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委员会需要处理的问题和议事情况 | Issues and proceedings before the Committee |
审议可否受理问题 | Consideration of admissibility |
6.1 在审议来文提交的任何申诉之前，委员会必须根据《公约》第 22 条，决定来文是否可予受理。委员会已经根据《公约》第 22 条第 5 款(a)确定，同一事项未曾而且目前也没有在另一国际调查和解决程序之下受到审查。 | 6.1 Before considering any complaint submitted in a communication, the Committee must decide whether it is admissible under article 22 of the Convention. The Committee has ascertained, as it is required to do under article 22 (5) (a) of the Convention, that the same matter has not been and is not being examined under another procedure of international investigation or settlement. |
6.2 委员会忆及，根据《公约》第 22 条第 5 款(b)项，除非委员会确定，个人已经用尽一切国内补救办法，否则委员会不得审议该个人提交的任何来文。委员会指出，在本案中，缔约国没有对申诉人已经用尽一切国内补救办法这一点提出异议。因此，委员会认定，它可以根据《公约》第 22 条第 5 款(b)项审议来文。 | 6.2 The Committee recalls that, in accordance with article 22 (5) (b) of the Convention, it shall not consider any communication from an individual unless it has ascertained that the individual has exhausted all available domestic remedies. The Committee notes that in the present case, the State party has not contested that the complainant has exhausted all available domestic remedies. The Committee therefore finds that it is not precluded from considering the communication under article 22 (5) (b) of the Convention. |
6.3 委员会注意到，缔约国对申诉的可受理性提出异议，理由是申诉人的指称明显缺乏根据。从所掌握的材料和当事方提出的论点来看，委员会认为，申诉人已经为受理目的充分证实了他的指称，这些指称会引起《公约》之下的严重问题。据此，委员会认定，来文可予受理。 | 6.3 The Committee notes that the State party has contested the admissibility of the complaint on the grounds that the complainant’s claims are manifestly unfounded. In the light of the information on file and the arguments presented by the parties, the Committee considers that, for purpose of admissibility, the complainant has sufficiently substantiated his claims, which raise serious issues under the Convention. Accordingly, the Committee finds that the communication is admissible. |
6.4 委员会认定，在受理方面不再有其他障碍，因此，委员会宣布，根据《公约》第 3 条提交的来文可予受理。委员会着手审议案件实质。 | 6.4 As the Committee finds no further obstacles to admissibility, it declares the communication submitted under article 3 of the Convention admissible and proceeds with its consideration of the merits. |
审议案件实质 | Consideration of the merits |
7.1 根据《公约》第 22 条第 4 款，委员会参照有关当事方向其提供的一切资料审议了本来文。 | 7.1 In accordance with article 22 (4) of the Convention, the Committee has considered the present communication in the light of all information made available to it by the parties concerned. |
7.2 在本案中，委员会需要处理的问题是，将申诉人遣返巴基斯坦，是否会构成对缔约国在《公约》第 3 条之下的义务的违反。这项义务是：如果有充分理由认为，某人会在另一国面临遭受酷刑的危险，相关缔约国不得将该人遣返(“驱回”)该国。 | 7.2 In the present case, the issue before the Committee is whether the return of the complainant to Pakistan would constitute a violation of the State party’s obligation under article 3 of the Convention not to expel or to return (“refouler”) a person to another State where there are substantial grounds for believing that he or she would be in danger of being subjected to torture. |
7.3 在本案中，委员会必须对以下问题进行评估：是否有充分理由认为，申诉人如果返回巴基斯坦，本人就会面临遭受酷刑的危险。在评估这项临时，委员会必须依据《公约》第 3 条第 2 款，考虑到所有相关因素，包括遣返目的地国境内是否存在一贯严重、公然、大规模侵犯人权的情况。委员会指出，评估的目的在于弄清相关个人本人是否会在遣返目的地国面临遭受酷刑的可预见、实际的危险。因此，一国存在一贯严重、公然、大规模侵犯人权的情况这一点本身，并不构成据以认定某人在返回该国后将面临遭受酷刑危险的充分理由，还须提出其他理由，证明相关个人本人将面临危险。反过来，不存在公然侵犯人权的情况，并不意味着某人从具体情况来看可能不会遭受酷刑。6 | 7.3 In the present case, the Committee must assess whether there are substantial grounds for believing that the complainant would be personally in danger of being subjected to torture upon return to Pakistan. In assessing that risk, the Committee must take into account all relevant considerations, pursuant to article 3 (2) of the Convention, including the existence of a consistent pattern of gross, flagrant or mass violations of human rights in the country of return. The Committee recalls that the aim of the evaluation is to establish whether the individual concerned would be personally at a foreseeable and real risk of being subjected to torture in the country to which he or she would be returned. The existence of a pattern of gross, flagrant or mass violations of human rights in a country therefore does not as such constitute sufficient reason for determining that a particular person would be in danger of being subjected to torture on return to that country, and additional grounds must be adduced to show that the individual concerned would be personally at risk. Conversely, the absence of a consistent pattern of flagrant violations of human rights does not mean that a person might not be subjected to torture in his or her specific circumstances.6 |
7.4 委员会忆及关于《公约》第 3 条的执行的第 1 号一般性意见(1997 年)，这项意见指出，在评估遭受酷刑的危险时，绝不能仅仅依据理论或怀疑。尽管危险并非必须符合“高度可能”这一检验标准，但委员会指出，举证责任通常在申诉人，申诉人必须提出可论证的理由，证明本人面临可预见的、真实的危险。7 委员会指出，根据第 1 号一般性意见，委员会对有关缔约国机关的事实调查结果给予相当大的重视，但同时，委员会不受这些调查结果的约束，而且根据《公约》第 22 条第 4 款，有权根据每起案件的详细案情，自行评估所涉事实。 | 7.4 The Committee recalls its general comment No. 1 (1997) on the implementation of article 3 of the Convention, according to which the risk of torture must be assessed on grounds that go beyond mere theory or suspicion. While the risk does not have to meet the test of being highly probable, the Committee recalls that the burden of proof generally falls on the complainant, who must present an arguable case that he or she faces a foreseeable, real and personal risk.7 The Committee recalls that, under the terms of general comment No. 1, it gives considerable weight to findings of fact that are made by organs of the State party concerned, while at the same time it is not bound by such findings and has the power, provided by article 22 (4), of the Convention, of free assessment of the facts based upon the full set of circumstances in every case. |
7.5 在本案中，申诉人说，一旦被遣返，他本人面临的可预见、实际的危险是，巴基斯坦主管机构会将他拘留，对他施以酷刑并将他杀害，因为主管机构认为，他掌握关于巴基斯坦俾路支民族主义运动的情况，或者曾与该运动合作。他说，他先前曾经遭受巴基斯坦主管机构实施的任意拘留和酷刑，如果被遣返巴基斯坦，他可能再次遭受拘留和酷刑，他还说，他在巴基斯坦没有藏身之地。委员会注意到缔约国的意见，即：申诉人未能证明，一种可预见的、实际的、涉及本人的危险是，如果被遣返巴基斯坦，他会遭受酷刑；国内主管机构已经按照国内立法并在考虑到巴基斯坦当前的人权状况的前提下，审查了他的指称；国内主管机构认定，申诉人如被遣返巴基斯坦，不会成为巴基斯坦主管机构注意的对象，也不会受到伤害。 | 7.5 In the present case, the complainant claims that, in case of return, there is a real, foreseeable and personal risk that he would be detained, tortured and killed by the Pakistani authorities as he is believed to have information on the Balochi nationalist movement in Pakistan or to have cooperated with them. He claims that he has previously been detained arbitrarily and tortured by the Pakistani authorities and that this is likely to be repeated if he is removed to Pakistan. He also claims that there is no safe place for him to relocate in Pakistan. The Committee takes note of the State party’s submission that the complainant has failed to substantiate that there is a foreseeable, real and personal risk that he would be subjected to torture by the authorities if he is returned to Pakistan; that his claims have been reviewed by the competent domestic authorities, in accordance with domestic legislation and taking into account the current human rights situation in Pakistan; and that the domestic authorities determined that he would not be of interest to the Pakistani authorities and would not suffer harm if returned to Pakistan. |
7.6 委员会注意到，移民与公民事务部及难民复审法庭在裁决中接受申诉人的以下说法：2012 年，他曾遭巴基斯坦主管机构的任意拘留和虐待。委员会还注意到缔约国的这一论点，即申诉人在多次当面询问和提交的材料中表示，实施虐待的人为巴基斯坦不同的主管机构的人员，这会使人们对他的可信度产生怀疑。同时，委员会注意到提交人的论点，即在进行庇护程序过程中，他一直通过口译员进行交流，而且他一直表示，行凶者为代表巴基斯坦主管机构、身穿制服的武装人员。委员会认为，申诉人作出的解释为何及解释。委员会并不认为，申诉人陈述中用语的不一致会使人们对他的可信度产生怀疑。6 例如，见第 550/2013 号来文，S.K.和其他人诉瑞典，2015 年 5 月 8 日通过的意见，第 7.3 段。7 例如，见第 203/2002 号来文，A.R.诉荷兰，2003 年 11 月 14 日通过的意见，第 7.3 段。 | 7.6 The Committee notes that, in its decisions, the Department of Immigration and Citizenship and the Refugee Review Tribunal accepted the complainant’s claim that, in 2012, he had been arbitrarily detained and subjected to ill-treatment by Pakistani authorities. The Committee also notes the State party’s argument that the fact that the complainant has in various interviews and submissions referred to the perpetrators of the ill-treatment as being members of different Pakistani authorities raises doubts as to his credibility. The Committee further notes the author’s argument that he had been communicating via interpreters during the asylum proceedings and that he has always been consistent in describing the perpetrators as armed, in uniform and representing Pakistani authorities. The Committee finds the explanation provided by the complainant to be reasonable and does not consider that the variation of terminology in his declarations raises doubts about his credibility. |
7.7 委员会注意到，经公布的国别资料8 显示，据报道，巴基斯坦主管机构特别是该国情报机构将涉嫌参与俾路支民族主义运动的俾路支人作为打击对象，使其遭遇强迫失踪。此外，国别报告指出，多数受害者似乎由于据称参加俾路支民族主义党派和运动以及俾路支学生组织而成为打击目标。还据指出，在一些案件中，有人似乎因属于某个部落而成为受害者，如果某个部落(例如 Bugti 或Mengal 部落)曾经参与同巴基斯坦武装部队进行的交战，那么该部落成员受害的可能性尤其大。另外，据指出，俾路支省因巴基斯坦安全部队的行为而失踪的人的确切数目仍然不详，不过俾路支民族主义者称，曾发生过数千起案件；而俾路支省主管机构则多次表示，强迫失踪案件约为 1,000 起。国别资料称，许多案件仍然没有报告，因为家属和目击者由于担心遭到主管机构的报复，往往不愿向主管机构或人权组织报案。9 关于申诉人和缔约国就申诉人在巴基斯坦可能前往的安全地点问题提出的论点，委员会指出，依据委员会的判例、“局部危险”概念不能作为可衡量的标准，而且不足以完全消除个人遭受酷刑的危险。10 | 7.7 The Committee notes that, as per country information publicly available,8 Pakistani authorities, particularly its intelligence agencies, have been reported to target ethnic Balochs suspected of involvement in the Balochi nationalist movement for enforced disappearance. Furthermore, it is noted in country reports that most of the victims appeared to have been targeted because of alleged participation in Baloch nationalist parties and movements, as well as Baloch student organizations. It is also noted that, in several cases, people appeared to have been targeted because of their tribal affiliation, especially when a particular tribe, such as the Bugti or Mengal, had been involved in fighting with Pakistan’s armed forces. It is further noted that the exact number of disappearances perpetrated by Pakistan’s security forces in the province remains unknown but that Baloch nationalists claim thousands of cases, while Balochistan provincial authorities on several occasions have cited the figure of about 1,000 enforced disappearances. As per country information, many cases remain unreported as families and witnesses often prefer not to report cases to the authorities or human rights organizations because of fear of retaliation by the authorities.9 As regards the arguments presented by the complainant and the State party regarding a safe place to which the complainant could potentially relocate within Pakistan, the Committee recalls that, in accordance with its jurisprudence, the notion of “local danger” does not provide for measurable criteria and is not sufficient to entirely dispel the personal danger of being tortured.10 |
7.8 在这方面，委员会注意到申诉人所作的以下陈述：由于他被认为与俾路支民族主义运动有联系，如果将他强行遣返巴基斯坦，他就有可能遭受巴基斯坦主管机构施行的违反《公约》第 3 条的虐待。委员会注意到，申诉人先前曾经遭到巴基斯坦主管机构的任意拘留和虐待，申诉人说，他被拘留了 10 天，被迫表示愿意向主管机构提供他可能获取的任何关于俾路支民族主义运动的信息，主管机构在他获释之后再次找到他，对他进行进一步询问。委员会注意到，缔约国认为，申诉人遭受任意拘留和虐待一事属实。委员会还注意到，缔约国没有接受申诉人关于拘留事件的说法，也没有接受申诉人关于被迫表示愿意向主管机构提供获取的任何关于俾路支民族主义运动的信息的说法。委员会指出，缔约国没有提出任何实际论点为其结论提供依据，也没有提供任何会对申诉人的说法产生怀疑具体资料。因此，委员会认为，在评估本案指称的危险时，缔约国没有恰当考虑到提交人在评估如被遣返原籍国将会面临的指称的危险时，就他曾在巴基斯坦经历的事件作出的指称。 | 7.8 In this connection, the Committee takes note of the complainant’s claim that he is at risk of being subjected to ill-treatment contrary to article 3 of the Convention by Pakistani authorities if forcibly returned to Pakistan owing to his perceived connection to the Balochi nationalist movement. The Committee notes that the complainant has previously been arbitrarily detained and ill-treated by Pakistani authorities, that he has asserted that he was detained for a period of 10 days and pressured into stating that he would provide any information he could obtain on the Balochi nationalist movement to the authorities and that 8 See, for example, Human Rights Watch, “Enforced Disappearances by Pakistan Security Forces in Balochistan” (July 2011). Available from www.hrw.org/report/2011/07/28/we-can-torture-kill-or-keep-you-years/enforced-disappearances-pakistan-security. 9 Ibid. 10 See communications No. 338/2008, Mondal v. Sweden, Views adopted on 23 May 2011, para. 7.4; and No. 343/2008, Kalonzo v. Canada, Views adopted on 18 May 2012, para. 9.7. the authorities contacted him after his release in order to question him further. The Committee observes that the State party has accepted as a fact that the complainant was detained arbitrarily and ill-treated. The Committee also observes that the State party has not accepted the complainant’s claims regarding the detention period or that he was pressured into stating that he would provide any information obtained on the Balochi nationalist movement to the authorities. The Committee notes that the State party does not provide any concrete arguments to justify its conclusion and that no specific information has been presented that would raise doubts about the complainant’s assertion. The Committee is therefore of the view that, when assessing the alleged risk in the particular case of the complainant, the State party failed to take into due consideration the author’s allegations regarding the events he had experienced in Pakistan when assessing the alleged risk he would face if returned to his country of origin. |
8. 因此，从收到的所有资料来看，委员会认为，申诉人已经提供了足够证据，使委员会认为，如将他遣返原籍国，他本人将会面临遭受酷刑的实际、现实的危险。 | 8. On the basis of all the information submitted to it, the Committee is therefore of the view that the complainant has provided sufficient evidence for it to consider that his return to his country of origin would put him at a real, present and personal risk of being subjected to torture. |
9. 委员会依据《公约》第 22 条第 7 款行事，得出结论认为，将申诉人遣返巴基斯坦，会构成对《公约》第 3 条的违反。8 例如，见 Human Rights Watch,“Enforced Disappearances by Pakistan Security Forces inBalochistan”(July 2011)。可查阅 www.hrw.org/report/2011/07/28/we-can-torture-kill-or-keep-you-years/enforced-disappearances-pakistan-security。9 同上。10 见第 338/2008 号来文，Mondal 诉瑞典，2011 年 5 月 23 日通过的意见，第 7.4 段；以及第343/2008 号来文，Kalonzo 诉加拿大，2012 年 5 月 18 日通过的意见，第 9.7 段。 | 9. The Committee, acting under article 22 (7) of the Convention, therefore concludes that the return of the complainant to Pakistan would constitute a breach of article 3 of the Convention. |
10. 鉴于上述，委员会依据《公约》第 22 条第 7 款行事，认为，缔约国有义务按照《公约》第 3 条，不将申诉人强行遣返巴基斯坦，也不将申诉人遣送至他确有可能被驱逐至或遣返巴基斯坦的任何其他国家。 | 10. In the light of the above, the Committee, acting under article 22 (7) of the Convention, is of the view that the State party has an obligation, in accordance with article 3 of the Convention, to refrain from forcibly returning the complainant to Pakistan or to any other country where he runs a real risk of being expelled or returned to Pakistan. |
联合国开发计划署、 | United Nations Development |
联合国人口基金和 | Population Fund and the United |
联合国项目事务署 | Nations Office for Project Services |
5 July 2019 | 5 July 2019 |
19-12945 X (C) 020819 020819 | 19-12945X (E) 020819 |
19-12945 X (C) 020819 020819*1912945* | *1912945* |
2019 年第二届常会 | Second regular session 2019 |
2019 年 9 月 3 日至 6 日，纽约 | 3-6 September 2019, New York |
临时议程项目 9 | Item 9 of the provisional agenda |
艾滋病署方案协调委员会会议后续行动 | Follow-up to UNAIDS Programme Coordinating Board meeting |
联合国艾滋病毒/艾滋病联合规划署方案协调委员会决定和建议执行情况报告 | Report on implementation of decisions and recommendations of the Programme Coordinating Board of the Joint United Nations Programme on HIV/AIDS |
摘要 | Summary |
本报告阐述联合国艾滋病毒/艾滋病联合规划署(艾滋病署)方案协调委员会(协委会)决定和建议的执行情况。报告重点是分别于 2018 年 6 月和 12 月举行的协委会第 42 次和第 43 次会议以及于 2019 年 3 月举行的特别会议所作决定的执行情况。报告还强调了开发署和人口基金在艾滋病毒/艾滋病应对方面作出的贡献。 | The present report addresses the implementation of decisions and recommendations of the Programme Coordinating Board (PCB) of the Joint United Nations Programme on HIV/AIDS (UNAIDS). The report focuses on the implementation of decisions from the 42nd and 43rd PCB meetings, held in June and December 2018, respectively, as well the special session held in March 2019. The report also highlights the contributions of UNDP and UNFPA to the HIV/AIDS response. |
I. 背景...................................................................................................................................... 3 | I. Context ................................................................................................................................. 3 |
II. 艾滋病署方案协调委员会的决定和建议.......................................................................... 3 | II. Decisions and recommendations of the UNAIDS Programme Coordinating Board ........... 4 |
A. 独立专家小组...................................................................................................................... 3 | A. Independent Expert Panel..................................................................................................... 4 |
B. 艾滋病署联合行动计划执行进展...................................................................................... 4 | B. Progress in the implementation of the UNAIDS Joint Action Plan..................................... 4 |
C. 更新艾滋病署 2016-2021 年战略中的获取途径要素....................................................... 4 | C. Update on the access components of the UNAIDS Strategy 2016-2021 ............................. 5 |
III. 开发署和人口基金的变革成果.......................................................................................... 5 | III. UNDP and UNFPA transformative results .......................................................................... 6 |
D. 战略成果领域 1：艾滋病毒检测和治疗........................................................................... 5 | D. Strategic results area 1: HIV testing and treatment.............................................................. 6 |
E. 战略成果领域 2：消除艾滋病毒母婴传播....................................................................... 7 | E. Strategic results area 2: Elimination of mother-to-child transmission of HIV..................... 8 |
F. 战略成果领域 3：青年的艾滋病毒预防........................................................................... 7 | F. Strategic results area 3: HIV prevention among young people............................................ 9 |
G. 战略成果领域 4：与重点人群一起和帮助他们预防艾滋病毒....................................... 8 | G. Strategic results area 4: HIV prevention with and for key populations ............................. 10 |
H. 战略成果领域 5：性别不平等和基于性别的暴力........................................................... 9 | H. Strategic results area 5: Gender inequality and gender-based violence ............................. 11 |
I. 战略成果领域 6：人权、污名化和歧视......................................................................... 10 | I. Strategic results area 6: Human rights, stigma and discrimination .................................... 13 |
J. 战略成果领域 7：投资和效率......................................................................................... 12 | J. Strategic results area 7: Investment and efficiency ............................................................ 14 |
K. 战略成果领域 8：艾滋病毒和卫生服务的整合............................................................. 12 | K. Strategic results area 8: HIV and health service integration .............................................. 15 |
IV. 结论.................................................................................................................................... 13 | IV. Conclusion.......................................................................................................................... 16 |
I. 背景 | I. Context |
1. 全球抗击艾滋病毒行动已经到达紧要关头。距离实现 2020 年目标仅剩下一半的时间，目前的进展速度与宏伟的全球目标相去甚远。全球新增艾滋病毒感染病例数量在过去 7 年中仅下降了 18%，从 2010 年的 220 万例下降到 2017 年的 180 万例。尽管 2017 年新增感染病例数量较 1996 年所达到的最高数值减少了将近一半，但按照这种减少速度，仍然不能在 2020实现新增病例数量少于 50 万的目标。非洲东部和南部是受艾滋病毒影响最为严重的地区，这里的新增艾滋病毒感染病例数量的降幅最大，自 2010 年以来已经减少了 30%。然而，新增艾滋病毒感染病例数量在大约 50 个国家仍然呈上升趋势。在过去 20 年中，东欧和中亚的每年新增艾滋病毒感染病例数量增加了一倍，而中东和北非的新增艾滋病毒感染病例数量则增加了四分之一以上。 | 1. The global response to HIV is at a precarious point. At the halfway point of the 2020 targets, the pace of progress is not matching global ambition. Globally, new HIV infections have declined by just 18 per cent in the past seven years, from 2.2 million in 2010 to 1.8 million in 2017. Although this is nearly half the number of new infections compared to the peak in 1996 (3.4 million), the decline is not quick enough to reach the target of fewer than 500,000 by 2020. The reduction in new HIV infections has been strongest in the regions most affected by HIV, Eastern and Southern Africa, where new HIV infections have been reduced by 30 per cent since 2010. However, new HIV infections are rising in around 50 countries. In Eastern Europe and Central Asia, the annual number of new HIV infections has doubled, and new HIV infections have increased by more than a quarter in the Middle East and North Africa over the past 20 years. |
2. 由于抗逆转录病毒疗法的推广，艾滋病相关死亡人数达到了本世纪的最低水平（94 万人），并且在 2016 年首次下降至 100 万人以下。然而，按照目前的下降速度，仍然无法实现2020 年艾滋病相关死亡人数少于 50 万的目标。2017 年，在 3690 万艾滋病毒携带者中，近60%正在接受治疗，这是一项重要成就，但要实现 3000 万人接受治疗的目标，每年新增接受治疗人数都需要达到 280 万人，而且有迹象表明，治疗人数增长速度正在放缓。 | 2. Due to the impact of antiretroviral therapy scale-up, the number of AIDS-related deaths is the lowest this century (940,000), having dropped below 1 million for the first time in 2016. Yet, the current pace of decline is not fast enough to reach the 2020 target of fewer than 500,000 AIDS-related deaths. Almost 60 per cent of the 36.9 million people living with HIV (PLHIV) were on treatment in 2017, an important achievement, but to reach the 30 million target, there needs to be an annual increase of 2.8 million people, and there are indications that the rate of scale-up is slowing down. |
3. 加快步伐消灭艾滋病毒疫情这一公众健康威胁并承诺不让任何人掉队，这需要加大力度解决艾滋病毒和健康的决定因素，以及由此而长期存在的不公平和差异问题。这些决定因素多种多样并且相互关联，包括但不限于贫穷、受教育程度、边缘化、经济和性别不平等、种族、残疾、法律地位以及移民经历。惩罚性和歧视性法律及政策进一步加剧了对艾滋病毒携带者和重点人群的污名化和歧视，成为妨碍他们获取和使用所需服务的主要障碍。 | 3. Accelerating progress towards ending the HIV epidemic as a public health threat and the pledge to leave no one behind requires intensified efforts to address the determinants of HIV and health and the inequities or disparities they perpetuate. These determinants are diverse and interconnected, including, but not limited to, poverty, levels of education, marginalization, economic and gender inequalities, race, disability, legal status and migration experience. Stigma and discrimination towards PLHIV and key populations, reinforced by punitive and discriminatory laws and policies, are major barriers preventing people from accessing and using the services they need. |
4. 本报告由开发署和人口基金联合编写，提供有关 2018 年 6 月和 12 月举行的艾滋病署方案协调委员会(协委会)第 42 次和第 43 次会议的决定和建议执行情况的最新信息。涉及开发署和人口基金的主要问题包括：设立独立专家小组（“小组”），负责预防和应对艾滋病署秘书处内部的骚扰问题，包括性骚扰、欺凌和滥用权力；报告艾滋病署联合行动计划执行进展情况；更新艾滋病署 2016-2021 战略的获取途径要素；以及协委会第 42 次会议中的关于“消灭结核病和艾滋病-可持续发展目标时代下的联合行动”的专题部分。 | 4. The present report, prepared jointly by UNDP and UNFPA, provides an update on the implementation of decisions and recommendations from the 42nd and 43rd meetings of the UNAIDS Programme Coordinating Board (PCB), held in June and December 2018 respectively. Key issues of relevance to UNDP and UNFPA included the Independent Expert Panel (the Panel) on prevention of and response to harassment, including sexual harassment, bullying and abuse of power at UNAIDS Secretariat; the report on progress in the implementation of the UNAIDS Joint Action Plan; an update on the access components of the UNAIDS 2016-2021 Strategy, and; the thematic segment of the forty-second PCB meeting on “Ending tuberculosis and AIDS – a joint response in the era of the Sustainable Development Goals (SDGs)”. |
5. 本报告还重点介绍开发署和人口基金在为支持各国实现可持续发展目标和不让任何一个人掉队的承诺而开展更广泛的卫生、人权和发展工作的背景下，在处理艾滋病毒方面所取得的成果。两个组织的工作成果详见《艾滋病署统一预算、成果和问责制框架（UBRAF）2018年绩效监测报告》。2019 年第二届常会的口头陈述内容将简要介绍 2019 年 6 月 25 日至 27日举行的协委会第 44 次会议的决定和建议。 | 5. This report also provides highlights of UNDP and UNFPA results in addressing HIV in the context of broader work on health, human rights and development to support countries to achieve the SDGs and the pledge to leave no one behind. More detailed results for both organizations are available in the UNAIDS Unified Budget, Results and Accountability Framework (UBRAF) 2018 Performance Monitoring Reports. The oral presentation at the second regular session 2019 will include a synopsis of decisions and recommendations from the 44th PCB meeting held 25-27 June 2019. |
II. 艾滋病署方案协调委员会的决定和建议 | II. Decisions and recommendations of the UNAIDS Programme Coordinating Board |
A. 独立专家小组 | A. Independent Expert Panel |
6. 2018 年初，艾滋病署秘书处在性骚扰和权力滥用方面引起大量媒体关注。为此，秘书处制定了旨在解决骚扰问题的五点计划，并于 2018 年 2 月开始实施该计划。此外，艾滋病署执行主任组建了独立专家小组。该小组的职责是审查秘书处在过去七年中如何处理骚扰、欺凌和滥用权力问题，评估现有政策和程序的有效性，以及围绕着如何在组织文化、政策以及公平和尽职流程程序方面形成一套完整的重点措施提供建议。 | 6. In early 2018, the UNAIDS Secretariat received significant media attention on issues of sexual harassment and abuse of authority. In response, the Secretariat developed a five-point plan to tackle harassment, launched in February 2018. Additionally, the UNAIDS Executive Director established an Independent Expert Panel. The Panel’s remit was to review how the Secretariat has dealt with issues of harassment, bullying and the abuse of power in the past seven years, evaluate the effectiveness of existing policies and procedures, and recommend a comprehensive set of prioritized measures on organizational culture, policies and fair and due process procedures. |
7. 专家小组向组向协委会第 43 次会议做了报告，并就以下四个方面提出建议：治理、领导、管理、政策和进程。小组就以下方面提出了建议：加强治理和问责制，重新调整领导团队，改善对必要文化改革的管理，围绕预防骚扰、欺凌和权力滥用问题开展培训，以及改进政策和程序，包括提高执行效果。小组发现，机构文化和政策执行方面存在大量系统性缺陷，即便现行政策已接近最佳做法，而且受访者普遍认为机构体系在整体上不适合工作人员。 | 7. The Panel presented its report to the 43rd PCB meeting, with recommendations under four areas: governance, leadership, management, and policy and process. The Panel made recommendations about strengthening governance and accountability, reconditioning the leadership team, improving management for the necessary culture change, implementing training to prevent harassment, bullying and abuse of power, and enhancing policy and processes, including more effective implementation. The Panel found pervasive and systemic weakness in organizational culture and policy implementation, even though the policies in place were close to best practice, as well as a widespread perception among respondents that the system was not working for the staff overall. |
8. 协委会欢迎管理层做出答复，并认可艾滋病署秘书处在 2018 年为解决骚扰问题所做出的努力。需要建立协委会工作组，指导执行局如何更好地监测和评估艾滋病署秘书处采取的行动，以确保在艾滋病署秘书处对骚扰问题（包括性骚扰、欺凌和权力滥用）采取零容忍态度。这种经验应该在更广泛的联合国系统内推广借鉴。在 2019 年 3 月的协委会特别会议上提交了管理行动计划的修订和改进版本。工作组将在 2019 年的协委会会议上提交这份报告。 | 8. The PCB welcomed the management response and recognized the efforts of the UNAIDS Secretariat through 2018 to tackle harassment. It requested that a PCB working group be established to provide guidance for the Board on how to better monitor and evaluate actions undertaken by the UNAIDS Secretariat to ensure zero tolerance against harassment, including sexual harassment, bullying and abuse of power at the UNAIDS Secretariat. This experience could also be used to inform the broader United Nations system. A revised and strengthened Management Action Plan was presented at a Special Session of the PCB in March 2019. The working group will present its report at the June 2019 PCB meeting. |
9. 开发署和人口基金致力于消灭一切形式的性剥削、性虐待以及性骚扰，为此，二者通过开展一系列协调行动，在彼此之间以及与更广泛的联合国系统进行密切合作。包括制定最高标准的政策、程序和制度，以预防和有效应对性骚扰以及性剥削和性虐待问题，保护工作人员免受其害。 | 9. UNDP and UNFPA are committed to eliminating all forms of sexual exploitation and abuse and sexual harassment and to this end are working closely with each other and the wider United Nations system through a range of coordinated actions. This includes ensuring the highest standards of policies, processes and systems in place for the protection from, prevention of and effective response to sexual harassment and sexual exploitation and abuse. |
10. 2018 年 12 月，艾滋病署执行主任宣布其将于 2019 年 6 月底卸任，并要求协委会建立一项过渡程序。新一任艾滋病署执行主任遴选委员会已经成立，并且于 2019 年 3 月的协委会特别会议上提交了过渡程序提案。遴选委员会将在 2019 年 6 月的协委会第 44 次会议上提交报告及候选人名单。 | 10. In December 2018, the UNAIDS Executive Director announced he would leave his post at the end of June 2019 and requested the PCB to put in place a transition process. A search committee for the selection of the next Executive Director of UNAIDS was established which presented the proposed process at a Special Session of the PCB in March 2019. The search committee will present its report including a shortlist of candidates at the forty-fourth PCB meeting in June 2019. |
B. 艾滋病署联合行动计划执行进展 | B. Progress in the implementation of the UNAIDS Joint Action Plan |
11. 协委会了解到艾滋病署联合行动计划的执行进展，以及为加强国家层面的工作而采取的措施。主要进步来自联合国抗击艾滋病毒联合计划，包括联合国 2018-2019 年支持行动（涵盖 97 个国家）以及国家封套（涵盖 71 个国家）。2019 年，开发署收到 2 205 600 美元，人口基金收到 3 456 400 美元，用于国家一级关于艾滋病毒的工作。 | 11. The PCB was briefed on the progress on implementing the UNAIDS Joint Action Plan and actions undertaken to strengthen country-level work. Improvements were focused around joint United Nations Plans on AIDS, covering United Nations support for 2018-2019 (in 97 countries), and country envelopes (in 71 countries). In 2019, UNDP received $2,205,600 and UNFPA received $3,456,400 for country-level work on HIV. |
12. 对行动计划进行了早期审查，以确定需要尽快处理的问题。审查结果表明，通过实施行动计划，形成了动态差异化资源分配模式，加强了共同赞助者在国家层面的协作，提高了地方自主性、透明度和问责制。主要难题包括联合规划署核心资源减少，造成财政资源缩减、人力资源有限。共同赞助者对国家封包难以灵活地应对新兴问题以及非快车道国家无法享受优先待遇表示关切，并警告称有些国家有可能不再将艾滋病毒预防和结构性干预措施作为重点。 | 12. An early review of the Action Plan was undertaken to identify issues requiring action as quickly as possible. The review showed that the Action Plan resulted in a dynamic and differentiated resource allocation model, was intensifying country-level collaboration between co-sponsors and promoting local ownership, transparency and accountability. The main challenges included shrinking financial resources and limited human resources due to the decline in the core resources of the Joint Programme. Co-sponsors noted concerns about the limited flexibility of country envelopes in terms of responding to emerging issues and the deprioritization of non-Fast-Track countries, and warned about the risk of countries deprioritizing HIV prevention and structural interventions. |
13. 成员国对国家封包方法以及将其纳入联合国联合规划进程表示欢迎。他们表示，协委会通过的行动计划完全契合联合国发展系统的重新定位工作。各国需要投入更多努力，加大力度保护人权和消灭污名化和歧视。联合规划署需要与民间社会一起制定指导方针和战略，确保国家方案考虑了大多数受影响人群。为国家封包预留的资金仅占联合规划署核心预算的一小部分（12%），因此协委会建议未来的评估和审查工作中，应对联合规划署进行更全面的考虑。 | 13. Member States welcomed the country envelope approach and its integration into the joint United Nations planning process. They stated that the Action Plan adopted by the PCB fits well within the repositioning exercise of the United Nations Development System. Countries were urged to invest more in strengthening the protection of human rights and ending stigma and discrimination. The Joint Programme was asked to develop guidelines and strategies with civil society to ensure that the most affected populations are factored into country plans. Since the amount set aside for country envelopes represents only a small portion of the Joint Programme’s core budget (12 per cent), the PCB suggested that future evaluations and reviews should consider the wider picture of the Joint Programme. |
C. 更新艾滋病署 2016-2021 年战略中的获取途径要素 | C. Update on the access components of the UNAIDS Strategy 2016-2021 |
14. 在协委会第 43 次会议上，报告了某份协委会文件在以下方面的发现：如何支持中低收入国家消除获取途径方面的障碍，包括知识产权相关障碍，以及哪些因素会影响对艾滋病及其合并感染和并发症卫生技术的获取和承担能力。文件强调，将近一半的艾滋病毒携带者仍然无法获取治疗，而且儿童的治疗覆盖率低于成人。大多数艾滋病毒携带者生活在中等收入国家，这些国家大多未被纳入自愿许可协议中，所以卫生商品价格非常高昂，而这类协议可以促进艾滋病毒相关药物和其他卫生技术的定价更容易负担得起。在尝试使用“与贸易有关的知识产权协定”时，各国经常遇到巨大难题，虽然当地生产规模正在扩大，但许多国家仍然难以获得价格亲民的抗逆转录病毒药物、丙型肝炎治疗服务和艾滋病暴露前预防服务。 | 14. The findings of a PCB paper on how low- and middle-income countries can be supported to overcome access barriers, including intellectual property-related barriers, and factors that affect the availability and affordability of health technologies for HIV and its co-infections and co-morbidities, were presented at the 43rd PCB meeting. The paper highlighted that almost half of PLHIV are still not accessing treatment, and that treatment coverage for children was lower than for adults. The majority of PLHIV now live in middle-income countries, the majority of which are not included in the voluntary licensing agreements that have facilitated more affordable pricing arrangements for HIV-related medicines and other health technologies, resulting in high prices for health commodities. Countries often encounter significant difficulties when trying to use the Trade-Related Aspects of Intellectual Property Rights agreement (TRIPS), and, though local production is expanding, many countries struggle to access affordable versions of antiretrovirals, treatment for hepatitis C and PrEP. |
15. 协委会对该文件表示欢迎，并且强调获取价格亲民、质量一流的药物是实现全民健康保障以及可持续发展目标的关键。成员国坚持认为，联合规划署有责任推动以亲民价格提供艾滋病毒及相关保健商品药物，从而保护公众的利益。他们呼吁联合规划署在该问题上加强政策一致性，并要求该署继续努力改善药物获取途径。联合规划署需要继续发挥倡导和号召作用，扩大价格亲民、质量有保障的艾滋病毒和相关健康商品的获取途径。 | 15. The PCB welcomed the paper and stressed that access to affordable quality medicines is crucial for universal health coverage (UHC) and the achievement of the SDGs. Members insisted that the Joint Programme has a responsibility to protect the public interest with regards to promoting affordable access to HIV and related health commodities medicines. They called for strengthened policy coherence across the Joint Programme on the issue and asked that it continue its efforts to improve access to medicines. The Joint Programme was requested to continue to use its advocacy and convening power to widen access to affordable, quality-assured HIV and related health commodities. |
关于“消灭结核病和艾滋病-可持续发展目标时代下的联合行动”的专题部分 | Thematic segment on ending tuberculosis and AIDS, a joint response in the era of the SDGs |
16. 协委会第 42 次会议的专题部分的讨论主题是消灭结核病和艾滋病。专题部分指出，生物医学干预措施与保护人权、消除贫穷、贫困生活和工作条件、污染等结构性干预措施相结合时，效果最明显。艾滋病毒和结核病方案应整合起来，并且共同倡导为推进全民健康保障而做出必要政治承诺，包括可持续健康供资、卫生系统治理、基本药物和保健产品、服务交付和质量。国内新型供资机制固然重要，但国际供资也必不可少。会议达成以下结论：结核病高级别会议为推进旨在于 2030 年消灭结核病的行动提供了机会，并且应与有关非传染性疾病和全民健康保障的其他高级别会议联系起来。记录专题部分关键信息的协委会主席函已提交给结核病高级别会议的共同协调人。 | 16. The thematic segment of the 42nd PCB meeting was dedicated to discussing ending tuberculosis and AIDS. It was noted that the impact of biomedical interventions is highest when they were combined with structural interventions that protect human rights and tackle poverty, poor living and working conditions, pollution, etc. HIV and tuberculosis programmes should be integrated and must advocate together for the political commitment needed to advance UHC, including sustainable health financing, health systems governance, essential medicines and health products, and service delivery and quality. While domestic and innovative financing are important, international financing is still needed. The meeting concluded that the high-level meeting on tuberculosis presented an opportunity to invigorate efforts to end tuberculosis by 2030 and should be linked to the other high-level meetings on non-communicable diseases and UHC. A letter from the PCB Chair capturing the key messages from the thematic segment was submitted to the co-facilitators of the high-level meeting on tuberculosis. |
III. 开发署和人口基金的变革成果 | III. UNDP and UNFPA transformative results |
17. 本节重点介绍了开发署和人口基金的成果，按《2016–2021 年统一预算、成果和问责制框架》的战略成果领域分列。作为艾滋病署的共同赞助者和全球基金的伙伴，开发署和人口基金与联合国和其他伙伴合作，在支持各国执行《2030 年议程》和不让任何一个人掉队的承诺方面发挥重要作用。2018 年，129 个开发署国家办事处和 81 个人口基金办事处向国家艾滋病毒和卫生对策提供了支持。 | 17. This section highlights the achievements of UNDP and UNFPA, structured according to the 2016-2021 UBRAF strategic results areas. As cosponsors of UNAIDS and partners of the Global Fund, UNDP and UNFPA play important roles in supporting countries to implement the 2030 Agenda and the commitment to leave no one behind, in partnership with United Nations and other partners. In 2018, 129 UNDP country offices and 81 UNFPA offices supported national responses to HIV and health. |
D. 战略成果领域 1：艾滋病毒检测和治疗 | D. Strategic results area 1: HIV testing and treatment |
18. 在实现艾滋病署 90–90–90 目标方面取得了进展。目前，3/4 的艾滋病毒携带者了解自身感染状况，而且他们当中有 79%在 2017 年获得治疗1，在这 79%的接受治疗者中，有 81%的人群的病毒载量已得到抑制。在儿童、青年和男性中，了解自身艾滋病毒状况的人数比率、治疗覆盖率和病毒抑制率依然相对较低。在重点人群中，各个国家呈现截然不同的趋势，但大多数证据表明，这些人群的治疗依从性较差，病毒抑制率较低。 | 18. There has been progress towards the UNAIDS 90–90–90 targets. Three in four PLHIV now know their HIV status; of the people who know their status, 79 per cent were accessing treatment in 2017; 1 and of the people accessing treatment, 81 per cent had supressed viral loads. Knowledge of HIV status, treatment coverage and viral suppression rates remained consistently lower among children, young people and men. Among key populations, trends differed widely from country to country, though most evidence pointed to weaker treatment adherence and lower viral suppression for those populations. |
19. 开发署与全球基金建立了伙伴关系，帮助在一些最具挑战性的环境中应对艾滋病毒、结核病和疟疾。据估计，自 2003 年以来，二者在伙伴关系下共挽救了 310 万个生命。截至 2019年 5 月，开发署共管理着全球基金的涵盖 19 个国家的 32 项艾滋病毒、结核病和疟疾相关拨款，还管理着覆盖其他 24 个国家的 3 项区域方案。开发署的工作包括实施大型方案，为提高卫生系统的适应能力和可持续性而开展能力建设，以及支持各国完善法律和政策，确保不让任何人掉队。通过与人口基金、儿基会、难民署、粮食署、世卫组织以及民间社会和私营部门建立伙伴关系并利用它们的专门知识，开发署实施了这种综合性端到端方法。 | 19. In partnership with the Global Fund, UNDP supports the response to HIV, tuberculosis and malaria in some of the most challenging contexts. Since 2003, the partnership has saved an estimated 3.1 million lives. As of May 2019, UNDP was managing 32 HIV, tuberculosis and malaria grants from the Global Fund in 19 countries and three regional programmes that cover an additional 24 countries. UNDP work involves implementing large-scale programmes, building capacity of health systems so that they are more resilient and sustainable, and supporting countries to strengthen laws and policies to ensure that no one is left behind. This integrated, end-to-end approach is done in partnership with, and leveraging the expertise of, other UNAIDS co-sponsors such as UNFPA, UNICEF, UNHCR, WFP, and WHO, as well as civil society and the private sector. |
20. 为支持国家合作伙伴，开发署目前正为 140 万人提供艾滋病毒抗逆转录病毒疗法。2018年取得其他重要成果包括：(a) 630 万人接受了艾滋病毒咨询和检测服务；(b) 97000 名孕妇接受抗逆转录病毒疗法，以预防垂直传播；(c) 检测和治疗了 54000 例新增涂阳肺结核病例；(d) 1600 人接受了多重耐药结核病治疗；(e) 分发了 1970 万个蚊帐；(f) 治疗了 760 万例疟疾病例。 | 20. In support of national partners, UNDP is currently providing 1.4 million people with antiretroviral treatment for HIV. Other key results in 2018 include: (a) 6.3 million people counselled and tested for HIV; (b) 97,000 pregnant women receiving ARVs for prevention of vertical transmission; (c) 54,000 new smear-positive tuberculosis cases detected and treated; (d) 1,600 people treated for multi-drug resistant tuberculosis; (e) 19.7 million bed nets distributed; (f) 7.6 million cases of malaria treated. |
21. 利用开发署与全球基金的伙伴关系，越来越多的国家要求开发署帮助他们提高卫生系统的适应能力和可持续性。开发署为 10 个国家提供额外采购和供应链管理支持，以便他们采购抗艾滋病毒药物和检测产品。2018 年，开发署利用全球基金或其他供资渠道获得 1.6 亿美元资金，帮助各国采购抗艾滋病毒药物和诊断产品。开发署还帮助完善 18 个国家的国家协调机制的运作。 | 21. Leveraging UNDP partnership with the Global Fund, a growing number of countries requested UNDP support for strengthening the resilience and sustainability of systems for health. UNDP provided additional procurement and supply chain management support to ten countries for the procurement of HIV medicines and tests. In 2018, UNDP supported countries to procure HIV medicines and diagnostics, with Global Fund or other funding, amounting to $160 million. UNDP also supported strengthening the functioning of Country Coordinating Mechanisms in 18 countries. |
22. 开发署正在帮助全球基金实施其战略：投资结束疫情 2017-2022，特别是与人权、重点人群和性别问题相关的战略目标。这包括为全球基金利益攸关方提供指导、工具和培训，以及将这些问题纳入开发署管理的全球基金拨款的预算和成果框架中进行考虑。例如，通过与全球基金合作来加强国家协调机制在防治艾滋病毒、结核病和疟疾的性别层面发挥的作用。在南苏丹，开发署通过提供能力建设支持，让国家艾滋病防治机构建议将全球基金拨款的一部分用于旨在促进性别平等的干预措施上。 | 22. UNDP is supporting the Global Fund on the implementation of their strategy: Investing to End the Epidemics 2017-2022, in particular the strategic objectives relating to human rights, key populations and gender. This includes guidance, tools and trainings for Global Fund stakeholders as well as incorporation of these issues in the budgets and results frameworks of Global Fund grants that UNDP manages. For example, by working with the Global Fund to 1 The latest available HIV estimates are for 2017; estimates for 2018 will be released later in 2019. strengthen the capacity of the Country Coordinating Mechanisms on gender dimensions of HIV, tuberculosis and malaria. In South Sudan, UNDP capacity building support led to national AIDS bodies recommending that a portion of a Global Fund grant be allocated to gender-responsive interventions. |
23. 开发署已与世卫组织、其他艾滋病署共同赞助者及合作伙伴开展合作，支持成员国促进艾滋病药物和其他卫生技术的创新和获取。例如，在 2018 年 5 月，经过一系列跨部门磋商后，南非政府批准了一项新知识产权政策，用于加强政策一致性并促进卫生技术的创新和获取，这对实现全民健康保障和其他 2030 年议程目标和具体目标至关重要。 | 23. UNDP has worked with WHO, other UNAIDS Cosponsors and partners in supporting Member States to promote innovation and access to HIV medicines and other health technologies. For example, in May 2018, after a series of multisectoral consultations the Government of South Africa approved a new Intellectual Property Policy that aims at increasing policy coherence and improving innovation and access to health technologies, all of which are critical for achieving UHC and other 2030 Agenda goals and targets. |
24. 开发署和非洲发展新伙伴关系（NEPAD）与联合国和民间社会伙伴一道支持制定《非洲联盟医疗产品监管示范法》。这部法律旨在完善和协调非洲各国法规，实现更高效地批准和推广应用有保障的新卫生技术。开发署牵头的获取和交付伙伴关系计划目前支持 13 个国家将《示范法》纳入国内法律体系，这将帮助实现在 2020 年通过该法律的成员国数量达到 25个的非洲联盟目标。获取和交付伙伴关系计划还为非洲药物管理局提供技术支持，帮助其协调各项举措，以实现各类药物产品法规相互一致；还就改善整个非洲大陆对药物和卫生技术的获取途径提供指导。 | 24. UNDP and the New Partnership for Africa's Development (NEPAD), together with United Nations and civil society partners, supported the development of the African Union Model Law on Medical Product Regulation. By improving and harmonizing regulations across Africa, the law will enable new, quality-assured health technologies to be approved and introduced more efficiently. The UNDP-led Access and Delivery Partnership is now supporting 13 countries domestication of the Model Law; this will help countries to meet the African Union target of 25 Member States adopting the law by 2020. Access and Delivery Partnership is also providing technical support to the African Medicines Agency on the coordination of initiatives to harmonize medical products regulation and provide guidance to improve access to medicines and health technologies across the continent. |
人道主义紧急情况中的艾滋病毒相关服务 | HIV-related services in humanitarian emergencies |
25. 2018 年，人口基金人道主义行动（性和生殖健康/性别暴力方面的服务、用品及信息）援助了大约 1500 万受危机影响的妇女、女童和青年。共计向 55 个国家发放了 12000 个紧急情况专用生殖保健箱，从而为下人群提供有对性的服务：(a) 340 万人获得强奸后保健箱，以便进行强奸临床管理；(b) 550 万人获得性传播疾病治疗服务；(c) 300 万人获得自愿计划生育服务；(d) 320 万妇女和女童获得基本和全面的产科急诊护理。 | 25. In 2018, UNFPA humanitarian action (Sexual and Reproductive Health (SRH)/gender-based violence (GBV) services, supplies and information) reached an estimated 15 million women, girls and young people affected by crises. In all, 12,000 emergency reproductive health kits were delivered to 55 countries with the capacity for targeted services for: (a) 3.4 million people to access post-rape kits for clinical management of rape; (b) 5.5 million for treatment of sexually transmitted infections; (c) 3 million to receive voluntary family planning services; (d) 3.2 million women and girls to receive basic and comprehensive emergency obstetric care. |
26. 人口基金还更新了最低初步成套服务计算器的预加载数据，以便在评估人道主义局势时更好地估测生殖健康商品需求。人口基金继续培训人道主义应急人员，内容包括使用最低初步成套服务以及基于性别的暴力的协调、准则和信息管理，包括通过电子学习课程进行。共计支持了 28 个国家将性和生殖健康纳入应急准备、响应和减灾计划。 | 26. UNFPA also updated pre-loaded data for the Minimum Initial Service Package calculator, to better estimate the reproductive health commodity requirements, when assessing humanitarian situations. UNFPA continued to train humanitarian responders, including on use of the Minimum Initial Service Package, and on gender-based violence response coordination, guidelines and information management, including through an e-learning course. A total of 28 countries were supported to integrate SRH into emergency preparedness, and response and disaster reduction plans. |
27. 确保提供男用和女用安全套仍然是重点工作。2017 年，人口基金的主要任务是支持各国完善国家生殖健康商品供应链管理系统、高效而透明地使用国内资源，确保为生殖健康商品提供充足的国家资助。到 2018 年，11 个国家制定了供应链管理战略以及旨在解决商品供应和获取方面各类问题的实施计划（含费用信息）。这些国家战略符合人口基金/世卫组织关于确保以人权为基础提供避孕服务的建议。 | 27. Ensuring access to male and female condoms continues to be a priority. During 2017, UNFPA Supplies sharpened its focus on supporting countries to strengthen their national reproductive health commodity supply chain management (SCM) systems, efficient and transparent use of domestic resources, and ensuring adequate national funding for reproductive health commodities. By 2018, 11 countries had supply chain management strategies in place, with costed implementation plans that address all elements of commodity availability and accessibility. These country strategies are aligned with UNFPA/WHO recommendations for ensuring human rights-based contraceptive service delivery. |
28. 人口基金代表世卫组织并与其共同管理男用和女用避孕套资格预审计划。通过资格预审的供应商名单已发布并提供给成员国以及避孕套采购国际机构（目前名单中共有 30 个男用避孕套生产商和 4 个女用避孕套生产商）。2018 年，避孕套总体采购量较 2016 年增加了 2倍。2018 年，人口基金提供了：(a) 12.4 亿只男用避孕套（价值 2730 万美元）；(b) 1290 亿只女用避孕套（价值 600 万美元）；(c) 4980 万包个人用润滑剂（价值 170 万美元）。 | 28. UNFPA manages the prequalification programme for male and female condoms on behalf of and in conjunction with WHO. A list of prequalified manufacturers is published and made available to Member States and international condom procurement agencies (currently 30 male condom manufacturers and four female condom manufacturers). In 2018, the overall commodity procurement had tripled since 2016. In 2018 UNFPA supplied: (a) 1.24 billion male condoms ($27.3 million); (b) 12.9 million female condoms ($6.0 million); (c) 49.8 million sachets for personal additional lubricants ($1.7 million). |
29. 要想实现在 2020 年将艾滋病相关死亡数量减少 50%的目标，还需要每年新增加 280 万人开始并保持接受抗逆转录病毒疗法。当务之急是要更有效地发现病例，提供治疗和护理服务，并留住更多患者接受服务。这需要投入额外资源，充分利用与贸易和知识产权相关的方案，提供更多机会获取负担得起的卫生技术。在生物医学和结构干预措施之间找到平衡点，同样至关重要。 | 29. Reaching the 2020 target of reducing AIDS-related deaths by 50 per cent requires that an additional 2.8 million people initiate and remain on antiretroviral therapy (ART) each year. More effective case finding and linkage to treatment and care services, and improved retention in care are priorities. This demands additional resources and taking full advantage of trade and intellectual property-related options to broaden access to affordable health technologies. An appropriate balance between biomedical and structural interventions is also vital. |
E. 战略成果领域 2：消除艾滋病毒母婴传播 | E. Strategic results area 2: Elimination of mother-to-child transmission of HIV |
30. 据估算，2010-2017 年前，全球大约新增 140 万（880000–2100000）名儿童避免感染艾滋病毒，使儿童（0-14 岁）新增艾滋病毒感染病例下降了 40%。12 个国家收到了世卫组织关于消除艾滋病毒和/或梅毒母婴传播的认证，并且所有地区都建立了验证制度。 | 30. Globally, an estimated 1.4 million (880,000–2,100,000) new child infections have been averted between 2010 and 2017, a 40 per cent reduction of new HIV infections in children (0-14 years). Twelve countries have received WHO certification of the elimination of mother-to-child transmission (EMTCT) of HIV and/or syphilis, and all regions have established validation systems. |
31. 人口基金继续支持各国在政策以及有利环境、卫生系统和综合性服务交付层面将艾滋病毒与性和生殖健康权利的其他方面联系起来。性和生殖健康权利/艾滋病毒综合性服务提供了重要交付平台，有助于消灭新生儿新增感染病例，同时确保新生儿母亲存活，特别是在女性艾滋病毒携带者的计划生育方面发挥作用。 | 31. UNFPA has continued supporting countries to link HIV with other aspects of sexual and reproductive health rights (SRHR) at the policy and enabling environment, health systems and integrated service delivery levels. Integrated SRHR/HIV services provide an important delivery platform towards the elimination of new infections in infants and keeping their mothers alive, particularly in relation to family planning for women living with HIV. |
32. 人口基金正支持各国制定基于人权的可持续计划生育方案，以满足包括边缘化群体在内的所有人的需要。在全球范围内，现代计划生育方法的使用率从 2000 年的 74.9%提高至2018 年 77.4%。在最不发达国家，已婚或同居且需要现代计划生育方法的妇女所占比例从 2004年的 39.4%提高至 2018 年的 58.5%。更具体而言，在对消除母婴传播战略 2 的贡献方面，2016–2017 年，人口基金帮助了 3 000 万人，避免了 3 010 万例意外怀孕(其中快车道国家 640万例)以及 73 500 例孕产妇死亡(其中快车道国家 52 000 例)。 | 32. UNFPA is supporting countries to develop sustainable human rights-based family planning programmes that meet the needs of all, including marginalized groups. Globally, access to modern family planning methods increased from 74.9 per cent in 2000 to 77.4 per cent in 2018. In Least Developed Countries, the proportion of women who are married or in a union and have their need for family planning satisfied with modern methods increased from 39.4 per cent in 2000 to 58.5 per cent in 2018. More specifically in contribution to prong two of EMTCT, in 2016-2017, UNFPA reached 30 million people, averting 30.1 million unintended pregnancies (16.4 million in Fast-Track countries) and 73,500 maternal deaths (52,000 in Fast-Track countries). |
33. 人口基金与世卫组织和儿基会建立伙伴关系，通过提供技术援助，帮助加强东欧和中亚地区的消除母婴传播工作。在格鲁吉亚，人口基金支持制定 2018-2019 年消除母婴传播国家计划、监测和评估计划以及带有护照和数据来源的自我评估指标。在乌克兰，作为消除母婴传播联合工作组的一部分工作，人口基金提高了初级保健服务机构的能力，并帮助支援女性艾滋病毒携带者弱势群体，以确保她们能获得性和生殖健康以及计划生育服务，包括早期艾滋病毒检测和咨询。在苏丹，艾滋病毒携带者项目在该国重点州提供了积极健康同伴教育成套服务，其中包括预防母婴传播服务。 | 33. In partnership with WHO and UNICEF, UNFPA provided technical assistance to strengthen EMTCT efforts in Eastern Europe and Central Asia. In Georgia, UNFPA supported development of the EMTCT National Plan for 2018-2019, Monitoring and Evaluation Plan, and self-assessment indicators with passports and data sources. In Ukraine, as part of the Joint Team EMTCT efforts, UNFPA strengthened capacity of primary healthcare providers and contributed to reaching out to most vulnerable women living with HIV to ensure access to SRH and family planning services, including early HIV testing and counselling. In Sudan, PLHIV projects included provision of positive health peer education service packages, including prevention of mother-to-child transmission services, in the priority states of the country. |
34. 在世卫组织的带领下，人口基金继续与合作伙伴共同行动，确保各国为避孕方法选择和防治艾滋病毒成果证据研究的结果做好准备，包括加强计划生育与艾滋病毒防治服务的整合。 | 34. UNFPA continues to work with partners under the leadership of WHO to ensure countries are prepared for the results of the Evidence for Contraceptive Options and HIV Outcomes (ECHO) study including through strengthening family planning and HIV integration. |
35. 实现目标将需要投入更多资源，帮助在消除母婴传播方面落后的国家提高孕产妇、新生儿和儿童卫生系统的质量。其他挑战包括难以对孕妇和哺乳期妇女进行检测并发现病情（主要是由于服务整合不良所致），开始接受抗逆转录病毒疗法时间较晚，由于患者留治率较低导致抗逆转录病毒疗法依从性不足，以及婴儿艾滋病毒感染的早期诊断存在缺口。各国还需要出台实用指南来简化目前的消除母婴传播投资流程。人口基金、儿基会、世卫组织及其他共同赞助者和合作伙伴将最终制定一份关键考虑事项文件，以推动这些改进行动。 | 35. Achieving the elimination targets will require greater investments to improve the quality of maternal newborn and child health systems in countries where EMTCT progress lags. Remaining challenges include testing and case finding among pregnant and breastfeeding women (mainly due to poor integration of services), late initiation of ART, inadequate adherence to ART due to poor retention in care, and gaps in the early diagnosis of HIV infections in infants. Countries also need practical guidance to streamline their current EMTCT investments. UNFPA, UNICEF, WHO and other co-sponsors and partners will finalize a key considerations document to facilitate such improvements. |
F. 战略成果领域 3：青年的艾滋病毒预防 | F. Strategic results area 3: HIV prevention among young people |
36. 艾滋病毒仍是造成青少年（10-19 岁）死亡的十大元凶之一。在撒哈拉以南非洲地区，少女和青年妇女（15-24 岁）仍在艾滋病毒感染者中占 25%。据估计，到 2030 年，青少年新增感染病例数量仅下降 23%。按照此比例，到 2030 年，将有 5000 万例青少年新感染艾滋病毒。 | 36. HIV remains among the top ten causes of death for adolescents (10-19). In Sub-Saharan Africa, adolescent girls and young women (AGYW) (15-24) still account for one in four HIV infections. Estimates predict only a 23 per cent decline in new infections among adolescents by 2030. At this rate, 50 million more adolescents will become infected with HIV by 2030. |
37. 在人口基金的新青少年和青年战略（2019 年）中，人口基金将青年及其发展阶段和对世界的认知放在中心位置。人口基金以全面方法保护青少年和青年的性和生殖健康权利，以确保青少年能够获得相关服务，包括支持各国实施艾滋病毒预防方案和全面性教育，消除政策和法律障碍（如父母同意），以及创造有利的政策环境，例如将青少年和青年的性和生殖健康权利纳入全民健康保障。新青少年和青年战略契合联合国青年战略：青年 2030，并将帮助为青年人实施和实现可持续发展目标议程。 | 37. In the new UNFPA adolescent and youth strategy (2019), UNFPA puts young people, their development phase and their perspectives of the world at the centre. UNFPA takes a holistic approach to adolescent and youth sexual and reproductive health rights (AYSRHR) to ensure adolescents’ access to services which include supporting countries to implement HIV prevention programmes and comprehensive sexuality education, remove policy and legal barriers, such as parental consent, and create an enabling policy environment, such as including adolescent and youth sexual and reproductive health rights in UHC. The new adolescent and youth strategy is aligned with the United Nations youth strategy: Youth 2030 and will contribute to implementing and achieving the SDG agenda for young people. |
38. 2018 年，人口基金在增强青少年和青年权能方面取得的主要成就包括：(a) 通过生活技能计划援助 270 万边缘化女童；(b) 29 个国家实施了以学校为基础的全面性教育计划；(c) 27 个国家实施了校外全面性教育计划。 | 38. Key UNFPA achievements for adolescent and youth empowerment in 2018 include: (a) 2.7 million marginalized girls reached by life skills programmes; (b) 29 countries operationalized school-based comprehensive sexual education (CSE); (c) 27 countries delivered out-of-school CSE. |
39. 72 个国家至少有 2 个部门（除卫生部门外）制定了将青少年和青年的性和生殖健康相结合的战略。 | 39. 72 countries, at least two sectors, apart from the health sector, have strategies that integrate the sexual and reproductive health of adolescents and youth. |
40. 70 个国家建立了青年参与政策对话和方案编制的体制机制。 | 40. 70 countries had institutional mechanisms for the participation of young people in policy dialogue and programming. |
41. 全面性教育行动示例：在尼泊尔，人口基金支持举办 27 场全面性教育宣传会和讲习班，在 2018 年援助了 1751 人。组织大约 23 场宣讲会，提高教师、家长、学生和卫生工作者的认识，为来自 7 个地区的 1679 人（1015 名男性和 664 名女性）提供了援助。在格林纳达，人口基金与合作伙伴召开了“全面性教育——健康家庭生活方式教育”高级别对话，讨论如何让加勒比地区的青少年更好地健康成长。在巴拉圭，人口基金与该国卫生部及教育部合作，为技校毕业生设计了包含全面性教育的新课程及交流计划。 | 41. Examples of action on CSE, in Nepal, UNFPA supported 27 advocacy meetings and workshops on CSE, reaching 1,751 people in 2018. Some 23 orientation meetings organized to sensitize teachers, parents, students and health workers reached a total of 1,679 people (1,015 male and 664 female) from seven districts. In Grenada, UNFPA and partners convened a High-Level Dialogue on CSE – Health Family Lifestyle Education to discuss achieving better health outcomes for Caribbean adolescents. In Paraguay, UNFPA worked with the Ministries of Health and Education to develop a new curriculum for technical graduates incorporating CSE and a communication plan. |
42. “完善法律和政策环境，在非洲南部地区减少艾滋病毒感染风险，并改善重点人群的性和生殖健康状况”方案是由开发署领导实施的一项方案，旨在为安哥拉、马达加斯加、莫桑比克、赞比亚和津巴布韦的青年重点人群改善性健康和生殖健康状况。安哥拉、马达加斯加、赞比亚、津巴布韦以及莫桑比克最终确定并开始启动了由多利益攸关方参与的关于青年重点人群的法律环境评估。在法律环境评估建议的指导下，马达加斯将加采取国家行动保护青年囚犯，赞比亚将在全面性教育中纳入女同性恋、男同性恋、双性恋、变性人和双性人问题，津巴布韦将审查合法年龄法律，安哥拉将更改对变性人和双性人的称呼和性别平等标码。在非洲男性性健康和权利组织以及夸祖鲁-纳塔尔大学卫生经济学和艾滋病毒/艾滋病研究部的联合倡导下，青年重点人群问题被纳入到南部非洲发展共同体性和生殖健康记分卡。 | 42. The UNDP-led “Strengthening Legal and Policy Environments for Reducing HIV Risk and Improving SRH for Young Key Populations in Southern Africa” is a regional programme seeking to improve sexual and reproductive health outcomes for young key populations in Angola, Madagascar, Mozambique, Zambia and Zimbabwe. Multi-stakeholder and participatory legal environment assessments (LEAs) on young key populations were finalized in Angola, Madagascar, Zambia and Zimbabwe, and Mozambique is initiating its LEA. The LEA recommendations are informing national action on the protection of young prison inmates in Madagascar, integration of lesbian, gay, bisexual, transgender and intersex (LGBTI) issues in CSE in Zambia, review age-of-consent laws in Zimbabwe, and a change of name and gender marker for transgender and intersex people in Angola. Because of joint advocacy by the African Men for Sexual Health and Rights and the Health Economics and HIV/AIDS Research Division of the University of KwaZulu-Natal, young key population issues were integrated into the Southern Africa Development Community SRH score card. |
43. 13 个国家（博茨瓦纳、喀麦隆、莱索托、肯尼亚、马拉维、莫桑比克、纳米比亚、斯威士兰、南非、坦桑尼亚、乌干达、津巴布韦以及赞比亚）已被列为优先获得全球基金的催化资金的对象，这些资金将用于旨在支持少女和青年妇女的方案。作为津巴布韦的主要资金接收者，开发署在制定少女和青年妇女方案方面发挥了重要作用，目前正在支持包括民间社会在内的国家利益攸关方实施方案。在莫桑比克和纳米比亚，开发署支持制定了以少女和青年妇女为重点的供资申请。 | 43. Thirteen countries – Botswana, Cameroon, Lesotho, Kenya, Malawi, Mozambique, Namibia, Swaziland, South Africa, Tanzania, Uganda, Zimbabwe and Zambia – have been prioritized to receive Global Fund catalytic funds for programmes tosupport AGYW. As principal recipient in Zimbabwe, UNDP was instrumental in the development of the AGYW programme and is currently supporting national stakeholders, including civil society, on implementation. In Mozambique and Namibia, UNDP supported the development of the funding request with a focus on AGYW programmes. |
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