University of Colorado, Aurora, 80045, USA.
AIDS. 2010 Sep 10;24(14):2145-9. doi: 10.1097/QAD.0b013e32833cbb41.
The Obama administration has unveiled a new 6-year, $63 billion Global Health Initiative. In addition to the reauthorization of the President's Emergency Plan for AIDS Relief (PEPFAR) to fund HIV/AIDS, tuberculosis, and malaria, the plan also supports maternal and child health (MCH) initiatives that are rooted in a proposal known as the Mother and Child Campaign. The architects of the Obama administration's Global Health Initiative recommend funding the Mother and Child Campaign at the expense of future funding increases for PEPFAR. The idea that differing global health initiatives must compete with each other lacks not only ethical legitimacy but also scientific merit. We believe that MCH need not to be framed in opposition to PEPFAR. Confronting illness in isolation - whether by funding PEPFAR at the expense of programs that target MCH or vice versa - cannot be our way forward. Given the intimate connection between HIV/AIDS and MCH, we affirm supporting PEPFAR and MCH programs together. We argue that policies that de-emphasize PEPFAR threaten to undermine, rather than support, MCH in countries with high HIV/AIDS prevalence. PEPFAR has directly and indirectly supported the care and treatment of other milieu specific diseases, including those afflicting mothers and children, bringing about broad benefits to the primary healthcare systems of recipient countries. We advocate the vertical integration of MCH initiatives into PEPFAR in order to create a comprehensive approach to addressing MCH against the global backdrop of HIV/AIDS.
奥巴马政府公布了一项新的六年、六十亿美元的全球健康倡议。除了重新授权总统艾滋病紧急救援计划（PEPFAR）以资助艾滋病毒/艾滋病、结核病和疟疾外，该计划还支持以“母婴运动”为基础的母婴健康倡议。奥巴马政府全球健康倡议的设计者建议以牺牲未来 PEPFAR 资金增加为代价，为“母婴运动”提供资金。认为不同的全球健康倡议必须相互竞争的观点不仅缺乏伦理合法性，而且也没有科学价值。我们认为，母婴健康不必与 PEPFAR 相对立。孤立地对抗疾病——无论是以牺牲针对母婴健康的方案为代价来资助 PEPFAR，还是反之——都不能成为我们前进的方向。鉴于艾滋病毒/艾滋病和母婴健康之间的密切关系，我们肯定会共同支持 PEPFAR 和母婴健康方案。我们认为，不重视 PEPFAR 的政策有可能破坏而不是支持高艾滋病毒/艾滋病流行国家的母婴健康。PEPFAR 直接和间接地支持了其他特定环境疾病的护理和治疗，包括影响母亲和儿童的疾病，给受援国的初级卫生保健系统带来了广泛的好处。我们主张将母婴健康倡议纳入 PEPFAR 的垂直整合，以便在艾滋病毒/艾滋病的全球背景下制定全面的母婴健康应对措施。
