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孟林：将艾滋病治疗纳入常规医疗体系是发展方向
周靓 宋平向记者 2011-05-17 18:12
经济观察网 记者 周靓 实习记者 宋平 “取消各地卫生行政部门以前向社会公布的各级各类‘艾滋病定点医院’的指定，将艾滋病治疗纳入常规医疗体系”， 该提议来自17日召开的“艾滋病与就医权保护”新闻发布会上发布的《关于解决我国艾滋病病毒感染者和艾滋病人“手术难”问题的建议》报告。
该发布会由中国艾滋病病毒携带者联盟（CAP+）与国际劳工组织（ILO）等机构共同举办，主要讨论艾滋病感染者就医难的问题。
“艾滋病定点医疗机构”的去向
2004年中国首个艾滋病医疗救治体系——河南省艾滋病医疗救治体系方案出台，根据该规定，河南的艾滋病救治网络由省、市、县、乡、村五级艾滋病定点救治医疗机构组成。
同年，《中华人民共和国传染病防治法》修订通过，并规定“（县级以上人民政府）应指定具备传染病救治条件和能力的医疗机构承担传染病救治任务，或者根据传染病救治需要设置传染病医院”。这种传染病定点收治的制度在我国的传染病防治方面做出了很大贡献。但由艾滋病感染者联盟秘书处负责撰写的《关于解决我国艾滋病病毒感染者和艾滋病人“手术难”问题的建议》报告提议“取消各地卫生行政部门以前向社会公布的各级各类’艾滋病定点医院’的指定，将艾滋病治疗纳入常规医疗体系”。
报告主笔人、中国艾滋病病毒携带者联盟秘书处协调人孟林指出，目前造成艾滋病感染者看病难的主要原因之一是“艾滋病定点医院成为各方推诿的借口”，但艾滋病定点医疗医院往往都是传染病专科医院，不具备综合性医院的学科体系和救治能力，无法为感染者提供综合性的诊疗服务。在此次调查的案例中，80%的艾滋病定点医院因能力和条件所限达不到手术条件，而最终不能为患者实施手术，造成病情延误。
鉴于我国艾滋病定点医院已有的作用，孟林也表示，一下子取消定点医院，将艾滋病感染者推到综合医院也是不行的，但这是一个发展方向。
北京佑安医院传染病副主任医师张可提到，对这个问题的讨论同样出现在2008年举办的一次全国传染病峰会上，随着社会的发展，新型传染病不断出现，现行的传染病防治方式已经不适合现实情况。张可表示，在国家层面应柔化定点医院作用，鼓励综合医院参与治疗。
在现场，一位河北的艾滋病感染者认为，他们受到的歧视不仅仅来自大众，也来自医疗机构。另一位来自天津的感染者则讲述了自己的就医过程。他因腰部有病去各大医院进行治疗，为了他人的安全，他会在医生进行治疗前将自己是艾滋病感染者的情况告知医院，提醒医院做好防护措施；但医院一旦知道就会拒绝为他进行治疗，目前病情已有加重。医院给出的答复是“同情但不敢做”。
在进行调研的过程中，孟林曾看到一名医生用高压锅消毒，在家里为艾滋病感染者做手术，手术条件不好，但许多人慕名而来，因为“起码他会为他们做手术”。
建立医务人员职业暴露赔偿机制
由“吃药就像吃金豆子”到目前一些地方出台免费治疗政策；近十年来，我国的艾滋病防治取得了很大进步，但就医难问题越来越突出。作为艾滋病专科医生，张可建议各地的艾滋病感染者小组应该加强与地方医院、医生的沟通，但这里所说的医生不是艾滋病的专业医生，而是其他科室医生，让不关心艾滋病的医生也来了解这个问题，“因为医生本身也存在心理压力”。
在新闻发布会上，联合国国际劳工组织发布了《中国艾滋病感染者就医歧视现状及其应对策略研究》报告，该报告中也提到，“2005年，我国艾滋病职业暴露事故近400起，主要发生在医院、防疫、公安系统。虽然目前我国医务人员中尚未发现因职业暴露而感染艾滋病的病例，但随着医护人员接触艾滋病概率的增加，因职业暴露感染艾滋病的危险也增大。而目前我国尚缺乏对因职业暴露感染艾滋病的医护人员接触艾滋病的医护人员的救助制度”。张可建议，可以建立“医务人员职业暴露赔偿机制”，减轻医生的心理压力。
国际劳工组织驻中国和蒙古办公室国家代表Ann Herbert认为“就医的权利是人的一项最基本的权利，人人都应当享有就医的权利。对医务人员开展艾滋病教育培训、通过培训促进医疗机构标准防护原则的落实，确保无歧视服务的提供”。
艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复
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| 图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
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Meng Lin: The AIDS treatment into routine health care system is the development direction
Song Ping Liang Zhou told reporters 2011-05-17 18:12
Economic Observer Online reporter Zhou Jing Song Ping trainee journalist "to cancel before the local health administrative departments at all levels to the public all kinds of 'AIDS designated hospitals' designation of AIDS treatment into routine health care system", the proposal was held from 17 "AIDS and the medical rights protection" press conference "issued on the settlement of HIV and AIDS" operation difficult "issue recommendations" report.
The conference, China's HIV carriers by the Union (CAP +) and the International Labour Organization (ILO) and other agencies to organize, discuss the AIDS problem is difficult for medical treatment.
"AIDS medical establishment," the whereabouts of
In 2004, China's first AIDS medical care system - Henan AIDS program introduced medical treatment system, under which treatment of AIDS in Henan province network, city, county, township and village where five HIV sentinel medical institutions.
In the same year, "People's Republic of Infectious Diseases Prevention Law" passed, and provides that "(people's government above the county level) should have specified the conditions and treatment of infectious diseases capacity of medical institutions undertake the task of infectious diseases treatment, or treatment according to need to set the transmission of infectious diseases disease hospital. " Admitted to the system designated the epidemic of infectious disease control in China has made great contributions. But by the AIDS Alliance Secretariat's "on the settlement of HIV and AIDS" operation difficult "issue recommendations" report proposes that "before the abolition of local health administrative departments at all levels to the public all kinds of 'AIDS sentinel Hospital 'is specified, the AIDS treatment into routine health care system. "
Report writer, Chinese HIV carriers Meng Lin pointed out that the Secretariat of the League Coordinator, is currently causing AIDS is one of the major medical treatment is difficult, "AIDS, the parties designated hospitals as an excuse for prevarication," but hospitals are often designated medical AIDS infectious diseases specialist hospitals, general hospitals do not have the discipline system and treatment capacity, unable to provide comprehensive HIV treatment services. In the case of the survey, 80% of AIDS capacity and conditions to designated hospitals for the limited reach operating conditions, and ultimately can not be implemented for patients with surgery, the disease caused by the delay.
AIDS in China has been given the role of designated hospitals, Meng Lin also said that all of a sudden abolition of designated hospitals, the HIV infection is not pushed to the General Hospital, but it is a development direction.
Beijing You An Hospital, Dr Zhang, deputy director of infectious diseases mentioned, the discussion of this issue in 2008, also held a national summit on the disease, with the development of society, new infectious diseases continue to emerge, the existing communicable disease control approach has not fit reality. Zhang said that softens at the national level should be the role of designated hospitals, general hospitals to encourage participation in treatment.
At the scene, a Hebei AIDS that discrimination not only from their public, but also from medical institutions. Tianjin, another infection from their medical treatment is about the process. He was sick the waist to the major hospital for treatment, for the safety of others, he will be treated in the doctor before they are HIV-infected persons informed the hospital, reminded the hospital a good job protection measures; but once you know the hospital will refuse to to treat him, the current condition has worsened. Hospital gives the answer is "sympathetic but did not dare to do."
During the research process, Meng Lin had seen a doctor sterilized with a pressure cooker at home for the AIDS surgery, surgery was poor, but many people come here especially, because "at least he will operate on them" .
Occupational exposure to medical staff to establish a compensation mechanism
By the "gold medication like eating beans" to the current introduction of free treatment policy in some places; the past decade, China has made great progress in AIDS prevention, medical treatment is difficult, but more and more problems. As AIDS specialists, Zhang AIDS around the proposed group should strengthen cooperation with local hospitals, doctor's communication, but the doctors are talking about here is not AIDS, medical professionals, but doctors of other departments, so that doctors do not care to AIDS aware of the problem, "because the doctors themselves have mental pressure."
In the press conference, the United Nations International Labour Organization issued a "AIDS medical status and coping strategies of discrimination," the report, the report also mentioned that "In 2005, AIDS in China from the occupational exposure of nearly 400 incidents, mainly in hospitals, quarantine, public security system. Although our medical staff have not yet been found infected with AIDS due to occupational exposure cases, but with the increased probability of health care access to AIDS due to occupational exposure also increases the risk of HIV infection. At present, China occupational exposure due to lack of health care workers infected with HIV access to AIDS relief system for medical personnel. " Zhang suggested that they could establish a "medical staff occupational exposure compensation mechanism" to alleviate the psychological pressure of a doctor.
ILO Office for China and Mongolia in Ann Herbert representatives that "the right to medical treatment is a fundamental human right, everyone should enjoy the right to medical treatment. On AIDS education and training of medical staff, through training standards for medical institutions implementation of the principle of protection to ensure the provision of services without discrimination. "
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