【布鲁金斯学会·北非】 全新的美国优先全球健康战略可能侵蚀多年成果

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总统紧急救援艾滋病计划（PEPFAR）于2003年在时任总统乔治·W·布什（George W. Bush）任内启动。截至2024年底，该计划已挽救了超过2500万人的生命，支持了21万人的治疗，防止了780万名婴儿感染艾滋病毒/艾滋病，资助了660万名艾滋病孤儿及其抚养人，并增强了受援国的应对大流行准备能力，而其成本尚不到美国2024财年政府总支出的0.08%。PEPFAR被广泛认为是一项……\n\n这一进展目前正受到威胁。2025年7月1日，美国国际开发署（USAID）正式解散，其剩余职能并入国务院，这标志着通过专门的发展机构提供超过60年的美国全球卫生援助（包括PEPFAR）宣告结束。此前拨款给美国国际开发署用于卫生项目的资金被转移至国务院——但缺乏庞大、专业、基于一线的美国政府……\n\n人道主义后果已经显现。2025年的资金中断导致全球接受艾滋病毒检测的人数下降了22%，检测出的新感染病例有所上升。在赞比亚，美国国际开发署曾是PEPFAR的主要实施机构，当地卫生官员报告称艾滋病毒感染率上升，并将其归咎于检测和预防项目的削减。在乌干达拉凯（Rakai），研究人员在那里监测艾滋病毒趋势已有二十多年，PEPFAR资助的……

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The President’s Emergency Plan for AIDS Relief (PEPFAR) was initiated in 2003 under President George W. Bush. As of end-2024, the program had saved over 25 million lives, supported treatment for 21 million people, prevented 7.8 million babies from contracting HIV/AIDS, supported 6.6 million AIDS orphans and their caregivers, and strengthened pandemic preparedness in recipient countries, all at a cost of less than 0.08% of total U.S. FY 2024 government spending. PEPFAR is widely regarded as one o

This progress is now threatened. On July 1, 2025, the U.S. Agency for International Development (USAID) was formally dissolved, with its remaining functions absorbed into the State Department, ending more than 60 years of U.S. global health assistance (including PEPFAR) delivered through a dedicated development agency. Funding that was previously appropriated to USAID for health programming was transferred to the State Department—but without the large, professional, field-based U.S. government (

The human consequences are already becoming visible. Funding disruptions in 2025 were associated with a 22% decline in the number of people tested for HIV globally and a rise in new infections detected. In Zambia, where USAID was the primary PEPFAR implementer, health officials report rising HIV infection rates and a growing emergency that they associate with cuts to testing and prevention programs. In Rakai, Uganda, where researchers have monitored HIV trends for more than two decades, PEPFAR-f

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来源：Brookings Africa in Focus (https://www.brookings.edu/blog/africa-in-focus/)
原文链接：https://www.brookings.edu/articles/the-new-america-first-global-health-strategy-could-erode-years-of-progress-under-pepfar/
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