VOA标准英语2010年-AIDS: Pioneer of “Treatment as Preve

The doctor who helped pioneer the "treatment as prevention" approach in the fight against HIV/AIDS will receive the Albert Einstein World Award of Science. Dr. Julio Montaner chaired the 18th International AIDS Conference in Vienna last July.
The former president of the International AIDS Society is director of the BC (British Columbia) Center for Excellence¹ in HIV/AIDS in Vancouver, Canada.
Montaner says he and others began promoting expanded treatment about 10 years ago as a means of slowing the epidemic². He says it's gratifying to see the concept of "treatment as prevention" so widely accepted today.
"A lot of people were interested in the potential role that treatment could have on both achieving better outcomes for people infected with HIV, but secondarily, decreasing their infectiveness," he says.
Unfounded fearSome initially³ raised concern, saying if HIV positive people believed they were less likely to infect others, they might be more likely to engage in risky⁴ behavior. For example, unprotected sex.
BC Center for Excellence in HIV/AIDSDr. Julio Montaner"What happened then," he says, "was that we were able to show that the effect of treatment on decreasing HIV infectiveness is actually quite dramatic – pretty much in excess of 90 percent decrease in transmission. By no means were we trying to advocate that people could just treat their way out of the epidemic. What we're saying is that the fear that overcompensation will negate⁵ this absolutely with any amount of risk compensation on the part of those infected with HIV is just not panning out to be the case."With no cure or vaccine⁶ available for HIV/AIDS, world leaders and health officials have pledged to provide broader access to treatment. Montaner says that had major, but unexpected, beneficial effects.
"Your promise to bring treatment to the people was a fair one, was a compassionate⁷ one, was an important one. But in addition, without even knowing, you actually were on the right track to control, to curb⁸, to decrease and to hopefully even extinguish the epidemic one day. Look at the data. By treating people, you're subtracting the pool of donors⁹ from the community. And so, the more you treat, the more you reduce transmission. So you made treatment actually part of the solution. You made treatment part of the end game," he says.
He says the knowledge exists to transform HIV/AIDS from a raging pandemic to perhaps a manageable, more endemic, disease.
Treating people infected with HIV much earlier, long before the immune system collapses¹⁰, has become more widely accepted. It's based on the number of CD4 immune cells in the blood.
But that decision has social, economic and political considerations, not just health concerns.
"I think it would be ethically¹¹ problematic," he says, "for me and for other people working in this area, if all of a sudden we were going to divert resources to treat people who have high viral loads, for example, because they are more infectious, at the expense of not treating people who have maybe lower viral loads, but lower CD4s, and therefore are at a higher risk of immediate¹² disease. What I'm trying to say is we need to be sensible and approach this one stage at a time, combining the competing priorities of both the individuals in need and controlling the epidemic."Dr. Montaner says as more people realize that expanding treatment saves money in the long run, "treatment as prevention" will be given even higher priority. It's already a central part of UNAIDS strategy on the pandemic called Treatment 2.0.
"We won't really complete the picture until we have both a cure and a vaccine. And you know, one or the other would be very welcome. The reality is we cannot promise a timeline for those developments," he says.
Nevertheless, he says, the tools exist to dramatically curb the pandemic. Montaner says "treatment as prevention" has had great success in British Columbia, citing a decrease of up to 70 percent in new HIV infections.
Montaner will receive the Albert Einstein World Award of Science December 8th in Mexico.

1 excellence   

n.优秀，杰出，(pl.)优点，美德

参考例句：

• His art has reached a high degree of excellence.他的艺术已达到炉火纯青的地步。
• My performance is far below excellence.我的表演离优秀还差得远呢。

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 initially   

adv.最初，开始

参考例句：

• The ban was initially opposed by the US.这一禁令首先遭到美国的反对。
• Feathers initially developed from insect scales.羽毛最初由昆虫的翅瓣演化而来。

4 risky   

adj.有风险的，冒险的

参考例句：

• It may be risky but we will chance it anyhow.这可能有危险，但我们无论如何要冒一冒险。
• He is well aware how risky this investment is.他心里对这项投资的风险十分清楚。

5 negate   

vt.否定，否认；取消，使无效

参考例句：

• Our actions often negate our principles.我们的行为时常与我们所信奉的原则背道而弛。
• Mass advertising could negate the classical theory of supply and demand.大宗广告可以否定古典经济学的供求理论。

6 vaccine   

n.牛痘苗，疫苗；adj.牛痘的，疫苗的

参考例句：

• The polio vaccine has saved millions of lives.脊髓灰质炎疫苗挽救了数以百万计的生命。
• She takes a vaccine against influenza every fall.她每年秋季接种流感疫苗。

7 compassionate   

adj.有同情心的，表示同情的

参考例句：

• She is a compassionate person.她是一个有同情心的人。
• The compassionate judge gave the young offender a light sentence.慈悲的法官从轻判处了那个年轻罪犯。

8 curb   

n.场外证券市场，场外交易；vt.制止，抑制

参考例句：

• I could not curb my anger.我按捺不住我的愤怒。
• You must curb your daughter when you are in church.你在教堂时必须管住你的女儿。

9 donors   

n.捐赠者( donor的名词复数 )；献血者；捐血者；器官捐献者

参考例句：

• Please email us to be removed from our active list of blood donors. 假如你想把自己的名字从献血联系人名单中删去，请给我们发电子邮件。
• About half this amount comes from individual donors and bequests. 这笔钱大约有一半来自个人捐赠及遗赠。 来自《简明英汉词典》

10 collapses   

折叠( collapse的第三人称单数 )； 倒塌； 崩溃； （尤指工作劳累后）坐下

参考例句：

• This bridge table collapses. 这张桥牌桌子能折叠。
• Once Russia collapses, the last chance to stop Hitler will be gone. 一旦俄国垮台，抑止希特勒的最后机会就没有了。

11 ethically   

adv.在伦理上，道德上

参考例句：

• Ethically , we have nothing to be ashamed about . 从伦理上说，我们没有什么好羞愧的。
• Describe the appropriate action to take in an ethically ambiguous situation. 描述适当行为采取在一个道德地模棱两可的情况。

12 immediate   

adj.立即的；直接的，最接近的；紧靠的

参考例句：

• His immediate neighbours felt it their duty to call.他的近邻认为他们有责任去拜访。
• We declared ourselves for the immediate convocation of the meeting.我们主张立即召开这个会议。