Trends Parasitol. 2012 Jun;28(6):231-8. doi: 10.1016/j.pt.2012.03.002. Epub 2012 Apr 12.
Whether global health interventions target diseases (vertical), systems (horizontal) or both (diagonal), they must address the challenge of delivering services in very remote areas of poor countries with inadequate infrastructure. The primacy of this challenge has been underscored by persistent service-delivery difficulties despite several large financial commitments - the latest, US $363 million in the January 2012 London Declaration. Community-driven approaches, pioneered in river blindness control, show that engaging communities can maximise access and performance. This experience should inform a paradigm shift in disease control whereby communities are empowered to extend health service access themselves.
无论全球卫生干预措施针对的是疾病（纵向）、系统（横向）还是两者（对角），它们都必须应对在基础设施不足的贫穷国家非常偏远地区提供服务的挑战。尽管做出了几项重大的财政承诺，包括 2012 年 1 月《伦敦宣言》中的最新承诺 3.63 亿美元，但持续存在的服务提供困难凸显了这一挑战的重要性。以河盲症控制为先导的社区驱动方法表明，让社区参与可以最大限度地提高获得服务和提高绩效。这一经验应该为疾病控制带来范式转变，使社区有能力自行扩大获得卫生服务的机会。
