜﻮﻣﻴﺔ اﻟﻮﻃﻨﻴﺔ ﻣﻦ اﻷﻣﻮر اﻷﺳﺎﺳﻴﺔ ﻓﻲ ﺗﺤﻘﻴﻖ اﻻﺗﺴﺎق واﻟﺘﻨﺴﻴﻖ ،وذﻟﻚ رﻏﻢ وﺟﻮب اﻻﻋﺘﺮاف ﺑﺄﻫﻤﻴﺔ اﻟﻼﻣﺮﻛﺰﻳﺔ ﻓﻲ ﺻﻨﻊ اﻟﻘﺮار ﺣﻴﺜﻤﺎ ﻛﺎن ﻣﻼﺋﻤﺎً . وﻟﻠﺒﻴﺎﻧﺎت اﻟﺘﻲ ﻳﻮﻓﺮﻫﺎ اﻟﻨﻈﺎم اﻟﻮﻃﻨﻲ ﻟﻠﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي أﻫﻤﻴﺔ ﺑﺎﻟﻐﺔ ﻓﻲ ﺗﻮﻓﻴﺮ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻼزﻣﺔ ﻟﻼﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﻮﻃﻨﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻟﺨﻄﺔ اﻟﺘﻨﻔﻴﺬ ،وﻟﻠﺠﻬﻮد وﻟﻺﺟﺮاءات اﻷﺧﺮى ذات اﻟﺼﻠﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻛﻤﺎ ﻳﻨﺒﻐﻲ أن ﺗﺤﺪد اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻏﺎﻳﺎت وﻃﻨﻴﺔ ﺗﺘﺴﻖ ﻣﻊ اﻟﻐﺎﻳﺎت اﻟﻌﺎﻟﻤﻴﺔ واﻹﺟﺮاءات اﻟﻤﻄﻠﻮﺑﺔ ﻟﺒﻠﻮغ ﻫﺬه اﻟﻐﺎﻳﺎت .ﻛﻤﺎ ﻳﺘﻌﻴﻦ أن ﺗﺒﻴﻦ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﺘﺪاﺑﻴﺮ اﻟﻬﻴﻜﻠﻴﺔ وﺗﺪاﺑﻴﺮ اﻟﺴﻴﺎﺳﺎت واﻟﻘﻮاﻧﻴﻦ اﻟﻤﻬﻤﺔ اﻟﻮاﺟﺐ اﺗﺨﺎذﻫﺎ ﻟﻠﺘﻤﻜﻴﻦ ﻣﻦ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﺤﺴﻴﻦ ﻫﺬه اﻻﺳﺘﺠﺎﺑﺔ. ﻳﻨﺒﻐﻲ ﺑﻴﺎن اﻟﺮواﺑﻂ ﺑﻮﺿﻮح ﺑﻴﻦ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﺼﺤﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻷﺧﺮى ذات اﻟﻌﻼﻗﺔ ،ﺑﻤﺎ ﻓﻴﻬﺎ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻘﻄﺎﻋﻴﺔ اﻟﻤﻌﻨﻴﺔ ﺑﺎﻟﻔﻴﺮوس؛ واﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻷﺧﺮى ذات اﻟﻌﻼﻗﺔ ﺑﺄﻣﺮاض ﻌ ﱠﻴﻨﺔ ،ﻛﺎﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻤﻌﻨﻴﺔ ﻣَ ﻣﺤﺪدة وﺑﻌﻮاﻣﻞ ﺧﻄﺮ ُ ﺑﺎﻟﺴﻞ واﻟﺼﺤﺔ اﻟﺠﻨﺴﻴﺔ واﻹﻧﺠﺎﺑﻴﺔ؛ واﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﺼﺤﻴﺔ واﻹﻧﻤﺎﺋﻴﺔ اﻟﻮﻃﻨﻴﺔ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً .
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
ﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ :٢ ﱡ اﻟﺘﺪﺧﻼت اﻟﺮاﻣﻴﺔ إﻟﻰ إﺣﺪاث اﻷﺛﺮ ﺗﺤﺪﻳﺪ ﺣﺰﻣﺔ اﻟﻔﻮاﺋﺪ اﻷﺳﺎﺳﻴﺔ ﻟﻠﻤﺼﺎﺑﻴﻦ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي
ﻳﻨﺒﻐﻲ أن ﻳﺤﺼﻞ اﻟﻨﺎس ﻋﻠﻰ اﻟﻤﺪى اﻟﻜﺎﻣﻞ ﻣﻦ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﺘﻲ ﻳﺤﺘﺎﺟﻮن إﻟﻴﻬﺎ ﻳﺘﻄﻠﺐ ﺗﺤﻘﻴﻖ اﻟﻐﺎﻳﺎت اﻟﻤﺤﺪدة ﻟﻌﺎم ٢٠٢٠ﺑﺸﺄن اﻟﻮﻗﺎﻳﺔ واﻻﺧﺘﺒﺎر واﻟﻌﻼج ﻧﻈﺎﻣﺎً ﺻﺤﻴﺎً ﻗﻮﻳﺎً وﻗﺎدراً ﻋﻠﻰ اﺟﺘﺬاب اﻟﻨﺎس واﻻﺣﺘﻔﺎظ ﺑﻬﻢ ﻋﻠﻰ اﻣﺘﺪاد اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ورﻋﺎﻳﺔ ﻣﺮﺿﺎه .وﻳﻠﺰم أن ﻳﻀﻤﻦ ﻫﺬا اﻟﻨﻈﺎم ﻟﻠﻨﺎس ﻣﺎ ﻳﻠﻲ :ﺣﺼﻮﻟﻬﻢ ﻋﻠﻰ ﺧﺪﻣﺎت وﻗﺎﻳﺔ ﻓﻌﺎﻟﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي؛ وإﺟﺮاء اﻻﺧﺘﺒﺎر واﻟﺘﺸﺨﻴﺺ ﻟﻬﻢ ،وﻓﻬﻤﻬﻢ اﻟﺘﺸﺨﻴﺺ ﻟﺘﺤﺮي إﺻﺎﺑﺘﻬﻢ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وإﺣﺎﻟﺘﻬﻢ إﻟﻰ ﺧﺪﻣﺎت اﻟﻮﻗﺎﻳﺔ اﻟﻤﻼﺋﻤﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي أو إﻟﺤﺎﻗﻬﻢ ﺑﺒﺮاﻣﺞ اﻟﺮﻋﺎﻳﺔ؛ واﻟﺒﺪء ﻣﺒﻜﺮاً ﻓﻲ ﻋﻼﺟﻬﻢ ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ إذا ُ ﺷﺨﺼﺖ إﺻﺎﺑﺘﻬﻢ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي؛ واﻻﺣﺘﻔﺎظ ﺑﻬﻢ ﻓﻲ اﻷﻃﺮ اﻟﺘﻲ ﺗﻘﺪم ﻟﻬﻢ اﻟﻌﻼج اﻟﻔﻌﺎل ﻟﻜﺒﺖ اﻟﻔﻴﺮوس ﻋﻠﻰ ﻧﺤﻮ ﻣﺴﺘﺪام؛ ﻈﻢ ﻋﻼﺟﻴﺔ ﺑﺪﻳﻠﺔ ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ وﻧﻘﻠﻬﻢ إﻟﻰ ﻧُ ُ إذا أﺧﻔﻖ اﻟﻌﻼج؛ وأن ﺑﺈﻣﻜﺎﻧﻬﻢ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺮﻋﺎﻳﺔ اﻟﺘﻠﻄﻴﻔﻴﺔ ورﻋﺎﻳﺔ اﻟﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﻮﻗﺎﻳﺔ واﻟﻤﻌﺎﻟﺠﺔ ﻣﻦ اﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ واﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ اﻟﻜﺒﻴﺮة.
ﻋﻠﻰ ﻛﻞ ﺑﻠﺪ أن ﻳﻘﻮم ﺑﻤﺮاﺟﻌﺔ ﺣﺰﻣﺔ اﻟﺨﺪﻣﺎت اﻷﺳﺎﺳﻴﺔ ﻟﻠﻤﺮﺿﻰ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺪﻳﻪ ﻓﻲ ﺿﻮء اﻷوﺑﺌﺔ اﻟﻤﺘﻐﻴﺮة ﻳﺤﺪد ﻣﺠﻤﻮﻋﺔ ﻣﻦ وﻣﺎ ﻳﺴﺘﺠﺪ ﻣﻦ ﻣﻌﺎرف واﺑﺘﻜﺎرات ،وأن ﱢ اﻟﺘﺪﺧﻼت واﻟﺨﺪﻣﺎت واﻷدوﻳﺔ واﻟﺴﻠﻊ اﻟﺘﻲ ﻳﻨﺒﻐﻲ إدراﺟﻬﺎ ﺿﻤﻦ ﺣﺰﻣﺔ اﻟﻔﻮاﺋﺪ اﻟﺼﺤﻴﺔ اﻟﻮﻃﻨﻴﺔ ﻟﻠﻤﺮﺿﻰ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﻳﻨﺒﻐﻲ ﺗﻐﻄﻴﺔ ﻫﺬه اﻟﺤﺰﻣﺔ ،ﻛﻠﻴﺎً أو ﺟﺰﺋﻴﺎً ،ﻣﻦ ﺧﻼل اﻟﺘﻤﻮﻳﻞ اﻟﺤﻜﻮﻣﻲ ﻟﺘﻘﻠﻴﻞ ﻧﻔﻘﺎت اﻟﻌﻼج اﻟﺘﻲ ﻳﺘﺤﻤﻠﻬﺎ اﻷﻓﺮاد ﺑﺪﻓﻌﻬﺎ ﻣﺒﺎﺷﺮة ﻣﻦ أﻣﻮاﻟﻬﻢ اﻟﺨﺎﺻﺔ ،وﺿﻤﺎن إﺗﺎﺣﺔ اﻟﺨﺪﻣﺎت ﻟﺠﻤﻴﻊ ﻣﻦ ﻳﺤﺘﺎﺟﻮن إﻟﻴﻬﺎ ،وﺗﻐﻄﻴﺔ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺄﻛﻤﻠﻬﺎ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﻮﻗﺎﻳﺔ واﻟﺘﺸﺨﻴﺺ واﻟﻌﻼج واﻟﺮﻋﺎﻳﺔ .وﻳﻠﺰم اﺧﺘﻴﺎر اﻟﺘﺪﺧﻼت واﻟﺨﺪﻣﺎت اﻟﻀﺮورﻳﺔ ﻣﻦ ﺧﻼل ﻋﻤﻠﻴﺔ ﺷﻔﺎﻓﺔ ﻳﺸﺎرك ﻓﻴﻬﺎ أﺻﺤﺎب اﻟﻤﺼﻠﺤﺔ اﻟﺮﺋﻴﺴﻴﻮن وﺗﺮاﻋﻲ اﻟﻤﻌﺎﻳﻴﺮ اﻟﺘﺎﻟﻴﺔ :اﻟﻔﻌﺎﻟﻴﺔ واﻟﺘﻜﻠﻔﺔ واﻟﻤﺮدودﻳﺔ واﻟﻤﺴﺎءﻟﺔ وﻗﺎﺑﻠﻴﺔ اﻟﺘﻨﻔﻴﺬ )اﻟﺠﺪوى( واﻟﻤﻼءﻣﺔ واﻟﻄﻠﺐ واﻷﺧﻼﻗﻴﺎت .ﻛﻤﺎ ﻳﺠﺐ ﻣﺮاﺟﻌﺔ اﻟﺤﺰﻣﺔ ﺑﺎﻧﺘﻈﺎم ﻟﻀﻤﺎن إﻇﻬﺎرﻫﺎ ﻵﺛﺎر اﻟﺘﺪﺧﻼت اﻟﻤﺨﺘﺎرة ﻟﻠﺘﻐﻴﺮات ﻓﻲ أوﺿﺎع اﻟﻮﺑﺎء اﻟﻤﺤﻠﻲ واﻟﺴﻴﺎق اﻟﻘﻄﺮي ،وﺟﻮاﻧﺐ اﻟﺘﻘﺪم ﻓﻲ اﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎت وﻧﻬﻮج ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ،واﻟﺒﻴﻨﺎت اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻵﺛﺎر أو ﺑﺎﻷﺿﺮار .وﻣﻦ اﻟﻀﺮوري أن ُﻳﻨﻈﺮ ﻋﻠﻰ وﺟﻪ اﻟﺘﺤﺪﻳﺪ ﻓﻲ ﻣﺠﻤﻮﻋﺎت اﻟﺘﺪﺧﻼت، ﻓﻌﺎﻻ أو ﻳﺤﻘﻖ أﻗﺼﻰ أﺛﺮ ﻣﻊ إدراك أن ﺑﻌﺾ اﻟﺘﺪﺧﻼت ﻟﻦ ﻳﻜﻮن ً ﻗﺪم ﻣﻘﺘﺮﻧﺎً ﺑﺘﺪﺧﻼت أﺧﺮى. ﻟﻪ إﻻ إذا ُ ﺗﻘﺪم اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺗﻮﺻﻴﺎت ﺑﺸﺄن اﺧﺘﻴﺎر واﺳﺘﺨﺪام اﻟﺘﺪﺧﻼت ﻋﻠﻰ اﻣﺘﺪاد اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﺗﻠﺨﺺ اﻟﺒﻴﻨﺎت اﻟﻤﺘﻮاﻓﺮة ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺄﻛﻤﻠﻬﺎ ،ﻛﻤﺎ ﱢ ﺣﻮل ﻓﻌﺎﻟﻴﺔ ﻣﺨﺘﻠﻒ اﻟﺘﺪﺧﻼت واﻟﺨﺪﻣﺎت ،وﺗﻘﺪم اﻹرﺷﺎدات ﺣﻮل ﻛﻴﻔﻴﺔ ﺗﻄﺒﻴﻖ ﻫﺬه اﻟﺘﺪﺧﻼت ﻓﻲ ﻣﺨﺘﻠﻒ اﻟﻈﺮوف.
– ٠٧ﻣﺘﻄﻮع ﻓﻲ ﺑﺮﻧﺎﻣﺞ ﺗﺒﺎدل اﻹﺑﺮ واﻟﻤﺤﺎﻗﻦ ﺑﺎﻟﺴﺠﻮن ،ﻣﻮﻟﺪوﻓﺎ.
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺎﻋﺘﺒﺎرﻫﻢ ﻣﻦ اﻟﺸﺮﻛﺎء اﻟﺬﻳﻦ ﻟﻬﻢ أﻫﻤﻴﺘﻬﻢ ﻓﻲ اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺧﻼل اﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ اﻟﻨﻮاﺣﻲ اﻹﻳﺠﺎﺑﻴﺔ ﻟﻠﺼﺤﺔ واﻟﻜﺮاﻣﺔ واﻟﻮﻗﺎﻳﺔ وﻳﺘﻐﻴﺮ اﻟﻤﺸﻬﺪ اﻟﺨﺎص ﺑﺎﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻫﺎﺋﻼ وﺳﺮﻳﻌﺎً ﻣﻊ إدﺧﺎل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﻐﻴﺮاً ً اﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎت واﻟﻨﻬﻮج اﻟﺠﺪﻳﺪة ،وﻻﺳﻴﻤﺎ اﺳﺘﺨﺪام اﻷدوﻳﺔ ﺳ َﺮﻳﺎن اﻟﻔﻴﺮوس اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ َ واﻛﺘﺴﺎﺑﻪ .وﺳﺘﻮاﺻﻞ اﻟﻮﻗﺎﻳﺔ اﻟﻤﺸﺘﺮﻛﺔ ﻣﻦ اﻟﻔﻴﺮوس اﻋﺘﻤﺎدﻫﺎ ﻋﻠﻰ اﻟﺘﺪﺧﻼت اﻟﻮﻗﺎﺋﻴﺔ اﻟﻤﺘﻮاﻓﺮة ﻣﻨﺬ زﻣﻦ ﻃﻮﻳﻞ واﻟﺸﺪﻳﺪة اﻟﻔﻌﺎﻟﻴﺔ ،واﻟﺘﻲ ﺗﺘﻀﻤﻦ اﻟﻌﻮازل اﻟﺬﻛﺮﻳﺔ واﻟﻌﻮازل اﻷﻧﺜﻮﻳﺔ، واﻟﺘﻮاﺻﻞ اﻟﺬي ﻳﺴﺘﻬﺪف ﺗﻐﻴﻴﺮ اﻟﺴﻠﻮﻛﻴﺎت ،وﺗﻘﻠﻴﺺ اﻷﺿﺮار ﺑﻴﻦ ﻣﺘﻌﺎﻃﻲ اﻟﻤﺨﺪرات ،واﺗﺨﺎذ اﻻﺣﺘﻴﺎﻃﺎت اﻟﺸﺎﻣﻠﺔ ﻓﻲ أﻣﺎﻛﻦ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ .وﻣﻊ ذﻟﻚ ،ﻓﺤﺘﻰ ﻟﻮ ﻻﻗﺖ ﻫﺬه اﻟﺘﺪﺧﻼت وﺗﻮﺳﻊ ﻧﻄﺎﻗﻬﺎ ،ﻓﻠﻦ ﻳﺴﺘﻄﻴﻊ اﻟﻘﺒﻮل ﻋﻠﻰ ﻧﻄﺎق واﺳﻊ ّ اﻟﻌﺎﻟﻢ ﻣﻊ ذﻟﻚ ﺗﺤﻘﻴﻖ ﻏﺎﻳﺔ ﻋﺎم .٢٠٢٠وﻳﻤﻜﻦ ﻟﻼﺳﺘﺨﺪام اﻻﺳﺘﺮاﺗﻴﺠﻲ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ وﺗﻮﺳﻴﻊ ﻧﻄﺎق اﻟﺨﺘﺎن اﻟﻄﺒﻲ اﻟﻄﻮﻋﻲ ﻟﻠﺬﻛﻮر ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس ﻳﻐﻴﺮ ﻣﺴﺎر اﻻﺳﺘﺠﺎﺑﺔ ﻟﻠﻔﻴﺮوس. اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي أن ّ وﻟﺘﺤﻘﻴﻖ ﻏﺎﻳﺔ اﻟﻮﻗﺎﻳﺔ ،ﺳﻮف ﺗﺘﻄﻠﺐ ﺑﺮاﻣﺞ اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻧﻬﺠﺎً ﻣﺸﺘﺮﻛﺎً وﻣﺮﻛﱠ ﺰاً وذﻟﻚ ﺑﺎﺳﺘﺨﺪام اﻟﺘﻌﺮض ﻟﻤﺨﺎﻃﺮ اﻟﻌﺪوى اﻟﺘﺪﺧﻼت اﻟﻌﺎﻟﻴﺔ اﻷﺛﺮ ﻟﺘﺨﻔﻴﻒ ﻗﺎﺑﻠﻴﺔ ﱡ اﻟﺴ َﺮﻳﺎن ﻣﻦ ﺧﻼل اﻟﺴ َﺮﻳﺎن ﻋﻦ ﻃﺮﻳﻖ اﻟﺠﻨﺲ وﻣﻦ ﱠ وﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﱠ اﻟﺴ َﺮﻳﺎن ﻓﻲ أﻣﺎﻛﻦ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﺗﻌﺎﻃﻲ اﻟﻤﺨﺪرات ﺣﻘﻨﺎً وﻣﻦ ﱠ اﻟﺴ َﺮﻳﺎن ﻣﻦ اﻷم إﻟﻰ اﻟﻄﻔﻞ. وﻣﻦ ﱠ وﻳﻨﺒﻐﻲ إدراج اﻟﺘﺪﺧﻼت اﻟﺘﺎﻟﻴﺔ اﻟﻌﺎﻟﻴﺔ اﻷﺛﺮ ﻓﻲ ﺣﺰﻣﺔ ﺷﺎﻣﻠﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي: واﻟﻤﺰَ ﻟﱢ ﻘﺎت :رﻏﻢ ﻣﺎ ﺗﺘﺴﻢ ﺑﻪ اﻟﻌﻮازل اﻟﺬﻛﺮﻳﺔ واﻷﻧﺜﻮﻳﺔ ُ اﻟﻌﻮازل اﻟﺬﻛﺮﻳﺔ واﻷﻧﺜﻮﻳﺔ ﻣﻦ ﻓﻌﺎﻟﻴﺔ وﻣﺎ ﻟﻬﺎ ﻣﻦ دور ﻣﺮﻛﺰي ﻓﻲ اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻏﻴﺮه ﻣﻦ ﺪﻳﺔ اﻟﺘﻲ ﺗﻨﺘﻘﻞ ﻋﻦ ﻃﺮﻳﻖ اﻟﺠﻨﺲ ،ﻓﺈن ﻗﺒﻮل ﻌِ اﻟﻤ ْ اﻷﻣﺮاض ُ ﻫﺬه اﻟﺘﺪﺧﻼت واﻹﻗﺒﺎل ﻋﻠﻴﻬﺎ ﻣﺎزال ﻣﺘﺪﻧﻴﺎً .وﻣﻦ اﻟﻔﺮص اﻟﻤﺘﺎﺣﺔ ﻟﺒﻠﻮغ اﻹﻣﻜﺎﻧﻴﺎت اﻟﻬﺎﺋﻠﺔ اﻟﺘﻲ ﱢ ﺗﺒﺸﺮ ﺑﻬﺎ ﻫﺬه اﻟﺘﺪﺧﻼت: ﺧﻔﺾ ﺗﻜﻠﻔﺔ اﻟﻌﻮازل اﻷﻧﺜﻮﻳﺔ؛ وﺗﻨﺸﻴﻂ أﺳﺎﻟﻴﺐ ﺗﺴﻮﻳﻖ اﻟﻌﻮازل؛ وﺗﻮﺳﻴﻊ ﻧﻄﺎق ﺗﻮزﻳﻊ اﻟﺨﺪﻣﺎت اﻟﻤﺘﻨﻮﻋﺔ وﻓﺘﺢ ﻣﻨﺎﻓﺬ ﻟﺘﺴﻮﻳﻘﻬﺎ. ﺗﻘﻠﻴﺺ اﻷﺿﺮار ﻟﺪى ﻣﺘﻌﺎﻃﻲ اﻟﻤﺨﺪرات ﺣﻘﻨﺎً : إن اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﻤﻮﺣﺪة ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺑﺸﺄن اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﺸﺨﻴﺼﻪ وﻋﻼﺟﻪ ﺗﺤﺪد اﻟﺤﺰﻣﺔ وﺗﻮﻓﻴﺮ اﻟﺮﻋﺎﻳﺔ ﻟﻠﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ ١٤،١٣،ﱢ اﻟﺸﺎﻣﻠﺔ ﻣﻦ ﺗﺪﺧﻼت ﺗﻘﻠﻴﺺ اﻷﺿﺮار .وإن ﺑﺮاﻣﺞ اﻹﺑﺮ واﻟﻤﺤﺎﻗﻦ اﻟﻤﻌﻘﻤﺔ ،واﻟﻌﻼج ﺑﺎﻻﺳﺘﻌﺎﺿﺔ ﻋﻦ اﻟﻤﻮاد اﻷﻓﻴﻮﻧﻴﺔ ﻟﻤﺘﻌﺎﻃﻲ اﻷﻓﻴﻮن واﻟﺘﻮاﺻﻞ ﻣﻦ أﺟﻞ اﻟﺤﺪ ﻣﻦ اﻟﻤﺨﺎﻃﺮ ﺗﻌﺘﺒﺮ ﺗﺪﺧﻼت ﻋﺎﻟﻴﺔ اﻷﺛﺮ ﺿﻤﻦ اﻟﺤﺰﻣﺔ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً ﻟﺘﻘﻠﻴﺺ اﻷﺿﺮار .وﺗﺤﻘﻖ ﺑﺮاﻣﺞ ﻟﺴ َﺮﻳﺎن ﻌﱠ ﻘﻤﺔ ﺧﻔﻀﺎً ﻛﺒﻴﺮاً وﻣﺮدودﻳﺔ ﻋﺎﻟﻴﺔ َ اﻟﻤ َ اﻹﺑﺮ واﻟﻤﺤﺎﻗﻦ ُ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻴﻦ ﻣﺘﻌﺎﻃﻲ اﻟﻤﺨﺪرات ﺣﻘﻨﺎً .ﻛﻤﺎ أن اﻟﻤﻌﺎﻟﺠﺔ ﺑﺎﻻﺳﺘﻌﺎﺿﺔ ﻋﻦ اﻟﻤﻮاد اﻷﻓﻴﻮﻧﻴﺔ ﻟﻤﺘﻌﺎﻃﻲ اﻷﻓﻴﻮن
اﻟﻤﺸﻬﺪ اﻟﺨﺎص ﺑﺎﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس ﻫﺎﺋﻼ اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﻐﻴﺮاً ً وﺳﺮﻳﻌﺎً ﻣﻊ إدﺧﺎل اﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎت واﻟﻨﻬﻮج اﻟﺠﺪﻳﺪة
اﻟﺘﻌﺮض ﻟﻤﺨﺎﻃﺮ اﻹﺻﺎﺑﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺧﻔﺾ ﱡ وﺳ َﺮﻳﺎن اﻟﻔﻴﺮوس واﻛﺘﺴﺎﺑﻪ َ
ﺳﻴﺘﻄﻠﺐ ﺧﻔﺾ ﻋﺪد ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻨﺴﺒﺔ ٪٧٥ﺑﻨﻬﺎﻳﺔ ﻋﺎم ٢٠٢٠ﻣﻘﺎرﻧﺔ ﻟﻤﺎ ﻛﺎﻧﺖ اﻟﺘﻌﺮض ﻋﻠﻴﻪ ﻋﺎم ٢٠١٠ﺗﺤﻘﻴﻖ ﺗﺨﻔﻴﺾ ﻛﺒﻴﺮ ﻓﻲ ﻣﻌﺪﻻت ﱡ ﻟﻺﺻﺎﺑﺔ ﺑﻪ واﻟﺴﻠﻮﻛﻴﺎت اﻟﺨﻄﺮة ،واﺗﺒﺎع ﻧﻬﻮج ﺟﺪﻳﺪة ﻓﻲ ﺗﻘﺪﻳﻢ اﻟﺘﺪﺧﻼت اﻟﻮﻗﺎﺋﻴﺔ اﻟﻔﻌﺎﻟﺔ إﻟﻰ ﻣﻦ ﻳﺤﺘﺎﺟﻮن إﻟﻴﻬﺎ ،واﺳﺘﺤﺪاث ﺗﻜﻨﻮﻟﻮﺟﻴﺎت ﺟﺪﻳﺪة ﻟﻠﻮﻗﺎﻳﺔ. ﻌ ﱠﺮﺿﺔ ﺑﻮﺟﻪ ﺧﺎص ﻟﻺﺻﺎﺑﺔ اﻟﻤ َ وﻫﻨﺎك ﺑﻌﺾ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ ُ ﺗﻌﺮﺿﺎً ﺑﻌﺪوى ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻧﻈﺮاً ﻟﺘﻌﺮﺿﻬﺎ ﱡ ﺷﺪﻳﺪاً ﻟﻠﻔﻴﺮوس و /أو ﻋﺪم ﻗﺪرﺗﻬﺎ ﻋﻠﻰ ﺗﺠﻨﺐ اﻟﻤﺨﺎﻃﺮ أو اﺳﺘﺨﺪام اﻟﺘﺪﺧﻼت اﻟﻔﻌﺎﻟﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻨﻪ .وﻛﻤﺎ ﺳﺒﻖ ذﻛﺮه ،ﻓﺈن اﻟﺘﻌﺮض ﻟﻠﻔﻴﺮوس ﻓﻲ ﻣﻮاﻗﻊ ﺟﻐﺮاﻓﻴﺔ اﻟﻌﻮاﻣﻞ اﻟﺘﻲ ﺗﺰﻳﺪ ﻣﻦ ﱡ ﻣﻌﻴﻨﺔ وﺑﻴﻦ ﻣﺠﻤﻮﻋﺎت ﺳﻜﺎﻧﻴﺔ ﻣﻌﻴﻨﺔ ،وﺧﺼﻮﺻﺎً ﺑﻴﻦ اﻟﻔﺘﻴﺎت واﻟﺸﺎﺑﺎت ﻓﻲ أﻓﺮﻳﻘﻴﺎ ﺟﻨﻮب اﻟﺼﺤﺮاء اﻟﻜﺒﺮى ،ﺗﺸﻤﻞ :اﻟﺘﻔﺎوت ﺑﻴﻦ اﻟﺠﻨﺴﻴﻦ واﻟﻌﻨﻒ اﻟﻘﺎﺋﻢ ﻋﻠﻰ ﻧﻮع اﻟﺠﻨﺲ واﻟﻌﻨﻒ اﻟﺠﻨﺴﻲ واﻟﻮﺻﻢ واﻟﺘﻤﻴﻴﺰ .وﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻷﺧﺮى ،ﻗﺪ اﻟﺘﻌﺮض ﻟﻠﻌﺪوى ﺑﺄوﺿﺎﻋﻬﻢ اﻟﻤﻌﻴﺸﻴﺔ ﻛﺎﻟﺮﺟﺎل اﻟﺬﻳﻦ ﻳﺘﺮاﻓﻖ ﱡ ﻳﻌﻴﺸﻮن ﻓﻲ ﻣﻮاﻗﻊ اﻟﺘﻌﺪﻳﻦ اﻟﻨﺎﺋﻴﺔ أو ﻓﻲ ﻣﻮاﻗﻊ اﻻﺣﺘﺠﺎز ،أو ﺑﻌﺪم ﻗﺪرﺗﻬﻢ ﻋﻠﻰ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺨﺪﻣﺎت ﻛﺎﻟﻤﻬﺎﺟﺮﻳﻦ واﻟﻨﺎزﺣﻴﻦ ﺑﺎﻟﺒﻴﻨﺎت وﺗﻜﻮن أﻃﺮ اﻟﻌﻤﻞ اﻟﺨﺎﺻﺔ ﺑﺎﻟﻮﻗﺎﻳﺔ اﻟﺸﺎﻣﻠﺔ واﻟﻤﺴﻨﺪة ﱢ أﻛﺜﺮ ﻓﻌﺎﻟﻴﺔ ﻋﻨﺪ وﺟﻮد ﻧﻬﻮج ﺳﻠﻮﻛﻴﺔ وﻃﺒﻴﺔ ﺑﻴﻮﻟﻮﺟﻴﺔ وﻫﻴﻜﻠﻴﺔ ﻣﺘﺸﺎرﻛﺔ ﻓﻲ ﻣﺎ ﺑﻴﻨﻬﺎ ﺑﺤﻴﺚ ﺗﺘﻀﻤﻦ اﻟﻮﻗﺎﻳﺔ اﻷوﻟﻴﺔ ﻃﺮﻗﺎً ﻟﻠﻮﺻﻮل ﻟﻠﻨﺎس اﻟﺬﻳﻦ ﻳﻜﻮن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺪﻳﻬﻢ ﺳﻠﺒﻴﺎً ،ﻛﻤﺎ ﺗﺘﻀﻤﻦ اﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ اﻟﻌﻤﻞ ﻣﻊ اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ
١٣ﻣﺒﺎدئ ﺗﻮﺟﻴﻬﻴﺔ ﻣﻮﺣﺪة ﺑﺸﺄن اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﺸﺨﻴﺼﻪ وﻋﻼﺟﻪ وﺗﻮﻓﻴﺮ اﻟﺮﻋﺎﻳﺔ ﻟﻠﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ اﻟﻤﻌﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ ،اﻧﻈﺮ: ) http://www.who.int/hiv/pub/guidelines/keypopulations/en/ﺗﻢ اﻻﻃﻼع ﻓﻲ ١٨آذار /ﻣﺎرس .(٢٠١٦ ١٤إن اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﻤﻮﺣﺪة ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺑﺸﺄن اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﺸﺨﻴﺼﻪ وﻋﻼﺟﻪ وﺗﻮﻓﻴﺮ اﻟﺮﻋﺎﻳﺔ ﻟﻤﺘﻌﺎﻃﻲ اﻟﻤﺨﺪرات ﺑﺎﻟﺤﻘﻦ ﺗﺸﺘﻤﻞ ﻋﻠﻰ اﻟﺘﺪﺧﻼت اﻟﺘﺎﻟﻴﺔ :ﺑﺮاﻣﺞ اﻹﺑﺮ واﻟﻤﺤﺎﻗﻦ اﻟﻤﻌﻘﻤﺔ ،واﻟﻌﻼج ﺑﺎﻻﺳﺘﻌﺎﺿﺔ واﻟﻤﻌﺎﻟﺠﺎت اﻷﺧﺮى ﻟﻼﻋﺘﻤﺎد ﻋﻠﻰ اﻷدوﻳﺔ ،وإﺟﺮاء اﻻﺧﺘﺒﺎرات ﻟﻜﺸﻒ اﻟﻌﺪوى ﺪ َﻳﺔ اﻟﺘﻲ ﺗﻨﺘﻘﻞ ﻋﻦ ﻌِ اﻟﻤ ْ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وإﺳﺪاء اﻟﻤﺸﻮرة ﺣﻮﻟﻪ ،واﻟﻤﻌﺎﻟﺠﺔ ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ واﻟﻤﻌﺎﻟﺠﺔ واﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻷﻣﺮاض ُ ﻃﺮﻳﻖ اﻟﺠﻨﺲ ،وﺑﺮﻧﺎﻣﺞ اﻟﻌﻮازل اﻟﺬﻛﺮﻳﺔ واﻷﻧﺜﻮﻳﺔ ﻟﻤﺘﻌﺎﻃﻲ اﻟﻤﺨﺪرات ﺑﺎﻟﺤﻘﻦ وﺷﺮﻛﺎﺋﻬﻢ ﻓﻲ اﻟﻤﻤﺎرﺳﺔ اﻟﺠﻨﺴﻴﺔ ،واﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺴﺘﻬﺪﻓﺔ ،واﻟﺘﺜﻘﻴﻒ واﻟﺘﻮاﺻﻞ ﻣﻦ اﻟﺤﺪ ﻣﻦ اﻟﻤﺨﺎﻃﺮ ﻟﺪى اﻷﺷﺨﺎص اﻟﺬﻳﻦ ﻳﺘﻌﺎﻃﻮن اﻟﻤﺨﺪرات ﺑﺎﻟﺤﻘﻦ وﻟﺪى ﺷﺮﻛﺎﺋﻬﻢ ﻓﻲ اﻟﻤﻤﺎرﺳﺔ اﻟﺠﻨﺴﻴﺔ ،واﻟﻠﻘﺎح واﻟﺘﺸﺨﻴﺺ واﻟﻤﻌﺎﻟﺠﺔ ﻟﻼﻟﺘﻬﺎب اﻟﻜﺒﺪي، أﺟﻞ ّ واﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻟﺴﻞ وﺗﺸﺨﻴﺼﻪ واﻟﻮﻗﺎﻳﺔ ﻣﻨﻪ ،واﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺗﻌﺎﻃﻲ اﻟﺠﺮﻋﺎت اﻟﻤﻔﺮﻃﺔ وﺗﺪﺑﻴﺮه.
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻟﺘﺸﺨﻴﺺ اﻟﻤﺒﻜﺮ ﻟﻠﺮﺿﻊ ،واﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ واﻟﻌﻼﺟﻴﺔ ﻟﻠﺮﺿﻊ. اﻟﺨﺘﺎن اﻟﻄﺒﻲ اﻟﻄﻮﻋﻲ ﻟﻠﺬﻛﻮر :ﺗﺸﻴﺮ اﻟﺘﻘﺪﻳﺮات ﻓﻲ اﻟﺒﻠﺪان اﻟﺘﻲ ﻳﺮﺗﻔﻊ ﻓﻴﻬﺎ ﻣﻌﺪل اﻧﺘﺸﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ أﻓﺮﻳﻘﻴﺎ ﺟﻨﻮب اﻟﺼﺤﺮاء اﻟﻜﺒﺮى ،إﻟﻰ أن ﺧﺘﺎن ٪٨٠ﻣﻦ اﻟﺮﺟﺎل اﻟﺬﻳﻦ ﺗﺘﺮاوح أﻋﻤﺎرﻫﻢ ٤٩–١٥ﺳﻨﺔ ﻣﻤﻦ ﻟﻢ ُﻳﺨﺘَ ﻨﻨﻮا ﻣﻦ ﻗﺒﻞ ﺳﻴﻤﻨﻊ ﺣﺪوث ٣٫٣ﻣﻠﻴﻮن ﺣﺎﻟﺔ ﻋﺪوى ﺑﺎﻟﻔﻴﺮوس ﺑﺤﻠﻮل ﻋﺎم ،٢٠٢٥ﻣﻤﺎ ﻳﺤﻘﻖ وﻓﻮرات ﺗﺒﻠﻎ ١٦ ٥٠٠ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ. وﻟﺘﺤﻘﻴﻖ ﻫﺬه اﻟﺘﻐﻄﻴﺔ ،ﻻﺑﺪ ﻣﻦ اﻟﺘﻮﺳﻊ اﻟﺴﺮﻳﻊ ﺑﺘﻄﺒﻴﻖ أﺳﺎﻟﻴﺐ ﻣﺒﺘﻜﺮة ﻣﺜﻞ اﺳﺘﺨﺪام أﺟﻬﺰة ﺧﺘﺎن اﻟﺬﻛﻮر اﻟﻤﺄﻣﻮﻧﺔ اﻟﺘﻲ ﺗﻤﻜّ ﻦ اﻟﻌﺎﻣﻠﻴﻦ ﻓﻲ اﻟﻤﺴﺘﻮى اﻟﻤﺘﻮﺳﻂ ﻟﻠﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﻣﻦ اﻟﻘﻴﺎم ﺑﻬﺬا اﻹﺟﺮاء ،وﻣﺜﻞ اﻟﺤﻤﻼت اﻟﻤﻮﺟﻬﺔ ﻟﺰﻳﺎدة اﻟﻄﻠﺐ ﻋﻠﻰ اﻟﺨﺘﺎن ﺑﻴﻦ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺘﻲ ﺗﺘﺪﻧﻰ ﻓﻴﻬﺎ ﻣﻌﺪﻻت اﻟﺨﺘﺎن وﻳﺮﺗﻔﻊ ﻓﻴﻬﺎ ﺧﻄﺮ اﻟﺘﻌﺮض ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. ﻣﺄﻣﻮﻧﻴﺔ اﻟﺤﻘﻦ واﻟﺪم :ﻋﻠﻰ اﻟﺮﻏﻢ ﻣﻦ اﻻﻓﺘﻘﺎر إﻟﻰ ﺑﻴﺎﻧﺎت ﻣﻮﺛﻮﻗﺔ ،ﻓﺈن ﻣﻦ اﻟﻤﺮﺟﺢ أن ﻋﻤﻠﻴﺎت اﻟﺤﻘﻦ اﻟﻄﺒﻲ واﻟﺪم ﻏﻴﺮ اﻟﻤﺄﻣﻮﻧﺔ ﻣﺴﺆوﻟﺔ ﻋﻦ أﻋﺪاد ﻛﺒﻴﺮة ﻣﻦ اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﺗﻤﺜﻞ ﻋﻤﻠﻴﺎت اﻟﺤﻘﻦ اﻟﻄﺒﻲ اﻟﻤﺄﻣﻮن وإﻣﺪادات اﻟﺪم اﻟﻤﺄﻣﻮﻧﺔ ،ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ اﺗﺨﺎذ اﻻﺣﺘﻴﺎﻃﺎت اﻟﺸﺎﻣﻠﺔ ﻣﻦ اﻟﻤﻘﻮﻣﺎت اﻟﻤﺤﻮرﻳﺔ ﻓﻲ أي ﻧﻈﺎم ﺻﺤﻲ ﺟﻴﺪ اﻷداء. وﻗﺪ رﻛﺰ إﻃﻼق ﺳﻴﺎﺳﺔ ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺣﻮل ﻣﺄﻣﻮﻧﻴﺔ اﻟﺤﻘﻦ ﻓﻲ ﻋﺎم ٢٠١٥اﻫﺘﻤﺎﻣﺎً أﻛﺒﺮ ﻋﻠﻰ اﻟﻘﻀﻴﺔ ،وﻋﺰﱠ ز اﻟﺘﺤﻮل إﻟﻰ اﺳﺘﺨﺪام أدوات اﻟﺤﻘﻦ اﻟﻤﺄﻣﻮﻧﺔ اﻟﺘﻲ ﺗﻤﺖ ﻫﻨﺪﺳﺘﻬﺎ وﺻﻨﻌﻬﺎ ﻹﻋﻄﺎء اﻟﺤﻘﻦ اﻟﻄﺒﻴﺔ وﻟﻠﺘﻄﻌﻴﻢ ﺑﺎﻟﻠﻘﺎﺣﺎت ﺑﺤﻴﺚ ﻳﻤﺘﻨﻊ إﻋﺎدة اﺳﺘﺨﺪاﻣﻬﺎ وﺗﻘﻲ ﻣﻦ اﻹﺻﺎﺑﺎت ﺑﻨﻬﺎﻳﺎﺗﻬﺎ اﻟﺤﺎدة. ﺗﺪﺧﻼت ﺗﻐﻴﻴﺮ اﻟﺴﻠﻮك :ﻫﻨﺎك ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻟﺘﺪﺧﻼت اﻟﺴﻠﻮﻛﻴﺔ ﻛﻼ ﻣﻦ اﻟﺘﻲ ﻳﻤﻜﻨﻬﺎ ﺗﻮﻓﻴﺮ اﻟﻤﻌﻠﻮﻣﺎت واﻟﻤﻬﺎرات اﻟﺘﻲ ﺗﺴﺎﻧﺪ ً اﻟﻮﻗﺎﻳﺔ اﻷوﻟﻴﺔ وﺗﻘﻠﻴﺺ اﻷﺿﺮار ،وﺗﺘﺼﺪى ﻟﻠﻌﻮاﻣﻞ اﻟﺘﻲ ﺗﺰﻳﺪ اﻟﺘﺤﻮل إﻟﻰ ﺳﻠﻮﻛﻴﺎت أﻗﻞ ﺧﻄﺮاً ﻣﻦ اﻟﺴﻠﻮﻛﻴﺎت اﻟﺨﻄﺮة ،وﺗﻌﺰﱢ ز ﱡ ﺳ َﺮﻳﺎن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﺗﺰﻳﺪ اﻹﻗﺒﺎل وﺗﻘﻲ ﻣﻦ َ ﻋﻠﻰ ﺧﺪﻣﺎت اﻟﻮﻗﺎﻳﺔ اﻟﻨﺎﺟﻌﺔ .وﻳﻤﻜﻦ ﻟﺮﺳﺎﺋﻞ ﺗﻐﻴﻴﺮ اﻟﺴﻠﻮك ﻣﻮﺟﻬﺔ وﻷﺳﺎﻟﻴﺐ اﻟﺘﻮاﺻﻞ أن ﺗﺤﻘﻖ اﻷﺛﺮ اﻟﻤﻨﺸﻮد إذا ﻛﺎﻧﺖ ﱠ ﻌ ﱠﻴﻨﺔ وﻣﺮﺗﺒﻄﺔ ﺑﺘﻮاﻓﺮ ﻣَ وﺧﺎﺻﺔ ﺑﻤﺠﻤﻮﻋﺎت وﺑﻤﻮاﻗﻊ ﺳﻜﺎﻧﻴﺔ ُ اﻟﻤﺰﻳﺪ ﻣﻦ ﺳﻠﻊ اﻟﻮﻗﺎﻳﺔ ﻛﺎﻟﻌﻮازل وأدوات اﻟﺤﻘﻦ اﻟﻤﻌﻘﻤﺔ. وﺗﺘﻄﻠﺐ اﻟﻤﺮاﻫﻘﺎت واﻟﺸﺎﺑﺎت ﻓﻲ أﻓﺮﻳﻘﻴﺎ ﺟﻨﻮب اﻟﺼﺤﺮاء اﻟﻜﺒﺮى ﻟﺘﻌﺮﺿﻬﻦ ﻟﺨﻄﺮ اﻟﻌﺪوى وﻟﻼرﺗﻔﺎع اﻟﺸﺪﻳﺪ اﻫﺘﻤﺎﻣﺎً ﺧﺎﺻﺎً ﻧﻈﺮاً ّ ﻓﻲ ﻣﻌﺪﻻت ﺣﺪوث اﻟﻔﻴﺮوس اﻟﺬي ﺗﺸﻬﺪه ﺑﻌﺾ اﻟﻤﺠﺘﻤﻌﺎت اﻟﻤﺤﻠﻴﺔ. اﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻟﻌﻨﻒ اﻟﻘﺎﺋﻢ ﻋﻠﻰ ﻧﻮع اﻟﺠﻨﺲ واﻟﻌﻨﻒ اﻟﺠﻨﺴﻲ واﻟﺘﺪﺑﻴﺮ اﻟﻌﻼﺟﻲ ﻟﻬﻤﺎ :ﻟﻘﺪ أﺻﺒﺢ ﻣﻦ اﻟﻤﻌﺮوف ﻋﻠﻰ ﻧﻄﺎق واﺳﻊ أن اﻟﻨﺴﺎء واﻟﻔﺘﻴﺎت أﻛﺜﺮ ﺗﻌﺮﺿﺎً ﺑﻮﺟﻪ ﺧﺎص ﻟﻠﻌﻨﻒ اﻟﻘﺎﺋﻢ ﻋﻠﻰ ﻧﻮع اﻟﺠﻨﺲ وﻟﻠﻌﻨﻒ اﻟﺠﻨﺴﻲ ،إﻻ أن اﻟﺼﺒﻴﺎن واﻟﺮﺟﺎل واﻟﻤﺘﺤﻮﻟﻴﻦ ﺟﻨﺴﻴﺎً ﻣﻌﺮﺿﻮن ﻟﺬﻟﻚ أﻳﻀﺎً .وﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﻫﺬا اﻟﻌﻨﻒ ﻻﺑﺪ ﻣﻦ ﺗﺪﺧﻼت ﻣﺘﻴﻨﺔ اﻟﺒﻨﻴﺎن ﻣﺜﻞ اﻟﺘﺼﺪي ﻟﻺﺟﺤﺎف اﻟﻤﺮﺗﻜﺰ ﻋﻠﻰ اﻟﺠﻨﺲ وﻟﻠﺴﻠﻮك اﻟﻤﻌﺎدي ﻟﻠﻤﺠﺘﻤﻊ ،وﻟﺘﻌﺎﻃﻲ اﻟﻜﺤﻮل ﻋﻠﻰ ﻧﺤﻮ ﺿﺎر وﻟﻌﻮاﻣﻞ اﻟﺨﻄﺮ اﻟﺮﺋﻴﺴﻴﺔ اﻷﺧﺮى .وﻫﻨﺎك دور ﻣﻬﻢ ﻳﺆدﻳﻪ ﻗﻄﺎع اﻟﺼﺤﺔ ﻓﻲ ﺗﻮﻓﻴﺮ اﻟﺮﻋﺎﻳﺔ ﻟﻤﻦ ﺗﻌﺮﺿﻮا ﻟﻬﺬا اﻟﻌﻨﻒ، ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺮﻋﺎﻳﺔ ﺑﻌﺪ اﻻﻏﺘﺼﺎب وﺗﻮﻓﻴﺮ اﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﺑﻌﺪ اﻟﺘﻌﺮض ﻟﻠﻔﻴﺮوس.
ﺗﻌﺮض ﺷﺪﻳﺪة اﻟﻔﻌﺎﻟﻴﺔ ﻓﻲ اﻟﺤﺪ ﻣﻦ ﺳﻠﻮﻛﻴﺎت اﻟﺤﻘﻦ اﻟﺘﻲ ﱢ ﱢ ﺗﺤﻘﻖ ﻫﺬه ﻣﺪﻣﻨﻲ اﻷﻓﻴﻮن ﻟﻤﺨﺎﻃﺮ اﻟﻌﺪوى ﺑﺎﻟﻔﻴﺮوس .وﻳﻠﺰم أن ﱢ اﻟﺨﺪﻣﺎت ﺗﻐﻄﻴﺔ ﻣﺮﺗﻔﻌﺔ ﻟﻜﻲ ﻳﻜﻮن ﻟﻬﺎ أﺛﺮ ﻋﻠﻰ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ. وﻻﺑﺪ ﻣﻦ إﻋﺎرة اﻫﺘﻤﺎم ﺧﺎص ﻟﻤﺘﻌﺎﻃﻲ اﻟﻜﻮﻛﺎﻳﻴﻦ واﻟﻤﻨﺒﻬﺎت ﻣﻦ ﻧﻤﻂ اﻷﻣﻔﻴﺘﺎﻣﻴﻨﺎت ،اﻟﺬﻳﻦ ﻻ ﻳﻔﻠﺢ ﻣﻌﻬﻢ اﻟﻌﻼج ﺑﺎﻻﺳﺘﻌﺎﺿﺔ ﻋﻦ اﻟﻤﻮاد اﻷﻓﻴﻮﻧﻴﺔ ،وﻟﻤﺘﻌﺎﻃﻲ اﻟﻤﺨﺪرات ﺑﻄﺮق أﺧﺮى ﻏﻴﺮ اﻟﺤﻘﻦ ﻓﻲ اﻷﺣﻮال اﻟﺘﻲ ﻗﺪ ﺗﻜﻮن ﻓﻴﻬﺎ ﻣﺨﺎﻃﺮ اﻻﻧﺘﻘﺎل ﻋﻦ ﻃﺮﻳﻖ اﻟﺠﻨﺲ ﻣﺮﺗﻔﻌﺔ. اﻟﻮﻗﺎﻳﺔ ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ :ﺗﺘﻤﺘﻊ اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﺳ َﺮﻳﺎن ﻓﻴﺮوس ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﺑﺈﻣﻜﺎﻧﻴﺎت ﻛﺒﻴﺮة ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ َ اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻛﺘﺴﺎﺑﻪ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻣﻦ ﺧﻼل اﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﻗﺒﻞ اﻟﺘﻌﺮض وﺑﻌﺪ اﻟﺘﻌﺮض ﻟﻠﻔﻴﺮوس ،وذﻟﻚ ﺑﺎﻟﻮﻗﺎﻳﺔ اﻟﺴ َﺮﻳﺎن ﻣﻦ اﻷم إﻟﻰ اﻟﻄﻔﻞ وﻣﻦ ﺧﻼل اﻟﻤﻌﺎﻟﺠﺔ ﺑﻤﻀﺎدات ﻣﻦ َ اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ اﻟﺘﻲ ﺗﺤﻘﻖ اﻟﻜﺒﺖ اﻟﻔﻴﺮوﺳﻲ .وﻳﻨﺒﻐﻲ أﻳﻀﺎً اﻟﻨﻈﺮ ﻓﻲ اﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﻗﺒﻞ اﻟﺘﻌﺮض ﻟﻠﻔﻴﺮوس ﺑﻮﺻﻔﻬﺎ أداة إﺿﺎﻓﻴﺔ ﻓﻌﺎﻟﺔ ﻓﻲ اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺪى اﻷﻓﺮاد اﻟﺸﺪﻳﺪي اﻟﺘﻌﺮض ﻟﻤﺨﺎﻃﺮ اﻛﺘﺴﺎب اﻟﻔﻴﺮوس ،ﻣﻊ ﺿﺮورة إﺗﺎﺣﺔ اﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﺑﻌﺪ اﻟﺘﻌﺮض ﻟﻠﻔﻴﺮوس ﻟﻸﺷﺨﺎص اﻟﺬﻳﻦ ﺗﻌﺮﺿﻮا ﺑﺸﺪة ﻟﻠﻔﻴﺮوس .وﺗﺘﻀﻤﻦ اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﻤﻮﺣﺪة ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺑﺸﺄن اﺳﺘﺨﺪام اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﻌﻼج اﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻮﻗﺎﻳﺔ ﻣﻨﻬﺎ إرﺷﺎدات ﺣﻮل اﺳﺘﺨﺪام اﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﻗﺒﻞ اﻟﺘﻌﺮض وﺑﻌﺪ اﻟﺘﻌﺮض ﻟﻠﻔﻴﺮوس واﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ اﻟﻔﻴﺮوس ١٥.وﻳﺘﻌﻴﻦ ﻋﻠﻰ اﻟﺒﻠﺪان وﺿﻊ ﻣﻌﺎﻳﻴﺮ ﻣﻼﺋﻤﺔ ﻟﺘﻘﻴﻴﻢ اﻟﻤﺨﺎﻃﺮ ،وإﻋﺪاد ﻧﻤﺎذج ﻟﺘﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ،واﺗﺨﺎذ اﻟﻘﺮار ﺣﻮل اﻟﻤﺸﺎرﻛﺔ اﻷﻛﺜﺮ اﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﻴﻦ ﻧﻬﺞ اﻟﻮﻗﺎﻳﺔ ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ وﻧﻬﻮج اﻟﻮﻗﺎﻳﺔ اﻷﺧﺮى اﺳﺘﻨﺎداً إﻟﻰ ﺳﻴﺎق ﻛﻞ ﺑﻠﺪ ﻋﻠﻰ ﺣﺪة .وﻳﻨﺒﻐﻲ إﻳﻼء اﻫﺘﻤﺎم ﺧﺎص ﻹﺟﺮاء اﻻﺧﺘﺒﺎرات ﻟﻔﻴﺮوس ﻟﻠﺘﻌﺮض اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻗﺒﻞ أن ﻳﺒﺎﺷﺮ اﻟﻨﺎس ﺑﺎﻻﺗﻘﺎء اﻟﺴﺎﺑﻖ ﱡ ﻣﻦ أﺟﻞ ﺗﻘﻠﻴﻞ ﻣﺨﺎﻃﺮ ﻇﻬﻮر اﻟﻤﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻟﻰ أدﻧﻰ ﻗﺪر ﻣﻤﻜﻦ ،وﻳﻨﺒﻐﻲ ﺗﻮﺳﻴﻊ ﻧﻄﺎق ﺗﺮﺻﺪ اﻟﻤﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﱡ ﺗﻢ إدﺧﺎﻟﻬﺎ ﺑﺎﻟﻔﻌﻞ. ﻟﻴﻐﻄﻲ ﺧﺪﻣﺎت اﻻﺗﻘﺎء اﻟﺴﺎﺑﻖ ﻟﻠﺘﻌﺮض إذا ﻣﺎ ّ ﺿﻊ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي: اﻟﺮ ﱠ اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻋﺪوى ﱡ أﺷﺎرت اﻟﺘﻘﺪﻳﺮات ﻓﻲ ﻋﺎم ،٢٠١٤أن ٪٦٢ﻓﻘﻂ ﻣﻦ اﻟﺤﻮاﻣﻞ اﻟﻤﺘﻌﺎﻳﺸﺎت ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻼﺋﻲ ﻳﺒﻠﻎ ﻋﺪدﻫﻦ ﺣﻮاﻟﻲ ١٫٥ﻣﻠﻴﻮن ﻗﺪ ﺗﻠﻘﻴﻦ ﻋﻼﺟﺎً ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻣﻦ ﺧﻼل ”اﻟﺨﻴﺎر ب .“+وﻋﻠﻰ اﻟﺮﻏﻢ ﻣﻦ أن اﻟﻘﻀﺎء ﻋﻠﻰ ﺳ َﺮﻳﺎن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻦ اﻷم إﻟﻰ اﻟﻄﻔﻞ أﻣﺮ َ ﻣﻤﻜﻦ ،ﻣﺎزاﻟﺖ ﻣﻌﺪﻻت اﻧﺘﻘﺎل اﻟﻔﻴﺮوس ﻣﺮﺗﻔﻌﺔ ارﺗﻔﺎﻋﺎً ﻏﻴﺮ ﻣﻘﺒﻮل ،ﺣﻴﺚ ﺗﺰﻳﺪ ﻋﻦ ٪١٠ﻓﻲ ﺑﻠﺪان ﻛﺜﻴﺮة .وﻣﻨﺬ ﻋﺎم ،٢٠١١ ﺳﺎﻋﺪت اﻟﺨﻄﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻠﻘﻀﺎء ﻋﻠﻰ ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻴﻦ اﻷﻃﻔﺎل ﺑﺤﻠﻮل ﻋﺎم ٢٠١٥ واﻟﺤﻔﺎظ ﻋﻠﻰ ﺣﻴﺎة أﻣﻬﺎﺗﻬﻢ ١٦ﻓﻲ ﺗﺴﺮﻳﻊ ﺟﻬﻮد اﻟﻘﻀﺎء ﻋﻠﻰ ﺗﻠﻚ اﻟﺤﺎﻻت .وﻋﻠﻰ ﻧﺤﻮ ﻣﻤﺎﺛﻞ ﻛﺬﻟﻚ ،ﺗﺒﺪي اﻟﺒﻠﺪان ﻧﺸﺎﻃﺎً ﺿﻊ. اﻟﺮ ﱠ ﻣﺘﺰاﻳﺪاً ﻓﻲ اﻟﻌﻤﻞ ﻋﻠﻰ اﻟﻘﻀﺎء ﻋﻠﻰ اﻟﺰﻫﺮي اﻟﺨﻠﻘﻲ ﺑﻴﻦ ﱡ وﻋﻠﻰ اﻟﺮﻏﻢ ﻣﻦ اﻟﻤﻜﺎﺳﺐ اﻟﺘﻲ ﺗﺤﻘﻘﺖ ،ﺳﻴﺘﻄﻠﺐ ﺑﻠﻮغ اﻟﻐﺎﻳﺔ اﻟﻤﺰدوﺟﺔ ﻋﺎم ٢٠٢٠أن ﻳﺒﺬل اﻟﻜﺜﻴﺮ ﻣﻦ اﻟﺒﻠﺪان ﺟﻬﻮداً ﻣﻜﺜﻔﺔ. وﺗﺘﻤﺜﻞ اﻟﻌﻨﺎﺻﺮ اﻟﺤﺎﺳﻤﺔ ﻓﻲ ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﻠﻘﻀﺎء ﻋﻠﻰ اﻟﻌﺪوى ﻓﻲ اﻟﻌﻼج ﻣﺪى اﻟﺤﻴﺎة ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﺠﻤﻴﻊ اﻟﺤﻮاﻣﻞ واﻟﻤﺮﺿﻌﺎت اﻟﻤﺘﻌﺎﻳﺸﺎت ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز
١٥ﻣﺒﺎدئ ﺗﻮﺟﻴﻬﻴﺔ ﻣﻮﺣﺪة ﺑﺸﺄن اﺳﺘﺨﺪام اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﻌﻼج اﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻮﻗﺎﻳﺔ ﻣﻨﻬﺎ ،اﻧﻈﺮ: ) http://www.who.int/hiv/pub/guidelines/en/ﺗﻢ اﻻﻃﻼع ﻓﻲ ١٨آذار /ﻣﺎرس .(٢٠١٦ ١٦اﻟﺨﻄﺔ اﻟﻌﺎﻟﻤﻴﺔ :اﻟﻘﻀﺎء ﻋﻠﻰ ﺣﺎﻻت اﻟﻌﺪوى اﻟﺠﺪﻳﺪة ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻴﻦ اﻷﻃﻔﺎل واﻟﺤﻔﺎظ ﻋﻠﻰ ﺣﻴﺎة أﻣﻬﺎﺗﻬﻢ ،اﻧﻈﺮ http://www.unaids.org/en/resources/documents/2011/20110609_JC2137_Global-Plan-Elimination-HIV-Children_en.pdf )ﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﺪﻋﻮة إﻟﻰ دﻋﻢ ﺗﻮﺳﻴﻊ ﻧﻄﺎق اﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎت واﻷﺳﺎﻟﻴﺐ اﻟﻮﻗﺎﺋﻴﺔ اﻟﺠﺪﻳﺪة ﻓﻲ ﺳﻴﺎق اﻟﻮﻗﺎﻳﺔ اﻟﻤﺸﺘﺮﻛﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺗﻨﻔﻴﺬ اﻟﻌﻼج اﻟﻤﺒﻜﺮ ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،واﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﻗﺒﻞ اﻟﺘﻌﺮض وﺑﻌﺪ اﻟﺘﻌﺮض ﻟﻠﻔﻴﺮوس ،وﻛﺬﻟﻚ اﻟﺨﺘﺎن اﻟﻄﺒﻲ اﻟﻄﻮﻋﻲ ﻟﻠﺬﻛﻮر ﻓﻲ اﻟﺒﻠﺪان ذات اﻷوﻟﻮﻳﺔ. ﺗﻘﺪﻳﻢ اﻹرﺷﺎدات ﺣﻮل اﻟﻮﻗﺎﻳﺔ اﻟﻤﺸﺘﺮﻛﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻹﺳﺮاع ﻓﻲ إدﻣﺎج اﻟﺘﺪﺧﻼت اﻟﺠﺪﻳﺪة واﻟﻤﺴﻨﺪة ﺑﺎﻟﺒﻴﻨﺎت ﻓﻲ ﻗﻄﺎع اﻟﺼﺤﺔ ﻓﻲ ﺣﺰﻣﺔ اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺿﻤﻦ ﻣﺨﺘﻠﻒ ﺳﻴﺎﻗﺎت اﻷوﺑﺌﺔ ﻣﻊ إﻳﻼء اﻫﺘﻤﺎم ﺧﺎص ﻟﻠﻤﺮاﻫﻘﻴﻦ وﻟﻠﻤﺮاﻫﻘﺎت واﻟﻔﺘﻴﺎت واﻟﻨﺴﺎء واﻟﻤﺠﻤﻮﻋﺎت اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ )ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ َ اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ(. اﻟﺸﺎﺑﺔ َ ﻣﺴﺎﻧﺪة زﻳﺎدة اﻻﻟﺘﺰام واﻟﻤﻮارد واﻹﺟﺮاءات ﻟﻠﻘﻀﺎء ﻋﻠﻰ اﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻴﻦ اﻷﻃﻔﺎل ،وذﻟﻚ ﺑﺎﻟﺘﻌﺎون ﻣﻊ اﻟﻴﻮﻧﻴﺴﻴﻒ .واﻟﺘﺤﻘﻖ ﻣﻦ اﻟﻘﻀﺎء ﻋﻠﻰ اﻧﺘﻘﺎل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺰﻫﺮي ﻣﻦ اﻷم إﻟﻰ اﻟﻄﻔﻞ ﻓﻲ اﻟﺒﻠﺪان. ﺗﻌﺰﻳﺰ اﻟﺘﻨﻔﻴﺬ ﻋﻠﻰ اﻟﺼﻌﻴﺪ اﻟﻘﻄﺮي ﻟﻤﻌﺎﻳﻴﺮ اﻟﻤﻨﻈﻤﺔ وﺳﻴﺎﺳﺎﺗﻬﺎ ﺑﺸﺄن اﻟﺘﺪﺧﻼت اﻟﻮﻗﺎﺋﻴﺔ اﻟﻤﻮﺟﻮدة ﺑﺎﻟﻔﻌﻞ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺑﺮاﻣﺞ واﻟﻤﺰَ ﻟﱢ ﻘﺎت اﻟﺠﻴﺪة اﻟﻨﻮﻋﻴﺔ وﻣﺄﻣﻮﻧﻴﺔ اﻟﻌﻮازل اﻟﺬﻛﺮﻳﺔ واﻷﻧﺜﻮﻳﺔ ُ اﻟﺤﻘﻦ واﻟﺪم. اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﺒﻠﺪان إﻋﻄﺎء أوﻟﻮﻳﺔ ﻟﻠﺘﺪﺧﻼت اﻟﻮﻗﺎﺋﻴﺔ اﻟﻌﺎﻟﻴﺔ اﻷﺛﺮ ،ﺑﻤﺎ ﻓﻴﻬﺎ إﻋﺪاد ﺑﺮاﻣﺞ اﺳﺘﺨﺪام اﻟﻌﻮازل اﻟﺬﻛﺮﻳﺔ واﻷﻧﺜﻮﻳﺔ وﻣﺄﻣﻮﻧﻴﺔ اﻟﺤﻘﻦ واﻟﺪم واﻟﺘﻮاﺻﻞ اﻟﺬي ﻳﺴﺘﻬﺪف ﺗﻐﻴﻴﺮ اﻟﺴﻠﻮك. ﺗﺤﻘﻴﻖ أﻛﺒﺮ ﻗﺪر ﻣﻦ اﻟﻔﻮاﺋﺪ اﻟﻮﻗﺎﺋﻴﺔ ﻟﻠﻌﻘﺎﻗﻴﺮ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﺑﺘﻮﺳﻴﻊ ﻧﻄﺎق ﺗﻐﻄﻴﺔ اﻟﻤﻌﺎﻟﺠﺔ ﺑﻬﺎ ﻟﺘﺸﻤﻞ ﺟﻤﻴﻊ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﻨﻔﻴﺬ اﺳﺘﺮاﺗﻴﺠﻴﺔ ﻣﺸﺘﺮﻛﺔ ﺗﺠﻤﻊ ﺑﻴﻦ اﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﻗﺒﻞ اﻟﺘﻌﺮض وﺑﻌﺪ اﻟﺘﻌﺮض ﻟﻠﻔﻴﺮوس واﻟﺘﺪﺧﻼت اﻟﻮﻗﺎﺋﻴﺔ اﻷﺧﺮى. اﻟﻘﻀﺎء ﻋﻠﻰ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﺨﻠﻘﻲ واﻟﺰﻫﺮي اﻟﺮﺿﻊ ﺑﻮﺿﻊ ﻏﺎﻳﺎت وﻃﻨﻴﺔ وﺗﻮﻓﻴﺮ اﻟﻌﻼج ﻣﺪى اﻟﺤﻴﺎة اﻟﺨﻠﻘﻲ ﺑﻴﻦ ﱠ ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﻠﺤﻮاﻣﻞ واﻟﻤﺮﺿﻌﺎت ،وﺗﻮﺳﻴﻊ ﻧﻄﺎق اﻟﺘﺸﺨﻴﺺ اﻟﺒﺎﻛﺮ ﻟﻠﺮﺿﻊ وﺗﻮﻓﻴﺮ اﻟﻌﻼج اﻟﻔﻮري ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﺠﻤﻴﻊ اﻟﺮﺿﻊ اﻟﺬﻳﻦ ﺗﺸﺨﺺ إﺻﺎﺑﺘﻬﻢ ﺑﺎﻟﻔﻴﺮوس. اﻟﺘﻨﻔﻴﺬ اﻟﻮاﺳﻊ اﻟﻨﻄﺎق ﻟﺤﺰﻣﺔ ﺷﺎﻣﻠﺔ ﻣﻦ ﺗﺪﺧﻼت ﺗﻘﻠﻴﺺ اﻷﺿﺮار اﻟﻤﺼﻤﻤﺔ ﺧﺼﻴﺼﺎً ﻟﺘﻼﺋﻢ اﻷﻧﻤﺎط اﻟﻤﺤﻠﻴﺔ ﻟﺘﻌﺎﻃﻲ اﻟﻤﺨﺪرات وﻟﻠﺴﻴﺎق اﻟﻘﻄﺮي .وﻳﻨﺒﻐﻲ إﻋﻄﺎء اﻷوﻟﻮﻳﺔ ﻟﻠﺘﺪﺧﻼت اﻟﻌﺎﻟﻴﺔ ﻘﻤﺔ واﻟﻌﻼج ﻌﱠ ﻣَ اﻷﺛﺮ واﻟﻤﻼﺋﻤﺔ واﻟﺘﻲ ﺗﺸﻤﻞ ﺗﻮﻓﻴﺮ أدوات ﺣﻘﻦ ُ ﺑﺎﻻﺳﺘﻌﺎﺿﺔ ﻋﻦ اﻟﻤﻮاد اﻷﻓﻴﻮﻧﻴﺔ وﺗﻘﺪﻳﻢ اﻟﻤﻌﻠﻮﻣﺎت ﺣﻮل ﺗﻘﻠﻴﺺ اﻷﺿﺮار واﻟﻌﻼج ﻣﻦ إدﻣﺎن اﻟﻤﺨﺪرات. إﻋﻄﺎء اﻷوﻟﻮﻳﺔ ﻟﻠﻮﻗﺎﻳﺔ اﻟﻤﺸﺘﺮﻛﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺪى اﻟﻤﺮاﻫﻘﻴﻦ واﻟﻔﺘﻴﺎت واﻟﺸﺎﺑﺎت ،وﺧﺼﻮﺻﺎً ﻓﻲ اﻟﻤﻮاﻗﻊ اﻟﺘﻲ ﺗﺮزح ﺗﺤﺖ ﻋﺐء ﻣﺮﺗﻔﻊ ﻓﻲ أﻓﺮﻳﻘﻴﺎ ﺟﻨﻮب اﻟﺼﺤﺮاء اﻟﻜﺒﺮى ،وذﻟﻚ ﺑﺎﺳﺘﺨﺪام ﺗﺪﺧﻼت ﺗﻬﺪف إﻟﻰ اﻟﺘﻘﻠﻴﻞ ﻣﻦ ﻛﻞ ﻣﻦ اﻟﺘﻌﺮض ﻟﻤﺨﺎﻃﺮ اﻟﻌﺪوى واﻟﺴﻠﻮﻛﻴﺎت اﻟﺨﻄﺮة ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﻌﻨﻒ ﱡ اﻟﻘﺎﺋﻢ ﻋﻠﻰ ﻧﻮع اﻟﺠﻨﺲ واﻟﻌﻨﻒ اﻟﺠﻨﺴﻲ واﻟﺴﻠﻮك اﻟﺠﻨﺴﻲ اﻟﺨﻄﺮ اﻟﺬي ﻳﺮاﻓﻖ ﺗﻌﺎﻃﻲ اﻟﻜﺤﻮل وﻣﻮاد اﻹدﻣﺎن اﻷﺧﺮى.
– ٠٨إﺳﺪاء اﻟﻤﺸﻮرة ﺑﺸﺄن اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻟﻰ اﻟﺮﺟﺎل اﻟﺬﻳﻦ ﻳﻤﺎرﺳﻮن اﻟﺠﻨﺲ ﻣﻊ اﻟﺮﺟﺎل ،إﻧﺪوﻧﻴﺴﻴﺎ
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
وﻳﻌﺘﺒﺮ اﻟﺘﺸﺨﻴﺺ اﻟﺒﺎﻛﺮ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ واﻟﻮﻓﻴﺎت ﺑﺸﺪةُ . اﻟﺒﺸﺮي ﺑﻴﻦ اﻟﺮﺿﻊ اﻟﻤﻮﻟﻮدﻳﻦ ﻟﻨﺴﺎء ﻣﺘﻌﺎﻳﺸﺎت ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺎﻟﻎ اﻷﻫﻤﻴﺔ ﻟﻀﻤﺎن ﺳﺮﻋﺔ اﻟﺒﺪء ﻓﻲ اﻟﻌﻼج اﻟﻤﻨﻘﺬ ﻟﻸرواح ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،وﻣﻊ ذﻟﻚ ،ﻓﻔﻲ ﻋﺎم ٢٠١٣ﻟﻢ ﻳﺘﻢ اﺧﺘﺒﺎر إﻻ أﻗﻞ ﻣﻦ ٪٥٠ﻣﻦ اﻟﺮﺿﻊ اﻟﻤﻌﺮﺿﻴﻦ ﻟﻺﺻﺎﺑﺔ ﺑﺎﻟﻔﻴﺮوس. وﺳﻴﻌﺘﻤﺪ اﺧﺘﻴﺎر أﻧﺴﺐ ﻣﺸﺎرﻛﺔ ﺑﻴﻦ ﻧﻬﻮج واﺳﺘﺮاﺗﻴﺠﻴﺎت اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻋﻠﻰ اﻷوﺿﺎع اﻟﻮﺑﺎﺋﻴﺔ ﻟﻠﻔﻴﺮوس واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺘﻀﺮرة واﻟﻨﻈﺎم اﻟﺼﺤﻲ اﻟﻤﺤﻠﻲ .وﺗﺘﻴﺢ اﻟﻨﻬﻮج اﻟﺠﺪﻳﺪة واﻟﻤﻮﺟﻬﺔ ﻓﺮﺻﺎً ﻟﻠﺘﻮﺳﻴﻊ اﻟﺴﺮﻳﻊ ﻓﻲ ﻧﻄﺎق اﻟﺘﻐﻄﻴﺔ ﺑﺨﺪﻣﺎت اﻻﺧﺘﺒﺎر وﺟﻮدﺗﻬﺎ وﻣﺮدودﻫﺎ ،وﻣﻨﻬﺎ ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل ،ﻋﺮض إﺟﺮاء اﻻﺧﺘﺒﺎر روﺗﻴﻨﻴﺎً ﻟﺠﻤﻴﻊ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ ﻓﻲ أﻣﺎﻛﻦ اﻟﺮﻋﺎﻳﺔ اﻷوﻟﻴﺔ واﻟﺴﺮﻳﺮﻳﺔ اﻟﺮﺋﻴﺴﻴﺔ َ ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺧﺪﻣﺎت اﻟﺴﻞ واﺧﺘﺒﺎر اﻷزواج واﻻﺧﺘﺒﺎرات اﻟﻤﺠﺘﻤﻌﻴﺔ واﻻﺧﺘﺒﺎر اﻟﺬاﺗﻲ واﺳﺘﺨﺪام اﻻﺧﺘﺒﺎر ﺑﻤﻌﺮﻓﺔ اﻷﺷﺨﺎص ﻏﻴﺮ اﻟﻤﺘﺨﺼﺼﻴﻦ ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ﺗﻜﻨﻮﻟﻮﺟﻴﺎت اﻻﺧﺘﺒﺎر اﻟﺘﻲ رﺑﻤﺎ ﺗﻜﻮن ﻣﺴﺘﺨﺪﻣﺔ ﻓﻲ ﻣﺮﻛﺰ اﻟﺮﻋﺎﻳﺔ .وﻋﻨﺪﻣﺎ ﺗﻜﻮن اﻟﻤﻮارد ﻣﺤﺪودة، ﻳﻨﺒﻐﻲ ﺗﻮﺟﻴﻪ اﻻﺧﺘﺒﺎر إﻟﻰ اﻟﻤﻮاﻗﻊ اﻟﺘﻲ ﺗﺤﻘﻖ أﻛﺒﺮ ﻗﺪر ﻣﻦ اﻟﻤﺮدود ﻣﻊ اﻟﺤﻔﺎظ ﻋﻠﻰ اﻹﻧﺼﺎف .وﻳﺘﻄﻠﺐ ﺗﻮﺳﻴﻊ ﻧﻄﺎق ﺗﻐﻄﻴﺔ اﻻﺧﺘﺒﺎر اﻫﺘﻤﺎﻣﺎً ﺧﺎﺻﺎً ﻟﻀﻤﺎن ﺟﻮدة وﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ وﺧﺪﻣﺎت اﻻﺧﺘﺒﺎر ﻟﻠﺤﺪ ﻣﻦ ﻣﺨﺎﻃﺮ اﻟﺨﻄﺄ ﻓﻲ ﺗﺸﺨﻴﺺ ﺣﺎﻟﺔ اﻹﺻﺎﺑﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﺗﺘﻀﻤﻦ اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﻤﻮﺣﺪة ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺑﺸﺄن ﺧﺪﻣﺎت اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إرﺷﺎدات ﺷﺎﻣﻠﺔ ﺣﻮل ﻧﻬﻮج واﺳﺘﺮاﺗﻴﺠﻴﺎت اﺧﺘﺒﺎر اﻟﻔﻴﺮوس.
ﻧﻄﺎق اﺧﺘﺒﺎرات ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي
ﺳﻴﺘﻄﻠﺐ ﺗﺤﻘﻴﻖ اﻟﻐﺎﻳﺔ اﻟﻤﺘﻤﺜﻠﺔ ﻓﻲ أن ﻳﻌﺮف ٪٩٠ﻣﻦ اﻷﺷﺨﺎص اﻟﻤﺼﺎﺑﻴﻦ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺄﻣﺮ إﺻﺎﺑﺘﻬﻢ ﺑﺤﻠﻮل ﻋﺎم ٢٠٢٠ﺗﻮﺳﻴﻊ ﻧﻄﺎق اﻻﺳﺘﺨﺪام ﻟﻨﻬﻮج واﺳﺘﺮاﺗﻴﺠﻴﺎت وﺗﻜﻨﻮﻟﻮﺟﻴﺎت ﺟﺪﻳﺪة ﻓﻌﺎﻟﺔ ﻓﻲ اﺧﺘﺒﺎر اﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻓﻲ اﻟﻮﻗﺖ ذاﺗﻪ ﺿﻤﺎن ﺟﻮدة اﻻﺧﺘﺒﺎر واﻟﻤﻤﺎرﺳﺎت اﻷﺧﻼﻗﻴﺔ ﻓﻲ ﻣﺠﺎل اﻻﺧﺘﺒﺎر .وﻳﻠﺰم أن ﺗﺴﺘﻬﺪف ﺧﺪﻣﺎت اﻻﺧﺘﺒﺎر اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻨﺎﻃﻖ واﻟﻤﻮاﻗﻊ اﻟﺠﻐﺮاﻓﻴﺔ اﻟﺘﻲ ﺗﺸﻬﺪ أﻋﻠﻰ ﻣﺴﺘﻮﻳﺎت ﻟﻤﺨﺎﻃﺮ واﻧﺘﻘﺎل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﻳﺠﺐ أن ﻳﻜﻮن اﻻﺧﺘﺒﺎر ﺑﺮﺿﺎ اﻟﻨﺎس وأن ﻳﻜﻮن ﺳﺮﻳﺎً وﻣﺼﺤﻮﺑﺎً ﺑﺘﻘﺪﻳﻢ اﻟﻤﻌﻠﻮﻣﺎت واﻟﻤﺸﻮرة اﻟﻤﻼﺋﻤﺔ. ﺗﻌﺘﺒﺮ اﺧﺘﺒﺎرات ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﺨﻄﻮة اﻷوﻟﻰ ﻋﻠﻰ ﻃﺮﻳﻖ ﺗﻤﻜﻴﻦ اﻟﻤﺼﺎﺑﻴﻦ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻦ ﻣﻌﺮﻓﺔ ﺣﺎﻟﺘﻬﻢ ورﺑﻂ اﻻﺧﺘﺒﺎر ﺑﺨﺪﻣﺎت اﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻟﻔﻴﺮوس وﻋﻼﺟﻪ ورﻋﺎﻳﺔ اﻟﻤﺼﺎﺑﻴﻦ ﺑﻪ .وﻗﺪ ﻳﺆدي اﻟﺘﺄﺧﺮ ﻓﻲ اﻟﺘﺸﺨﻴﺺ إﻟﻰ ﺗﻘﻠﻴﻞ أﺛﺮ اﻟﺠﻬﻮد اﻟﺮاﻣﻴﺔ إﻟﻰ ﺿﻤﺎن ﻓﻌﺎﻟﻴﺔ اﻟﻌﻼج ﻋﻠﻰ اﻟﻤﺪى اﻟﻄﻮﻳﻞ وﺗﻘﻠﻴﻞ اﻷﺛﺮ اﻟﻤﺤﺘﻤﻞ ﻋﻠﻰ اﻟﻮﻗﺎﻳﺔ .وﺗﺸﻴﺮ اﻟﺘﻘﺪﻳﺮات ﻋﻠﻰ اﻟﺼﻌﻴﺪ اﻟﻌﺎﻟﻤﻲ ﺑﺄن ﺣﻮاﻟﻲ ﻧﺼﻒ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺣﺎﻟﻴﺎً ﻻ ﻳﻌﺮﻓﻮن ﺣﺎﻟﺘﻬﻢ. ﻛﻤﺎ ﻳﺘﻴﺢ اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﺮﺻﺔ ﻣﻮازﻳﺔ ﻣﻊ ذﻟﻚ ﻟﺘﺤﺮي اﻷﻣﺮاض واﻷﺣﻮال اﻟﺼﺤﻴﺔ اﻷﺧﺮى ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻷﻣﺮاض اﻟﻤﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎً واﻟﺴﻞ واﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ ،وﻫﻮ ﻣﺎ ﻳﺮﺟﺢ أن ﻳﺴﻬﻢ إﺳﻬﺎﻣﺎً ﻛﺒﻴﺮاً ﻓﻲ ﺗﻘﻠﻴﺺ ﻣﻌﺪﻻت اﻟﻤﺮاﺿﺔ
اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﺒﻠﺪان اﻟﺘﻨﻮع ﻓﻲ ﻧﻬﻮج وﺧﺪﻣﺎت اﻻﺧﺘﺒﺎر ﺑﺎﻟﺠﻤﻊ ﺑﻴﻦ إﺟﺮاء اﻻﺧﺘﺒﺎرات ﺑﻤﺒﺎدرة ﻣﻦ ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺎت واﻻﺧﺘﺒﺎرات اﻟﺘﻲ ﺗﺮﺗﻜﺰ ﻋﻠﻰ اﻟﻤﺠﺘﻤﻊ، ﺗﺤﻘﻴﻖ ّ وﺗﺸﺠﻴﻊ ﻻﻣﺮﻛﺰﻳﺔ اﻟﺨﺪﻣﺎت ،واﻻﺳﺘﻔﺎدة ﻣﻦ ﺧﺪﻣﺎت اﺧﺘﺒﺎر اﻟﻔﻴﺮوس ﻻﺧﺘﺒﺎر وﺗﺤﺮي اﻹﺻﺎﺑﺔ ﺑﺎﻷﻣﺮاض واﻷﺣﻮال اﻟﺼﺤﻴﺔ اﻷﺧﺮى. ﺗﺮﻛﻴﺰ ﺧﺪﻣﺎت اﻻﺧﺘﺒﺎر ﻟﻠﻮﺻﻮل إﻟﻰ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻷﻣﺎﻛﻦ اﻟﺘﻲ ﺗﺸﻬﺪ أﻋﻠﻰ ﻋﺐء ﻟﻠﻔﻴﺮوس وﻟﺘﺤﻘﻴﻖ اﻹﻧﺼﺎف. اﻟﻤﻮﺳﻌﺔ ﺑﺘﻜﻨﻮﻟﻮﺟﻴﺎت اﻟﺘﺸﺨﻴﺺ اﻟﻤﺒﻜﺮ ﻟﻠﺮﺿﻊ. إﻋﻄﺎء اﻷوﻟﻮﻳﺔ ﻟﻠﺘﻐﻄﻴﺔ ﱠ ﺿﻤﺎن اﺳﺘﻴﻔﺎء ﺧﺪﻣﺎت اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻠﻤﻌﺎﻳﻴﺮ اﻷﺧﻼﻗﻴﺔ وﻟﻤﻌﺎﻳﻴﺮ اﻟﺠﻮدة. اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﺘﺤﺪﻳﺚ اﻟﻤﻨﺘﻈﻢ ﻟﻠﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﻤﻮﺣﺪة ﺑﺸﺄن اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﺧﺘﺒﺎر ﺣﺎﻻت اﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ اﻟﺸﺎﺋﻌﺔ، واﻹدﻣﺎج ﻟﻠﺴﺮﻳﻊ ﻟﻺرﺷﺎدات ﺣﻮل اﻟﺠﺪﻳﺪ ﻣﻦ ﻧﻬﺞ اﻻﺧﺘﺒﺎر واﻻﺳﺘﺮاﺗﻴﺠﻴﺎت ووﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ. ﻣﺴﺎﻧﺪة اﻟﺒﻠﺪان ﻟﺘﻨﻔﻴﺬ ﺑﺮاﻣﺞ ﻟﻀﻤﺎن ﺟﻮدة اﻻﺧﺘﺒﺎرات ﻣﻊ اﻻﺳﺘﺮﺷﺎد ﺑﺎﻟﺒﻴﺎﻧﺎت ﺣﻮل اﻟﺨﻄﺄ ﻓﻲ اﻟﺘﺸﺨﻴﺺ واﻟﺨﻄﺄ ﻓﻲ اﻟﺘﺼﻨﻴﻒ. اﻟﻤﺤﺪﺛﺔ واﻟﺪﻋﻢ اﻟﺘﻘﻨﻲ ﻟﻠﺒﻠﺪان ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻣﺴﺎﻧﺪة ﺗﻮﺳﻴﻊ ﻧﻄﺎق اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻴﻦ اﻷﻃﻔﺎل ﻣﻦ ﺧﻼل اﻹرﺷﺎدات ﱠ اﻟﺘﺸﺨﻴﺺ واﻻﺧﺘﺒﺎر اﻟﺒﺎﻛﺮان ﻟﻠﺮﺿﻊ ﻓﻲ اﻟﺒﻴﺌﺎت اﻟﺘﻲ ﺗﻘﻞ ﻓﻴﻬﺎ ﻣﻌﺪﻻت اﻻﻧﺘﺸﺎر.
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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ﻧﺠﺎﻋﺔ اﻟﻌﻼج وﺑﺸﺄن اﻟﺴﻤﻴﺔ ،ﻣﻊ اﻟﺘﺤﺪﻳﺜﺎت اﻟﻤﻨﺘﻈﻤﺔ ﻟﻠﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﻤﻮﺣﺪة ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺑﺸﺄن ﻣﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،ﺗﻀﻤﻦ اﺳﺘﺮﺷﺎد اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ واﻟﺒﺮوﺗﻮﻛﻮﻻت اﻟﻮﻃﻨﻴﺔ ﻟﻠﻌﻼج ﺑﺄﺣﺪث اﻟﺒﻴﻨﺎت اﻟﻌﻠﻤﻴﺔ واﻷدوﻳﺔ واﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎت اﻟﺠﺪﻳﺪة واﻟﺘﺠﺎرب اﻟﻘﻄﺮﻳﺔ ﻓﻲ ﺗﻮﺳﻴﻊ ﻧﻄﺎق اﻟﻌﻼج .وﻳﺸﻜﻞ اﻻﻓﺘﻘﺎر إﻟﻰ اﻟﺘﺸﺨﻴﺺ اﻟﺒﺎﻛﺮ ﻟﻠﺮﺿﻊ وإﻟﻰ ﺗﻮﻟﻴﻔﺎت اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ اﻟﺜﺎﺑﺘﺔ اﻟﺠﺮﻋﺔ وإﻟﻰ ﺗﺮﻛﻴﺒﺎت ﻣﺴﺘﺴﺎﻏﺔ ﻣﻦ اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻋﻮاﺋﻖ ﺧﺎﺻﺔ أﻣﺎم اﻟﺘﻮﺳﻊ ﻓﻲ ﻋﻼج اﻷﻃﻔﺎل. وﻟﺘﺤﻘﻴﻖ أﻗﺼﻰ ﻗﺪر ﻣﻤﻜﻦ ﻣﻦ اﻟﺤﺼﺎﺋﻞ اﻟﻌﻼﺟﻴﺔ ،ﻳﻨﺒﻐﻲ اﻟﺒﺪء ﻓﻲ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻓﻲ أﻗﺮب وﻗﺖ ﻳﻮﺿﺢ ﻣﺪى اﻟﺤﺎﺟﺔ إﻟﻰ ﻣﻤﻜﻦ ﻟﻜﻞ ﻣﻦ اﻟﺒﺎﻟﻐﻴﻦ واﻷﻃﻔﺎل ،ﻣﻤﺎ ﱢ اﻟﺘﺸﺨﻴﺺ اﻟﺒﺎﻛﺮ وإﻟﻰ اﻟﺮواﺑﻂ اﻟﻔﻌﺎﻟﺔ ﺑﺎﻟﻌﻼج ﻟﻤﻦ ﻳﺜﺒﺖ اﻻﺧﺘﺒﺎر إﺻﺎﺑﺘﻬﻢ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. اﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻤﺼﺎﺣﺒﺔ ﺑﺎﻟﺴﻞ وﺗﺪﺑﻴﺮﻫﺎ اﻟﻌﻼﺟﻲ :أﺳﻔﺮت ﻓﻌﺎﻟﻴﺔ اﻟﺘﺪﺑﻴﺮ اﻟﻌﻼﺟﻲ اﻟﻤﺸﺘﺮك ﻟﻠﺴﻞ وﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻋﻦ ﺗﺮاﺟﻊ ﻋﺪد اﻷﺷﺨﺎص اﻟﺬﻳﻦ ﻳﻤﻮﺗﻮن ﻧﺘﻴﺠﺔ اﻟﺴﻞ اﻟﻤﺮﺗﺒﻂ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻤﻘﺪار اﻟﻨﺼﻒ ﺑﻴﻦ ﻋﺎﻣﻲ ٢٠٠٤ و .٢٠١٤ﻟﻜﻦ اﻟﺴﻞ ﻳﻈﻞ اﻟﺴﺒﺐ اﻟﺮﺋﻴﺴﻲ ﻟﻠﻤﺮاﺿﺔ ﺑﻴﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﺗﺸﻴﺮ اﻟﺘﻘﺪﻳﺮات اﻟﻌﺎﻟﻤﻴﺔ إﻟﻰ أﻧﻪ ﻳﺸﻜﻞ ﻧﺤﻮ ﺛﻠﺚ اﻟﻮﻓﻴﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .ﻛﻤﺎ ﺗﺸﻴﺮ إﻟﻰ أن أﻛﺜﺮ ﻣﻦ ﻧﺼﻒ ﺣﺎﻻت اﻟﺴﻞ اﻟﻤﺼﺎﺣﺒﺔ ﻟﻠﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻢ ﻳﺘﻢ ﻛﺸﻔﻬﺎ ،ﻣﻤﺎ ﻳﻘﻠﱢ ﻞ ﻣﻦ إﻣﻜﺎﻧﻴﺔ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﻌﻼج اﻟﻤﻨﻘﺬ ﻟﻸرواح ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ .وﻣﻦ أﺟﻞ ﺧﻔﺾ ﻣﻌﺪﻻت اﻟﻤﺮاﺿﺔ واﻟﻮﻓﻴﺎت ذات اﻟﻌﻼﻗﺔ ﺑﺎﻟﺴﻞ ﻻﺑﺪ ﻣﻦ اﻟﺘﻨﻔﻴﺬ اﻟﻤﻜﺜﻒ ﻟﻠﺘﺪﺧﻼت اﻟﺮﺋﻴﺴﻴﺔ واﻹﻗﺒﺎل ﻋﻠﻴﻬﺎ ﺑﻜﺜﺎﻓﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺘﺤﺮي اﻟﻤﻨﻬﺠﻲ ﻟﻠﺴﻞ ﺑﻴﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻟﻌﻼج اﻟﻮﻗﺎﺋﻲ ﺑﺎﻹﻳﺰوﻧﻴﺎزﻳﺪ، وإﺟﺮاء اﺧﺘﺒﺎر ﺗﺤﺮي ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻜﻞ اﻷﺷﺨﺎص اﻟﺬﻳﻦ ﻳﺜﺒﺖ اﻟﺘﺸﺨﻴﺺ إﺻﺎﺑﺘﻬﻢ ﺑﺎﻟﺴﻞ أو ﻣﻦ ﻳﻔﺘﺮض إﺻﺎﺑﺘﻬﻢ ﺑﺎﻟﺴﻞ ،وﺳﺮﻋﺔ اﻟﺒﺪء ﻓﻲ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ واﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﺑﺎﻟﻜﻮﺗﺮﻳﻤﻮﻛﺴﺎزول. اﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻤﺼﺎﺣﺒﺔ ﺑﺎﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ وﺗﺪﺑﻴﺮﻫﺎ اﻟﻌﻼﺟﻲ :ﺗﻌﺘﺒﺮ ﺣﺎﻟﺔ اﻟﻌﺪوى اﻟﻤﺰﻣﻨﺔ ﺑﻔﻴﺮوس اﻟﺘﻬﺎب اﻟﻜﺒﺪ Bوﺣﺎﻟﺔ اﻟﻌﺪوى اﻟﻤﺰﻣﻨﺔ ﺑﻔﻴﺮوس اﻟﺘﻬﺎب اﻟﻜﺒﺪ Cﺳﺒﺒﻴﻦ ﻣﺘﺰاﻳﺪﻳﻦ ﻟﻠﻤﺮاﺿﺔ واﻟﻮﻓﻴﺎت ﺑﻴﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻟﺒﻠﺪان .وﺗﺮﺗﻔﻊ ﻣﻌﺪﻻت اﻹﺻﺎﺑﺔ ﺑﺎﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻤﺼﺎﺣﺒﺔ ﺑﻔﻴﺮوس اﻟﺘﻬﺎب اﻟﻜﺒﺪ Cأﻋﻠﻰ ﻣﺎ ﻳﻜﻮن ﺑﻴﻦ ﻣﺘﻌﺎﻃﻲ اﻟﻤﺨﺪرات ﺣﻘﻨﺎً ، وﻫﻮ أﻣﺮ ﻳﺆﺛﺮ ﻓﻲ ﺟﻤﻴﻊ اﻷﻗﺎﻟﻴﻢ ،وﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﺄﺛﻴﺮ ﻋﻤﻴﻖ ﻋﻠﻰ اﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﺘﻬﺎب اﻟﻜﺒﺪ B وﻓﻴﺮوس اﻟﺘﻬﺎب اﻟﻜﺒﺪ ،Cﻣﻤﺎ ﻳﺘﺴﺒﺐ ﻓﻲ ارﺗﻔﺎع ﻣﻌﺪﻻت اﻟﻌﺪوى اﻟﻤﺰﻣﻨﺔ ﺑﻔﻴﺮوس اﻟﺘﻬﺎب اﻟﻜﺒﺪ وﺗﺴﺮﻳﻊ وﺗﻴﺮة اﻟﺘﻔﺎﻗﻢ اﻟﺘﺸﻤﻊ اﻟﻜﺒﺪي وﻛﺎرﺳﻴﻨﻮﻣﺔ ﺗﻠﻴﻒ اﻟﻜﺒﺪ ﻣﻊ ازدﻳﺎد ﻣﺨﺎﻃﺮ ّ إﻟﻰ ﱡ اﻟﺨﻼﻳﺎ اﻟﻜﺒﺪﻳﺔ وارﺗﻔﺎع ﻣﻌﺪﻻت اﻟﻮﻓﻴﺎت اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﻜﺒﺪ. وﻻﺑﺪ ﻣﻦ ﺗﻮﻓﻴﺮ اﻟﺘﺪﺑﻴﺮ اﻟﻌﻼﺟﻲ اﻟﻤﺘﻜﺎﻣﻞ ﻟﻠﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺑﻔﻴﺮوس اﻟﺘﻬﺎب اﻟﻜﺒﺪ ،ﻣﻊ اﻟﺘﺸﺨﻴﺺ واﻟﻌﻼج اﻟﺒﺎﻛﺮﻳﻦ ﻟﻠﻌﺪوى ﺑﻜﻞ ﻣﻨﻬﻤﺎ اﺳﺘﻨﺎداً إﻟﻰ اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺑﺸﺄن ﻋﻼج ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻓﻴﺮوس اﻟﺘﻬﺎب اﻟﻜﺒﺪ Bوﻓﻴﺮوس اﻟﺘﻬﺎب اﻟﻜﺒﺪ .C اﻟﺘﺼﺪي ﻟﺤﺎﻻت أﺧﺮى ﻣﻦ اﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي :ﻳﺘﺒﺎﻳﻦ اﻧﺘﺸﺎر وأﺛﺮ اﻟﺤﺎﻻت اﻷﺧﺮى ﻣﻦ اﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ ،اﻻﻧﺘﻬﺎزﻳﺔ ﻣﻨﻬﺎ وﻏﻴﺮ اﻻﻧﺘﻬﺎزﻳﺔ ،ﺑﻴﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺣﺴﺐ
ﺗﻮﺳﻴﻊ ﻧﻄﺎق اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ واﻟﺘﺪﺑﻴﺮ اﻟﻌﻼﺟﻲ ﻟﻸﻣﺮاض اﻟﻤﺼﺎﺣﺒﺔ وﺗﻮﻓﻴﺮ اﻟﺮﻋﺎﻳﺔ ﻟﻠﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ
ﺳﻴﺘﻄﻠﺐ ﺗﺤﻘﻴﻖ اﻟﻐﺎﻳﺔ اﻟﻤﺘﻤﺜﻠﺔ ﻓﻲ ﻣﻌﺎﻟﺠﺔ ٪٩٠ﻣﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﺑﺤﻠﻮل ﻋﺎم ٢٠٢٠ﺗﺴﺮﻳﻊ وﺗﻴﺮة اﻟﺘﻮﺳﻊ ﻓﻲ ﻫﺬا اﻟﻌﻼج وﺗﺤﺴﻴﻦ اﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﺮﺿﻰ ﻓﻲ اﻟﺮﻋﺎﻳﺔ. وﺳﻴﺘﻄﻠﺐ ﺗﺤﻘﻴﻖ اﻟﻐﺎﻳﺔ اﻟﻤﺘﻤﺜﻠﺔ ﻓﻲ ﻛﺒﺖ اﻟﻔﻴﺮوس ﻟﺪى ٪٩٠ ﻣﻦ اﻟﺬﻳﻦ ﻳﻌﺎﻟﺠﻮن ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﺗﺤﺴﻴﻨﺎت ﺑﺘﻘﺒﻞ ﺟﻴﺪ ﻛﺒﻴﺮة ﻓﻲ اﻻﻟﺘﺰام ﺑﺎﻟﻌﻼج ،وﻧﻈﻤﺎً ﻗﻮﻳﺔ وﺗﺤﻈﻰ ّ ﻓﻌﺎﻻ ﻟﻤﻘﺎوﻣﺔ ﻟﻠﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،وﺗﺮﺻﺪاً ً أدوﻳﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وأﻧﻈﻤﺔ ﻟﺮﺻﺪ اﻟﺴﻤﻴﺔ ﻹﻧﻘﺎص إﺧﻔﺎق اﻟﻌﻼج .وﺗﻘﺪم اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺣﻮل اﺳﺘﺨﺪام اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ اﻟﻮﺳﻴﻠﺔ ﻟﺘﺤﻘﻴﻖ ﻏﺎﻳﺔ ﺗﻐﻄﻴﺔ ٪٩٠واﻟﻤﺴﺎﻋﺪة ﻓﻲ ﺗﺒﺴﻴﻂ ﺑﺮوﺗﻮﻛﻮﻻت اﻟﺒﺪء ﺑﺎﻟﻤﻌﺎﻟﺠﺔ ﻣﻦ ﺧﻼل ﺗﻮﺻﻴﺘﻬﺎ ﺑﻀﺮورة ﺑﺪء ﻛﻞ ﺷﺨﺺ ﻳﺘﻢ ﺗﺸﺨﻴﺺ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺪﻳﻪ ﺑﺎﻟﻤﻌﺎﻟﺠﺔ ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻓﻲ أﻗﺮب وﻗﺖ ﻣﻤﻜﻦ ﺑﻌﺪ اﻟﺘﺸﺨﻴﺺ .وﻋﻠﻰ اﻟﺒﻠﺪان أن ﺗﻀﻊ ﺧﻄﻄﻬﺎ اﻟﻮﻃﻨﻴﺔ ﻟﻠﻤﻌﺎﻟﺠﺔ اﻟﺘﻲ ﺗﻜﻮن ﺑﻤﺜﺎﺑﺔ ﺧﺮﻳﻄﺔ ﻃﺮﻳﻖ ﻟﺘﻮﺳﻴﻊ ﻧﻄﺎق اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﻤﻌﺎﻟﺠﺔ ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻣﻦ ﺧﻼل اﻟﺮﻋﺎﻳﺔ اﻟﺘﻔﺎﺿﻠﻴﺔ اﻟﺘﻲ ﺗﻀﻤﻦ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﻤﻌﺎﻟﺠﺔ ﺑﺴﺮﻋﺔ وﺑﺈﻧﺼﺎف وﻻﺳﻴﻤﺎ ﻟﻠﻨﺎس اﻟﺬﻳﻦ ﻳﻌﺎﻧﻮن ﻣﻦ ﻣﺮﺣﻠﺔ ﻣﺘﻘﺪﻣﺔ ﻣﻦ اﻟﻤﺮض اﻟﻤﺮﺗﺒﻂ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي . ﻟﻘﺪ ﺗﺤﻘﻘﺖ اﻟﻐﺎﻳﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﻤﺘﻤﺜﻠﺔ ﻓﻲ ﺗﻠﻘﻲ ١٥ﻣﻠﻴﻮن ﺷﺨﺺ ﻟﻠﻌﻼج ﻓﻲ ﻣﻄﻠﻊ ﻋﺎم ،٢٠١٥وﻣﻊ ذﻟﻚ ﻓﺈن ﻫﺬا اﻟﻌﺪد ﻻ ﻳﻤﺜﻞ إﻻ ٪٤٠ﻣﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻟﺬﻳﻦ ﻳﻨﺒﻐﻲ أن ﻳﺤﺼﻞ ﺟﻤﻴﻌﻬﻢ ﻋﻠﻰ اﻟﻌﻼج .وﻳﺒﺪو أن اﻟﻮﺿﻊ ﺳﻴﺊ ﺑﺨﺎﺻﺔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻷﻃﻔﺎل اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،اﻟﺬﻳﻦ ﻟﻢ ﻳﻜﻦ ﻳﺘﻠﻘﻰ ﻣﻨﻬﻢ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻓﻲ ﻋﺎم ٢٠١٤إﻻ .٪٣٢ ﻛﺬﻟﻚ ﻓﺈن ﻣﻦ ﻳﻨﺘﻤﻮن إﻟﻰ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ ﻋﺎدة ﻣﺎ ﻳﺘﺪﻧﻰ ﻣﺴﺘﻮى ﺣﺼﻮﻟﻬﻢ ﻋﻠﻰ اﻟﻌﻼج َ ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ .ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ذﻟﻚ ،ﻓﻤﻊ ﻋﻼج اﻟﻤﺰﻳﺪ ﻣﻦ اﻷﺷﺨﺎص اﻟﺬﻳﻦ ﻟﻴﺲ ﻟﺪﻳﻬﻢ أﻋﺮاض ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻤﻞ اﻟﻔﻴﺮوﺳﻲ ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،ﺳﻴﻜﻮن ﻣﻦ اﻟﻤﻬﻢ اﺧﺘﺒﺎر ِ اﻟﺤ ْ ﻟﺪﻳﻬﻢ ﻣﻦ أﺟﻞ ﺗﻘﻴﻴﻢ ﻓﻌﺎﻟﻴﺔ اﻟﻌﻼج وﻣﻨﻊ ﻇﻬﻮر اﻟﻤﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﻣﻦ اﻟﻀﺮوري ﺗﺮﺻﺪ اﻟﻤﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ أن ﻳﺘﻢ ّ اﻟﺒﺸﺮي ﻋﻠﻰ ﻣﺴﺘﻮى اﻟﺴﻜﺎن ﻟﺮﺻﺪ ﺟﻮدة ﺑﺮاﻣﺞ اﻟﻌﻼج واﺧﺘﻴﺎر ﻈﻢ اﻟﻌﻼﺟﻴﺔ .وﻣﺎزال اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺨﻂ اﻟﺜﺎﻧﻲ واﻟﺜﺎﻟﺚ ﻣﻦ اﻟﻨﱡ ُ ﻈﻢ اﻟﻌﻼﺟﻴﺔ ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻣﺤﺪوداً اﻟﻨﱡ ُ ﺑﺸﺪة ﻓﻲ ﻣﻌﻈﻢ اﻟﺒﻠﺪان اﻟﻤﻨﺨﻔﻀﺔ اﻟﺪﺧﻞ واﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ، ﻳﻮﺿﺢ أﻫﻤﻴﺔ ﻣﻨﻊ اﻹﺧﻔﺎق ﻓﻲ ﻋﻼج اﻟﺨﻂ اﻷول. ﻣﻤﺎ ﱢ وﻣﻊ اﺗﺴﺎع ﻧﻄﺎق اﻟﺘﻐﻄﻴﺔ ﺑﺎﻟﻤﻌﺎﻟﺠﺔ ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،ﻳﻌﺎﻧﻲ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻮن ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي أﻳﻀﺎً ﻣﻦ ﻣﺠﻤﻮﻋﺔ واﺳﻌﺔ ﻣﻦ اﻟﻤﺸﻜﻼت اﻟﺼﺤﻴﺔ اﻷﺧﺮى ،ﻣﻦ ﺿﻤﻨﻬﺎ اﻟﻤﺸﻜﻼت اﻟﻤﺘﻌﻠﻘﺔ ﺑﻌﺪوى ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺑﻌﻼج ﻫﺬا اﻟﻔﻴﺮوس ،واﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ واﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ ﻏﻴﺮ اﻟﻤﺮﺗﺒﻄﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻟﺸﻴﺨﻮﺧﺔ ،وﻛﻠﻬﺎ ﺗﺘﻄﻠﺐ رﻋﺎﻳﺔ وﺗﺪﺑﻴﺮاً ﻋﻼﺟﻴﺎً ﺷﺎﻣﻠﻴﻦ. ﺗﻮﺳﻴﻊ ﻧﻄﺎق اﻟﺘﻐﻄﻴﺔ ﺑﺎﻟﻤﻌﺎﻟﺠﺔ ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت ﻈﻢ اﻟﻌﻼﺟﻴﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ :إن اﻟﻨﱡ ُ ﺪم ﻓﻲ اﻟﺨﻂ اﻷول وﺗﺘﺴﻢ ﺑﺎﻟﻤﺄﻣﻮﻧﻴﺔ اﻟﻘﻬﻘﺮﻳﺔ اﻟﺘﻲ ﺗُ ﺴﺘَ ْ ﺨَ وﺑﺎﻟﺒﺴﺎﻃﺔ وﺑﺎﻟﺘﻜﻠﻔﺔ اﻟﻤﻴﺴﻮرة وﺑﺎﻟﺘﻘﺒﻞ اﻟﺠﻴﺪ وﺑﺎﺳﺘﺨﺪام ﺗﻮﻟﻴﻔﺎت ﺛﺎﺑﺘﺔ اﻟﺠﺮﻋﺔ ﺑﻘﺮص واﺣﺪ ﻳﻮﻣﻴﺎً ،ﺗﻤﻜﱢ ﻦ ﻣﻦ اﻟﺘﻮﺳﻴﻊ اﻟﺴﺮﻳﻊ واﻟﻤﺴﺘﺪام ﻟﻠﻌﻼج ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﺪى اﻟﺒﺎﻟﻐﻴﻦ .وإن اﻟﺘﻘﻴﻴﻢ اﻟﻤﺴﺘﻤﺮ ﻟﻠﺒﻴﻨﺎت ﺑﺸﺄن
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
ﺗﻮﻓﻴﺮ رﻋﺎﻳﺔ ﺗﺮﻛﱢ ﺰ ﻋﻠﻰ اﻷﺷﺨﺎص ﻟﻠﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ ﻣﻦ اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي :ﻳﻤﻜﻦ ﺗﺤﺴﻦ اﻟﺤﺎﻟﺔ اﻟﺼﺤﻴﺔ ﻟﺘﺪﺧﻼت اﻟﺮﻋﺎﻳﺔ اﻟﺒﺴﻴﻄﺔ واﻟﻔﻌﺎﻟﺔ أن ﱢ ﱠ اﻟﻌﺎﻣﺔ واﻟﻤﻌﺎﻓﺎة ﻟﺪى اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻣﻦ ﺗﻠﻚ اﻟﺘﺪﺧﻼت ﺗﻮاﻓﺮ اﻟﺘﻐﺬﻳﺔ اﻟﻜﺎﻓﻴﺔ اﻟﻤﻴﺎه اﻟﻤﺄﻣﻮﻧﺔ واﻹﺻﺤﺎح واﻟﺮﻋﺎﻳﺔ اﻟﺘﻠﻄﻴﻔﻴﺔ .وﻳﻌﺘﺒﺮ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻮن ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻌﺮﺿﻴﻦ ﺑﺼﻮرة زاﺋﺪة ﻟﻤﺨﺎﻃﺮ اﻹﺻﺎﺑﺔ ﺑﻤﺠﻤﻮﻋﺔ ﻣﻦ اﻷﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ ﻧﺘﻴﺠﺔ ﻋﺪواﻫﻢ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي أو اﻵﺛﺎر اﻟﺠﺎﻧﺒﻴﺔ ذات اﻟﺴﻦ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ أﻣﺮاض اﻟﻌﻼﻗﺔ ﺑﻌﻼﺟﻬﻢ أو ﺑﺘﻘﺪﻣﻬﻢ ﻓﻲ ّ اﻟﻘﻠﺐ واﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ واﻟﺴﻜﺮي وأﻣﺮاض اﻟﺮﺋﺔ اﻟﻤﺰﻣﻨﺔ وﻣﺨﺘﻠﻒ أﻣﺮاض اﻟﺴﺮﻃﺎن .وﻣﻦ اﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ اﻷﺧﺮى اﻟﺸﺎﺋﻌﺔ ذات اﻟﻌﻼﻗﺔ ﺑﺎﻟﺼﺤﺔ اﻟﻨﻔﺴﻴﺔ اﻻﻛﺘﺌﺎب واﻟﻘﻠﻖ واﻟﺨﺮف واﻻﺿﻄﺮاﺑﺎت اﻷﺧﺮى ﻓﻲ اﻹدراك .وﻳﻨﺒﻐﻲ أن ﺗﺸﻤﻞ ﺧﺪﻣﺎت اﻟﺮﻋﺎﻳﺔ اﻟﻤﻘﺪﻣﺔ ﻟﺤﺎﻻت اﻹﺻﺎﺑﺔ اﻟﻤﺰﻣﻨﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﺪﺧﻼت ﺗﺸﻤﻞ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﻠﺮﻋﺎﻳﺔ ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺗﺤﺮي اﻟﻤﺨﺎﻃﺮ اﻟﺼﺤﻴﺔ واﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ اﻷﻛﺜﺮ ﺷﻴﻮﻋﺎً ﺑﻴﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي، ورﺻﺪﻫﺎ وﺗﺪﺑﻴﺮﻫﺎ اﻟﻌﻼﺟﻲ .وﻳﺘﻄﻠﺐ ﻛﻞ ﻣﻦ ﻋﺐء ﺳﺮﻃﺎن ﻋﻨﻖ اﻟﺮﺣﻢ اﻟﻤﺘﺰاﻳﺪ ﺑﻴﻦ اﻟﻤﺘﻌﺎﻳﺸﺎت ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻟﺬي ﻳﺮﺗﺒﻂ ﺑﺎﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻮرم اﻟﺤﻠﻴﻤﻲ اﻟﺒﺸﺮي، ﻓﻌﺎل ﻣﻀﺎد ﻟﻔﻴﺮوس اﻫﺘﻤﺎﻣﺎً ﺧﺎﺻﺎً ،وﻻﺳﻴﻤﺎ ﻣﻊ ﺗﻮاﻓﺮ ﻟﻘﺎح ّ اﻟﻮرم اﻟﺤﻠﻴﻤﻲ اﻟﺒﺸﺮي ،وﺗﻮاﻓﺮ اﻟﺘﺤﺮي واﻟﻌﻼج اﻟﻨﺎﺟﻌﻴﻦ .وﻳﻌﺘﺒﺮ اﻟﺘﺪﺑﻴﺮ اﻟﻌﻼﺟﻲ اﻟﻔﻌﺎل ﻟﻸﻟﻢ واﻟﺮﻋﺎﻳﺔ اﻟﻤﻠﻄﻔﺔ واﻟﺮﻋﺎﻳﺔ ﻓﻲ ﻧﻬﺎﻳﺔ اﻟﺤﻴﺎة أﻳﻀﺎً ﺗﺪﺧﻼت ﺿﺮورﻳﺔ ﻳﻨﺒﻐﻲ إدراﺟﻬﺎ ﻓﻲ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي.
ﻤﻢ ﻛﻞ ﺼﱠ اﻟﺒﻠﺪ واﻟﻤﺠﻤﻮﻋﺔ اﻟﺴﻜﺎﻧﻴﺔ ،ﻣﻤﺎ ﻳﺘﻄﻠﺐ اﺳﺘﺠﺎﺑﺎت ﺗُ َ ﻣﻨﻬﺎ ﻟﺘﻼﺋﻢ ذﻟﻚ اﻟﺒﻠﺪ وﺗﻠﻚ اﻟﻤﺠﻤﻮﻋﺔ اﻟﺴﻜﺎﻧﻴﺔ .وإذا ﻟﻢ ﻳﺘﻢ اﻟﺘﺼﺪي ﻟﺤﺎﻻت اﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ ﻫﺬه ﻓﻤﻦ ﺷﺄﻧﻬﺎ أن ﺗﻘﻠﱢ ﻞ ﻣﻦ اﻟﻤﻜﺎﺳﺐ اﻟﺘﻲ ﺗﻢ ﺗﺤﻘﻴﻘﻬﺎ ﻣﻦ ﺧﻼل اﻟﺘﻮﺳﻊ ﻓﻲ اﻟﻌﻼج ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ .ﻛﻤﺎ ﻳﻨﺒﻐﻲ إﻳﻼء اﻫﺘﻤﺎم ﺧﺎص ﻟﻠﻮﻗﺎﻳﺔ وﻟﻼﻛﺘﺸﺎف اﻟﺒﺎﻛﺮ واﻟﻌﻼج ﻟﻠﺤﺎﻻت اﻷﺧﺮى ﻣﻦ اﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ ﻀﺎت ،وداء اﻟﻤﺴﺘﺨﻔﻴﺎت ،واﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻤ ْﺒ َﻴ ﱠ اﻟﺸﺎﺋﻌﺔ ،ﻣﺜﻞ داء ُ اﻟﺤﻠَ ْﻴﻤﻲ اﻟﺒﺸﺮي واﻷﻣﺮاض اﻷﺧﺮى ﻟﻠﻌﺪوى اﻟﻤﻨﻘﻮﻟﺔ ﺟﻨﺴﻴﺎً، اﻟﻮرم ُ واﻟﻤﻼرﻳﺎ ،واﻻﻟﺘﻬﺎب اﻟﺮﺋﻮي ﺑﺎﻟﻤﺘﻜﻴﺴﺔ اﻟﺠﺆﺟﺆﻳﺔ. اﻟﻮﻗﺎﻳﺔ واﻟﺘﺪﺑﻴﺮ اﻟﻌﻼﺟﻲ ﻟﻠﻤﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي :إن ﻟﻤﻨﻊ ﻇﻬﻮر اﻟﻤﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺘﺪﺑﻴﺮ اﻟﻌﻼﺟﻲ ﻟﺘﻠﻚ اﻟﻤﻘﺎوﻣﺔ أﻫﻤﻴﺔ ﺣﺎﺳﻤﺔ ﻓﻲ وﻗﺖ ﻳﻤﻀﻲ ﻓﻴﻪ اﻟﻌﺎﻟﻢ ﻧﺤﻮ ﻛﻞ ﻣﻦ ﺗﻮﺳﻴﻊ ﻧﻄﺎق اﺳﺘﺨﺪام اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻌﻼج اﻟﻔﻴﺮوس وﻟﻠﻮﻗﺎﻳﺔ ﻣﻨﻪ وﻣﻦ اﻟﺘﺒﻜﻴﺮ ﻓﻲ ذﻟﻚ .وﻳﻌﺘﺒﺮ اﻟﺘﺼﺪي ﻟﻤﻘﺎوﻣﺔ اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺎﻟﻎ اﻷﻫﻤﻴﺔ ﻟﺘﺤﻘﻴﻖ اﻟﻜﺒﺖ اﻟﻔﻴﺮوﺳﻲ واﻟﺘﺼﺪي ﻹﺧﻔﺎق اﻟﻌﻼج وﺗﻔﺎدي اﻟﺤﺎﺟﺔ إﻟﻰ اﻻﻧﺘﻘﺎل إﻟﻰ أدوﻳﺔ اﻟﺨﻄﻴﻦ اﻟﺜﺎﻧﻲ واﻟﺜﺎﻟﺚ – وﻫﻲ أدوﻳﺔ أﻛﺜﺮ ﺗﻜﻠﻔﺔ وأﺷﺪ ﺳﻤﻴﺔ ﻣﻦ أدوﻳﺔ اﻟﺨﻂ اﻷول -ﻣﻦ ﻈﻢ اﻟﻌﻼج ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ .وﻻﺑﺪ ﻣﻦ ﻧُ ُ ﺗﺮﺻﺪ اﻟﻤﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ دﻣﺞ ّ اﻟﺒﺸﺮي ورﺻﺪ ﻣﺆﺷﺮات اﻹﻧﺬار اﻟﻤﺒﻜﺮ ﻓﻲ اﻟﺨﺪﻣﺎت اﻟﻮﻃﻨﻴﺔ ﻟﻌﻼج ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺟﻬﻮد ﺗﺤﺴﻴﻦ اﻟﺠﻮدة وﻧﻈﻢ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ اﻟﻮﻃﻨﻴﺔ ﺑﺸﻜﻞ أﻋﻢ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻣﺎ ﻳﺨﺺ اﻟﻤﻘﺎوﻣﺔ ﻟﻤﻀﺎدات اﻟﻤﻴﻜﺮوﺑﺎت.
اﻟﻌﻼج واﻟﺮﻋﺎﻳﺔ اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﺒﻠﺪان اﻟﻤﺮاﺟﻌﺔ واﻟﺘﺤﺪﻳﺚ اﻟﻤﻨﺘﻈﻢ ﻟﻠﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ واﻟﺒﺮوﺗﻮﻛﻮﻻت اﻟﻮﻃﻨﻴﺔ ﻟﻌﻼج ورﻋﺎﻳﺔ ﻣﺮﺿﻰ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﺑﻤﺎ ﻓﻴﻬﺎ اﻹرﺷﺎدات ﺣﻮل اﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ اﻟﺸﺎﺋﻌﺔ وﺗﺪﺑﻴﺮﻫﺎ اﻟﻌﻼﺟﻲ. ﻈﻢ وأﺳﺎﻟﻴﺐ وﺿﻊ وﺗﺤﺪﻳﺚ ﺧﻄﻂ اﻟﻤﻌﺎﻟﺠﺔ ﻟﻀﻤﺎن اﺳﺘﻤﺮارﻳﺔ اﻟﻌﻼج ،واﻟﺮﻋﺎﻳﺔ اﻟﺘﻔﺎﺿﻠﻴﺔ ،ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ اﻻﻧﺘﻘﺎل ﻓﻲ اﻟﻮﻗﺖ اﻟﻤﻨﺎﺳﺐ ﻣﻦ ﻧُ ُ ﻈﻢ وأﺳﺎﻟﻴﺐ ﺟﺪﻳﺪة. ﻗﺪﻳﻤﺔ ﻟﻠﻌﻼج إﻟﻰ ﻧُ ُ ﺗﻨﻔﻴﺬ اﺳﺘﺮاﺗﻴﺠﻴﺎت ﻟﺘﻘﻠﻴﻞ اﻟﻤﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻟﻰ أﻗﻞ ﻗﺪر ﻣﻤﻜﻦ واﺳﺘﺮﺷﺎد اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ واﻟﺴﻴﺎﺳﺎت اﻟﻮﻃﻨﻴﺔ ﺑﺎﻟﺒﻴﺎﻧﺎت ﺑﺸﺄن اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ. ﺗﻮﻓﻴﺮ ﺧﺪﻣﺎت اﻟﺮﻋﺎﻳﺔ اﻟﻌﺎﻣﺔ ورﻋﺎﻳﺔ اﻟﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ وإﺗﺎﺣﺔ ﺣﺰﻣﺔ ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻠﺘﺪﺧﻼت اﻟﻀﺮورﻳﺔ ﻟﻸﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ ﻟﻠﺮﻋﺎﻳﺔ اﻷوﻟﻴﺔ ١٧ ،وﺗﻮﻓﻴﺮ اﻟﺮﻋﺎﻳﺔ اﻟﺘﻲ ﺗﺮﺗﻜﺰ ﻋﻠﻰ اﻟﻤﺠﺘﻤﻊ وﻋﻠﻰ اﻟﻤﻨﺰل ،وﺿﻤﺎن ﺗﻮاﻓﺮ اﻷدوﻳﺔ اﻷﻓﻴﻮﻧﻴﺔ ﻟﻠﺘﺪﺑﻴﺮ اﻟﻌﻼﺟﻲ ﻟﻸﻟﻢ واﻟﺮﻋﺎﻳﺔ ﻓﻲ ﻧﻬﺎﻳﺔ اﻟﺤﻴﺎة. اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻣﺮاﺟﻌﺔ اﻷﺳﺒﺎب اﻟﺮﺋﻴﺴﻴﺔ ﻟﻠﻤﺮاﺿﺔ واﻟﻮﻓﻴﺎت واﺗﺠﺎﻫﺎﺗﻬﺎ ﺑﻴﻦ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻹﺑﻼغ ﻋﻨﻬﺎ ،ﻣﻊ ﺗﺼﻨﻴﻔﻬﺎ ﺣﺴﺐ اﻟﻤﻨﻄﻘﺔ اﻟﺠﻐﺮاﻓﻴﺔ واﻟﻤﺠﻤﻮﻋﺔ اﻟﺴﻜﺎﻧﻴﺔ وﻧﻮع اﻟﺠﻨﺲ. وﻣﺤﺪﺛﺔ ﺑﺸﺄن اﺳﺘﺨﺪام اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻓﻲ ﻋﻼج ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻮﺣﺪة إﻋﺪاد ﻣﺒﺎدئ ﺗﻮﺟﻴﻬﻴﺔ ﱠ ﱠ واﻟﻮﻗﺎﻳﺔ ﻣﻨﻪ واﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ اﻟﺸﺎﺋﻌﺔ وﺗﺪﺑﻴﺮﻫﺎ اﻟﻌﻼﺟﻲ ﻟﻜﻲ ﻳﺘﻢ اﻻﺳﺘﺮﺷﺎد ﺑﻬﺎ ﻓﻲ اﻟﺘﻮﺳﻴﻊ اﻟﺴﺮﻳﻊ واﻟﻤﺴﺘﺪام ﻟﻌﻼج ﺟﻤﻴﻊ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﺗﻘﺪﻳﻢ اﻹرﺷﺎدات ﺑﺸﺄن اﻟﺮﻋﺎﻳﺔ اﻟﺘﻔﺎﺿﻠﻴﺔ ﻟﻠﻤﺮﺿﻰ اﻟﺬﻳﻦ ﻳﻤﺮون ﺑﻤﺮاﺣﻞ ﻣﺨﺘﻠﻔﺔ ﻣﻦ إﺻﺎﺑﺘﻬﻢ ﺑﻌﺪوى وﻣﺮض ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. ﺗﻘﺪﻳﻢ اﻟﻤﺴﺎﻋﺪة ﻟﻠﺒﻠﺪان ﻹﻋﺪاد وﺗﻨﻔﻴﺬ ﻣﺒﺎدئ ﺗﻮﺟﻴﻬﻴﺔ وﺧﻄﻂ وﺑﺮوﺗﻮﻛﻮﻻت وﻃﻨﻴﺔ ﻟﻌﻼج ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﺳﺘﻨﺎداً إﻟﻰ اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ. ﺗﺮﺻﺪ اﻟﻤﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺗﻠﻚ اﻟﻤﻘﺎوﻣﺔ وﺗﺪﺑﻴﺮﻫﺎ ﺗﻘﺪﻳﻢ اﻹرﺷﺎدات ﻟﻠﺒﻠﺪان ﺑﺸﺄن ّ اﻟﻌﻼﺟﻲ واﻹﺑﻼغ ﺑﺎﻧﺘﻈﺎم ﻋﻦ اﻧﺘﺸﺎرﻫﺎ واﺗﺠﺎﻫﺎﺗﻬﺎ ﻋﺎﻟﻤﻴﺎً .
١٧ﺣﺰﻣﺔ اﻟﺘﺪﺧﻼت اﻟﻀﺮورﻳﺔ ﻟﻸﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ ﻟﻠﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻷوﻟﻴﺔ ﻓﻲ اﻟﻤﻮاﻗﻊ اﻟﻘﻠﻴﻠﺔ اﻟﻤﻮارد ،اﻧﻈﺮhttp://www.who.int/cardiovascular_diseases/ : ) publications/pen2010/en/ﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ :٣ ﱡ ﺗــﻮﻓﻴﺮ اﻟﺨــﺪﻣﺎت ﻟﻀــﻤﺎن اﻹﻧﺼــﺎف ﺳﻴﺘﻄﻠﺐ ﺑﻠﻮغ اﻟﻐﺎﻳﺎت اﻟﻤﺤﺪدة ﻟﻌﺎم ٢٠٢٠اﻟﻤﺘﻌﻠﻘﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻧﻈﺎﻣﺎً ﺻﺤﻴﺎً ﺻﺎرﻣﺎً وﻣﺮﻧﺎً ﻳﺘﻀﻤﻦ :ﻧﻈﺎﻣﺎً ﻗﻮﻳﺎً ﻟﻠﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ ،وﻧﻤﺎذج ﺗﺘﺴﻢ ﺑﺎﻟﻜﻔﺎءة ﻟﺘﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ،وﻗﻮى ﻋﺎﻣﻠﺔ ﻛﺎﻓﻴﺔ وﻣﺪرﺑﺔ ﺟﻴﺪاً ،وإﺗﺎﺣﺔ ﻳﻌﻮل ﻋﻠﻴﻬﺎ ﻟﻠﻤﻨﺘﺠﺎت واﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎت اﻟﻄﺒﻴﺔ اﻷﺳﺎﺳﻴﺔ ،واﻟﺘﻤﻮﻳﻞ اﻟﺼﺤﻲ اﻟﻜﺎﻓﻲ ،واﻟﻘﻴﺎدة اﻟﻘﻮﻳﺔ واﻟﺘﺼﺮﻳﻒ اﻟﺴﺪﻳﺪ ﻟﻠﺸﺆون. وﺗﺒﻠﻎ اﻟﺘﺪﺧﻼت اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي أﻗﺼﻰ درﺟﺔ ﻣﻦ اﻟﻔﻌﺎﻟﻴﺔ ﻋﻨﺪﻣﺎ ﻳﺘﻢ ﺗﻨﻔﻴﺬﻫﺎ ﻓﻲ اﻟﺒﻴﺌﺎت اﻻﺟﺘﻤﺎﻋﻴﺔ واﻟﻘﺎﻧﻮﻧﻴﺔ واﻟﺴﻴﺎﺳﺎﺗﻴﺔ واﻟﻤﺆﺳﺴﺎﺗﻴﺔ اﻟﻤﻼﺋﻤﺔ اﻟﺘﻲ ﺗﺸﺠﻊ اﻟﻨﺎس وﺗﻤﻜّ ﻨﻬﻢ ﻣﻦ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺨﺪﻣﺎت واﻻﻧﺘﻔﺎع ﺑﻬﺎ، وﻋﻨﺪﻣﺎ ﺗﺨﻠﻮ ﻫﺬه اﻟﺨﺪﻣﺎت ذاﺗﻬﺎ ﻣﻦ اﻟﻮﺻﻢ واﻟﺘﻤﻴﻴﺰ .وﺑﺎﻟﺘﺎﻟﻲ ﻳﺠﺐ أن ﺗﺴﺘﻨﺪ ﻫﺬه اﻟﺘﺪﺧﻼت إﻟﻰ ﺑﻴﺌﺔ ﻣﻼﺋﻤﺔ ﺗﺸﺠﻊ اﻹﻧﺼﺎف وﺣﻘﻮق اﻹﻧﺴﺎن ﻓﻲ ﻣﺠﺎل اﻟﺼﺤﺔ ،وﺗﺸﺘﻤﻞ ﻋﻠﻰ ﻧﻈﻢ ﺻﺤﻴﺔ وﻣﺠﺘﻤﻌﻴﺔ ﻣﺪﻋﻮﻣﺔ ﺟﻴﺪاً . ﻳﻌﺘﺒﺮ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻦ ﻣﺠﺎﻻت اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ اﻟﺘﻲ ﺗﺸﻬﺪ ﺗﻔﺎوﺗﺎت ﻛﺒﻴﺮة ﻣﻦ ﺣﻴﺚ ﺳﺮﻋﺔ اﻟﺘﺄﺛﺮ ﺑﺎﻟﻌﺪوى واﻟﺘﻌﺮض ﻟﻠﻤﺨﺎﻃﺮ ،وﺗﻮاﻓﺮ اﻟﺨﺪﻣﺎت ،واﻟﺤﺼﺎﺋﻞ اﻟﺼﺤﻴﺔ واﻻﺟﺘﻤﺎﻋﻴﺔ .وﻳﺠﺐ أن ﺗﻮازن اﻟﺒﻠﺪان ﺑﻴﻦ ﺗﺮﻛﻴﺰ أﻧﺸﻄﺔ اﺳﺘﺠﺎﺑﺘﻬﺎ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺘﺤﻘﻴﻖ أﻋﻈﻢ ﻗﺪر ﻣﻤﻜﻦ ﻣﻦ اﻷﺛﺮ ﻣﻦ ﺟﻬﺔ وﺿﻤﺎن ﻋﺪم إﻫﻤﺎل أﺣﺪ ﻣﻦ ﺟﻬﺔ أﺧﺮى ،وﺧﺼﻮﺻﺎً اﻷﻃﻔﺎل واﻟﻤﺮاﻫﻘﻴﻦ ،واﻟﻔﺘﻴﺎت واﻟﻨﺴﺎء، اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ ،وﻣﻦ واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ َ ﻳﻌﻴﺸﻮن ﻓﻲ ﻣﻨﺎﻃﻖ ﻧﺎﺋﻴﺔ .وﻳﻨﺒﻐﻲ إﻋﻄﺎء اﻷوﻟﻮﻳﺔ ﻟﻠﻮﺻﻮل إﻟﻰ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻮاﻗﻊ اﻟﺘﻲ ﻫﻲ ﻓﻲ أﺷﺪ اﻟﺤﺎﺟﺔ واﻟﺘﻐﻠﺐ ﻋﻠﻰ اﻟﺘﻔﺎوﺗﺎت اﻟﻜﺒﻴﺮة.
ﻳﻨﺒﻐﻲ أن ﻳﺤﺼﻞ ﺟﻤﻴﻊ اﻟﻨﺎس ﻋﻠﻰ اﻟﺨﺪﻣﺎت اﻟﺘﻲ ﻳﺤﺘﺎﺟﻮن إﻟﻴﻬﺎ ،وأن ﺗﻜﻮن ﻫﺬه اﻟﺨﺪﻣﺎت ذات ﺟﻮدة ﻛﺎﻓﻴﺔ ﻹﺣﺪاث ﺗﺄﺛﻴﺮ إﻳﺠﺎﺑﻲ
وﻳﺠﺐ أن ﺗﻮازن اﻟﺒﻠﺪان ﺑﻴﻦ ﺗﺮﻛﻴﺰ أﻧﺸﻄﺔ اﺳﺘﺠﺎﺑﺘﻬﺎ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺘﺤﻘﻴﻖ أﻋﻈﻢ ﻗﺪر ﻣﻤﻜﻦ ﻣﻦ اﻷﺛﺮ ﻣﻦ ﺟﻬﺔ وﺿﻤﺎن ﻋﺪم إﻫﻤﺎل أﺣﺪ ﻣﻦ ﺟﻬﺔ أﺧﺮى
اﻟﺮﻋﺎﻳﺔ اﻟﺘﻔﺎﺿﻠﻴﺔ :وﻣﻊ ﺗﻄﻮر اﻟﻤﺒﺎدئ اﻹرﺷﺎدﻳﺔ اﻟﻮﻃﻨﻴﺔ ﻧﺤﻮ ﺗﻘﺪﻳﻢ اﻟﻤﻌﺎﻟﺠﺔ ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﺠﻤﻴﻊ اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻐﺾ اﻟﻨﻈﺮ ﻋﻦ أوﺿﺎﻋﻬﻢ اﻟﺴﺮﻳﺮﻳﺔ )اﻹﻛﻠﻴﻨﻴﻜﻴﺔ( واﻟﻤﻨﺎﻋﻴﺔ ،ﺳﺘﻮاﺟﻪ ﺧﺪﻣﺎت اﻟﻤﻜﺎﻓﺤﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﺤﺪﻳﺎت ﺗﺪﺑﻴﺮ اﻟﻌﺪد اﻟﻤﺘﺰاﻳﺪ ﻣﻦ اﻟﻤﺮﺿﻰ اﻟﺬﻳﻦ ُﻳﻌﺎﻟَ ﺠﻮن ،وﺗﺰاﻳﺪ اﻟﻤﺠﻤﻮﻋﺎت اﻟﻤﺘﻨﻮﻋﺔ ﻣﻦ اﺣﺘﻴﺎﺟﺎت اﻟﻤﺮﺿﻰ .وﺗﺸﺘﻤﻞ اﻟﺮﻋﺎﻳﺔ اﻟﺘﻔﺎﺿﻠﻴﺔ ﻋﻠﻰ ﺗﻘﺪﻳﻢ ﺣﺰَ م ﻣﺨﺘﻠﻔﺔ ﻣﻦ اﻟﺮﻋﺎﻳﺔ ﻟﻠﻤﺮﺿﻰ اﻟﺬﻳﻦ ُﻳﻌﺎﻟَ ﺠﻮن ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ِ ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ اﺳﺘﻨﺎداً إﻟﻰ اﻟﻤﺮاﺣﻞ اﻟﺘﻲ وﺻﻠﻮا إﻟﻴﻬﺎ ﻓﻲ اﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وإﻟﻰ ﺛﺒﺎﺗﻬﻢ ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ وإﻟﻰ اﻻﺣﺘﻴﺎﺟﺎت اﻟﻨﻮﻋﻴﺔ ﻟﻠﺮﻋﺎﻳﺔ .ﻓﺈن اﻟﻤﺮﺿﻰ اﻟﺬﻳﻦ ﺛﺒﺘﺖ ﺣﺎﻻﺗﻬﻢ ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ ،ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل ،ﻳﻤﻜﻦ ﺗﺤﻮﻳﻠﻬﻢ إﻟﻰ اﻟﺮﻋﺎﻳﺔ اﻟﺘﻲ ﺗﺮﺗﻜﺰ ﻋﻠﻰ اﻟﻤﺠﺘﻤﻊ ،ﻣﻤﺎ ﻳﺘﻴﺢ ﻟﻤﻮاﻗﻊ اﻟﺮﻋﺎﻳﺔ اﻟﺴﺮﻳﺮﻳﺔ اﻟﺘﻲ ﺗﻨﻮء ﺑﺄﻋﺒﺎء ﺟﺴﻴﻤﺔ أن ﺗﺮﻛﱢ ﺰ ﻋﻠﻰ اﻟﻤﺮﺿﻰ ذوي ﺳﻮاء ﺑﺴﺒﺐ ﻋﺪم ﺛﺒﺎت ﺣﺎﻻﺗﻬﻢ ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ اﻟﺤﺎﻻت اﻟﺴﻴﺌﺔ ً ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ أو ﺑﺴﺒﺐ ﺣﻀﻮرﻫﻢ إﻟﻰ اﻟﻌﻴﺎدة وﻫﻢ ﻓﻲ ﻣﺮﺣﻠﺔ ﻣﺘﻘﺪﻣﺔ ﻣﻦ اﻹﺻﺎﺑﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي أو ﻹﺻﺎﺑﺘﻬﻢ ﺑﺄﻣﺮاض ﻣﺼﺎﺣﺒﺔ ﻛﺒﻴﺮة.
ﺗﻜﻴﻴﻒ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺘﻼﺋﻢ ﻣﺨﺘﻠﻒ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻮاﻗﻊ
ﻳﻨﺒﻐﻲ ﺗﻜﻴﻴﻒ اﻟﺘﺪﺧﻼت اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎﺗﻪ ﺗﺒﻌﺎً ﻟﻤﺨﺘﻠﻒ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻮاﻗﻊ ،وذﻟﻚ ﻟﻠﻮﺻﻮل إﻟﻰ اﻟﻔﺌﺎت اﻷﺷﺪ ﺗﻀﺮراً وﻟﻀﻤﺎن ﻋﺪم وﺗﺤﺪد اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ إﻫﻤﺎل أﺣﺪ. ﱢ ُ ﺪت ﺑﺎﻟﺘﻌﺎون ﻣﻊ اﻟﺸﺮﻛﺎء ﺣﺰﻣﺎً أﺳﺎﺳﻴﺔ ﻋ ِ أ اﻟﺘﻲ اﻟﺘﻨﻔﻴﺬ وأدوات ﱠ ﻣﻦ ﺗﺪﺧﻼت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻧﻤﺎذج ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ﻟﻤﺨﺘﻠﻒ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﺒﻴﺌﺎت ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺣﺰم ﺧﺎﺻﺔ ﻟﻠﻤﺮاﻫﻘﻴﻦ ،واﻟﻨﺴﺎء واﻟﻔﺘﻴﺎت ،وﻣﺘﻌﺎﻃﻲ اﻟﻤﺨﺪرات، واﻟﻌﺎﻣﻠﻴﻦ ﻓﻲ ﺗﺠﺎرة اﻟﺠﻨﺲ ،واﻟﺮﺟﺎل اﻟﺬﻳﻦ ﻳﻤﺎرﺳﻮن اﻟﺠﻨﺲ ﻣﻊ اﻟﺮﺟﺎل ،واﻟﻤﺘﺤﻮﻟﻴﻦ ﺟﻨﺴﻴﺎً ،واﻟﺴﺠﻨﺎء. اﻟﻼﻣﺮﻛﺰﻳﺔ :إن ﻟﻤﺨﺘﻠﻒ ﻣﺴﺘﻮﻳﺎت اﻟﻨﻈﺎم اﻟﺼﺤﻲ أدواراً ﻣﺨﺘﻠﻔﺔ ﻓﻲ ﺗﻘﺪﻳﻢ ﺧﺪﻣﺎت ﺧﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻣﺎ ﻳﺘﻌﻠﻖ ﺑﻪ .وﺗﺘﻴﺢ ﻻﻣﺮﻛﺰﻳﺔ اﻟﺨﺪﻣﺎت واﻟﺘﻜﺎﻣﻞ واﻟﺮﺑﻂ اﻻﺳﺘﺮاﺗﻴﺠﻲ ﺑﻴﻨﻬﺎ ﻓﺮﺻﺎً ﻟﺰﻳﺎدة ﺗﻮاﻓﺮﻫﺎ وﻣﺪى ﺗﻐﻄﻴﺘﻬﺎ وﻣﻘﺒﻮﻟﻴﺘﻬﺎ وﺟﻮدﺗﻬﺎ. وﺑﺈﻣﻜﺎن ﻻﻣﺮﻛﺰﻳﺔ اﻟﺨﺪﻣﺎت ﺗﻘﻮﻳﺔ إﺷﺮاك اﻟﻤﺠﺘﻤﻊ وﺗﺤﺴﻴﻦ ﺗﻮاﻓﺮ اﻟﺨﺪﻣﺎت وﺗﻌﺰﻳﺰ ﺳﻠﻮك اﻟﺘﻤﺎس اﻟﺮﻋﺎﻳﺔ واﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﺮﺿﻰ ﻓﻲ اﻟﺮﻋﺎﻳﺔ.
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
وﺣﺼﺎﺋﻞ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﺗﺆدي اﻟﻤﻨﻈﻤﺎت واﻟﺸﺒﻜﺎت اﻟﻤﺠﺘﻤﻌﻴﺔ دوراً أﺳﺎﺳﻴﺎً ﻓﻲ ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ﻟﻸﺷﺨﺎص اﻟﺬﻳﻦ ﻻ ﺗﺼﻠﻬﻢ اﻟﺨﺪﻣﺎت اﻟﺤﻜﻮﻣﻴﺔ، ﻈﻢ وإﻧﺘﺎج ﻣﻌﻠﻮﻣﺎت اﺳﺘﺮاﺗﻴﺠﻴﺔ ﻗﺪ ﻻ ﺗﻜﻮن ﻣﺘﺎﺣﺔ ﻣﻦ ﺧﻼل اﻟﻨﱡ ُ اﻟﻮﻃﻨﻴﺔ ﻟﻠﻤﻌﻠﻮﻣﺎت ﺣﻮل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﺗﻌﺰﻳﺰ وﺣﻤﺎﻳﺔ ﺣﻘﻮق اﻹﻧﺴﺎن .وﺗﺴﺎﻋﺪ ﺗﻨﻤﻴﺔ اﻟﻘﺪرات اﻟﻤﺠﺘﻤﻌﻴﺔ ﻣﻦ ﺧﻼل اﻟﺘﺪرﻳﺐ واﻹﺷﺮاف اﻟﻜﺎﻓﻴﻴﻦ ﻋﻠﻰ ﺗﺤﺴﻴﻦ ﺟﻮدة اﻟﺨﺪﻣﺎت واﻟﺒﺮاﻣﺞ اﻟﺘﻲ ﺗﺮﺗﻜﺰ ﻋﻠﻰ اﻟﻤﺠﺘﻤﻊ .وﻳﻨﺒﻐﻲ أن ﺗﺘﻴﺢ ﺑﺮاﻣﺞ ﻓﻴﺮوس ﺗﻤﻮﻳﻼ ﻳﻤﻜﻦ اﻟﺘﻨﺒﺆ ﺑﻪ ﻟﻠﻤﻨﻈﻤﺎت اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻮﻃﻨﻴﺔ ً اﻟﻤﺠﺘﻤﻌﻴﺔ وأﺟﻮراً ﻛﺎﻓﻴﺔ ﻋﻦ اﻟﺨﺪﻣﺎت اﻟﺘﻲ ﺗﻘﺪﻣﻬﺎ. ﺗﻠﺒﻴﺔ ﺣﺎﺟﺎت اﻟﻤﻮاﻗﻊ اﻟﺨﺎﺻﺔ :ﻫﻨﺎك ﻣﻮاﻗﻊ ﺧﺎﺻﺔ ﺗﺮﺗﻔﻊ ﻓﻴﻬﺎ ﻣﺴﺘﻮﻳﺎت اﻟﺘﺄﺛﺮ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺘﻌﺮض ﻟﻤﺨﺎﻃﺮه ،وﻗﺪ ﻳﺘﺪﻧﻰ ﻓﻴﻬﺎ ﺗﻮاﻓﺮ اﻟﺨﺪﻣﺎت اﻷﺳﺎﺳﻴﺔ اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﺪﻧﻴﺎً ﺷﺪﻳﺪاً ،ﻛﻤﺎ ﻓﻲ اﻟﺴﺠﻮن وﻣﺮاﻛﺰ اﻻﺣﺘﺠﺎز وﻣﺨﻴﻤﺎت اﻟﻼﺟﺌﻴﻦ واﻷﻣﺎﻛﻦ اﻟﺘﻲ ﺗﺜﻴﺮ اﻟﻘﻠﻖ ﻣﻦ اﻟﻨﺎﺣﻴﺔ اﻹﻧﺴﺎﻧﻴﺔ .وﻳﻨﺒﻐﻲ أن ﺗﻜﻮن اﻟﺨﺪﻣﺎت اﻟﻤﻘﺪﻣﺔ ﻟﻸﻓﺮاد ﻓﻲ ﻣﺜﻞ ﻫﺬه اﻟﻤﻮاﻗﻊ ﻣﺴﺎوﻳﺔ ﻟﻠﺨﺪﻣﺎت اﻟﻤﺘﻮاﻓﺮة ﻟﻠﻤﺠﺘﻤﻊ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً .وﺗﺴﺒﺐ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺘﻨﻘﻠﺔ واﻟﻨﺎزﺣﻴﻦ، ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﻤﺘﻀﺮرون ﻣﻦ اﻟﺼﺮاﻋﺎت واﻟﻜﻮارث اﻟﻄﺒﻴﻌﻴﺔ وﻣﻦ اﻟﻬﺠﺮة ﻷﺳﺒﺎب اﻗﺘﺼﺎدﻳﺔ ،ﺗﺤﺪﻳﺎت ﺧﺎﺻﺔ ،ﻷن أﻓﺮاد ﻫﺬه اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ ﺑﻌﻴﺪون ﻋﻦ ﻣﺠﺘﻤﻌﺎﺗﻬﻢ وﻋﻦ ﺷﺒﻜﺎت اﻟﺪﻋﻢ واﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻟﻤﻨﺘﻈﻤﺔ ،ﻣﻤﺎ ﻗﺪ ﻳﺆدي إﻟﻰ اﻧﻘﻄﺎع ﻓﻲ اﺳﺘﻤﺮارﻳﺔ ﻣﺎ ﻳﺘﻠﻘﻮن ﻣﻦ ﺧﺪﻣﺎت ﻟﻠﻮﻗﺎﻳﺔ واﻟﻌﻼج واﻟﺮﻋﺎﻳﺔ. ﻓﻌﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل ،رﺑﻤﺎ ﻻ ﻳﻜﻮن أﻣﺜﺎل ﻫﺆﻻء ﻗﺎدرﻳﻦ ﻋﻠﻰ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺨﺪﻣﺎت اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻷﺧﺮى أو اﻻﺳﺘﻔﺎدة ﻣﻨﻬﺎ ﻧﺘﻴﺠﺔ ﻟﻌﺪم اﻣﺘﻼﻛﻬﻢ ﻟﻠﻮﺛﺎﺋﻖ اﻟﻼزﻣﺔ أو ﻻرﺗﻔﺎع ﺗﻜﺎﻟﻴﻒ اﻟﺨﺪﻣﺎت وﻋﺪم ﺗﻤﺘﻌﻬﻢ ﺑﺄي ﺻﻮرة ﻣﻦ ﺻﻮر اﻟﺤﻤﺎﻳﺔ اﻟﻤﺎﻟﻴﺔ ﻛﺎﻟﺘﺄﻣﻴﻦ اﻟﺼﺤﻲ. ﺿﻤﺎن ﺟﻮدة اﻟﺘﺪﺧﻼت واﻟﺨﺪﻣﺎت :ﻳﻨﺒﻐﻲ أﻻ ﻳﺆدي اﻟﺘﻮﺳﻊ اﻟﺴﺮﻳﻊ ﻓﻲ اﻟﺒﺮاﻣﺞ ﻣﻦ أﺟﻞ ﺗﺤﺴﻴﻦ اﻟﺘﻐﻄﻴﺔ إﻟﻰ اﻟﺘﻘﻠﻴﻞ ﻣﻦ ﻣﺴﺘﻮى ﺟﻮدة اﻟﺨﺪﻣﺎت ،وأن ﻻ ﻳﺴﻬﻢ ﻓﻲ اﻹﺟﺤﺎف ﻓﻲ إﺗﺎﺣﺔ اﻟﺨﺪﻣﺎت وﻓﻲ اﻟﺤﺼﺎﺋﻞ اﻟﺼﺤﻴﺔ .وﻋﻠﻰ اﻟﺒﻠﺪان أن ﺗﺮﺻﺪ ﺳﻼﻣﺔ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺪﻳﻬﺎ ،ﻣﻦ أﺟﻞ ﺗﺤﺪﻳﺪ اﻟﻤﻮاﺿﻊ اﻟﺘﻲ ﺗﺤﺘﺎج إﻟﻰ ﺗﺤﺴﻴﻦ .ﻛﻤﺎ ﻳﻠﺰم ﺗﻨﻈﻴﻢ ﻫﺬه اﻟﺨﺪﻣﺎت ﻟﻺﻗﻼل ﻣﻦ ”اﻟﺘﺴﺮب“ إﻟﻰ أﻗﻞ ﻗﺪر ﻣﻤﻜﻦ وﺗﺤﻘﻴﻖ أﻋﻠﻰ ﻣﺴﺘﻮﻳﺎت اﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﺮﺿﻰ ﻓﻲ اﻟﺮﻋﺎﻳﺔ وﻓﻲ اﻻﻟﺘﺰام ﺑﺎﻟﻌﻼج .وﺗﺸﻤﻞ اﻟﺘﺤﺪﻳﺎت اﻟﺮﺋﻴﺴﻴﺔ :ﻣﺪى اﻟﻘﺒﻮل ﻟﺘﺪﺧﻼت اﻟﻮﻗﺎﻳﺔ اﻟﻔﻌﺎﻟﺔ واﻹﻗﺒﺎل ﻋﻠﻴﻬﺎ؛ ﺗﻮﺟﻴﻪ اﻻﺧﺘﺒﺎرات واﻟﻤﺸﻮرة اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺘﺤﻘﻴﻖ أﻛﺒﺮ ﻣﺮدود؛ ﺿﻤﺎن ﺟﻮدة اﻻﺧﺘﺒﺎرات ﻟﻠﺤﺪ ﻣﻦ اﻟﺘﺸﺨﻴﺼﺎت اﻟﺨﺎﻃﺌﺔ؛ رﺑﻂ ﻣﻦ ﻳﺘﻢ ﺗﺸﺨﻴﺼﻬﻢ ﺑﺨﺪﻣﺎت اﻟﻮﻗﺎﻳﺔ واﻟﻌﻼج اﻟﻤﻼﺋﻤﺔ ﻓﻲ أﻗﺮب وﻗﺖ ﻣﻤﻜﻦ؛ ﺿﻤﺎن اﻻﻟﺘﺰام ﺑﺎﻟﻌﻼج واﺳﺘﻤﺮارﻳﺘﻪ؛ ﺗﻮﻓﻴﺮ اﻟﺮﻋﺎﻳﺔ ﻟﻠﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ اﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ وﺗﺪﺑﻴﺮﻫﺎ اﻟﻌﻼﺟﻲ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺴﻞ واﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ؛ رﺻﺪ اﻟﺤﺼﺎﺋﻞ اﻟﻌﻼﺟﻴﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺳﻤﻴﺔ اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ واﻟﻜﺒﺖ اﻟﻔﻴﺮوﺳﻲ ﻟﻀﻤﺎن اﻟﺘﺤﻮل ﻓﻲ اﻟﻮﻗﺖ اﻟﻤﻨﺎﺳﺐ إﻟﻰ اﻟﺨﻂ اﻟﺜﺎﻧﻲ واﻟﺜﺎﻟﺚ ﻣﻦ اﻟﻌﻼج وﻟﻤﻨﻊ ﻇﻬﻮر اﻟﻤﻘﺎوﻣﺔ ﻷدوﻳﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي.
اﻟﺮﻋﺎﻳﺔ اﻟﻤﺘﻜﺎﻣﻠﺔ اﻟﺘﻲ ﺗُ َﺮﻛﱢ ﺰ ﻋﻠﻰ اﻟﺸﺨﺺ :ﻳﻌﺎﻧﻲ اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻮن ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻤﺠﺘﻤﻌﺎت اﻟﻤﺘﻀﺮرة ﻣﻦ ﻃﺎﺋﻔﺔ ﻋﺮﻳﻀﺔ ﻣﻦ اﻟﻤﺨﺎﻃﺮ واﻟﻤﺸﻜﻼت اﻟﺼﺤﻴﺔ، وﺑﺎﻟﺘﺎﻟﻲ ﻳﻠﺰم أن ﺗﻘﺪم ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺨﺪﻣﺎت ذات اﻟﻌﻼﻗﺔ اﻟﺘﺪﺧﻼت اﻟﻤﻼﺋﻤﺔ ﻣﻦ أﺟﻞ اﻟﺘﺼﺪي ﻟﻸﺣﻮال اﻟﺼﺤﻴﺔ اﻟﺸﺎﺋﻌﺔ اﻟﺤﺪوث .وﻓﻲ ﻇﻞ ﻓﻌﺎﻟﻴﺔ اﻟﻌﻼج ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ وﺗﻘﺪم اﻷﻋﻤﺎر ﻓﻲ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺘﻌﺎﻳﺸﺔ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،أﺻﺒﺢ ﻣﻦ اﻟﻀﺮوري أن ﺗﺘﻄﻮر ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺘﻮﻓﻴﺮ رﻋﺎﻳﺔ ﺷﺎﻣﻠﺔ ﻟﻠﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ ﺗﺘﻀﻤﻦ اﻟﺘﺪﺑﻴﺮ اﻟﻌﻼﺟﻲ ﻟﻸﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ .وإن اﻟﻤﺰﻳﺪ ﻣﻦ اﻟﺘﻜﺎﻣﻞ واﻟﺮﺑﻂ واﻟﺘﻨﺴﻴﻖ ﺑﻴﻦ اﻟﺨﺪﻣﺎت اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺳﺎﺋﺮ اﻟﺨﺪﻣﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻟﻤﺠﺎﻻت اﻟﺼﺤﻴﺔ ذات اﻟﺼﻠﺔ اﻟﻤﻌﺪﻳﺔ اﻟﺘﻲ ﺗﻨﺘﻘﻞ ﺟﻨﺴﻴﺎً ،واﻟﺼﺤﺔ )ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻷﻣﺮاض ُ اﻟﺠﻨﺴﻴﺔ واﻹﻧﺠﺎﺑﻴﺔ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً ،واﺿﻄﺮاﺑﺎت ﺗﻌﺎﻃﻲ ﻣﻮاد اﻹدﻣﺎن ،واﻟﺘﻬﺎب اﻟﻜﺒﺪ ،واﻟﺴﻞ ،وﻣﺄﻣﻮﻧﻴﺔ اﻟﺪم ،واﻷﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ ،واﻟﻌﻨﻒ اﻟﻘﺎﺋﻢ ﻋﻠﻰ ﻧﻮع اﻟﺠﻨﺲ( ،ﺳﻴﺆدي إﻟﻰ ﺧﻔﺾ اﻟﺘﻜﺎﻟﻴﻒ وزﻳﺎدة أوﺟﻪ اﻟﻜﻔﺎءة وإﻟﻰ ﺣﺼﺎﺋﻞ أﻓﻀﻞ .وﺳﺘﻌﺘﻤﺪ اﻟﻨﻤﺎذج اﻟﻤﻼﺋﻤﺔ ﻟﻠﺘﻜﺎﻣﻞ واﻟﺮﺑﻂ ﻋﻠﻰ اﻟﺴﻴﺎق اﻟﻘﻄﺮي واﻟﻨﻈﺎم اﻟﺼﺤﻲ ،وﻳﻨﺒﻐﻲ أن ﺗﺴﺘﺮﺷﺪ ﺑﺎﻟﺒﺤﻮث اﻟﻤﻴﺪاﻧﻴﺔ .وﻳﻨﺒﻐﻲ أن ﻳﺠﺮي اﻟﺘﺨﻄﻴﻂ اﻟﻤﺸﺘﺮك ﻟﻠﻤﺠﺎﻻت اﻟﺸﺎﻣﻠﺔ ،ﻣﺜﻞ ﻧُ ﻈﻢ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺼﺤﻴﺔ واﻟﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ ،وﺧﺪﻣﺎت اﻟﻤﺨﺘﺒﺮات واﻟﺘﺸﺨﻴﺺ، وﺗﺨﻄﻴﻂ اﻟﻤﻮارد اﻟﺒﺸﺮﻳﺔ وﺑﻨﺎء اﻟﻘﺪرات ،واﻟﺸﺮاء وإدارة ﺳﻠﺴﻠﺔ اﻹﻣﺪاد ،وﺣﺸﺪ اﻟﻤﻮارد. اﻟﺮﺑﻂ ﺑﻴﻦ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺧﺪﻣﺎت اﻟﺴﻞ :ﻳﺘﻴﺢ اﻟﺮﺑﻂ واﻟﺘﻜﺎﻣﻞ اﻻﺳﺘﺮاﺗﻴﺠﻲ ﻟﺨﺪﻣﺎت وﺑﺮاﻣﺞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺧﺪﻣﺎت وﺑﺮاﻣﺞ اﻟﺴﻞ ﻧﻤﻮذﺟﺎً ﺟﻴﺪاً ﻟﻠﺮﺑﻂ. وﺗﺤﺪد اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻠﺒﺮاﻣﺞ اﻟﻮﻃﻨﻴﺔ اﻟﻤﻌﻨﻴﺔ ﺑﺎﻷﻧﺸﻄﺔ اﻟﺘﻌﺎوﻧﻴﺔ ﻓﻲ ﻣﺠﺎﻻت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺴﻞ ١٢ﻧﺸﺎﻃﺎً ﺗﻌﺎوﻧﻴﺎً ﻳﺠﺐ ﺗﻨﻔﻴﺬﻫﺎ ﻟﺘﺤﻘﻴﻖ اﻟﺘﻜﺎﻣﻞ ﺑﻴﻦ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺧﺪﻣﺎت ﺑﺘﻘﺒﻞ اﻟﺨﺪﻣﺎت اﻟﺴﻞ .وﻳﺴﺎﻋﺪ اﺳﺘﺨﺪام اﻟﻤﺆﺷﺮات اﻟﺨﺎﺻﺔ ﱡ واﻟﻤﺴﺘﻤﺪة ﻣﻦ ﻣﻄﺒﻮﻋﺔ اﻟﻤﻨﻈﻤﺔ ”دﻟﻴﻞ رﺻﺪ وﺗﻘﻴﻴﻢ اﻷﻧﺸﻄﺔ اﻟﺘﻌﺎوﻧﻴﺔ ﻟﻤﻜﺎﻓﺤﺔ اﻟﺴﻞ /ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي“ )ﻣﺮاﺟﻌﺔ ﻋﺎم ١٨،(٢٠١٥اﻟﺒﻠﺪان ﻋﻠﻰ ﺗﺤﺪﻳﺪ اﻟﺮواﺑﻂ اﻟﻀﻌﻴﻔﺔ داﺧﻞ ﺗﺴﻠﺴﻞ اﻟﺮﻋﺎﻳﺔ واﻟﺤﺪ ﻣﻨﻬﺎ .وﻳﻤﻜﻦ ﻟﺘﻄﺒﻴﻖ اﻹﺑﻼغ اﻹﻟﻜﺘﺮوﻧﻲ ﻌ ﱢﺮﻓﺎت ﻓﺮﻳﺪة ﻟﻬﻮﻳﺔ اﻟﻤﺮﺿﻰ ﻣَ وﻧﻈﻢ ﺷﺒﻜﺔ اﻹﻧﺘﺮﻧﺖ اﻟﺘﻲ ﺗﺘﻀﻤﻦ ُ ﻳﻴﺴﺮ اﻟﺘﺸﻐﻴﻞ اﻟﺒﻴﻨﻲ اﻟﺴﻠﺲ ﺑﺤﻴﺚ ﻳﺴﺘﺨﺪﻣﻬﺎ ﻛﻼ اﻟﺒﺮﻧﺎﻣﺠﻴﻦ أن ّ وﻳﻨﻬﺾ ﺑﻤﺴﺘﻮى ﻣﺘﺎﺑﻌﺔ اﻟﻤﺮﺿﻰ. إﺷﺮاك اﻟﻤﺠﺘﻤﻊ واﻟﺨﺪﻣﺎت اﻟﺘﻲ ﺗﺮﺗﻜﺰ ﻋﻠﻰ اﻟﻤﺠﺘﻤﻊ :إن ﻣﻦ اﻟﻀﺮوري أن ﻳﺘﻢ اﻹﺷﺮاك اﻟﻬﺎدف ﻟﻠﻤﺠﺘﻤﻊ ،وﺧﺼﻮﺻﺎً اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻓﻲ ﻓﻌﺎﻟﻴﺔ ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً ،وﺧﺼﻮﺻﺎً ﻓﻲ اﻟﻤﻮاﻗﻊ وﺑﻴﻦ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺘﻀﺮرة ﻣﻦ اﻟﻮﺻﻢ واﻟﺘﻤﻴﻴﺰ واﻟﺘﻬﻤﻴﺶ .وﻳﻌﺰز إﺷﺮاك اﻟﻤﺠﺘﻤﻌﺎت ﻋﻠﻰ ﻛﻞ اﻟﻤﺴﺘﻮﻳﺎت وﻳﻘﻮي ﺟﻬﻮد اﻟﺪﻋﻮة واﺗﺴﺎق اﻟﺴﻴﺎﺳﺎت واﻟﺘﻨﺴﻴﻖ ﺑﻴﻦ اﻟﺒﺮاﻣﺞ، ﱢ اﻟﻤﺴﺎءﻟﺔ ،وﻳﻤﻜﻦ ﻟﻪ أن ﻳﺘﺼﺪى ﻟﻠﻌﻮاﻣﻞ اﻟﺘﻲ ﺗﺆﺛﺮ ﻓﻲ ﺗﻮاﻓﺮ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻹﻗﺒﺎل ﻋﻠﻴﻬﺎ وأداﺋﻬﺎ
١٨دﻟﻴﻞ رﺻﺪ وﺗﻘﻴﻴﻢ اﻷﻧﺸﻄﺔ اﻟﺘﻌﺎوﻧﻴﺔ ﻟﻤﻜﺎﻓﺤﺔ اﻟﺴﻞ /ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي :ﻣﺮاﺟﻌﺔ ﻋﺎم ،٢٠١٥اﻧﻈﺮ ) http://www.who.int/tb/publications/monitoring-evaluation-collaborative-tb-hiv/en/ﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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وﻳﻤﻜﻦ ﺗﺤﻘﻴﻖ أﻋﻈﻢ اﻷﺛﺮ ﻟﺠﻮدة اﻟﺮﻋﺎﻳﺔ ﺑﻀﻤﺎن اﻟﺘﺰام ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﺑﻤﺎ ﻓﻴﻬﺎ ﺧﺪﻣﺎت اﻻﺧﺘﺒﺎر واﻟﻤﺨﺘﺒﺮات ،ﺑﺎﻟﻘﻮاﻋﺪ واﻟﻤﻌﺎﻳﻴﺮ اﻟﻮﻃﻨﻴﺔ واﻟﺪوﻟﻴﺔ ،ورﺻﺪﻫﺎ ً وإﺗﺎﺣﺔ ﻟﻠﻤﺮﺿﻰ وأﻧﺴﺐ ﻗﺒﻮﻻ وﺗﺤﺴﻴﻨﻬﺎ ﺑﺎﺳﺘﻤﺮار ،وﺟﻌﻠﻬﺎ أﻛﺜﺮ ً ﻟﺘﻠﺒﻴﺔ ﺣﺎﺟﺎﺗﻬﻢ وأﻓﻀﻠﻴﺎﺗﻬﻢ .وﻳﻨﺒﻐﻲ أن ﺗﺘﻌﺎﻣﻞ ﻣﺆﺷﺮات وآﻟﻴﺎت رﺻﺪ ﺟﻮدة اﻟﺨﺪﻣﺎت ﻣﻊ ﻗﻀﺎﻳﺎ ﻗﻮاﺋﻢ اﻻﻧﺘﻈﺎر ،وأوﻗﺎت اﻻﻧﺘﻈﺎر ﻓﻲ اﻟﻤﺮاﻛﺰ اﻟﺼﺤﻴﺔ ،وﺗﻜﺮار اﻟﺰﻳﺎرات ،وﻛﻔﺎءات اﻟﻌﺎﻣﻠﻴﻦ ﻓﻲ ﻣﺠﺎل اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ واﻹﺷﺮاف ﻋﻠﻴﻬﻢ .وﻓﻲ اﻟﻨﻬﺎﻳﺔ ،ﻳﺠﺐ ﻗﻴﺎس ﺟﻮدة اﻟﺘﺪﺧﻼت اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻘﺪرﺗﻬﺎ ﻋﻠﻰ ﺗﺤﺴﻴﻦ ﺻﺤﺔ اﻟﻨﺎس وﻋﺎﻓﻴﺘﻬﻢ.
ﺗﻜﻴﻴﻒ اﻟﺨﺪﻣﺎت اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﺤﺰَ م اﻷﺳﺎﺳﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ ﺪﺛﺔ ﺑﺸﺄن ِ ﺤﱠ ﻣَ ﺗﻘﺪﻳﻢ إرﺷﺎدات ُ ﻌ ﱠﻴﻨﺔ ﻣَ اﻟﺒﺸﺮي واﻟﺮﻋﺎﻳﺔ اﻟﺘﻔﺎﺿﻠﻴﺔ وﻧﻤﺎذج ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ﻟﻤﺠﻤﻮﻋﺎت ُ ﻌ ﱠﻴﻨَ ﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﻤﺮاﻫﻘﻮن واﻟﻤﺠﻤﻮﻋﺎت ﻣَ ﻣﻦ اﻟﺴﻜﺎن وﻟﻤﻮاﻗﻊ ُ اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺘﻨﻘﻠﺔ واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ ﻓﻲ اﻟﻤﻮاﻗﻊ اﻟﺘﻲ ﺗﺜﻴﺮ اﻟﻘﻠﻖ ﻣﻦ اﻟﻨﺎﺣﻴﺔ اﻹﻧﺴﺎﻧﻴﺔ )ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺑﺎﻟﺘﻌﺎون ﻣﻊ اﻟﻤﻔﻮﺿﻴﺔ اﻟﺴﺎﻣﻴﺔ ﻟﻸﻣﻢ اﻟﻤﺘﺤﺪة ﻟﺸﺆون اﻟﻼﺟﺌﻴﻦ( ،واﻟﺴﺠﻨﺎء )ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺑﺎﻟﺘﻌﺎون ﻣﻊ ﻣﻜﺘﺐ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﻌﻨﻲ ﺑﺎﻟﻤﺨﺪرات واﻟﺠﺮﻳﻤﺔ( اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ. واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ َ ﻣﺴﺎﻧﺪة اﻟﺒﻠﺪان ﻓﻲ ﺟﻬﻮدﻫﺎ ﻟﺘﻜﻴﻴﻒ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎﺗﻬﺎ اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وذﻟﻚ اﺳﺘﻨﺎداً إﻟﻰ ﺗﺤﻠﻴﻞ وﺿﻌﻬﺎ ،ﻣﻊ اﻟﺘﺮﻛﻴﺰ ﺑﻮﺟﻪ ﺧﺎص ﻋﻠﻰ ﺗﺤﺴﻴﻦ اﻻﻟﺘﺰام ﺑﺎﻟﻌﻼج واﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﺮﺿﻰ ﻓﻲ اﻟﺮﻋﺎﻳﺔ. ﺗﻘﺪﻳﻢ اﻟﺪﻋﻢ اﻟﺘﻘﻨﻲ ﻟﻠﺒﻠﺪان ﻟﺘﻨﻔﻴﺬ ﺳﻴﺎﺳﺔ ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ٢٠ ﺑﺸﺄن أﻧﺸﻄﺔ ﻣﻜﺎﻓﺤﺔ اﻟﺴﻞ /ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﺘﻌﺎوﻧﻴﺔ ودﻟﻴﻞ رﺻﺪ وﺗﻘﻴﻴﻢ اﻷﻧﺸﻄﺔ اﻟﺘﻌﺎوﻧﻴﺔ ﻟﻤﻜﺎﻓﺤﺔ اﻟﺴﻞ /ﻓﻴﺮوس اﻟﻌﻮز ٢١ اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. ﺗﻘﺪﻳﻢ اﻹرﺷﺎدات ﺑﺸﺄن اﻟﺨﺪﻣﺎت اﻟﻤﺠﺘﻤﻌﻴﺔ وإﺷﺮاك اﻟﻤﺠﺘﻤﻊ ،وإﺷﺮاك اﻟﻤﺠﺘﻤﻊ اﻟﻤﺪﻧﻲ ﻓﻲ إﻋﺪاد ﺳﻴﺎﺳﺎت اﻟﻤﻨﻈﻤﺔ وإرﺷﺎداﺗﻬﺎ وﺗﻨﻔﻴﺬﻫﺎ. ﺗﻘﺪﻳﻢ اﻟﻤﺴﺎﻋﺪة اﻟﺘﻘﻨﻴﺔ ﻟﻠﺒﻠﺪان واﻟﺸﺮﻛﺎء ﻹﺟﺮاء ﺗﻘﻴﻴﻤﺎت ﻓﻲ اﻟﻮﻗﺖ اﻟﻤﻨﺎﺳﺐ ﻟﻼﺣﺘﻴﺎﺟﺎت اﻟﺼﺤﻴﺔ ﻓﻲ اﻷﻣﺎﻛﻦ اﻟﺘﻲ ﺗﺜﻴﺮ اﻟﻘﻠﻖ ﻣﻦ اﻟﻨﺎﺣﻴﺔ اﻹﻧﺴﺎﻧﻴﺔ وﺿﻤﻦ اﻟﻤﺠﺘﻤﻌﺎت اﻟﻤﺤﻠﻴﺔ اﻟﻬﺸﺔ. اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﺒﻠﺪان وﺿﻊ ﻗﻮاﻋﺪ وﻣﻌﺎﻳﻴﺮ وﻃﻨﻴﺔ ﺗﺸﻤﻞ ﺟﻤﻴﻊ ﻣﺮاﺣﻞ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﺳﺘﻨﺎداً إﻟﻰ اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﺪوﻟﻴﺔ واﻟﻤﻌﺎﻳﻴﺮ اﻷﺧﺮى ورﺻﺪ ﺗﻨﻔﻴﺬﻫﺎ. ﺗﺤﺪﻳﺪ وﺗﻨﻔﻴﺬ ﺣﺰﻣﺔ ﻣﻦ ﺗﺪﺧﻼت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﺼﻤﻤﺔ ﺧﺼﻴﺼﺎً ﻟﺘﻼﺋﻢ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﻤﻮاﻗﻊ اﻟﺠﻐﺮاﻓﻴﺔ اﻟﻤﻌﻴﻨﺔ ،ﺑﻤﺎ ﻳﻀﻤﻦ ﻣﻼءﻣﺔ اﻟﺨﺪﻣﺎت وﻣﻘﺒﻮﻟﻴﺘﻬﺎ وﺗﻮاﻓﺮﻫﺎ ﻟﻠﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻷﺷﺪ ﺗﻀﺮراً . ﺣﺰَ م ﻣﻦ اﻟﺘﺪﺧﻼت اﻟﻤﺼﻤﻤﺔ ﺗﻘﺪﻳﻢ اﻟﺮﻋﺎﻳﺔ اﻟﺘﻔﺎﺿﻠﻴﺔ ﻣﻦ ﺧﻼل ﺗﻘﺪﻳﻢ ِ ﺧﺼﻴﺼﺎً ﻟﺘﻼﺋﻢ أﺷﺨﺎﺻﺎً ﻓﻲ ﻣﺴﺘﻮﻳﺎت ﻣﺨﺘﻠﻔﺔ ﻣﻦ ﻣﺮض اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻟﺘﻠﺒﻲ اﻻﺣﺘﻴﺎﺟﺎت اﻟﻤﺨﺘﻠﻔﺔ ﻟﻠﻤﻌﺎﻟﺠﺔ. ﺗﻜﻴﻴﻒ ﻧﻤﺎذج ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ﻣﻦ أﺟﻞ ﺗﻘﻮﻳﺔ اﻟﺘﻜﺎﻣﻞ واﻟﺮواﺑﻂ ﻣﻊ اﻟﻤﺠﺎﻻت اﻟﺼﺤﻴﺔ اﻷﺧﺮى وﻟﺘﺤﻘﻴﻖ اﻹﻧﺼﺎف ،ﻣﻊ ﺗﺮﻛﻴﺰ ﺧﺎص ﻋﻠﻰ اﻟﻮﺻﻮل إﻟﻰ اﻟﻤﺮاﻫﻘﻴﻦ واﻟﺸﺎﺑﺎت واﻟﺮﺟﺎل واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ. َ اﻟﺘﻤﻜﻴﻦ ﻣﻦ اﻹﺷﺮاك اﻟﻔﻌﺎل ﻟﻠﻤﺠﺘﻤﻌﺎت وﺑﻨﺎء ﻗﺪراﺗﻬﺎ وﺿﻤﺎن أن ﺗﻴﺴﺮ اﻷﻃﺮ اﻟﻘﺎﻧﻮﻧﻴﺔ واﻟﺘﻨﻈﻴﻤﻴﺔ ﺗﻌﺎوﻧﺎً وﺷﺮاﻛﺎت أﻗﻮى ﻣﻊ اﻟﻤﺠﻤﻮﻋﺎت اﻟﻤﺠﺘﻤﻌﻴﺔ وﺑﻴﻦ اﻟﻘﻄﺎﻋﻴﻦ اﻟﻌﺎم واﻟﺨﺎص. إدﻣﺎج ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ ﺧﻄﻂ اﻟﻄﻮارئ اﻟﻮﻃﻨﻴﺔ ﻟﻀﻤﺎن اﺳﺘﻤﺮارﻳﺔ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻀﺮورﻳﺔ أﺛﻨﺎء ﺣﺎﻻت اﻟﻄﻮارئ وﻓﻲ اﻷﻣﺎﻛﻦ اﻟﺘﻲ ﺗﺜﻴﺮ اﻟﻘﻠﻖ ﻣﻦ اﻟﻨﺎﺣﻴﺔ اﻹﻧﺴﺎﻧﻴﺔ ،ﻣﻊ اﻟﺘﺮﻛﻴﺰ ﺑﻮﺟﻪ ﺧﺎص ﻋﻠﻰ ﻣﻨﻊ اﻻﻧﻘﻄﺎﻋﺎت ﻓﻲ اﻟﻌﻼج .وﺗﻮﻓﻴﺮ اﻟﺘﺪرﻳﺐ ﻟﻠﻌﺎﻣﻠﻴﻦ اﻷﺳﺎﺳﻴﻴﻦ ﻓﻲ ﻣﺠﺎﻟﻲ ﺧﺪﻣﺎت اﻟﻄﻮارئ واﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﺳﺘﻨﺎداً إﻟﻰ اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﺘﻲ وﺿﻌﺘﻬﺎ اﻟﻠﺠﻨﺔ اﻟﺪاﺋﻤﺔ اﻟﻤﺸﺘﺮﻛﺔ ﺑﻴﻦ اﻟﻮﻛﺎﻻت واﻟﻤﻌﻨﻴﺔ ﺑﺎﻟﺘﺪﺧﻼت ﻓﻲ ﻣﺠﺎل ﻣﺮض اﻷﻳﺪز واﻟﻌﺪوى ﺑﻔﻴﺮوﺳﻪ ١٩ ﻓﻲ ﻣﻮاﻗﻊ اﻟﻄﻮارئ. ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ﺑﺈﻧﺼﺎف ﻓﻲ اﻷوﺳﺎط اﻟﻤﻐﻠﻘﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺗﻨﻔﻴﺬ اﻟﺤﺰﻣﺔ اﻟﺸﺎﻣﻠﺔ ﻣﻦ ﺗﺪﺧﻼت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻠﺴﺠﻨﺎء وﻓﻲ ﻣﻮاﻗﻊ اﻻﺣﺘﺠﺎز ﻋﻠﻰ اﻟﻨﺤﻮ اﻟﺬي أﻋﺪﺗﻪ ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ وﻣﻜﺘﺐ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﻌﻨﻲ ﺑﺎﻟﻤﺨﺪرات واﻟﺠﺮﻳﻤﺔ.
١٩اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﻤﻌﻨﻴﺔ ﺑﺎﻟﺘﺪﺧﻼت ﻓﻲ ﻣﺠﺎل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي /اﻷﻳﺪز ﻓﻲ ﺣﺎﻻت اﻟﻄﻮارئ ،اﻧﻈﺮ: ) http://www.who.int/3by5/publications/documents/en/iasc_guidelines.pdfﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦ ٢٠ﺳﻴﺎﺳﺔ ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺑﺸﺄن اﻷﻧﺸﻄﺔ اﻟﺘﻌﺎوﻧﻴﺔ ﻟﻤﻜﺎﻓﺤﺔ اﻟﺴﻞ /ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي :ﻣﺒﺎدئ ﺗﻮﺟﻴﻬﻴﺔ ﻟﻠﺒﺮاﻣﺞ اﻟﻮﻃﻨﻴﺔ وأﺻﺤﺎب اﻟﻤﺼﻠﺤﺔ اﻵﺧﺮﻳﻦ ،اﻧﻈﺮ ) :http://apps.who.int/iris/bitstream/10665/44789/1/9789241503006_eng.pdf?ua=1ﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦ ٢١دﻟﻴﻞ رﺻﺪ وﺗﻘﻴﻴﻢ اﻷﻧﺸﻄﺔ اﻟﺘﻌﺎوﻧﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي /اﻟﺴﻞ ،اﻧﻈﺮ: http://www.unaids.org/sites/default/files/media_asset/2015_guide_monitoring_evaluation_collaborative_TB-HIV_activities_en.pdf )ﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
وﻳﺘﺰاﻳﺪ اﺳﺘﺨﺪام إﻋﺎدة ﺗﻮزﻳﻊ اﻟﻤﻬﺎم ﻛﺠﺰء ﻣﻦ إﻃﺎر اﻹﺻﻼﺣﺎت اﻷﻋﻢ ﻟﻠﻤﻮارد اﻟﺒﺸﺮﻳﺔ ﻟﺘﺤﺴﻴﻦ ﺗﻮاﻓﺮ اﻟﺨﺪﻣﺎت واﻟﻜﻔﺎءة واﻟﺠﻮدة .وﻗﺪ أﺗﺎﺣﺖ ﻫﺬه اﻟﻨﻬﻮج ﺑﺎﻟﻔﻌﻞ ﺳﺮﻋﺔ اﻟﺘﻮﺳﻊ ﻓﻲ اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻋﻼﺟﻪ واﻟﺨﺪﻣﺎت اﻷﺧﺮى اﻟﺨﺎﺻﺔ ﺑﻪ ﻓﻲ ﻇﺮوف ﺷﺢ اﻟﻤﻮارد ،وﺳﺘﻠﻌﺐ دوراً ﻣﺘﺰاﻳﺪ اﻷﻫﻤﻴﺔ ﻈﻢ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ .وﻓﻲ ﺳﻴﺎق إﻋﺎدة ﺗﻮزﻳﻊ ﻓﻲ ﺗﻮﺳﻴﻊ ﻗﺪرات ﻧُ ُ اﻟﻤﻬﺎم وﺗﻘﺎﺳﻤﻬﺎ ،ﻳﻠﺰم وﺿﻊ آﻟﻴﺎت داﻋﻤﺔ ﻣﻮﺿﻊ اﻟﺘﻄﺒﻴﻖ ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻹرﺷﺎد واﻹﺷﺮاف ﻟﻀﻤﺎن ﺟﻮدة اﻟﺨﺪﻣﺎت .وﻳﺴﺘﻄﻴﻊ اﻟﻌﺎﻣﻠﻮن ﻓﻲ ﻣﺠﺎل دﻋﻢ اﻷﻗﺮان ﺗﻘﺪﻳﻢ ﺧﺪﻣﺎت ﺛﻤﻴﻨﺔ ،وﻳﻤﻜﻨﻬﻢ اﻟﻤﺴﺎﻋﺪة ﻋﻠﻰ رﺑﻂ اﻟﺨﺪﻣﺎت اﻟﻤﺠﺘﻤﻌﻴﺔ واﻟﺼﺤﻴﺔ ،وﻳﻨﺒﻐﻲ ﺑﺎﻟﺘﺎﻟﻲ أن ﻳﺘﻠﻘﻮا ﺗﺪرﻳﺒﺎً ﻣﻨﺘﻈﻤﺎً وإرﺷﺎداً وإﺷﺮاﻓﺎً وأﺟﺮاً ﻣﻨﺎﺳﺒﺎً ﻋﻠﻰ ﻋﻤﻠﻬﻢ. وﻧﻈﺮاً ﻟﻤﺨﺎﻃﺮ اﻧﺘﻘﺎل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ أﻣﺎﻛﻦ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ،ﻳﻨﺒﻐﻲ ﺣﻤﺎﻳﺔ اﻟﻌﺎﻣﻠﻴﻦ اﻟﺼﺤﻴﻴﻦ ﺑﺒﺮاﻣﺞ ﺷﺎﻣﻠﺔ ﻓﻲ اﻟﺼﺤﺔ اﻟﻤﻬﻨﻴﺔ واﻟﺴﻼﻣﺔ اﻟﻤﻬﻨﻴﺔ ﻟﺘﻌﺰﻳﺰ اﻻﺣﺘﻴﺎﻃﺎت اﻟﺸﺎﻣﻠﺔ ،وﺗﻮﻓﻴﺮ ﺳﻠﻊ اﻟﻮﻗﺎﻳﺔ ﻛﺎﻟﻌﻮازل واﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﻓﻲ أﻋﻘﺎب اﻟﺘﻌﺮض ﺑﺸﺪة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي، واﻻﺧﺘﺒﺎرات اﻟﺴﺮﻳﺔ ﻟﺘﺤﺮي ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻋﻼج اﻟﻌﺎﻣﻠﻴﻦ ﻓﻲ ﻣﺠﺎل اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ورﻋﺎﻳﺘﻬﻢ.
ﺗﻘﻮﻳﺔ اﻟﻤﻮارد اﻟﺒﺸﺮﻳﺔ اﻟﺼﺤﻴﺔ
ﺳﻴﺘﺮﺗﺐ ﻋﻠﻰ ﺗﻮﺳﻴﻊ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺘﺤﻘﻴﻖ اﻟﻐﺎﻳﺎت اﻟﻤﺘﻌﻠﻘﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻌﺎﻣﻲ ٢٠٢٠و ٢٠٣٠ﻃﻠﺐ ﻏﻴﺮ ﻣﺴﺒﻮق ﻋﻠﻰ اﻟﻘﻮى اﻟﻌﺎﻣﻠﺔ اﻟﺼﺤﻴﺔ .وﺳﻮف ﻳﺘﻌﻴﻦ ﻋﻠﻰ ﻣﺨﺘﻠﻒ ﻛﻮادر اﻟﻌﺎﻣﻠﻴﻦ ﻓﻲ ﻣﺠﺎل اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ اﻟﻘﻴﺎم ﺑﺄدوار ﻣﺨﺘﻠﻔﺔ ﻋﺒﺮ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .ﻛﻤﺎ ﺳﺘﺘﻄﻠﺐ ﻧﻤﺎذج ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت اﻟﺠﺪﻳﺪة ﻣﻦ أﺟﻞ ﺑﻠﻮغ اﻟﻐﺎﻳﺎت اﻷﻛﺜﺮ ﻃﻤﻮﺣﺎً ﺗﻌﺰﻳﺰ اﻟﻘﻮى اﻟﻌﺎﻣﻠﺔ اﻟﺼﺤﻴﺔ وﻣﺮاﺟﻌﺔ اﻷدوار واﻟﻤﻬﺎم اﻟﻤﻨﻮﻃﺔ ﺑﺎﻟﻌﺎﻣﻠﻴﻦ ﻓﻲ ﻣﺠﺎل اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ وﻧﺸﺮﻫﻢ ﻋﺒﺮ ﻣﺨﺘﻠﻒ اﻟﺨﺪﻣﺎت .وﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ﺗﻮﻓﻴﺮ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﺮوﺗﻴﻨﻴﺔ ،ﺳﺘﻜﻮن ﻫﻨﺎك ﺣﺎﺟﺔ ﻣﺘﺰاﻳﺪة إﻟﻰ ﺗﻤﺘﻊ اﻟﻌﺎﻣﻠﻴﻦ ﻓﻲ ﻣﺠﺎل اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﺑﺎﻟﻜﻔﺎءة ﻓﻲ ﺗﻘﺪﻳﻢ ﻌ ﱠﻴﻨﺔ ،ﺑﻤﺎ ﻓﻴﻬﺎ اﻟﻤﺠﻤﻮﻋﺎت ﻣَ اﻟﺨﺪﻣﺎت ﻟﻤﺠﻤﻮﻋﺎت ﺳﻜﺎﻧﻴﺔ ُ ﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ واﻟﻤﻬﻤﺸﺔ ،وﻓﻲ ﺗﻘﺪﻳﻢ اﻟﻤ َ اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ ُ رﻋﺎﻳﺔ اﻟﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ ﻟﻸﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﻳﻨﺒﻐﻲ ﻟﻠﺨﻄﺔ اﻟﻮﻃﻨﻴﺔ اﻟﺸﺎﻣﻠﺔ ﻟﻠﻘﻮى اﻟﻌﺎﻣﻠﺔ اﻟﺼﺤﻴﺔ أن ﺗﻠﺒﻲ اﺣﺘﻴﺎﺟﺎت اﻟﻨﻈﺎم اﻟﺼﺤﻲ ﻓﻲ ﻣﺠﻤﻠﻬﺎ، ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ﻣﺎ ﻫﻮ ﻣﻄﻠﻮب ﻟﺘﻘﺪﻳﻢ ﺳﻠﺴﻠﺔ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺄﻛﻤﻠﻬﺎ.
اﻟﻤﻮارد اﻟﺒﺸﺮﻳﺔ اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﺒﻠﺪان وﺿﻊ ﺧﻄﺔ وﻃﻨﻴﺔ ﻟﻠﻘﻮى اﻟﻌﺎﻣﻠﺔ اﻟﺼﺤﻴﺔ ﻓﻲ ﻣﺠﺎل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ورﺻﺪ ﺗﻨﻔﻴﺬﻫﺎ وﺗﺤﺪﻳﺜﻬﺎ ﺑﺎﻧﺘﻈﺎم ﻋﻠﻰ أن ﺗﻜﻮن ﺟﺰءاً ﻣﻦ ﺧﻄﺔ أﺷﻤﻞ ﻟﻠﻘﻮى اﻟﻌﺎﻣﻠﺔ اﻟﺼﺤﻴﺔ وأن ﺗﺘﺴﻖ ﻣﻊ اﻟﺨﻄﺔ اﻟﻮﻃﻨﻴﺔ واﻷوﻟﻮﻳﺎت اﻟﺼﺤﻴﺔ اﻟﻮﻃﻨﻴﺔ. ﺗﻨﻤﻴﺔ ﻗﺪرات اﻟﻘﻮى اﻟﻌﺎﻣﻠﺔ اﻟﺼﺤﻴﺔ ﺑﺘﺤﺪﻳﺪ اﻟﻜﻔﺎءات اﻷﺳﺎﺳﻴﺔ ﻟﻤﺨﺘﻠﻒ اﻷدوار ﻓﻲ ﺗﻘﺪﻳﻢ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﺸﺎﻣﻠﺔ ،وﺗﻮﻓﻴﺮ اﻟﺘﺪرﻳﺐ ذي اﻟﻌﻼﻗﺔ ،واﺳﺘﺤﺪاث ﻋﻤﻠﻴﺎت ﻣﻨﺎﺳﺒﺔ ﻟﻼﻋﺘﻤﺎد وﻣﻨﺢ اﻟﺸﻬﺎدات. ﺗﺤﺪﻳﺪ ﻓﺮص إﻋﺎدة ﺗﻮزﻳﻊ اﻟﻤﻬﺎم ﻟﺘﻮﺳﻴﻊ ﻗﺪرات اﻟﻘﻮى اﻟﻌﺎﻣﻠﺔ اﻟﺼﺤﻴﺔ وﺗﻄﺒﻴﻖ ﻧﻈﺎم اﻟﺘﺪرﻳﺐ واﻹﻃﺎر اﻟﺘﻨﻈﻴﻤﻲ اﻟﻤﻨﺎﺳﺒﻴﻦ ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻣﺎ ﻳﺨﺺ اﻟﻌﺎﻣﻠﻴﻦ اﻟﺼﺤﻴﻴﻦ اﻟﻤﺠﺘﻤﻌﻴﻴﻦ. ﺗﻌﺰﻳﺰ اﻻﺣﺘﻔﺎظ ﺑﺎﻟﻌﺎﻣﻠﻴﻦ اﻟﺼﺤﻴﻴﻦ ﻣﻦ ﺧﻼل اﻟﺤﻮاﻓﺰ اﻟﻤﻨﺎﺳﺒﺔ ،وﺧﺼﻮﺻﺎً ﺿﻤﺎن اﻷﺟﻮر اﻟﻜﺎﻓﻴﺔ ﻟﻜﻞ اﻟﻌﺎﻣﻠﻴﻦ اﻟﺼﺤﻴﻴﻦ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﻌﺎﻣﻠﻮن ﻓﻲ ﺻﺤﺔ اﻟﻤﺠﺘﻤﻊ واﻟﻌﺎﻣﻠﻮن ﻏﻴﺮ اﻟﻤﺘﺨﺼﺼﻴﻦ. اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﺪﻋﻮة إﻟﻰ ﺗﺪرﻳﺐ اﻟﻌﺎﻣﻠﻴﻦ اﻟﺼﺤﻴﻴﻦ ﻟﻠﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺗﻘﺪﻳﻢ رﻋﺎﻳﺔ ﺗﺮﻛﱢ ﺰ ﻋﻠﻰ اﻟﻨﺎس وﺗﺘﺼﺪى ﻟﻠﺘﻤﻴﻴﺰ ﻓﻲ ﻗﻄﺎع اﻟﺼﺤﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ. اﻟﻤ َ اﻟﺘﻤﻴﻴﺰ ﺿﺪ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ ُ ﺗﻘﺪﻳﻢ إرﺷﺎدات ﺑﺸﺄن إﻋﺎدة ﺗﻮزﻳﻊ اﻟﻤﻬﺎم ﻋﺒﺮ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺑﺸﺄن اﺳﺘﺨﺪام اﻷﺷﺨﺎص ﻏﻴﺮ اﻟﻤﺘﺨﺼﺼﻴﻦ ﻟﺘﻘﺪﻳﻢ ﺧﺪﻣﺎت ﻣﻌﻴﻨﺔ ،ﻣﺜﻞ اﺧﺘﺒﺎرات ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻣﺴﺎﻧﺪة اﻹﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﻗﺒﻞ اﻟﺘﻌﺮض وﺗﻘﺪﻳﻢ اﻟﻌﻼج ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،واﻟﻮﻗﺎﻳﺔ ﻣﻦ اﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ اﻟﺸﺎﺋﻌﺔ وﺗﺪﺑﻴﺮﻫﺎ اﻟﻌﻼﺟﻲ.
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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وﻟﺘﺄﻣﻴﻦ إﻣﺪادات ﻣﻀﻤﻮﻧﺔ ﻋﻠﻰ اﻟﻤﺪى اﻟﻄﻮﻳﻞ ﻟﻠﺒﻠﺪان ،ﻳﻨﺒﻐﻲ ﻋﻠﻰ اﻟﺒﻠﺪان دﻣﺞ ﺷﺮاء وإدارة إﻣﺪادات ﺳﻠﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ اﻟﻨﻈﺎم اﻟﻮﻃﻨﻲ اﻷﻋﻢ ﻟﻠﺸﺮاء وإدارة اﻹﻣﺪادات .وﻗﺪ أدى اﻟﻄﻠﺐ ﻋﻠﻰ ﻋﻼج ﻣﻴﺴﻮر اﻟﺘﻜﻠﻔﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻟﻰ اﺳﺘﺮاﺗﻴﺠﻴﺎت ﺷﺎﻣﻠﺔ ﻟﺨﻔﺾ أﺳﻌﺎر أدوﻳﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻳﻤﻜﻦ ﺗﻄﺒﻴﻘﻬﺎ ﻋﻠﻰ اﻷدوﻳﺔ ووﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ واﻟﺴﻠﻊ اﻟﺼﺤﻴﺔ اﻷﺧﺮى .وﺗﺸﻤﻞ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت ﺗﻌﺰﻳﺰ اﻟﻤﻨﺎﻓﺴﺔ ﻋﻠﻰ اﻷدوﻳﺔ اﻟﺠﻨﻴﺴﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻣﻦ ﺧﻼل اﻟﺮﺧﺺ اﻟﻄﻮﻋﻴﺔ ،ﻋﻨﺪﻣﺎ ﻳﻜﻮن ذﻟﻚ ﻣﻼﺋﻤﺎً ،واﻟﺘﻲ ﺗﺘﻀﻤﻦ ﺷﺮوﻃﺎً وﺑﻨﻮداً ﻟﻠﺤﺼﻮل اﻟﻤﺴﺒﻖ ﻣﺜﻞ اﻟﺸﺮوط واﻟﺒﻨﻮد ﻗ َﺒﻞ وﻋﺎء اﻟﺒﺮاءات اﻟﻄﺒﻴﺔ ،وﺗﻄﺒﻴﻖ، اﻟﺘﻲ ﺗﻢ اﻟﺘﻔﺎوض ﻋﻠﻴﻬﺎ ﻣﻦ ِ ﺣﺴﺐ اﻻﻗﺘﻀﺎء ،اﺳﺘﺨﺪام أﺣﻜﺎم اﺗﻔﺎق ﻣﻨﻈﻤﺔ اﻟﺘﺠﺎرة اﻟﻌﺎﻟﻤﻴﺔ اﻟﻤﺘﻌﻠﻖ ﺑﺎﻟﺠﻮاﻧﺐ اﻟﻤﺘﺼﻠﺔ ﺑﺎﻟﺘﺠﺎرة ﻣﻦ ﺣﻘﻮق اﻟﻤﻠﻜﻴﺔ اﻟﻔﻜﺮﻳﺔ اﻟﻤﺘﻌﻠﻘﺔ ﺑﺄوﺟﻪ اﻟﻤﺮوﻧﺔ اﻟﻼزﻣﺔ ﻟﺤﻤﺎﻳﺔ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ،وﺑﻤﺎ ﻳﺘﻤﺎﺷﻰ ﻣﻊ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﻌﺎﻟﻤﻴﺔ وﺧﻄﺔ اﻟﻌﻤﻞ ﺣﻮل اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ واﻻﺑﺘﻜﺎر واﻟﻤﻠﻜﻴﺔ اﻟﻔﻜﺮﻳﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺮﺧﺺ اﻹﻟﺰاﻣﻴﺔ وﺗﻘﺪﻳﻢ اﻻﻋﺘﺮاﺿﺎت ﻋﻠﻰ ﺑﺮاءات اﻻﺧﺘﺮاع ،واﻟﺘﺴﻌﻴﺮ اﻟﺘﻔﺎﺿﻠﻲ ،واﻟﻤﻔﺎوﺿﺎت اﻟﻤﺒﺎﺷﺮة ﻋﻠﻰ اﻷﺳﻌﺎر ﻣﻊ اﻟﻤﻨﺘﺠﻴﻦ، ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ اﻟﺘﺼﻨﻴﻊ اﻟﻤﺤﻠﻲ .وﺗﺤﺘﻔﻆ اﻟﻤﻨﻈﻤﺔ ﺑﻘﺎﻋﺪة ﺑﻴﺎﻧﺎت ﺣﻮل أﺳﻌﺎر أدوﻳﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ووﺳﺎﺋﻞ ﺗﺸﺨﻴﺼﻪ ،وﺗﺘﻌﺎون ﻣﻊ وﻋﺎء ﺑﺮاءات اﻷدوﻳﺔ ،اﻟﺘﻲ ﺗﺤﺘﻔﻆ ﺑﻘﺎﻋﺪة ﺑﻴﺎﻧﺎت ﺣﻮل وﻋﺎء اﻟﺒﺮاءات ٢٢ﻟﻤﺴﺎﻋﺪة اﻟﺒﻠﺪان ﻋﻠﻰ اﻟﺤﺼﻮل ﻋﻠﻰ أﻓﻀﻞ أﺳﻌﺎر ﻣﻤﻜﻨﺔ ﻟﻬﺬه اﻟﺴﻠﻊ. ﻛﻤﺎ أن ﻫﻨﺎك أﻳﻀﺎً ﻓﺮﺻﺎً ﻛﺜﻴﺮة ﻹﻧﻔﺎق ﻗﺪر أﻗﻞ ﻋﻠﻰ ﺷﺮاء أدوﻳﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ووﺳﺎﺋﻞ ﺗﺸﺨﻴﺼﻪ وﺳﻠﻌﻪ، وﺗﺤﺴﻴﻦ أوﺟﻪ اﻟﻜﻔﺎءة ﻓﻲ إدارة اﻹﻣﺪاد ،ﻛﺎﻟﺸﺮاء ﺑﻜﻤﻴﺎت ﻛﺒﻴﺮة ﻋﻠﻰ أن ﻳﺘﻢ اﻟﺘﺴﻠﻴﻢ ﻋﻠﻰ ﻣﺮاﺣﻞ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺴﻠﻊ ذات ﺻﻼﺣﻴﺔ اﻻﺳﺘﻌﻤﺎل اﻟﻘﺼﻴﺮة ،واﻟﺸﺮاء اﻟﻤﺴﺒﻖ وﺗﺤﺴﻴﻦ اﻟﺘﻨﺒﺆ ﺑﺎﻻﺣﺘﻴﺎﺟﺎت ﻟﺘﺠﻨﺐ اﻹﻫﺪار ﻣﻦ ﺧﻼل اﻟﻤﻨﺘﺠﺎت اﻟﻤﻨﺘﻬﻴﺔ اﻟﺼﻼﺣﻴﺔ.
ﺗﺄﻣﻴﻦ إﻣﺪادات اﻷدوﻳﺔ ووﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ واﻟﺴﻠﻊ اﻟﺠﻴﺪة اﻟﻨﻮﻋﻴﺔ واﻟﻤﻴﺴﻮرة اﻟﺘﻜﻠﻔﺔ
ﻳﺘﻮﻗﻒ اﻟﺘﻮﺳﻴﻊ اﻟﺴﺮﻳﻊ ﻓﻲ اﻟﺘﻐﻄﻴﺔ ﺑﺘﺪﺧﻼت اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﺸﺨﻴﺼﻪ وﻋﻼﺟﻪ ﻋﻠﻰ ﺗﻮاﻓﺮ إﻣﺪادات ﻣﻀﻤﻮﻧﺔ ﻣﻦ اﻷدوﻳﺔ ووﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ واﻟﺴﻠﻊ اﻷﺧﺮى اﻟﻤﻴﺴﻮرة اﻟﺘﻜﻠﻔﺔ واﻟﻌﺎﻟﻴﺔ اﻟﺠﻮدة .وﺗﺆدي اﻹﻣﺪادات اﻟﻤﺘﺪﻧﻴﺔ اﻟﻨﻮﻋﻴﺔ واﻟﻤﺘﻘﻄﻌﺔ ﻣﻦ اﻟﺴﻠﻊ اﻷﺳﺎﺳﻴﺔ ﻓﻲ ﻣﺠﺎل ﻣﻜﺎﻓﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﺳﻮاء أﻛﺎﻧﺖ ﻫﺬه اﻟﺴﻠﻊ ﻋﻮازل أم أدوات ﺣﻘﻦ أم أﺟﻬﺰة ﺧﺘﺎن اﻟﺬﻛﻮر أم وﺳﺎﺋﻞ ﺗﺸﺨﻴﺺ أم أدوﻳﺔ أم ﺳﻠﻌﺎً أﺧﺮى ،إﻟﻰ ﻋﺮﻗﻠﺔ ﺗﻮﺳﻴﻊ ﻧﻄﺎق اﻟﺒﺮاﻣﺞ وﺗﻌﺮﺿﻬﺎ ﻟﻤﺨﺎﻃﺮ إﺧﻔﺎق اﻟﻮﻗﺎﻳﺔ واﻟﻌﻼج ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻇﻬﻮر ﱢ اﻟﻤﻘﺎوﻣﺔ ﻟﻸدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. وﻳﻠﺰم اﻟﺘﻨﺒﺆ اﻟﺪﻗﻴﻖ ﺑﺎﻟﺤﺎﺟﺎت ﻋﻠﻰ اﻟﺼﻌﻴﺪ اﻟﻘﻄﺮي وﻋﻠﻰ اﻟﺼﻌﻴﺪ اﻟﻌﺎﻟﻤﻲ ﻟﺠﻤﻴﻊ ﺳﻠﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻜﻲ ﻳﺴﺘﺮﺷﺪ اﻟﻤﻨﺘﺠﻮن ﺑﻬﺎ ﻓﻲ ﺗﺄﻫﺒﻬﻢ وﻗﺪرﺗﻬﻢ ﻋﻠﻰ ﺗﻠﺒﻴﺔ اﻟﺤﺎﺟﺎت اﻟﻤﺘﻮﻗﻌﺔ وﺿﻤﺎن اﺳﺘﻤﺮارﻳﺔ اﻹﻣﺪادات .وﻳﻨﺒﻐﻲ أن ﺗﺆﺧﺬ ﻗﺪرة اﻟﺘﺼﻨﻴﻊ اﻟﻤﺤﻠﻴﺔ ﺑﻌﻴﻦ اﻻﻋﺘﺒﺎر ،ﻓﻲ ﻇﻞ إﻣﻜﺎﻧﻴﺔ ﺧﻔﺾ اﻷﺳﻌﺎر وﺿﻤﺎن اﻹﻣﺪادات وﺗﺸﺠﻴﻊ اﻟﻤﻠﻜﻴﺔ اﻟﻮﻃﻨﻴﺔ .وﻳﻨﺒﻐﻲ ﻛﺬﻟﻚ أن ﺗﻠﺒﻲ اﻟﺨﻄﻂ واﻟﻤﻴﺰاﻧﻴﺎت اﻟﻮﻃﻨﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺨﻄﻂ واﻟﻤﻴﺰاﻧﻴﺎت اﻟﺼﺤﻴﺔ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً اﺣﺘﻴﺎﺟﺎت اﻟﺸﺮاء وإدارة ﺳﻠﺴﻠﺔ اﻹﻣﺪاد .وﺗﺸﻜﻞ اﻷدوﻳﺔ ووﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ واﻟﺴﻠﻊ اﻷﺧﺮى ﻣﻜﻮﻧﺎً ﻣﻬﻤﺎً ﻣﻦ ﻣﻜﻮﻧﺎت ﺗﻜﺎﻟﻴﻒ ﺑﺮاﻣﺞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻮﻃﻨﻴﺔ .وﻳﻌﺘﺒﺮ اﺧﺘﻴﺎر اﻟﻤﻨﺘﺠﺎت اﻟﻤﻨﺎﺳﺒﺔ ذات اﻟﺠﻮدة اﻟﻜﺎﻓﻴﺔ ﺑﺎﻟﻎ اﻷﻫﻤﻴﺔ ﻟﺘﺤﻘﻴﻖ أﺣﺴﻦ اﻟﺤﺼﺎﺋﻞ ﺑﺴﻌﺮ ﻣﻴﺴﻮر .وﺗﻘﺪم ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ ﻟﻠﺒﻠﺪان ﻟﺘﻴﺴﻴﺮ ﻋﻤﻠﻴﺔ اﻻﺧﺘﻴﺎر ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻣﺒﺎدئ ﺗﻮﺟﻴﻬﻴﺔ ﺣﻮل اﺳﺘﺨﺪام اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﻌﻼج ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻮﻗﺎﻳﺔ ﻣﻨﻪ ،وﻗﺎﺋﻤﺔ اﻟﻤﻨﻈﻤﺔ ﻟﻸدوﻳﺔ اﻷﺳﺎﺳﻴﺔ ،واﺳﺘﺮاﺗﻴﺠﻴﺎت اﻻﺧﺘﺒﺎرات ،وﻗﺎﺋﻤﺔ اﻟﻤﻨﻈﻤﺔ ﻟﻠﻤﻨﺘﺠﺎت اﻟﺘﻲ أﺟﺮﻳﺖ ﻟﻬﺎ اﺧﺘﺒﺎرات ﻣﺴﺒﻘﺔ ﻟﻠﺼﻼﺣﻴﺔ.
– ٠٩اﻻﺳﺘﻌﺪاد ﻟﺘﻨﺎول اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ،أوﻏﻨﺪا.
٢٢وﻋﺎء ﺑﺮاءات اﻷدوﻳﺔ ،اﻧﻈﺮ) http://www.medicinespatentpool.org/ :ﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
ﺗﺄﻣﻴﻦ اﻹﻣﺪادات اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﺒﻠﺪان ﺗﻌﺰﻳﺰ اﻟﻬﻴﺎﻛﻞ واﻟﻌﻤﻠﻴﺎت اﻟﻮﻃﻨﻴﺔ ﻟﺸﺮاء وإدارة إﻣﺪادات ﺳﻠﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻀﻤﺎن دﻣﺠﻬﺎ ﻓﻲ اﻟﻨﻈﺎم اﻟﻮﻃﻨﻲ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً ﻟﻠﺸﺮاء وإدارة اﻹﻣﺪادات. ﺿﻤﺎن ﺷﺮاء اﻟﻠﻘﺎﺣﺎت واﻷدوﻳﺔ ووﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ واﻟﻌﻮازل وأﺟﻬﺰة ﺧﺘﺎن اﻟﺬﻛﻮر واﻟﺴﻠﻊ اﻷﺧﺮى اﻟﻤﺮﺗﺒﻄﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻤﻀﻤﻮﻧﺔ اﻟﺠﻮدة ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻣﻦ ﺧﻼل اﺳﺘﺨﺪام اﺧﺘﺒﺎرات اﻟﻤﻨﻈﻤﺔ اﻟﻤﺴﺒﻘﺔ ﻟﻠﺼﻼﺣﻴﺔ. ﺗﺨﻄﻴﻂ وﺗﻨﻔﻴﺬ اﺳﺘﺮاﺗﻴﺠﻴﺔ ﻹﺗﺎﺣﺔ أدوﻳﺔ وﺳﻠﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﺨﻔﺾ أﺳﻌﺎر اﻷدوﻳﺔ ووﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ واﻟﺴﻠﻊ اﻷﺧﺮى اﻟﻤﺮﺗﺒﻄﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﺳﺘﺨﺪام اﻷﺣﻜﺎم اﻟﻮاردة ﻓﻲ اﻻﺗﻔﺎق ﺑﺸﺄن اﻟﺠﻮاﻧﺐ اﻟﻤﺘﺼﻠﺔ ﺑﺎﻟﺘﺠﺎرة ﻣﻦ ﺣﻘﻮق اﻟﻤﻠﻜﻴﺔ اﻟﻔﻜﺮﻳﺔ اﻟﻤﺘﻌﻠﻘﺔ ﺑﺄوﺟﻪ اﻟﻤﺮوﻧﺔ اﻟﻼزﻣﺔ ﻟﺤﻤﺎﻳﺔ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ. ﺿﻤﺎن وﺗﻮﺳﻴﻊ ﺗﻮاﻓﺮ اﻷدوﻳﺔ اﻟﺠﻨﻴﺴﺔ اﻟﺘﻲ أﺟﺮت ﻟﻬﺎ اﻟﻤﻨﻈﻤﺔ اﻻﺧﺘﺒﺎرات اﻟﻤﺴﺒﻘﺔ ﻟﻠﺼﻼﺣﻴﺔ وذﻟﻚ ﻣﻦ ﺧﻼل ﺗﻮﺳﻴﻊ اﺗﻔﺎﻗﻴﺎت اﻟﺘﺮﺧﻴﺺ، وﺗﺴﺮﻳﻊ اﻟﺘﺴﺠﻴﻞ ﻋﻠﻰ اﻟﻤﺴﺘﻮى اﻟﻮﻃﻨﻲ. اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﺘﻨﺒﺆ ﺑﺎﻟﻄﻠﺐ ﻋﻠﻰ اﻷدوﻳﺔ ووﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ واﻟﺴﻠﻊ اﻷﺧﺮى ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻻﻋﺘﻼﻻت اﻟﻤﺸﺘﺮﻛﺔ اﻟﺨﻄﻴﺮة وﺗﻮاﻓﺮﻫﺎ واﻹﻗﺒﺎل ﻋﻠﻴﻬﺎ ،واﺳﺘﺨﺪام ﻫﺬه اﻟﻤﻌﻠﻮﻣﺎت ﻟﻠﺪﻋﻮة إﻟﻰ اﻣﺘﻼك اﻟﻤﻨﺘﺠﻴﻦ اﻟﻘﺪرة اﻟﺘﺼﻨﻴﻌﻴﺔ اﻟﻜﺎﻓﻴﺔ ،وﻳﺘﻀﻤﻦ ذﻟﻚ ،ﻓﻲ اﻟﻤﺠﺎﻻت اﻟﻤﻼﺋﻤﺔ، ﻓﻲ اﻟﺒﻠﺪان اﻟﻤﻨﺨﻔﻀﺔ اﻟﺪﺧﻞ واﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ. ﺗﺸﺠﻴﻊ ﺑﺮﻧﺎﻣﺞ اﻟﻤﻨﻈﻤﺔ ﻟﻼﺧﺘﺒﺎر اﻟﻤﺴﺒﻖ ﻟﺼﻼﺣﻴﺔ اﻷدوﻳﺔ ﻟﻠﺴﻤﺎح ﺑﺘﻌﺠﻴﻞ ﺗﺴﺠﻴﻞ اﻷدوﻳﺔ واﻟﺴﻠﻊ ذات اﻷوﻟﻮﻳﺔ ،وﻟﻀﻤﺎن وﺗﻮﺳﻴﻊ ﺗﻮاﻓﺮ أدوﻳﺔ ووﺳﺎﺋﻞ ﺗﺸﺨﻴﺺ ﻣﻀﻤﻮﻧﺔ اﻟﺠﻮدة. ﺗﻘﺪﻳﻢ اﻹرﺷﺎدات ﺑﺸﺄن اﺧﺘﻴﺎر ﻣﻨﺘﺠﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻤﻌﺮﻓﺔ اﻟﺒﺮاﻣﺞ اﻟﻮﻃﻨﻴﺔ واﻟﺠﻬﺎت اﻟﻤﺎﻧﺤﺔ واﻟﻬﻴﺌﺎت اﻟﻤﺴﺆوﻟﺔ ﻋﻦ إدارة اﻟﺘﻨﻔﻴﺬ ﻣﻦ ﺧﻼل إﻧﺘﺎج وﻧﺸﺮ ﻣﻌﻠﻮﻣﺎت اﺳﺘﺮاﺗﻴﺠﻴﺔ ﺣﻮل اﻷﺳﻌﺎر وﻣﻨﺘﺠﻲ أدوﻳﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ووﺳﺎﺋﻞ ﺗﺸﺨﻴﺼﻪ واﻟﺴﻠﻊ اﻷﺧﺮى اﻟﺘﻲ ﺗﺮﺗﺒﻂ ﺑﻪ. ﺗﻘﺪﻳﻢ اﻟﺪﻋﻢ اﻟﺘﻘﻨﻲ ﻟﻠﺒﻠﺪان ﻟﻠﺘﻨﺒﺆ ﺑﺎﻟﺤﺎﺟﺔ إﻟﻰ اﻟﺴﻠﻊ اﻟﻀﺮورﻳﺔ اﻟﺘﻲ ﺗﺮﺗﺒﻂ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وإدراﺟﻬﺎ ﻓﻲ ﺧﻄﻄﻬﺎ اﻟﻮﻃﻨﻴﺔ ﻟﻠﺸﺮاء وإدارة اﻹﻣﺪادات ،ووﺿﻊ اﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﻠﺘﻔﺎوض ﻋﻠﻰ ﺗﺨﻔﻴﻀﺎت ﻓﻲ اﻷﺳﻌﺎر ﻣﻊ اﻟﻤﻨﺘﺠﻴﻦ. ﻣﺴﺎﻧﺪة اﻟﺴﻠﻄﺎت اﻟﺘﻨﻈﻴﻤﻴﺔ ﻓﻲ اﻟﺘﻘﻴﻴﻢ وﺗﺴﺠﻴﻞ أدوﻳﺔ ووﺳﺎﺋﻞ ﺗﺸﺨﻴﺺ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﺠﺪﻳﺪة ﻗﺒﻞ ﻃﺮﺣﻬﺎ ﻓﻲ اﻷﺳﻮاق ،وﺗﺮﺻﺪﻫﺎ ﺑﻌﺪ ﺗﺴﻮﻳﻘﻬﺎ. ﺗﻘﺪﻳﻢ اﻟﺪﻋﻢ اﻟﺘﻘﻨﻲ ﻟﻠﺒﻠﺪان ﻹﻋﺪاد اﺳﺘﺮاﺗﻴﺠﻴﺔ ﺷﺎﻣﻠﺔ ﻟﺨﻔﺾ اﻷﺳﻌﺎر ﻟﻀﻤﺎن إﺗﺎﺣﺔ اﻷدوﻳﺔ اﻷﺳﺎﺳﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ووﺳﺎﺋﻞ ﺗﺸﺨﻴﺼﻪ واﻟﺴﻠﻊ اﻷﺧﺮى اﻟﺘﻲ ﺗﺮﺗﺒﻂ ﺑﻪ.
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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ﺑﻴﺌﺔ اﻟﺘﻤﻜﻴﻦ اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﺒﻠﺪان إﺻﻼح اﻟﺴﻴﺎﺳﺎت واﻟﻘﻮاﻧﻴﻦ واﻟﻠﻮاﺋﺢ اﻟﺘﻨﻈﻴﻤﻴﺔ اﻟﺘﻲ ﺗﻌﻴﻖ اﻹﻧﺼﺎف ﻓﻲ ﺗﻮﻓﻴﺮ اﻟﺨﺪﻣﺎت اﻟﻤﺘﻌﻠﻘﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي، ﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ وﻟﻠﻔﺌﺎت اﻟﻤ َ وﺧﺼﻮﺻﺎً ﻟﻠﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ ُ اﻷﺧﺮى اﻟﺴﺮﻳﻌﺔ اﻟﺘﺄﺛﺮ ﺑﻬﺎ. إﻧﻬﺎء اﻟﺴﻴﺎﺳﺎت واﻟﻤﻤﺎرﺳﺎت اﻟﺘﻲ ﺗﺮﺳﺦ اﻟﻮﺻﻢ واﻟﺘﻤﻴﻴﺰ )وﺧﺼﻮﺻﺎً ﻓﻲ ﻣﻮاﻗﻊ ﺗﻘﺪﻳﻢ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ( وﺗﺤﺪﻳﺪاً ﺗﺠﺎه اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ. اﻟﺮﺋﻴﺴﻴﺔ َ ﺗﻬﻴﺌﺔ ﺑﻴﺌﺎت ﻣﺆﺳﺴﻴﺔ وﻣﺠﺘﻤﻌﻴﺔ ﺗﻜﻔﻞ اﻷﻣﺎن ﻟﻠﻨﺎس ﻟﻠﺤﺼﻮل ﻋﻠﻰ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي دون ﺧﻮف ﻣﻦ اﻟﺘﻤﻴﻴﺰ ،وإﺷﺮاك اﻟﻤﺠﺘﻤﻌﺎت ﻓﻲ ﺗﺨﻄﻴﻂ اﻟﺨﺪﻣﺎت وﺗﻘﺪﻳﻤﻬﺎ ﻟﺘﺤﺴﻴﻦ ﻓﺮص اﻟﻮﺻﻮل إﻟﻴﻬﺎ وﺟﻮدﺗﻬﺎ وﻓﻌﺎﻟﻴﺘﻬﺎ. اﻟﺘﺼﺪي ﻟﻠﺘﻔﺎوت ﺑﻴﻦ اﻟﺠﻨﺴﻴﻦ ﺑﺪﻣﺞ اﻟﺘﺪﺧﻼت اﻟﻤﺴﻨﺪة ﺑﺎﻟﺒﻴﻨﺎت ﻓﻲ اﻟﺨﻄﻂ واﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻮﻃﻨﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﺒﻴﻨﺎت ﻓﻲ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﻟﺼﻴﺎﻏﺔ ﻗﻮاﻧﻴﻦ اﻟﺪﻋﻮة ﻻﺳﺘﺨﺪام ّ وﺗﺪاﺑﻴﺮ ﻣﻌﺰزة ﻟﻠﺼﺤﺔ اﺳﺘﻨﺎداً إﻟﻰ اﻷﺧﻼﻗﻴﺎت اﻟﻄﺒﻴﺔ وﺣﻘﻮق اﻹﻧﺴﺎن وﻣﺒﺎدئ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ. وﺿﻊ وﺗﻌﺰﻳﺰ ﺳﻴﺎﺳﺎت ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ وﻣﺒﺎدﺋﻬﺎ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﺘﻲ ﺗﺘﺼﺪى ﺑﻮﺿﻮح ﻟﻠﺘﻔﺎوت ﺑﻴﻦ اﻟﺠﻨﺴﻴﻦ واﻟﻌﻨﻒ اﻟﻘﺎﺋﻢ ﻋﻠﻰ اﻟﺠﻨﺲ واﻟﻮﺻﻢ واﻟﺘﻤﻴﻴﺰ وﺣﻘﻮق اﻹﻧﺴﺎن واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ وﺑﺪاﺋﻞ اﻟﺘﺠﺮﻳﻢ ﻓﻲ ﻣﺠﺎل اﻟﺼﺤﺔ اﻟﺮﺋﻴﺴﻴﺔ َ اﻟﻌﻤﻮﻣﻴﺔ. وﺿﻊ إرﺷﺎدات وأدوات ﻟﻠﺘﻨﻔﻴﺬ وﺗﺤﺪﻳﺜﻬﺎ وﺗﻨﻔﻴﺬﻫﺎ ﺑﺸﺄن ﻣﻨﻊ اﻟﻌﻨﻒ اﻟﻘﺎﺋﻢ ﻋﻠﻰ ﻧﻮع اﻟﺠﻨﺲ واﻟﺘﻌﺎﻣﻞ ﻣﻌﻪ وإزاﻟﺔ اﻟﻌﻮاﺋﻖ اﻟﻬﻴﻜﻠﻴﺔ أﻣﺎم اﻟﺤﺼﻮل ﻋﻠﻰ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻷﺳﺎﺳﻴﺔ ﻟﻤﺨﺘﻠﻒ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻷﻃﻔﺎل واﻟﻤﺮاﻫﻘﻮن اﻟﻤﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ. واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ َ
ﺗﻬﻴﺌﺔ واﺳﺘﺪاﻣﺔ ﺑﻴﺌﺔ اﻟﺘﻤﻜﻴﻦ
ﺗﺘﻄﻠﺐ اﻻﺳﺘﺠﺎﺑﺔ اﻟﻔﻌﺎﻟﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻴﺌﺔ اﺟﺘﻤﺎﻋﻴﺔ وﻗﺎﻧﻮﻧﻴﺔ وﺳﻴﺎﺳﺎﺗﻴﺔ داﻋﻤﺔ ﺗﺸﺠﻊ اﻟﻨﺎس وﺗﻤﻜّ ﻨﻬﻢ ﻣﻦ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺨﺪﻣﺎت واﻻﻧﺘﻔﺎع ﺑﻬﺎ .وﻳﺘﻄﻠﺐ اﻟﻮﺻﻮل إﻟﻰ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﺘﻨﻮﻋﺔ ﻓﻲ ﻣﺨﺘﻠﻒ اﻟﻤﻮاﻗﻊ ﻧﻈﻤﺎً ﺻﺤﻴﺔ وﻣﺠﺘﻤﻌﻴﺔ ﻗﻮﻳﺔ وﺗﺤﻈﻰ ﺑﺪﻋﻢ ﺟﻴﺪ ،وﺑﻴﺌﺔ ﺗﻤﻜﻴﻦ ﺗﺸﺠﻊ اﻹﻧﺼﺎف ﻓﻲ ﻣﺠﺎل اﻟﺼﺤﺔ واﻟﻤﺴﺎواة ﺑﻴﻦ اﻟﺠﻨﺴﻴﻦ وﺣﻘﻮق اﻹﻧﺴﺎن. اﻟﺴﻴﺎﺳﺎت واﻟﻘﻮاﻧﻴﻦ واﻟﻠﻮاﺋﺢ اﻟﺘﻨﻈﻴﻤﻴﺔ :ﻳﻠﺘﺰم ﻗﻄﺎع اﻟﺼﺤﺔ اﻟﺘﺰاﻣﺎً ﻛﺒﻴﺮاً ﺑﻀﻤﺎن أن ﺗﻜﻮن اﻟﺴﻴﺎﺳﺎت واﻟﻘﻮاﻧﻴﻦ واﻟﻠﻮاﺋﺢ اﻟﺘﻨﻈﻴﻤﻴﺔ ،ﺑﻤﺎ ﻓﻴﻬﺎ اﻟﺴﻴﺎﺳﺎت واﻟﻘﻮاﻧﻴﻦ واﻟﻠﻮاﺋﺢ اﻟﺘﻨﻈﻴﻤﻴﺔ اﻟﺨﺎﺻﺔ ﺑﺎﻟﻘﻄﺎﻋﺎت اﻷﺧﺮى ،ﻣﺆﻳﺪة ﻟﻠﺼﺤﺔ وﻣﺴﺎﻧﺪة ﻷﻧﺸﻄﺔ اﻻﺳﺘﺠﺎﺑﺔ اﻟﻮﻃﻨﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﺑﺈﻣﻜﺎن اﻟﻘﻮاﻧﻴﻦ واﻟﺴﻴﺎﺳﺎت اﻟﺘﻲ ﺗﻘﻀﻲ ﻋﻠﻰ اﻟﻔﺮوق ﺑﻴﻦ اﻟﺠﻨﺴﻴﻦ وﺗﺤﻤﻲ ﺣﻘﻮق اﻹﻧﺴﺎن وﺗﻌﺰزﻫﺎ ،ﻋﻨﺪﻣﺎ ﻳﺘﻢ إﻧﻔﺎذﻫﺎ ﻋﻠﻰ ﻧﺤﻮ ﻣﻼﺋﻢ ،أن ﺗﻘﻠﻞ ﻣﻦ ﺳﺮﻋﺔ اﻟﺘﺄﺛﺮ واﻟﺘﻌﺮض ﻟﻤﺨﺎﻃﺮ اﻟﻌﺪوى ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وأن ﺗﻮﺳﻊ إﺗﺎﺣﺔ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وزﻳﺎدة ﻧﻄﺎﻗﻬﺎ وﺟﻮدﺗﻬﺎ وﻓﻌﺎﻟﻴﺘﻬﺎ ،وﺧﺼﻮﺻﺎً ﺑﺎﻟﻨﺴﺒﺔ ﻌ ﱠﺮﺿﺔ ﻟﻠﻤﺨﺎﻃﺮ. اﻟﻤ َ ﻟﻠﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﺮﺋﻴﺴﻴﺔ ُ ﻏﻴﺮ أن ﻫﻨﺎك ﻃﺎﺋﻔﺔ ﻣﻦ اﻟﻌﻮاﺋﻖ اﻟﺘﻲ ﻣﺎزاﻟﺖ ﺗﺤﻮل دون ﺣﺼﻮل ﻣﺠﻤﻮﻋﺎت ﺳﻜﺎﻧﻴﺔ ﻣﻌﻴﻨﺔ ﻋﻠﻰ اﻟﺘﺪﺧﻼت اﻟﻔﻌﺎﻟﺔ واﻻﻧﺘﻔﺎع ﺑﻬﺎ ،ﻣﺜﻞ اﻟﻘﻮاﻧﻴﻦ اﻟﺘﻲ واﻟﺨﺪﻣﺎت ّ ﺗﺤﺪد اﻟﺴﻦ اﻟﺘﻲ ﻳﻤﻜﻦ أن ﺗﺆﺧﺬ ﻓﻴﻬﺎ اﻟﻤﻮاﻓﻘﺔ ﻣﻦ اﻟﻤﺮاﻫﻘﻴﻦ ،وﻓﻘﺪ اﻟﻤﻬﺎﺟﺮﻳﻦ واﻟﻤﺸﺮدﻳﻦ ﻟﻠﺤﻤﺎﻳﺔ اﻻﺟﺘﻤﺎﻋﻴﺔ ،ووﺳﻢ ﺑﻌﺾ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ وﺑﻌﺾ اﻟﺴﻠﻮﻛﻴﺎت ﺑﺎﻟﺠﺮﻳﻤﺔ )ﻣﺜﻞ ﺗﻌﺎﻃﻲ اﻟﻤﺨﺪرات واﻟﻌﻤﻞ ﻓﻲ اﻟﺠﻨﺲ وﻣﻤﺎرﺳﺔ اﻟﺮﺟﺎل ﻟﻠﺠﻨﺲ ﻣﻊ اﻟﺮﺟﺎل( .وﻟﺒﺮاﻣﺞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي دور ﻣﻬﻢ ﻓﻲ رﺻﺪ اﻟﺴﻴﺎﺳﺎت واﻟﻘﻮاﻧﻴﻦ واﻟﻠﻮاﺋﺢ اﻟﺘﻨﻈﻴﻤﻴﺔ ﻓﻲ اﻟﻘﻄﺎﻋﺎت اﻷﺧﺮى ﻟﺘﺤﺪﻳﺪ ﻣﻀﺎﻣﻴﻨﻬﺎ اﻟﻤﺤﺘﻤﻠﺔ ﻓﻴﻤﺎ ﻳﺨﺺ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﺟﻤﺎﻻ ،وﻣﻮاﺿﻊ وﺟﻮد اﻟﻌﻮاﺋﻖ واﻻﺳﺘﺠﺎﺑﺔ اﻟﺼﺤﻴﺔ ً ﻣﻦ أﺟﻞ اﻟﺪﻋﻮة إﻟﻰ إﺟﺮاء ﻣﺎ ﻳﻠﺰم ﻣﻦ ﻣﺮاﺟﻌﺎت وإﺻﻼﺣﺎت ﻟﻀﻤﺎن اﻟﺤﺼﻮل ﻋﻠﻰ ﺣﺼﺎﺋﻞ ﺗﻌﺰز اﻟﺼﺤﺔ.
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ :٤ ﱡ اﻟﺘﻤﻮﻳﻞ ﻷﻏﺮاض اﻻﺳﺘﺪاﻣﺔ زﻳﺎدة اﻻﺳﺘﺜﻤﺎرات ﻣﻦ ﺧﻼل اﻟﺘﻤﻮﻳﻞ اﻟﻤﺒﺘﻜﺮ وأﺳﺎﻟﻴﺐ اﻟﺘﻤﻮﻳﻞ اﻟﺠﺪﻳﺪة
ﻳﻨﺒﻐﻲ أن ﻳﺘﻠﻘﻰ ﻛﺎﻓﺔ اﻟﻨﺎس اﻟﺨﺪﻣﺎت اﻟﺘﻲ ﻳﺤﺘﺎﺟﻮن إﻟﻴﻬﺎ دون اﻟﻤﻌﺎﻧﺎة ﻣﻦ ﺻﻌﻮﺑﺎت ﻣﺎﻟﻴﺔ
ﻻ ﺗﻜﻔﻲ اﻟﺘﺰاﻣﺎت اﻟﺘﻤﻮﻳﻞ اﻟﺪوﻟﻴﺔ واﻟﻤﺤﻠﻴﺔ اﻟﻤﻮﺟﻮدة ﺣﺎﻟﻴﺎً ﻟﺘﺤﻘﻴﻖ اﻟﻐﺎﻳﺎت اﻟﻤﺤﺪدة ﻟﻌﺎﻣﻲ ٢٠٢٠و ٢٠٣٠اﻟﻤﺒﻴﻨﺔ ﻓﻲ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻫﺬه ،وﺳﻴﺘﻌﻴﻦ إﻳﺠﺎد ﻣﺼﺎدر ﺟﺪﻳﺪة ﻟﻠﺘﻤﻮﻳﻞ ،ﻻ ﺗﻘﺘﺼﺮ ﻋﻠﻰ ﺗﻤﻮﻳﻞ اﻟﺘﻮﺳﻴﻊ اﻟﻤﺴﺘﺪام ﻟﻠﺘﺪﺧﻼت واﻟﺨﺪﻣﺎت ذات اﻟﻌﻼﻗﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﺤﺴﺐ، ﺑﻞ أﻳﻀﺎً ﻟﺴﺪ اﻟﻔﺠﻮات اﻟﺘﻤﻮﻳﻠﻴﺔ اﻟﻨﺎﺷﺌﺔ ﻋﻦ ﺗﺒﺪل أوﻟﻮﻳﺎت اﻟﻤﺎﻧﺤﻴﻦ .ﻟﻘﺪ ﺣﻔﺰت اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺎﻟﻔﻌﻞ اﻻﺑﺘﻜﺎر ﻓﻲ ﺗﻤﻮﻳﻞ ﻗﻄﺎع اﻟﺼﺤﺔ ،ﻋﻠﻰ اﻟﻤﺴﺘﻮﻳﻴﻦ اﻟﻌﺎﻟﻤﻲ واﻟﻘﻄﺮي ،ﻛﺎﺳﺘﺨﺪام اﻟﺮﺳﻮم اﻟﻤﻔﺮوﺿﺔ ﻋﻠﻰ ﺗﺬاﻛﺮ اﻟﻄﻴﺮان واﻟﻬﻮاﺗﻒ اﻟﺠﻮاﻟﺔ واﻧﺘﻬﺎء ﺑﻀﺮاﺋﺐ اﻟﺪﺧﻞ .وﻻﺑﺪ ﻣﻦ اﻟﺘﻮﺻﻞ إﻟﻰ اﺑﺘﻜﺎرات أﺧﺮى ﻟﺘﻮﻓﻴﺮ اﻟﻤﻮارد اﻟﻤﻄﻠﻮﺑﺔ ﻣﻦ أﺟﻞ اﺳﺘﺠﺎﺑﺔ ﻣﺴﺘﺪاﻣﺔ. ﻳﺠﺐ أن ﺗﻜﻮن زﻳﺎدة ﺗﻤﻮﻳﻞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺟﺰءاً ﺬل ﻟﺰﻳﺎدة إﺟﻤﺎﻟﻲ اﻻﺳﺘﺜﻤﺎرات ﻓﻲ اﻟﻤﺠﺎل ﻣﻦ ﺟﻬﻮد أوﺳﻊ ﺗُ ْﺒ َ اﻟﺼﺤﻲ ،وذﻟﻚ ﻟﻀﻤﺎن إﻣﻜﺎﻧﻴﺔ ﺗﻮﺳﻴﻊ ﺟﻤﻴﻊ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وﺻﻮﻻ إﻟﻰ اﻟﺘﻐﻄﻴﺔ اﻟﺼﺤﻴﺔ اﻟﺸﺎﻣﻠﺔ .وﻳﻌﺘﺒﺮ ذات اﻷوﻟﻮﻳﺔ ً اﻟﺘﻤﻮﻳﻞ اﻟﻌﻤﻮﻣﻲ اﻟﻤﺤﻠﻲ ﻋﻨﺼﺮاً ﻣﺤﻮرﻳﺎً ﻓﻲ ﺗﻤﻮﻳﻞ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻷﺳﺎﺳﻴﺔ واﻟﻤﺴﺘﺪاﻣﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻣﺎ ﻳﺨﺺ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﻗﺪ وﺿﻊ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ﻏﺎﻳﺎت ﻟﻌﺎم ٢٠٢٠ﻟﻠﺘﻤﻮﻳﻞ اﻟﻤﺤﻠﻲ ﻟﺒﺮاﻣﺞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﻣﻨﻬﺎ ﺗﻮﻓﻴﺮ ﺗﻤﻮﻳﻞ ﻣﺤﻠﻲ ﺑﻨﺴﺒﺔ ٪١٢ﻟﻠﺒﺮاﻣﺞ ﻓﻲ اﻟﺒﻠﺪان اﻟﻤﻨﺨﻔﻀﺔ اﻟﺪﺧﻞ و٪٤٥ اﻟﺪﻧﻴﺎ ﻣﻦ اﻟﺒﻠﺪان اﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ و٪٩٥ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺸﺮﻳﺤﺔ ُ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺸﺮﻳﺤﺔ اﻟﻌﻠﻴﺎ ﻣﻦ اﻟﺒﻠﺪان اﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ .وﻳﻤﻜﻦ زﻳﺎدة اﻹﻧﻔﺎق اﻟﻌﺎم ﻋﻠﻰ اﻟﺼﺤﺔ إﻣﺎ ﺑﺘﺤﺼﻴﻞ اﻟﻤﺰﻳﺪ ﻣﻦ اﻹﻳﺮادات اﻟﻀﺮﻳﺒﻴﺔ )زﻳﺎدة اﻟﻘﺪرة اﻟﻤﺎﻟﻴﺔ ﻟﻠﺤﻜﻮﻣﺔ( وإﻣﺎ ﺑﺘﺨﺼﻴﺺ ﻧﺼﻴﺐ أﻛﺒﺮ ﻣﻦ اﻷﻣﻮال اﻟﺤﻜﻮﻣﻴﺔ اﻹﺟﻤﺎﻟﻴﺔ ﻟﻠﺼﺤﺔ )إﻋﻄﺎء اﻟﺼﺤﺔ أوﻟﻮﻳﺔ أﻛﺒﺮ ﻓﻲ اﻟﻤﻴﺰاﻧﻴﺔ اﻟﻌﻤﻮﻣﻴﺔ( .وﻳﺠﺐ ﻋﻠﻰ وزارات اﻟﺼﺤﺔ أن ﺗﺘﺸﺎرك ﺑﺎﻟﻌﻤﻞ ﺑﻔﻌﺎﻟﻴﺔ ﻣﻊ وزارات اﻟﻤﺎﻟﻴﺔ ﺑﺸﺄن اﻟﻤﺴﺎﺋﻞ اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻟﻤﻴﺰاﻧﻴﺎت وﻧﻈﻢ إدارة اﻟﻤﺎﻟﻴﺔ اﻟﻌﺎﻣﺔ ،واﻟﻤﺴﺎﺋﻞ اﻟﺘﻲ اﻟﺤﻴﺰ اﻟﻤﺎﻟﻲ اﻟﻌﺎم .وﻳﻨﺒﻐﻲ اﺳﺘﺨﺪام ﻣﺒﺮرات ﺗﺜﻴﺮ اﻟﻘﻠﻖ ﻓﻲ ﱢ اﻻﺳﺘﺜﻤﺎر ﻓﻲ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻠﺪﻋﻮة إﻟﻰ ﺗﺨﺼﻴﺺ ﺣﺼﺔ ﻋﺎدﻟﺔ ﻟﻠﻤﻮارد اﻟﻌﻤﻮﻣﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻟﻠﺘﻔﺎوض ﻋﻠﻰ ذﻟﻚ. اﻟﺪﻧﻴﺎ ﺳﻴﻮاﺻﻞ ﻣﻌﻈﻢ اﻟﺒﻠﺪان اﻟﻤﻨﺨﻔﻀﺔ اﻟﺪﺧﻞ واﻟﺸﺮﻳﺤﺔ ُ ﻣﻦ اﻟﺒﻠﺪان اﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ اﻋﺘﻤﺎدﻫﺎ ﻋﻠﻰ اﻟﺘﻤﻮﻳﻞ اﻟﺨﺎرﺟﻲ وﺗﻤﻮﻳﻞ اﻟﻘﻄﺎع اﻟﺨﺎص ﻟﺨﺪﻣﺎﺗﻬﺎ وﺗﺪﺧﻼﺗﻬﺎ اﻟﻤﺘﻌﻠﻘﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺣﺘﻰ ﻋﺎم ٢٠٢٠وﻣﺎ ﺑﻌﺪﻫﺎ .وﻣﻦ اﻟﻤﻬﻢ أن ﺗﺘﺴﻖ ﺗﺪﻓﻘﺎت اﻹﻳﺮادات اﻵﺗﻴﺔ ﻣﻦ ﻫﺬه اﻟﻤﺼﺎدر ﺗﻤﺎم اﻻﺗﺴﺎق ﻣﻊ اﻷوﻟﻮﻳﺎت واﻟﺒﺮاﻣﺞ واﻟﺨﻄﻂ اﻟﻮﻃﻨﻴﺔ اﻟﻤﺘﻌﻠﻘﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺘﻲ ﺗﻢ إدراﺟﻬﺎ ﻓﻲ ﺧﻄﺔ وﻃﻨﻴﺔ ﻣﺘﻤﺎﺳﻜﺔ ﻟﻠﺼﺤﺔ ،ﻣﻊ ﺿﺮورة أن ﺗﻜﻮن ﻫﺬه اﻟﺘﺪﻓﻘﺎت ﻣﺴﺘﻘﺮة وﻳﻤﻜﻦ اﻟﺘﻨﺒﺆ ﺑﻬﺎ ﻟﻠﺘﻘﻠﻴﻞ ﻣﻦ ﻣﺨﺎﻃﺮ اﻧﻘﻄﺎع اﻟﺨﺪﻣﺎت.
ﻳﺠﺐ أن ﺗﻜﻮن زﻳﺎدة ﺗﻤﻮﻳﻞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺟﺰءاً ﻣﻦ ﺟﻬﻮد ﺬل ﻟﺰﻳﺎدة إﺟﻤﺎﻟﻲ أوﺳﻊ ﺗُ ْﺒ َ اﻻﺳﺘﺜﻤﺎرات ﻓﻲ اﻟﻤﺠﺎل اﻟﺼﺤﻲ،
إن ﺗﻨﻔﻴﺬ اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﻘﻀﺎء ﻋﻠﻰ وﺑﺎء اﻷﻳﺪز ﺑﺤﻠﻮل ﻋﺎم ٢٠٣٠ﻳﺘﻄﻠﺐ اﺳﺘﺜﻤﺎرات ﻋﺎﻟﻤﻴﺔ ﺟﺪﻳﺪة ﻛﺒﻴﺮة ﻣﻊ زﻳﺎدﺗﻬﺎ ﻣﻦ ٢١ ٧٠٠ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ ﻓﻲ ﻋﺎم ٢٠١٥إﻟﻰ ٣٢ ٠٠٠ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ ﻓﻲ ﻋﺎم .٢٠٢٠وﺑﺘﻮﻓﻴﺮ اﻻﺳﺘﺜﻤﺎرات ﻓﻲ ﺑﺪاﻳﺔ اﻟﻔﺘﺮة ،ﻳﻤﻜﻦ ﺑﺴﺮﻋﺔ ﺗﻮﺳﻴﻊ ﻧﻄﺎق وﺗﺪﺧﻼت اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. وﻳﺘﻄﻠﺐ ﺗﻮﻓﻴﺮ اﻟﺘﻤﻮﻳﻞ ﻣﻦ أﺟﻞ اﺳﺘﺠﺎﺑﺔ ﻣﺴﺘﺪاﻣﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺬل اﻟﺠﻬﻮد ﻓﻲ ﺛﻼﺛﺔ ﻣﺠﺎﻻت: زﻳﺎدة اﻹﻳﺮادات ﻟﺪﻓﻊ ﺗﻜﺎﻟﻴﻒ ﺗﺪﺧﻼت وﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻣﻊ اﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺗﺤﺴﻴﻦ ﺟﻤﻊ اﻟﻀﺮاﺋﺐ اﻟﺪاﺧﻠﻴﺔ )ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻹﻳﺮادات اﻟﻌﺎﻣﺔ وﻣﺴﺎﻫﻤﺎت اﻟﺘﺄﻣﻴﻦ اﻟﺼﺤﻲ ﻛﺎﻟﻤﻨَ ﺢ ِ ﺗﻜﻤﻠﻬﺎ اﻟﻤﺼﺎدر اﻟﺨﺎرﺟﻴﺔ اﻹﻟﺰاﻣﻲ ﻋﻠﻰ اﻟﺴﻮاء( ﻋﻠﻰ أن ّ واﻹﻳﺮادات اﻟﺨﺎﺻﺔ؛ اﻟﺤﻤﺎﻳﺔ ﻣﻦ اﻟﻤﺨﺎﻃﺮ اﻟﻤﺎﻟﻴﺔ وﺗﺠﻤﻴﻊ ﻣﺼﺎدر اﻟﺘﻤﻮﻳﻞ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ إﻧﺸﺎء آﻟﻴﺎت ﻣﻨﺼﻔﺔ ﻟﺘﺠﻤﻴﻊ ﻣﺼﺎدر اﻟﺘﻤﻮﻳﻞ ﻓﻲ ﻋﻤﻮم اﻟﻘﻄﺎع اﻟﺼﺤﻲ ﻟﻀﻤﺎن اﻟﺘﻐﻄﻴﺔ اﻟﻜﺎﻓﻴﺔ ﻋﻠﻰ اﻣﺘﺪاد اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،واﻟﺤﺪ ﻣﻦ اﻟﻌﻮاﺋﻖ اﻟﻤﺎﻟﻴﺔ أﻣﺎم ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ﻣﻊ ﺗﻮﻓﻴﺮ ﺣﻤﺎﻳﺔ ﻣﻦ اﻟﻤﺨﺎﻃﺮ اﻟﻤﺎﻟﻴﺔ ﻓﻲ اﻟﻮﻗﺖ ﻧﻔﺴﻪ؛ ﺗﺤﺴﻴﻦ اﻟﻜﻔﺎءة ﻓﻲ اﺳﺘﺨﺪام ﻣﻮارد اﻟﻨﻈﻢ اﻟﺼﺤﻴﺔ ﻟﺘﻬﻴﺌﺔ ﺗﻐﻄﻴﺔ أﻛﺜﺮ ﻓﻌﺎﻟﻴﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺧﻔﺾ ﺗﻜﺎﻟﻴﻒ أدوﻳﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ووﺳﺎﺋﻞ ﺗﺸﺨﻴﺼﻪ وﺳﻠﻌﻪ اﻷﺧﺮى ،واﻟﺘﻘﻠﻴﻞ ﻣﻦ ازدواﺟﻴﺔ اﻟﻨﻈﻢ اﻟﻔﺮﻋﻴﺔ اﻟﻬﺎﻣﺔ ﻣﻊ اﻟﺒﺮاﻣﺞ اﻷﺧﺮى وﻣﻊ اﻟﻨﻈﺎم اﻟﺼﺤﻲ اﻷوﺳﻊ ﻧﻄﺎﻗﺎً ،ﻣﺜﻞ اﻟﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ واﻟﻤﻮارد اﻟﺒﺸﺮﻳﺔ وإدارة اﻟﺸﺮاء واﻹﻣﺪادات .وﻳﻨﺒﻐﻲ أن ﻳﻜﻮن اﻻﺳﺘﺨﺪام اﻟﻤﻨﻬﺠﻲ ﻟﺪراﺳﺎت وﺑﺮاﻣﺞ اﻟﺘﻜﺎﻟﻴﻒ وﺑﻴﺎﻧﺎت اﻟﺘﻤﻮﻳﻞ ﻣﺼﺎدر اﻟﻤﻌﻠﻮﻣﺎت ﻋﻨﺪ ﺗﺤﺪﻳﺪ أوﻟﻮﻳﺎت اﻟﺒﺮاﻣﺞ. ﻳﻨﺒﻐﻲ أن ﻳﺘﺼﺪى اﻟﻨﻈﺎم اﻟﻮﻃﻨﻲ ﻟﻠﺘﻤﻮﻳﻞ اﻟﺼﺤﻲ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ﺟﻤﻴﻊ اﻻﺣﺘﻴﺎﺟﺎت اﻟﺼﺤﻴﺔ اﻟﻮﻃﻨﻴﺔ اﻷﺧﺮى ذات اﻷوﻟﻮﻳﺔ ،ﻣﻊ ﺗﺠﻨﺐ ﺗﺠﺰيء ﻗﻨﻮات اﻟﺘﻤﻮﻳﻞ وﺗﺤﻘﻴﻖ ﻏﺎﻳﺔ اﻹﻧﺼﺎف اﻟﺼﺤﻲ.
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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ﺧﻔﺾ اﻷﺳﻌﺎر واﻟﺘﻜﺎﻟﻴﻒ وﺗﺤﺴﻴﻦ أوﺟﻪ اﻟﻜﻔﺎءة
ﺗﻔﺮض اﻟﻀﻐﻮط اﻟﻤﺎﻟﻴﺔ ﻋﻠﻰ اﻟﺒﻠﺪان اﺧﺘﻴﺎر اﻟﺘﺪﺧﻼت واﻟﻨﻬﻮج اﻷﺷﺪ ﻓﻌﺎﻟﻴﺔ ،وﺗﻮﺟﻴﻪ ﻫﺬه اﻷﻧﺸﻄﺔ إﻟﻰ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ واﻟﺒﻴﺌﺎت اﻟﺘﻲ ﻳﺘﺤﻘﻖ ﻓﻴﻬﺎ أﻋﻈﻢ ﻗﺪر ﻣﻦ اﻷﺛﺮ ،وإﻟﻰ ﺧﻔﺾ أﺳﻌﺎر اﻷدوﻳﺔ وﺳﺎﺋﺮ اﻟﺴﻠﻊ اﻟﺼﺤﻴﺔ ،وإﻟﻰ زﻳﺎدة ﻛﻔﺎءة اﻟﺨﺪﻣﺎت .وﺗﻌﺘﺒﺮ اﻟﺒﺮاﻣﺞ اﻟﺘﻲ ﻳﻤﻜﻨﻬﺎ إﺛﺒﺎت ﺗﺤﻘﻴﻖ ﻣﺮدود ﺟﻴﺪ ﻣﻘﺎﺑﻞ اﻟﺘﻜﻠﻔﺔ وﺗﺤﺴﻴﻦ اﻟﻜﻔﺎءة أﻓﻀﻞ ﻣﻦ ﻏﻴﺮﻫﺎ ﻓﻲ اﻟﻤﻄﺎﻟﺒﺔ ﺑﺘﺨﺼﻴﺺ ﻋﺎدل ﻟﻠﻤﻮارد وﺣﺼﻮﻟﻬﺎ ﻋﻠﻰ ﻣﺴﺎﻧﺪة ﻣﺎﻟﻴﺔ ﺧﺎرﺟﻴﺔ. وﻫﻨﺎك اﻟﻌﺪﻳﺪ ﻣﻦ اﻟﻔﺮص ﻟﺘﺤﺴﻴﻦ أوﺟﻪ اﻟﻜﻔﺎءة وﺧﻔﺾ اﻟﺘﻜﺎﻟﻴﻒ. اﻹدارة اﻟﺠﻴﺪة ﻟﻠﺒﺮاﻣﺞ ﻳﻤﻜﻨﻬﺎ ﺗﺤﺴﻴﻦ ﻛﻔﺎءة ﺗﺪﻓﻖ اﻟﻤﻮارد وﺗﺨﺼﻴﺼﻬﺎ واﻻﺳﺘﻔﺎدة ﻣﻨﻬﺎ ﺑﻌﺪ اﺳﺘﻤﺪادﻫﺎ ﻣﻦ اﻟﻤﻴﺰاﻧﻴﺔ اﻟﻮﻃﻨﻴﺔ أو ﻣﻦ ﻣﺼﺎدر ﺧﺎرﺟﻴﺔ ﻟﺘﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت .وﺗﺸﻤﻞ اﻹدارة اﻟﺠﻴﺪة ﻟﻠﺒﺮاﻣﺞ ﺗﺤﺴﻴﻦ ﺗﻨﺴﻴﻖ ﺗﻤﻮﻳﻞ اﻟﻤﺎﻧﺤﻴﻦ واﻻﺗﺴﺎق ﻣﻊ اﻟﺨﻄﻂ اﻟﻮﻃﻨﻴﺔ واﻟﻨﻈﺎم اﻟﺼﺤﻲ اﻷوﺳﻊ وﺗﺠﻤﻴﻊ اﻟﻤﻮارد واﻟﺘﻤﻮﻳﻞ اﻟﻤﺴﺘﻨﺪ إﻟﻰ اﻷداء وزﻳﺎدة اﻟﻤﺤﺎﺳﺒﺔ ﻋﻠﻰ ﻛﻞ اﻟﻤﺴﺘﻮﻳﺎت وﻋﺒﺮ ﺟﻤﻴﻊ أﺻﺤﺎب اﻟﻤﺼﻠﺤﺔ ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﻤﻨﻔﺬون واﻟﻤﻤﻮﻟﻮن. ﺗﺤﺴﻴﻦ اﻻﺧﺘﻴﺎر واﻟﺸﺮاء واﻹﻣﺪاد ﻣﻦ اﻷدوﻳﺔ ووﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ واﻟﺴﻠﻊ اﻟﺼﺤﻴﺔ اﻷﺧﺮى اﻟﻤﻴﺴﻮرة اﻟﺘﻜﻠﻔﺔ إذ ﻳﻤﻜﻦ ﻟﺬﻟﻚ ﺧﻔﺾ ﺗﻜﻠﻔﺔ اﻟﺨﺪﻣﺎت واﻟﻘﻀﺎء ﻋﻠﻰ اﻹﻫﺪار .وﻳﺒﻴﻦ اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٣ﻫﺬه اﻟﻨﻬﻮج. ﱡ زﻳﺎدة اﻟﻜﻔﺎءة واﻟﺠﻮدة اﻟﻌﺎﻟﻴﺔ ﻓﻲ ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت وﻳﻤﻜﻨﻬﺎ أن اﻟﺘﻮﺟﻪ ﺗﺤﻘﻖ وﻓﻮرات ﻛﺒﻴﺮة ﻣﻊ ﺗﺤﺴﻴﻦ اﻟﺤﺼﺎﺋﻞ اﻟﺼﺤﻴﺔ .وﻳﺘﻨﺎول ﱡ اﻻﺳﺘﺮاﺗﻴﺠﻲ ٣ﺑﺎﻟﻔﻌﻞ ﻓﺮص ﺗﺤﺴﻴﻦ ﻧﻤﺎذج ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت، ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺗﺤﺴﻴﻨﻬﺎ ﻣﻦ ﺧﻼل اﻟﺘﻜﺎﻣﻞ واﻟﺮواﺑﻂ واﻟﻼﻣﺮﻛﺰﻳﺔ وإﻋﺎدة ﺗﻮزﻳﻊ اﻟﻤﻬﺎم واﺳﺘﺨﺪام ﻣﻘﺪﻣﻲ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﻣﻦ وﻳﻌﺘﺒﺮ ﺿﻤﺎن ﺟﻮدة ﻏﻴﺮ اﻟﻤﺘﺨﺼﺼﻴﻦ وﺗﻌﺰﻳﺰ اﻟﻨﻈﻢ اﻟﻤﺠﺘﻤﻌﻴﺔُ . اﻟﺨﺪﻣﺎت ﺿﺮورﻳﺎً ﻟﺘﺤﺴﻴﻦ أوﺟﻪ اﻟﻜﻔﺎءة؛ إذ ﺳﺘﺤﻘﻖ اﻟﺨﺪﻣﺎت ﻳﻨﻔﻖ. اﻟﺠﻴﺪة اﻟﻨﻮﻋﻴﺔ ﻣﻜﺎﺳﺐ ﺻﺤﻴﺔ أﻛﺒﺮ ﻣﻘﺎﺑﻞ ﻛﻞ دوﻻر َ وﺳﻴﺆدي اﻻﻟﺘﺰام اﻟﺠﻴﺪ ﺑﺎﻟﻌﻼج واﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﺮﺿﻰ ﻓﻲ اﻟﺮﻋﺎﻳﺔ، ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل ،إﻟﻰ ﺗﻘﻠﻴﻞ اﻟﺤﺎﺟﺔ إﻟﻰ دﺧﻮل اﻟﻤﺴﺘﺸﻔﻴﺎت وﺗﻘﻠﻴﻞ اﻟﺤﺎﺟﺔ إﻟﻰ اﻟﺘﺤﻮل إﻟﻰ اﻟﺨﻄﻴﻦ اﻟﺜﺎﻧﻲ واﻟﺜﺎﻟﺚ ﻣﻦ اﻟﻌﻼج اﻷﻛﺜﺮ ﺗﻜﻠﻔﺔ .ﻛﻤﺎ ﺳﻴﺆدي ﺗﻨﺴﻴﻖ ﺗﺪﺧﻼت وﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻊ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ اﻷﺧﺮى واﻟﻨﻈﺎم اﻟﺼﺤﻲ إﺟﻤﺎﻻ إﻟﻰ ﺗﻘﻠﻴﻞ أوﺟﻪ اﻟﻘﺼﻮر وﻋﺪم اﻟﻜﻔﺎءة وزﻳﺎدة اﻟﻨﺘﺎﺋﺞ ً اﻟﻤﺮﺟﻮة إﻟﻰ أﻗﺼﻰ ﻗﺪر ﻣﻤﻜﻦ ﻧﺘﻴﺠﺔ ﻟﺬﻟﻚ. ﱠ
اﻟﺘﺼﺪي ﻟﻠﻌﻘﺒﺎت اﻟﻤﺎﻟﻴﺔ أﻣﺎم ﺣﺼﻮل اﻟﻨﺎس ﻋﻠﻰ اﻟﺨﺪﻣﺎت وﺗﻮﻓﻴﺮ اﻟﺤﻤﺎﻳﺔ ﻟﻬﻢ ﻣﻦ اﻟﻤﺨﺎﻃﺮ اﻟﻤﺎﻟﻴﺔ
ﺗﺰﻳﺪ ﻧﻈﻢ اﻟﺘﻤﻮﻳﻞ اﻟﺼﺤﻲ اﻟﺘﻲ ﺗﻘﻠﻞ ﻣﻦ إﻧﻔﺎق اﻟﻨﺎس ﻣﻦ أﻣﻮاﻟﻬﻢ اﻟﺨﺎﺻﺔ ﻟﻠﺤﺼﻮل ﻋﻠﻰ ﺟﻤﻴﻊ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻟﻀﺮورﻳﺔ ﻣﻦ ﺗﻮاﻓﺮ ﻫﺬه اﻟﺨﺪﻣﺎت وﺗﻘﻴﻬﻢ ﻣﻦ اﻟﻮﻗﻮع ﻓﻲ اﻟﻔﻘﺮ .وﻟﺘﻘﻠﻴﻞ اﻟﻤﺪﻓﻮﻋﺎت اﻟﺼﺤﻴﺔ اﻟﻜﺎرﺛﻴﺔ إﻟﻰ ﺣﺪﻫﺎ اﻷدﻧﻰ ،ﻳﻨﺒﻐﻲ أﻻ ﺗﺘﺠﺎوز ﻫﺬه اﻟﻨﻔﻘﺎت ٪٢٠–١٥ﻣﻦ إﺟﻤﺎﻟﻲ اﻹﻧﻔﺎق اﻟﺼﺤﻲ. وﻳﻨﺒﻐﻲ إدراج اﻟﺘﺪﺧﻼت اﻟﻀﺮورﻳﺔ اﻟﺨﺎﺻﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻤﻮﺟﻮدة ﻓﻲ اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻓﻲ ﺣﺰﻣﺔ اﻟﻔﻮاﺋﺪ اﻟﺼﺤﻴﺔ اﻟﻮﻃﻨﻴﺔ ،وﺗﻘﺪﻳﻤﻬﺎ ﺑﺼﻔﺔ ﻣﺠﺎﻧﻴﺔ .ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ذﻟﻚ ،ﻓﺈن ﺗﻮﻓﻴﺮ ﺗﺮﺗﻴﺒﺎت ﻣﺴﺎﻧﺪة )ﻣﺜﻞ ﻻﻣﺮﻛﺰﻳﺔ اﻟﺨﺪﻣﺎت أو ﺗﻘﺪﻳﻢ ﻗﺴﺎﺋﻢ ﻟﻮﺳﺎﺋﻞ اﻟﻤﻮاﺻﻼت( ﻟﺨﻔﺾ اﻟﺘﻜﺎﻟﻴﻒ ﻏﻴﺮ اﻟﻤﺒﺎﺷﺮة اﻟﺘﻲ ﻳﺘﺤﻤﻠﻬﺎ اﻟﻤﺴﺘﻔﻴﺪون ﺑﺎﻟﺨﺪﻣﺔ ،ﻳﻤﻜﻨﻪ ﺗﺤﺴﻴﻦ اﻹﻗﺒﺎل ﻋﻠﻰ اﻟﺨﺪﻣﺔ وأﺛﺮﻫﺎ .وﺗﺆدي اﻟﺮﺳﻮم اﻟﻤﻔﺮوﺿﺔ ﻋﻠﻰ اﻟﻤﺴﺘﻔﻴﺪﻳﻦ إﻟﻰ ﺗﻔﺎوﺗﺎت ﻓﻲ إﺗﺎﺣﺔ ﻋﻼج ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،وﺗﻘﻠّ ﻞ ﻣﻦ اﻻﺳﺘﻔﺎدة ﻣﻦ اﻟﺨﺪﻣﺔ ،وﺗﺴﻬﻢ ﻓﻲ ﺿﻌﻒ اﻻﻟﺘﺰام ﺑﺎﻟﻌﻼج ،وﺗﺰﻳﺪ ﻣﺨﺎﻃﺮ إﺧﻔﺎق اﻟﻌﻼج ،وﺗﺸﻜﻞ أﻋﺒﺎء ﻣﺎﻟﻴﺔ ﻏﻴﺮ ﺿﺮورﻳﺔ ﻋﻠﻰ اﻷﺳﺮ. وﻳﻌﺘﻤﺪ ﺗﻮﻓﻴﺮ اﻟﺤﻤﺎﻳﺔ ﻣﻦ اﻟﻤﺨﺎﻃﺮ اﻟﻤﺎﻟﻴﺔ واﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺨﺪﻣﺎت اﻟﻼزﻣﺔ ﻟﻸﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻷﺧﺮى اﻟﻤﺘﻀﺮرة ﻋﻠﻰ وﺟﻮد ﻧﻈﺎم وﻃﻨﻲ أوﺳﻊ ﻟﻠﺘﻤﻮﻳﻞ اﻟﺼﺤﻲ ﻳﺘﺴﻢ ﺑﺎﻟﻘﻮة وﺑﺎﻟﻌﺪل. وﺗُ ﻌﺪ ﻧﻈﻢ اﻟﺘﻤﻮﻳﻞ اﻟﻌﻤﻮﻣﻴﺔ ﻟﻠﺼﺤﺔ ،اﻟﺘﻲ ﺗﺘﻀﻤﻦ ﻏﻠﺒﺔ اﻻﻋﺘﻤﺎد ﻋﻠﻰ اﻹﻳﺮادات اﻟﺘﻲ ﻳﺘﻢ ﺗﺤﺼﻴﻠﻬﺎ ﻣﻦ اﻟﻀﺮاﺋﺐ اﻟﻌﺎﻣﺔ و /أو ﺿﺮاﺋﺐ اﻟﺪﺧﻞ ﻟﻠﺘﺄﻣﻴﻦ اﻟﺼﺤﻲ اﻹﻟﺰاﻣﻲ ،ﻫﻲ اﻟﻨﻈﻢ اﻷﺷﺪ إﻧﺼﺎﻓﺎً وﻛﻔﺎءة .وﻳﻨﺒﻐﻲ أن ﺗﺴﺘﻨﺪ آﻟﻴﺎت اﻟﻤﺪﻓﻮﻋﺎت اﻟﻤﺴﺒﻘﺔ ﻫﺬه إﻟﻰ اﻟﻘﺪرة ﻋﻠﻰ اﻟﺪﻓﻊ ،ﻣﻊ ﺗﺠﻤﻴﻊ واﺳﻊ اﻟﻨﻄﺎق ﻟﻠﻤﻮارد ﻹﺗﺎﺣﺔ ﺗﻮﻓﻴﺮ اﻟﻤﻨﺎﻓﻊ ﻟﻤﻦ ﻳﺤﺘﺎﺟﻮن إﻟﻴﻬﺎ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻣﻦ ﻻ ﻳﻘﺪرون ﻋﻠﻰ ﺳﺪاد اﻻﺷﺘﺮاﻛﺎت ﻓﻲ ﻫﺬا اﻟﻨﻈﺎم.
– ١٠ﺗﻌﺰﻳﺰ وﻋﻲ اﻟﻤﺸﺮدﻳﻦ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﺑﻨﻐﻼدﻳﺶ.
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻟﺘﻤﻮﻳﻞ ﻷﻏﺮاض اﻻﺳﺘﺪاﻣﺔ اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺗﻘﺪﻳﺮ اﻻﺣﺘﻴﺎﺟﺎت إﻟﻰ اﻟﻤﻮارد واﻟﻤﺮاﺟﻌﺔ اﻟﻤﻨﺘﻈﻤﺔ ﻟﻬﺎ )ﺑﺎﻟﺘﻌﺎون ﻣﻊ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز( ﻟﺘﺤﻘﻴﻖ اﻟﻐﺎﻳﺎت اﻟﻤﺤﺪدة ﻟﻌﺎﻣﻲ ٢٠٢٠و.٢٠٣٠ اﻟﺪﻋﻮة إﻟﻰ اﻟﺘﻤﻮﻳﻞ اﻟﻜﺎﻣﻞ ﻻﺳﺘﺠﺎﺑﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺒﻨﺎء اﻻﻟﺘﺰام اﻟﺴﻴﺎﺳﻲ ﺗﺠﺎه اﻟﺘﻤﻮﻳﻞ اﻟﻮﻃﻨﻲ اﻟﻤﺴﺘﺪام وﺑﺘﻌﺰﻳﺰ ﺷﺮاﻛﺎت اﻟﺘﻤﻮﻳﻞ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺸﺮاﻛﺎت ﻣﻊ اﻟﺼﻨﺪوق اﻟﻌﺎﻟﻤﻲ ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز واﻟﺴﻞ واﻟﻤﻼرﻳﺎ ،واﻟﻤﺮﻓﻖ اﻟﺪوﻟﻲ ﻟﺸﺮاء اﻷدوﻳﺔ ،وﺧﻄﺔ رﺋﻴﺲ اﻟﻮﻻﻳﺎت اﻟﻤﺘﺤﺪة ﻟﻠﻄﻮارئ ﻟﻠﻤﺴﺎﻋﺪة ﻓﻲ ﻣﺠﺎل ﻣﻜﺎﻓﺤﺔ اﻷﻳﺪز ،وﻣﺆﺳﺴﺔ ﺑﻴﻞ وﻣﻴﻠﻴﻨﺪا ﻏﻴﺘﺲ وﻏﻴﺮﻫﺎ. ﻣﺴﺎﻧﺪة اﻟﺒﻠﺪان ﻟﺼﻴﺎﻏﺔ ﻣﺒﺮرات اﺳﺘﺜﻤﺎر وﻃﻨﻴﺔ ﻓﻲ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺧﻄﻂ اﻧﺘﻘﺎﻟﻴﺔ ﻣﺎﻟﻴﺔ ﻟﻠﺘﺤﻮل ﻣﻦ اﻟﺘﻤﻮﻳﻞ اﻟﺨﺎرﺟﻲ إﻟﻰ اﻟﻤﺤﻠﻲ. ﺗﻮﻓﻴﺮ اﻹرﺷﺎدات واﻷدوات ﻟﺘﻘﻴﻴﻢ ورﺻﺪ ﺗﻜﺎﻟﻴﻒ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وﻣﺮدودﻳﺘﻬﺎ ،وﻣﺴﺎﻧﺪة اﻟﺒﻠﺪان ﻻﻋﺘﻤﺎد ﻣﻨﺼﺔ ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ ٢٣ اﻟﻘﻄﺮﻳﺔ ﻟﻠﺤﺴﺎﺑﺎت اﻟﺼﺤﻴﺔ. اﻟﻌﺎﻟﻤﻴﺔ ُ دﻋﻮة اﻟﺒﻠﺪان إﻟﻰ إدراج ﺗﺪﺧﻼت وﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻷﺳﺎﺳﻴﺔ ﻓﻲ ﺣﺰم اﻟﻔﻮاﺋﺪ اﻟﺼﺤﻴﺔ اﻟﻮﻃﻨﻴﺔ وإزاﻟﺔ اﻟﻌﻮاﺋﻖ اﻟﻤﺎﻟﻴﺔ أﻣﺎم اﻟﺤﺼﻮل ﻋﻠﻰ ﺧﺪﻣﺎت وﺳﻠﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. اﻹﺟﺮاءات ذات اﻟﻤﺴﺎر اﻟﺴﺮﻳﻊ ﻟﻠﺒﻠﺪان ﺻﻴﺎﻏﺔ ﻣﺒﺮرات ﻗﻮﻳﺔ ﻟﻼﺳﺘﺜﻤﺎر ﻓﻲ ﻋﻼج ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻠﺪﻋﻮة إﻟﻰ اﻟﺘﺨﺼﻴﺺ اﻟﻜﺎﻓﻲ ﻟﻠﻤﻮارد اﻟﻤﺤﻠﻴﺔ وﺣﺸﺪ اﻟﺪﻋﻢ ﺑﺎﻟﺘﻤﻮﻳﻞ اﻟﺨﺎرﺟﻲ. ﺗﻘﺪﻳﺮ اﻻﺣﺘﻴﺎﺟﺎت اﻟﻮﻃﻨﻴﺔ ﻣﻦ اﻟﻤﻮارد اﻟﻼزﻣﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ووﺿﻊ ﺧﻄﻂ ،ﻋﻨﺪ اﻟﻠﺰوم ،ﻟﻼﻧﺘﻘﺎل ﻣﻦ اﻟﺘﻤﻮﻳﻞ اﻟﺨﺎرﺟﻲ إﻟﻰ اﻟﺘﻤﻮﻳﻞ اﻟﻌﻤﻮﻣﻲ اﻟﻤﺤﻠﻲ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻣﻊ اﻟﺘﺮﻛﻴﺰ ﺑﻮﺟﻪ ﺧﺎص ﻋﻠﻰ ﺣﻤﺎﻳﺔ اﻟﺨﺪﻣﺎت اﻷﺳﺎﺳﻴﺔ اﻷﻛﺜﺮ اﻋﺘﻤﺎداً ﻋﻠﻰ اﻟﺘﻤﻮﻳﻞ اﻟﺨﺎرﺟﻲ ﻟﺘﻔﺎدي اﻧﻘﻄﺎع اﻟﺨﺪﻣﺎت. ﺗﺬﻟﻴﻞ اﻟﻌﻘﺒﺎت اﻟﻤﺎﻟﻴﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻹﻧﻬﺎء اﻟﺘﺪرﻳﺠﻲ ﻟﻠﻨﻔﻘﺎت اﻟﺘﻲ ﻳﺪﻓﻌﻬﺎ اﻷﻓﺮاد ﻣﻦ أﻣﻮاﻟﻬﻢ اﻟﺨﺎﺻﺔ ﻟﻠﺤﺼﻮل ﻋﻠﻰ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ اﻷﺧﺮى. رﺻﺪ اﻟﻨﻔﻘﺎت واﻟﺘﻜﺎﻟﻴﻒ اﻟﺼﺤﻴﺔ وﻣﺮدودﻳﺔ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻦ ﺧﻼل اﻟﻨﻈﺎم اﻟﻮﻃﻨﻲ ﻟﻠﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ ﻣﻦ أﺟﻞ ﺗﺤﺪﻳﺪ اﻟﻔﺮص ﻟﺨﻔﺾ اﻟﺘﻜﺎﻟﻴﻒ وﺗﺤﻘﻴﻖ اﻟﻮﻓﻮرات. ﺗﻘﻮﻳﺔ اﻟﺘﻨﺴﻴﻖ ﻣﻊ اﻟﺒﺮاﻣﺞ اﻟﺼﺤﻴﺔ اﻷﺧﺮى ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺗﺤﺪﻳﺪ اﻟﻔﺮص ﻟﺘﻮﺣﻴﺪ اﻟﻨﻈﻢ اﻟﺼﺤﻴﺔ اﻷﺳﺎﺳﻴﺔ ،ﻛﻨﻈﻢ اﻟﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ واﻟﻤﻮارد اﻟﺒﺸﺮﻳﺔ وإدارة اﻟﺸﺮاء واﻹﻣﺪادات.
وﻳﻌﺘﺒﺮ ﺿﻤﺎن ﺟﻮدة اﻟﺨﺪﻣﺎت ُ ﺿﺮورﻳﺎً ﻟﺘﺤﺴﻴﻦ أوﺟﻪ اﻟﻜﻔﺎءة؛ إذ ﺳﺘﺤﻘﻖ اﻟﺨﺪﻣﺎت اﻟﺠﻴﺪة اﻟﻨﻮﻋﻴﺔ ﻣﻜﺎﺳﺐ ﺻﺤﻴﺔ أﻛﺒﺮ ﻣﻘﺎﺑﻞ ﻳﻨﻔﻖ ﻛﻞ دوﻻر َ
٢٣ﻟﻠﻤﺰﻳﺪ ﻣﻦ اﻟﻤﻌﻠﻮﻣﺎت ﺣﻮل ﻧﻬﺞ ﻣﻨﺼﺔ ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﻘﻄﺮﻳﺔ ﻟﻠﺤﺴﺎﺑﺎت اﻟﺼﺤﻴﺔ ،اﻧﻈﺮ: ) http://www.who.int/health-accounts/platform_approach/en/ﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ :٥ ﱡ اﻻﺑﺘﻜﺎر ﻣﻦ أﺟﻞ ﺗﺴﺮﻳﻊ وﺗﻴـﺮة اﻟﺨـﺪﻣﺎت ﺑﻠﻮغ اﻟﻮﻗﺎﻳﺔ اﻟﻤﺜﻠﻰ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي
ﻋﺰزت اﻻﺑﺘﻜﺎرات اﻟﺤﺪﻳﺜﺔ ﻓﻲ ﺗﻜﻨﻮﻟﻮﺟﻴﺎت اﻟﻮﻗﺎﻳﺔ ﻣﻠﻔﺎت اﻟﺘﺪﺧﻼت ﻓﻲ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﻌﺰﻳﺰاً ﺷﺪﻳﺪاً ، ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﺳﺘﺨﺪام اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ اﻧﺘﻘﺎل اﻟﻔﻴﺮوس وﻣﻦ اﻛﺘﺴﺎﺑﻪ ،واﻟﺘﻮﺳﻊ ﻓﻲ اﻟﺨﺘﺎن اﻟﺘﻮﺳﻊ اﻟﻄﺒﻲ ﻟﻠﺬﻛﻮر ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ اﻛﺘﺴﺎب اﻟﻔﻴﺮوس .وﺳﻴﺆدي ﱡ ﻓﻲ اﻻﺳﺘﺨﺪام اﻟﻤﻜﺜﻒ ﻟﻬﺬه اﻟﻔﺮص وﻟﻼﺑﺘﻜﺎرات اﻷﺧﺮى، ﻳﻤﺮ ﺑﻌﻀﻬﺎ ﺑﺎﻟﻔﻌﻞ ﺑﻤﺮاﺣﻞ اﻟﺘﻄﻮﻳﺮ ،إﻟﻰ زﻳﺎدة اﻷﺛﺮ. واﻟﺘﻲ ّ وﺳﻴﺘﻄﻠﺐ ﺗﺤﻘﻴﻖ اﻹﻣﻜﺎﻧﻴﺎت اﻟﻜﺎﻣﻠﺔ ﻟﻺﺟﺮاءات اﻻﺗﻘﺎﺋﻴﺔ ﻗﺒﻞ اﻟﺘﻌﺮض ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﺤﺴﻴﻦ اﻟﺘﺮﻛﻴﺒﺎت اﻟﺪواﺋﻴﺔ وﻧﻈﻢ ﺗﻘﺪﻳﻤﻬﺎ وﻧﻤﺎذج ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺘﺮﻛﻴﺒﺎت اﻟﻘﺎﺑﻠﺔ ﻟﻠﺤﻘﻦ اﻟﻤﻮﺿﻌﻲ واﻟﻄﻮﻳﻠﺔ اﻟﻤﻔﻌﻮل. وﻳﻨﺒﻐﻲ أن ﺗﻬﺪف اﻻﺑﺘﻜﺎرات ﻓﻲ ﺗﺼﻤﻴﻢ اﻟﻌﻮازل اﻟﺬﻛﺮﻳﺔ واﻷﻧﺜﻮﻳﺔ وأﺟﻬﺰة اﻟﺨﺘﺎن اﻟﻄﺒﻲ ﻟﻠﺬﻛﻮر إﻟﻰ ﺗﺤﺴﻴﻦ اﻟﻤﻘﺒﻮﻟﻴﺔ ﻟﻬﺎ واﻹﻗﺒﺎل ﻋﻠﻴﻬﺎ .وﺳﻮف ﺗﻈﻞ اﻟﺒﺤﻮث ﺣﻮل ﻟﻘﺎﺣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺠﻬﻮد اﻟﺮاﻣﻴﺔ إﻟﻰ اﻟﻌﺜﻮر ﻋﻠﻰ ﻋﻼج ﻧﺎﺟﻊ ﻟﻸﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻦ اﻟﻤﻜﻮﻧﺎت اﻟﺮﺋﻴﺴﻴﺔ ﻟﺨﻄﻂ اﻟﺒﺤﻮث ﺣﻮل اﻟﻔﻴﺮوس .وﻳﻨﺒﻐﻲ اﺳﺘﺨﺪام اﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎت اﻟﺠﺪﻳﺪة ﻓﻲ اﻟﻤﻌﻠﻮﻣﺎت واﻻﺗﺼﺎﻻت ﻟﺘﻘﺪﻳﻢ ﺗﺪﺧﻼت وﻗﺎﺋﻴﺔ ﻓﻌﺎﻟﺔ ،ﻣﻦ ﺧﻼل اﻟﺼﺤﺔ اﻹﻟﻜﺘﺮوﻧﻴﺔ ﺑﺎﺳﺘﺨﺪام اﻟﺘﻄﺒﻴﻘﺎت اﻟﺘﻲ ﺗﻌﺘﻤﺪ ﻋﻠﻰ ﺷﺒﻜﺔ اﻹﻧﺘﺮﻧﺖ اﻟﻤﺘﻨﻘﻠﺔ.
ﺗﻐﻴﻴﺮ ﻣﺴﺎر اﻻﺳﺘﺠﺎﺑﺔ ﻟﺘﺤﻘﻴﻖ اﻟﻐﺎﻳﺎت اﻟﻄﻤﻮﺣﺔ ﺗﻮﻓﺮ اﻟﺒﺤﻮث واﻻﺑﺘﻜﺎرات اﻷدوات واﻟﻤﻌﺮﻓﺔ اﻟﺘﻲ ﻳﻤﻜﻨﻬﺎ ﺗﻐﻴﻴﺮ ﻣﺴﺎر اﻻﺳﺘﺠﺎﺑﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺗﺤﺴﻴﻦ اﻟﻜﻔﺎءة واﻟﺠﻮدة وﺗﺤﻘﻴﻖ اﻹﻧﺼﺎف واﻟﻮﺻﻮل إﻟﻰ أﻋﻈﻢ ﻗﺪر ﻣﻦ اﻷﺛﺮ .وﻣﻦ اﻟﻤﺴﺘﺒﻌﺪ أن ﻳﺘﻢ ﺗﺤﻘﻴﻖ اﻟﻐﺎﻳﺎت اﻟﻄﻤﻮﺣﺔ اﻟﻤﺤﺪدة ﻟﻌﺎﻣﻲ ٢٠٢٠و ٢٠٣٠ﻓﻴﻤﺎ ﻳﺨﺺ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻮ اﻗﺘﺼﺮت اﻟﺒﻠﺪان ﻓﻲ اﻋﺘﻤﺎدﻫﺎ ﻋﻠﻰ ﻣﻌﺎرف وﺗﻜﻨﻮﻟﻮﺟﻴﺎت وﻧﻬﻮج ﺗﻘﺪﻳﻢ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻟﻤﻮﺟﻮدة ﺣﺎﻟﻴﺎً . وﻻ ﻳﻘﺘﺼﺮ ﺳﺒﺐ اﻟﻄﻠﺐ ﻋﻠﻰ اﻻﺑﺘﻜﺎر ﻋﻠﻰ ﺗﻄﻮﻳﺮ -١٢١ ﺗﻜﻨﻮﻟﻮﺟﻴﺎت وﻧﻬﻮج ﺟﺪﻳﺪة ﻓﺤﺴﺐ ،ﺑﻞ ﻳﺘﺠﺎوز ذﻟﻚ إﻟﻰ اﺳﺘﺨﺪام اﻷدوات اﻟﻤﻮﺟﻮدة ﺑﺸﻜﻞ أﻛﺜﺮ ﻛﻔﺎءة وﻟﺘﻜﻴﻴﻔﻬﺎ ﺗﺒﻌﺎً ﻟﻤﺨﺘﻠﻒ اﻟﻔﺌﺎت اﻟﺴﻜﺎﻧﻴﺔ أو اﻷﻣﺎﻛﻦ أو اﻷﻏﺮاض .وﻗﺪ ﺗﺘﻄﻠﺐ اﻟﺘﺪﺧﻼت ورﺳﺨﺖ ﻓﻲ أﺣﺪ اﻷﻗﺎﻟﻴﻢ ”إﻋﺎدة ﻫﻨﺪﺳﺘﻬﺎ“ ﻟﻜﻲ اﻟﺘﻲ ُ ﻃﻮرت ُ ﺗﻜﻮن ﻓﻌﺎﻟﺔ ﻓﻲ ﻣﻜﺎن آﺧﺮ ،ﻛﻤﻔﻬﻮم إﻋﺎدة ﺗﻮزﻳﻊ اﻟﻤﻬﺎم اﻟﺬي ﻃﻮر ﻓﻲ اﻷﻣﺎﻛﻦ اﻟﺘﻲ ﺗﺮﺗﻔﻊ ﻓﻴﻬﺎ ﻣﻌﺪﻻت اﻻﻧﺘﺸﺎر ﻓﻲ ﻣﻨﻄﻘﺔ ُ أﻓﺮﻳﻘﻴﺎ اﻟﺠﻨﻮﺑﻴﺔ وﻳﺠﺮي ﺗﻜﻴﻴﻔﻪ ﺑﻮﺻﻔﻪ ﻧﻬﺠﺎً ﺟﺪﻳﺪاً ﻓﻲ أوروﺑﺎ اﻟﺸﺮﻗﻴﺔ أو آﺳﻴﺎ .وﺳﻮف ﺗﺘﻄﻠﺐ ﺑﺮاﻣﺞ ﺗﻘﻠﻴﺺ اﻷﺿﺮار اﻟﺘﻲ ﺗﻢ ﺗﻄﻮﻳﺮﻫﺎ ﻟﻤﺘﻌﺎﻃﻲ اﻷﻓﻴﻮن ﻧﻬﻮﺟﺎً ﻣﺒﺘﻜﺮة ﻟﺠﻌﻠﻬﺎ ﻣﻼﺋﻤﺔ ﻟﻤﺘﻌﺎﻃﻲ اﻟﻜﻮﻛﺎﻳﻴﻦ .وﻳﻤﻜﻦ ﻟﻠﻨﻘﻞ اﻟﺴﺮﻳﻊ ﻟﻠﻤﻌﺎرف أن ﻳﺴﺎﻋﺪ اﻟﺒﻠﺪان ﻋﻠﻰ ﺗﺤﻘﻴﻖ ﻗﻔﺰة ﻛﺒﻴﺮة ﻓﻲ أﻧﺸﻄﺔ اﺳﺘﺠﺎﺑﺘﻬﺎ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﺑﺤﻴﺚ ﺗﺘﻌﻠﻢ ﻣﻦ ﺗﺠﺎرب اﻵﺧﺮﻳﻦ ﻟﺘﺤﺪد اﻟﺘﺪﺧﻼت واﻟﻨﻬﻮج اﻟﺘﻲ ﱢ ﺗﺒﺸﺮ أﻛﺜﺮ ﻣﻦ ﻏﻴﺮﻫﺎ ﺑﺎﻟﻨﺠﺎح ﺑﺴﺮﻋﺔ وﺗﻜﻴﻔﻬﺎ .ﻛﻤﺎ ﻳﻤﻜﻦ ﻟﻠﺒﺤﻮث اﻟﻤﻴﺪاﻧﻴﺔ أن ﺗﻘﺪم اﻹرﺷﺎد إﻟﻰ ّ ﺟﻮاﻧﺐ اﻟﺘﺤﺴﻴﻦ ﻓﻲ ﺧﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻀﻤﺎن ﺗﺤﻘﻴﻖ أﻋﻈﻢ ﻗﺪر ﻣﻦ اﻷﺛﺮ ﻣﻦ اﻻﺳﺘﺜﻤﺎرات. وﺗﺴﺎﻧﺪ اﻟﻤﻨﻈﻤﺔ ﺑﺤﻮث ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ أرﺑﻌﺔ ﻣﺠﺎﻻت رﺋﻴﺴﻴﺔ وﻫﻲ :ﺑﻨﺎء اﻟﻘﺪرات ﻓﻲ ﻧُ ﻈﻢ اﻟﺒﺤﻮث اﻟﺼﺤﻴﺔ؛ ﺗﺠﻤﻴﻊ اﻟﺸﺮﻛﺎء ﺣﻮل ﺗﺤﺪﻳﺪ أوﻟﻮﻳﺎت اﻟﺒﺤﻮث؛ وﺿﻊ ﻗﻮاﻋﺪ وﻣﻌﺎﻳﻴﺮ ﻟﻠﻤﻤﺎرﺳﺎت اﻟﺠﻴﺪة ﻓﻲ اﻟﺒﺤﻮث؛ ﺗﻴﺴﻴﺮ ﺗﺮﺟﻤﺔ اﻟﺒﻴﻨﺎت إﻟﻰ ﺗﻜﻨﻮﻟﻮﺟﻴﺎت ﺻﺤﻴﺔ ﻣﻴﺴﻮرة اﻟﺘﻜﻠﻔﺔ وإﻟﻰ ﺳﻴﺎﺳﺎت ﻣﺴﺘﻨﻴﺮة ﺑﺎﻟﺒﻴﻨﺎت .وﻋﻠﻰ اﻟﺮﻏﻢ ﻣﻦ اﺿﻄﻼع اﻟﻤﻨﻈﻤﺔ ﺑﺪور ﻣﺤﺪود ﺟﺪاً ﻓﻲ ّ اﻟﺒﺤﻮث وﺗﻄﻮﻳﺮ اﻟﻤﻨﺘﺠﺎت ،ﻓﺈﻧﻬﺎ ﺗﻌﻤﻞ ﻋﻦ ﻗﺮب ﻣﻊ اﻟﺸﺮﻛﺎء ﻓﻲ ﻣﺠﺎل اﻟﺒﺤﻮث واﻟﺘﻄﻮﻳﺮ واﻟﻤﻨﺘﺠﻴﻦ ﻟﻀﻤﺎن أن ﺗﻜﻮن اﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎت اﻟﺠﺪﻳﺪة واﻷﺳﺎﺳﻴﺔ اﻟﺘﻲ ﺗﺴﺘﻌﻤﻞ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﺘﺎﺣﺔ وﻣﻴﺴﻮرة اﻟﺘﻜﻠﻔﺔ ﻟﻠﺒﻠﺪان ﺑﺄﺳﺮع ﻣﺎ ﻳﻤﻜﻦ. وﻧﻈﺮاً ﻟﻠﺪور اﻟﺤﻴﻮي اﻟﺬي ﻳﺆدﻳﻪ اﻟﺸﺮﻛﺎء ﻓﻲ ﻣﺠﺎل اﻻﺑﺘﻜﺎر، اﻟﺘﻮﺟﻪ اﻻﺳﺘﺮاﺗﻴﺠﻲ اﻟﻤﺠﺎﻻت اﻟﺮﺋﻴﺴﻴﺔ ﻟﻼﺑﺘﻜﺎر اﻟﺘﻲ ﻳﺒﻴﻦ ﻫﺬا ﱡ ﺳﺘﺘﻄﻠﺐ ﺟﻬﺪاً ﻣﺸﺘﺮﻛﺎً ﻣﻦ ﺟﺎﻧﺐ اﻟﺒﻠﺪان واﻟﻤﻨﻈﻤﺔ واﻟﺸﺮﻛﺎء اﻵﺧﺮﻳﻦ .وﻧﻈﺮاً ﻟﻸﻓﻖ اﻟﺰﻣﻨﻲ اﻟﺒﺎﻟﻎ ١٥ﺳﻨﺔ ﻟﺘﺤﻘﻴﻖ ﻏﺎﻳﺎت ﻋﺎم ،٢٠٣٠ﻳﻨﺒﻐﻲ اﻟﻨﻈﺮ ﻓﻲ ﺗﺤﺪﻳﺪ أوﻟﻮﻳﺎت ﺑﺤﺜﻴﺔ ﻋﻠﻰ اﻟﻤﺪى اﻟﻘﺼﻴﺮ واﻟﻤﺘﻮﺳﻂ واﻟﻄﻮﻳﻞ .وﺗﺮﻛﺰ ﻣﺴﻮدة ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻋﻠﻰ اﻷوﻟﻮﻳﺎت ﻋﻠﻰ اﻟﻤﺪى اﻟﻘﺼﻴﺮ واﻟﻤﺘﻮﺳﻂ.
ﺑﻠﻮغ اﻟﺤﺪ اﻷﻣﺜﻞ ﻣﻦ وﺳﺎﺋﻞ اﻻﺧﺘﺒﺎر واﻟﺘﺸﺨﻴﺺ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي
ﺳﺘﺆدي ﺗﻜﻨﻮﻟﻮﺟﻴﺎت اﻟﺘﺸﺨﻴﺺ وﻧﻬﻮج اﻻﺧﺘﺒﺎر اﻟﺠﺪﻳﺪة ﺴﻨﺔ إﻟﻰ ﺗﺸﺨﻴﺺ ﻣﺒﻜﺮ أﻛﺜﺮ وأدق ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ ﺤﱠ واﻟﻤ َ ُ اﻟﺒﺸﺮي وﺗﻌﺰﻳﺰ رﺻﺪ اﻟﻤﺮﺿﻰ .وﻫﻨﺎك ﻓﺮص ﻋﺪﻳﺪة ﻟﻼﺑﺘﻜﺎر. وﻳﻤﻜﻦ ﻟﻠﺘﻄﻮرات اﻟﺠﺪﻳﺪة ﻓﻲ اﻻﺧﺘﺒﺎر اﻟﺬاﺗﻲ ﻟﺘﺤﺮي ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي أن ﺗﺴﻔﺮ ﻋﻦ ﺗﻮﺳﻊ ﻫﺎﺋﻞ ﻓﻲ اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻟﻜﻦ ﺳﻴﺘﻌﻴﻦ ﺿﻤﺎن ﺟﻮدﺗﻬﺎ ورﺑﻄﻬﺎ رﺑﻄﺎً ﻛﺎﻓﻴﺎً ﺑﺎﻻﺧﺘﺒﺎر اﻟﺘﺄﻛﻴﺪي وﺑﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي اﻷوﺳﻊ ﻧﻄﺎﻗﺎً .وﺳﺘﻤﻜﱢ ﻦ اﻟﻮﺳﺎﺋﻞ اﻟﺒﺴﻴﻄﺔ واﻟﻤﻴﺴﻮرة اﻟﺘﻜﻠﻔﺔ واﻟﻤﻮﺛﻮﻗﺔ ﻟﺘﺸﺨﻴﺺ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻤﺮاﻛﺰ اﻟﺮﻋﺎﻳﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺘﺸﺨﻴﺺ اﻟﻤﺒﻜﺮ اﻟﺤﻤﻞ اﻟﻔﻴﺮوﺳﻲ، ﻟﻠﺮﺿﻊ ورﺻﺪ اﻟﻤﺮﺿﻰ وﺧﺼﻮﺻﺎً ﻟﻘﻴﺎس ِ ﻣﻦ إﺟﺮاء اﺧﺘﺒﺎرات اﻟﻔﻴﺮوس ورﺻﺪ ﻣﺮﺿﺎه ﻓﻲ اﻟﻤﺠﺘﻤﻌﺎت ﻣﻨﺼﺎت ﺗﺸﺨﻴﺼﻴﺔ اﻟﻤﺤﻠﻴﺔ واﻟﻤﻨﺎﻃﻖ اﻟﻨﺎﺋﻴﺔ .وﻳﻤﻜﻦ ﻟﺘﻄﻮﻳﺮ ّ ﻣﺘﻌﺪدة اﻻﺳﺘﺨﺪاﻣﺎت أو ﻣﺘﻜﺎﻣﻠﺔ ﻟﻠﺘﺸﺨﻴﺺ اﻟﻤﺸﺘﺮك ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﻟﺤﺎﻻت اﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ ﻟﻪ، ﻛﺎﻟﺴﻞ واﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ واﻟﺰﻫﺮي ،أن ﻳﺰﻳﺪ أوﺟﻪ ﻛﻔﺎءة ﻳﺤﺴﻦ رﻋﺎﻳﺔ اﻟﻤﺮﺿﻰ. اﻟﺨﺪﻣﺎت وأن ﱢ
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
ﺑﻠﻮغ اﻟﺘﻘﺪﻳﻢ اﻷﻣﺜﻞ ﻟﻠﺨﺪﻣﺎت
ﻳﻤﻜﻦ أن ﻳﻌﺰى ﺟﺎﻧﺐ ﻛﺒﻴﺮ ﻣﻦ ﻧﺠﺎح اﻟﺘﻮﺳﻊ اﻟﺴﺮﻳﻊ ﻓﻲ اﻟﻌﻼج ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ إﻟﻰ اﻋﺘﻤﺎد ﻧﻬﺞ اﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﻓﻲ ﻋﻼج ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ورﻋﺎﻳﺔ اﻟﻤﺼﺎﺑﻴﻦ ﺑﻪ ،وﻫﻮ ﻧﻬﺞ ﻳﻌﺰز اﺳﺘﺨﺪام اﻟﺒﺮوﺗﻮﻛﻮﻻت واﻷﺳﺎﻟﻴﺐ اﻟﻤﺒﺴﻄﺔ واﻟﻤﻌﻴﺎرﻳﺔ اﻟﻤﻮﺣﺪة ،وﻳﺆدي إﻟﻰ اﻻﺳﺘﺨﺪام اﻟﺬي ﻳﺘﺴﻢ ﺑﺎﻟﻜﻔﺎءة ﻟﻤﺨﺘﻠﻒ ﻣﺴﺘﻮﻳﺎت اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ واﻟﻤﺸﺎرﻛﺔ اﻟﺘﺎﻣﺔ ﻣﻊ اﻟﻤﺠﺘﻤﻌﺎت اﻟﻤﺤﻠﻴﺔ .وﺑﺎﻟﻤﺜﻞ ،ﻓﺈن اﻟﻌﺪﻳﺪ ﻣﻦ اﻟﻨﺠﺎﺣﺎت اﻟﺘﻲ ﺗﺤﻘﻘﺖ ﻓﻲ ﻣﺠﺎل اﻟﻮﻗﺎﻳﺔ ﻣﻦ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻳﻤﻜﻦ أن ﺗﻌﺰى إﻟﻰ اﻻﺑﺘﻜﺎرات ﻓﻲ ﻣﺠﺎل اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وﺗﻌﺰﻳﺰ ﻧُ ﻈﻢ اﻟﻤﺠﺘﻤﻌﺎت اﻟﻤﺤﻠﻴﺔ ،ﺑﺤﻴﺚ ﻳﻤﻜﻦ ﺗﻮﺻﻴﻞ اﻟﺘﺪﺧﻼت اﻟﻔﻌﺎﻟﺔ إﻟﻰ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻷﻛﺜﺮ ﺗﺄﺛﺮاً وﺗﻌﺮﺿﺎً ﻟﻠﻤﺨﺎﻃﺮ. ﱡ ﻟﻜﻦ ﻣﻊ وﺻﻮل ﺑﺮاﻣﺞ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻟﻰ ﻣﺮﺣﻠﺔ اﻟﻨﻀﺞ ،ﻳﻠﺰم ﺗﻜﻴﻴﻔﻬﺎ ﻟﻠﺘﺼﺪي ﻟﻠﺘﺤﺪﻳﺎت اﻟﺠﺪﻳﺪة وﺗﻮﺳﻴﻊ ﻧﻄﺎﻗﻬﺎ وﺗﻌﺰﻳﺰ اﻹﻧﺼﺎف ﻓﻲ اﻟﺤﺼﻮل ﻋﻠﻰ ﺧﺪﻣﺎﺗﻬﺎ .ﻛﻤﺎ ﻳﺘﻌﻴﻦ إﻳﺠﺎد ﺗﻮازن دﻗﻴﻖ ﻳﻤﻜﻦ ﻣﻦ ﺧﻼﻟﻪ ﺗﻜﻴﻴﻒ اﻟﺨﺪﻣﺎت ﺗﺒﻌﺎً ﻟﻠﻤﻮاﻗﻊ وﻟﻠﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ اﻟﻤﻌﻴﻨﺔ ،وﻓﻲ اﻟﻮﻗﺖ ﻧﻔﺴﻪ اﻟﺤﻔﺎظ ﻋﻠﻰ ﻣﺴﺘﻮى ﻣﻌﻴﻦ ﻣﻦ اﻟﺒﺴﺎﻃﺔ واﻟﺘﻮﺣﻴﺪ اﻟﻤﻌﻴﺎري ﻟﻠﺴﻤﺎح ﺑﺎﻟﺘﻮﺳﻊ اﻟﻜﻒء واﻟﻤﺴﺘﺪام ﻋﻠﻰ ﻧﻄﺎق ﻛﺒﻴﺮ .وﻗﺪ ﺳﻠﻄﺖ اﻟﺨﺒﺮة اﻟﻤﺴﺘﻤﺪة ﻣﻦ ﺗﻮﺳﻴﻊ اﻟﻌﻼج ﺑﻤﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ اﻟﻀﻮء ﻋﻠﻰ ﺿﺮورة ﻣﺮاﻋﺎة ﺗﻘﺪﻳﻢ ﻋﻼج ورﻋﺎﻳﺔ ﻣﺨﺘﻠﻔﻴﻦ ﻓﻲ ﻣﺠﺎل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻟﻼﺳﺘﺠﺎﺑﺔ ﻟﻤﺨﺘﻠﻒ اﻻﺣﺘﻴﺎﺟﺎت اﻟﻌﻼﺟﻴﺔ ﻟﺪى اﻷﺷﺨﺎص اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي )ﺗﺒﻌﺎً ﻟﻠﻌﻤﺮ ،وﻟﻤﺮﺣﻠﺔ اﻟﻤﺮض ،وﻟﻼﺳﺘﺠﺎﺑﺔ ﻟﻠﻌﻼج ،وﻟﻮﺟﻮد اﻋﺘﻼﻻت ﻣﺼﺎﺣﺒﺔ وأﺣﻮال ﺻﺤﻴﺔ أﺧﺮى ،وﻟﻠﺴﻴﺎﻗﺎت اﻟﻤﺤﻠﻴﺔ(. ﻣ ْﺒﺘَ ﻜَ ﺮة ﺗﻬﺪف وﻳﻨﺒﻐﻲ اﻟﺘﺮﻛﻴﺰ ﺑﺸﻜﻞ ﺧﺎص ﻋﻠﻰ ﺗﻄﻮﻳﺮ ﺧﺪﻣﺎت ُ إﻟﻰ اﻟﻮﺻﻮل إﻟﻰ ﻋﺪد ﻣﻦ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ وإﺷﺮاﻛﻬﺎ واﻻﺣﺘﻔﺎظ ﺑﻬﺎ ﻓﻲ اﻟﺮﻋﺎﻳﺔ وﻋﻠﻰ ﺗﻘﺪﻳﻢ ﺣﺰم ﻣﻌﻴﻨﺔ ﻣﻦ اﻟﺘﺪﺧﻼت. وﺗﻤﺲ اﻟﺤﺎﺟﺔ ﻋﻠﻰ وﺟﻪ اﻟﺴﺮﻋﺔ إﻟﻰ ﺣﺰم ﻣﻦ اﻟﺘﻮﻟﻴﻔﺎت اﻟﺘﻲ ﱡ اﻟﻤ ْﺒﺘَ ﻜَ ﺮة ﻟﻠﺘﻌﺎﻣﻞ ﻣﻊ ارﺗﻔﺎع ﻣﻌﺪل ﺣﺪوث ﺗﻀﻢ وﺳﺎﺋﻞ اﻟﻮﻗﺎﻳﺔ ُ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻴﻦ ﺑﻌﺾ اﻟﻤﺠﻤﻮﻋﺎت اﻟﺴﻜﺎﻧﻴﺔ ﻣﻦ اﻟﻤﺮاﻫﻘﺎت واﻟﺸﺎﺑﺎت وﺧﺼﻮﺻﺎً ﻓﻲ أﻓﺮﻳﻘﻴﺎ ﺟﻨﻮب اﻟﺼﺤﺮاء اﻟﻜﺒﺮى ،وﻟﺰﻳﺎدة إﺷﺮاك اﻟﺼﺒﻴﺎن واﻟﺮﺟﺎل ﻓﻲ ﻛﻞ ﻣﻦ ﺧﺪﻣﺎت اﻟﻮﻗﺎﻳﺔ واﻟﻌﻼج .وﻳﺘﻄﻠﺐ ﺿﻌﻒ اﻻﻟﺘﺰام ﺑﺎﻟﻌﻼج واﻧﺨﻔﺎض ﻣﻌﺪﻻت اﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﺮﺿﻰ ﻓﻲ اﻟﺮﻋﺎﻳﺔ وازدﻳﺎد ﻣﻌﺪﻻت اﻟﻮﻓﻴﺎت ﺑﻴﻦ اﻟﻤﺮاﻫﻘﻴﻦ اﻟﻤﺘﻌﺎﻳﺸﻴﻦ ﻣﻊ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي إﻳﻼء اﻷوﻟﻮﻳﺔ ﻓﻲ اﻻﻫﺘﻤﺎم ،ﻣﻊ ﺿﺮورة اﻟﺘﺼﺪي ﻻﻧﺨﻔﺎض ﻣﻌﺪﻻت ﺗﻐﻄﻴﺔ اﻟﺨﺘﺎن اﻟﻄﺒﻲ اﻟﻄﻮﻋﻲ ﻟﻠﺬﻛﻮر ﺑﻴﻦ اﻟﺼﺒﻴﺎن اﻟﻤﺮاﻫﻘﻴﻦ واﻟﺮﺟﺎل اﻷﻛﺒﺮ ﺳﻨﺎً .
اﻟﻤﺜﻠﻰ ﻷدوﻳﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻠﻮغ اﻟﺤﺪود ُ ﻈﻤﻪ اﻟﻌﻼﺟﻴﺔ وﻧُ ُ
ﻋﻠﻰ اﻟﺮﻏﻢ ﻣﻦ اﻟﺘﻄﻮرات اﻟﻜﺒﻴﺮة ﻓﻲ ﻣﺄﻣﻮﻧﻴﺔ وﻓﻲ ﻗﻮة وﻓﻲ ﻈﻢ اﻟﻌﻼج ﺑﻬﺎ، ﻣﻘﺒﻮﻟﻴﺔ اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ وﻧُ ُ ﻣﺎزاﻟﺖ ﻫﻨﺎك ﻣﺠﺎﻻت ﺗﺘﻄﻠﺐ اﻟﻤﺰﻳﺪ ﻣﻦ اﻻﺑﺘﻜﺎرات واﻟﺘﺤﺴﻴﻨﺎت. ﻈﻢ ﻋﻼﺟﻴﺔ وﺗﺮﻛﻴﺒﺎت وﻓﻲ ﺣﻴﻦ أﻧﻪ ﺗﺤﻘﻖ ﺗﻘﺪم ﻛﺒﻴﺮ ﻓﻲ ﺗﻄﻮﻳﺮ ﻧُ ُ اﻟﺨﻂ اﻷول اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ، ّ وﻓﻌﺎﻟﺔ ﺑﺄدوﻳﺔ ﺑﺴﻴﻄﺔ ّ ﻈﻢ ﻋﻼج ﺛﺎﺑﺘﺔ اﻟﺠﺮﻋﺔ ﻻﺗﺰال اﻟﺤﺎﺟﺔ ﻣﺎﺛﻠﺔ إﻟﻰ اﻻﺑﺘﻜﺎر ﻟﺘﻄﻮﻳﺮ ﻧُ ُ وﺑﺴﻴﻄﺔ وﻗﻮﻳﺔ ﻣﻦ اﻟﺨﻄﻴﻦ اﻟﺜﺎﻧﻲ واﻟﺜﺎﻟﺚ .وﻳﻨﺒﻐﻲ أن ﺗﻬﺪف اﻟﺒﺤﻮث اﻟﺘﻲ ﺗﺠﺮى ﻋﻠﻰ اﻟﺠﺮﻋﺎت اﻟﻤﺜﻠﻰ ﻣﻦ اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻈﻢ ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ إﻟﻰ ﺗﻮﻓﻴﺮ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻼزﻣﺔ ﺣﻮل اﻟﻨﱡ ُ اﻟﻌﻼﺟﻴﺔ اﻟﻔﻌﺎﻟﺔ وﻓﻲ اﻟﻮﻗﺖ ﻧﻔﺴﻪ اﻟﺘﻘﻠﻴﻞ ﻣﻦ اﻟﺴﻤﻴﺔ وﻣﻦ اﻟﺘﻔﺎﻋﻼت ﻓﻴﻤﺎ ﺑﻴﻦ دواء وآﺧﺮ ﻣﻨﻬﺎ وﺧﻔﺾ اﻟﺘﻜﺎﻟﻴﻒ .وﻣﺎزاﻟﺖ ﻣﺎﺳﺔ إﻟﻰ اﻟﻜﺜﻴﺮ ﻣﻦ اﻻﺑﺘﻜﺎر ﻓﻲ ﺗﻄﻮﻳﺮ ﺗﺮﻛﻴﺒﺎت ﻣﻀﺎدة اﻟﺤﺎﺟﺔ ّ ﻈﻢ ﻋﻼﺟﻴﺔ ﻣﺘﻨﺎﺳﻘﺔ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ وﻧُ ُ ﻈﻢ اﻟﻌﻼﺟﻴﺔ اﻟﺘﺮﻛﻴﺒﺎت اﻟﺒﺴﻴﻄﺔ واﻟﻤﺴﺘﺴﺎﻏﺔ ﻟﻠﺮﺿﻊ واﻷﻃﻔﺎل ،واﻟﻨﱡ ُ ﻟﻠﻤﺮاﻫﻘﻴﻦ ﻟﺘﺤﺴﻴﻦ ﻣﻘﺒﻮﻟﻴﺘﻬﻢ ﻟﻬﺎ واﻟﺘﺰاﻣﻬﻢ ﺑﻬﺎ ،واﻟﺘﺮﻛﻴﺒﺎت اﻟﻄﻮﻳﻠﺔ اﻷﻣﺪ اﻟﺘﻲ ﺗﺆﺧﺬ ﻋﻦ ﻃﺮﻳﻖ اﻟﻔﻢ وﺑﺎﻟﺤﻘﻦ ﻟﺘﺤﺴﻴﻦ اﻻﻟﺘﺰام واﻟﻜﺒﺖ اﻟﻔﻴﺮوﺳﻲ .وﻓﻲ اﻟﻮﻗﺖ ﻧﻔﺴﻪ ،ﻻﺑﺪ ﻣﻦ ﺗﻄﻮﻳﺮ ﻈﻢ ﻋﻼﺟﻴﺔ أﺷﺪ ﻓﻌﺎﻟﻴﺔ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ اﻟﻌﺪوى اﻟﻤﺼﺎﺣﺒﺔ ﻋﻘﺎﻗﻴﺮ وﻧُ ُ واﻻﻋﺘﻼﻻت اﻟﻤﺼﺎﺣﺒﺔ اﻷﺧﺮى واﻟﺨﻄﻴﺮة وﺗﺪﺑﻴﺮﻫﺎ اﻟﻌﻼﺟﻲ.
ُ - ١١أﺳﺮ ﻓﻲ إﺛﻴﻮﺑﻴﺎ ﺗﺘﻜﺎﺗﻒ ﻣﻦ أﺟﻞ اﻟﺘﺼﺪي ﻟﻠﻮﺻﻢ اﻟﻨﺎﺟﻢ ﻋﻦ اﻹﺻﺎﺑﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي.
ﺗﻨﻔﻴﺬ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ: اﻟﺸﺮاﻛﺎت واﻟﻤﺴﺎءﻟﺔ واﻟﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ وﺗﻘﺪﻳﺮ اﻟﺘﻜﺎﻟﻴﻒ
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
ﻳﻌﺘﻤﺪ اﻟﺘﻨﻔﻴﺬ اﻟﻔﻌﺎل ﻟﻬﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻋﻠﻰ ﺗﻀﺎﻓﺮ ﺟﻬﻮد ﺟﻤﻴﻊ اﻷﻃﺮاف اﻟﻤﻌﻨﻴﺔ ﻓﻲ اﺳﺘﺠﺎﺑﺔ اﻟﻘﻄﺎع اﻟﺼﺤﻲ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﻳﺘﻄﻠﺐ اﻟﻨﺠﺎح ﺷﺮاﻛﺎت ﻗﻮﻳﺔ ﻟﻀﻤﺎن اﺗﺴﺎق اﻟﺴﻴﺎﺳﺎت واﻟﺒﺮاﻣﺞ .وﻳﻠﺰم إرﺳﺎء وﺗﻌﺰﻳﺰ اﻟﺼﻼت ﺑﻴﻦ ﻣﺨﺘﻠﻒ اﻟﺒﺮاﻣﺞ اﻟﻨﻮﻋﻴﺔ واﻟﻤﻌﻨﻴﺔ ﺑﺄﻣﺮاض ﻣﺤﺪدة واﻟﺒﺮاﻣﺞ اﻟﺸﺎﻣﻠﺔ داﺧﻞ ﻗﻄﺎع اﻟﺼﺤﺔ.
اﻟﺘﻌﺎون ﻣﻊ اﻟﺸﺮﻛﺎء ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ووﻛﺎﻻت اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﺸﺮﻳﻜﺔ :ﺗﻌﺘﻤﺪ اﻟﻤﻨﻈﻤﺔ ،ﺑﺎﻋﺘﺒﺎرﻫﺎ ﺟﻬﺔ ﻣﺸﺎرﻛﺔ ﻓﻲ رﻋﺎﻳﺔ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ،ﻋﻠﻰ ﻣﻨﻈﻮﻣﺔ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻷوﺳﻊ ﻓﻲ ﺗﻘﺪﻳﻢ اﺳﺘﺠﺎﺑﺔ ﺷﺎﻣﻠﺔ ﻣﺘﻌﺪدة اﻟﻘﻄﺎﻋﺎت ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. وﺗﺴﻬﻢ اﻟﺠﻬﺎت اﻟﺮاﻋﻴﺔ اﻟﻌﺸﺮ اﻷﺧﺮى ﻟﺒﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ،ﺑﺠﺎﻧﺐ أﻣﺎﻧﺔ اﻟﺒﺮﻧﺎﻣﺞ ،ﻓﻲ اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ،ﻣﺴﺘﺮﺷﺪة ﻳﻮﺿﺢ اﻟﻤﺠﺎﻻت ﺑﺠﺪول ”ﺗﻘﺴﻴﻢ اﻟﻌﻤﻞ“ اﻟﺨﺎص ﺑﺎﻟﺒﺮﻧﺎﻣﺞ واﻟﺬي ّ اﻟﺮﺋﻴﺴﻴﺔ ﻟﻠﻤﺴﺆوﻟﻴﺎت ﻓﻲ أﺳﺮة اﻟﺒﺮﻧﺎﻣﺞ. اﻟﺸﺮﻛﺎء اﻟﺘﻘﻨﻴﻮن :أﻧﺸﺄت اﻟﻤﻨﻈﻤﺔ ﻟﺠﻨﺔ اﺳﺘﺸﺎرﻳﺔ اﺳﺘﺮاﺗﻴﺠﻴﺔ وﺗﻘﻨﻴﺔ ﻣﻌﻨﻴﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﺘﺄﻟﻒ ﻣﻦ ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻟﺨﺒﺮاء اﻟﺘﻘﻨﻴﻴﻦ ﻣﻦ اﻟﺒﺮاﻣﺞ اﻟﻮﻃﻨﻴﺔ ﻟﻤﻜﺎﻓﺤﺔ ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﻤﻨﻈﻤﺎت اﻟﻤﻨﻔﺬة واﻟﻤﻌﺎﻫﺪ اﻟﺒﺤﺜﻴﺔ واﻟﻤﺠﺘﻤﻊ اﻟﻤﺪﻧﻲ ﻹﺳﺪاء اﻟﻤﺸﻮرة إﻟﻰ اﻟﻤﺪﻳﺮ اﻟﻌﺎم ﺑﺸﺄن ﺳﻴﺎﺳﺎت اﻟﻤﻨﻈﻤﺔ اﻟﻤﻌﻨﻴﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺑﺮﻧﺎﻣﺞ ﻋﻤﻠﻬﺎ .وﻳﺆدي اﻟﺸﺮﻛﺎء اﻟﺘﻘﻨﻴﻮن دوراً ﺣﺎﺳﻤﺎً ﻓﻲ ﻓﺮﻳﻖ اﻟﻌﻤﻞ اﻟﺘﺎﺑﻊ ﻟﻠﻤﻨﻈﻤﺔ اﻟﻤﺴﺆول ﻋﻦ وﺿﻊ ﺳﻴﺎﺳﺎت اﻟﻤﻨﻈﻤﺔ وﻣﺒﺎدﺋﻬﺎ اﻟﺘﻮﺟﻴﻬﻴﺔ. ﺗﺆدي ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ دوراً ﺗﻨﻈﻴﻤﻴﺎً ﻣﻬﻤﺎً ﺑﺎﻟﺠﻤﻊ ﺑﻴﻦ ﺷﺘﻰ اﻟﺠﻬﺎت واﻟﻘﻄﺎﻋﺎت واﻟﻤﻨﻈﻤﺎت اﻟﻤﻌﻨﻴﺔ ﻟﺪﻋﻢ اﺳﺘﺠﺎﺑﺔ ﻣﻨﺴﻘﺔ وﻣﺘﺴﻘﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ ﺗﺠﺎه ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ اﻟﻌﻤﻞ ﻣﻊ وزارات اﻟﺼﺤﺔ ﺑﺎﻟﺪول اﻷﻋﻀﺎء، ﺗﻌﻤﻞ أﻣﺎﻧﺔ اﻟﻤﻨﻈﻤﺔ ﻋﻦ ﻗﺮب ﻣﻊ ﺷﺮﻛﺎء رﺋﻴﺴﻴﻴﻦ آﺧﺮﻳﻦ ﻣﻦ ﺿﻤﻨﻬﻢ: اﻟﺠﻬﺎت اﻟﻤﺎﻧﺤﺔ اﻟﺜﻨﺎﺋﻴﺔ اﻷﻃﺮاف واﻟﻤﺘﻌﺪدة اﻷﻃﺮاف واﻟﻮﻛﺎﻻت اﻹﻧﻤﺎﺋﻴﺔ واﻟﺼﻨﺎدﻳﻖ واﻟﻤﺆﺳﺴﺎت :وﺿﻌﺖ ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﺧﻄﻂ ﻋﻤﻞ ﻣﺸﺘﺮﻛﺔ وﺗﺮﺗﻴﺒﺎت ﺗﻌﺎوﻧﻴﺔ أﺧﺮى ﺣﻮل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻣﻊ ﻣﺠﻤﻮﻋﺔ ﻣﻦ ﻛﺒﺮى اﻟﻮﻛﺎﻻت اﻟﻤﺎﻧﺤﺔ ﻓﻲ ﻣﺠﺎل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺼﻨﺪوق اﻟﻌﺎﻟﻤﻲ ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز واﻟﺴﻞ واﻟﻤﻼرﻳﺎ ،واﻟﻤﺮﻓﻖ اﻟﺪوﻟﻲ ﻟﺸﺮاء اﻷدوﻳﺔ ،وﺧﻄﺔ رﺋﻴﺲ اﻟﻮﻻﻳﺎت اﻟﻤﺘﺤﺪة ﻟﻠﻄﻮارئ ﻟﻠﻤﺴﺎﻋﺪة ﻓﻲ ﻣﺠﺎل ﻣﻜﺎﻓﺤﺔ اﻷﻳﺪز. اﻟﻤﺠﺘﻤﻊ اﻟﻤﺪﻧﻲ :أﻧﺸﺄت ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻓﺮﻳﻘﺎً ﻣﺮﺟﻌﻴﺎً ﻟﻠﻤﺠﺘﻤﻊ اﻟﻤﺪﻧﻲ ﺑﺸﺄن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻳﺠﻤﻊ ﺑﻴﻦ ﻣﻤﺜﻠﻴﻦ ﻣﻦ ﻧﻄﺎق واﺳﻊ ﻣﻦ اﻟﻤﺠﻤﻮﻋﺎت وﺷﺒﻜﺎت اﻟﻤﺠﺘﻤﻊ اﻟﻤﺪﻧﻲ اﻟﻤﻌﻨﻴﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﻳﺴﺪي ﻫﺬا اﻟﻔﺮﻳﻖ اﻟﻤﺸﻮرة ﻟﻠﻤﻨﻈﻤﺔ ﺑﺸﺄن ﺳﻴﺎﺳﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وﺑﺮاﻣﺞ اﻟﻌﻤﻞ ،وﻳﻴﺴﺮ ﻧﺸﺮ ﺳﻴﺎﺳﺎت اﻟﻤﻨﻈﻤﺔ وإرﺷﺎداﺗﻬﺎ وﺗﻨﻔﻴﺬﻫﺎ .وﻟﻠﻤﺠﺘﻤﻊ اﻟﻤﺪﻧﻲ ﻣﻤﺜﻠﻮن ﻓﻲ ﻛﻞ ﻓﺮﻳﻖ ﻋﺎﻣﻞ وﺗﻘﻨﻲ ﺗﺎﺑﻊ ﻟﻠﻤﻨﻈﻤﺔ ،وﻣﻦ ﺿﻤﻨﻬﺎ اﻟﻔﺮﻳﻖ اﻟﻌﺎﻣﻞ اﻟﻤﻌﻨﻲ ﺑﻮﺿﻊ ﺳﻴﺎﺳﺎت اﻟﻤﻨﻈﻤﺔ وﻣﺒﺎدﺋﻬﺎ اﻟﺘﻮﺟﻴﻬﻴﺔ وأدواﺗﻬﺎ .وﻫﻨﺎك ﻣﺠﻤﻮﻋﺔ ﻣﻦ ﻣﻨﻈﻤﺎت اﻟﻤﺠﺘﻤﻊ اﻟﻤﺪﻧﻲ ﺗﺮﺑﻄﻬﺎ ﻋﻼﻗﺎت رﺳﻤﻴﺔ ﺑﺎﻟﻤﻨﻈﻤﺔ ،ﻣﻤﺎ ﻳﻤﻜّ ﻨﻬﺎ ﻣﻦ ﺣﻀﻮر اﺟﺘﻤﺎﻋﺎت ﻣﺨﺘﻠﻒ اﻷﺟﻬﺰة اﻟﺮﺋﺎﺳﻴﺔ ﻓﻲ اﻟﻤﻨﻈﻤﺔ ﺑﺼﻔﺔ ﻣﺮاﻗﺐ ،ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺣﻀﻮر ﺟﻤﻌﻴﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ.
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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اﻟﻤﺴﺎءﻟﺔ ﻋﻠﻰ اﻟﺼﻌﻴﺪ اﻟﻌﺎﻟﻤﻲ وﻋﻠﻰ اﻟﺼﻌﻴﺪ اﻟﻘﻄﺮي ﺗﻜﺘﺴﺐ آﻟﻴﺎت اﻟﻤﺴﺎءﻟﺔ اﻟﺠﻴﺪة اﻷداء واﻟﺸﻔﺎﻓﺔ اﻟﺘﻲ ﺗﺘﻤﺘﻊ ً ﻛﺒﻴﺮة ﻧﻈﺮاً ﻻﺗﺴﺎع ﻃﺎﺋﻔﺔ ً أﻫﻤﻴﺔ ﻗﻮﻳﺔ ٍ ﻣﺠﺘﻤﻌﻴﺔ ٍ ﺑﻤﺸﺎرﻛﺔ ٍ اﻟﺸﺮﻛﺎء وأﺻﺤﺎب اﻟﻤﺼﻠﺤﺔ ﻣﻤﻦ ﻳﻌﺘﺒﺮ وﺟﻮدﻫﻢ ﺿﺮورﻳﺎً ﻟﻠﺤﺼﻮل ﻋﻠﻰ اﺳﺘﺠﺎﺑﺔ ﻓﻌﺎﻟﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﺗﺸﻤﻞ اﻟﻠﱠ ِﺒﻨﺎت اﻷﺳﺎﺳﻴﺔ ﻓﻲ ﻫﺬا اﻟﺸﺄن إﻧﺸﺎء اﻟﻘﻴﺎدة اﻟﻘﻮﻳﺔ واﻟﺘﺼﺮﻳﻒ اﻟﺴﺪﻳﺪ ﻟﻠﺸﺆون ،وﺗﺘﻀﻤﻦ ﻋﻠﻰ :اﻟﻤﺸﺎرﻛﺔ اﻟﻜﺎﻣﻠﺔ ﻣﻊ ﺟﻤﻴﻊ أﺻﺤﺎب اﻟﻤﺼﻠﺤﺔ ،ووﺿﻊ ﻏﺎﻳﺎت وﻃﻨﻴﺔ ﺻﺮﻳﺤﺔ ﺗﺘﻀﺢ ﻓﻴﻬﺎ اﻷﻫﺪاف اﻹﻧﻤﺎﺋﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ ،ﺣﻴﺚ ﻳﻜﻮن ذﻟﻚ ﻣﻼﺋﻤﺎً ،ﻛﻤﺎ ﺗﺘﻀﺢ ﻓﻴﻬﺎ اﻷﻫﺪاف اﻟﻤﺪرﺟﺔ ﻓﻲ ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ إﻟﻰ ﺟﺎﻧﺐ اﻻﻟﺘﺰاﻣﺎت اﻷﺧﺮى ﻋﻠﻰ اﻟﺼﻌﻴﺪ اﻟﻌﺎﻟﻤﻲ؛ ﻣﻊ اﺳﺘﺨﺪام ﻣﺆﺷﺮات ﻣﻼﺋﻤﺔ ﻟﺘﻮاﻓﺮ اﻟﺘﺪﺧﻼت وﺗﻐﻄﻴﺘﻬﺎ وﺟﻮدﺗﻬﺎ وأﺛﺮﻫﺎ ﻣﻦ أﺟﻞ اﻗﺘﻔﺎء ﻣﺴﺎر اﻟﺘﻘﺪم؛ وﺗﺮﺳﻴﺦ ﻋﻤﻠﻴﺎت ﺷﻔﺎﻓﺔ وﺷﺎﻣﻠﺔ ﻟﻠﺘﻘﻴﻴﻢ واﻹﺑﻼغ .وﻫﻨﺎك أدوات ﻣﻮﺟﻮدة ﺑﺎﻟﻔﻌﻞ ﻟﻘﻴﺎس اﻟﺘﻘﺪم اﻟﻤﺤﺮز )ﺑﻤﺎ ﻓﻲ ذﻟﻚ أدوات ﻟﺘﻬﻴﺌﺔ اﻟﺒﻴﺌﺔ اﻟﺘﻤﻜﻴﻨﻴﺔ( .وﻳﻌﺘﺒﺮ ﻛﻞ ﻣﻦ اﻟﺮﺻﺪ اﻟﻤﺘﺴﻖ واﻹﺑﻼغ اﻟﻤﻨﺘﻈﻢ ﻋﻦ اﻟﺘﻘﺪم ﻋﻠﻰ اﻟﻤﺴﺘﻮﻳﻴﻦ اﻟﻘﻄﺮي واﻟﻌﺎﻟﻤﻲ ﻣﻦ اﻷﻣﻮر اﻟﺒﺎﻟﻐﺔ اﻷﻫﻤﻴﺔ ﻟﺘﻘﻮﻳﺔ اﻟﻤﺴﺎءﻟﺔ.
- ١٣إﺟﺮاء ﻓﺤﺺ ﻓﻲ اﻟﻔﺘﺮة اﻟﻤﺤﻴﻄﺔ ﺑﺎﻟﻮﻻدة ،أﻣﺮﻳﻜﺎ اﻟﻼﺗﻴﻨﻴﺔ وﻣﻨﻄﻘﺔ اﻟﻜﺎرﻳﺒﻲ.
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
اﻟﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ واﻹﺑﻼغ اﻟﻤﺤﺮز ﻧﺤﻮ اﻷﻫﺪاف رﺻﺪ اﻟﺘﻘﺪم ُ واﻟﻐﺎﻳﺎت اﻟﻌﺎﻟﻤﻴﺔ واﻹﺑﻼغ ﻋﻨﻪ
ﺳﻴﺠﺮي رﺻﺪ ﺗﻨﻔﻴﺬ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻋﻠﻰ أرﺑﻌﺔ ﻣﺴﺘﻮﻳﺎت ﺑﺎﺳﺘﺨﺪام اﻵﻟﻴﺎت اﻟﻤﻮﺟﻮدة ﺑﺎﻟﻔﻌﻞ: اﻟﻤﺤﺮز ﻧﺤﻮ اﻷﻫﺪاف واﻟﻐﺎﻳﺎت اﻟﻌﺎﻟﻤﻴﺔ واﻹﺑﻼغ • رﺻﺪ اﻟﺘﻘﺪم ُ ﻋﻨﻪ؛ • رﺻﺪ اﻻﺳﺘﺠﺎﺑﺔ ﻋﻠﻰ اﻟﻤﺴﺘﻮﻳﻴﻦ اﻹﻗﻠﻴﻤﻲ واﻟﻘﻄﺮي وﺗﻘﻴﻴﻤﻬﺎ؛ • ﺗﻄﺒﻴﻖ إﻃﺎر ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻺدارة اﻟﻘﺎﺋﻤﺔ ﻋﻠﻰ ﺗﺤﻘﻴﻖ اﻟﻨﺘﺎﺋﺞ؛ • ﺗﻄﺒﻴﻖ إﻃﺎر اﻟﻤﺴﺎءﻟﺔ اﻟﺨﺎص ﺑﺒﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز.
ﺳﺘﻘﻴﻢ اﻟﻤﺮاﺟﻌﺎت اﻟﻤﻨﺘﻈﻤﺔ اﻟﺘﻘﺪم ﻋﻠﻰ اﻟﺼﻌﻴﺪ اﻟﻌﺎﻟﻤﻲ، ّ اﻟﻤﺤﺮز ﻓﻲ ﻣﺨﺘﻠﻒ اﻻﻟﺘﺰاﻣﺎت واﻟﻐﺎﻳﺎت ،وﺳﺘﺴﺘﻨﺪ ﻫﺬه اﻟﻤﺮاﺟﻌﺎت إﻟﻰ اﻟﺒﻴﺎﻧﺎت اﻟﻤﺘﻠﻘﺎة ﻣﻦ اﻟﺒﻠﺪان ﻣﻦ ﺧﻼل ﻣﺨﺘﻠﻒ آﻟﻴﺎت وإﺟﺮاءات اﻟﺮﺻﺪ واﻟﺘﻘﻴﻴﻢ اﻟﺤﺎﻟﻴﺔ ،ﻣﺜﻞ اﻟﻨﻈﺎم اﻟﻌﺎﻟﻤﻲ ﻟﻺﺑﻼغ ﻋﻦ اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻓﻲ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻸﻳﺪز ،ﻋﻠﻰ أن ﺗﻜﻤﻠﻬﺎ ﺑﻴﺎﻧﺎت إﺿﺎﻓﻴﺔ ﻋﻨﺪ اﻟﻠﺰوم .وﻗﺪ ﺣﺪدت اﻟﻤﻨﻈﻤﺔ ﻣﺠﻤﻮﻋﺔ ﺗﺘﻜﻮن ﻣﻦ ﻋﺸﺮة ﻣﺆﺷﺮات ﻋﺎﻟﻤﻴﺔ رﺋﻴﺴﻴﺔ ﺗﻢ ﺗﻨﻈﻴﻤﻬﺎ ﻋﻠﻰ اﻣﺘﺪاد اﻟﺴﻠﺴﻠﺔ اﻟﻜﺎﻣﻠﺔ ﻟﺨﺪﻣﺎت ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي، وﻳﻨﺒﻐﻲ اﺳﺘﺨﺪاﻣﻬﺎ ﻟﻠﺮﺻﺪ واﻹﺑﻼغ ﻋﻦ اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻓﻲ اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي )اﻧﻈﺮ اﻟﺸﻜﻞ .(٧ وﺳﻴﺘﻢ ﺑﺎﻧﺘﻈﺎم ﺗﻘﻴﻴﻢ اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻋﻠﻰ اﻟﺼﻌﻴﺪﻳﻦ اﻟﻌﺎﻟﻤﻲ واﻹﻗﻠﻴﻤﻲ ﻧﺤﻮ اﻟﻐﺎﻳﺎت اﻟﻤﻮﺿﻮﻋﺔ ﻓﻲ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻫﺬه .ﻛﻤﺎ ﺳﻴﺠﺮي أﻳﻀﺎً اﺳﺘﺨﺪام أﺳﺲ اﻟﻤﻘﺎرﻧﺔ اﻟﻤﺮﺟﻌﻴﺔ -أو اﻟﻤﻘﺎرﻧﺎت ﺑﻴﻦ اﻟﺒﻠﺪان وﻓﻲ داﺧﻞ ﻛﻞ ﺑﻠﺪ -ﻟﺘﻘﻴﻴﻢ اﻷداء ﻓﻲ ﺑﻠﻮغ ﺻﻤﻤﺖ ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﺘﻜﻮن ﻣﺮﻧﺔ ﺑﻤﺎ ﻳﻜﻔﻲ اﻟﻐﺎﻳﺎت .وﻗﺪ ُ ﻟﺘﺘﻀﻤﻦ أوﻟﻮﻳﺎت إﺿﺎﻓﻴﺔ أو ﻟﺴﺪ اﻟﺜﻐﺮات اﻟﺘﻲ ﻗﺪ ﻳﺘﻢ ﺗﺤﺪﻳﺪﻫﺎ ﻓﻲ اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي. وﻟﻬﺬا اﻟﻐﺮض ﺳﺘﻮاﺻﻞ اﻟﻤﻨﻈﻤﺔ ﻋﻤﻠﻬﺎ ﻣﻊ ﺷﺮﻛﺎﺋﻬﺎ ﻟﺘﻘﺪﻳﻢ اﻟﻤﺴﺎﻧﺪة ﻟﻠﺒﻠﺪان ﻣﻦ أﺟﻞ اﻟﺠﻤﻊ اﻟﻤﻨﺴﻖ واﻟﻤﻮﺣﺪ ﻟﻠﺒﻴﺎﻧﺎت ﺣﻮل اﻟﻤﺆﺷﺮات اﻟﺮﺋﻴﺴﻴﺔ ،وذﻟﻚ اﺳﺘﻨﺎداً إﻟﻰ اﻟﻤﺒﺎدئ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﻤﻮﺣﺪة ﻟﻠﻤﻨﻈﻤﺔ ﺑﺸﺄن اﻟﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ ﻗﻄﺎع اﻟﺼﺤﺔ ٢٤،وﻓﻲ إﻋﺪاد اﻟﺘﻘﺎرﻳﺮ اﻟﻌﺎﻟﻤﻴﺔ واﻹﻗﻠﻴﻤﻴﺔ ،وﺗﺪﻋﻮ اﻻﻗﺘﺮاﺣﺎت إﻟﻰ رﻓﻊ ﺗﻘﺎرﻳﺮ ﻣﻨﺘﻈﻤﺔ ﺑﺎﻟﺒﻴﺎﻧﺎت. ﺳﺘﻨﻔﺬ اﻟﻤﻨﻈﻤﺔ إﻃﺎراً ﻟﻠﺮﺻﺪ واﻟﻤﺴﺎءﻟﺔ ﺧﺎﺻﺎً ﺑﺎﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﺎﻟﺘﺸﺎور ﻣﻊ أﺻﺤﺎب اﻟﻤﺼﻠﺤﺔ ،ﻛﻤﺎ ﺳﺘﺮﺻﺪ وﺗﺘﺒﺎدل اﻟﺒﻴﺎﻧﺎت ﺣﻮل اﻻﺳﺘﻔﺎدة ﺑﻤﺒﺎدﺋﻬﺎ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﻤﻌﻨﻴﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وأﻳﻀﺎً ﺣﻮل اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻓﻲ ﺗﻨﻔﻴﺬ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ، ﻟﺘﺴﻠﻴﻂ اﻟﻀﻮء ﻋﻠﻰ اﻟﻌﻘﺒﺎت وﻟﺘﺸﺠﻴﻊ أﻓﻀﻞ اﻟﻤﻤﺎرﺳﺎت. اﻟﺒﺸﺮي واﻹﺑﻼغ ﻋﻨﻬﺎ. ﻣﻨﺼﺔ ﻣﺸﺘﺮﻛﺔ ﺪ ﻣﺆﺷﺮات رﺻﺪ ﺗﻘﻮﻳﺔ اﻟﻨُ ﻈﻢ اﻟﺼﺤﻴﺔ ﻣﻦ ّ ﻤّ ﺴﺘَ َ وﺗُ ْ ﻟﺮﺻﺪ وﺗﻘﻴﻴﻢ اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﺼﺤﻴﺔ اﻟﻮﻃﻨﻴﺔ ﺗﻘﻮم اﻟﻤﻨﻈﻤﺔ ﻓﻴﻬﺎ ﺑﺪور اﻟﺘﻨﺴﻴﻖ ،وﻫﻨﺎك أﻳﻀﺎً وﺳﺎﺋﻞ ﻟﺘﻘﺪﻳﺮ اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻓﻲ ﺗﻨﻔﻴﺬ اﻟﺴﻴﺎﺳﺎت واﻟﺘﺪاﺑﻴﺮ اﻟﻘﺎﻧﻮﻧﻴﺔ واﻟﻬﻴﻜﻠﻴﺔ اﻟﺮاﻣﻴﺔ إﻟﻰ ﺗﻌﺰﻳﺰ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي.
ﻛﻤﺎ ﺳﻴﺠﺮي أﻳﻀﺎً اﺳﺘﺨﺪام أﺳﺲ اﻟﻤﻘﺎرﻧﺔ اﻟﻤﺮﺟﻌﻴﺔ -أو اﻟﻤﻘﺎرﻧﺎت ﺑﻴﻦ اﻟﺒﻠﺪان وﻓﻲ داﺧﻞ ﻛﻞ ﺑﻠﺪ -ﻟﺘﻘﻴﻴﻢ اﻷداء ﻓﻲ ﺑﻠﻮغ اﻟﻐﺎﻳﺎت
رﺻﺪ وﺗﻘﻴﻴﻢ اﻻﺳﺘﺠﺎﺑﺔ ﻋﻠﻰ اﻟﻤﺴﺘﻮى اﻟﻘﻄﺮي
ﻳﻨﺒﻐﻲ ﺗﻘﻴﻴﻢ اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻓﻲ ﺗﻨﻔﻴﺬ اﺳﺘﺠﺎﺑﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺎﺳﺘﺨﺪام ﻣﺆﺷﺮات ﺣﻮل اﻟﺘﻮاﻓﺮ وﺣﺎﺻﻞ اﻟﺘﻐﻄﻴﺔ واﻷﺛﺮ ،ﻣﻊ أﺧﺬ اﻟﺘﻮﺻﻴﺎت اﻷﺧﺮى ذات اﻟﻌﻼﻗﺔ ﻟﺮﺻﺪ اﻟﺘﻨﻔﻴﺬ ﺑﻌﻴﻦ اﻻﻋﺘﺒﺎر .وﺗﻮﺻﻲ ﻣﺒﺎدئ اﻟﻤﻨﻈﻤﺔ اﻟﺘﻮﺟﻴﻬﻴﺔ اﻟﻤﻮﺣﺪة ﺑﺸﺄن اﻟﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﻤﺠﻤﻮﻋﺔ أﺳﺎﺳﻴﺔ ﻣﻮﺣﺪة ﺗﻀﻢ ٥٠ﻣﺆﺷﺮاً وﻃﻨﻴﺎً ﺑﺤﻴﺚ ﺗﺴﺘﺨﺪﻣﻬﺎ اﻟﺒﻠﺪان ﻓﻲ اﻟﺮﺻﺪ واﻹﺑﻼغ ﻋﻦ ﺑﺮاﻣﺠﻬﺎ اﻟﻮﻃﻨﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي وأﻧﺸﻄﺔ اﺳﺘﺠﺎﺑﺘﻬﺎ اﻟﻮﻃﻨﻴﺔ اﻟﻜﻠﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي .وﺳﻴﺘﻢ ﺗﺘﺒﻊ اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﺻﻮب ﺗﺤﻘﻴﻖ أﻫﺪاف اﻟﺘﻨﻤﻴﺔ اﻟﻤﺴﺘﺪاﻣﺔ اﻟﻤﺮﺗﺒﻄﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ
٢٤ﻣﺒﺎدئ ﺗﻮﺟﻴﻬﻴﺔ ﻣﻮﺣﺪة ﺑﺸﺄن اﻟﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻟﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ ﻗﻄﺎع اﻟﺼﺤﺔ ،اﻧﻈﺮ: ) http://who.int/hiv/pub/guidelines/strategic-information-guidelines/en/ﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦
اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
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إﻃﺎر اﻟﻤﺴﺎءﻟﺔ اﻟﺨﺎص ﺑﺒﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز
إﻃﺎر ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻺدارة اﻟﻘﺎﺋﻤﺔ ﻋﻠﻰ ﺗﺤﻘﻴﻖ اﻟﻨﺘﺎﺋﺞ
ﻳﺘﻀﺢ ﻋﻤﻞ اﻟﻤﻨﻈﻤﺔ ﻓﻲ ﻣﺠﺎل ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ اﻟﻤﻴﺰاﻧﻴﺔ وﺧﻄﺔ اﻟﻌﻤﻞ اﻟﻤﺘﻀﻤﻨﺘﻴﻦ ﻓﻲ اﻟﻤﻴﺰاﻧﻴﺔ اﻟﻤﻮﺣﺪة ﻟﺒﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز وﻧﺘﺎﺋﺠﻪ وإﻃﺎر اﻟﻤﺴﺎءﻟﺔ اﻟﺨﺎص ﺑﻪ ٢٦،اﻟﺬي ﻳﻔﺮض إﻃﺎراً واﺣﺪاً ﻓﻲ اﻟﻔﺘﺮة ٢٠٢١–٢٠١٦ﻳﺪﻋﻢ اﻟﺘﺨﻄﻴﻂ واﻟﻤﻴﺰﻧﺔ اﻟﻤﺸﺘﺮﻛﻴﻦ ﻓﻴﻤﺎ ﺑﻴﻦ اﻟﺠﻬﺎت اﻟﺮاﻋﻴﺔ اﻹﺣﺪى ﻋﺸﺮة وأﻣﺎﻧﺔ اﻟﺒﺮﻧﺎﻣﺞ .وﺗﻮﺿﻊ ﺧﻄﻂ ﻋﻤﻞ وﻣﻴﺰاﻧﻴﺎت ﻣﻔﺼﻠﺔ ﻟﻠﺜﻨﺎﺋﻴﺎت ﻃﻮال ﻓﺘﺮة ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﺪءاً ﺑﺎﻟﺜﻨﺎﺋﻴﺔ .٢٠١٧–٢٠١٦وﺗﺘﻮﻟﻰ ﻛﻞ ﺟﻬﺔ ﻣﺸﺎرﻛﺔ ﻓﻲ رﻋﺎﻳﺔ اﻟﺒﺮﻧﺎﻣﺞ ﻣﺴﺆوﻟﻴﺔ ﺗﻨﻔﻴﺬ ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻷﻧﺸﻄﺔ اﻟﻌﺎﻣﺔ اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﺧﺘﺼﺎﺻﺎﺗﻬﺎ اﻟﺘﻨﻈﻴﻤﻴﺔ ووﻓﻖ ﺟﺪول ﺗﻘﺴﻴﻢ اﻟﻌﻤﻞ واﻟﺪﻋﻢ اﻟﺘﻘﻨﻲ ﻓﻲ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ،وﻳﺘﺮاﻓﻖ إﻃﺎر اﻟﻤﻴﺰاﻧﻴﺔ اﻟﻤﻮﺣﺪة واﻟﻨﺘﺎﺋﺞ واﻟﻤﺴﺎءﻟﺔ ﺑﺈﻃﺎر ﻳﺤﺪد ﻣﺆﺷﺮات ﻳﻘﺎس وﻓﻘﻬﺎ اﻟﺘﻘﺪم ﻓﻲ ﺗﻨﻔﻴﺬ ﻟﺮﺻﺪ اﻷداء ﱢ اﻟﻤﻴﺰاﻧﻴﺔ وﺧﻄﺔ اﻟﻌﻤﻞ ،وﻳﺘﻢ ﺗﻘﺪﻳﻢ ﺗﻘﺮﻳﺮ ﻣﺮﺣﻠﻲ ﺳﻨﻮي ﺣﻮل ﺤ َﺮز إﻟﻰ ﻣﺠﻠﺲ ﺗﻨﺴﻴﻖ اﻟﺒﺮاﻣﺞ ﻓﻲ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤ ْ اﻟﺘﻘﺪم ُ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز.
ﻳﻮﻓﺮ ﺑﺮﻧﺎﻣﺞ اﻟﻌﻤﻞ اﻟﻌﺎم اﻟﺜﺎﻧﻲ ﻋﺸﺮ ﻟﻠﻤﻨﻈﻤﺔ ﻟﻠﻔﺘﺮة –٢٠١٤ ٢٥٢٠١٩رؤﻳﺔ اﺳﺘﺮاﺗﻴﺠﻴﺔ رﻓﻴﻌﺔ اﻟﻤﺴﺘﻮى ﻟﻌﻤﻞ اﻟﻤﻨﻈﻤﺔ ،وﻳﺒﻴﻦ ﺳﺘﺔ ﻣﺠﺎﻻت ﻋﻤﻞ .وﺗﻨﺪرج ﻣﻌﻈﻢ اﻷﻧﺸﻄﺔ اﻟﻤﺘﻌﻠﻘﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ اﻟﻔﺌﺔ :١اﻷﻣﺮاض اﻟﺴﺎرﻳﺔ .ﻟﻜﻦ ﻫﻨﺎك أﻧﺸﻄﺔ أﺧﺮى ﻣﻬﻤﺔ ﻣﺘﻌﻠﻘﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺗﻨﺪرج ﻓﻲ ﻓﺌﺎت أﺧﺮى ،وﺧﺼﻮﺻﺎً اﻟﻔﺌﺔ :٢اﻷﻣﺮاض ﻏﻴﺮ اﻟﺴﺎرﻳﺔ )ﺑﻤﺎ ﻓﻴﻬﺎ ﺗﻌﺎﻃﻲ ﻣﻮاد اﻹدﻣﺎن واﻟﺼﺤﺔ اﻟﻨﻔﺴﻴﺔ ورﻋﺎﻳﺔ اﻟﺤﺎﻻت اﻟﻤﺰﻣﻨﺔ( ،واﻟﻔﺌﺔ :٣ﺗﻌﺰﻳﺰ اﻟﺼﺤﺔ ﻃﻴﻠﺔ اﻟﻌﻤﺮ )ﺑﻤﺎ ﻓﻴﻬﺎ ﺻﺤﺔ اﻷم واﻟﻤﺮاﻫﻖ واﻟﻄﻔﻞ واﻟﺼﺤﺔ اﻟﺠﻨﺴﻴﺔ واﻹﻧﺠﺎﺑﻴﺔ( ،واﻟﻔﺌﺔ ٤ )ﺑﻤﺎ ﻓﻴﻬﺎ اﻟﺤﺼﻮل ﻋﻠﻰ اﻷدوﻳﺔ ووﺳﺎﺋﻞ اﻟﺘﺸﺨﻴﺺ ،واﻟﺘﻘﺪﻳﻢ اﻟﻤﺘﻜﺎﻣﻞ ﻟﻠﺨﺪﻣﺎت ،واﻟﻤﻌﻠﻮﻣﺎت اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ،واﻟﻤﻮارد اﻟﺒﺸﺮﻳﺔ( .وﻳﻨﺪرج ﻓﻲ اﻟﻔﺌﺔ ١ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي واﻟﺘﻬﺎب اﻟﻜﺒﺪ اﻟﻔﻴﺮوﺳﻲ ،وﻟﻬﻤﺎ ﻣﺠﺎل ﻋﻤﻠﻬﻤﺎ اﻟﺨﺎص اﻟﺬي ﺗﻮﺿﻊ ﻟﻪ ﺧﻄﻂ ﻋﻤﻞ ﺛﻨﺎﺋﻴﺔ اﻟﺴﻨﻮات ﻣﻊ ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻟﺤﺼﺎﺋﻞ اﻟﻤﺘﻔﻖ ﻋﻠﻴﻬﺎ وﻣﻴﺰاﻧﻴﺔ. وﺗﻐﻄﻲ ﻣﺴﻮدة اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﻫﺬه ﺛﻼث ﺛﻨﺎﺋﻴﺎت ﻣﻦ اﻟﺴﻨﻮات ) ،٢٠١٧–٢٠١٦و ،٢٠١٩–٢٠١٨و .(٢٠٢١–٢٠٢٠وﻳﺘﻢ رﺻﺪ ﺗﻨﻔﻴﺬ ﺧﻄﺔ اﻟﻌﻤﻞ ﻣﻦ ﺧﻼل اﻟﺘﻘﺮﻳﺮ اﻟﻤﺮﺣﻠﻲ ﺣﻮل اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻓﻲ ﻧﻬﺎﻳﺔ ﻛﻞ ﺛﻨﺎﺋﻴﺔ ،ﻣﻊ اﻟﻘﻴﺎم ﺑﻤﺮاﺟﻌﺔ ﻓﻲ ﻣﻨﺘﺼﻒ اﻟﺜﻨﺎﺋﻴﺔ ﻟﺘﻴﺴﻴﺮ اﻟﺘﻨﻔﻴﺬ.
– ١٤اﻟﺘﺪرﻳﺐ أﺛﻨﺎء اﻟﺨﺪﻣﺔ اﻟﺼﺤﻴﺔ ﻓﻲ ﺳﻴﺮاﻟﻴﻮن.
٢٥ﺑﺮﻧﺎﻣﺞ اﻟﻌﻤﻞ اﻟﻌﺎم اﻟﺜﺎﻧﻲ ﻋﺸﺮ ﻟﻠﻔﺘﺮة :٢٠١٩–٢٠١٤ﻟﻴﺲ ﻣﺠﺮد اﻟﺘﺤﺮر ﻣﻦ اﻟﻤﺮض ،اﻧﻈﺮ: ) http://www.who.int/about/resources_planning/twelfth-gpw/en/ﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦ ﻃﺮح ﻫﺬا اﻹﻃﺎر ﺧﻼل اﻻﺟﺘﻤﺎع اﻟﺴﺎﺑﻊ واﻟﺜﻼﺛﻴﻦ ﻟﻤﺠﻠﺲ ﺗﻨﺴﻴﻖ اﻟﺒﺮاﻣﺞ اﻟﺘﺎﺑﻊ ﻟﺒﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز )ﺟﻨﻴﻒ ٢٨-٢٦ ،ﺗﺸﺮﻳﻦ اﻷول /أﻛﺘﻮﺑﺮ (٢٠١٥وﻛﺎن ُ ٢٦ ﻋﻨﻮاﻧﻪ :اﻟﻤﻴﺰاﻧﻴﺔ اﻟﻤﻮﺣﺪة ﻟﺒﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز وﻧﺘﺎﺋﺠﻪ وإﻃﺎر اﻟﻤﺴﺎءﻟﺔ اﻟﺨﺎص ﺑﻪ ﻓﻲ اﻟﻔﺘﺮة ،٢٠٢١-٢٠١٦اﻧﻈﺮ: ) http://www.unaids.org/sites/default/files/media_asset/20151103_UNAIDS_UBRAF_PCB37_15-19_EN.pdfﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
ﺗﻜﻠﻔﺔ ﺗﻨﻔﻴﺬ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﻘﻬﻘﺮﻳﺔ واﻧﺨﻔﺎﺿﺎت ﻓﻲ ﻛﻞ ﻣﻦ ﺗﻜﺎﻟﻴﻒ اﻟﻤﺨﺘﺒﺮات )ﻣﻊ ﺗﺒﺴﻴﻂ ﻈﻢ اﻻﺧﺘﺒﺎر( وﺗﻜﺎﻟﻴﻒ ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺎت ،ﻣﻊ ﺗﺤﻮﻳﻞ ﺑﻌﺾ ﻧُ ً اﻟﻤﺮﺿﻰ إﻟﻰ اﻟﺮﻋﺎﻳﺔ اﻟﻤﺠﺘﻤﻌﻴﺔ .أﻣﺎ ﻏﺎﻳﺎت اﻟﺘﻐﻄﻴﺔ اﻟﻤﺴﺘﻘﺒﻠﻴﺔ ﻓﻬﻲ ﻣﺴﺘﻤﺪة ﻣﻦ اﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ﻓﻲ اﻟﻔﺘﺮة .٢٠٢١-٢٠١٦ وﺗﺸﻴﺮ اﻟﺘﻘﺪﻳﺮات إﻟﻰ أن اﻟﺘﻜﺎﻟﻴﻒ اﻹﺟﻤﺎﻟﻴﺔ ﻟﻤﺴﻮدة ﻫﺬه اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ﺳﺘﺮﺗﻔﻊ ﻣﻦ ﻧﺤﻮ ٢٠ ٠٠٠ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ ﻓﻲ ﻋﺎم ٢٠١٦إﻟﻰ ﻧﺤﻮ ٢٢ ٠٠٠ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ ﻓﻲ ﻋﺎم ٢٠٢٠ و ٢١ ٠٠٠ﻣﻠﻴﻮن دوﻻر أﻣﺮﻳﻜﻲ ﻓﻲ ﻋﺎم ) ٢٠٢١اﻧﻈﺮ اﻟﺸﻜﻞ .(٨ وﻳﺘﻄﻠﺐ اﻟﻌﻼج ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ أﻛﺒﺮ ﻗﺪر ﻣﻦ اﻟﻤﻮارد ،ﺑﻨﺴﺒﺔ ٪٤٧ﻣﻦ اﻟﻤﺠﻤﻮع؛ وﻳﻤﺜﻞ ﻣﻨﻔﺬو اﻟﺒﺮﻧﺎﻣﺞ اﻟﻤﻜﻮن اﻟﺬي ﻳﺘﻠﻮه ﻣﻦ ﺣﻴﺚ اﻟﻜﺒﺮ ﺑﻨﺴﺒﺔ ٪١٣ﺗﻠﻴﻬﺎ ﺧﺪﻣﺎت اﺧﺘﺒﺎر ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﻨﺴﺒﺔ .٪٩ ﻫﻨﺎك أرﺑﻌﺔ ﺑﻠﺪان )ﻣﺮﺗﺒﺔ ﺣﺴﺐ اﻟﻌﺐء( ﺗﺤﺘﺎج إﻟﻰ أﻛﺜﺮ ﻣﻦ ﺛﻠﺚ اﻟﻤﻮارد ﻛﺎﻓﺔ ،وﻫﻲ :ﺟﻨﻮب أﻓﺮﻳﻘﻴﺎ وﻧﻴﺠﻴﺮﻳﺎ واﻟﺒﺮازﻳﻞ واﻟﺼﻴﻦ .وﻣﺎ ﻳﺰﻳﺪ ﻋﻠﻰ ﻧﺼﻒ اﻟﻤﻮارد ﻛﺎﻓﺔ اﻟﻤﻄﻠﻮﺑﺔ ﻟﻠﺒﻠﺪان اﻟﻤﻨﺨﻔﻀﺔ اﻟﺪﺧﻞ واﻟﺒﻠﺪان اﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ ﻳﺨﺼﺺ ﻟﻺﻗﻠﻴﻢ اﻷﻓﺮﻳﻘﻲ ) ،(٥٥ﻳﻠﻴﻬﺎ ﺑﻌﺪ ذﻟﻚ أﻛﺒﺮ أﻗﺎﻟﻴﻢ ٢٩واﻟﻤﺘﻤﺜﻠﺔ ﻓﻲ اﻹﻗﻠﻴﻢ اﻷﻣﺮﻳﻜﻲ ﺑﻨﺤﻮ ٪١٦وإﻗﻠﻴﻢ ﻏﺮب اﻟﻤﺤﻴﻂ اﻟﻬﺎدئ ﺑﻨﺤﻮ ٪١٣وإﻗﻠﻴﻢ ﺟﻨﻮب ﺷﺮق آﺳﻴﺎ ﺑﻤﺎ ﻳﻘﺪر ﺑﺤﻮاﻟﻲ .٪٨وﻓﻲ اﻹﻗﻠﻴﻢ اﻷورﺑﻲ ﻫﻨﺎﻟﻚ ﺣﺎﺟﺔ ﻟﻨﺤﻮ ٪٥ﻣﻦ اﻟﻤﻮارد ﻛﻤﺎ ﻳﺤﺘﺎج إﻗﻠﻴﻢ ﺷﺮق اﻟﻤﺘﻮﺳﻂ إﻟﻰ .٪٤ وﺗﺤﺘﺎج اﻟﺒﻠﺪان اﻟﻤﻨﺨﻔﻀﺔ اﻟﺪﺧﻞ إﻟﻰ ﻧﺤﻮ رﺑﻊ ﻫﺬه اﻟﻤﻮارد ،ﻓﻲ اﻟﺪﻧﻴﺎ ﻣﻦ اﻟﺒﻠﺪان ﻣﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ إﻟﻰ ﻧﺤﻮ ﺣﻴﻦ ﺗﺤﺘﺎج اﻟﺸﺮﻳﺤﺔ ُ رﺑﻌﻬﺎ ،ﻛﻤﺎ ﺗﺤﺘﺎج اﻟﺸﺮﻳﺤﺔ اﻟﻌﻠﻴﺎ ﻣﻦ اﻟﺒﻠﺪان ﻣﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ إﻟﻰ ﻗﻠﻴﻼ ﻋﻦ ﻧﺼﻔﻬﺎ. ﻣﺎ ﻳﻘﻞ ً ﺗﺼﻒ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ ﺑﺸﺄن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﻓﻲ اﻟﻔﺘﺮة ٢٠٢١-٢٠١٦ﻣﺴﺎﻫﻤﺔ ﻗﻄﺎع اﻟﺼﺤﺔ ﻓﻲ ﻫﺪف اﻟﻘﻀﺎء ﻋﻠﻰ ﻣﺮض اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺑﺎﻋﺘﺒﺎره أﺣﺪ اﻟﺘﻬﺪﻳﺪات اﻟﺘﻲ ﺗﺤﺪق ﺑﺎﻟﺼﺤﺔ اﻟﻌﻤﻮﻣﻴﺔ ﺑﺤﻠﻮل ﻋﺎم .٢٠٣٠ ﺑﻨﺎء ﻋﻠﻰ ﺗﻘﺪﻳﺮ ﺗﻜﺎﻟﻴﻒ وﻗﺪ ﺗﻢ ﺗﻘﺪﻳﺮ ﺗﻜﻠﻔﺔ ﺗﻨﻔﻴﺬ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ ً اﺳﺘﺮاﺗﻴﺠﻴﺔ ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ﻓﻲ اﻟﻔﺘﺮة ،٢٠٢١-٢٠١٦واﻟﺘﻲ اﺳﺘﺨﺪﻣﺖ ﺗﻜﺎﻟﻴﻒ ﻟﻠﻐﺎﻳﺎت وﻟﻮﺣﺪات ﻣﻌﻴﻨﺔ ﻓﻲ اﻟﺘﺪﺧﻼت اﻟﻤﺪرﺟﺔ ﻓﻲ اﻻﺳﺘﺮاﺗﻴﺠﻴﺔ. اﺳﺘُ ﻤﺪت اﻟﺒﻴﺎﻧﺎت اﻟﺨﺎﺻﺔ ﺑﺘﻘﺪﻳﺮ اﻟﺘﻜﺎﻟﻴﻒ ﻣﻦ اﻟﺘﻘﺪﻳﺮات اﻟﺪﻳﻤﻐﺮاﻓﻴﺔ اﻟﺘﻲ أﻋﺪﺗﻬﺎ ﺷﻌﺒﺔ اﻟﺴﻜﺎن ﺑﺎﻷﻣﻢ اﻟﻤﺘﺤﺪة ،ودراﺳﺎت اﻟﻤﺴﺢ اﻟﻮﻃﻨﻲ ﻟﻸﺳﺮ )اﻟﻤﺴﻮﺣﺎت اﻟﺪﻳﻤﻮﻏﺮاﻓﻴﺔ واﻟﺼﺤﻴﺔ وﻣﺴﺢ ﻣﺆﺷﺮات اﻷﻳﺪز( ٢٧،وﺗﻘﺪﻳﺮات ﺑﺮﻧﺎﻣﺞ اﻷﻣﻢ اﻟﻤﺘﺤﺪة اﻟﻤﺸﺘﺮك ﻟﻤﻜﺎﻓﺤﺔ اﻷﻳﺪز ﻟﻌﺐء ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ﺣﺴﺐ اﻟﺒﻠﺪان ،واﻟﺘﻘﺎرﻳﺮ اﻟﻘﻄﺮﻳﺔ ﻣﻦ ﺧﻼل اﻟﻨﻈﺎم اﻟﻌﺎﻟﻤﻲ ﻟﻺﺑﻼغ ﻋﻦ اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻓﻲ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻸﻳﺪز ٢٨ .وﺗﻢ ﺣﺴﺎب اﻟﺘﻜﺎﻟﻴﻒ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺒﻠﺪان اﻟﻤﺎﺋﺔ واﻟﻌﺸﺮﻳﻦ اﻟﻤﻨﺨﻔﻀﺔ اﻟﺪﺧﻞ واﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ ﻋﺒﺮ أﻗﺎﻟﻴﻢ ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ اﻟﺴﺘﺔ. وﺗﺴﺘﻨﺪ ﺗﻜﺎﻟﻴﻒ اﻟﻮﺣﺪات إﻟﻰ ﻣﺮاﺟﻌﺎت ﻟﺪراﺳﺎت ﺗﻘﺪﻳﺮ اﻟﺘﻜﺎﻟﻴﻒ، وﻗﺪ راﺟﻌﻬﺎ ﺧﺒﺮاء ﻣﻦ ﻣﺠﻤﻮﻋﺔ ﻣﻦ اﻟﺒﻠﺪان .وﻗﺪم ﻓﺮﻳﻖ ﻣﻦ اﻟﺨﺒﺮاء ﺗﻘﺪﻳﺮات ﻟﻠﺘﻜﺎﻟﻴﻒ اﻟﻤﺴﺘﻘﺒﻠﻴﺔ ﻟﻠﻌﻼج ﺑﺎﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ .وﺗﻔﺘﺮض ﺗﻠﻚ اﻟﺘﻘﺪﻳﺮات ﺣﺪوث ﺑﻌﺾ اﻟﺘﺮاﺟﻊ اﻟﻤﺴﺘﻤﺮ ﻓﻲ أﺳﻌﺎر اﻷدوﻳﺔ اﻟﻤﻀﺎدة ﻟﻠﻔﻴﺮوﺳﺎت
اﻟﺸﻜﻞ :٨اﻟﺘﻜﺎﻟﻴﻒ ﺣﺴﺐ اﻟﺘﺪﺧﻞ واﻟﺴﻨﺔ )ﺑﺎﻟﺪوﻻر اﻷﻣﺮﻳﻜﻲ( ţĵēŵőŤē ƻĔŭŝĨ ěēijİĭũŤē ŵňĔőĝŨ ŗİŲĝĹŻ źIJŤē ŦŀēŵĝŤē şŵťĹŤē ĴżżŕĜ ķŴĴżřŤēţĔŝĝŬēŮŨĚŻĔŜŵŤē ŦřʼnŤēŹŤčŧǜēŮŨ ijŵŠIJťŤ ŽŐŵʼnŤē ŽėʼnŤē ūĔĝĭŤē ŃĴőĝŤēİőĖĚżĐĔŝĜǘēěēĆēĴĤǞē ŃĴőĝŤēŦėŜĚżĐĔŝĜǘēěēĆēĴĤǞē ģǙőŤē ijĔėĝĬǘē ģǙőŤē ŦėŜ ĦŨĔŬĴėťŤ ęİŐĔĹũŤē ŦŨēŵőŤē ĚżŐĔũĝĤǘē ęİŐĔĹũŤē ŦŨēŵőŤē ĚżĩŁŤē Ūō ƿŭŤē ǨǦǨǧ ǨǦǨǦ ǨǦǧǯ ǨǦǧǮ ǨǦǧǭ ǨǦǧǬ ǨǦǧǫ ǨǦǧǪ ǨǦǧǩ $ǫ,ǦǦǦ$ ǧǦ,ǦǦǦ$ Ǩǫ,ǦǦǦ $ ǨǦ,ǦǦǦ $ ŮżŻǙũŤĔĖ
ǧǫ,ǦǦǦ$
٢٧ﺑﺮﻧﺎﻣﺞ اﻟﻤﺴﺢ اﻟﺪﻳﻤﻐﺮاﻓﻲ واﻟﺼﺤﻲ ،اﻧﻈﺮ) http://dhsprogram.com/What-We-Do/Survey-Types/DHS.cfm :ﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦ ٢٨اﻟﻨﻈﺎم اﻟﻌﺎﻟﻤﻲ ﻟﻺﺑﻼغ ﻋﻦ اﻟﺘﻘﺪم اﻟﻤﺤﺮز ﻓﻲ اﻻﺳﺘﺠﺎﺑﺔ ﻟﻸﻳﺪز ،اﻧﻈﺮ: ) http://www.unaids.org/en/dataanalysis/knowyourresponse/globalaidsprogressreportingﺗﻢ اﻻﻃﻼع ﻓﻲ ٢٢آذار /ﻣﺎرس .(٢٠١٦ ٢٩ﺗﺸﻴﺮ اﻷﻗﺎﻟﻴﻢ إﻟﻰ أﻗﺎﻟﻴﻢ اﻟﻤﻨﻈﻤﺔ اﻟﺴﺘﺔ ،ﺣﻴﺚ ﺗﻐﻄﻰ اﻟﺒﻴﺎﻧﺎت ١٢٠ﻣﻦ اﻟﺒﻠﺪان اﻟﻤﻨﺨﻔﻀﺔ اﻟﺪﺧﻞ واﻟﺒﻠﺪان اﻟﻤﺘﻮﺳﻄﺔ اﻟﺪﺧﻞ.
٢٠٢١–٢٠١٦ ˛اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ
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اﻟﺘﺼﻮﻳﺮ
;Kunle Ajayi, Courtesy of Photoshare 2014 © – 01 Location: Lagos, Nigeria
أﻣﺮﻳﻜﺎ اﻟﻼﺗﻴﻨﻴﺔ- – ﻋﻘﺪ ﻣﺆﺗﻤﺮ ﺑﺸﺄن ﻓﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي٠٢ .وﻣﻨﻄﻘﺔ اﻟﻜﺎرﻳﺒﻲ WHO/PAHO ©
ﻋﻴﻨﺔ ﻣﻦ دم ﻃﻔﻞ ﻋﻤﺮه ﺳﺒﻌﺔ أﺷﻬﺮ ﻟﻐﺮض إﻋﺪادﻫﺎ ﻻﺧﺘﺒﺎر ﺗﺤﺮي ّ – أﺧﺬ٠٣ . ﻛﻤﺒﻮدﻳﺎ،اﻹﺻﺎﺑﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي ,David Snyder for the CDC Foundation 2011 © Courtesy of Photoshare; Location: Seireisophon, Cambodia
WHO © – 04
UNAIDS © – 05
WHO/PAHO © – 06
UNAIDS © – 07
Aulia Human, Courtesy of Photoshare 2015 © – 08 Location: DKI Jakarta Indonesia
UNAIDS © – 09
M Ponir Hossain, Courtesy of Photoshare 2014 © – 10 Location: Dhaka Bangladesh
UNAIDS © – 11
WHO/PAHO © – 12
WHO/PAHO © – 13
+Abbie Trayler-Smith/Panos/H4 © – 14
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اﻻﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻌﺎﻟﻤﻴﺔ ﻟﻘﻄﺎع اﻟﺼﺤﺔ˛ ٢٠٢١–٢٠١٦
ﻟﻠﺤﺼﻮل ﻋﻠﻰ ﻣﺰﻳﺪ ﻣﻦ اﻟﻤﻌﻠﻮﻣﺎت، ُﻳﺮﺟﻰ اﻻﺗﺼﺎل ﺑﻤﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ: ﻣﻨﻈﻤﺔ اﻟﺼﺤﺔ اﻟﻌﺎﻟﻤﻴﺔ، اﻹدارة اﻟﻤﻌﻨﻴﺔ ﺑﻔﻴﺮوس اﻟﻌﻮز اﻟﻤﻨﺎﻋﻲ اﻟﺒﺸﺮي، avenue Appia ،20 1211 Geneva 27 Switzerland ﻋﻨﻮان اﻟﺒﺮﻳﺪ اﻹﻟﻜﺘﺮوﻧﻲhiv-aids@who.int : www.who.int/hiv WHO/HIV/2016.05