Table of Contents
Uncedo lwamanye amazwe luye lwalungisa ngokusisiseko ulungiso lwempilo-ntle yoluntu kwi-Saharan esezantsi kwe-Afrika. Kwiminyaka engamashumi amathathu edluleyo, ukuthutheleka okukhulu kobuncwane obuvela kwabanikeli bomnxeba, imibutho emininzi, kunye neengingqi zoncedo lwabucala ziye zanciphisa ngokuphawulekayo ukufa nokugula okusuka kwizifo ezimandundundu ezintathu zelizwekazi: iHIV/AIDS, isifo somalariya, kunye nesifo sephepha. Iziphumo ezingenakuphicokiselwa zikho zimbali. Iinkqubo ezifana nePresiPresieter’s Preant Prent Precieve for AIDS (PEFAR) kunye neNgxowaleko yomhlaba wonke yokulwa noGawulayo yokulwa noGawulayo, isifo sesifo se-malaleveries zifake amashumi amawaka ezigidi zeerandi ezingamawaka ezigidi zeerandiyo e-R3 ukuya kunyango, ukukhusela unyango, kunye nenkqubo yempilo. Izigidi zabantu abaphila ubomi beziphila ngokubhidingo zihlala kumazwe amashumi amashumi amashumi amahlanu amashumi anethoba-90
Naphezu kwezi mpumelelo ziphawulekayo, indima yoncedo lwamanye amazwe kwimpilo yaseAfrika ayilula okanye ayidunyiswa jikelele. Ukudalwa kweenkqubo ezinkulu, ezi-okanye ezithe ngqo izifo, ezidla ngokuchazwa njengeseti entsonkothileyo "ethe nkqo" yengxoxo. Abahlalutyi baphikisa ngelithi uncedo olukhulu lungadala ukuxhomekeka, ukugqwetha izinto eziphambili, kwaye luthob'iiinkqubo zempilo kawonke wonke ezicekecekethekileyo ezicekeselwe ukuxhasa. Iingxaki zokonakala, ulawulo olubuthathaka, kunye nemiqobo yokufikelela kubemi abakude ibeke umda wemali elinganiselwe kwimpembelelo yoncedo. Njengokuba uluntu lwehlabathi lonke lukhangeleka kwikamva, ukuqwalaselwa komzekelo woncedo lwenkxaso-zibonelelo, ukuxhasa, ukulawulwa, nokulawulwa kwemeko-onke. Ukulwa kwezifo ezikhoyo kungumqobo kwi-Afrika, ukuhambelanabango zamazwe ngamazwe ngamazwe ngamazwe.
Imeko - ngqangi Yembali: Ukusuka EAlma Ata Ukuya Kwingxaki KaGawulayo
Ixesha langoku loncedo lwempilo lwehlabathi lonke eAfrika laqalisa ukumila ngasekupheleni kwenkulungwane yama-20. Ubhengezo lonyaka ka-1978 i-Alma Ata, olwamisela usukelo olunemanyukuso "lokuphilisa Bonke ngonyaka wama- 2000," lwaseka ubuchule obuphambili bezempilo njengendlela engundoqo. Noko ke, ubunzima boqoqosho kunye neenkqubo zolungiso lwesakhiwo zoorhulumente bokongamela uluntu kulo lonke ilizwekazi. Urhulumente wanyanzeleka ukuba anciphise ukuchithwa kwemiqathango yempilo, uqeqesho, kunye nemivuzo, zivelise umngxuma oshiye iinkqubo zempilo zisengozini kwaye ziphantsi komthombo.
Ukudumba kwesifo seHIV/AIDS kwiminyaka yee-1990 kwabhenca umlinganiselo opheleleyo wokungalawuleki. Kumazwe anjengeBotswana, iZimbabwe, kunye noMzantsi Afrika, umlinganiselo wobomi bomntu kunye nowezoqoqosho wancipha ngeminyaka engama-20 okanye ngaphezulu. Umlinganiselo wengxaki waso wasongamela umgangatho wezibonelelo zempilo kawonke-wonke ezibuthathaka. Kwakungekho nyango eAfrika; kwakungekho mayeza alwa noGawulayo awayeguqula uGawulayo kwisigwebo sokufa abe yisifo esinganyangekiyo eNtshona.
Ukusabela kwingxaki kaGawulayo kwaphawula ukushicilelwa kwemali yemali yemali yelinye ilizwe kuncedo lwempilo. Ngo-2001] Ingqungquthela yeZizwe Ezimanyeneyo yaba neNgqungquthela ekhethekileyo kwi-HIV/AIDS (UNGASS), ivakalisa isifo esingungxamiseko yomhlaba wonke. Ngonyaka wama200, iNgxowa-mali yehlabathi yemali yemali yaqaliswa njengenkqubo yemali yemali yemali eninzi yemali elungiselelwe ukuqokelela izinto zemali eninzi elungiselelwe ukuqokelela kunye nokuzikhokelela ekulweni noGawulayo, isifo sephepha, kunye nemalariya. Kwandula ke oko, uMongameli George W. Bush wavakalisa iPFAR, izigidi eziyi5 zeminyaka elishumi elinesihlanu ezimbalini zembali ezinikezelwe kwisifo esinye. Ezi nkqubo zoncedo ezikhoyo, kunye neenkqubo zokusasazo zonyango, ezisetyenziswa ngurhulumente eziqhelekileyo, kunye neenkonzo zempilo.
Izifo Ezinkulu, Iimali Ezininzi: Impembelelo Yoncedo
Inkoliso yoncedo lwempilo lwamanye amazwe eAfrika iye yasiwa kwizifo ezintathu ezingundoqo ezasulelayo. Iziphumo, nangona zahluka, ziye zatshintsha kwisikali selizwekazi.
IHIV/AIDS: Ukusuka ekubulaweni kwabantu kwabantu ukusa kwimeko enganyangekiyo
Ngencopho yalo bhubhani, ingxaki yeHIV/AIDS kwi-Saharan Afrika esezantsi yachazwa njengembubhiso. Ngowama-2003, abantu abangaphantsi kwama-50 000 kweli lizwekazi babenokufumana unyango olulwa ne-DSV (ART). Ekupheleni kowama-2022, ngenxa yomsebenzi wePEPFAR neNgxowa-mali yehlabathi, abantu abangaphezu kwezigidi ezingama-20 babenonyango olusindisa ubomi.
Impembelelo yesi sikali sonyango iyamangalisa. Ukufa okunxulumene noGawulayo kwi-Seaharan Africa kuye kwehla ngaphezu kwama-60% ukususela kwincopho yonyaka wama-2004. Ukusulelwa kweHIV entsha kuye kwehla ngaphezu kwama-50% ngexesha elinye. Ukuphuhliswa koMthintelo lukaMama-ukuya-eMn Mon Mobile (PMTTTT) iinkqubo zezoloyiso zempilo enkulu, zinciphisa izifo ezintsha phakathi kwabantwana ngama-80%. I-UNAIDS "959-95" izihlolo zokuqinisekisa ukuba abantu abaphila neHIV bayazazi iimeko zabo, 95% yabo bafunyaniswe kunyango, kunye nama-9% ezo mayeza athengwayo.
Iindlela ezixhaswe ngokuxhasweyo zibonelelo ezixhaswa ngoncedo lwamanye amazwe ziye zaba zezona zibalulekileyo kule mpumelelo. Ulwandiso lobudoda lolwaluko lwamadoda, olunciphisa ukudluliselwa kweHIV ukuya kuma-60%, luye lwalinganiswa ngokuphawulekayo kumazwe aphezulu aphezulu. Iinkqubo zokufikelela kubemi abangundoqo, njengabasebenzi besini, amadoda abanobufana namadoda, nabantu abafaka iziyobisi, baye baba nobuchule obuphezulu. Phezu kwayo nje le nkqubela, iingxaki ezibalulekileyo ziyaqhubeka. Amanani amanani amantombazana namabhinqa aselula kuMazantsi Afrika ahlala eqinile. iStigma kunye nocalucalucalucalulo ayaqhubeka ukuvala ukufikelela kwinkonzo ezitshixo abantu abakhoyo. Yaye kukho umngcipheko okwandayo wokudinwa njengohlobo olungxamisekileyo loxa lwemeko oludede, ulawulo olungapheliyo.
Isifo Sengcongconi: Umlo Othabatha ixesha elide Nomuntu Wamandulo Obulalayo
I-malariya ihlala ingomnye woonobangela abaphambili bokufa kwabantwana abangaphantsi kweminyaka emihlanu eAfrika. Kangangamashumi eminyaka, ukulwa nesi sifo kwakungathandeki kakhulu. Ukunduluka komanyano lweRolll Back Malaria ngo-1998 kunye nokudalwa kweNgxowa-mali yomhlaba wonke kunye ne-U.S. uMongameli we-Malaria Initivetive (PMI) wayiguqula ngokuphawulekayo ingeniso yemali. Ukungeniswa kwemali yehlabathi ekulawuleni i-malariya kuye kwasindisa ubomi obuqikelelwa kwizigidi ezili-11,7 ukususela ngo-20000.
[[FLT:] Ungenelelo oluxhaswe luncedo lwamanye amazwe lumiselwe kakuhle kwaye lusebenza kakhulu.
- [FLT]]] [[FLT]] i-Incaticide (Ii-TNS): [[FULT]] I-FOTS exhaswe yi-invide (iii-'i-Antaroma)] I-'i-FOLTS' [inani]] Ibonisa ukuba ngaphezu kwezindlu ezikwi-Sharan, ngoku koluvolu hlobo olunye, ulwando olunamandla oluphezulu [[FFFF:6] [FT:] [FT] [FT] [5] ukusetyenziswa kwemijeko yoncedo oluphezulu, i-futhe qha: [FF] [FT] [10] [effe] [effe] [ethev] [eat] amayeza aluncedo kakhulu]
Iziphumo ziye zabonakala. Ingxelo yeWorld Malariya yehlabathi iqikelela ukuba amanani okufa kweemalariya eAfrika ahlile ngaphezu kwama-50% ukususela ngowama-20.
Isifo sephepha: Isifo esidala se-andemic nocelomngeni lwe-MDR-TB
Isifo sephepha sesona sifo sasulelayo sibulala abantu abaninzi ehlabathini, sibulala abantu abangaphezu kwe-1.5 lezigidi ngonyaka. Ngoxa sigqunywa yiHIV nemalariya, isifo sephepha sisekho ngokumandundu eAfrika, nto leyo ebangela ukuba abantu abamalunga nama-25 ekhulwini ehlabathini lonke bafumane iziphumo ezingalindelekanga. Ukudibana kweTB kunye neHIV kubulala kakhulu; isifo sephepha singunobangela ophambili wokufa kwabantu abaneHIV.
Uncedo lwe-Survekia luye lwafuneka kakhulu ukumelana ne-TB eAfrika. INgxowa-mali yehlabathi lilelona ngxowa-mali enkulu yangaphandle yeenkqubo zeTB, inika uninzi lwemali yehlabathi jikelele yokuxilonga, unyango, kunye nokuthintela. I-World Health Organization’s Ithiwerly TB, Short-course (DOTS), kunye nelandela kwayo, iStop TB Stratection, inikezele inkqubo yoomatshini boburhulumente. Umlinganiselo we-GeneXerpert, onokuthi ucothe ukufumanisa ukuchasana kwesifo sephepha, kwaye uluxhase ngokuphambili, luxhaswa ngoncedo oluninzi.
Ucelomngeni olukhulu kwimpendulo yeTB lunyuko lwemininzi yeTB enqanda ukunyuka. [FLT] Unyango lwe-MDR-TB lude, luxabisa kakhulu, lunetyhefu, lufuna iinyanga zezitofu zemihla ngemihla kunye neziyobisi ezininzi. Kude kube mvanje, unyango lwe-MDR-TB lusezantsi kakhulu. Ukuphuhliswa kwamayeza omfutshane, onke asetyenziswayo, njenge BPALGRAGE, luye lwatshintsha unyango, kodwa ukufikelela kwezi ziyobisi zitsha kuhlala kulinganiselwe kumazwe amaninzi aseAfrika ngenxa yokungabhaliswa. Umsantsabalalo omkhulu phakathi kwabantu abakhulayo kunye nabanga abachaphazelelwayo, kufuneka ukwanda kwe-TBPPR, kodwa unikezelo oluthe kracke kakhulu.
Ucelomngeni Nezityholo: Inxalenye Eny ’ Inxalenye Yoncedo
Kuzo zonke impumelelo yayo, umzekelo ophambili woncedo lwangaphandle lwezifo ezasulelayo eAfrika uye wajamelana nokugxekwa okunzulu nokuqhubekayo. Ingxoxo ayibhekiseli ekutheni ingaba inganikela uncedo kusini na, kodwa ngendlela yokuyinika ngokunempumelelo nangokuzinzileyo.
Incoko yababini Ethe nkqo
Eyona njongo ibalulekileyo ixhalabisa ulwakhiwo lwezakhono zempilo yomhlaba wonke. "Nkqo" iinkqubo ezifana nePEPFAR kunye neNgxowa-mali yomhlaba wonke zidibene nezifo ezithe ngqo, ezinemijelo enikezelweyo yemali, amatyathanga, kunye nezakhiwo zolawulo. "Udweliso" iinkqubo zijolise ekomelezeni iinkqubo zempilo jikelele. Abahlalutyi, kuquka amanani aphambili empilo kawonke wonke afana noLauri Garrett, bathe iziphumo zokwakha kunye nabaqeqeshi bezinto zobunyani zixakekisa ukuba iinkqubo ezinkulu ezithe nkqo zingaguqula iinkqubo ezikhupha izinto ezikhoyo eziphuma kwimiqatha yempilo. Abaxhasi baphikisa ukuba iinkqubo ezithe nkqo ziphumele iziphumo ezikhawulezi, kwaye zikwazi, ngokwenene, zomeleza iinkqubo zempilo ngokwakha kunye nokuqeqesha abasebenzi. Ucelomngeni luntsonkongo.
Ukhuseleko nozinzo
Uloyiko oluzingisileyo lolokuba uncedo lwamanye amazwe lubangela ukuxhomekeka. Kwenzeka ntoni xa ipePFAR okanye iNgxowa-mali yomhlaba wonke ixhasa? Imali yasekhaya yempilo kumazwe amaninzi aseAfrika ihlala isezantsi, ngezantsi kweSibhengezo se-Abuja sexhoba le-15% ye-GDP. Abanye oorhulumente baye becotha ukuthatha iindleko zeenkqubo, belindele ukuba abanikeli baqhubeke ngokungenasiphelo. Ukuguqula utshintsho olugudileyo ukusuka kwimali yomnikeli ukuya kwimali yasekhaya kuyalucelomngeni, kwaye ngokufuthi alupheliseki, ucelomngeni. Ingcamango ye-"Ouniverhostry," umgaqo ombindi weSindululo soncedo soncedo, ngokufuthi ingqine ngqine yokuba nzima ukuzalisekisa ukuqhelisa xa abanikeli benolawulo olubalulekileyo kwimali naxa lokuxhasa imali.
Ulawulo Norhwaphilizo
Imali enkulu empompoza inkqubo ehamba ngolwalathiso olubuthathaka lulungiselelo lokulahlwa kwenkunkuma norhwaphilizo. Kuye kwakho amatyala abhaliweyo okunganyaniseki kwiNgxowa-mali yehlabathi kunye nezinye iinkqubo zoncedo, apho kuye kwabiwa khona amayeza, abasebenzi bezipoko bahlawulwa, kwaye izivumelwano zanikwa amahlakani zobupolitika. Ngelixesha zombini iPEPFAR kunye ne-Global Fund ibomeleze ulawulo lwazo kunye nobuchule bokuphendula, ubuqhophololo buhlala bungumqobo wokuqinisekisa ukuba yonke idola ifikelela kwimali efunwa ngabaxhamkeli. Ukungabi nabuchule bolwazi kunye nokunikezela ngeminxeba yemi kumazwe amaninzi kukhokelela kwimisebenzi ebalulekileyo ye-efficene, njengeeages, njengeeages esetyenziswa yimichiza ephelelweyo namayeza aphelelweyo.
Impahla nonyango oluqhelekileyo
Ixabiso eliphezulu leziyobisi ezigunyazisiweyo yayingumba ophambili kwingxaki kaGawulayo. Ukudalwa kweNgxowa-mali yomhlaba wonke ngokwenxalenye kwayimpendulo yokubonelela ngemfuneko yokungafikeleleki kwe-TRV. Ukusetyenziswa kwamayeza afanayo, axhotyiswe ngo-2001 iDoha Isindululo seTRIPS Appegion kunye ne-Primey yempilo ka-R200,000 ngonyaka, inciphiswe kakhulu kuncedo lomguli wangaphandle kunye ne-R350 ngonyaka. Le mfazwe iyaqhubeka namhlanje ingaphezulu kwamayeza amatsha e-MDR ne-TBC, kunye ne-hepatitis C, kunye ne-Prificial e-accitys e-C, kunye nonyango lo-2001. Ukulwela ukufikelela kumayeza anokungenwayo kusemgangathweni wamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe.
Ikamva Loncedo: Ukubuyiselwa, Ukulingana, Nobumnini
Umhlaba wonke wobomi bobomi bomntu utshintsha ngokukhawuleza. Isifo se-COVID-19 sibhenca ukuchachana kwesixokelelwano sonyango kuyo yonke indawo kwaye sibalaselisa ukungabi nakusesikweni okunzulu kokufumaneka emhlabeni wonke kwimichiza yokugonya, ukuxilonga, kunye nonyango. Imodeli entsha yoncedo lwamanye amazwe iyavela, egxininisa ukumelana, ukuveliswa kwezinto zasekuhlaleni, kunye nemali exhasekileyo.
Ukwakha Iinkqubo zempilo ezinokuphinda Zibekho
Kukho ungqinelwano olubanzi lokuba ukuqwalasela kuphela kwizifo ezithile alwanele. Ikamva loncedo lwamanye amazwe likukomeleza iibloko zokwakha iinkqubo zempilo: inkxaso-mali, abasebenzi, iinkqubo zolwazi, amatyathanga, kunye nokunikezelwa kwenkonzo. Uqhwithela lwe-Ebola eNtshona Afrika (204-2016) kunye neCHOVID-19 yezandisa olu hlomelo. Imali yeBhanki yehlabathi yePandemic, esungulwe ngo-2022, licebo elitsha lokuxhasa ukukhusela izifo ezimachithi, ukulungiselela, kunye nokuphendula (PPR) kumazwe asezantsi naphakathi afikayo.
Ukwenziwa kwemibutho yasekuhlaleni kunye noLungiselelo olutsha loLuntu loLuntu lwaseAfrika
Enye yezona nkqubela zibalulekileyo kukutyhalela phambili ukwenziwa kwemveliso yempilo yasekuhlaleni eAfrika. Ilizwekazi lingenisa amayeza alo angaphezu kwama-70% kunye nama-99% eepesenti ezixhobo zalo zokugoma. I-Afrikaan Union ibeke usukelo olunelindelo lokuvelisa ama-60% ee-antiums efunekayo kwilizwekazi ngo-2040. Inyathelo elifana ne-Priventene shaftian Vaccine Manufactrificing (PAVM) kunye nophuhliso lobugcisa bokunyanga i-MRNA eMzantsi Afrika lungathath-mswana ekunciphiseni ukuxhomekeka kwabavelisi bemi bamazwe angaphandle nokwakha amandla enzululwazi yasekuhlaleni.
Inkqubo yempilo yamanani kunye neyoluntu
Ubuxhakaxhaka buguqula ukunikezelwa kwempilo yamanani. Iinkqubo zenqwelo-moya (mHealth) zisebenzisa iSMS kunye neecell phone ukuthumela izikhumbuzo zonyango, ugcino-lwazi lomguli olunomzila, kunye nokunika imfundo yempilo. I-Arhente yeNkcubeko yezizwe ngezizwe (USAID) ne-PEPFAR ithenge kakhulu kwimpilo yamanani. Ukunikezelwa kwe-Drafoni, edume kakhulu ngenkampani i-Zipline, izisa igazi, amakhamanti, kunye namayeza kwiindawo ezikude eRwanda naseGhana. Kwiibhinkile, indima yabasebenzi bezonyango (CHWS) iyagqalwa njengesiseko se-Etiyopiya, ngenkqubo yayo yokwandiswando, ibonise ukuba i-Chyldiant, i-anerw ephiweyo, i-ChW i-artdiactive processsssssss.
Ukusetyenziswa kwemali emakhaya nokudluliselwa
Usukelo lwexesha elide lukumazwe aseAfrika ukuxhasa inkqubo yawo yempilo. Oku kufuna ukukhula kwezoqoqosho, iinkqubo zerhafu eziqhubekayo, kunye nokuthanda kwezobupolitika. Kukho ukugxininiswa okukhulayo "kuncedo olusebenzisa izibonelelo zelizwe lonke ezikhoyo. Iimfuno zemali yeGlobal ye-cone-finant, ezigunyazisa ukuba amazwe andise imali yawo yenkcitho yezempilo, ingumzekelo wendlela abanikelayo abanokuyifaka ngayo ubunikazi. Ingxoxo isuka ku "umbutho-okanye noMphathi-mandla" ukuya "umanyano," apho oorhulumente kunye nemicimbi yaseAfrika bakhokela khona ekucwangceni izinto eziphambili kunye nenkxaso ephuma kumaqabane ehlabathi.
Isiphelo
Uncedo lwamanye amazwe luye lwabangela enye yezona nguqulelo zibalulekileyo zempilo kawonke-wonke kwimbali yanamhlanje. Umlo nxamnye neHIV/AIDS, isifo seengcongconi, kunye nesifo sephepha eAfrika uye wadibana ukuze wakhe ubudlelane obungakaze bubonwe ngaphambili, uxhase iinkqubo ezinkulu, kwaye usindise amashumi ezigidi zabantu. Injongo yokuphelisa ezi zifo njengezisongelo zempilo kuluntu olukhulu ngowama-2030, ngoxa kuselucelomngeni olukhulu, isondele kwinyaniso kunanini nangaphambili.
Indlela engaphambili ifuna indaleko kwimodeli yoncedo lwamanye amazwe. Ifuna umanyano oluthe kratya, olulinganayo, oludlula ngaphaya kokuthunyelwa okulula kwemali. Ifuna ukujoliseka ekwakheni, iinkqubo zempilo ezilungiselelwe ekuhlaleni ezinokuphatha izifo zanamhlanje kwaye zilungiselele iindyikitya zokufa zangomso. Isahluko esilandelayo asikoku "kushiya i-Afrika" ngoncedo lwamanye amazwe, kodwa ngokufaka imali kukhuseleko lwempilo lwehlabathi lonke. Impumelelo iza kuchazwa ngotshintsho olungenamthungo olusuka kuxhomekeko loncedo ukuya kwizinto zasekhaya, ukusuka kwiinkqubo ezithe nkqo ukuya kwiinkqubo ezidityanisiweyo, nakwizinto eziphambili ezisetyenziswayo ukuze zifumane izicombululo. Izigidi zobomi zisindisa oko kunokwenziwa ngesenzo, kodwa umsebenzi ude ukugqitywa.