第5章 我们终将战胜病魔[4] We Can Beat the Disease

谢谢你，桑杰。今天能来到这里和各位聚集一堂，并且在基奎特总统[5]和布什总统之后发表讲话，我深感荣幸。波诺、艾丽西亚，以及“统一”行动组织，感谢你们将我们召集在一起。由于你们的工作，非洲各地的一些儿童已不再挨饿；母亲们不再被可治愈的疾病夺去生命；父亲们能够重新养家糊口。而且，在你们大家的努力下，那么多人现在有了希望。

今天在座的有为这项事业作出重大贡献的国会议员们，我们要向他们表示感谢。布什总统从坦桑尼亚回来参加这次活动，请允许我向他致谢，并感谢他在这件事上所发挥的大刀阔斧的领导作用。我相信，“总统防治艾滋病紧急救援计划”将作为他的最伟大的遗产载入史册。这项计划，其雄心勃勃的程度，当时就超出了艾滋病防治的主要倡议者们的想象，现在已经拯救了无数人的生命，激发起国际行动，并为一项综合性全球计划奠定了基础，它将改变数以百万计人的生活。我们为有机会继续推动这项工作而感到自豪。

今天是一个值得纪念的日子。今天，我们聚集在这个全球性的社区，跨越各大洲以及信仰和文化的界限，来重申我们的承诺，我们要一劳永逸，彻底终结艾滋病的流行。

现在，如果你们回顾过去，看看以往世界艾滋病日的主题，如果你们一个接一个地读下来，就能了解到人类是如何抗击有史以来最为致命的一种传染病的。你们会看到，在最初几年，当男人和女人开始因这种尚无人完全了解的疾病而丧生的时候，主要的努力是敲响警钟，呼吁全球行动，向世人证明这种致命的疾病并不局限于某个地区或某个群体。

而这也是今天值得纪念的原因之一，因为在最初的那几年，很少有人够想像到——我们在展望未来时会有那样的“见微知著”的眼光[6]——有朝一日，我们可以提出“向零艾滋迈进”的口号，来作为某一年世界艾滋病日的主题。世界艾滋病日的设立是在抗击艾滋病的早期起步阶段，那时人们对这个问题的前景心中无数。很少有人能够想像，我们可以讨论艾滋病被消灭的时代的现实可能性。但是，我们现在谈论的就是这个主题。我们为了这个主题在这里聚会。我们能走到这一步，是因为有你们大家的努力以及你们毫不动摇的信念：我们能够，而且必将，战胜这种疾病。

我们投资开发抗逆转录疗法，使得原来可能死于艾滋病的人，过上了正常的和富有活力的生活，其中一些人今天也来到了这里。我们研发出新的技术手段，使得越来越多的母亲生育出没有受到艾滋病病毒感染的婴儿。而且，由于我们始终重视提高公众的认识，使得全球的新发感染率和死亡率都在下降。

这就是说，毫无疑问，我们正在赢得这场斗争，但战斗并没有结束，远远没有结束。新发感染率或许正在其他地方下降，但在美国却没有下降。在美国，感染率十多年来一直没有变化。在这个国家，一些群体仍在饱受艾滋病的摧残。

面对三年之内年轻黑人男同性恋者的新感染人数上升了将近50%的形势，我们必须做出更多的努力，要使他们明白，自己的生命不该轻掷。拉美裔群体比其他群体更早死亡，黑人妇女，虽然她们在女性新患者中占大多数，然而却感到被人遗忘在一旁，在这样的形势下，我们必须付出更大的努力。

这么看来，这场战斗并没有结束。对当前120万携带艾滋病病毒的美国人来说，没有结束；对每天都有人被感染的美国人来说，没有结束。这场斗争不但对他们来说尚未结束，对他们的家人来说也尚未结束。因此，对在座的每一个人来说都不可能结束——当然，对你们的总统而言，战斗也没有结束。

自我就任总统以来，我们就艾滋病病毒/艾滋病问题开展了广泛深入的全国性对话。联邦政府的成员走遍全国各地，与艾滋病病毒携带者会面，与研究人员、宗教领袖、医务工作者和私营部门合作伙伴晤谈。我们与4000多人做了交谈。然后，根据所有这些谈话材料，我们起草了一份抗击艾滋病的新计划。去年，我们公布了这一计划——这是第一个全国性的艾滋病病毒/艾滋病防治战略。

我们回到预防和治疗的基本环节上来，并集中力量于最需要的地方。然后，我们提出了一个愿景，即每一个美国人，不分年龄、性别、种族、民族、性取向、性别认同或社会经济状况，都能得到延长生命的治疗护理。

在此，我还要指出另外一点：自本届政府就任以来，我们已经把防治艾滋病病毒/艾滋病的总资金提高到创纪录的水平。在两党的一致支持下，我们重新批准了《瑞安·怀特医疗保健法》。而且，在签署该法案的时候，我非常自豪地宣布，本届政府将解除不准许艾滋病病毒携带者进入美国的禁令。（掌声）由于迈出了这一步，我们将在明年，20年来的第一次，举办国际艾滋病大会。（掌声）

可以说，过去3年我们已经做了许多工作。然而，我们还可以做得更多。今天，我要宣布一些新的承诺。我们承诺为“瑞安·怀特计划”增加拨款1500万美元，支持全国各地艾滋病病毒医疗诊所继续提供服务。我们希望确保它们继续开门营业，以挽救生命。我们承诺增加拨款3500万美元，支援州一级的艾滋病药物资助计划的顺利进行。

仅有联邦政府的努力是不够的，所以我也呼吁各州政府、制药公司和私人基金会，尽到各自的责任，帮助美国人获得拯救生命的一切治疗手段。

这是一场全球性的斗争，是美国必须继续发挥领导作用的斗争。回顾艾滋病病毒/艾滋病的历史，你们就会看到，美国所做的贡献，超过了任何一个其他国家，这充分证明了我们作为一个国家的领导地位。但是，我们不能因此而志得意满。

我认为，这一事业值得回忆并可以引以为豪的是，国会中共和党人和民主党人一贯齐心协力地为这场斗争提供资金，不仅是向国内，而且是向全球。这充分表明了我们美国人的共同价值观；这是一种超越党派界限的承诺，今天曾经的布什总统、克林顿总统和我一起来到这里，就是这一点的体现。

自从我上任以来，我们加大了对“防治艾滋病、结核病和疟疾全球基金”的支持。我们发起了“全球健康行动计划”，改善了接受医疗服务的便利性，推动了疫苗价格的下降，并将在今后五年内协助挽救400万儿童的生命。一直以来，我们始终重视扩大所取得的成效。

今天，我自豪地宣布，截至9月份，美国正在为世界上将近400万人的抗逆转录病毒治疗提供支持。（掌声）400万人。还有，仅去年一年，我们就为60万艾滋病病毒测试阳性的母亲提供了药物，使20万婴儿免受艾滋病病毒感染。（掌声）另外，有将近1300万人获得了护理和治疗，其中包括400万以上的儿童。所以说，我们取得的成绩是值得骄傲的。

但是，我们还要做更多的事情。我们并非仅靠一已之力便取得了这些成果，而是通过与坦桑尼亚等发展中国家和基奎特总统这样的领导人合作，才得以实现的。

在今后的征途上，我们必须不断改善对策，以挽救尽可能多的人的生命。科学界提出要重视预防，他们的意见必须认真听取。正因为如此，作为一个方针，我们现在投资于从医药救治手段到提倡健康行为方式的各种有效措施上面。正因为如此，我们正在制定目标，在今后两年内，为超过150万名艾滋病病毒检测阳性的孕妇提供抗逆转录病毒药物，使她们的婴儿或可免受病毒感染。

我们并不会就此止步。我们明白，治疗也是预防。今天，我们正在制定一个新目标，到2013年年底，帮助600万人得到治疗。（掌声）这比我们的原定目标多了200万人。

值此世界艾滋病日之际，我向所有不在这里的人们发出以下呼吁：

我们向全球村的居民们呼吁：请你们加入进来。那些已经保证支持“全球基金”的国家，应该拿出他们承诺的资金。（掌声）还没有做出保证的国家，则应该做出承诺。（掌声）这包括那些过去或许是受援者而现在成为重要捐助者的国家。中国和其他一些重要经济体现在已经有能力实现这样的转变，使更多人得到帮助。

我们向美国国会呼吁：请继续合作共事，信守你们已经做出的承诺。眼下在华盛顿，我们有那么多的分歧，但是抗击艾滋病的斗争，把我们团结在一起，不分党派，无论是现总统还是前总统。事实证明，只要共和党和民主党人把人类的共同利益置于政治纷争之上，我们就能成就伟大的事业。所以我们必须继续发扬这种精神。

全体美国人民：我们必须继续战斗，不仅是为今天需要我们帮助的每一个人而战斗，而且要为所有那些没有能够活下来看到这一刻的人而战斗；为洛克·哈德森、阿瑟·阿什，为所有那些唤醒我们直面艾滋病病毒/艾滋病这一现实的人而战斗。我们一定要为瑞恩·怀特和他的妈妈珍妮，为雷氏兄弟，为所有那些迫使我们正视自己的恶意偏见和无端恐惧的人而战斗。要为魔术师约翰逊、玛丽·费歇尔，为所有那些人——男人、女人和孩子们——他们得知自己将因这种疾病而死亡时却说，“不，我们不会死，我们将活下去”，要为他们而战斗。

我们要继续为所有这些人而抗争，因为我们能够终结这种流行病。我们终将战胜病魔。我们能够打赢这场战争。我们绝不能半途而废，必须坚持不懈，奋斗不止——今天，明天，每一天，直到把这种疾病消灭干净。只要我有幸担任你们的总统，联邦政府就会一直这么做下去。这是我的誓言。这是我对你们大家的承诺。这也应当是我们彼此之间的承诺——既然我们已经取得了这么大的进展，既然我们已经拯救了这么多的生命，那么，我们就索性把这场斗争进行到底吧。

感谢你们所做的一切。上帝保佑你们。上帝保佑美国。谢谢大家。（掌声）

附：英文原文

Well, thank you, Sanjay. It is an honor to be with you today and to follow President Kikwete and President Bush. To Bono and Alicia, to the ONE campaign, thank you for bringing us together. Because of your work, all across Africa there are children who are no longer starving, mothers who are no longer dying of treatable diseases, fathers who are again providing for their families. And because of all of you, so many people are now blessed with hope.

We've got members of Congress who have done so much for this cause who are here today, and we want to thank them. Let me also thank President Bush for joining us from Tanzania and for his bold leadership on this issue. I believe that history will record the President's Emergency Plan for AIDS Relief as one of his greatest legacies. And that program — more ambitious than even the leading advocates thought was possible at the time — has saved thousands and thousands and thousands of lives, and spurred international action, and laid the foundation for a comprehensive global plan that will impact the lives of millions. And we are proud that we have the opportunity to carry that work forward.

Today is a remarkable day. Today, we come together as a global community, across continents, across faiths and cultures, to renew our commitment to ending the AIDS pandemic once and for all.

Now, if you go back and you look at the themes of past World AIDS Days, if you read them one after another, you'll see the story of how the human race has confronted one of the most devastating pandemics in our history. You'll see that in those early years — when we started losing good men and women to a disease that no one truly understood — it was about ringing the alarm, calling for global action, proving that this deadly disease was not isolated to one area or one group of people.

And that's part of what makes today so remarkable, because back in those early years, few could have imagined this day — that we would be looking ahead to“The Beginning of the End”, marking a World AIDS Day that has gone from that early beginning when people were still uncertain to now a theme, “Getting to Zero”. Few could have imagined that we'd be talking about the real possibility of an AIDS-free generation. But that's what we're talking about. That's why we're here. And we arrived here because of all of you and your unwavering belief that we can — and we will — beat this disease.

Because we invested in anti-retroviral treatment, people who would have died, some of whom are here today, are living full and vibrant lives. Because we developed new tools, more and more mothers are giving birth to children free from this disease. And because of a persistent focus on awareness, the global rate of new infections and deaths is declining.

So make no mistake, we are going to win this fight. But the fight is not over —not by a long shot. The rate of new infections may be going down elsewhere, but it's not going down here in America. The infection rate here has been holding steady for over a decade. There are communities in this country being devastated, still, by this disease.

When new infections among young black gay men increase by nearly 50 percent in 3 years, we need to do more to show them that their lives matter. When Latinos are dying sooner than other groups, and when black women feel forgotten, even though they account for most of the new cases among women, then we've got to do more.

So this fight is not over. Not for the 1.2 million Americans who are living with HIV right now. Not for the Americans who are infected every day. This fight is not over for them, it's not over for their families, and as a consequence, it can't be over for anybody in this room — and it certainly isn't over for your President.

Since I took office, we've had a robust national dialogue on HIV/AIDS. Members of my administration have fanned out across the country to meet people living with HIV; to meet researchers, faith leaders, medical providers and private sector partners. We've spoken to over 4,000 people. And out of all those conversations, we drafted a new plan to combat this disease. Last year, we released that plan — a first-ever national HIV/AIDS strategy.

We went back to basics: prevention, treatment and focusing our efforts where the need is greatest. And we laid out a vision where every American, regardless of age, gender, race, ethnicity, sexual orientation, gender identity or socioeconomic status, can get access to life-extending care.

And I want to be clear about something else: Since taking office, we've increased overall funding to combat HIV/AIDS to record levels. With bipartisan support, we reauthorized the Ryan White Care Act. And as I signed that bill, I was so proud to also announce that my administration was ending the ban that prohibited people with HIV from entering America. (Applause.) Because of that step, next year, for the first time in two decades, we will host the international AIDS conference. (Applause.)

So we've done a lot over the past three years, but we can do so much more. Today, I'm announcing some new commitments. We're committing an additional$15 million for the Ryan White Program that supports care provided by HIV medical clinics across the country. We want to keep those doors open so they can keep saving lives. We're committing an additional $35 million for state AIDS-drug assistance programs.

The federal government can't do this alone, so I'm also calling on state governments, and pharmaceutical companies, and private foundations to do their part to help Americans get access to all the life-saving treatments.

This is a global fight, and it's one that America must continue to lead. Looking back at the history of HIV/AIDS, you'll see that no other country has done more than this country, and that's testament to our leadership as a country. But we can't be complacent.

I think this is an area where we can also look back and take pride that both Republicans and Democrats in Congress have consistently come together to fund this fight — not just here, but around the world. And that's a testament to the values that we share as Americans; a commitment that extends across party lines, that's demonstrated by the fact that President Bush, President Clinton and I are joining you all today.

Since I took office, we've increased support for the Global Fund to Fight AIDS, Tuberculosis and Malaria. We've launched a Global Health Initiative that has improved access to health care, helping bring down the cost of vaccines, and over the next five years, will help save the lives of 4 million more children. And all along, we kept focusing on expanding our impact.

Today, I'm proud to announce that as of September, the United States now supports anti-retroviral treatment for nearly 4 million people worldwide. (Applause.) Four million people. And in just the past year, we've provided 600,000 HIV-positive mothers with access to drugs so that 200,000 babies could be born HIV-free. (Applause.) And nearly 13 million people have received care and treatment, including more than 4 million children. So we've got some stuff to be proud of.

But we've got to do more. We're achieving these results not by acting alone, but by partnering with developing countries like Tanzania, and with leaders like President Kikwete.

Now, as we go forward, we've got to keep refining our strategy so that we're saving as many lives as possible. We need to listen when the scientific community focuses on prevention. That's why, as a matter of policy, we're now investing in what works — from medical procedures to promoting healthy behavior.And that's why we're setting a goal of providing anti-retroviral drugs to more than 1.5 million HIV-positive pregnant women over the next two years so that they have the chance to give birth to HIV-free babies.

We're not going to stop there. We know that treatment is also prevention. And today, we're setting a new target of helping 6 million people get treatment by the end of 2013. (Applause.) That's 2 million more people than our original goal.

And on this World AIDS Day, here's my message to everybody who is out there:

To the global community — we ask you to join us. Countries that have committed to the Global Fund need to give the money that they promised. (Applause.) Countries that haven't made a pledge, they need to do so. (Applause.) That includes countries that in the past might have been recipients, but now are in a position to step up as major donors. China and other major economies are in a position now to transition in a way that can help more people.

To Congress — keep working together and keep the commitments you've made intact. At a time when so much in Washington divides us, the fight against this disease has united us across parties and across presidents. And it shows that we can do big things when Republicans and Democrats put their common humanity before politics. So we need to carry that spirit forward.

And to all Americans — we've got to keep fighting. Fight for every person who needs our help today, but also fight for every person who didn't live to see this moment; for the Rock Hudsons and the Arthur Ashes, and every person who woke us up to the reality of HIV/AIDS. We've got to fight for Ryan White and his mother Jeanne, and the Ray brothers, and every person who forced us to confront our destructive prejudices and our misguided fears. Fight for Magic Johnson and Mary Fisher, and every man, woman and child, who, when told they were going to die from this disease, they said, “No, we're not. We're going to live.”

Keep fighting for all of them because we can end this pandemic. We can beat this disease. We can win this fight. We just have to keep at it, steady, persistent —today, tomorrow, every day until we get to zero. And as long as I have the honor of being your President, that's what this administration is going to keep doing. That's my pledge. That's my commitment to all of you. And that's got to be our promise to each other — because we've come so far and we've saved so many lives, we might as well finish the fight.

Thank you for all you've done. God bless you. God bless America. Thank you. (Applause.)