美国国家卫生研究院国家过敏和传染病研究所主任医学博士安东尼·S·福西
3月24日是世界防治结核病日,今年是为期两年的“在我们的有生之年制止结核病(Stop TB in my lifetime)”世界防治结核病日主题活动的第二年。
3月24日是世界防治结核病日,人们在这一天纪念1882年的今天,罗伯特·科赫博士宣布发现导致结核病的细菌。每年这一天,我们花时间来提高人们对世界各地奇高结核病负担的认识。严峻的现实是,估计三分之一的世界人口被认为感染了结核病菌,虽然不一定表现出症状。2011年,约870万人患结核病,140万人死亡。这相当于每天近4000人死亡,或每分钟近三人死亡。令人鼓舞的是,自1990年以来,患结核病和因此死亡的人数一直在下降。特别是中国,自那时以来,与结核相关的死亡已经历了80%的下降。尽管如此,中国仍是世界第二大拥有结核病感染人数的国家。此外,耐药结核病形式继续增加,并威胁抵消我们在控制该疾病上取得的进展。
今年是为期两年的题为“在我们的有生之年制止结核病”世界防治结核病日活动的第二年。美国政府已经动用了相当多的资源来制止结核病,如支持开发新的诊断试验以提早发现结核病,更有效的药物来治疗药物敏感和耐药结核病,以及新的和更好的疫苗来预防结核病。美国国家卫生研究院(NIH)是美国政府的医学研究机构和世界上最大的医学研究资助机构。
NIH支持将基础科学的研究发现转化为实际应用以改善健康的科学研究。 2009年,隶属于NIH的国家过敏和传染病研究所(NIAID)与中国河南卫生厅开始了一项合作,在郑州建立一个联合结核病研究所,目标是开发新的结核病(特别是耐药结核病)治疗和诊断方法。这不仅与中国而且与整个世界相关。
由于此合作到目前为止的成功, 2012年11月15日,中国科技部(MOST)宣布将与NIAID已承诺的100万美元相应,另投同样100万美元到此合作中。这项来自我们两国政府的财政贡献,展示了美中对解决结核病带给世界的严重公共卫生挑战的承诺。
除了支持郑州的联合结核病研究所以外,NIAID还在帮助促进在中国建立一个可以对新结核药物和诊断进行更大规模临床试验的结核病医院联盟。此外,NIH目前正与MOST讨论建立一个联合资助的研究项目,美中研究人员将在此项目中一起工作。科学家们会研究包括结核病在内的呼吸系统疾病,以及心血管疾病、脑血管疾病和癌症,这些都是对我们两国来说特别重要的疾病。这项合作对另一非常成功的NIH和中国国家自然科学基金会(NSFC)联合资助的项目是一个补充,该项目于2010年启动以支持美中研究人员在基础生物医学科学领域的合作项目。这个NIH-NSFC联合资助的项目汇集了我们两国的资源,包括研究人员、病人、技术和资金。我相信,这个NIH-MOST联合资助的特别侧重于应用生物医学研究的合作,将一样会是富有成效和成功的。
此应对中国结核病的共同承诺得到美国疾病控制和预防中心(US CDC)及其中国卫生部的伙伴以及中国疾病控制和预防中心的大力支持。这些机构并肩努力,就结核病感染控制程序制定国家政策并开展教育。这项工作将有助于保护卫生保健工作者,改善病人护理并最终减少感染。
尽管近期全球结核病有所下降,结核病仍然是一个重大的公共卫生威胁,需要全世界的关注,并承诺采取行动。我相信,通过共同努力,中国和美国能在你我的有生之年,在世界各地制止结核病方面取得巨大进步并做出贡献。(作者:美国国家卫生研究院 国家过敏和传染病研究所主任 安东尼·S·福西)
World Tuberculosis Day 2013:Stop TB in Our Lifetime
Anthony S. Fauci, MD
Director, National Institute of Allergy and Infectious Diseases
U.S. National Institutes of Health
March 24th is World Tuberculosis Day, which commemorates the date in 1882 when Dr. Robert Koch announced his discovery of the bacterium that causes TB. On this date each year, we take time to raise awareness about the extraordinarily high burden of TB across the world. The sobering reality is that, although not necessarily showing symptoms, an estimated one third of the world’s population is thought to be infected with TB bacteria. In 2011, about 8.7 million people became sick with TB and 1.4 million people died. This was equivalent to almost 4,000 people dying each day, or almost three people every minute. An encouraging note is that the numbers of people getting sick and dying from TB have been decreasing since 1990. China, in particular, has experienced an 80 percent decline in TB-related deaths since that time. Nevertheless, China still has the second largest number of people infected with TB in the world. In addition, drug-resistant forms of TB continue to increase and threaten to erase our progress in controlling this disease.
This year is the second year of the two-year “Stop TB in my Lifetime” World TB Day campaign. The U.S. government has spent considerable resources to stop TB, such as supporting the development of new diagnostic tests to identify TB earlier, more potent drugs to treat drug-sensitive and drug-resistant TB, and new and better vaccines to prevent TB disease. The U.S. National Institutes of Health (NIH) is the medical research agency of the United States government and the largest funding agency for medical research in the world.
The NIH supports scientific studies that turn basic science research discoveries into practical applications to improve health. In 2009, the National Institute of Allergy and Infectious Diseases (NIAID), a component of NIH, began a collaboration with China’s Henan Bureau of Health to establish a joint TB research institute in Zhengzhou with the goal of developing new TB treatments and diagnostics, particularly for drug-resistant TB. This would be relevant not only for China but for the entire world.
Due to the success of this collaboration thus far, the China Ministry of Science and Technology (MOST) announced on November 15, 2012, that it would match the $1 million that NIAID had already committed to the collaboration with another 1 million USD equivalent. This financial contribution from both of our governments demonstrates commitment on behalf of the United States and China to tackle the serious public health challenges that tuberculosis presents to the world.
In addition to supporting the joint TB research institute in Zhengzhou, NIAID is also helping foster the establishment of a consortium of TB hospitals in China that can conduct larger clinical trials for new TB drugs and diagnostics. Furthermore, NIH is currently in discussion with MOST to establish a jointly funded research program in which U.S. and Chinese researchers would work together. The scientists would conduct research on respiratory diseases including tuberculosis, as well as cardiovascular diseases, cerebrovascular diseases, and cancer, all of which are diseases of particular importance to both of our countries. This collaboration would complement another very successful joint funding program between NIH and the China National Natural Science Foundation (NSFC), which started in 2010 to support collaborative projects between U.S. and Chinese researchers in the basic biomedical sciences. The NIH-NSFC joint funding program has brought together resources from both of our countries, including researchers, patients, technologies, and funding. I believe that an NIH-MOST joint funding collaboration with a particular emphasis on applied biomedical research would be just as productive and successful.
These research collaborations are complemented by the work of the U.S. Centers for Disease Control and Prevention (U.S. CDC) and its partners in the Ministry of Health and the Chinese Center for Disease Control and Prevention. The agencies have worked side by side to develop national policies and education on TB infection control procedures in healthcare settings. This work will help to protect health care workers, improve patient care, and ultimately reduce infections.
Despite recent declining rates of TB globally, TB remains a major public health threat requiring worldwide attention and commitment to action. I am confident that by working together, China and the United States can make great progress and contributions to stopping TB in our lifetimes throughout the world.