Hargreaves Sally
The Lancet, 32 Jamestown Road, London NW1 7BY, UK.
Lancet. 2002 Jun 8;359(9322):2030-5. doi: 10.1016/S0140-6736(02)08826-8.
Nigeria, once heralded as the beacon of Africa, has fallen somewhat short of this potential. Years of kleptocratic repressive dictators and military rule, coupled with widespread corruption, have resulted in large-scale neglect and deterioration of public services. Nowhere is this more apparent than within the health sector. Government-run health-care services barely function: half the population are unvaccinated for routine diseases, and a burgeoning epidemic of HIV/AIDS, only now being adequately addressed, leaves 3.5 million already infected and without access to the most basic of care. A poorly structured health service that relies on vertical programmes for HIV, tuberculosis, and malaria, means that coordination is chaotic, and already scant resources fail to reach the lower levels in which they are needed most. I visited Nigeria in October, 2001, with Médecins Sans Frontières, a humanitarian aid organisation that has been working in Nigeria since 1996. I witnessed the poor level of health care in Nigeria for myself--a country that is more than capable of providing effective services--and concluded that, even now, political priorities are being put ahead of the population's basic needs. The challenges to the new civilian government are monumental, and it is yet to show any solid commitment to improving the health of Africa's biggest nation.
尼日利亚曾被誉为非洲的灯塔，但在某种程度上却未能发挥出这种潜力。多年的盗贼统治、镇压性独裁者统治和军事统治，再加上普遍存在的腐败现象，导致公共服务遭到大规模忽视并不断恶化。这在卫生部门体现得最为明显。政府运营的医疗服务几乎无法正常运转：一半人口未接种常规疾病疫苗，而艾滋病病毒/艾滋病疫情不断蔓延，目前才得到适当应对，已有350万人感染且无法获得最基本的护理。结构不良的卫生服务依赖于针对艾滋病毒、结核病和疟疾的垂直项目，这意味着协调混乱，本就稀缺的资源无法送达最需要的基层。2001年10月，我随无国界医生组织访问了尼日利亚，该人道主义援助组织自1996年以来一直在尼日利亚开展工作。我亲眼目睹了尼日利亚糟糕的医疗水平——这个国家完全有能力提供有效的服务——并得出结论，即使在现在，政治优先事项仍被置于民众的基本需求之上。新文官政府面临的挑战是巨大的，而且尚未表现出任何改善这个非洲最大国家健康状况的坚定承诺。
