Kufambira Mberi Mukurwisa AIDS

Dr. Gerald J. Stine mubhuku rake rinonzi AIDS Update 2003 akataura kuti zvakatsvakurudzwa nezveHIV/AIDS kufambira mberi kwesayenzi kunoshamisa. Pane zvakawanda zvakadzidzwa munguva pfupi pamusoro pechirwere ichi chakaoma kunzwisisa.” Zvii zvave zvichiitwa?

RUZIVO nounyanzvi zvokurapa zvemazuva ano zvakaita kuti vatsvakurudzi vagadzire mishonga yakasiyana-siyana iyo inoita kuti vanhu vane utachiona hweHIV vatarisire zvitsva. Uyezve, mapurogiramu okudzidzisa vanhu nezveAIDS akabatsira munyika dzakawanda. Asi kubudirira kwezviri kuitwa izvozvo kunoratidza kuti denda iri rinouraya rava kutanga kuguma here? Zviri kuedza kuitwa nesayenzi nedzidzo zvanhasi zvinogona kumisa kupararira kweAIDS here? Chimbofunga nezvezvinotevera.

Mishonga Yokurapa

“Katariro Kadukuduku Pakurwisana neAIDS,” ndiwo waiva musoro mukuru mumagazini yeTime yaSeptember 29, 1986. “Katariro kadukuduku” aka kakavapo nemhaka yezvakawanikwa pakuongorora kwakaitwa pachishandiswa azidothymidine (AZT), mushonga weHIV unoita kuti utachiona husaberekane. Zvinoshamisa kuti vanorwara neHIV vaishandisa mushonga unonzi AZT vairarama kwenguva refu. Kubvira panguva iyoyo, mishonga inoita kuti utachiona husaberekane (ARV) yakawedzera upenyu hwemazana ezviuru zvevanhu. (Ona bhokisi rakanzi “Chii Chinonzi ARV?” riri papeji 7) Mishonga yacho yave ichibudirira zvakadini mukurapa utachiona hweHIV?

Pasinei nokufara kwakamboitwa pakatanga kushandiswa AZT, magazini yeTime yakashuma kuti vanotsvakurudza nezveAIDS “vaiva nechivimbo chokuti AZT [yakanga] isiri mushonga chaiwo weAIDS.” Vaitaura chokwadi. AZT yakanga isingashandi zvakanaka kune vamwe varwere, saka mamwe marudzi eARV akagadzirwa. Gare gare, U.S. Food and Drug Administration yakabvumira ARV inoshandiswa pamwe chete nemimwe mishonga kuti ishandiswe pavarwere vanenge vava noutachiona hweHIV hwadzika midzi. Mishonga inoshandiswa pamwe chete nemimwe, iyo yakazosanganisira kunwa mishonga yemhando nhatu kana kupfuura inoita kuti utachiona husaberekane, yakagamuchirwa nomufaro nevashandi vezvoutano vanotarisira vanhu vane AIDS. Kutaura zvazviri, pane mumwe musangano wemarudzi ose weAIDS wakaitwa muna 1996, mumwe chiremba akatozivisa kuti mishonga yacho ingagona kupedza zvachose utachiona hweHIV mumuviri!

Zvinosuruvarisa kuti, mugore rimwe chete zvakanga zvava pachena kuti kunyange kunyatsotevedzera urongwa hwokushandisa mishonga mitatu  kwaisagona kupedza utachiona hweHIV. Kunyange zvakadaro, mumwe mushumo weUNAIDS wakataura kuti “kushandiswa kwemarudzi eARV anoshandiswa panguva imwe chete kwakaita kuti vanhu vane HIV vararame kwenguva refu, vaine utano, vachigona kuita zvimwe zvinhu.” Somuenzaniso, muUnited States uye muEurope, kushandiswa kweARV kwakaderedza nzufu dzinokonzerwa neAIDS nekanopfuura ka70 muzana. Uyezve, kuongorora kwakawanda kwakaratidza kuti kushandiswa kweARV pakurapa kunogona kuderedza mukana wokuti utachiona hweHIV hupfuudzwe kubva kuna amai vane pamuviri kuenda kumwana wavo.

Asi, mamiriyoni evanhu vane utachiona hweHIV anonyimwa ARV. Nei?

“Chirwere Chevarombo”

Nyika dzakapfuma ndidzo dzinonyanya kurapa neARV. Zvisinei, World Health Organization (WHO) inofungidzira kuti mune dzimwe nyika dzichiri kubudirira, 5 muzana bedzi yevanoda kurapwa neARV ndiyo inowana mushonga wacho. Nhume dzeUnited Nations dzakatorondedzera mamiriro ezvinhu aya asingaiti kuti pave nokuenzana so“kusaruramisira kwakanyanya” uye se“tsika yakaipa zvikuru iri kuitwa mazuva ano.”

Vagari vomunyika imwe chete havagoni kuwana mushonga wacho zvakaenzana. Pepanhau rinonzi The Globe and Mail rinoti munhu mumwe chete pavatatu vokuCanada anofa neAIDS anenge asina kumborapwa neARV. Kunyange zvazvo mishonga yacho ichiwanika pachena kuCanada, vamwe vanhu havaiwani. “Vaya vasiri kurapwa zvakatsarukana,” rinodaro pepanhau rinonzi Globe, “ndivo vanenge vachitonyanya kufanira kurapwa: vaaborigine, vakadzi uye varombo.” The Guardian rakatora mashoko evamwe amai vokuAfrica vane HIV vaiti: “Handizvinzwisisi. Nei ngochani dzechichena idzi dzichiwana mushonga wokuti dzirambe dzichirarama asi ini ndichifanira kufa?” Mhinduro yomubvunzo wavo ine chokuita nemari inoshandiswa pakugadzirwa kwemishonga nokuparadzirwa kwayo.

Avhareji yomutengo wemishonga mitatu inoshandiswa panguva imwe weARV muUnited States uye muEurope inotangira paUS$10,000 (Z$56 000-000) kusvika paUS$15,000 (Z$84 000 000) pagore. Kunyange zvazvo mishonga yakafanana neiyi asi iine mazita akasiyana yava kuwanikwa nomutengo usingapfuuri US$300 (Z$1 680 000) pagore, mune dzimwe nyika dzichiri kubudirira, vanhu vakawanda vane HIV uye vanorarama kunonyanya kudiwa ARV havakwanisi kuwana mari iyi. Dr. Stine anopedzisa kutaura nezvemamiriro acho ezvinhu achiti: “AIDS chirwere chevarombo.”

Mabhizimisi Okugadzira Mishonga

Zvave zvisiri nyore kugadzira mishonga yakafanana neyagara iripo asi iine mazita akasiyana uye kuitengesa nemitengo yakaderera. Munyika dzakawanda, mitemo youridzi yakaomarara inorambidza vanhu kugadzira mishonga mitsva vachitevedzera iya ine mazita ouridzi vasina kupiwa mvumo. “Uku kurwira upfumi,” anodaro mumwe mutungamiri wekambani inogadzira mishonga. Kugadzira mishonga yakafanana neyagara iripo asi yopiwa mazita akasiyana uye kuitengesa kunyika dzichiri kubudirira kuti pave nepurofiti, “hakusi kururamisira kune vakatanga kugadzira mishonga iyoyo,” anodaro. Makambani emishonga ine mazita ouridzi anotiwo kuderera kwepurofiti kunogona kukonzera kuderera kwemari yokushandisa pazvirongwa zvokutsvakurudza nokuvandudza kurapa. Vamwewo vanotyira kuti kuderedzwa mutengo kweARV kunoitirwa nyika dzichiri kubudirira kunogona kuzoita kuti iwanikwe pamisika isiri yepamutemo munyika dzakabudirira.

Vanotsigira kuderedzwa mutengo kweARV vanosimbirira kuti mishonga mitsva inogona kugadzirwa  nemari iri pakati pezvikamu zvishanu negumi muzana zvemari yakataurwa neindasitiri inogadzira mishonga. Vanotaurawo kuti makambani akazvimirira oga anogadzira mishonga haadi kutsvakurudza nokuvandudza mishonga inorapa zvirwere zviri kuonesa ndondo nyika dzevarombo. Saka, Daniel Berman, mutungamiriri wechirongwa cheAccess to Essential Medicines, anoti: “Panofanira kuva nechirongwa chinotsigirwa pasi pose chokuderedza mitengo yemishonga mitsva kusvikira pamwero wokuti inogona kutengwa munyika dzichiri kubudirira.”

Nemhaka yokudiwa kweARV pasi pose, WHO yakatanga chirongwa chokupa ARV kumamiriyoni matatu evanhu vari kurarama neHIV/AIDS kusvika panozopera 2005. “Iyi haifaniri kuva imwe vavariro yeUnited Nations isingazobudiriri,” akayambira kudaro Nathan Ford weMédecins Sans Frontières. “Mamiriyoni matatu anongova hafu yevanhu vane HIV/AIDS vanofungidzirwa kuti vanoda mushonga nhasi uye nhamba iyi ichange yawedzera chaizvo [pachasvika 2005].”

Zvimwe Zvipingamupinyi

Kunyange kana ARV yakakwana ikatumirwa kunyika dzichiri kubudirira, pane zvimwe zvipingamupinyi zvinofanira kukurirwa. Mimwe mishonga inofanira kunwiwa nemvura yakachena uye pashure pokunge munhu adya, asi mazana ezviuru zvevanhu mune dzimwe nyika anongodya kamwe chete mumazuva maviri. ARV (inowanzova mapiritsi 20 kana kupfuura pazuva) inofanira kunwiwa panguva dzinenge dzakarongwa zuva roga roga, asi varwere vakawanda havana wachi. Mishonga inonwiwa panguva imwe chete inofanira kuitwa kuti ienderane nemamiriro ezvinhu omurwere. Asi munyika zhinji mune chinetso chakakomba chokushayikwa kwavanachiremba. Zviri pachena kuti kupa nyika dzichiri kubudirira ARV kuchava chipingamupinyi chakaoma kukurira.

Kunyange varwere vari munyika dzakabudirira vanosanganawo nezvinetso pavanoshandisa mishonga inonwiwa panguva imwe chete. Kutsvakurudza kunoratidza kuti kukundikana kushandisa mishonga yose inenge yanzi ishandiswe panguva yakarongwa kuri kupararira zvinotyisa. Izvi zvingaita kuti utachiona huve nhinhi kumishonga. Utachiona hweHIV uhu husina zvahunoitwa nemishonga hunogona kutapukira kuvamwe.

Dr. Stine anotaura nezverimwe dambudziko rinosangana nevarwere vane utachiona hweHIV.  Anoti, “Chinhu chisinganzwisiswi pamusoro pokurapwa kweHIV ndechokuti dzimwe nguva kurapa kunoita mushonga wacho kunorwadza kutopfuura chirwere chacho, kazhinji kana munhu akatanga kurapwa nepo zviratidzo zvokuti ane chirwere zvisati zvava kuoneka.” Vane utachiona hweHIV avo vanoshandisa ARV vanowanzorwara nezvirwere zvinokonzerwa nemishonga yavanenge vachishandisa zvakadai sechirwere cheshuga, kusapararira zvakanaka kwemafuta uye kuwandisa kwawo mumuviri nokudererawo kwouremu hwemapfupa. Zvimwe zvinetso zvinokonzerwa nemishonga yacho zvinogona kuuraya.

Kuedza Kudzivirira

Kuedza kudzivirira kwave kuchibudirira sei kuderedza kupararira kweAIDS uye kuderedza maitiro ane ngozi zvikuru anokonzera kupararira kwoutachiona hweHIV? Kudzidzisa vanhu nezveAIDS muUganda yose kwakaitwa muma1990 kwakaderedza kupararira kweHIV munyika iyoyo kubva pa14 muzana kusvika panenge pa8 muzana muna 2000. Saizvozvowo, kuedza kunoitwa neSenegal kuyambira vagari vemo nezvengozi yokubata utachiona hweHIV kwakabatsira nyika iyi kuti kupararira kweHIV kurambe kuri pasi pechikamu chimwe muzana pavanhu vakura. Migumisiro yakadaro inokurudzira.

Asiwo, kudzidzisa vanhu nezveAIDS hakuna kubudirira zvakadaro mune dzimwe nyika. Kuongorora kwakaitwa vechiduku 11 000 vokuCanada mugore ra2002 kwakaratidza kuti hafu yevadzidzi vaiva mugore ravo rokutanga pachikoro chesekondari vaidavira kuti AIDS inogona kurapika. Maererano nokuongorora kwakaitwa kuBritain gore iroro, 42 muzana yevakomana vaiva nemakore 10 kusvika ku11 vakanga vasati vambonzwa nezveHIV kana AIDS. Asi, kunyange vechiduku vanoziva nezveHIV neAIDS uye kuti hairapiki vari kuisa zvimiti munzeve. “Kune vechiduku vakawanda,” anodaro mumwe chiremba, “HIV yava kungoita sechimwe chezvinetso zvavo zvakawanda zvoupenyu, zvakadai sokuti vachazowana zvokudya zvakanaka here, kuti ndiani wavachazogara naye, kana kuti vachaenda kuchikoro here.”

Saka, hazvishamisi kuti WHO inoti “kunangana nevechiduku kunogona kuva chinhu chinonyatsoshanda pakurwisa denda iri, kunyanya munyika dzarakapararira zvikuru.” Vechiduku vangabatsirwa sei kuti vaite chimwe chinhu nezveyambiro dzavanenge vapiwa pamusoro peAIDS? Uye zvine musoro here kutarisira kuti icharapika?

[Mashoko okukwezva vaverengi ari papeji 6]

Gore rapera, pane vaya vaida ARV muAfrica, 2 muzana chete ndivo vakaiwana, kana zvichienzaniswa ne84 muzana yevokuAmerica

[Bhokisi/Mifananidzo iri papeji 7]

Chii Chinonzi ARV? *

Kana munhu aine utano hwakanaka, masero anonzi T okubatsira anowedzera kana kuti anochangamutsa gadziriro iri mumuviri yokudzivirira zvirwere. HIV inonyanya kurwisa masero anonzi T aya. Inoshandisa masero acho kuti iberekane, ichipedza simba uye ichiparadza masero anonzi T anobatsira kusvikira gadziriro iri mumuviri yokurwisa zvirwere isisina simba zvachose. Mushonga unoita kuti utachiona husaberekane (ARV) unokanganisa kuberekana uku.

Pari zvino, marudzi mana makuru eARV ndiwo ari kushandiswa. Marudzi enucleoside an­a­logues nenon-nucleoside analogues anodzivirira HIV kuti isatevedzere zvakaita DNA yomunhu. Rudzi rweprotease inhibitors runovharidzira mamwe makemikari eprotease ari mumasero anenge ane utachiona kuti asagadzirazve humwe utachiona oita HIV yakawanda. Rudzi rweFusion in­hib­i­tors runongomirira kudzivisa HIV kuti isapinde mumasero. Nokudzivisa kuberekana kwe­HIV, ARV inogona kuita kuti utachiona hwe­HIV hutore nguva refu husati hwava ­AIDS, utachiona hwe­HIV pahunenge hwasvika pakaipisisa.

[Mashoko Omuzasi]

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KENYA—Chiremba anorayira murwere ane AIDS nezvemarapiro eARV

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© Sven Torfinn/Panos Pictures

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KENYA—Murwere weAIDS anogamuchira mushonga wake unonzi ARV pachipatara

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© Sven Torfinn/Panos Pictures

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Vakadzi neAIDS

Vakadzi vava kusvika 50 muzana yevanhu vakuru vari kurarama neHIV/AIDS

Muna 1982, pazvakaonekwa kuti vakadzi vaiva neAIDS, zvakafungidzirwa kuti vangangodaro vakanga vaiwana mumishonga inopinzwa nomutsinga. Nenguva isipi zvakazozivikanwa kuti vakadzi vaigona kubata utachiona nokuita zvepabonde chaiko uye vaiva pangozi huru yokubata HIV. Vakadzi vava kusvika 50 muzana yevanhu vakuru vari kurarama neHIV/AIDS mupasi rose. “Denda racho rinonyanya kutambudza vakadzi nevasikana vachiri kuyaruka avo vasina chinonyanya kuvadzivirira pamagariro, patsika, mumuviri, uye mune zvemari, uye vanenge vachifanira kutarisira vanorwara nevanenge vava kufa,” inodaro UNAIDS.

Nei vashandi vanoona nezveAIDS vari kunyanya kunetseka nezvokupararira kwechirwere kuvakadzi? Vakadzi vane HIV vanowanzosarurwa kupfuura zvinoitwa varume, kunyanya mune dzimwe nyika dzichiri kubudirira. Kana mukadzi wacho aine pamuviri, utano hwomwana wake hunova pangozi, kana achitova nevana, kuvatarisira kunobva kwava chinetso, kunyanya kana ari amai vasina murume. Uyezve, hapana zvakawanda zvinozivikanwa nezvevakadzi vane HIV uye kutarisirwa kwavanofanira kuitwa.

Dzimwe tsika dzinoita kuti mamiriro acho ezvinhu anyanye kuva nengozi kuvanhukadzi. Munyika dzakawanda vakadzi havabvumirwi kutaura zvepabonde, uye vanozviisa pangozi yokubatwa zvisina kunaka kana vakaramba kuita zvepabonde. Varume vanowanzoita zvepabonde nevanhu vakawanda uye vanovapa utachiona hweHIV vasingazivi. Vamwe varume vokuAfrica vanoita zvepabonde nevakadzi vechiduku kuitira kuti vasabata HIV kana kuti vachibvuma nhema dzokuti kurara nemhandara kunogona kurapa AIDS. Ndokusaka WHO ichiti: “Kuti vakadzi vadzivirirwe, panofanira kutorwa matanho akanangana nevarume (uyewo nevakadzi).”

[Mufananidzo]

PERU—Amai vane HIV nomwanasikana wavo asina HIV

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© Annie Bungeroth/Panos Pictures

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THAILAND—Sechikamu chezvidzidzo zvavo, vadzidzi vanoshanyirawo murwere weAIDS

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© Ian Teh/Panos Pictures

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KENYA—Musangano unoitwa nenhengo dzesangano reWomen Living With AIDS

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© Sven Torfinn/Panos Pictures

[Bhokisi/Mufananidzo uri papeji 9]

Nhema Pamusoro peAIDS

▪ Vanhu vane utachiona hweHIV vanongooneka nokuperezeka. “Paavhareji, zvinotora makore anenge 10 kusvika ku12 kuti munhu ane HIV aite AIDS,” anodaro Dr. Gerald J. Stine. “Munguva iyi, munhu ane HIV angasaoneka kuti ane utachiona, asi anenge achikwanisa kuhutapurira vamwe vanhu.”

▪ AIDS chirwere chinongobata ngochani. Mukutanga-tanga kwema1980, AIDS yaizivikanwa sechirwere chinongobata ngochani. Zvisinei, nhasi kurara pamwe kwomurume nomukadzi ndicho chinhu chikuru chinonyanya kukonzera kupararira kweHIV munyika dzakawanda.

▪ Kurara nomunhu nomumukanwa “hakuna ngozi.” Maererano neCenters for Disease Control and Prevention, “kuongorora kwakasiyana-siyana kwakaratidza kuti kurara nomunhu nomumukanwa kunogona kuguma nokubata HIV uye zvimwe zvirwere zvinotapuriranwa pabonde.” Ngozi yokubata HIV nokurara nomunhu nomukanwa haina kunyanya sezvakaita yemimwe miitiro yokurara pamwe kwevanhu. Kunyange zvakadaro, muitiro wacho wakakurumbira zvokuti vamwe vanachiremba vanotarisira kuti uchange wava nzira yakakurumbira yokuparadzirwa kweHIV.

▪ Kune mushonga weAIDS. Kunyange zvazvo mushonga unoita kuti utachiona husaberekane uchigona kuderedza kuchinja kweHIV kuti iite AIDS mune vamwe varwere, pari zvino hapasati pava nomushonga kana chimwe chinorapa chirwere ichi.

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CZECH REPUBLIC—Kuongorora kuti ropa rine AIDS here, iyo yava nemishonga asi isingarapiki

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© Liba Taylor/Panos Pictures

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ZAMBIA—Vasikana vaduku vaviri vane HIV vakamirira mushonga wavo

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© Pep Bonet/Panos Pictures