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巴西里约热内卢 — 在我们回到埋葬死者的阶段之前，计划是什么？\n\n当南非医护人员Belinda Tewela在里约热内卢举行的国际艾滋病会议上接过麦克风时，她没有谈论数十亿美元的资金缺口或国际政策。\n\n同时也是一名HIV携带者的Tewela说：等待时间变长了。医疗机构的人员短缺是真实存在的。像Anova这样的组织曾填补了巨大的空白，而现在他们离开了。这导致我们获得的医疗服务质量正在下降。\n\n对Tewela而言，美国对HIV项目支持的缩减带来的影响已不再是一个抽象的政策辩论。每次她去诊所时都能看到这一点，更长的排队队伍、更少的医护人员以及公共卫生设施日益增加的压力已成为新的现实。\n\n在她回到埋葬死者的阶段之前，计划是什么？她问道。作为一个HIV携带者，这真的很可怕。\n\n她的问题悬在会议其余部分的上方——这次会议的部分目的，是为了审视在美总统艾滋病紧急救援计划（PEPFAR）进行全面削减之后的非洲艾滋病应对情况。该计划在过去二十多年里一直是支撑该大陆艾滋病应对工作的主要力量。\n\n对南非而言，利害关系尤为重大。作为全球最大艾滋病治疗项目的所在地，该国在扩大抗逆转录病毒疗法获取和减少艾滋病相关死亡方面取得了显著进展。尽管政府为大部分艾滋病药物提供资金，但多年的PEPFAR投资支持了数千名医护人员、社区组织、艾滋病预防项目、研究工作以及针对关键人群的专业服务。随着这一支持的收缩，当地的健康状况

中文导读

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非洲各国正艰难应对美国（United States）资金大幅削减带来的冲击，这些削减已扰乱了治疗、预防、研究以及社区健康等各类项目。诊所纷纷关闭，预防项目规模已缩减，研究陷入停滞。数千民众已开始失去获得服务的机会，而这些服务直到最近他们还习以为常。



原文原文 / Original Text

Rio de Janeiro, Brazil — "What is the plan before we get back to a stage where we are burying people?"

When Belinda Tewela, a South African healthcare worker, took the microphone at the International AIDS Conference in Rio de Janeiro, she did not speak about billion-dollar funding gaps or international policy.

"The waiting time has increased. The shortages of staff in facilities are real," said Tewela, who also lives with HIV. "There were people from organisations like Anova who filled a huge gap, and now they're gone. That results in the quality of healthcare services that we're getting declining."

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For Tewela, the impact of shrinking United States support for HIV programmes is no longer an abstract policy debate. It is visible every time she visits a clinic, where longer queues, fewer healthcare workers and growing pressure on public health facilities have become the new reality.

"What is the plan before we get back to a stage where we are burying people?" she asked. "As a person living with HIV, it's really scary."

Her question hung over the rest of the session - a session convened, in part, to examine Africa's HIV response in the wake of sweeping cuts to the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the programme that has underpinned much of the continent's HIV response for more than two decades.

For South Africa, the stakes are especially high. Home to the world's largest HIV treatment programme, the country has made remarkable progress in expanding access to antiretroviral therapy and reducing AIDS-related deaths. While the government finances most HIV medicines, years of PEPFAR investment have supported thousands of healthcare workers, community organisations, HIV prevention programmes, research studies and specialised services for key populations. As that support contracts, health of

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