无国界医生新任主席：人道救助的践行者
无国界医生新任主席卡云勒卡亚说，不一定非要去非洲才可以成为人道精神者，人道精神是你看问题的方式
□ 本刊特派香港记者 王端 实习记者 姚远 | 文
卡云勒卡亚简历
卡云勒卡亚（Dr.Unni Karunakara）在印度卡斯特柏医学院取得医学学士学位，其后在美国耶鲁大学、约翰霍普金斯大学取得公共卫生学士学位。曾在南非、津巴布韦、乌干达、德国以及英国进行各种学科研究，1995年首次参与无国界医生的工作。2002年，卡云勒卡亚加入无国界医生阿姆斯特丹分部的公共卫生部门，为中东、非洲南部、南美和中美地区的项目担任顾问。三年后，他成为无国界医生“病者有其药”运动的医学总监。2010年6月，正式上任为新任无国界医生国际议会主席。
在
46岁的卡云勒卡亚（Unni Karunakara）身上，看不到一众医生的古板和严肃。他身着浅灰色麻质外衣，脚踩一双夹指拖鞋，把眼镜架在头上，挥洒自如地谈论对人道精神的理解。
上个月，他正式上任无国界医生（Médecins Sans Frontières，MSF）国际议会主席后，首次来到香港，出席当地办事处的周年大会。恰逢美国富豪巴菲特和盖茨9月的“中国慈善行”正被媒体炒热。卡云勒卡亚在接受本刊记者访问时，希望更多的中国人对“人道救援”产生认识，“中国人应该走出去，在全球的人道救援工作中施展拳脚”。
卡云勒卡亚是无国界医生第一位亚裔国际议会主席。他出生于印度喀拉拉邦，早年在印度首家私营医学院——卡斯特柏医学院（Kasturba Medical College）取得医学学士学位；之后赴美，在耶鲁大学和约翰霍普金斯大学攻读公共卫生专业。他得意地说，“我的弟弟也是医生，一个妹妹是建筑师，幺妹即将完成博士学业，专业是环境政策与科学”。
踏上埃塞俄比亚
卡云勒卡亚的毕业论文，是有关被迫迁徙人口的人口统计学研究。1999年底开始，他花了大半年时间，在尼罗河西岸的乌干达北部和苏丹南部，访问了当地3000多名民众，“这是当时研究尼罗河西岸被迫迁徙人群的最大项目。”
论文超过200页，从迫迁经历如何影响难民的心理状态，到死亡率、生育率等一系列专门研究。
其中结论之一，就是在难民营中妇女的生育率高于现实生活。因为“她们希望以此取代往生的子女”。
他曾考虑过做电视新闻记者、建筑师，最终还是选择了医学。他向本刊记者回忆说，当他还是学生时候，曾致信给无国界医生，希望参与人道救援工作，但是很遗憾没有收到回声。“我第一次知道无国界医生是在BBC的新闻里，看到他们在非洲一些非常困难的地区工作。”
十年之后，卡云勒卡亚如愿以偿加入无国界医生，有机会到埃塞俄比亚参与救助项目。
在全球众多非政府组织中，无国界医生可谓成绩斐然，并于1999年荣获诺贝尔和平奖。这个成立于1971年、由一群医生和新闻从业者创立的组织，目前在19个国家设有地区办事处，在全球约70个国家和地区实施救援。其核心工作，是向受到武装冲突影响的人群提供紧急医疗救援，为被排拒于医疗体系之外的人群提供医疗照顾，还投身于疫病和天灾的抵御。
“当你看到在世界的某个角落，有人那样艰难地生存着，迫切需要帮助，你很难再回去做其他事。”
卡云勒卡亚印象最深的一次救援是在1995年，他31岁，刚刚加入无国界医生组织，参与了在埃塞俄比亚的控制结核病项目。“这也是我的第一项任务。当时这一地区局势非常不稳定，几乎每天都有难民从邻近的索马里逃难过来。肺结核正成为一个非常严重的问题，我们和当地医院合作防控和治疗。多年之后，这一项目由当地卫生部门接管。”
卡云勒卡亚的履历上有这样的记载：曾在阿塞拜疆担任医疗统筹，援助被迫迁徙的难民；在刚果共和国开展昏睡病的治疗项目；参与孟加拉风灾的紧急救援……
救助贫穷者
这是卡云勒卡亚上任主席以来第一次接受中国媒体专访。他腋下夹着一沓文件和一台iPad，带着印度人标准的微笑。在同本刊记者的交谈中，他几次提到“病者有其药”运动（The Access Campaign）。他于2005年成为这项运动的医药总监。
“病者有其药”的基本理念是，应对“无药可救”的现象，通过呼吁新药研发、打破专利限制、引进仿制药等方法，一方面降低现有昂贵药物的价格，另一方面开发罕见疾病的治疗方案。
卡云勒卡亚举例说，1999年，非洲可以享受艾滋病治疗的病人为零，而今是400万人。这主要受惠于艾滋病治疗费用的下跌。在十年前，一名艾滋病患者一年的治疗费用高达1万多美元，现在已降到不满100美元，使艾滋病的治疗比率大幅提升。“发起这项运动本身是医药史上的一个重要转折点。”卡云勒卡亚这样看。
由于没有对药品化学成分的专利保护，印度的仿制药价格全球最低。2005年，印度按照WTO要求修改专利法，开始向药品的化学成分授予专利，受理的第一起申请即引发一场国际风波。2006年1月，印度专利办公室拒绝了瑞士诺华制药公司一种治疗慢性白血病的药物Glivec的申请专利，理由是这一申请只不过是现有药物的版本，未有显著的效用提高，不符合印度专利法。
诺华公司认为裁决对“效用”的解释太主观，便在同年5月上诉，并宣称印度专利法案含糊暧昧，同WTO《与贸易有关的知识产权协定》（TRIPS）相违背。同时，诺华公司对几家仿制药生产商提出诉讼，禁止它们销售Gilvec的仿制药。
2006年末，在卡云勒卡亚等人的带动下，无国界医生发起了一项全球请愿活动，敦促诺华公司撤诉。他指出，全球用于治疗艾滋病的药物超过半数来自印度，而印度有三分之二的仿制药会出口到发展中国家；在无国界医生工作项目里接受治疗的8万名艾滋病患者，80％以上使用来自印度的仿制药。
敦促诺华撤诉的运动当时获得超过30万人签名声援。2007年8月，新德里高级法院驳回了诺华的一项诉讼。该项条款禁止为现有药物的微小改变注册专利。
中国可以更有作为
卡云勒卡亚更愿意讨论对于人道救援的感悟，而非惊心动魄的救人故事。他严格区分了人道救援机构工作与助人脱贫的发展项目，并更强调人道精神的普世价值。“我们并不会通过救助活动试图改变当地的社会结构、经济结构等，我们是在人们需要的时候帮助他们，直到他们能够自己做出决定，选择他们想过的生活。”
无国界医生在全球拥有2000多名志愿者，但来自中国内地的志愿者仅有五人，其中只包括一名医生；在中国的项目，只有在广西南宁市设有免费的艾滋病综合护理及治疗项目，且也将移交给当地政府。
“无国界医生是人道救援组织，并非卫生部。因此我们所做的只是个催化剂的作用。”卡云勒卡亚解释说，“我们提出问题，并展示解决问题的方法。现在（中国）当地的治疗队伍和设施已经完成，我们的任务便完成了。我们不可能在一个地方呆很长时间，也不可能对每个患者施以治疗。”
随着中国在全球政治经济角色的变化，卡云勒卡亚认为，中国作为大国，无论是医药或者人员方面都有很好的资源，希望更多的中国人参加到人道救援行动中去。中国对非洲也有一定的影响力，包括政策制订等。这不仅关乎13亿中国人口的福利，也影响到非洲等发展中地区的福利。
“我在印度长大，以前曾经认为街上穷人的贫穷是理所当然的。但自从我在非洲和南美工作后，再回到印度，对贫穷和穷人有了不同理解，认为应该去帮助他们。”因此，不一定非要去非洲才可以成为人道精神者，“人道精神是你看问题的方式，一种解决问题的方法，以及推动政府采纳正确政策的渠道。”
“我个人很喜欢教书，教书能激励学生去响应时代议题，去做一些对社会有益的事。”卡云勒卡亚希望在无国界医生的任期届满后，仍能回到讲台。
在无国界医生工作12年之后，卡云勒卡亚曾短暂回到校园，出任哥伦比亚大学地球研究所“千禧村落计划”的卫生副总监，并兼任公共卫生学院的临床助理教授，直到今年6月，无国界医生国际议会会议选举他为主席。
“每一代人都有他们对周围世界的独特观察。当我将我的经历和知识分享给学生的时候，我发现他们的激情和解决问题的方法。这也让我成为一个更好的人道精神者。”卡云勒卡亚说。
- 艾滋病早期治疗是康复与延长30～60年生命的保
- 艾滋病免疫重建的重要意义是挽救生命的根本
- 从食品植物研究开发的治疗艾滋病新药三合皂甙
- 康生丹颗粒免疫实验提示符合艾滋病、肿瘤等应
- 鸡尾酒疗法并非万能，抗药性与毒副作用导致联合疗法与中药疗法应用的迫切性
- 康生丹配合西药治疗AIDS总结
- 三合皂甙，康生丹片
- 中药康生丹治愈艾滋病中医论析
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The new Chairman of Medecins Sans Frontieres: humanitarian aid practitioner http://www.sina.com.cn 2010 年 09 月 27 日 00:34 "New Century" magazine
MSF said the new Chairman of card cloud Le Kaya, not necessarily going to Africa who can be humane, humanity is the way you look at
□ Independent magazine trainee journalist in Hong Kong reporter Wang Yao Yuan-side | text
CV Card cloud Le Kaya
Card cloud Le Kaya (Dr.Unni Karunakara) School of Medicine in India, a medical degree Fidel Tebo, then at Yale University, Johns Hopkins University of Public Health degree. In South Africa, Zimbabwe, Uganda, Germany and the UK research in various disciplines, the first time in 1995, the work of MSF. In 2002, the card goes Le Kaya joined the MSF Amsterdam branch of public health sector in the Middle East, southern Africa, South America and Central America project as a consultant. Three years later, he became the MSF, "the patients have their medicines," director of sports medicine. June 2010, officially took office as the new President of MSF International Council.
In
46-year-old card cloud Le Kaya (Unni Karunakara) who do not see a public doctor's stuffy and serious. He wore a light gray linen jacket, a pair of clip means foot slippers, glasses frame in the head with ease to talk about the understanding of humanity.
Last month, he officially took the MSF (Médecins Sans Frontières, MSF) International Council chairman, first came to Hong Kong to attend the local office of the Annual General Meeting. U.S. billionaires Warren Buffett and Gates coincided with September of the "China Charity Walk" is by the media rose. Yun Le Kaya cards accepted correspondents visit in the hope that more Chinese people "humanitarian aid" have recognized, "Chinese people should go out humanitarian relief work around the world display their fists."
Card cloud Le Kaya is the first Asian MSF International Council. He was born in Kerala, India, early years, the first private Medical College in India - Fidel Tebo Medicine (Kasturba Medical College) degree in medicine; after the United States, at Yale University and Johns Hopkins University study public health professions. He says proudly, "My brother is also a doctor, a sister is an architect, Yaomei completing doctoral studies, majoring in environmental policy and science."
Set foot in Ethiopia
Card cloud Le Kaya's thesis is about the population demography of forced migration. The end of 1999, he spent six months, the West Bank of the Nile in northern Uganda and southern Sudan, access to more than 3,000 local people, "which was the population of the West Nile Bank had the largest forced migration."
More than 200 papers, from the experience of how the eviction of the psychological state of refugees, to mortality, fertility and a series of special studies.
One of the conclusions of which is that fertility rates of women in the camps than in real life. Because "they hoped to replace the deceased's children."
He had considered doing TV news reporters, architects, and ultimately chose medicine. He told the reporter recalled that when he was a student when the Doctors Without Borders sent a letter to take part in the humanitarian relief work, but unfortunately did not receive the echo. "The first time I know that MSF is BBC's news, see them in Africa, the work of some very difficult areas."
Ten years later, the card goes Le Kaya got his wish to join Doctors Without Borders, have the opportunity to participate in aid projects in Ethiopia.
In many non-governmental organizations in the world, MSF can be described as impressive, and in 1999 won the Nobel Peace Prize. This was established in 1971 by a group of doctors and journalists who founded the organization, currently has regional offices in 19 countries in the world about 70 countries and territories to implement the rescue. Its core work is to people affected by armed conflict to provide emergency medical assistance, as being excluded from the population outside the health care system to provide medical care, but also engaged in resisting disease and natural disasters.
"When you see a corner of the world, it was so hard to survive with the urgent need of help, it is hard to come back to do other things."
Card cloud Le Kaya impressed a rescue in 1995, he was 31 years old, has just joined the MSF involved in TB control programs in Ethiopia. "This is my first task. Was very unstable situation in the region, almost every day, fleeing refugees came from neighboring Somalia. TB is becoming a very serious problem, and we cooperate with local prevention and treatment of hospital . years later, the project taken over by the local health department. "
Card cloud Le Kaya resume on this record: as a health care co-ordination in Azerbaijan, assistance to refugees forced migration; sleeping sickness in the Republic of the Congo to carry out treatment programs; in Bangladesh cyclone emergency relief ... ...
Poor relief
This is the card cloud Le Kaya first time since the President took office to accept the Chinese media interviews. His stack of paper under his arm and a iPad, with a smile of Indian Standards. In conversation with the reporter, he made several references to "the patient should have their drugs" campaign (The Access Campaign). In 2005, he became medical director of the sport.
"Patients have their medicines," the basic idea is to deal with "incurable" phenomenon, by calling for new drug development, to break the patent restrictions, the introduction of generic drugs and other methods, while reducing the current high price of drugs, on the other hand development of rare disease treatment.
Card cloud Le Kaya, for example, in 1999, the African AIDS treatment patients can enjoy zero, and now is 400 million. This is mainly attributable to the cost of AIDS treatment down. A decade ago, an AIDS patient year of treatment costs up to more than 10,000 U.S. dollars, is now down to less than 100 dollars, the rate of AIDS treatment has increased significantly. "The campaign itself was launched a major turning point in the history of medicine." Card cloud Le Kaya think so.
In the absence of the chemical constituents of pharmaceutical patent protection, India's generic drug prices lowest in the world. In 2005, the Indian patent law amended in accordance with WTO requirements, the chemical composition started to grant pharmaceutical patents, received the first application that is triggered from an international storm. January 2006, the Indian Patent Office rejected Novartis Pharmaceuticals a treatment for chronic leukemia drug Glivec patent application on the grounds that this application is only the current version of the drug, did not significantly improve the effectiveness, not consistent with India's patent laws.
Novartis ruling that the "utility" of the interpretation is too subjective and would appeal in the same year in May, and claimed that Indian patent bill vague ambiguous, with the WTO "Agreement on Trade-Related Intellectual Property Rights" (TRIPS) contrary. Meanwhile, Novartis on several generic drug makers filed suit against their sales Gilvec generic drugs.
In late 2006, Yun Le Kaya and others in the card driven, MSF launched a global petition urging Novartis withdrawal. He pointed out that the global AIDS drugs for the treatment of more than half from India, while India has two-thirds of generic drugs will be exported to developing countries; in projects where MSF treated 80,000 AIDS patients, 80% more use of generic drugs from India.
Novartis urged the withdrawal of the movement was more than 30 million signatures of support received. August 2007, New Delhi High Court dismissed a lawsuit Novartis. The provision of drugs against small changes to existing registered patent.
China could be more as a
Cards are more willing to discuss cloud Le Kaya insights for humanitarian relief rather than rescue thrilling story. Strict distinction between his work and humanitarian aid agencies for development projects to help others out of poverty, and more emphasis on the universal values of humanity. "We do not attempt to change the relief activities through the local social structure, economic structure, we are in when people need to help them until they can make their own decisions, choose their thought life."
MSF has more than 2,000 volunteers around the world, but volunteers from the Chinese mainland only five people, including a doctor only; projects in China, only in Nanning City has a free and comprehensive care of AIDS treatment programs, and will also be handed over to local government.
"MSF is a humanitarian organization, not the Ministry of Health. So we did just a catalyst." Cloud Le Kaya Card explained, "We ask questions, and demonstrate solutions to the problem. Now (China) local treatment team and facilities have been completed, the task is complete. We can not stay very long in one place, it is impossible to impose treatment for each patient. "
With China's economic role in the global political changes, the card Yunlekaya that China as a great power, whether for medical or personnel have very good resources, I hope more Chinese people to participate in humanitarian relief operations to go. China and Africa has some influence, including policy formulation and so on. This is not only about the welfare of the 1.3 billion Chinese people, also affects the developing regions of Africa and other benefits.
"I grew up in India, was once thought that poverty in the poor streets for granted. But since I work in Africa and South America, then returned to India, the poor and the poor have a different understanding, that should go to help them." Therefore, we can not necessarily going to Africa to become a humane person, "humanity is the way you look at the problem, a solution to the problem, and the Government to adopt the right policies to promote the channel."
"I personally like to teach, teaching to encourage students to respond to contemporary issues, to do some socially useful things." Cloud Le Kaya card MSF hopes after the expiry of the term of office, can still return to the podium.
MSF work in 12 years, the card goes back to school briefly Le Kaya, the Earth Institute at Columbia University as the "Millennium Villages Programme", vice director of health, and is also the School of Public Health, clinical assistant professor, until 6 this year months, MSF International Council Conference elected him as Chairman.
"Every generation has their unique observations on the world around them. When I would share my experience and knowledge to the students, I find their passion and resolve the problem. It also made me a better humanity persons. "card cloud Le Kaya said.
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