2004年世界卫生报告.ppt

Cost of achieving treatment scale-up Estimated cost of treating 3 million people by end of 2005: US$ 5.5 billion Assumptions: ? 25% of target reached in 2004 and remaining 75% in 2005 ? Medicine prices stable (significant savings if drug prices fall further) Projected costs of scale-up 2004–2005: US$ 5.5 billion Community participation in public health ? “Health for All” vision: people’s right to health ? Civil society helped propel HIV/AIDS onto the international agenda ? Involvement of PLWHA at each step of the process Community health workers: strengthening health systems ? Treatment programmes rely on community ? Mixture of incentives can be used to compensate health workers ? Programmes need budget, supervision, reliable drug supply, feedback from lessons learnt Treatment scale-up can strengthen health systems ? Attracting resources beyond HIV/AIDS ? Spurring investment in physical infrastructure ? Helping develop procurement and distribution systems of products and commodities ? Fostering interaction with communities NGO private-sector providers NGOs ? Pioneers in treatment delivery, innovative approaches Private sector ? Firms provide treatment to employees, community ? Only a fraction of those in need get treatment in this way Government leadership is vital Strong central leadership, encouraging local innovation and participation ? Defining national strategic framework ? Building coalitions and maintaining stakeholders’ commitment ? Formulating/enforcing rules and incentives for all providers ? Strategic overview 政府领导至关重要 强有力的中央领导, 可以鼓励地方革新和参与 明确国家策略框架 构建联盟, 鼓励利益相关者的参与 制定/实施法规和奖励性机制 战略性视角 卫生信息系统与监测 决策者需要: 知识的采集、分析和传播 监测的重要性: 患者的数目 坚持治疗的情况、医疗服务的质量、药物的可得性 加强卫生系统 提供服务与扩大治疗的切入点 多数病人是来自机会性感染已经很明显的机构 病人也可以从其它机构找到 利用初级卫生保健机构 医务工作者队伍的危机 越来越多的人死于HIV/AIDS 缺勤: 医务工作者要照顾患病的亲属, 参加葬礼 需求增加: 报酬、培训、HIV暴露的职业防护 发展中国家用于治疗的资金增加 满足最小医疗服务需求, 人均每年需要35-40美元, 但实际支出远远不够 国内资源无法填补空缺 需要定期、灵活的国际援助, 可以避免以前经历的负性经济学影响 共享研究成果与知识 新开展的研究需要采用革新性的方法来采集、管理和共享信息 国际性合作: 更快地获得研究结果 一致认可的研究标准 加强