内罗毕/伦敦/尼亚盖齐，刚果民主共和国，10月16日 - 在数月的不确定性和供应挑战之后，美国政府已达成协议，继续向全球一些最贫困的国家提供免费的救命药品和设备，用于母亲、婴儿和幼儿。
NAIROBI/LONDON/NYANGEZI, Democratic Republic of Congo, Oct 16 - The US government has struck a deal to continue supplying some of the world's poorest nations with free life-saving medication and equipment for mothers, infants and young children, after months of uncertainty and challenges with supply.
美国国务院发言人通过电子邮件告诉路透社，联合国儿童基金会（UNICEF）将负责采购这些物资，但未透露协议的细节。UNICEF表示，该协议价值2500万美元，为期一年。
The UN children's agency UNICEF will now procure these items, a State department spokesperson told Reuters by email, without giving details of the arrangement. UNICEF said the agreement is worth $25 million and will last for one year.
这笔金额仅为特朗普政府削减和拆解美国国际开发署（USAID）所影响援助的一小部分。
That sum represents only a small part of the aid affected by the Trump administration's cuts and dismantling of the US Agency for International Development (USAID).
但这意味着，世界上一些最脆弱的国家在与美国谈判新的人道主义援助协议期间，将不会面临他们此前依赖的供应再次出现突发中断。九名前美国援助官员、非政府组织和政府官员告诉路透社，这一直是一个真实的担忧，因为现已不复存在的USAID与其承包商之间的协议原定于上个月到期。
But it means that some of the world's most vulnerable nations will not face another abrupt disruption to supplies they relied on while they work on new health aid deals with the US. Nine former US aid officials, NGOs and government officials told Reuters that this had been a real concern because the deal the now-defunct USAID had with its contractor was due to run out last month.
供应短缺 该协议涵盖向此前已覆盖的至少15个国家采购和交付孕产妇和儿童健康用品，以及部分营养用品，包括刚果民主共和国、海地和马里，UNICEF表示。
SHORTAGES The agreement covers the procurement and delivery of maternal and child health supplies, as well as some nutrition supplies, to at least 15 countries previously covered, including Democratic Republic of Congo, Haiti and Mali, UNICEF said.
此协议是在华盛顿因实施“美国优先全球健康战略”而冻结然后削减许多美国援助项目近18个月后达成的。在刚果等国，由于这一中断导致的短缺已经在基层显现。
It follows almost 18 months of disruption after Washington's move to freeze and then scale back many US aid programmes as part of its "America First Global Health Strategy". In countries such as Congo, shortages due to the disruption have already been showing up on the ground.
在刚果东部的尼亚盖齐综合医院，卫生工作者表示，他们已经用完了包括催产素在内的救命药物，催产素用于预防和治疗产后出血；以及阿莫西林，这是一种用于儿科和分娩期间的抗生素。
At the Nyangezi General Hospital in eastern Congo, health workers said they had run out of supplies of life-saving medications including oxytocin to prevent and treat post-partum haemorrhage and amoxicillin, an antibiotic for paediatric use and during childbirth.
“这是我们之前从美国国际开发署收到的一笔捐赠，目前已没有，”助产士艾丽丝·布拉莫向路透社表示。
"It was a donation we received (previously) from USAID, and at the moment, there is none," midwife Alice Bulambo told Reuters.
该地区主要的政府运营仓库已面临断货超过一年，尼亚恩吉齐卫生区首席医疗官奥利维尔·卡巴拉蒂·阿马尼表示。
The main government-run warehouse in the area has faced stockouts for over a year, said Olivier Kabarati Amani, chief medical officer for Nyangezi health zone.
因此，医疗机构被迫按市场价格购买药品。过去六个月，“医疗成本翻了一番，甚至翻了三番，”阿马尼表示，而刚果东部的医疗体系本已因埃博拉疫情举步维艰。
As a result, facilities are forced to buy medicines at market prices. Over the last six months, "the cost of care has doubled, if not tripled," Amani said, at a time when the healthcare system in eastern Congo is already struggling with Ebola.
美国国务院表示，它“已将确保所有救命物资持续可靠供应作为优先事项。”过渡期 根据最新可得的年度报告，美国国际开发署全球卫生供应链计划在2016年至2023年间支出的超过50亿美元中，母婴健康物资支出不足1%。该支出通过私人承包商基米尼克斯公司渠道进行。
The US State Department said it "has prioritized ensuring all life-saving commodities have continued to be made reliably available." TRANSITION Maternal and newborn health items amounted to less than 1% of the more than $5 billion spent by the USAID Global Health Supply Chain program between 2016 and 2023, according to the most recently available annual report. The spending was channelled through private contractor Chemonics.
路透社四月率先报道了关闭该计划的计划，该计划还负责疟疾和艾滋病防治物资的捐赠与配送，援助官员警告称，9月30日的关闭可能导致短缺。
Reuters first reported on plans to close this programme, which also managed the donation and delivery of supplies to tackle malaria and HIV, in April, with aid officials warning that the September 30 shutdown could cause shortages.
关闭基米尼克斯供应链的计划是更广泛的美国全球卫生战略的一部分，该战略旨在在缩减美国支持、减少对承包商依赖的同时，推动各国走向自力更生。
The plans to close the Chemonics supply chain are part of the broader US global health strategy, which aims to move countries towards self-reliance alongside scaled-back US support and reduced reliance on contractors.
美国相反与包括刚果在内的受援国签署了30多项双边卫生援助协议，这些协议要求受援国共同融资，总价值数十亿美元。
The US has instead signed more than 30 bilateral deals on health aid with recipient countries, including Congo, which require co-financing from the countries and are worth billions of dollars in total.
但协议细节仍在敲定之中，此前尚不清楚在此期间将由什么填补订购程序的空白。
But the details of the deals are still being worked out and it had been unclear what would fill the gap in the ordering procedure in the meantime.
五名前美国国际开发署官员表示，虽然许多国家已开始承担母婴健康需求，但订单的前置期可达一年或更长。
While many nations were already moving towards taking over their maternal and child health needs, lead times for orders can be a year or more, five former USAID officials said.
刚果政府计划明年接管，但近期的不确定性带来了困难，总统办公室全民医疗保健计划协调员波利多尔·卡比拉表示。
The Congolese government aims to take over by next year, but has struggled with the recent uncertainty, said Polydor Kabila, coordinator of the universal healthcare programme in the president’s office.
美国国务院发言人对路透社表示，在联合国儿童基金会协议之外，美国当局已延长了基莫尼克斯交付部分关键疟疾和艾滋病物资的截止日期。美国还与全球抗击艾滋病、结核病和疟疾基金签署协议，允许各国通过该基金的订购平台订购新的美国资助的艾滋病和疟疾物资。
Alongside the UNICEF deal, the US authorities have extended the deadline for Chemonics deliveries of some key malaria and HIV items, the State Department spokesperson told Reuters. The US has also signed a deal with the Global Fund to Fight AIDS, Tuberculosis and Malaria to allow countries to order new US-funded HIV and malaria supplies through the Fund's order platform.
联合国儿童基金会在一份声明中表示，将与美国合作，保持卫生和营养物资的流动，让更多儿童获得救命治疗，并补充称，目前尚未下订单，但预计很快将下订单。
In a statement, UNICEF said it would work with the US to "keep health and nutrition supplies moving so more children receive life-saving care," adding that no orders have yet been placed but are expected shortly.