Moerman F, Lengeler C, Chimumbwa J, Talisuna A, Erhart A, Coosemans M, D'Alessandro U
Institute of Tropical Medicine, Antwerp, Belgium.
Lancet Infect Dis. 2003 Feb;3(2):99-102. doi: 10.1016/s1473-3099(03)00518-8.
HIV and AIDS, tuberculosis, and malaria, besides presenting a large mortality and morbidity burden in developing countries, are also responsible for poor economic development. In the past international agencies devoted resources and efforts to control malaria and other diseases without taking into account health-system performance and sustainability. Even assuming that the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM)--a recent international initiative--would provide the necessary funds, a poorly performing health-care system will not be able to use these funds optimally. Moreover, even if all interventions are cost-effective, their impact on mortality and morbidity will only be marginal if access to proper care is not guaranteed. It is the responsibility of scientists and health managers to highlight to donor agencies the importance of an accessible and well functioning health-care system at all levels for the control of specific diseases.
除了在发展中国家造成巨大的死亡率和发病率负担外，艾滋病毒和艾滋病、结核病以及疟疾还导致经济发展不佳。过去，国际机构投入资源和精力控制疟疾及其他疾病，却未考虑卫生系统的绩效和可持续性。即便假设抗击艾滋病、结核病和疟疾全球基金（全球基金）——一项近期的国际倡议——会提供必要资金，但表现不佳的卫生保健系统也无法最佳地利用这些资金。此外，即便所有干预措施都具有成本效益，但如果无法保证获得适当护理，它们对死亡率和发病率的影响也将微乎其微。科学家和卫生管理人员有责任向捐助机构强调各级可及且运转良好的卫生保健系统对于控制特定疾病的重要性。
