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通过群众运动控制麻风病:“技术转让的一个新概念”

Leprosy control by a people's program: "a new concept in technology transfer".

作者信息

Antia N H

出版信息

Int J Health Serv. 1987;17(2):327-31. doi: 10.2190/Q3UT-7U6V-JR78-J7WD.

Abstract

Leprosy is a major health hazard in tropical countries as it also is in China. All programs for the control of this disease have been based on the cheap, effective, and low-toxicity antileprosy drug Dapsone (DDS), available since the early 1950s. The emphasis has been on early detection and regularity of treatment, which has to be maintained for several years, if not a lifetime. Despite the availability of what might be rightly termed the "magic bullet," World Health Organization (WHO) figures demonstrate that leprosy has not been controlled in most countries and is generally on the increase. Blame has been ascribed to the patients for hiding the disease and for irregularity of treatment. Emphasis has now shifted to high-technology research to evolve more expensive and much more difficult multidrug regimens and an antileprosy vaccine. China, isolated from the rest of the world and using only simple DDS therapy, but ensuring its use through its barefoot doctor approach, has shown a reduction of leprosy cases from 500,000 to 100,000 in the past three decades. The author suggests that the world, including WHO, should learn from the experience of China rather than try to impose its own low effective and more expensive high-technology approach on this country.

摘要

麻风病在热带国家以及中国都是一个主要的健康危害。自20世纪50年代初以来,所有控制这种疾病的项目都基于廉价、有效且低毒的抗麻风病药物氨苯砜(DDS)。重点一直是早期发现和规律治疗,这种治疗必须持续数年,如果不是终身的话。尽管有了可以被恰当地称为“神奇子弹”的药物,但世界卫生组织(WHO)的数据表明,在大多数国家麻风病并未得到控制,而且总体上还在增加。人们将其归咎于患者隐瞒病情和治疗不规律。现在重点已转向高科技研究,以研发更昂贵且困难得多的联合用药方案以及一种抗麻风病疫苗。中国与世界其他地区隔绝,仅使用简单的氨苯砜疗法,但通过其赤脚医生模式确保了该药物的使用,在过去三十年里麻风病病例已从50万减少到10万。作者建议,包括WHO在内的全世界应该借鉴中国的经验,而不是试图将其自身低效且更昂贵的高科技方法强加给这个国家。

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