Kwamitin manyan jami'an G20 (HLIP) kan shirye-shiryen barkewar cutar sun yi taro har zuwa shekarar 2025 domin bayar da rahoto mai taken Rufe Yarjejeniyar: Ba da Tallafin Tsaronmu Don Yaƙi da Barazanar Annoba zuwa taron shugabannin G20 na watan Nuwamba a Afirka ta Kudu. Rahoton ya kasance a matsayin ci gaba da rahoton HLIP na 2022 kan Yarjejeniyar Duniya don Zamanin Cutar Mu inda kwamitin ya bayyana kiyasin kuɗinsu na shirye-shiryen da mayar da martani ga annoba (PPPR). Dangane da rage kuɗaɗen tallafin ci gaba ga lafiya (DAH), rahoton na 2025 an yi shi ne don sake nanata buƙatar kuɗin da ake da ita da kuma ƙara matsin lamba ga dukkan ƙasashe don ware ƙarin kuɗin jama'a don ceton ɗan adam daga annobar. Kamar yadda HLIP ta lura:
"Haɗarin annoba na ci gaba da ƙaruwa - wanda duniyarmu da ke da alaƙa da juna, yaduwar cutar dabbobi, rikicin jin kai, da kuma ƙaruwar barazanar bazata da gangan. Barkewar cutar na ƙara bayyana akai-akai..." (HLIP, shafi na 9).
Hakika, zai zama kamar kyakkyawan dalili, amma rahoton kwanan nan daga REPPARE a Jami'ar Leeds ya ga akasin haka ne. Matsalar da ke tattare da wannan bayani, kamar yadda muka takaita a cikin rahoton da kuma a nan, ita ce kawai ba ta da alaƙa da duniyar da G20 ke aiki a ciki. Manufofi, aƙalla kyakkyawan tsari, dole ne su dogara ne akan gaskiya.
Hadarin Annoba
"Duniya mai alaƙa" hakika tana ba da damar wasu ƙwayoyin cuta su yaɗu da sauri, amma ba tare da wani bambanci na gaske a sakamakon da ake tsammani ba. Sabbin nau'ikan mura da sauran ƙwayoyin cuta na numfashi sun bazu a duniya tsawon fiye da ƙarni ɗaya - ba lallai bane sabuwar matsala. Haɗin kai na duniya yana tabbatar da cewa waɗannan ƙwayoyin cuta suna guje wa faɗawa kan manyan mutane tare da rashin cikakken kariya. A wata ma'anar, bala'o'in kyanda da ƙura a lokacin mulkin mallaka na Amurka, Ostiraliya, ko Tsibirin Pacific ba za su sake faruwa ba, aƙalla ba saboda barkewar cutar ta halitta ba.
A taƙaice, manyan abubuwan da suka faru a baya za su ci gaba da wanzuwa a baya. Muna da ingantattun alluran rigakafin zazzabin rawaya, an kawar da cutar ƙanjamau, mun san yadda za mu guji kwalara, kuma maganin rigakafi yana magance annobar bubonic da typhus kamar yadda da sun hana yawancinsu. Mutuwar mura ta SpainBabu ɗaya daga cikin waɗannan da aka ƙalubalanci sosai, tare da babban haɗarin sake bullowa saboda ko dai babban rashin samun damar yin amfani da matakan da aka sani ko kuma daga nau'ikan ƙwayoyin cuta masu jure wa ƙwayoyin cuta waɗanda galibi ke haifar da amfani da magunguna marasa kyau. Shin wata sabuwar cuta za ta taso ne daga yaduwar halitta don haifar da barkewar bala'i kwatsam a duniya? SARS-CoV-2, mafi muni cikin shekaru ɗari, galibi barazana ce ga tsofaffi marasa lafiya, kuma asalinta yana kama da ba a tabbatar da shi ba.
Shin za su taso ne daga dakin gwaje-gwaje? Wataƙila, amma wannan wani labari ne daban da dabarun rigakafi daban. Dabaru da aka yi watsi da su gaba ɗaya a cikin rahoton HLIP na 2022 kan ba da kuɗi ga PPPR kuma tare da ɗan taƙaitaccen ambato a cikin sabon rahotonta na 2025 (watakila rashin ƙarfi, amma sabon yarda da haɗarin tserewa daga dakin gwaje-gwaje).
A kwanakin nan muna ganin barkewar cutar MERS, SARS, mura ta tsuntsaye, kwayar cutar Nipah, da Zika domin muna iya gano su. Kafin shekarar 1980, ba mu da manyan hanyoyin yin hakan - wato gwaje-gwajen PCR, jerin kwayoyin halitta, antigen na kulawa, da gwaje-gwajen serology. Duk da haka, wannan rashin kulawa kusan babu shakka abu ne mai wahala. babban tushe don saurin gudu (ko kuma "ma'ana mai faɗi"") ƙaruwar barkewar cutar da aka ruwaito (musamman a tsakiyar shekarun 1980 bayan ƙirƙirar PCR) wanda ke jagorantar ajandar annobar duniya. Ya bayyana dalilin da ya sa wannan ƙaruwar ta faru. ya fara faruwa a ƙasashe masu ci gaban masana'antu da kuma daga baya a waɗanda ba su da ci gaba sosai a fannin fasaha. Ba wai kawai manyan kwamitin G20 ba, har ma da rahotanni daga Hukumar Lafiya ta Duniya da Bankin Duniya sun yi watsi da wannan gaskiyar domin inganta damar da suke da ita na samun tallafin kuɗi daga ƙasashe.
Haka kuma yana yiwuwa a samar da kimantawa mai ban tsoro game da matsakaicin adadin mutanen da ke mutuwa sakamakon annoba kowace shekara - kamar miliyan 2.5 (jimillar mace-macen tarin fuka sau biyu). Wani kamfani da ke Amurka, Ginkgo Bioworks, ya yi haka kamar yadda tattauna wani wuri, kuma G20 HLIP ta dogara ne akan wannan kimantawa a cikin rahotonsu. Ana samun wannan matsakaicin mace-mace ta hanyar haɗa da annoba ta Tsakiya kamar Mutuwa Baki da sauran barkewar cutar tun lokacin da kimiyya ta ba da shawarar a rataye fure a ƙarƙashin hanci a matsayin mafi kyawun matakin rigakafi. Duk da cewa wasu fannoni na kimiyyar lafiyar jama'a sun ci gaba, ƙirar samfura ba ta yi ba. Yawancin mutane za su iya ganin kuskuren da ke cikin shawarwarin cewa Baƙar fata - wanda ƙudaje ke wucewa ba tare da maganin rigakafi na yau da kullun ba kuma a cikin yanayi mara tsafta - na iya sake faruwa gobe.
Matsalar da ke tattare da wannan samfurin ita ce, ta hanyar haɗa wata cuta ta da ta kashe kashi ɗaya bisa uku na al'umma a lokacin, za ta ƙara yawan matsakaitan bayanai da kuma karkatar da sakamakon sosai. Ko da shekaru uku na farko na Covid-19, bisa ga rahotannin da aka aika wa WHO, ba su kai wannan matsakaicin matakin ba. Duk da haka, irin waɗannan zato da aka yi bisa ga bayanan tarihi marasa wakilci suna haifar da shawarwari ga gwamnatocinmu.
Kudin Annoba
Hukumar HLIP ta yi la'akari da cewa Covid-19 ya kashe dala tiriliyan 13.8 (ko dala biliyan 700 a kowace shekara). Da wannan nau'in kuɗi, kusan duk wani farashi da za a iya tsammani a shirye-shirye da rigakafi ya yi kama da ya cancanci hakan. Wannan na iya zama mafi gamsarwa ga gwamnatoci fiye da mace-mace, amma irin wannan farashin yana ɗauka cewa martanin ya yi tasiri kuma za a maimaita shi a karo na gaba.
Don haka, dala tiriliyan 13.8 da aka kashe yana ɗauka cewa lokaci na gaba da barkewar cutar ta sake faruwa tare da ƙimar mace-mace a cikin kamuwa da cuta. a kusa da 0.15% (kamar mura) da kuma matsakaicin shekarun mutuwa a ƙasashe da yawa na sama da shekaru 80, za mu rufe yawancin wuraren aiki, mu rufe ƙananan kasuwanci, mu rufe makarantun da yara ba su da haɗarin mutuwa, sannan mu dakatar da yawancin tafiye-tafiye da yawon buɗe ido na ƙasashen duniya. Sannan gwamnatocinmu za su buga tiriliyan daloli don tallafi da Ramuwa shirye-shirye.
Kwamitin G20 ya ɗauka cewa hakan gaskiya ne, duk da cewa akwai abubuwa masu kyau sosai. nazarin tsari wanda ke nuna cewa matakan kulle-kullen ba su da wani tasiri ga mace-mace. Kasashe kamar Sweden waɗanda ba su sanya irin waɗannan matakan ba, ko kuma ba su da ɗan takura sosai, sun yi irin wannan sakamakon mace-maceDuk da haka, ƙaruwar talauci, raguwar damar samun kulawar lafiya, tashin hankalin cikin gida, shan muggan kwayoyi, rashin lafiyar kwakwalwa, asarar ilimi, da kuma ƙaruwar auren yara ƙanana da suka taso daga waɗannan martanin za su haifar da sakamako na dogon lokaci ga lafiya da daidaito.
To ta yaya wannan yake da ma'ana? A kowace shekara, Annobar mura ta 1968-69 yana da irin wannan adadin mace-mace, a cikin ƙaramin rukuni, kuma maimakon kulle-kullen da ke kusa da duniya, muna da Woodstock. A da, Lockdown kalma ce da ake amfani da ita a wuraren gano masu laifi musamman ma a wuraren gano waɗanda suka aikata laifuka. an yi jayayya a kai daga WHO a matsayin abin da ke kawo cikas ga lafiya da walwala gaba ɗaya. Amfani da shi a babban matakin jama'a a lokacin Covid-19 abu ne da ba a taɓa ganin irinsa ba, kuma idan bai taimaka sosai ba to babu dalilin sake yin hakan. Wannan ba shakka, yana ɗauka cewa masu tsara manufofinmu za su ɗauki waɗannan bayanai a matsayin hujja, wanda ke neman a yi amfani da shi. ba don haka lamarin ya kasance ba.
Shin Tsarin Tallafin Kuɗi Ya Yi Ma'ana?
Dalilin da ya sa aka gabatar da sabon rahoton HLIP ga G20 shine jinkirin amsa buƙatun tallafin kuɗi na PPPR zuwa yanzu. Duk da ƙoƙarin shawo kan ƙasashe su ware kuɗi. Dala biliyan 31.1 don yaƙi da annobar korona da kuma wani $ 10 + biliyan kan shirye-shiryen One Health masu alaƙa, kuɗaɗen gwamnati sun yi kasa a gwiwa a kan maganganu masu alaƙa. HLIP ta gabatar da shawarar ware kashi 0.1 zuwa 0.2% na Jimlar Kuɗin Shiga Cikin Gida (GDP) daga kowace ƙasa da aka ware wa PPPR, da kuma wani kashi 0.5 zuwa 1% na kasafin kuɗin soja.
Ba sabon abu ba ne ga hukumomin kiwon lafiyar jama'a su bayar da shawarwari kan yadda ƙasashe ke ware kasafin kuɗin soja, kuma wannan yana haifar da tambayoyi game da yadda za a ware irin wannan kuɗaɗen, da kuma ko fifikon lafiyar jama'a zai zama abin da zai yanke shawara maimakon fifikon soja. Duk da haka, tare da shawarar da aka bayar dangane da GDP, hakan kuma yana ƙara haifar da damuwa.
Bugu da ƙari, mummunan tasirin da ake samu daga sake mayar da kashi 0.1 zuwa 0.2% na GDP na cikin gida don shirye-shiryen annoba yana da yawa. Na farko, sadaukar da waɗannan kuɗaɗen ga PPPR zai karkatar da ƙarancin albarkatu daga abubuwan da aka sani na kiwon lafiya, musamman yana shafar ƙasashe masu ƙarancin albarkatu waɗanda suka riga suka yi fama da samar da ayyukan kiwon lafiya. Na biyu, yana haɓaka tsarin 'girma ɗaya-ɗaya', duk da cewa ƙasashe suna da buƙatu daban-daban na kiwon lafiya (nauyin cututtuka) da abubuwan da ke ƙayyade lafiya (matsakaicin shekarun jama'a, matakin talauci, muhalli, matakan tsafta, da sauransu).
Misalai a nan suna da amfani. A Jamhuriyar Dimokuradiyyar Kongo (DRC), fiye da yara 60,000 mace-mace kowace shekara daga zazzabin cizon sauro - duk za a iya hana su idan za a iya samar da ingantattun hanyoyin gano cututtuka da magani na yanzu da kuma masu araha. Rashin abinci mai gina jiki yana rage juriyar mutane miliyan 106 daga cututtuka daban-daban, kuma tsawon rai a lokacin haihuwa yana raguwa. 62 shekaru da GDP ga kowane mutum kimanin dala 1,650 na AmurkaWannan babban ci gaba ne idan aka kwatanta da shekaru 25 da suka gabata, kuma yana da rauni, inda cututtukan da ke yaɗuwa har yanzu ke zama babban sanadin mutuwa. Tsawon rayuwar mutane miliyan 5,5 a Norway shine 21 shekaru fiyekuma GDP ya ƙare 84,000 kowane mutumDon ba da shawarar cewa mutanen DRC ya kamata su karkatar da albarkatu daga waɗanda aka sani suna da alhakin tsawon rai kuma su shiga cikin wani yunƙuri na ƙasashen yamma don inganta shirye-shiryen Pharma don magance cututtukan da ba a saba gani ba waɗanda galibi ke shafar su. tasiri ga tsofaffi ba wata hanya ce da aka samo daga ƙa'idodin lafiyar jama'a da aka yarda da su ba.
Bugu da ƙari, akwai damuwa game da ƙarfafa alaƙa tsakanin sojoji da lafiya, wanda za a iya cewa zai ƙara inganta tsaron lafiya. Kamar yadda ake yawan yi. an yi nuni a cikin littattafan ilimi, tsaro yana haifar da barazana da yawa kuma yana haifar da ƙarancin albarkatu zuwa takamaiman matsalolin tsaro tare da rage buƙatun lafiyar jama'a. Hakanan yana fifita hanyoyin likitanci da na kayayyaki don kiwon lafiya, yana haifar da tasirin da ba a so wanda ke yin watsi da cututtuka masu yaduwa da kuma abubuwan da ke haifar da rashin lafiya a sama.
A ƙarshe, kamar yadda aka ambata a sama, babban gibin rahotannin HLIP guda biyu shine gaskiyar cewa babu wani bambanci tsakanin kuɗaɗen kai tsaye na amsawar annoba (asibiti, kayan aikin likita, magunguna, da sauransu) da kuɗaɗen kai tsaye na martanin Covid-19 (rashin kuɗi, tanadin jin daɗi, fakitin ƙarfafa gwiwa, asarar GDP, da sauransu). Sakamakon haka, ƙimar dala tiriliyan 13.8 na annobar da HLIP ta kiyasta ta yi la'akari da cewa duk waɗannan kuɗaɗen sun zama dole ga duk wani martanin annoba a nan gaba, ba tare da ɗan tunani game da yadda yawancin waɗannan kuɗaɗen suka jawo wa kansu, ba dole ba ne, kuma galibi ba su da amfani.
Kamar yadda Ya kasance
Wannan rahoton HLIP na biyu abin takaici ne domin babu shakka zai yi tasiri ga rabon albarkatun gwamnati a fannin kiwon lafiyar jama'a na duniya, yayin da ya gaza cika ka'idojin da ya kamata a bi don irin waɗannan shawarwari. Yana amfani da ma'auni don haɗarin da ba su yi la'akari da batutuwa na asali kamar canje-canjen zamantakewa tun zamanin Tsakiyar Zamani da ƙirƙirar kayan aikin bincike da sadarwa na zamani ba. Ya ambaci irin waɗannan batutuwa kamar ƙaruwar motsin ɗan adam kawai a cikin mahallin haɗari, yin watsi da rashin yawan jama'a masu garkuwa da mutane na zamani. Yana kashe bala'o'i na gaba bisa ga farashin kai tsaye da na kai tsaye na martanin Covid-19 wanda ya fi tsada fiye da hanyoyin da suka gabata ba tare da fa'ida a fili a rage cututtuka ba. A ƙarshe, ya yi watsi da matsalar yawancin al'ummomi da ke da manyan nauyin kiwon lafiya don magancewa wanda babu shakka zai sha wahala daga karkatar da albarkatu zuwa hanyar PPPR da HLIP ke fafutukar yi. Ba annoba mai tsanani ba ce ke haifar da rashin daidaito a sakamakon lafiya, kuma PPPR ba za ta magance su da ma'ana ba.
Duniya tana buƙatar hanyar magance annoba da annoba da ke cikin faffadan fannin kiwon lafiyar jama'a da kuma muhimman abubuwan da suka shafi al'umma. An yi nufin lafiyar jama'a ta duniya don inganta daidaito da rage rashin daidaito, tare da fahimtar buƙatun al'umma daban-daban don yin hakan. Akwai lokacin da burin Alma Ata, na magance matsalar kulawa ta farko da kuma muhimman abubuwan da ke haifar da walwala, sun haifar da lafiyar jama'a. Idan ƙasashen G20 suka nemi duniya mai kwanciyar hankali da juriya, mataki mai sauƙi na dawo da tsarin lafiyar jama'a ga shaida da gaskiya zai iya zama mataki na gaba.
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REPPARE (Sake kimanta Shirye-shiryen Cutar Kwayar cuta Da Ajandar Amsa) ya ƙunshi ƙungiyar darussan da yawa da Jami'ar Leeds ta kira.
Garrett W. Brown
Garrett Wallace Brown shine Shugaban Manufofin Lafiya na Duniya a Jami'ar Leeds. Shi ne Co-Jagoran na Sashen Bincike na Lafiya na Duniya kuma zai zama Darakta na sabuwar Cibiyar Haɗin gwiwar WHO don Tsarin Lafiya da Tsaron Lafiya. Binciken nasa ya mayar da hankali kan gudanar da harkokin kiwon lafiya na duniya, ba da kuɗaɗen kiwon lafiya, ƙarfafa tsarin kiwon lafiya, daidaiton lafiya, da ƙiyasin farashi da yuwuwar bayar da tallafi na shirye-shiryen rigakafin cutar da martani. Ya gudanar da manufofi da haɗin gwiwar bincike a cikin lafiyar duniya fiye da shekaru 25 kuma ya yi aiki tare da kungiyoyi masu zaman kansu, gwamnatoci a Afirka, DHSC, FCDO, Ofishin Majalisar Dinkin Duniya na Birtaniya, WHO, G7, da G20.
David Bell
David Bell likita ne na asibiti da lafiyar jama'a tare da PhD a cikin lafiyar jama'a da asali a cikin likitancin ciki, ƙirar ƙira da cututtukan cututtukan cututtuka. A baya can, ya kasance Darakta na Fasahar Kiwon Lafiya ta Duniya a Asusun Intellectual Ventures Global Good Fund a Amurka, Shugaban Shirin Malaria da Cutar Cutar Kwalara a Gidauniyar Innovative New Diagnostics (FIND) a Geneva, kuma ya yi aiki a kan cututtuka masu yaduwa da daidaita dabarun gano cutar zazzabin cizon sauro a Hukumar Lafiya ta Duniya. Ya yi aiki na tsawon shekaru 20 a fannin kimiyyar halittu da lafiyar jama'a na duniya, tare da wallafe-wallafe sama da 120. David yana zaune a Texas, Amurka.
Blagovesta Tacheva
Blagovesta Tacheva ƙwararren mai bincike ne na REPPARE a Makarantar Siyasa da Nazarin Duniya a Jami'ar Leeds. Tana da PhD a cikin Harkokin Ƙasashen Duniya tare da gwaninta a ƙirar cibiyoyi na duniya, dokokin kasa da kasa, 'yancin ɗan adam, da martanin jin kai. Kwanan nan, ta gudanar da bincike na hadin gwiwa na WHO game da shirye-shiryen cutar sankara da kiyasin farashin mayar da martani da yuwuwar samar da sabbin hanyoyin samar da kudade don saduwa da wani yanki na wannan kiyasin. Matsayinta a cikin ƙungiyar REPPARE shine ta bincika shirye-shiryen cibiyoyi na yanzu waɗanda ke da alaƙa da shirye-shiryen balaguron balaguro da ajandar mayar da martani da kuma tantance dacewarta ta la'akari da nauyin haɗari da aka gano, farashin dama da sadaukarwa ga wakilci / yanke shawara mai adalci.
Jean Merlin von Agris
Jean Merlin von Agris dalibi ne na REPPARE wanda ke samun tallafin PhD a Makarantar Siyasa da Nazarin Duniya a Jami'ar Leeds. Yana da digiri na biyu a fannin raya tattalin arziki tare da sha'awar ci gaban karkara na musamman. Kwanan nan, ya mai da hankali kan yin bincike kan iyaka da tasirin ayyukan da ba na magunguna ba yayin bala'in Covid-19. A cikin aikin REPPARE, Jean zai mai da hankali kan tantance zato da kuma ƙwaƙƙwaran tushen shaida da ke ƙunshe da shirye-shiryen balaguron bala'in duniya da ajandar mayar da martani, tare da mai da hankali musamman kan abubuwan da ke haifar da jin daɗi.
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