美国–非洲卫生合作伙伴关系
简报白宫华盛顿特区2022年12月13日
美国政府自豪地与包括非洲联盟（African Union）和非洲疾病控制与预防中心（Africa Centres for Disease Control and Prevention）在内的非洲各国政府和机构合作，以推进共同的公共卫生目标。在我们继续努力终止新冠大流行的严重阶段时，我们仍然致力于加强卫生系统和机构；促进全球卫生安全；抗击艾滋病病毒/艾滋病、疟疾和结核病；促进性健康和生殖健康及权利，以及孕产妇、新生儿和儿童健康；缩小营养和非传染性疾病方面的差距；加快实现全民健康覆盖以及2030年可持续发展议程（2030 Agenda for Sustainable Development）。促进包括性别公平和平等在内的卫生公平是拜登-哈里斯政府的重点要务，并被纳入我们的全球性卫生项目中，其中包括通过直接向妇女、女童和LGBTQI+人口提供卫生服务。
自拜登-哈里斯政府就职以来，美国已在非洲地区投入并承诺提供近200亿美元用于卫生项目。这包括近115亿美元用于应对艾滋病病毒/艾滋病；超过20亿美元用于抗击疟疾；超过20亿美元用于支持计划生育和生殖健康以及孕产妇和儿童健康；还有超过20亿美元用于应对新冠疫情在卫生、人道主义和经济方面的影响。这些双边项目与美国对多边组织的重大投资相辅相成，有关多边组织为改善非洲的卫生状况提供了大量支持，例如世界卫生组织（World Health Organization）、全球疫苗免疫联盟（Gavi）、全球抗击艾滋病病毒/艾滋病、结核病和疟疾基金（Global Fund to Fight HIV/AIDS, TB, and Malaria）、联合国人口基金（United Nations Population Fund）以及联合国艾滋病联合规划署（Joint United Nations Program on HIV/AIDS）等。
美国在非洲卫生领域的投资和伙伴关系挽救了数百万人的生命，加强了卫生系统，并使非洲和全世界能更好地准备应对当前和未来的卫生安全威胁。由于有持续的伙伴关系和投资，整个非洲大陆的孕产妇和儿童死亡率以及疟疾死亡率已大幅下降。美国仅在2021财年的投资就为1540万非洲妇女提供了计划生育和生殖健康服务，避免了470万例意外怀孕并防止了10780例孕产妇死亡。在过去20年里，总统防治艾滋病紧急救援计划（PEPFAR）挽救了超过2500万人的生命，预防了数百万例艾滋病病毒感染，并帮助各国建立起坚实的基础来预防、检测及应对其他健康威胁。
美国在非洲大陆14个国家的密集的卫生安全投资和伙伴关系在生物安全和生物安全能力、防治人畜共患疾病的能力、监测系统、国家实验室系统、应急准备和应急响应行动方面取得了进展。仅在2021年，美国和非洲国家就共同应对了非洲大陆的多起疫情，其中包括新冠疫情和埃博拉疫情，有效地利用了这些伙伴关系所推进的关键的全球性卫生安全的改善。
投资于卫生人力资源以建立更具复原力的卫生系统
2022年5月，白宫启动了全球卫生工作者倡议（Global Health Worker Initiative），认识到获得支持、设备和保护以提供必不可少的公共卫生职能的卫生工作者是弥补在新冠疫情中的损失并准备应对未来的卫生威胁的有机部分。为了到2030年实现可持续发展目标（Sustainable Development Goals），非洲将需要增加530万名卫生工作者，其中大多数将是女性。认识到这一差距，非洲有关机构为非洲大陆制定了卫生人力资源目标，反映出包括预防服务、医疗保健服务以及大流行病的防范和应对在内的整个卫生领域的状况。
作为全球卫生工作者倡议的一部分，本届政府计划与国会合作，从2022年到2024年每年为非洲地区的卫生工作者投资13.3亿美元，到2025财年总计至少达到40亿美元，以帮助我们的非洲合作伙伴弥补在卫生人力资源方面的差距，其中包括临床医生、社区卫生和护理人员以及公共卫生专业人员。美国联邦机构将与区域合作伙伴共同努力，根据国家需求调整投资并使其最大化，而且将就体现我们整个政府对非洲卫生人力资源投资的标准化指标做出报告。
支持这一区域性卫生人力资源承诺的行动计划包括：
o 通过国家公共卫生研究所（National Public Health Institute）项目支持非洲疾控中心，该项目提供持续培训并给予技术援助，以加强非洲疾控中心工作人员在监测方法以及疾病预防和控制方面的能力。自本届政府就职以来，疾病控制和预防中心通过目前及计划投资至少970万美元，正在支持非洲疾控中心建立一个在线平台，以支持非洲疾控中心在非洲联盟成员国内建设人力资源能力的目标。
o 现场流行病学培训项目（Field Epidemiology Training Program）自2021财年以来已投入并计划投入4700万美元的疾病控制和预防中心资金，加强各国预防、发现并应对公共卫生威胁的能力。在最近于毛里塔尼亚爆发的裂谷热（Rift Valley Fever）和克里米亚-刚果出血热（Crimean-Congo hemorrhagic fever）、在乌干达爆发的苏丹埃博拉病毒（Sudan Ebolavirus）、在几内亚爆发的2021年埃博拉疫情以及多个国家的新冠疫情应对期间，现场流行病学培训项目的结业学员都被动员起来。
o 全球实验室领导力项目（Global Laboratory Leadership Program）自2021财年以来已投入并计划投入520万美元的疾病控制和预防中心支持，指导当前和新兴的实验室领导者建立、加强及保持以“同一健康”（One Health）为重点的国家实验室系统。
合作建立更强大的卫生体系并加强全球卫生安全
美国继续加强全球、地区和国家预防、检测和应对传染病威胁的能力。作为美国扩大全球卫生安全伙伴关系的承诺的一部分，美国宣布自本届政府就职以来，已通过美国国际发展署、疾病控制和预防中心以及其他联邦机构在非洲投资并承诺提供7.82亿美元用于全球卫生安全项目，与伙伴国家合作弥补能力差距并支持其国家卫生安全行动计划（National Action Plans for Health Security）。除了目前与非洲大陆14个国家的密切伙伴关系外，美国还欢迎加纳、莫桑比克和赞比亚成为这一努力的新伙伴。美国进一步宣布提供2.15亿美元——用于应对非洲新冠疫情的新资金，重点在于加速广泛、公平地获得及发送安全有效的新冠疫苗；降低新冠病毒的发病率和死亡率；减轻传播；以及加强卫生体系。推进疫情防范和应对的其他行动包括：
o 总统防治艾滋病紧急救援计划目前每年支出大约7.5亿美元购买与防治艾滋病病毒相关的商品，但其中只有不到1%用于从非洲生产商那里采购商品。总统防治艾滋病紧急救援计划正在积极探索改变其采购工作的机会，以刺激地区生产生态系统的增长。基于现有能力以及对未来扩展潜力的分析：在艾滋病病毒快速诊断方面，总统防治艾滋病紧急救援计划的目标是到2025年以2000万美元的估计成本采购1500万支由非洲生产商生产的检测剂。在抗逆转录病毒药物方面，总统防治艾滋病紧急救援计划的目标是到2030年与其他合作伙伴和买家合作，让至少200万接受一线抗逆转录病毒药物治疗的患者转而使用非洲生产的产品。国际开发金融公司（DFC）还寻求资助符合条件的私营部门项目，这些项目在发展中国家建设治疗、诊断和辅助用品的地区生产能力，并以非洲为重点。
o 总统防治疟疾行动计划致力于建立更具复原力的供应链，并利用其采购量来加速地区生产的增长。在最近与非洲大陆的生产活动相关的招标中纳入评估标准，促使总统防治疟疾行动计划的2023年标准蚊帐采购据估计有30%来自非洲生产商。
投资于卫生基础设施
七国集团（G7）领导人于2022年6月启动了全球基础设施和投资伙伴关系（Partnership for Global Infrastructure and Investment），目标是调动数千亿美元并提供优质的、可持续的基础设施，包括开发及升级卫生体系的基础设施并为全球卫生安全做出贡献。自2021年1月以来，为支持全球基础设施和投资伙伴关系，并作为国际开发金融公司的全球健康与繁荣行动计划（Global Health and Prosperity Initiative）的一部分，国际开发金融公司已承诺提供超过2.53亿美元用于重点改善非洲的大流行病防范及卫生体系复原力的项目。其中包括对卫生服务和基础设施、卫生商品生产和供应链、数字卫生以及水、环境卫生和营养的投资。除了对卫生人力资源和疫苗生产的投资外，支持全球基础设施和投资伙伴关系的项目还包括：
合作开展癌症预防、检测、治疗和研究
美国致力于与非洲各国政府合作，在我们共同努力实现总统提出的终结我们所知癌症的愿景的同时，减轻日益沉重的癌症负担。肩负着这一共同责任，美国有关机构推动并支持与非洲合作伙伴的有影响力的行动计划，其中包括制定及实施务实的技术干预、支持各研究中心、提供癌症预防、早期检测和治疗以及临床试验开发，并为非洲的全球癌症研究增强机构能力，旨在使全球癌症研究人员多样化。在我们共同努力开发新的创新解决方案来预防、检测和治疗癌症的过程中，非洲是一个重要的合作伙伴。加强卫生体系和公共卫生基础设施的努力，以及私营部门的投资，也将有助于终结我们所知的癌症。
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欲查看原稿内容: https://www.whitehouse.gov/briefing-room/statements-releases/2022/12/13/fact-sheet-u-s-africa-partnership-in-health-cooperation/
本译文仅供参考，只有英文原稿才可以被视为权威资料来源。

U.S.-Africa Partnership in Health Cooperation
Fact SheetThe White HouseWashington, D.C.December 13, 2022
The United States Government is proud to work in partnership with governments and institutions in Africa, including the African Union (AU) and Africa Centres for Disease Control and Prevention (Africa CDC), to advance shared public health goals.  As we continue to work to end the acute phase of the COVID-19 pandemic, we remain committed to strengthening health systems and institutions; advancing global health security; combatting HIV/AIDS, malaria, and tuberculosis; advancing sexual and reproductive health and rights, and maternal, neonatal, and child health; closing gaps in nutrition and non-communicable diseases; and accelerating efforts to achieve universal health coverage and the 2030 Agenda for Sustainable Development.  Advancing health equity, including gender equity and equality, are priorities for the Biden-Harris Administration, and are integrated throughout our global health programs, including through direct provision of health services to women, girls, and LGBTQI+ populations.
Since the beginning of the Biden-Harris Administration, the United States has invested and committed to provide nearly $20 billion in health programs in the Africa region.  This includes nearly $11.5 billion to address HIV/AIDS; more than $2 billion to combat malaria; more than $2 billion in support of family planning and reproductive health as well as maternal and child health; and more than $2 billion to address the health, humanitarian, and economic impacts of COVID-19.  These bilateral programs complement significant U.S. investments in multilateral organizations that provide substantial support to improving health outcomes in Africa, such as the World Health Organization; Gavi, the Vaccine Alliance; the Global Fund to Fight HIV/AIDS, TB, and Malaria; the United Nations Population Fund, and the Joint United Nations Program on HIV/AIDS, among others.
U.S. investments and partnerships on health in Africa have saved millions of lives, strengthened health systems, and made Africa and the world better prepared for current and future health security threats.  Thanks to sustained partnership and investment, maternal and child mortality and malaria mortality across the continent have declined dramatically.  U.S. investments in Fiscal Year 2021 alone enabled the provision of family planning and reproductive health services to 15.4 million African women, averting 4.7 million unintended pregnancies and preventing 10,780 maternal deaths.  In the last twenty years, PEPFAR has saved more than 25 million lives, prevented millions of HIV infections, and helped countries build a strong foundation to prevent, detect, and respond to other health threats.
U.S. intensive health security investments and partnership across fourteen countries on the continent have yielded progress in biosafety and biosecurity capacity, zoonotic disease capacity, surveillance systems, national laboratory systems, emergency preparedness, and emergency response operations.  In 2021 alone, the United States and African nations tackled multiple outbreaks on the continent together, including COVID-19 and Ebola, effectively using the critical global health security improvements that these partnerships have advanced.
Investing in the health workforce to build more resilient health systems
In May 2022, the White House launched the Global Health Worker Initiative (GHWI), recognizing that a health workforce that is supported, equipped and protected to provide essential public health functions is integral to reclaiming lost ground from the COVID-19 pandemic and preparing for future health threats.  In order to achieve the Sustainable Development Goals by 2030, Africa will need 5.3 million additional health workers, the majority of whom will be women.  Recognizing this gap, African institutions have established health workforce goals for the continent that reflect the whole spectrum of health, including preventive services, health care services, and pandemic preparedness and response.
As part of the GHWI, the Administration plans to work with Congress to invest $1.33 billion annually from 2022 to 2024 in health workforce in the Africa region, for a total of at least $4 billion by Fiscal Year 2025, to help our African partners close the gap in health workers, including clinicians, community health and care workers, and public health professionals. U.S. federal agencies will work together with regional partners to align and maximize investments with country needs, and will report on standardized metrics that capture our whole of government investments in health workforce in Africa.
Initiatives in support of this regional health workforce commitment include:
o Support for Africa CDC through the National Public Health Institute (NPHI) Program, which offers ongoing trainings and directs technical assistance that strengthen the capacity of Africa CDC staff in surveillance methodologies and disease prevention and control.  Since the beginning of the Administration, with current and planned investments of at least $9.7 million, CDC is supporting Africa CDC to build out an online platform for supporting Africa CDC’s goals of building workforce capacity within African Union Member States.
o The Field Epidemiology Training Program (FETP), with $47 million in invested and planned CDC funding since Fiscal Year 2021, strengthens countries’ capacity to prevent, detect, and respond to public health threats.  FETP graduates were mobilized during recent outbreaks of Rift Valley Fever and Crimean-Congo hemorrhagic fever in Mauritania, Sudan Ebolavirus in Uganda, and the 2021 Ebola outbreak in Guinea, as well as the COVID-19 response in multiple countries.
o The Global Laboratory Leadership Program (GLLP), with $5.2 million in invested and planned CDC support since Fiscal Year 2021, mentors current and emerging laboratory leaders to build, strengthen, and sustain national laboratory systems with a One Health focus.
Partnering to build stronger health systems and strengthen global health security
The United States continues to strengthen global, regional, and national capacities to prevent, detect, and respond to infectious disease threats.  As part of the U.S. commitment to expand global health security partnerships, the United States announced it has invested and committed to provide $782 million in global health security programs in Africa since the beginning of the Administration through USAID and CDC, alongside other federal agencies, to work with partner countries to address capacity gaps and support their National Action Plans for Health Security.  In addition to its current intensive partnership with fourteen countries across the continent, the United States welcomes the addition of Ghana, Mozambique, and Zambia as new partners in this effort.  The United States further announced $215 million – new funding to address the COVID-19 pandemic in Africa, which will focus on accelerating widespread and equitable access to and delivery of safe and effective COVID-19 vaccinations; reducing morbidity and mortality from COVID-19; mitigating transmission; and strengthening health systems.  Additional actions to advance pandemic preparedness and response include:
o PEPFAR currently spends roughly $750 million in the purchase of HIV-related commodities every year, but less than 1 percent of that total is used to procure commodities from African manufacturers.  PEPFAR is actively exploring opportunities to shift its procurement practices to spur growth in the regional manufacturing ecosystem. Building on existing capabilities and an analysis of future expansion potential: for HIV rapid diagnostics, by 2025, PEPFAR aims to procure 15 million tests produced by African manufacturers at an estimated cost of $20 million.  For ARVs, by 2030, PEPFAR aims to work alongside other partners and buyers to shift at least two million patients on first-line ARV treatments to use African-made products.  DFC also seeks to finance eligible private sector projects that build regional manufacturing capacity for therapeutics, diagnostics, and ancillary supplies in developing countries, with a focus on Africa.
o PMI is committed to building a more resilient supply chain and is leveraging its procurement volume to accelerate the growth in regional manufacturing.  The inclusion of evaluation criteria in recent tenders related to manufacturing on the continent led to an estimated 30 percent of PMI’s 2023 standard mosquito net procurement being sourced from African-based manufacturers.
Investing in Health Infrastructure
G7 leaders launched the Partnership for Global Infrastructure and Investment (PGII) in June 2022, with a goal of mobilizing hundreds of billions of dollars and delivering quality, sustainable infrastructure, including developing and upgrading the infrastructure of health systems and contributing to global health security.  In support of PGII, and as part of DFC’s Global Health and Prosperity Initiative, DFC has committed more than $253 million to projects focused on improving pandemic preparedness and health system resilience in Africa since January 2021.  These include investments in health services and infrastructure, health commodity manufacturing and supply chain, and digital health as well as water, sanitation, and nutrition. In addition to investments in the health workforce and vaccine manufacturing, programs in support of PGII include:
Partnering on Cancer Prevention, Detection, Treatment and Research
The United States is committed to working together with African governments to reduce the rising burden of cancer, as we collectively work towards the President’s vision of ending cancer as we know it.  With this shared responsibility, U.S. agencies drive and support impactful initiatives with African partners, including the design and implementation of pragmatic technological interventions, support for research centers, providing access to cancer prevention, early detection and treatment, clinical trial development and strengthening institutional capacity for global cancer research in Africa with a goal to diversify the global cancer research workforce.  Africa is a critical partner as we work together to develop new and innovative solutions to prevent, detect and treat cancer.  Efforts to strengthen health systems and public health infrastructure, as well as investments by the private sector, will also help end cancer as we know it.
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