PBS高端访谈:艾滋病治疗取得进展 预防传染仍是关键

 　　MARGARET WARNER:Countries around the globe will mark World AIDS Day this weekend. The toll¹ of the disease is still enormous. More than 30 million have died since the epidemic² broke out. And AIDS accounted for 1.7 million deaths last year.

　　But there is growing optimism about curbing³ and perhaps ending the epidemic for the next generation, even as daunting⁴ hurdles⁵ remain.

　　Ray Suarez has the story.

　　RAY SUAREZ:The numbers are still staggering. Some number 34 million are live well HIV, almost 5 million more than a decade ago. The U.S. substantially increased its commitment to fighting AIDS under President George W. Bush.

　　Yesterday, Secretary of State Hillary Clinton unveiled the Obama administration's road map to increase access to treatment and eliminate new infections in children by 2015.

　　SECRETARY OF STATE HILLARY CLINTON: So, as we continue to drive down the number of new infections and drive up the number of people on treatment, eventually, we will be able to treat more people than become infected every year. That will be the tipping point. We will then get ahead of the pandemic and an AIDS-free generation will be in our sight.

　　RAY SUAREZ:It's been more than 30 years since the first known AIDS cases appeared in 1981. In the early years, contracting AIDS was a near-certain death sentence.

　　JIM LEHRER: There are few scarier things than the discovery of a new killer⁶ disease, one medical science admits is mostly a mystery for which there is no certain cause or cure. Doctors have called the new one bizarre, frustrating⁷, frightening.

　　RAY SUAREZ:Yet, wider access to drugs in recent years has changed the way people live with AIDS. Deaths have dropped by 26 percent from their highest levels in 2005. New infection rates have fallen by 50 percent in more than two dozen countries, 13 of them in Sub-Saharan Africa.

　　Those modern achievements are due in part to activists⁸ who took on policy-makers and the medical establishment early on to fight for new approaches to treatment.

　　A new documentary, "How to Survive a Plague," chronicles the uphill journey.

　　MAN: This is it. This is the plan we're presenting. We need our government to read this plan. We need them to work with us. If they want to change it a little, we will talk to them.

　　But I want them to adopt it. I want them to get started on it. I want them to save our lives. Thank you.

　　RAY SUAREZ:These days, governments are doing more. But big problems remain. Some seven million people in developing countries still can't get the drugs they need. And in the U.S., a new report found more than half of HIV-infected young people are unaware⁹ of their status.

　　Dr. Anthony Fauci has been on the front lines of this battle for the past 30 years. He's head of the National Institute of Allergy¹⁰ and Infectious Diseases at the National Institutes of Health, where he joins us this evening.

　　Dr. Fauci, good to you have with us on the eve another World AIDS Day.

　　Is there embedded¹¹ in that statistic¹², 34 million people living with AIDS, both good news and bad news, that people are living, but still continue to get infected?

　　DR. ANTHONY FAUCI, National Institute of Allergy and Infectious Diseases: That is correct. And that is the reason why there is such an important push going on domestically and internationally, where most of the cases are, to get people into a treatment regimen, because what's become clear over the past couple of years, that despite those daunting statistics, that when you treat people, identify people who are HIV-infected, you not only give them lifesaving therapy, but you dramatically diminish the likelihood that they will infect their sexual partners.

　　And so although the numbers are very high, we are now starting to go in the direction in several countries where the death rates are down, where the infection incidence is down, and where we're getting more people on therapy than we actually are getting newly infected. And we call that the tipping point.

　　And we're starting to see that in some countries. So the bad news is that it's still an immense epidemic/pandemic, but the good news is that we are clearly going in the right direction.

　　RAY SUAREZ:It's been 16 years since the combination therapies have really widely taken hold. Looking back over your shoulder, did it work better than you had even hoped back in 1996?

　　DR. ANTHONY FAUCI:Well, yes, yes. In many respects, Ray, it did work better, because we had been incrementally¹³ with newer drugs, one drug and then two drugs in combination, doing better and better.

　　But the idea of being able to suppress the virus to the point where you actually transform the life of an HIV-infected individual, where you have patients who otherwise would have died, who had been very, very debilitated¹⁴ essentially¹⁵ leading normal lives, and the statistics now are proving that to be the case, because we know now that if you put a young person in their mid-20s who is newly infected on these drugs in an appropriate combination, you can predict that they would live an additional 50 years to almost a normal life span.

　　I really—even though we were doing every day over decades, I really didn't imagine that we would have been this successful with having a combination that could do that. The real thing now is to implement¹⁶ that and get that to the people that need it. So that's really the challenge for the future.

　　Although the data are very encouraging, we still need to implement. And that's what we're talking about in World AIDS Day this year in 2012, that although we have accomplished¹⁷ a lot, we still have major challenges.

　　RAY SUAREZ:Your perspective is won the hard way, day by day over the decades. In the documentary "How to Survive the Plague," we see a shockingly young Tony Fauci, but we also see and are reminded of the terrible toll the early days of this disease took. Take us back to that time.

　　DR. ANTHONY FAUCI:Those are very dark years, Ray.

　　Before we had any therapy, it was like putting a Band-Aid on a hemorrhage. We had people who were presenting and not knowing that they were ill until they were far advanced in their illness.

　　My own personal experience was very dark and very depressing in many respects, although dealing¹⁸ with the patients gave me and them hope.

　　For example, in the mid-'80s, when I would be seeing patients here in the Washington area, that the median survival was six to eight months, which means that 50 percent of my patients would be dead in six to eight months. That was a terrible statistic and very painful for everyone involved.

　　And to have over the decades transformed into where we are now is an extraordinary accomplishment¹⁹. And that's the reason why we are—we're energized²⁰ because we have been so successful to make sure this gets very broadly implemented²¹ both domestically and internationally.

　　RAY SUAREZ:In one of the earliest publish pieces you wrote on the disease, before we even knew it was caused for sure by a virus, you wrote: "The mortality may well approach 100 percent, making this one of the most extraordinary transmissible diseases in history."

　　Even though the mortality is way down from 100 percent, is it that, one of the most extraordinary transmissible diseases in history?

　　DR. ANTHONY FAUCI:Oh, there is no doubt about that, Ray, that—by anybody's accounting²², that if you look historically over centuries at the handful of diseases that have been public health disasters, the bubonic plague, the influenza²³ pandemic of 1918, the smallpox²⁴ pandemics, the measle pandemics, clearly, HIV-AIDS is in the very, very short list of one of the most devastating²⁵ pandemics in the history of our civilization.

　　And that is not hyperbole. You look at the numbers, you look to see what has happened, and that is just the fact.

　　RAY SUAREZ:Right now, the big frontier seems to be lowering sexual transmission, because we have apparently²⁶ caused great decreases in the mother-to-child in utero transmission. How come that is so much more stubborn?

　　DR. ANTHONY FAUCI:Well, it is sexual behavior, and it is very, very difficult when you have something that is so natural to the human species to get people to avoid risks.

　　I mean, for example, if you look here in the United States, the majority of cases are actually among men who have sex with men, particularly among the African-American population.

　　If you look internationally, where 90-plus percent of the cases are, male-to-female heterosexual transmissibility is the overwhelming modality of transmissibility.

　　As part of human nature, people take risks or even people don't even understand what the risks are. And that is a tough nut to crack when you are dealing with it.

　　That is the reason why educating and getting people to be tested, to identify whether they are infected or not and to counsel them if they are not infected and get them into a care treatment program if they are infected is so terribly important.

　　RAY SUAREZ:A lot of reasons to be encouraged and a lot of challenges ahead.

　　Dr. Anthony Fauci, thanks for joining us.

　　DR. ANTHONY FAUCI:You're quite welcome.

　　RAY SUAREZ:And, online, you can watch my interview with the director of the documentary we just mentioned, "How to Survive a Plague." Plus, we ask journalist Jon Cohen to take stock of the latest AIDS developments.

1 toll   

n.过路(桥)费；损失，伤亡人数；v.敲(钟)

参考例句：

• The hailstone took a heavy toll of the crops in our village last night.昨晚那场冰雹损坏了我们村的庄稼。
• The war took a heavy toll of human life.这次战争夺去了许多人的生命。

2 epidemic   

n.流行病；盛行；adj.流行性的，流传极广的

参考例句：

• That kind of epidemic disease has long been stamped out.那种传染病早已绝迹。
• The authorities tried to localise the epidemic.当局试图把流行病限制在局部范围。

3 curbing   

n.边石，边石的材料v.限制，克制，抑制( curb的现在分词 )

参考例句：

• Progress has been made in curbing inflation. 在控制通货膨胀方面已取得了进展。
• A range of policies have been introduced aimed at curbing inflation. 为了抑制通货膨胀实施了一系列的政策。

4 daunting   

adj.使人畏缩的

参考例句：

• They were faced with the daunting task of restoring the house.他们面临着修复房子的艰巨任务。
• Starting a new job can be a daunting prospect.开始一项新工作有时会让人望而却步。

5 hurdles   

n.障碍( hurdle的名词复数 )；跳栏；（供人或马跳跃的）栏架；跨栏赛

参考例句：

• In starting a new company, many hurdles must be crossed. 刚开办一个公司时，必须克服许多障碍。 来自《简明英汉词典》
• There are several hurdles to be got over in this project. 在这项工程中有一些困难要克服。 来自辞典例句

6 killer   

n.杀人者，杀人犯，杀手，屠杀者

参考例句：

• Heart attacks have become Britain's No.1 killer disease.心脏病已成为英国的头号致命疾病。
• The bulk of the evidence points to him as her killer.大量证据证明是他杀死她的。

7 frustrating   

adj.产生挫折的，使人沮丧的，令人泄气的v.使不成功( frustrate的现在分词 )；挫败；使受挫折；令人沮丧

参考例句：

• It's frustrating to have to wait so long. 要等这么长时间，真令人懊恼。
• It was a demeaning and ultimately frustrating experience. 那是一次有失颜面并且令人沮丧至极的经历。 来自《简明英汉词典》

8 activists   

n.（政治活动的）积极分子，活动家( activist的名词复数 )

参考例句：

• His research work was attacked by animal rights activists . 他的研究受到了动物权益维护者的抨击。
• Party activists with lower middle class pedigrees are numerous. 党的激进分子中有很多出身于中产阶级下层。 来自《简明英汉词典》

9 unaware   

a.不知道的，未意识到的

参考例句：

• They were unaware that war was near. 他们不知道战争即将爆发。
• I was unaware of the man's presence. 我没有察觉到那人在场。

10 allergy   

n.(因食物、药物等而引起的)过敏症

参考例句：

• He developed an allergy to pollen.他对花粉过敏。
• The patient had an allergy to penicillin.该患者对青霉素过敏。

11 embedded   

a.扎牢的

参考例句：

• an operation to remove glass that was embedded in his leg 取出扎入他腿部玻璃的手术
• He has embedded his name in the minds of millions of people. 他的名字铭刻在数百万人民心中。

12 statistic   

n.统计量；adj.统计的，统计学的

参考例句：

• Official statistics show real wages declining by 24%.官方统计数字表明实际工资下降了24%。
• There are no reliable statistics for the number of deaths in the battle.关于阵亡人数没有可靠的统计数字。

13 incrementally   

adv.逐渐地

参考例句：

• Incrementally update the shared dimensions used in this cube. 增量更新此多维数据集中使用的共享维度。 来自互联网
• Grand goals are inspiring, but be sure to approach them incrementally. 辉煌的目标令人鼓舞，但一定要逐步实现。 来自互联网

14 debilitated   

adj.疲惫不堪的，操劳过度的v.使（人或人的身体）非常虚弱( debilitate的过去式和过去分词 )

参考例句：

• Prolonged strike action debilitated the industry. 长时间的罢工削弱了这个行业的活力。
• This is especially important when dealing with the geriatric or debilitated patient. 这对老年和虚弱病人尤其重要。 来自互联网

15 essentially   

adv.本质上，实质上，基本上

参考例句：

• Really great men are essentially modest.真正的伟人大都很谦虚。
• She is an essentially selfish person.她本质上是个自私自利的人。

16 implement   

n.(pl.)工具，器具；vt.实行，实施，执行

参考例句：

• Don't undertake a project unless you can implement it.不要承担一项计划，除非你能完成这项计划。
• The best implement for digging a garden is a spade.在花园里挖土的最好工具是铁锹。

17 accomplished   

adj.有才艺的；有造诣的；达到了的

参考例句：

• Thanks to your help,we accomplished the task ahead of schedule.亏得你们帮忙,我们才提前完成了任务。
• Removal of excess heat is accomplished by means of a radiator.通过散热器完成多余热量的排出。

18 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

19 accomplishment   

n.完成，成就，（pl.）造诣，技能

参考例句：

• The series of paintings is quite an accomplishment.这一系列的绘画真是了不起的成就。
• Money will be crucial to the accomplishment of our objectives.要实现我们的目标，钱是至关重要的。

20 energized   

v.给予…精力，能量( energize的过去式和过去分词 )；使通电

参考例句：

• We are energized by love if we put our energy into loving. 如果我们付出能量去表现爱意，爱就会使我们充满活力。 来自辞典例句
• I am completely energized and feeling terrific. 我充满了活力，感觉非常好。 来自辞典例句

21 implemented   

v.实现( implement的过去式和过去分词 )；执行；贯彻；使生效

参考例句：

• This agreement, if not implemented, is a mere scrap of paper. 这个协定如不执行只不过是一纸空文。 来自《现代汉英综合大词典》
• The economy is in danger of collapse unless far-reaching reforms are implemented. 如果不实施影响深远的改革，经济就面临崩溃的危险。 来自辞典例句

22 accounting   

n.会计，会计学，借贷对照表

参考例句：

• A job fell vacant in the accounting department.财会部出现了一个空缺。
• There's an accounting error in this entry.这笔账目里有差错。

23 influenza   

n.流行性感冒，流感

参考例句：

• They took steps to prevent the spread of influenza.他们采取措施
• Influenza is an infectious disease.流感是一种传染病。

24 smallpox   

n.天花

参考例句：

• In 1742 he suffered a fatal attack of smallpox.1742年，他染上了致命的天花。
• Were you vaccinated against smallpox as a child?你小时候打过天花疫苗吗？

25 devastating   

adj.毁灭性的，令人震惊的，强有力的

参考例句：

• It is the most devastating storm in 20 years.这是20年来破坏性最大的风暴。
• Affairs do have a devastating effect on marriages.婚外情确实会对婚姻造成毁灭性的影响。

26 apparently   

adv.显然地；表面上，似乎

参考例句：

• An apparently blind alley leads suddenly into an open space.山穷水尽，豁然开朗。
• He was apparently much surprised at the news.他对那个消息显然感到十分惊异。