MMWR Morb Mortal Wkly Rep. 2023 Jan 27;72(4):90-94. doi: 10.15585/mmwr.mm7204a2.
On January 28, 2003, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the largest commitment by any nation to address a single disease in history, was announced.* In April 2004, the first person in the world to receive PEPFAR-supported antiretroviral therapy (ART) was a man aged 34 years in Uganda. Effective ART reduces morbidity and mortality among persons with HIV infection (1) and prevents both mother-to-child transmission (MTCT) (2) and sexual transmission once viral load is suppressed to undetectable levels (<200 viral copies/mL) (3). By September 2022, more than 1.3 million persons with HIV infection in Uganda were receiving PEPFAR-supported ART, an increase of approximately 5,000% from September 2004. As indicators of the ART program's effectiveness, a proxy MTCT rate decreased 77%, from 6.4% in 2010 to 1.5% in 2022, and the viral load suppression rate (<1,000 viral copies/mL) increased 3%, from 91% in 2016 to 94% in September 2022. During 2004-2022, ART scale-up helped avert nearly 500,000 HIV infections, including more than 230,000 infections among HIV-exposed infants, and approximately 600,000 HIV-related deaths. Going forward, efforts will focus on identifying all persons with HIV infection and rapidly linking them to effective ART. PEPFAR remains committed to continued strong partnership with the Government of Uganda, civil society, and other development partners toward sustainable solutions aligned with the Joint United Nations Programme on HIV/AIDS (UNAIDS) fast-track strategy to ending the global AIDS epidemic by 2030 and safeguarding impact achieved in the long term.
2003 年 1 月 28 日，美国艾滋病救援总统紧急计划（PEPFAR）宣布，这是历史上任何一个国家对单一疾病的最大承诺。2004 年 4 月，世界上第一个接受 PEPFAR 支持的抗逆转录病毒疗法（ART）的人是乌干达的一名 34 岁男子。有效的 ART 降低了 HIV 感染者的发病率和死亡率（1），并防止了母婴传播（MTCT）（2）和一旦病毒载量被抑制到无法检测的水平（<200 拷贝/mL）（3）就发生的性传播。截至 2022 年 9 月，乌干达已有超过 130 万人接受了 PEPFAR 支持的 ART，比 2004 年 9 月增加了约 5000%。作为该计划有效性的指标，一个替代的 MTCT 率下降了 77%，从 2010 年的 6.4%降至 2022 年的 1.5%，病毒载量抑制率（<1,000 拷贝/mL）上升了 3%，从 2016 年的 91%上升到 2022 年 9 月的 94%。在 2004 年至 2022 年期间，ART 的扩大帮助避免了近 50 万例 HIV 感染，包括 23 万多名 HIV 暴露婴儿的感染，以及大约 60 万例与 HIV 相关的死亡。今后，将重点努力发现所有 HIV 感染者，并迅速将他们与有效的 ART 联系起来。PEPFAR 仍然致力于与乌干达政府、民间社会和其他发展伙伴继续保持强有力的伙伴关系，以实现与联合国艾滋病规划署（UNAIDS）快速通道战略相一致的可持续解决方案，该战略旨在到 2030 年结束全球艾滋病流行，并确保长期取得的成果得到保障。
