Just over fifty years ago, there were approximately fifty million smallpox cases in the world. In the 20th century alone, nearly 500 million deaths could be attributed to this disease; however, in 1979, the World Health Organization (WHO) announced that due to vaccinations, smallpox had been completely eliminated from the world. Now, imagine that same announcement being made about HIV. According to some ambitious researchers, this could be just around the corner.
According to recently published research in The Lancet, if populations in countries that have high instances of HIV were to be tested and treated on a regular basis, HIV, like smallpox, could be completely eradicated. The researchers used mathematical models and assumptions to come up with this grand announcement. While some feel that the undertaking would be ambitious and worth a try, some critics feel that logistically it would be impossible to make this happen. Charlie Gilks, an expert on AIDS at the WHO and one of the lead authors of the research stated, “It’s quite a startling result. In a relatively short amount of time, we could potentially knock the epidemic on its head.”
In the mathematical model, Gilks and his fellow researchers gathered data from both Malawi and South Africa (both regions hit hard by HIV infections) and demonstrated how infections could drop by nearly 95% if the region’s population got tested every year and received AIDS treatments straight away if they tested positive, without waiting until they got sick. The model also took into consideration males being regularly circumcised and regional safe sex campaigns. According to published results, AIDS fatalities could be reduced by half between the years 2008 and 2050 with limited instances of HIV infections. If the model was actually put into place, its projected annual costs would be close to $3.5 billion. Myron Cohen who comes from the University of North Carolina adds, “This is certainly beyond the bounds of the current infrastructure for many countries, but that is not a reason to think big.”
Currently WHO estimates roughly 33 million HIV cases worldwide. Of those cases, 3 million patients are on an AIDS drug treatment, 7 million are hoping to begin a drug treatment and 3 million new HIV cases emerged last year. Some opponents of the study feel that instantly giving a newly infected patient AIDS treatments would not be in the best interest of the patient or already strained health systems in countries like Africa. States Jennifer Kates, a director of HIV policy, “This is not like giving someone a Tylenol. The idea should be explored, but it’s a huge leap.”
Another criticism is that AIDS drug treatments are a very big commitment. Once the treatment begins, it must continue forever. Also as AIDS drugs are fairly new, there is no research done on how long term treatment affects the body. Some also worry that by forcing every HIV patient to immediately take the drugs, it might cause the body to grow resistant to treatment. Because AIDS drugs are extremely powerful, they also come with some extreme side effects including, but not limited to, heart problems, liver problems and vomiting. WHO will be taking a closer look at the outcomes of this research in order to more thoroughly study the research’s feasibility.
译文:
根除艾滋病---梦想成真
就在五十多年前，世界上大约有五千万人患有天花，单在20世纪该疾病就导致将近五亿人死亡。然而在1979年，世界卫生组织就宣布，由于注射疫苗，天花已经从世界上彻底根除。如今，有人对艾滋病也做出了同样的表态。在一些雄心勃勃的研究者看来，这并不遥远。
Lancet杂志最近发布的研究表明，如果艾滋病高发国家的病人都能得到及时救治并接受定期检测，艾滋病将如同天花一样会被彻底根除。这个惊人的结论是研究人员运用数学模型和推算得出的。对于这项宣布，有人认为其想法颇为大胆而值得一试，也有批评者指出，从逻辑上看，得出这个结论是根本不可能的。世卫组织的一名艾滋病专家查理.吉尔克斯以及其中一名撰写该研究报告的作者指出：“这只是个开始。在不久的将来，我们就将彻底征服艾滋病。”
在他们的数学模型中，吉尔克斯和他的同事们从马拉维地区和南非搜集了一些数据（这两个地区都是艾滋病高发地），论证了如果上述地区每年进行艾滋病检测并且对检测出呈阳性的病人马上进行有效救治，而不是拖到病人感觉到不良反应之后，感染的几率将会下降近95%。该模型还考虑了包皮切割手术以及当地推行的安全性行为运动带来的可能影响。研究结果还表明，随着HIV病毒感染的有效控制，在2008年到2050年间，艾滋病致死的情况会减少一半。倘若该模型能投入实际应用，每年投入的费用将近35亿美元。对此北卡罗来纳大学的麦伦.科恩表示：“这么大的投入显然是很多国家目前承担不起的，不过这不会妨碍我们大胆想象。”
据世卫组织初略估计，目前世界上大约有3300万人感染艾滋病。其中，只有300万人在接受治疗，有700万人正期待接受药物治疗，还包括去年新增的300万艾滋病例。一些反对者表示，立即对新感染艾滋病毒的病人实施治疗不会引起病人多大兴趣，像南非这样医疗系统本身就很捉襟见肘的国家也是如此。负责指导制定艾滋病政策的States Jennifer Kates表示：“这不像给人一片止痛药那么简单。想法值得探索，但步子不能太大。”
还有一种批评意见认为，药物治疗的投入是十分惊人的，因为一旦采用了药物治疗就不可能中途停下来。此外，因为是采用新药，要多长的周期才能起效目前也没得以研究证实。有些人还担心，强制治疗新感染的艾滋病人可能导致病人产生抗药性。此外，治疗艾滋病的强力药物往往会带来很严重的副作用包括（但不限于）心脏病，肝病，呕吐。世界卫生组织将密切关注该研究的成果以便更加全面的研究该项目的可操作性。