Gabatarwa
Duniyar lafiya ta duniya tana kokawa. Tsawon shekaru biyu da rabi da suka gabata, ya dogara ne kan tsarin samar da kudade na ci gaba, wanda aka samo daga masu biyan haraji da masu saka hannun jari na kasashe masu arziki, ta hanyar kungiyoyin tsaka-tsaki wadanda galibinsu ke aiki daga kasashe guda zuwa kasashe masu karba wadanda ke da karancin kudin shiga da karancin kayayyakin kiwon lafiya. Wannan samfurin ya ceci rayuka, duk da haka ya gina dogaro daga tsarin kiwon lafiya na ƙasashen da aka karɓa da kuma daga sojojin ma'aikata masu albashi da ƙungiyoyi masu zaman kansu, waɗanda suka ci gaba daga manyanta. Ba zato ba tsammani da gwamnatin Amurka ta yi wa hukumar ba da agaji ta duniya USAID, da rage tallafin da take baiwa Hukumar Lafiya ta Duniya da GAVI (Hukumar Alurar riga kafi) ya jefa al'ummar duniya cikin fargaba.
Yawancin martani mara kyau ne. Tsohuwar shugabar hukumar ta USAID Samantha Power kwanan nan ya gaya wa CNN cewa guguwar USAID, wanda ke haifar da yanke "tsarin ceton rai," na iya haifar da mutuwar miliyoyin mutane a duniya. Sakon a bayyane yake - an magance barkewar cutar Ebola ta yammacin Afirka saboda taimakon USAID, don haka kare Amurkawa daga Ebola. Bugu da ari, miliyoyin yara za su mutu sakamakon zazzabin cizon sauro saboda USAID ba ta ceto su. Bisa ga dukkan alamu an samu raguwar mace-macen kananan yara a shekarun baya-bayan nan saboda kudaden kasashen waje, musamman na USAID da Mista Bill Gates, yayin da aka ceci rayuka miliyan 25 daga cutar kanjamau ta hanyar tallafin gwamnatin Amurka.
Ra'ayi na kwanan nan a cikin mujallar kimiyya PLOS Lafiyar Jama'a ta Duniya yana nuna irin wannan ra'ayi. Ooms et al. yayi kira ga al'ummar duniya da su kare martanin duniya game da cutar HIV, tarin fuka da zazzabin cizon sauro a yayin da kasar Amurka (Amurka) ta rage kudaden tallafi na baya-bayan nan. Marubutan sun yi iƙirarin cewa dole ne wasu ƙasashe su cika gibin da aka samu, musamman don sake cika shekara ta 2027-2029 na asusun duniya don yaƙi da cutar kanjamau, zazzabin cizon sauro da tarin fuka (GFATM), tunda GFATM ya dogara sosai kan tallafin Amurka. Don tallafawa wannan kiran taron, marubutan suna jayayya cewa HIV/AIDS, zazzabin cizon sauro, da tarin fuka, barazana ce ga lafiyar duniya da ke buƙatar ci gaba da aiki tare. 'Rage irin wannan aikin gama gari,' in ji su, 'yana sa duniya ta zama ƙasa da aminci ga kowa.'
HIV/AIDS, zazzabin cizon sauro, da tarin fuka sun kasance manyan cututtuka guda uku masu yaɗuwa, suna kashe miliyoyin mutane a kowace shekara tare da tasirin tattalin arziki mai mahimmanci, kuma ko shakka babu kuɗin yammacin duniya yana rage cutar da su. Bugu da ƙari, manufofin taimakon ya kamata a ɗaure su zuwa mafi girman nauyin cututtuka, irin waɗannan. Suna kuma buƙatar haɓaka mallakin gida, daidaitacce, inganci, inganci, da amsa daidai. Haɓaka haɓaka ƙarfin gida da na ƙasa da dorewa.
Anan abin damuwa ya ta'allaka ne. Idan, kamar yadda aka yi iƙirari, janye tallafin a yanzu zai sami irin wannan tasiri cikin sauri da ɓarna, to shekaru da yawa yayin da aka sayo da isar da kayayyaki, ba a iya gina ƙarfin sarrafa nauyin cututtuka a matakin gida da na ƙasa ba. Samfurin, yayin da yake da kyau wajen daidaita ramuka, ya kasance mai rauni sosai. Neman karkatar da kuɗaɗe iri ɗaya kawai zuwa fiye da ɗaya, bayan fiye da shekaru ashirin na yin iri ɗaya, yana nuna gazawar tsarin kiwon lafiya na duniya. Dogaro na dindindin shine rashin adalci. Kamar yadda muke jayayya a ƙasa, iƙirarin nasarorin da aka samu a tsaron lafiyar al'ummar (s) masu ba da gudummawa suma sun dogara ne akan ƙasa mai girgiza.
Tsaron Lafiya daga Me?
Ooms et al. gardama, kuma Samantha Power na nuni da cewa rashin aiki kan gano bullar cutar HIV/AIDS, zazzabin cizon sauro, da tarin fuka ya sa duniya ta zama ƙasa da aminci ga kowa da kowa. Wannan magana ta kwatanta wani sanannen magana a cikin rigakafin cutar ta duniya, shirye-shirye, da martani (PPPR) ƙamus; wato 'babu wanda ya tsira sai kowa ya tsira.' Bayanan irin waɗannan suna da manufa mai matukar tsaro da kuzari, haɓaka sha'awar gama gari ta hanyar roƙon kai tsaye don kiyaye kai.
Duk da haka, irin waɗannan ikirari suna sau da yawa rashin daidaito da wuce gona da iri.
Na farko, a cikin yanayin GFATM, 71% na sa kudi fayil Ana ba da umarnin zuwa yankin kudu da hamadar Saharar Afirka (kamar yadda mafi yawan tallafin USAID ga waɗannan cututtuka), wanda ke da kashi 95% na duk mace-mace daga zazzabin cizon sauro, kashi 70% na mace-mace daga cutar kanjamau, da kashi 33% na duk mace-mace daga tarin fuka. Kodayake illar cututtukan guda uku suna wakiltar haɗarin tsaro a matsayin masu tabbatar da rashin zaman lafiya a siyasance, gazawar tattalin arziƙi, da haɗin kan al'umma, sun kasance cikin ƙaƙƙarfan yanki. Bugu da ƙari, duk da tasirin yanayi akan kewayon vector, ƙasashe masu zafi da ƙasashe masu zafi suna ci gaba da samun ci gaba rage nauyin zazzabin cizon sauro yayin da sauran yankuna ke ci gaba da gazawa. Wannan shi ne saboda cututtuka guda uku suna da alaƙa da talauci da rashin aiki na tsarin kiwon lafiya. Don haka, suna wakiltar muradun tsaro na geopolitical da manufofin ɗabi'a ga ƙasashe masu ba da gudummawa maimakon manyan barazanar kai tsaye ga lafiyar lafiyarsu.
Na biyu, zato da aka bayyana shi ne cewa ƙarin kuɗin masu ba da gudummawa yana nufin sakamako mafi kyau. Duk da yake wannan na iya zama gaskiya na ɗan gajeren lokaci, shekaru 25 na sanya albarkatu masu yawa a cikin cibiyoyin kiwon lafiya na duniya ba su haifar da daidaitattun sakamakon kiwon lafiya ba, tare da wasu. sakamakon kara muni a cikin 'yan shekarun nan. Maimakon a ba da ƙarin kuɗi iri ɗaya, wannan ya kamata ya zama wata dama don sake la'akari da tsarin kiwon lafiya gabaɗayan cuta da kayayyaki waɗanda shirye-shiryen USAID da GFATM suka fi yawa. Ya kamata mu nemi ƙarin kuɗi, gami da Ooms et al. bayar da shawarar, fitar da kudade daga kasashe masu karamin karfi da za a yi amfani da keken keke ta hanyar cibiyoyi na yammacin duniya kamar GFATM, ko la'akari da sabbin samfura waɗanda ke ba da fifiko ga tsarin kiwon lafiya da ƙaƙƙarfan juriyar tattalin arziki da lafiya?
Na uku, hujjar karuwar saka hannun jari a hukumomin bayar da agaji a karkashin yanayin karanci ya yi la'akari da babbar barazana ga kudaden kiwon lafiya a duniya; karkatar da kuɗaɗen da ba a taɓa yin irinsa ba zuwa ajandar bala'in da ke tasowa. A cewar hukumar WHO da Bankin Duniya, Buƙatun kuɗi na PPPR shine dala biliyan 31.1 a kowace shekara, tare da saka hannun jari na shekara-shekara na dala biliyan 26.4 da ake buƙata na ƙasashe masu ƙanƙanta da matsakaita (LMICs) da kuma kimanin dala 10.5 a cikin ƙarin taimakon ci gaban ƙasashen waje (ODA). The Bankin duniya yana ba da shawarar ƙarin dala biliyan 10.5 zuwa dala biliyan 11.5 a shekara don Lafiya ɗaya.
As jayayya a wani wuri, tattara ko da wani ɓangare na waɗannan albarkatun zuwa PPPR bai dace da hadarin da aka sani ba, yana wakiltar gagarumin damar halin kaka ta hanyar karkatar da kudade daga AIDS, zazzabin cizon sauro, da tarin fuka. A cikin mahallin, wannan ya ƙunshi a rarrabawar rashin daidaituwa inda kiyasin dala biliyan 10.5 na ODA na shekara-shekara na PPPR yana wakiltar sama da kashi 25% na 2022 ODA jimlar kashewa akan duk shirye-shiryen kiwon lafiya na duniya, yayin da tarin fuka, wanda ke kashe mutane miliyan 1.3 a kowace shekara, zai sami sama da kashi 3% na ODA.
Tsaron Lafiya ga Wane?
A na kowa gardama kan tabbatar da lafiya shi ne cewa yana ƙunshe da wani masanin ilimin halitta wanda ya fahimci barazanar cewa ya fito ne kawai daga 'Global South', wanda ƙasashen da suka ci gaba ke buƙatar yin taka tsantsan. Duk da haka, ana iya yin gardama cewa a haƙiƙanin tsaro na kiwon lafiya na Duniya ta Kudu yana da rauni ta hanyar taimakon da Arewa ke jagoranta da kuma hukumomin da ke jagorantar shi.
Hujja uku ce. Na farko, duk da shekaru 25 na karuwar saka hannun jari, daidaiton lafiyar duniya ya kasance a cikin kundin sa karkashin ruwa. Na biyu, saka hannun jari na GFATM bai sami sauƙi ba mallakar kasa, dogaro da kai, Da kuma iya aiki, zance mai dawwama agajin taimako. Na uku, kuma dangane da haka, ko da yake wasu cibiyoyi irin su GFATM an yi niyya ne da farko don su zama masu sake aiki, tare da wajabcin inganta ayyukan matakin kasa a matsayin 'asusun gada,' akwai 'yan alamun sakewa. Haƙiƙa sun ci gaba da faɗaɗa yawan ma'aikatansu da fayil ɗin su.
Kammalawa
Mun yarda cewa ya kamata kasashen duniya su ci gaba da tallafawa mambobin da ba su da wadata, tare da ba da fifiko ga mafi girman nauyin cututtuka. Duk da haka, ba mu yarda cewa wannan ya ƙunshi na dindindin da kuma ƙara yawan biyan kuɗi ga hukumomi kamar GFATM, GAVI, da Asusun Tallafawa, ko hukumomin bayar da agaji kamar USAID. Akwai tambayoyi masu fadi dole ne a yi tambaya kan yadda aka tsara da aiwatar da manufofin kiwon lafiyar duniya, musamman ma'auni tsakanin magance matsalolin direbobin kiwon lafiya da wadatar tattalin arziki tare da shirye-shiryen tsaye na tushen kayayyaki, da ma'anar ma'anar. me ya kunshi nasara.
A halin yanzu, lafiyar duniya tana shirin kashe biliyoyin kan barazanar barkewar cutar da ba a san tsananin ba bisa la'akari shaidun da ba a haɓaka ba, Da kuma matakai na siyasa abin tambaya. Yana da isar da talauci A kan alkawuran 'zamanin zinare' na mallakar ƙasa, tasirin taimako, da ƙarfafa tsarin kiwon lafiya. A ƙarshe, tsaro na kiwon lafiya yana raunana ta hanyar ci gaba da dogaro da taimako da ta tsarin zamani. A wannan batun, ƙari bai fi kyau ba, amma kawai ƙari iri ɗaya ne. Ya kamata a sake nazarin abubuwan da Amurka ta fi ba da fifiko da tsarin da ya kamata ya sa a sake tunani sosai.
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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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