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Edtkbxtybt vfcinf,jd ghbvtytybzfynbhtnhjdbhecyjq nthfgbb d

eckjdbz[ juhfybxtyys[ htcehcjd

Herjdjlcndj gj ghbvtytyb.vtnjljd j,otcndtyyjuj

plhfdjj[hfytybz

Htp.vt

Dctvbhyfz jhufybpfwbz plhfdjj[hfytybzLtgfhnfvtyn DBX#CGBLf

Rkfcnth pljhjdmz ctvmb b j,obys

Lfyyst lkz rfnfkjuf ,b,kbjntrb DJP

Edtkbxtybt vfcinf,jd ghbvtytybz fynbhtnhjdbhecyjq nthfgbb d eckjdbz[ juhfyb-xtyys[ htcehcjd% Herjdjlcndj gj ghbvtytyb. vtnjljd ujcelfhcndtyyjuj plhfdjj[h-fytybz% htp.vt

1& Dtotcndf^ ghbvtyztvst ghjnbd DBX --nthfgtdnbxtcrjt ghbvtytybz2& Dtotcndf^ ghbvtyztvst ghjnbd DBX --ghbvtytybt b ljpbhjdrf3& DBX--byatrwbb --vtlbrfvtynjpyjt ktxtybt 4& Ytelfxyjt ktxtybt5& Uheggf yfctktybz^ gjldthuf.ofzcz hbcre 6& Dphjcksq 7& Ht,tyjr8& Herjdjlzobt ghbywbgs

ISBN 92 4 454 567 5 (NLM classification: QV 268.5)

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Q Dctvbhyfz jhufybpfwbz plhfdjj[hfytybz^ 2003 ujl

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gjlujnjdktyj gjl htlfrwbtq%l-hf Crjnnf {fvvthf (Scott Hammer)^ Rjkev,bqcrbq eybdthcbntn^

Ym.-Qjhr^ CIFÛkfdysq htlfrnjh* f nfr;t

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htlfrnjh^ ukfdf gj gtlbfnhbb*

l-hf Lbfys {fdkbh (Diane Havlir)^ Rfkbajhybqcrbq eybdthcbntn^ Cfy-Lbtuj^ CIF^htlfrnjh^ ukfdf gj cjgencnde.obv byatrwbzv^ cdzpfyysv c DBX*

l-hf Kbyy Vjatycjy (Lynne Mofenson)^ Yfwbjyfkmyst bycnbnens plhfdjj[hfytybz^Yfwbjyfkmysq bycnbnen j[hfys pljhjdmz ht,tyrf b uevfybnfhyjuj hfpdbnbz^

<tntplf^ CIF htlfrnjh^ ukfdf gj djghjcfv ,thtvtyyjcnb*

l-hf Byuhbl dfy <br (Ingrid Van Beek)^ Cblytq^ Fdcnhfkbz^htlfrnjh^ ukfdf^ rfcf.ofzcz gjnht,bntktq by]trwbjyys[ yfhrjnbrjd*

l-hf Cntafyj Dtkkf (Stefano Vella)^ Vt;leyfhjlyjt j,otcndj gj CGBLe^Hbv^ Bnfkbz htlfrnjh^ ukfdf gj rkbybxtcrjve b kf,jhfnjhyjve vjybnjhbyue

ghbvtytybz fynbhtnhjdbhecyjq nthfgbb*

b crjjhlbybhjdfyj%l-hjv <fpbk Dfhtklpbc (Basil Vareldzis) b l-hjv Qjc Gthhb/yc (Jos Perriens)^

Jnltk gj DBX#CGBLe^ :tytdf

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CJLT:FYBT

Cjrhfotybz ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 5

Ghtlbckjdbt ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 6

Ddtltybt __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 8

Wtkb ljrevtynf _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 10

Rjulf yfxbyfnm fynbhtnhjdbhecye. nthfgb. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 12

Htrjvtyletvst c[tvs ktxtybz gthdjuj hzlf lkz dphjcks[ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________ 16

Ghbxbys bpvtytybz fynbhtnhjdbhecyjq nthfgbb ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 19

Ds,jh c[tv fynbhtnhjdbhecyjuj ktxtybz dnjhjuj hzlf _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 20

Hfccvjnhtybt rjyrhtnys[ gjluhegg ,jkmys[ _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 22

:tyobys^ cgjcj,yst hj;fnm^ bkb ,thtvtyyst ;tyobys ____________________________________________________________________________________________________________ 22

Ltnb ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 22

<jkmyst ne,threktpjv c cjgencnde.otq DBX-byatrwbtq ____________________________________________________________________________________________________ 24

Gjnht,bntkb by]trwbjyys[ yfhrjnbrjd _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 25

Cj,k.ltybt c[tvs fynbhtnhjdbhecyjq nthfgbb _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 25

Rjynhjkm pf htpbcntynyjcnm. r ktrfhcndtyysv chtlcndfv __________________________________________________________________________________ 26

Rkbybxtcrbq b kf,jhfnjhysq vjybnjhbyu ghbvtytybzfynbhtnhjdbhecyjq nthfgbb ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 26

Ghbkj;tybt F% Ljpbhjdrf fynbhtnhjdbhecys[ghtgfhfnjd lkz dphjcks[ b gjlhjcnrjd ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 29

Ghbkj;tybt D% Rhfnrfz byajhvfwbz j cjcnfdt b ljpf[ktrfhcndtyys[ chtlcnd^ ghbvtyztvs[ d gtlbfnhbb ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 30

CJRHFOTYBZ

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5

Htp.vt^ fghtkm 2002 u

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Gj jwtyrfv DJP^ d 2002 ujle d gjllth;bdf.otq ;bpym FHD--nthfgbbye;lftncz jrjkj 6 vbkkbjyjd xtkjdtr d hfpdbdf.ob[cz cnhfyf[& Yf ltkt^ dyfcnjzott dhtvz njkmrj 230 000 xtkjdtr bvt.n nfrjq ljcneg^ b gjkjdbyf bpyb[ ;bden d jlyjq cnhfyt -- <hfpbkbb& Vs cxbnftv^ xnj r rjywe 2005 ujlfcnhfys hfpdbdf.otujcz vbhf ljk;ys bvtnm djpvj;yjcnm j,tcgtxbdfnmljcneg rFHD--nthfgbb lkz 3 vbkkbjyjd xtkjdtr^ ghb eckjdbb^ xnj vbh ,eltnghjljk;fnm vt;leyfhjlyst cjukfcjdfyyst ecbkbz gj hfcibhtyb. ljcnegfr ktxtyb. DBX b e[jle& Nfrjt ltcznbrhfnyjt edtkbxtybt bvttn pyfxtybt gjvyjubv ghbxbyfv& Nhtv vbkkbjyfv k.ltq ,eltn ghjlktyf ;bpym^ hfcib-htybt ljcnegf r ktxtyb. ,eltn cnbvekbhjdfnm ghjabkfrnbre^ b ’nj ,eltnbvtnm gjkj;bntkmyst gjcktlcndbz lkz cjwbfkmyj--’rjyjvbxtcrjuj hfpdb-nbz^ gjcrjkmre k.lb^ ;bdeobt c DBX^ ,elen;bnm ljkmit^ b b[;bpym cnfytn,jktt ghjlernbdyjq&

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6

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:tytdf

Fghtkm 2003u&


7

I. Ddtltybt

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R cj;fktyb.^ lkz ,jkmibycndf bp 36 vbkkbjyjd k.ltq d hfpdbdf.otvczvbht^ ;bdeob[ d yfcnjzott dhtvz c DBX#CGBLjv^ lfyyst jgnbvbcnb-xtcrbt gthcgtrnbds ybxtuj yt vtyz.n& Cjukfcyj rjycthdfnbdysv jwtyrfvDJP^ d 2002 u& ghb,kbpbntkmyj 6 vbkkbjyjd xtkjdtr^ yf[jlzob[cz deckjdbz[ juhfybxtyys[ htcehcjd^ e;t d yfcnjzott dhtvz ye;lf.ncz dgjllth;bdf.otq ;bpym fynbhtnhjdbhecyjq nthfgbb& F d htfkmyjcnb kbim230 000 xtkjdtr bvt.n ljcneg r ktxtyb.^ b gjkjdbyf bp yb[ ;bden d jlyjqcnhfyt - <hfpbkbb&

Gjckt ghjdtltybz Vt;leyfhjlyjq rjyathtywbb gj CGBLe d Leh,fyt d2000 u& b Cgtwbfkmyjq ctccbb Utythfkmyjq Fccfv,ktb JhufybpfwbbJ,]tlbytyys[ Yfwbq gj DBX#CGBLe d 2001 u& vt;leyfhjlyjtcjj,otcndj c ytdblfyyjq hfytt htibvjcnm. yfvthtyj ecnhfybnm hfpb-ntkmysq rjynhfcn vt;le bvt.obvb ljcneg r ktxtyb.^ b ntvb^ rnj tuj ytbvttn^ vt;le ,jufnsvb b ,tlysvb&Vbh ghbpyftn ytjnkj;ye.vjhfkmye.^cjwbfkmye.^ gjkbnbxtcre. b ’rjyjvbxtcre. ytj,[jlbvjcnm crjhtqitujhtfkmyjuj hfcibhtybz ljcnegf r fynbhtnhjdbhecyjq nthfgbb lkz vyjub[vbkkbjyjd k.ltq^ ;bdeob[ c DBX#CGBLjv^ b ghbcnegbk r vj,bkbpfwbb‘juhjvyjuj ukj,fkmyjuj fkmzycf\ r cjplfyb. rjnjhjuj ghbpdfk Utyt-hfkmysq ctrhtnfhm JJYRjab Fyyfy^ lkz ljcnb;tybz wtktq^ gjcnfdktyys[Cgtwbfkmyjq ctccbtq Utythfkmyjq Fccfv,ktb JJY&

Yfcnjzott herjdjlcndj gjlujnjdktyj d hfvrf[ Dctvbhyjq jhufybpfwbbplhfdjj[hfytybz (DJP) gthtl ’nbvbv fkmzycjv&Lkz wtktq tuj hfphf,jnrb dntxtybt dctuj 2001 ujlf ghjdjlbkbcm vt;leyfhjlyst rjycekmnfnbdyst


8

cjdtofybz^ d rjnjhs[ ghbybvfkb exfcnbt ,jktt 200 rkbybwbcnjd^ extys[^ghtlcnfdbntktq ghfdbntkmcnd^ ghtlcnfdbntktq uhf;lfycrjuj j,otcndf bk.ltq c DBX#CGBLjv bp ,jktt xtv 60 exfcnde.ob[ cnhfy& Htrjvtylfwbb^drk.xtyyst d yfcnjzobq ljrevtyn^ jnhf;f.n jgnbvfkmyst ghfrnbxtcrbtgjl[jls ^ jcyjdfyyst yf fyfkbpt ceotcnde.ob[ afrnbxtcrb[ lfyys[& D nt[ckexfz[^ rjulf j,]tv afrnbxtcrb[ lfyys[ yt ,sk e,tlbntkmysv^ d rfxtcndtjcyjds lkz ’nb[ htrjvtylfwbq bcgjkmpjdfkcz rjyctycec ’rcgthnjdjd& DJPghbpyftn^ xnj d ’njq ,scnhj hfpdbdf.otqcz j,kfcnb lfyyst htrjvtylfwbbytj,[jlbvj ,eltn j,yjdkznm yf htuekzhyjq jcyjdt&

{jnz yfcnjzobq ljrevtyn b zdkztncz df;ysv ifujv dgthtl^ tuj yt cktletn‘vfubxtcrbv jhelbtv\ lkz hfcibhtybz ljcnegf r fynbhtnhjdbhecyjvektxtyb.& Ljcneg r ktrfhcndtyysv chtlcndfv lkz vbkkbjyjd ye;lf.ob[czd yb[ k.ltq vj;tn ,snm hfcibhty yt njkmrj ,kfujlfhz herjdjlcnde djnyjitybb hfwbjyfkmyjuj ds,jhf b ghbvtytybz fynbhtnhjdbhecys[ktrfhcndtyys[ chtlcnd^ yj nfr;t ,kfujlfhz cjplfyb. ,jktt ghbtvktvs[b cnf,bkmys[ eckjdbq abyfycbhjdfybz pfregjr ktrfhcndtyys[ chtlcnd bceotcndjdfyb. ljcnegys[^ yflkt;fobv j,hfpjv jhufybpjdfyys[ b rjv-gtntynys[ cke;, plhfdjj[hfytybz& Ltqcnde.obt d hfvrf[ cbcntvs JJY bdyt tt exfcnybrb ghjljk;f.n cgjcj,cndjdfnm jceotcndktyb. ’nb[ ghjxb[df;ys[ ’ktvtynjd yf jcyjdt cktle.ob[v vthjghbznbq%

. Bybwbfnbdf gj ecrjhtyb. ljcnegf^ rjnjhfz ghbdtkf r htprjvecjrhfotyb. cnjbvjcnb fynbhtnhjdbhecys[ ktrfhcndtyys[ chtlcnd d20 hfpdbdf.ob[cz cnhfyf[ r zydfh. 2002 u&*

. gkfybhjdfybt bcnjxybrjd b wty yf ktrfhcndtyyst chtlcndf^ cdzpfyyst cDBX^ jceotcndkztvjt>YBCTA^>Y"QLC^ jhufybpfwbtq ‘Dhfxb ,tpuhfybw\ (MSF) b DJP*

. bccktljdfybt cntgtyb gfntynyjq pfobns ktrfhcnd^ ghbvtyztvs[ lkznthfgbb DBX--byatrwbb^ ghjdjlbvjt DJP b >Y"QLC*

. edtkbxtybt abyfycjds[ b rflhjds[ htcehcjd lkz jceotcndktybz DJPcdjtq ltzntkmyjcnb gj erhtgktyb. gjntywbfkf cbcntv plhfdjj[hfytybzd j,kfcnb DBX#CGBLf^ drk.xfz jhufybpfwb. vt;leyfhjlyjq ctnbexht;ltybq gj gjlujnjdrt rflhjd d j,kfcnb jrfpfybz gjvjob^cdzpfyyjq c DBX*

. Ukj,fkmysq ajyl gj ,jhm,t cj CGBLjv^ ne,threktpjv b vfkzhbtq^jhufybpjdfyysq Utythfkmysv ctrhtnfhtv JJY d 2001 u& b ghtlcnfd-kz.obq cj,jq pyfxbntkmyst yjdst bydtcnbwbb lkz ,jhm,s ghjnbd ’nb[nht[ jcyjdys[ byatrwbjyys[ ,jktpytq&


9

II. Wtkb ljrevtynf

D yfcnjzott dhtvz d eckjdbz[ juhfybxtyys[ htcehcjd vtytt 5¢ye;lf.ob[cz d fynbhtnhjdbhecyjv ktxtybb^ vjuen gjkexbnm ljcneg

r ’nbv ktrfhcndtyysv chtlcndfv& DJP cxbnftn^ xnj^ gj vtymitq vtht^nhtv vbkkbjyfv k.ltq^ ye;lf.obvcz d gjvjob^ cktletn ghtljcnfdbnmdjpvj;yjcnm gjkextybz ktrfhcndtyys[ chtlcnd r 2005 u& "nj zdbkjcm ,s,jktt xtv ltcznbrhfnysv hfcibhtybtv ljcnegf&

Yfcnjzott herjdjlcndj ghtlyfpyfxtyj lkz jrfpfybz gjllth;rb b cjltq-cndbz yflkt;fotve ktxtyb. b hfcibhtyb. vfcinf,jd ghbvtytybz FHN dghtlcnjzobt ujls gjchtlcndjv vtnjljd ujcelfhcndtyyjuj plhfdjj[hfyt-ybz^ jcyjdysvb ghbywbgfvb rjnjhs[ zdkz.ncz%

1) edtkbxtybt vfcinf,jd ltzntkmyjcnb ghjuhfvv gj fynbhtnhjdbhecyjvektxtyb. lkz eljdktndjhtybz gjnht,yjcntq k.ltq c DBX#CGBLjv deckjdbz[ juhfybxtyys[ htcehcjd*

2) cnfylfhnbpfwbz b eghjotybt c[tv fynbhtnhjdbhecyjuj ktxtybz d wtkz[cjltqcndbz ’aatrnbdyjve jceotcndktyb. ghjuhfvv gj ktxtyb.*

3) j,tcgtxtybt njuj^ xnj,s ghjuhfvvs gj fynbhtnhjdbhecyjve ktxtyb.,skb jcyjdfys yf cfvs[ yflt;ys[ yfexys[ lfyys[^ c ntv xnj,sbp,tufnm bcgjkmpjdfybz ytcnfylfhnys[ ghjnjrjkjd ktxtybz^ rjnjhstcnfdzn gjl euhjpe htpekmnfns ktxtybz jnltkmys[ ,jkmys[ b cjplf.ngjntywbfkmyst djpvj;yjcnb gjzdktybz htpbcntynys[ ajhv dbhecf&

{jnz tcnm jcyjdfybz yfltznmcz yf nj^ xnj yfcnjzobq ljrevtyn ,eltngjktpty lkz rkbybwbcnjd^ hf,jnf.ob[ d eckjdbz[ juhfybxtyys[ htcehcjd^jy d gthde. jxthtlm ghtlyfpyfxty lkz bcgjkmpjdfybz rjycekmnfnbdysvbcjdtnfvb gj djghjcfv ktxtybz^ herjdjlbntkzvb yfwbjyfkmys[ ghjuhfvvgj CGBLe b lheubvb herjdjlbntkzvb dscjrjuj ehjdyz d j,kfcnbhfphf,jnrb gjkbnbrb^ pfybvf.obvbcz djghjcfvb gkfybhjdfybz yfwbj-yfkmys[ b vt;leyfhjlys[ cnhfntubq gj jrfpfyb. gjvjob k.lzv^;bdeobv c DBX^ d eckjdbz[ juhfybxtyys[ htcehcjd& "nj herjdjlcndjcke;bn jcyjdjq lkz ds,jhf yfb,jktt ltqcndtyys[ b jceotcndbvs[ c[tvfynbhtnhjdbhecyjuj ktxtybz d hfvrf[ hfcibhtyys[ yfwbjyfkmys[ jn-dtnys[ vth yf ’gbltvb.& Lfyyfz jcyjdf yfwtktyf yf ‘ cnfylfhnbpfwb. \ beghjotybt fynbhtnhjdbhecyjq nthfgbb^ d pyfxbntkmyjq cntgtyb fyfkjubx-yj ktxtyb. ne,threktpf d hfvrf[ yfwbjyfkmys[ ghjuhfvv gj ,jhm,t cne,threktpjv^ c extnjv jnyjcbntkmyjq ckj;yjcnb b cgtwbabrb ktxtybzDBX& Gj’njve ghtlcnfdktyyst dfhbfyns ktxt,ys[ c[tv gthdjuj b dnjhjujhzlf exbnsdf.n gjnht,yjcnb cbcntv plhfdjj[hfytybz^ rjnjhst xfcnjbcgsnsdf.n ytljcnfnjr d rdfkbabwbhjdfyys[ rflhf[ b j,jheljdfybblkz vjybnjhbyuf^ ,tp yfytctybz eoth,f rfxtcnde b htpekmnfnfv ghtl-kj;tyys[ dbljd ktxtybz&


10

Lfyyjt herjdjlcndj hfccvfnhbdftn nfrbt djghjcs^ rfr FHD nthfgbz^jgnbvfkmyst c[tvs gthdjuj hzlf^ rhbnthbb bpvtytybz c[tvs ktxtybz brjv,byfwbb^ bcgjkmpetvst lkz pfvtys nthfgbb& Nfr;t jcdtoftncz djghjcj njv^ rfrbv j,hfpjv jceotcndkznm vjybnjhbyu ’aatrnbdyjcnb ktxtybz cextnjv vjybnjhbyuf gj,jxys[ ltqcndbq ghtgfhfnjd^ b ghtlcnfdktysrjyrhtnyst htrjvtylfwbb gj dtltyb. cgtwbabxtcrb[ gjluhegg gfwbtynjd&


11

III& Rjulf yfxbyfnm fynbhtnhjdbhecye.nthfgb.

D JP htrjvtyletn^ xnj,s d hfvrf[ ghjuhfvv gj fynbhtnhjdbhecyjvektxtyb. d eckjdbz[ juhfybxtyys[ htcehcjd DBX--byabwbhjdfyyst

gjlhjcnrb b dphjckst yfxbyfkb fynbhtnhjdbhecye. nthfgb.^ rjulf jybyf[jlzncz yf%

. cnflbb IV DBX--byatrwbb cjukfcyj rkfccbabrfwbb DJP (rkbybxtcrfzajhvf CGBLf) ytpfdbcbvj jn rjkbxtcndf CD4*

. cnflbz[ I^ II bkb III DBX--byatrwbb cjukfcyj rkfccbabrfwbb DJP crjkbxtcndjv CD4 vtytt 200#vv3*

. cnflbz[ II bkb III DBX--byatrwbb cjukfcyj rkfccbabrfwbb DJP ghbj,otv rjkbxtcndt kbvajwbnjd vtymit 1200#vv3&

Nfv^ ult djpvj;yj^ cnhfyfv htrjvtyletncz bcgjkmpjdfnm gjlcxtn rjkb-xtcndf rktnjr CD4 d cdjb[ ghjuhfvvf[ gj fynbhtnhjdbhecyjve ktxtyb. bhfccvjnhtnm djghjc j ghbvtytybb bvt.ob[cz d yfcnjzott dhtvz ghjcns[^b ytljhjujcnjzob[ vtnjljkjubq gjlcxtnf CD4 lkz j,tcgtxtybz lfyyjujbccktljdfybz lkz gfwbtynjd& Jlyfrj d nt[ ckexfz[^ rjulf jghtltktybtrjkbxtcndf ytljcnegyj^ cktletn ghbvtyznm gjrfpfntkm j,otuj rjkbxtcndfkbvajwbnjd vtytt 1200# vv3 d rfxtcndt rhbnthbz lkz yfxfkf fynbhtnhj-dbhecyjq nthfgbb lkz gfwbtynjd c rkbybxtcrbvb ghjzdktybzvb DBX--byatrwbb ( cnflbz II bkb III cjukfcyj rkfccbabrfwbb DJP)& {jnz j,ottrjkbxtcndj kbvajwbnjd jnyjcbntkmyj gkj[j rjhhtkbhetn c rjkbxtcndjvCD4^ d cjxtnfybb c jghtltktybtv rkbybxtcrjq cnflbb pf,jktdfybz lfyysqgjrfpfntkm zdkztncz gjktpysv vfhrthjv lkz cjcnfdktybz rkbybxtcrjujghjuyjpf b b ds;bdftvjcnb& Jghtltktybt dbhecyjq yfuheprb (yfghbvth^bcgjkmpjdfybt rjkbxtcndtyyjuj jghtltktybz ehjdyz HYR DBX--1 d gkfpvt)yt hfccvfnhbdftncz d rfxtcndt ceotcndtyyjuj eckjdbz lkz yfxfkf ghbvt-ytybz nthfgbb&

D jnyjitybb ltntq DJP htrjvtyletn cktle.obt rhbnthbb yfxfkfrjv,bybhjdfyyjq FHD nthfgbb lkz DBX--gjpbnbdys[ ltntq d djphfcnt lj18 vtczwtd% gjlndth;ltyyfz dbhecjkjubxtcrbv gentv byatrwbz (gjchtlcn-djv bcgjkmpjdfybz GWH DBX bkb h24--fynbutyf DBX lbccjwbbhjdfyyjujbvveyyjuj rjvgktrcf^ bkb rekmnehs DBX) b gtlbfnhbxtcrfz cnflbz IIIDBX--byatrwbb cjukfcyj gtlbfnhbxtcrjq rkfccbabrfwbb DJP (n&t& rkbyb-xtcrfz ajhvf CGBLf) bkb gtlbfnhbxtcrbt cnflbb I b II DBX--byatrwbb gjDJP ghb ghjwtynyjv gjrfpfntkt CD4--rktnjr (CD4 )<20¢& D ckexfz[^ rjulfjncencndetn dbhecjkjubxtcrjt gjlndth;ltybt^ rhbnthbtv yfxfkf fynbht-nhjdbhecyjq rjv,bybhjdfyyjq nthfgbb lkz DBX--gjkj;bntkmys[ ltntqvj;tn cke;bnm III cnflbz DBX--byatrwbb cjukfcyj rkfccbabrfwbb DJP bghjwtynyjt cjlth;fybt CD4 <20¢& D jnyjitybb ltntq cnfhit 18 vtczwtd cgjkj;bntkmysv htpekmnfnjv ntcnf yf fynbntkf r DBX DJP htrjvtyletnghbvtytybt FHN^ tckb jyb yf[jlzncz yf cnflbb III DBX--byatrwbb cjukfcyjrkfccbabrfwbb DJP (n&t& rkbybxtcrfz ajhvf CGBLf)^ ytpfdbcbvj jn


12

ghjwtynyjuj cjlth;fybz CD4& D jnyjitybb ltntq ,jktt cnfhitujdjphfcnf^ yf[jlzob[cz yf cnflbb I bkb II DBX--byatrwbb cjukfcyjrkfccbabrfwbb DJP^ htrjvtyletncz ghbvtytybt FHN^ tckb ghjwtynyjtcjlth;fybt CD4<15¢&

Nf,kbwf F& Htrjvtylfwbb gj ghbvtytyb. fynbhtnhjdbhecyjqnthfgbb lkz ktxtybz dphjcks[ b gjlhjcnrjd cgjlndth;ltyyjq DBX--byatrwbtq

Tckb ljcnegyj ntcnbhjdfybt yf rjkbxtcndj CD4--rktnjr%

. Cnflbz IV ,jktpyb cjukfcyj rkfccbabrfwbb DJP^ ytpfdbcbvj jnrjkbxtcndf rktnjr CD4

. Cnflbz I^ II bkb IIIa cjukfcyj rkfccbabrfwbb DJP c rjkbxtcndjv rktnjrCD4 4200#vv3 b

Tckb ytljcnegyj ntcnbhjdfybt yf cjlth;fybt CD4--rktnjr%

. Cnflbz IV cjukfcyj cnfylfhnfv DJP ytpfdbcbvj jn j,otuj rjkbxtcndfkbvajwbnjd

. Cnflbz II bkb IIIa ,jktpyb cjukfcyj cnfylfhnfv DJP ghb j,otvrjkbxtcndt kbvajwbnjd 41200#vv3 c

a Ktxtybt nfr;t htrjvtyletncz lkz,jkmys[ c ghjuhtccbhe.otq cnflbtq III

,jktpyb cjukfcyj cnfylfhnfv DJP^drk.xfz htwblbdbhe.obq bkb gthcbc-nbhe.obq rfylbljp hjnjdjq gjkjcnb bhtwblbdbhe.obt bydfpbdyst ,frnt-hbfkmyst byatrwbb ytpfdbcbvj jn xbc-kf rktnjr CD4 bkb j,otuj xbckfkbvajwbnjd&

b Njxysq ehjdtymCD4^ ghtdsif.obq 200#vv3^ yf rjnjhjv cktletn yfxbyfnm fynb-htnhjdbhecyjt ktxtybt^ yt ,sk jghtlt-kty* ’nj jpyfxftn^ xnj ghb ghbyznbbhtitybz cktletn exbnsdfnmghbcencndbtcbvgnjvjd b crjhjcnm cjrhfotybz xbckfrktnjr CD4 (tckb ghjdjlbncz bpvtht-ybt)& Ehjdtym CD4^ hfdysq 200#vv3^cjjndtncndetn ghjwtynyjve cjlth;fyb.CD4 - jrjkj 15¢&

c J,ott xbckj kbvajwbnjd d rjkbxtcndt41200#vv3 vj;tn ,snm bcgjkmpjdfyjdvtcnj xbckf rktnjr CD4^ d nt[ ckexfz[^rjulf gjcktlytt bccktljdfybt ytljc-negyj b ceotcnde.n cbvgnjvs^ cdzpfy-y s t c D B X ( b k b c b v g n j v sghjuhtccbhjdfybz DBX--byatrwbb)&Jghtltktybtj,otujxbckfkbvajwbnjdbvtt n vtymitt p yfxtybt lkz,tccbvgnjvys[ gfwbtynjd& Nfrbvj,hfpjv^ ghb jncencndbb ntcnbhjdfybzyf rktnrb CD4 yt cktletn yfxbyfnmktxtybt ,tccbvgnjvys[ DBX--byabwb-hjdfyys[ ,jkmys[ (cnflbz I cjukfcyjcnfylfhnfv DJP)^ gjnjve xnj d yfcnj-zott dhtvz yt ceotcndetn lheub[ yf-lt;ys[ fkmnthyfnbdys[ vfhrthjd deckjdbz[ xhtpdsxfqyj juhfybxtyys[htcehcjd&


13

Nf,kbwf D% Htrjvtylfwbb gj ghbvtytyb. fynbhtnhjdbhecyjqnthfgbb lkz ktxtybz ltntq uhelyjuj b hfyytuj djphfcnf

Ntcnbhjdfybtyfcj-lth;fybt CD4

Djphfcn Lbfuyjcnbxtcrjtntcnbhjdfybt yf DBX

Htrjvtylfwbb gjktxtyb.

Tckb ghjdjlbnczntcnbhjdfybt yfcjlth;fybt CD4

<18vtczwtd

Gjpbnbdysq dbhecjkj-ubxtcrbq ntcn yf DBX1

. Gtlbfnhbxtcrfz cnflbz III

cjukfcyj rkfccbabrfwbb DJP(CGBL) ytpfdbcbvj jnghjwtynyjuj cjlth;fybzrktnjr CD42

. Gtlbfnhbxtcrfz cnflbz I

,jktpyb (,tccbvgnjvyjq) bkbcnflbz II ,jktpyb cjukfcyjcnfylfhnfvDJPcghjwtynysvcjlth;fybtv CD4 <20¢3

Dbhecjkjubxtcrjt ntc-nbhjdfybt yf DBX ytghjdjlbncz^ yj ht,tyjrzdkztncz DBX-cthjgjpb-nbdysv bkb hj;lty DBX-byabwbhjdfyyjqvfnthm. (Ghbvtxfybt%ntcn yf fynbntkf r DBXytj,[jlbvj gjdnjhbnm ddjphfcnt 18 vtczwtd lkzgjkextybz njxyjujlbfuyjpf DBX-byatrwbb)


,jktpyb (CGBL) cjukfcyjcnfylfhnfv DJP c ghjwtyn-ysv cjlth;fybtvrktnjr CD4 <20¢

518 vtc-zwtd

Gjpbnbdysq cthjkjub-xtcrbq ntcn yf fynbntkf rDBX


,jktpyb (CGBL) cjukfcyjcnfylfhnfv DJP ytpfdbcbvjjn ghjwtynyjuj cjlth;fybzrktnjr CD42

. Gtlbfnhbxtcrfz cnflbz I

,jktpyb (,tccbvgnjvyjq) bkbcnflbb II ,jktpyb cjukfcyjcnfylfhnfvDJPcghjwtynysvcjlth;fybtv CD4 <15¢3

Tckb yt ghjdjlbnczntcnbhjdfybt yfcjlth;fybt CD4

<18vtczwtd

Gjpbnbdysq dbhecjkj-ubxtcrbq ntcn yf DBX


cjukfcyj cnfylfhnfv DJP2

Dbhecjkjubxtcrjt ntc-nbhjdfybt yf DBX ytghjdjlbncz^ yj ht,tyjrzdkztncz DBX-cthjgj-pbnbdysv bkb hj;ltyDBX-byabwbhjdyfyjqvfnthm.

. Ktxtybt yt htrjvtyletncz4

518vtczwtd

Gjpbnbdysq ntcn yffynbntkf r DBX


,jktpyb cjukfcyj cnfylfhnfvDJP2


14

1 Ntcns yf GWH LYR DBX bkb GWH HYRDBXbkbh24 fynbuty lbccjwbbhjdfyyjujbvveyyjuj rjvgktrcf bkb rekmnehsDBX&

2 Vj;yj nfr;t hfccvjnhtnm djghjc jyfxfkt FHN lkz ktxtybz ltntq^ yf[j-lzob[cz yf ghjuhtccbhe.otq gtlbf-nhbxtcrjq cnflbb II ,jktpyb cjukfcyjcnfylfhnfv DJP^ drk.xf.otq nfrbtcbvgnjvs^ rfr nz;tkfz ajhvf htwblb-dbhe.otuj bkb gthcbcnbhe.otuj rfylb-ljpf hjnjdjq gjkjcnb gjckt ytjyf-nfkmyjuj gthbjlf^ gjnthz vfccs ntkf^ntvgthfnehf bkb htwblbdbhe.obtnz;tkst ajhvs ,frnthbfkmys[byatrwbq^ ytpfdbcbvj jn rjkbxtcndfCD4&

3 Ehjdtym evtymitybz ghjwtynyjujcjlth;fybz CD4 (tckb ghjdjlbnczbpvthtybt) cktletn exbnsdfnm ghbghbyznbb htitybz&

4 Vyjubt rkbybxtcrbt cbvgnjvs^ yf,k.-lftvst yf gtlbfnhbxtcrjq cnflbb II b III

,jktpyb cjukfcyj rkfccbabrfwbb DJP^yt zdkz.ncz cgtwbabxysvb lkz DBX--byatrwbb b d pyfxbntkmyjq cntgtybxfcnbxyj cjdgflf.n c cbvgnjvfvb^ rj-njhst yf,k.lf.ncz e ltntq ,tp DBX--byatrwbb d eckjdbz[ juhfybxtyys[htcehcjd cbcntvs plhfdjj[hfytybz* nf-rbv j,hfpjv^ ghb jncencndbb dbhecjkj-ubxtcrjuj ntcnbhjdfybz b ntcnf yf rktnrbCD4 d wtkjv yt cktletn hfccvfnhbdfnmdjghjc j ghbvtytybb FHN lkz ktxtybzDBX--byabwbhjdfyys[ ltntq d djphfcnt418 vtczwtd^ ytp

fdbcbvj jn bvt.ob[cz cbvgnjvjd&


15

IV& Htrjvtyletvst c[tvs ktxtybz gthdjujhzlf lkz dphjcks[

C nhfyfv htrjvtyletncz bcgjkmpjdfnm vtnjls j,otcndtyyjuj plhfdj-j[hfytybz lkz cjltqcndbz edtkbxtyb. vfcinf,jd ghbvtytybz fynb-

htnhjdbhecyjq nthfgbb d eckjdbz[ juhfybxtyys[ htcehcjd& "nj jpyfxftn^xnj cktletn hfphf,jnfnm ghjuhfvvs gj fynbhtnhjdbhecyjve ktxtyb.^ bcjplfnm tlbyst cnfylfhns tuj ghbvtytybz& D xfcnyjcnb^ cnhfyfv ghtlkf-uftncz ds,hfnm tlbycndtyye. ktxt,ye. c[tve gthdjuj hzlf b juhfybxtyyjtxbckj ktxt,ys[ c[tv dnjhjuj hzlf lkz ibhjrjvfcinf,yjuj bcgjkmpjdfybzc extnjv njuj^ xnj jnltkmyst kbwf^ rjnjhst yt vjuen gthtyjcbnm c[tvsktxtybz gthdjuj b dnjhjuj hzlf bkb lkz rjnjhs[ ’nb c[tvs jrfpsdf.nczyt’aatrnbdysvb^ ,elen yfghfdkznmcz r cgtwbfkbcnfv lkz ghjdtltybzbylbdblefkmyjuj ktxtybz&

Ghb ds,jht c[tv fynbhtnhjdbhecyjuj ktxtybz rfr yf ehjdyt ghjuhfvvs^ nfrb yf ehjdyt jnltkmys[ ,jkmys[^ cktletn exbnsdfnm frnbdyjcnm^ [fhfrnthgj,jxys[ ltqcndbq^ djpvj;yjcnb lkz cj[hfytybz ,eleob[ dfhbfynjdktxtybz^ ghtlgjkfuftvjt cj,k.ltybt ,jkmysvb ktxt,yjq c[tvs^cjgencnde.obt eckjdbz (yfghbvth^ cjgencnde.obt byatrwbb^ yfheitybzj,vtyf dtotcnd)^ ,thtvtyyjcnm bkb hbcr tt gjzdktybz^ bcgjkmpjdfybtcjgencnde.ob[ ktrfhcndtyys[ chtlcnd (n&t& gjntywbfkmyjt dpfbvjltqcndbtktrfhcndtyys[ chtlcnd)^ djpvj;yjcnb gthdbxyjuj byabwbhjdfybz htpbc-ntynysvb ajhvfvb dbhecf^ f nfr;t cnjbvjcnm b ljcnegyjcnm ktxtybz& Dxbckj ljgjkybntkmys[ hfccvfnhbdftvs[ afrnjhjd^ cdzpfyys[ c eckjdbzvbjuhfybxtyys[ htcehcjd^ vj;tn d[jlbnm ljcneg kbim r juhfybxtyyjve xbckefynbhtnhjdbhecys[ ghtgfhfnjd^ juhfybxtyyfz byahfcnernehf cke;, plhfdj-j[hfytybz^ ytj,[jlbvjcnm gjcnfdjr ktrfhcndtyys[ chtlcnd d ctkmcrbthfqjys^ dscjrfz pf,jktdftvjcnm ne,threktpjv b utgfnbnjv D b#bkb C^ fnfr;t ghbcencndbt hfpkbxys[ uhegg b gjlnbgjd DBX--byatrwbb&

C extnjv dct[ hfccvjnhtyys[ afrnjhjd^ pf bcrk.xtybtv cnjbvjcnbktrfhcndtyys[ chtlcnd^ ghtlgjxnbntkmyst ktxt,yst c[tvs fynbhtnhjdb-hecyjq nthfgbb gthdjuj hzlf lkz dphjcks[ b gjlhjcnrjd gthtxbcktys dNf,kbwt C& Dct ktxt,yst c[tvs drk.xf.n ldf yerktjpblys[ byub,bnjhfj,hfnyjq nhfycrhbgnfps^ f nfr;t cbkmyjltqcnde.ott nhtnmt ktrfhcndtyyjtchtlcndj^ bcgjkmpetvjt lkz tuj ljgjkytybz& Pbljdelby (PLD)#kfvbdelby(3NC) ghtlcnfdkty d rfxtcndt yfxfkmyjq htrjvtylfwbb d jnyjitybbldjqyjuj yerktjpblyjuj rjvgjytynf^ bc[jlz bp ’aatrnbdyjcnb^ njrcbx-yjcnb^ rkbybxtcrjuj jgsnf b yfkbxbz PLD#3NC d rfxtcndt abrcbhjdfyyjqrjv,bybhjdfyyjq ljps& PLD#3NC vj;yj pfvtybnm lheubvb ldjqysvbrjv,byfwbzvb yerktjpblys[ rjvgjytynjd^ drk.xfz cnfdelby (d4T)#3NC^d4N#lblfyjpby (LLB) b PLD#LLB d pfdbcbvjcnb jn cgtwbabrb cnhfys&Jlyfrj ybrjulf yt cktletn bcgjkmpjdfnm dvtcnt PLD#d4T d cdzpb cgjlndth;ltyysv fynjujybpvjv vt;le ’nbvb ldevz ktrfhcndtyysvbchtlcndfvb&


16

Cktletn jnvtnbnm^ xnj ,jkmit yt htrjvtyle.ncz kbim jlyb ldjqystyerktjpblyst c[tvs vtlbrfvtynjpyjuj ktxtybz (,bnthfgbz -- ghbv& gtht-djlxbrf)^ gjcrjkmre jyb fltrdfnysv j,hfpjv yt gjlfdkz.n htgkbrfwb.DBX--byatrwbb b j,sxyj dtlen r ,scnhjve gjzdktyb. htpbcntywbb&

Nf,kbwf C& Htrjvtyletvst rjv,bybhjdfyyst ktxt,yst c[tvs fynb-htnhjdbhecyjq nthfgbb gthdjuj hzlf lkz dphjcks[ b gjl-hjcnrjd c ljrevtynfkmyj gjlndth;ltyyjq DBX-byatrwbtq

Ktxt,yst c[tvsa Ckexfb ,thtvtyyjcnb Jcyjdyst dbls njrcbxyjcnb

PLD#3NC#"AP bkbPLD#PNC#YDG

Dvtcnj "AP bpgjkmpjdfnmYDG lkz ,thtvtyys[;tyoby bkb ;tyoby^ lkzrjnjhs[ ytdjpvj;yjj,tcgtxbnm ’aatrnbdye.rjynhfwtgwb.

Fytvbz^ cdzpfyyfz c PLD

Cbvgnjvs yfheitybz wtynhfkm-yjq ythdyjq cbcntvs^ dspdfyyst"AP

Djpvj;yfz nthfnjutyyjcnm "AP

Utgfnjnjrcbxyjcnm b cbkmyfzcsgm^ dspdfyyst YDG

PLD#3NC#F<R Juhfybxtyyst lfyyst gj,tpjgfcyjcnb F<R


Ubgthxedcndbntkmyjcnm ( ,jkttnjxysq nthvby)

Fkkthubz yf F<R

PLD#3NC#BG-HNDb

bkb PLD#PNC#YADJuhfybxtyyst lfyyst gj,tpjgfcyjcnb KGD#hnd

YAD% yfb,jktte,tlbntkmyst lfyyst gj,tpjgfcyjcnb


Lbfhtz^ dspdfyyfz YAD

Ytahjkbnbfp^ cdzpfyysq c BLD

Gj,jxyjt djpltqcndbt yf j,vtydtotcnd^ cdzpfyyjt c BG

Ghtbveotcndf bcgjkmpjdfybz rjv,byfwbb bp lde[ ytyerktjpblys[ fyfkj-ujd byub,bnjhjd j,hfnyjq nhfycrhbgnfps d cjxtnfybb c jlybvytyerktjpbl-

a PLD#3NC ghtlcnfdkty d rfxtcndt yf-xfkmyjq htrjvtylfwbb d jnyjitybbldjqyjuj yerktjpblyjuj rjvgjytynf cextnjv ’aatrnbdyjcnb^ njrcbxyjcnb^rkbybxtcrjuj jgsnf b yfkbxbz abrcb-hjdfyyjq rjv,byfwbb cjcnfdf ljps&Lheubt ldjqyst rjvgjytyns NsRTIdrk.xfz d4T/3TC^ d4T#LLB b PLD# LLB^vj;yj pfvtybnm d pfdbcbvjcnb jnds,jhf rjyrhtnys[ cnhfy& Ybrjulf ytcktletn bcgjkmpjdfnm dvtcnt PLD# d4T dcdzpb c gjlndth;ltyysv fynfujybpvjv&

b BG--HND drk.xftn BLD#hnd^ KGD#hnd bCRD#hnd &


17

ysv byub,bnjhjv pfrk.xf.tncz d njv^ xnj ’nb ktrfhcndtyyst chtlcndfibhjrj hfcghjcnhfytys gj ljcnegysv wtyfv b c ghbtvktvsv rjkbxtcndjvnf,ktnjr& Jcyjdysvb ytljcnfnrfvb zdkz.ncz hfpdbnbt htpbcntynyjcnb rktrfhcndtyysv chtlcndfv^ gjntywbfkmyfz utgfnjnjrcbxyjcnm ytdbhfgbyf(YDG)^ f nfr;t ytj,[jlbvjcnm hfphf,jnrb jnltkmys[ ktxt,ys[ c[tv lkzve;xby b ;tyoby d cdzpb c djpvj;ysv nthfnjutybxtcrbv djpltqcndbtv’afdbhtypf ("AP)^ rjnjhjt bcrk.xftn tuj ghbvtytybt lkz ,thtvtyys[;tyoby bkb ;tyoby ltnjhjlyjuj djphfcnf^ gjldthuf.ob[cz hbcreyt;tkfntkmyjq ,thtvtyyjcnb& Cnhfys cj pyfxbntkmyjq hfcghjcnhfyty-yjcnm. dbhecf DBX--2^ f nfr;t dbhecf DBX--1 Uheggs J vjuen hfccvjnhtnmdjghjc j, juhfybxtybb ghbvtytybz ktxt,ys[ c[tv^ cjlth;fob[ ytyerktjpb-ls^ njkmrj lkz ,jkmys[ c gjlndth;ltyyjq byatrwbtq DBX--1^ gjcrjkmredbhec DBX--2^ f nfr;t dbhec DBX--1 Uheggs J gj ghbhjlt htpbcntynyst r’njve rkfcce ktrfhcndtyys[ chtlcnd&

Ktxt,yfz c[tvf PLD#3NC#f,frfdbh (F<R) zdkztncz yfb,jktt ghbtvktvjqrfr lkz ,jkmys[ nfr b lkz ghjuhfvvs d wtkjv (ldt nf,ktnrb d ltym bjncencndbt pyfxbntkmyjuj dpfbvjltqcndbz ktrfhcndtyys[ chtlcnd)& D xbckjtt jcyjdys[ ytljcnfnrjd d[jlbn ytrjnjhfz ytjghtltktyyjcnm d jnyjitybbnjuj^ ltqcndetn kb jyf d nt[ ckexfz[^ rjulf dbhecyfz yfuheprf jxtym dscjrf e,jkmys[ c ghjuhtccbhe.otq ajhvjq ,jktpyb^ ytedthtyyjcnm d njv^ xnj ’nbktrfhcndtyyst chtlcndf --jcj,tyyj F<R --,elen ljcnegys gj ghbtvktvsvwtyfv^ f nfr;t djpvj;yjt ghjdjwbhjdfybt ktnfkmys[ htfrwbqubgthxedcndbntkmyjcnb^ rjnjhst ytdjpvj;yj jghtltkbnm d eckjdbz[ yt-pyfxbntkmys[ htcehcjd& Ceotcnde.njnyjcbntkmyj juhfybxtyyst lfyyst gj’aatrnbdyjcnb lheub[ djpvj;ys[ nhjqys[ rjv,byfwbq yerktjpblys[byub,bnjhjd j,hfnyjq nhfycrhbgnfps (NsRTI)& "nj pfcnfdkztn DJPdjplth;fnmcz jn htrjvtylfwbb b[ ghbvtytybz d yfcnjzott dhtvz&

Ghtbveotcndjv ktxt,ys[ c[tv c bcgjkmpjfdfybtv 2 yerktjpblys[byub,bnjhjd j,hfnyjq nhfycrhbgnfps b byub,bnjhf ghjntfps (BG)zdkztncz gjlndth;ltyyfz dscjrfz frnbdyjcnm d cyb;tybb dbhecyjq yfuhep-rb& Ytljcnfnrfvb zdkz.ncz ,jkmijt rjkbxtcndj nf,ktnjr^ pyfxbntkmyjtdpfbvjltqcndbt c lheubvb ktrfhcndtyysvb chtlcndfvb^ rjnjhjt bcrk.xftnbkb jckj;yztn b[ bcgjkmpjdfybt dj dhtvz ktxtybz ne,threktpf c ghbvtyt-ybtvhbafvgbwbyf^ d ckexft yfheitybzj,vtyf dtotcnd^ f nfr;tghbvtytybtht;bvjd c bcgjkmpjdfybtv hbnjyfdbhf nht,etn yfkbxbz bkb ytj,[jlbvjcnbaeyrwbjybhjdfybz [jkjljdjq wtgb lkz ktxt,ys[ c[tv c gjdsityysvcjlth;fybtv hbnjyfdbhf&


18

V& Ghbxbys bpvtytybz fynbhtnhjdbhecyjqnthfgbb

F HN vj;tn gjnht,jdfnm bpvtytybz kb,j d cdzpb c yt’aatrnbdyjcnm.ghjdjlbvjuj ktxtybz^ kb,j d cdzpb c njrcbxyjcnm.& Yt’aatrnbdyjcnm

ktxtybz vj;yj jghtltkbnm rkbybxtcrbv gentv^ bvveyjkjubxtcrbv gentvgjchtlcndjv bpvthtybz rjkbxtcndf CD4 b#bkb dbhecjkjubxtcrbv gentvgjchtlcndjv bpvthtybz dbhecyjq yfuheprb& Jlyfrj^ gjcrjkmre gjcktlybqcgjcj, j,sxyj yt ghbvtyztncz d eckjdbz[ juhfybxtyys[ htcehcjd^ htrj-vtyletncz^ xnj,s d ghjuhfvvf[^ jceotcndkztvs[ d nfrb[ eckjdbz[ûkfdysvj,hfpjv bcgjkmpjdfkbcm rkbybxtcrbt rhbnthbb b^ gj djpvj;yjcnb^rhbnthbb^ cdzpfyyst c rjkbxtcndjv CD4 lkz jghtltktybz ’aatrnbdyjcnbghjdjlbvjq nthfgbb&

Njrcbxyjcnm cdzpfyf c ytcgjcj,yjcnm. gthtyjcbnm gj,jxyst ltqcndbzvtlbrfvtynjpyjuj ktxtybz b cj pyfxbntkmysv yfheitybtv aeyrwbbjhufyjd^ rjnjhjt vj;tn gjzdbnmcz d htpekmnfnt ’njuj&Vj;yj jceotcndkznmvjybnjhbyu rkbybxtcrbv gentv yf jcyjdt ;fkj, ,jkmys[ b abpbxtcrb[j,cktljdfybq^ f nfr;t vj;tn bcgjkmpjdfnmcz juhfybxtyyjt xbckjkf,jhfnjhys[ ntcnjd^ d pfdbcbvjcnb jn ghbvtyztvjq rjyrhtnyjqrjv,bybhjdfyyjq ktxt,yjq c[tvs&

Tckb gjnht,etncz dytcnb bpvtytybz d ktxt,ye. c[tve d cdzpb c ytelfxysvktxtybtv^ ytj,[jlbvj ,eltn ghbvtybnm yjde. ktxt,ye. c[tve dnjhjujhzlf& Tckb ’nj cdzpfyj c njrcbxyjcnm.^ nj vj;yj kb,j yfpyfxbnmcjdthityyj yjde. ktxt,ye. c[tve dnjhjuj hzlf^ kb,j (d njv ckexft^ rjulfnjrcbxyjcnm cdzpfyf c ytrjnjhsv ktrfhcndtyysv chtlcndjv d ktxt,yjqc[tvt^ rjnjhjt vj;yj jghtltkbnm) ’nj dspsdf.ott yfheitybt ktrfhcn-dtyyjt chtlcndjvj;yj pfvtybnmlheubvktrfhcndtyysvchtlcndjv^ rjnjhjtyt j,kflftn fyfkjubxysv gj,jxysv ltqcndbtv&


19

VI& Ds,jh c[tv fynbhtnhjdbhecyjuj ktxtybzdnjhjuj hzlf

D ckexft ytelfxyjuj ktxtybz DJP htrjvtyletn pfvtybnm dc. c[tvektxtybz gthdjuj hzlf yf rjv,bybhjdfyye. c[tve ktxtybz dnjhjuj

hzlf& D yjdjq ktxt,yjq c[tvt dnjhjuj hzlf ytj,[jlbvj ,eltn bcgjkmpjdfnmktrfhcndtyyst chtlcndf^ rjnjhst cj[hfyz.n frnbdyjcnm d jnyjitybbinfvvf dbhecf e ,jkmys[ b d bltfkmyjv ckexft drk.xf.n yt vtytt nht[yjds[ ktrfhcndtyys[ chtlcndf^ ghbxtv^ gj rhfqytq vtht^ jlyj bp yb[ bpyjdjuj rkfccf^ c ntv xnj,s gjdscbnm dthjznyjcnm ecgtiyjuj ktxtybz bcdtcnb r vbybveve hbcr gthtrhtcnyjq htpbcntynyjcnb&

D Nf,kbwt D gthtxbcktys ktxt,yst c[tvs dnjhjuj hzlf^ rjnjhst vj;yjhfccvjnhtnm d jnyjitybb gjlhjcnrjd b dphjcks[ lkz rf;ljq bp ktxt,ys[c[tv gthdjuj hzlf^ jghtltktyys[ d nf,kbwt C& Ghbtvktvsv ldjqysvyerktjpblysv rjvgjytynjv^ rjnjhsq zdkztncz fkmnthyfnbdjq PLD#3NC^zdkztncz d4T#LLB& Rhjvt njuj^ PLD#LLB vj;tn pfvtybnm d4T#3NC byfj,jhjn c ghtleght;ltybtv j njv^ xnj gthtrhtcnyfz htpbcntywbz yer-ktjpblys[ fyfkjujd dspsdftn djphfcnf.oe. j,tcgjrjtyyjcnm&

D nt[ ckexfz[^ rjulf bcgjkmpjdfkcz PLD#3NC d ktxt,yjq c[tvt gthdjuj hzlf^gthtrhtcnyfz htpbcntynyjcnm r yerktjpble vj;tn gjcnfdbnm gjl euhjpefrnbdyjcnm d4N#LLB d ktxt,yjq c[tvt dnjhjuj hzlf^ jcj,tyyj ghb yfkbxbblkbntkmyjq dbhecjkjubxtcrjq yt’aatrnbdyjcnb ghjdjlbvjuj ktxtybz (jn-cencndbt ’aatrnbdyjuj gjlfdktybz dbhecyjq yfuheprb -- ghbv& Htl&)&Gjcrjkmre dthjznyjcnm gthtrhtcnyjq htpbcntynyjcnb ytcrjkmrjevtymiftncz ghb gtht[jlt r F<R#LLB gj chfdytyb. c gtht[jljv r d4N#LLB^ gthdsq vj;yj nfr;t hfccvfnhbdfnm d rfxtcndt yerktjpblyjq jcyjdslkz ktxt,yjq c[tvs dnjhjuj hzlf d njv ckexft^ tckb ktxt,yfz c[tvf gthdjujhzlf yt drk.xfkfF<R&Jlyfrj dscjrbq ehjdtym htpbcntynyjcnb r PLD#3NCdspsdftn evtymitybt xedcndbntkmyjcnb r F<R&

Ghb eckjdbb evtymitybz gjntywbfkf gjxnb k.,juj yerktjpblyjuj rjvgj-ytynf dnjhjuj hzlf^ rjvgjytyn BG--HND [bylbyfdbh (BLD#hnd)^ kjgbyfdbh(KGD#hnd)^ cfrbyfdbh (CRD#hnd)] zdkztncz ,jktt ghtlgjxnbntkmysv gjchfdytyb. c ytkabyfdbhjv (YAD) d ktxt,ys[ c[tvf[ dnjhjuj hzlf c extnjvb[ frnbdyjcnb& YAD vj;yj hfccvfnhbdfnm d rfxtcndt fkmnthyfnbds lkzrjvgjytynf BG^ tckb jncencnde.n BG c bcgjkmpjdfybtv HND bkb tckbceotcnde.n rkbybxtcrbt ghjnbdjgjrfpfybz lkz tuj ghbvtytybz&


20

Nf,kbwfD& Htrjvtyletvst ktxt,yst c[tvs dnjhjuj hzlf lkzdphjcks[ b gjlhjcnrjd

Ktxt,yst c[tvsgthdjuj hzlf

Ktxt,ysq c[tvsdnjhjujhylfdckexft ytelfxyjujktxtybz

Fkmnthyfnbdyst ktxt,ystc[tvs dnjhjuj hzlf dckexft ytelfxyjuj ktxtybz

PLD#3NC#"AP bkb PLD#3NC#YDG

d4T#LLY + BG-HND1 F<R#LLB + BG-HND

F<R#LLB + YAD bkb

d4N#LLB + YAD

PLD#3NC#F<R NNRTI2 + KGD#h c bkb ,tpd4N bkb LLB

d4N#LLB + BG-HND

PLD#3NC#BG-HND bkbPLD#3NC#YAD

- d4N#LLB + NNRTI2 F<R#LLB + NNRTI2

1 BG-HND vj;tn ghtlcnfdkznm cj,jq BLD#hnd^ KGD#hnd bkb CRD#hnd

2 NNRTI vj;tn ,snm "AP bkb YDG


21

VII& Hfccvjnhtybt rjyrhtnys[ gjluhegg,jkmys[

F& :tyobys^ cgjcj,yst hj;fnm^ bkb ,thtvtyyst ;tyobys

DJP htrjvtyletn ghbvtytybt PLD^ 3NC^ YDG^ YAD b CRD d cjxtnfybb cybprjqljpjqhbnjyfdbhf^ gjcrjkmrejybyfb,jkttibhjrjghbvtyz.nczghbfynbhtnhjdbhecyjv ktxtybb ,thtvtyys[ ;tyoby& Yt htrjvtyletncz ghb-vtyznm "AP lkz ktxtybz ;tyoby^ rjnjhst vjuen pf,thtvtytnm^ d cdzpb c tujgjntywbfkmysv nthfnjutybxtcrbv djpltqcndbtv yf gkjl d ntxtybt gthdjujnht[vtczxyjuj gthbjlf &

Ds,jh FHN lkz ;tyoby^ cgjcj,ys[ ,thtvtytnm^ vj;tn drk.xfnm hfccvj-nhtybt djpvj;yjcnb gjkextybz fynbhtnhjdbhecys[ ghtgfhfnjd d yfxfktgthdjuj nht[vtczxyjuj gthbjlf lj jghtltktybz ,thtvtyyjcnb b d ntxtybbyfxfkmyjuj gthbjlf hfpdbnbz jhufyjd gkjlf& :tyobys^ r rjnjhsvghbvtyztncz FHN^ ljk;ys bvtnm ljcneg r ’aatrnbdysv b yflkt;fobvvtnjlfv rjynhfwtgwbb lkz evtymitybz dthjznyjcnb yt;tkfntkmyjq,thtvtyyjcnb& Df;yj jnvtnbnm^ xnj ytrjnjhst fynbhtnhjdbhecyst ght-gfhfns (NNRTI^ YDG b "AP b dct BG c ghbvtytybtv HND) vjuenevtymifnm rjywtynhfwb. jhfkmys[ rjynhfwtgnbdjd d rhjdb^ bytj,[jlbvj ghbvtytybt ljgjkybntkmyjq bkb fkmnthyfnbdyjq rjynhfwt-gwbb lkz bp,t;fybz ,thtvtyyjcnb e ;tyoby^ ghbybvf.ob[ ’nb ktrfhcn-dtyyst chtlcndf&

Lkz ,thtvtyys[ ;tyoby ;tkfntkmyj ghbcnegbnm r FHN gjckt gthdjujnht[vtczxyjuj gthbjlf^ [jnz lkz nz;tkj ,jkmys[ ,thtvtyys[ ;tyobyghtbveotcndf crjhtqituj ghbvtytybz nthfgbb gthtdtibdftn k.,jqgjntywbfkmysq hbcr lkz gkjlf& Rhjvt njuj^ ldjqyjt cjxtnfybt d4N#LLB d rfxtcndt yerktjpblyjuj rjvgjytynf nhb--nthfgbb cktletn bcgj-kmpjdfnm dj dhtvz ,thtvtyyjcnb kbim d nt[ ckexfz[^ rjulf jncencnde.nlheubt fkmnthyfnbds^ d cdzpb c gjntywbfkmysv gjdsityysv hbcrjvvjkjxyjuj fwbljpf e ,thtvtyys[ ;tyoby^ dspdfyyjuj ’njq rjv,byfwbtq&

D& Ltnb

Juhfybxtyyst bccktljdfybz gjcktlcndbq ghbvtytybz FHN lkz pljhjdmzltntq gjrfpsdf.n^ xnj ghbvtytybt hfpkbxys[ nthfgtdnbxtcrb[ c[tv FHDlf.n c[jlyst ekexitybz cehhjufnys[ gjrfpfntktq -- nj tcnm^ gjrfpfntktqdbhecjkjubxtcrjuj b bvveyjkjubxtcrjuj cjcnjzybz&

<jkmibycndj fynbhtnhjdbhecys[ ghtgfhfnjd^ bvt.ob[cz lkz dphjcks[^nfr;t bvt.ncz d gtlbfnhbxtcrb[ ajhvf[ c hfcxtnjv ljps yf tlbybwegkjoflb gjdth[yjcnb ntkf bkb tlbybwe vfccs& Dfhbfyns ktxtybz gthdjujhzlf lkz ltntq drk.xf.n PLD#3NC b#bkb ytyerktjpbl (YDG bkb "AP) bkbF<R& Cktletn gjvybnm^ xnj "AP ytkmpz ghbvtyznm lkz ktxtybz ltntq d


22

djphfcnt lj nht[ ktn d cdzpb c jncencndbtv yflt;yjq byajhvfwbb djnyjitybb ljpbhjdrb& Jlyfrj "AP ,eltn ghtlgjxnbntkmysv ytyerktjpb-ljv lkz ltntq^ ghbybvf.ob[ hbafvgbwby^ d njv ckexft^ tckb fynbhtnhj-dbhecyjt ktxtybt ytj,[jlbvj yfxfnm lj pfdthitybz ghjnbdjne,threktpyjqnthfgbb& Nthfgbz dnjhjuj hzlf lkz ltntq^ d ckexft ytelfxyjq ktxt,yjqc[tvs gthdjuj hzlf^ ,eltn drk.xfnm bpvtytybt yerktjpblyjuj rjvgjytynf(yfghbvth^ gtht[jl jn PLD+3NC r d4T+LLB) b byub,bnjh ghjntfps&Bcgjkmpjdfybt lheub[ byub,bnjhjd ghjntfps^ rhjvt KGD#hnd b YAD^zdkztncz ghj,ktvfnbxysv d jnyjitybb ltntq d cdzpb c jncencndbtvgjl[jlzob[ ltncrb[ ljpbhjdjr BLD b CRD&

Nf,kbwf T& Htrjvtyletvst c[tvs fynbhtnhjdbhecyjuj ktxtybzgthdjuj hzlf lkz ltntq1

Ktxt,yst c[tvs Pfvtxfybz

PLD#3NC2 + F<R Zdkztncz ghtlgjxnbntkmyjq^ tckb ghbvtyztnczcjgencnde.ofz ghjnbdjne,threktpyfz nthfgbz

PLD#3NC2 + NNRTI Ds,jhNNRTI%. tckb djphfcn<3 ktn bkb vfccf ntkf<10 ru^ ghbvtyznm YDG. tckb djphfcn53 ktn bkb vfccf ntkf510 ru^ ghbvtyznm YDGbkb "AD

1 Rjyrhtnyst cnhfys c extnjv cdjb[gjpbwbq b ds,jhf ljk;ys jghtltkbnm^rfre. ktxt,ye. c[tve bkb c[tvs ckt-letn ghbvtyznm&

2 PLD#3NC zdkztncz ghtlgjxnbntkmyjqldjqyjq c[tvjq lkz ltntq^ gjcrjkmrejyf cdzpfyf c yfb,jkmibv rkbybxtcrbv

jgsnjv& Lheubvb rjv,byfwbzvb yer-ktjpblys[ rjvgjytynjd vjuen ,snm%PLD#LLB^ d4N#3NC^ d4N#LLB b LLB#3TC&Ybrjulf yt cktletn dvtcnt ghbvtyznmPLD#d4N d cdzpb c gjlndth;ltyysvfynfujybpvjv&


23

Nf,kbwf F Htrjvtyletvst c[tvs fynbhtnhjdbhecyjuj ktxtybzdnjhjuj hzlf lkz ltntq

Ktxt,yst c[tvs gthdjuj hzlf Ktxt,yst c[tvs dnjhjuj hzlf

PLD#3NC#F<R d4T#LLB#KGD#hnd1 bkbd4T#LLB#YAD bkbd4T#LLB#NNRTI2

PLD#3NC# NNRTI2 d4T#LLB#KGD#hnd1 bkbd4T#LLB#YAD

C& <jkmyst ne,threktpjv c cjgencnde.otq DBX--byatrwbtq

DJP htrjvtyletn k.lzv c N<#DBX pfdthifnm ghjnbdjne,threktpye.nthfgb. lj yfxfkf fynbhtnhjdbhecyjuj ktxtybz^ tckb jncencndetn dscjrbqhbcr ghjuhtccbhjdfybz DBX--byatrwbb b cvthnb dj dhtvz gthbjlf ktxtybzN< (n&t& rjkbxtcndj CD4 <200#vv3 bkb ceotcndetn lbcctvbybhjdfyysqN<)& D nt[ ckexfz[^ rjulf xtkjdtre ytj,[jlbvj jlyjdhtvtyyjt ktxtybt N< bDBX--byatrwbb^ dfhbfyns ktxtybz gthdjuj hzlf drk.xf.n PLD#3NC bkbd4T#3NC gk.c ytyerktjpbl bkb F<R& D rfxtcndt ytyerktjpblyjuj rjvgj-ytynf ghtlgjxnybntkmyj bcgjkmpjdfnm "AP ^ gjcrjkmre tuj gjntywbfkmyfzcgjcj,yjcnm j,jcnhznm utgfnjnjrcbxyjcnm ktxtybz ne,threktpf zdkztnczvtymit^ xtv gjntywbfkmyfz cgjcj,yjcnm YDG& Jlyfrj vj;tn gj-nht,jdfnmcz edtkbxtybt tuj ljpbhjdrb lj 800 vu d ltym& Pf bcrk.xtybtvCRD#hnd yt htrjvtyletncz ghbvtytybt byub,bnjhjd ghjntfps dj dhtvzktxtybz N< hbafvgbwbyjv d cdzpb c b[ dpfbvjltqcndbtv c gjcktlybvktrfhcndtyysv chtlcndjv&

1 Lkz ltntq^ rjnjhst vjuen ukjnfnm rfg-ceks b lkz rjnjhs[ ceotcnde.obt dyfcnjzott dhtvz cjcnfds rfgcek gjp-djkz.n hfccxbnfnm ljpbhjdre c yflkt-;fobv extnjv vfccs bkb gjdth[yjcnbntkf^ ljgjkybntkmyst dfhbfyns lkzpfvtys KGD#hnd drk.xf.n CRD#hnd bBLD#hnd&

2 Ds,jhNNRTI% tckb djphfcn<3 ktn bkbvfccf ntkf<10 ru^ ghbvtyznm YDG* tckbdjphfcn 53 ktn bkb vfccf ntkf 510 ru^ghbvtyznm YDG bkb "AD&


24

Nf,kbwf G& Fynbhtnhjdbhecyfz nthfgbz lkz k.ltq c cjgencnde.otqbyatrwbtq ne,threktpf

Cbnefwbz Htrjvtylfwbb

Ne,threktp kturb[ b rjkbxtcndjCD4<50#vv3 bkb dytktujxysqne,threktp

Yfxfnm ghjnbdjne,threktpye. nthfgb.& Yfxfnmjlye bp cktle.ob[ c[tv FHN^ rfr njkmrj jghtltkt-yf gthtyjcbvjcnm ghjnbdjne,threktpyjq nthfgbb%

PLD#3NC#F<RPLD#3NC#"APPLD#3NC#CRD#hndPLD#3NC#YDG

Ne,threktp kturb[ b rjkbxtcndjCD4 cjcnfdkztn 50-200#vv3

bkb j,ott xbckj kbvajwbnjd41200#vv3

Yfxfnm ghjnbdjne,threktpye. nthfgb.& Yfxfnmjlye bp cktle.ob[ ktxt,ys[ c[tv gjckt pfdthit-ybz lde[vtczxyjuj rehcf ghjnbdjne,threktpyjqnthfgbb%

PLD#3NC#F<RPLD#3NC#"APPLD#3NC#CRD#hPLD#3NC#YDG

Ne,threktp kturb[ b rjkbxtcndjCD4>200#vv3 bkb j,ott xbckjkbvajwbnjd>1200#vv3

Ktxbnm N<& Tckb djpvj;yj^ ghjdjlbnm vjybnjhbyurjkbxtcndf CD4& Yfxfnm FHN d cjjndtncndbb cnf,kbwfvb F b D gjckt pfdthitybz ktxtybz N<&

D& Gjnht,bntkb by]trwbjyys[ yfhrjnbrjd

Gjnht,bntkzv by]trwbjyys[ yfhrjnbrjd^ rjnjhsv ghtlgbcfyf FHN^cktletn j,tcgtxbnm ljcneg r ’njq nthfgbb lkz cgfctybz ;bpyb& Afrnjhs^nht,e.obt jcj,juj hfccvjnhtybz lkz ’njq uheggs yfctktybz^ drk.xf.ncjdvtcnbvjcnm ljcnfnjxyj [fjnbxyjuj j,hfpf ;bpyb c eckjdbzvb cnhjujujcj,k.ltybz ghbtvf ktrfhcndtyys[ chtlcnd^ f nfr;t gjntywbfkmyjt dpfbvj-ltqcndbt fynbhtnhjdbhecys[ ktrfhcndtyys[ chtlcnd c nfrbvb dtotcndfvb^rfr vtnfljy& Gjjohztncz hfphf,jnrf ghjuhfvv^ rjnjhst cjdvtof.nktxtybt yfhrjvfybb b DBX& D ’nb[ eckjdbz[ vj;yj jceotcndkznm nfrbtgjl[jls^ rfr nthfgbz gjl ytgjchtlcndtyysv yf,k.ltybtv& C[tvs^ ght-lecvfnhbdf.obt jlyjrhfnysq ghbtv ghtgfhfnjd d ltym^ e;t bpexf.ncz bvjuen ,snm ghtlkj;tys rfr jlby bp gjl[rjljd&

F& Cj,k.ltybt c[tvs fynbhtnhjdbhecyjq nthfgbb

DJP htrjvtyletn hfphf,jnfnm yjdfnjhcrbt gjl[jls r ,jktt cnhjujvecj,k.ltyb. c[tvs FHN d cdzpb c gj;bpytyysv [fhfrnthjv ’njuj ktxtybz&

Cnhfntubb gj ,jktt cnhjujve cj,k.ltyb. c[tvs drk.xf.n cdtltybt rvbybveve rjkbxtcndf nf,ktnjr b xfcnjns jghtltktybz ljp gjchtlcndjvghtlgjxnbntkmyjuj ghbvtytybz rjv,bybhjdfyys[ nf,ktnjr yf jcyjdtjlyjhfpjdjuj bkb lde[hfpjdjuj t;tlytdyjuj ghbtvf& D yfcnjzott dhtvz d


25

ghjlf;t bvttncz hzl ghtgfhfnjd c abrcbhjdfyysv cjxtnfybtv ljp^cjlth;fob[ ldf bkb nhb fynbhtnhjdbhecys[ ktrfhcndtyys[ chtlcndf^rjnjhst vj;yj ghbvtyznm ldf hfpf d ltym& Jlyfrj^ [jnz d yfcnjzott dhtvz,sk endth;lty hzl fynbhtnhjdbhecys[ ghtgfhfnjd lkz jlyjhfpjdjujt;tlytdyjuj ghbtvf^ jnyjcbntkmyj ytvyjubt ktxt,yst c[tvs c jlyjhfpj-dsv t;tlytdysv ghbtvjv nht[ bkb xtnsht[ ktrfhcndtyys[ chtlcnd frnbdyjghjdthz.ncz d rkbybxtcrb[ bcgsnfybz[& Lheubt gjl[jls^ rjnjhst vjuencgjcj,cndjdfnm cj,k.ltyb. ht;bvf^ drk.xf.n% j,tcgtxtybt gjvjom.xktyjd ctvmb bkb j,obys lkz jrfpfybz gjllth;rb ,jkmysv d ghbtvt b[ktrfhcndtyys[ chtlcnd yf htuekzhyjq b cdjtdhtvtyyjq jcyjdt* ibhjrjtrjycekmnbhjdfybt b ghjcdtotybt ,jkmys[* b nthfgbz gjl ytgjchtlcndtyysvyf,k.ltybtv& Ytj,[jlbvj exbnsdfnm gcb[jcjwbfkmyst ghj,ktvs^rjnjhst vjuen nfr;t cgjcj,cndjdfnm e[elityb. cj,k.ltybz ht;bvfnthfgbb^ jcj,tyyj gjnht,bntkzvb by]trwbjyys[ yfhrjnbrjd b lheubvbezpdbvsvb uheggfvb yfctktybz&

G& Rjynhjkm pf htpbcntynyjcnm. r ktrfhcndtyysv chtlcndfv

DJP htrjvtyletn cnhfyfv^ gkfybhe.obv ghbvtytybt ghjuhfvv FHN^nfr;t jlyjdhtvtyyj ghbvtyznm cbcntve rjynhjkmyjuj yflpjhf pf htpbc-ntynyjcnm. DBX r ktrfhcndtyysv chtlcndfv& "nj gjpdjkbn cnhfyfvdszdkznm gjntywbfkmye. htpbcntynyjcnm r ktrfhcndtyysv chtlcndfv yfehjdyt yfctktybz b cjjndtncnde.obv j,hfpjv vtyznm htrjvtyletvstc[tvs ktxtybz& Lkz jrfpfybz gjvjob ujcelfhcndfv--xktyfv d ’njq j,kfcnb^DJP d cjnhelybxtcndt c gfhnythcrbvb jhufybpfwbzvb cjplftn Ukj,fkmye.ctnm rjynhjkz pf htpbcntynyjcnm. DBX r ktrfhcndtyysv chtlcndfv&

Y& Rkbybxtcrbq b kf,jhfnjhysq vjybnjhbyu ghbvtytybz fynbhtnhj-dbhecyjq nthfgbb

DJP ^ d eckjdbz[ juhfybxtyys[htcehcjd^ htrjvtyletn lj yfxfkf ghbvtytybzFHN ghjdtltybt jcyjdyjq rkbybxtcrjq jwtyrb^ rjnjhfz drk.xftn ljrevty-nfwb. ghjikjq bcnjhbb ,jktpyb^ dszdktybt ceotcnde.ob[ d yfcnjzottdhtvz b ceotcndjdfdib[ d ghjikjv pf,jktdfybq^ cdzpfyys[ c DBX^jghtltktybt cjgencnde.ob[ vtlbwbycrb[ cjcnjzybq^ rjnjhst vjuenjrfpfnm dkbzybt yf ds,jh nthfgbb (nfrb[ rfr N< bkb ,thtvtyyjcnm)^ f nfr;tceotcnde.ob[ cbvgnjvjd b abpbxtcrb[ ghbpyfrjd&

C wtkm. cjltqcndbz edtkbxtyb. vfcinf,jd ghbvtytybz fynbhtnhjdbhec-yjuj ktxtybz d eckjdbz[ juhfybxtyys[ htcehcjd DJP ghjdtkf uhflfwb.cnfylfhnjd rkbybrj--kf,jhfnjhyjuj vjybnjhbyuf^ d pfdbcbvjcnb jn ljc-negyjcnb gj xtnshtv rfntujhbzv%

. f,cjk.nysq ytj,[jlbvsq vbybvev ntcnjd*

. jcyjdyst htrjvtyletvst ntcns*


26

. ;tkfntkmyst ntcns* b

. ytj,zpfntkmyst (ds,jhjxyst) ntcns&

F,cjk.nyst vbybvfkmyst ntcns zdkz.ncz ytj,[jlbvsvb ghtldfhbntkm-ysvb eckjdbzvb lkz drk.xtybz fynbhtnhjdbhecyjq nthfgbb d yfwbjyfkm-ye. ghjuhfvve& Jcyjdyst htrjvtyletvst ntcns ibhjrj bcgjkmpe.ncz drkbybxtcrb[ eckjdbz[ b ytj,[jlbvs lkz j,tcgtxtybz ’aatrnbdyjuj vj-ybnjhbyuf ,jkmibycndf c[tv fynbhtnhjdbhecyjuj ktxtybz& D cdtntytjnkj;yjcnb jrfpfybz ;bpytyyj df;yjq cnjkm vyjubv vbkkbjyfvk.ltq gjvjob DJP yfvthtdftncz cdtcnb r vbybveve ghtgzncndbz lkz ttjrfpfybz& D rfxtcndt nfrjds[^ jncencndbt jcyjdys[ htrjvtyletvs[kf,jhfnjhys[ ntcnjd yt ljk;yj ,snm ghtgzncndbtv lkz njuj^ xnj,s yfxfnmktxtybt^ [jnz b[ ytj,[jlbvj jceotcndkznm nfv^ ult bvt.ncz cjjndtncn-de.obt htcehcs& :tkfntkmyst ntcns cltkf.n ujhfplj ,jktt ’aatrnbdysvvjybnjhbyu b jwtyre ’aatrnbdyjcnb ghjuhfvv^ f ds,jhjxyst ntcnsvj;yjbcgjkmpjdfnm d eckjdbz[ ljcnegyjcnb pyfxbntkmys[ htcehcjd&

F,cjk.nyst vbybvfkmyst kf,jhfnjhyst ntcns^ rjnjhst ytj,[jlbvjghjdtcnb lj yfxfkf FHN^ drk.xf.n ntcn yf fynbntkf r DBX b jghtltktybtehjdyz utvjukj,byf bkb utvfnjrhbnf&Jcyjdyfzghbxbyf pfrk.xftncz d njv^xnj ytj,[jlbvj bvtnm ljrfpfntkmcndj yfkbxbz DBX--byatrwbb e gfwbtynflj yfxfkf ghbvtytybz fynbhtnhjdbhecyjq nthfgbb d gthdsq hfp^ f crhbybyulkz dszdktybz fytvbb zdkztncz ceotcndtyysv lj yfxfkf ghbvtytybzktxt,ys[ c[tv^ cjlth;fob[ pbljdelby&

Jcyjdyjt htrjvtyljdfyyjt ntcnbhjdfybt ljk;yj drk.xfnm jghtltktybtrjkbxtcndf ktqrjwbnjd b tuj rjkt,fybz (c ntv xnj,s gjpdjkbnm ghjdtcnbjwtyre gj,jxyjuj djpltqcndbz yf ytqnhjgtyb. b gjlcxtn j,otuj xbckfkbvajwbnjd)^ ehjdyz csdjhjnjxyjuj fkfybyf bkb fcgfhnfn fvbyjnhfyath-fps lkz jwtyrb djpvj;yjcnb ceotcndjdfybz cjgencnde.otq byatrwbbutgfnbnf b lkzvjybnjhbyuf utgfnjnjrcbxyjcnb^ csdjhjnjxyjuj rhtfnbybyfb #bkb fpjnf vjxtdbys rhjdb lkz jwtyrb jcyjdyjq gjxtxyjq aeyrwbb^csdjhjnjxyjq uk.rjps b ntcnjd yf ,thtvtyyjcnm lkz ;tyoby& {jnz ’nbntcnsyt zdkz.ncz f,cjk.nyjytj,[jlbvsvb^ jybjxtym htrjvtyle.ncz lkznjuj^ xnj,s bvtnm djpvj;yjcnm ghjdjlbnm vjybnjhbyu ,tpjgfcyjujghbvtytybz ’nb[ dtotcnd b ghbybvfnm j,jcyjdfyyst htitybz j pfvtytktxt,ys[ c[tv& Jghtltktybt rjkbxtcndf rktnjr CD4 d yfcnjzott dhtvz ythfccvfnhbdftncz d rfxtcndt jcyjdyjuj htrjvtyletvjuj ntcnf& Jlyfrjdshf;ftncz yflt;lf yf nj^ xnj c dytlhtybtv ghjcns[ b vtytt ljhjujcnj-zob[ vtnjljd jghtltktybz rjkbxtcndf rktnjr CD4^ ’njn ntcn cnfytn ,jkttibhjrj ljcnegysv& DJP htrjvtyletn cxbnfnm tuj ghbjhbntnysv^ gjnjvexnj rjkbxtcndj rktnjr CD4 zdkztncz yfbkexibv gjrfpfntktv bvveyyjqhtfrwbb yf ktxtybt&

:tkfntkmyst ntcns drk.xf.n ntcnbhjdfybt yf ,bkbhe,by^ fvbkfpe bcsdjhjnjxyst kbgbls^ f nfr;t yf xbckj rktnjr CD4& "nb ntcns^ [jnz b ytzdkz.ncz ceotcndtyysvb^ ,tpeckjdyj^ ghtljcnfdkz.n pyfxbntkmye. by-ajhvfwb.^ rjnjhfz vj;tn jrfpfnmcz gjktpyjq ghb vjybnjhbyut ghbvtyt-ybz fynbhtnhjdbhecyjuj ktxtybz d eckjdbz[ juhfybxtyys[ htcehcjd&


27

Ntcnbhjdfybt yf dbhecye. yfuhepre d yfcnjzott dhtvz cxbnftnczytj,zpfntkmysvb bp--pf pfnhelytybq^ cdzpfyys[ c htcehcfvb& Rkbybxtcrbqvjybnjhbyu bvttn ceotcndtyyjt pyfxtybt lkz j,tcgtxtybz ,tpjgfcyjcnb b’aatrnbdyjcnb fynbhtnhjdbhecyjq nthfgbb& {jnz kf,jhfnjhysq vjyb-njhbyu juhfybxty^ nofntkmysq rkbybxtcrbq vjybnjhbyu ghbj,htnftn tot,jkmitt pyfxtybt&

DJP nfr;t hfcghtltkbkf kf,jhfnjhyst ntcns gj rfntujhbzv d cjjndtncndbbc ehjdyzvb cke;, plhfdjj[hfytybz^ d rjnjhs[ jyb vjuen ,snm bcgjkmpj-dfys& Ghjcnst jgthfnbdyst lbfuyjcnbxtcrbt ntcns DBX b jnghfdrf ghj,lkz ntcnbhjdfybz yf CD4 ljk;ys jceotcndkznmcz yf ehjdyt gthdbxyjqvtlbrj--cfybnfhyjq gjvjob b yf hfqjyyjv ehjdyt& Exht;ltybz yfhfqjyyjv ehjdyt ljk;ys nfr;t hfcgjkfufnm djpvj;yjcnzvb lkz ntcnb-hjdfybz ,thtvtyyjcnb^ ghjdtltybz ntcnjd gj jghtltktyb. ehjdyz utvj-ukj,byf^ aeyrwbb gtxtyb^ rhtfnbybyf b ehjdyz cf[fhf& Rhjvtdsiterfpfyys[ ntcnjd^ exht;ltybz gthbathbqyjuj ehjdyz ljk;ys hfcgj-kfufnm djpvj;yjcnzvb lkz ghjdtltybz ntcnjd gj jghtltktyb. rjkbxtcndfrktnjr CD4&

Tckb gjpdjkz.n htcehcs^ nj ntcnbhjdfybt yf dbhecye. yfuhepre bbccktljdfybt htpbcntywbb dbhecjd cktletn jceotcndkznm yf wtynhfkmyjvehjdyt&


28

Ghbkj;tybt F& Ljpbhjdrb fynbhtnhjdbhecys[ ghtgfhfnjd lkzdphjcks[ b gjlhjcnrjd1

Rkfcc ktrfhcndtyys[ chtlcnd#ktrfhcndtyyjt chtlcndj

Ljpf

Yerktjpblysq fyfkju byub,bnjhjd j,hfnyjq nhfycrhbgnfps

Pbljdelby (PLD) 300 vu ldf hfpf d ltym

Cnfdelby (d4N) 40 vu ldf hfpf d ltym (30 vu ldf hfpf d ltym^tckb vfccf ntkf<60 ru)

Kfvbdelby (3NC) 150 vu ldf hfpf d ltym

Lblfyjpby (LLB) 400 vu jlby hfp d ltym(250 vu jlby hfp d ltym^tckb vfccf ntkf<60 ru)

F,frfdbh (F<R) 300 vu ldf hfpf d ltym

Yerktjnblyst byub,bnjhs j,hfnyjq nhfycrhbgnfpsNtyjajdbh (NLA) 300 vu jlby hfp d ltym

Ytyerktjpblyst fyfkjub byub,bnjhjd j,hfnyjq nhfycrhbgnfps"afdbhtyp ("AP) 600 vu jlby hfp d ltym

Ytdbhfgby (YDG) 200 vu jlby hfp d ltym d ntxtybt 14 lytq^pfntv200 vu ldf hfpf d ltym

Byub,bnjhs ghjntfps

Ytkabyfdbh (YAD) 1250 vu ldf hfpf d ltym

Bylbyfdbh#hbnjyfdbh (BLD#hnd) 800 vu#100 vu ldf hfpf d ltym2^ 4

Kjgbyfdbh#hbnjyfdbh (KGD#hnd) 400 vu#100 vu ldf hfpf d ltym(533 vu#133 vu ldf hfpf d ltym^ rjulfghbybvftncz d cjxtnfybb c "AP bkb YDG)

Cfrbyfdbh#hbnjyfdbh (CRD#hnd) 1000 vu#100 vu ldf hfpf d ltym3^ 4

1 "nb ljpbhjdrb bvt.n hfcghjcnhfytyyjtrkbybxtcrjt ghbvtytybt& Ljpbhjdrbêrfpfyyst d ’njq nf,kbwt^ ,skbds,hfys yf jcyjdt yfbkexib[bvt.ob[cz rkbybxtcrb[ lfyys[&Ghtlgjxnbntkmytq bcgjkmpjdfnm ljpb-hjdrb^ rjnjhst vj;yj ghbybvfnm jlbybkb ldf hfpf d ltym d wtkz[ ,jkttcnhjujuj cj,k.ltybz c[tvs nthfgbb&Gthtxbcktyyst ljps zdkz.ncz ljpfvblkz gfwbtynjd c yjhvfkmyjq aeyrwbtqgjxtr b gtxtyb& Cktletn exbnsdfnmcgtwbfkmye. byajhvfwb. j ghtgfhfntghb rjhhtrnbhjdrt ljps^ rjnjhfz vj;tn,snm cdzpfyf c yfheitybtv aeyrwbbgjxtr bkb gtxtyb bkb c djpvj;ysvdpfbvjltqcndbtv c lheubvb ktrfhcndty-ysvb chtlcndfvb^ ghbtv rjnjhs[ cdzpfybkb yt cdzpfy c DBX&

2 "nf c[tvf ghbtvf ktrfhcndtyyjujchtlcndf ibhjrj bcgjkmpetncz d rkbyb-

xtcrjq ghfrnbrt& Lheubt c[tvs ghbtvfBLD#hnd^ rjnjhst rjkt,k.ncz jn 800 vu#200 vu ldf hfpf d ltym lj 400 vu#100 vuldf hfpf d ltym nfr;t bcgjkmpe.ncz drkbybxtcrjq ghfrnbrt&

3 Vjuen bcgjkmpjdfnmcz rfr rfgceks cndthlsv utktv^ nfr b rfgceks c vzurbvutktv d nt[ ckexfz[^ rjulf CRD ghbyb-vftncz d cjxtnfybb c HND&

4 Erfpsdftncz rjhhtrnbhjdrf c[tvs ghbt-vfktrfhcndtyyjuj chtlcndf d ckexft tujcjxtnfybz c ytyerktjpblysv by-ub,bnjhjv j,hfnyjq ghjntfps^ yj d yfc-njzott dhtvz ytdjpvj;yj ghtlcnfdbnmjabwbfkmye. htrjvtylfwb.& Htrjvty-letncz kbim edtkbxbnm rjvgjytyn HNDlj 200 vu^ rjulf jy ghbybvftncz dcjxtnfybb c "AP bkb YDG& Nht,e.nczljgjkybntkmyst lfyyst j dpfbvjltq-cndbb ktrfhcndtyys[ chtlcnd&


29

Ghbkj;tybt D& Rhfnrfz byajhvfwbz j cjcnfdt b ljpf[ktrfhcndtyys[ chtlcnd^ ghbvtyztvs[ d gtlbfnhbb

Yfbvtyjdfybt ktrfh-cndtyyjuj chtlcndf

Cjcnfd Bvt.obtczlfyyst jafhvfrjrbytnbrt

Yerktjpblst byub,bnjhs j,hfnyjq nhfycrhbgnfps

Pbljdelby (PLD) Cbhjg% 10 vu#vkRfgceks% 100 vu* 250 vuNf,ktnrb% 300 vu

Dct djphfcns

Kfvbdelby (3NC) Gthjhfkmysq hfcndjh%10vu#vkNf,ktnrb% 150 vu

Dct djphfcns

Abrcbhjdfyyfzrjv,bybhjdfyyfz ljpfPLD b 3NC

Jncencndetn d ;blrjv dbltNf,ktnrb% 300 vu PLD b 150 vu 3NC

Gjlhjcnrb bdphjckst

Lblfyjpby (LLB^lbltjrcbbyjpby)

Jhfkmyfz cecgtypbz ltncrjuj gjhjirf#djls10 vu#vk& Dj vyjub[ cnhfyf[ nht,etnczghbujnjdktybt c bcgjkmpjdfybtv ljgjkyb-ntkmyjuj fynfwblyjuj chtlcndf&:tdfntkmyst nf,ktnrb%25 vu* 50 vu* 100 vu*150 vu* 200 vuGjrhsnst ’ynthjcjk.,bkmyjqj,jkjxrjq uhfyeks d rfgcekf[% 125 vu*200 vu* 250 vu* 400 vu

Dct djphfcns

Cnfdelby (d4N) Gthjhfkmysq hfcndjh%1vu#vkRfgceks% 15 vu^ 20 vu^ 30 vu^40 vu

Dct djphfcns


30

Djphfcn (VFCCF NTKF)^ LJPF'

B XFCNJNF ghbtvfLheubt pfvtxfybz

<4 ytltkb% 4 vu#ru#ldf hfpf d ltymjn 4 ytltkm lj 13 ktn% 180 vu# v2#ldf hfpf d ltymVfrcbvfkmyfz ljpf%513 ktn% 300 vu#ldf hfpf d ltym

<jkmijt rjkbxtcndj cbhjgf yt jxtym[jhjij gthtyjcbncz ltnmvb ,jkttcnfhituj djphfcnf&Nht,etn [hfytybz d cntrkzyys[cjcelf[ d ntvyjv vtcnt&Vj;yj ghbybvfnm dvtcnt c gbotq&Ljps 600vu#v2#ldf hfpf d ltym^ytj,[jlbvst lkz ’ywtafkjgfnbb&Yt ghbybvfnm dvtcnt c d4N (fynfujybc-nbxtcrjt fynbhtnhjdbhecyjt ltq-cndbt)&

<30 lytq% 2vu#ru#ldf hfpf d ltym530 lytq bkb vfccf ntkf<60 ru%4 vu#ru# ldf hfpf d ltymVfrcbvfkmyfz ljpf%vfccf ntkf>60 ru%150 vu#ldf hfpf d ltym

{jhjij gthtyjcbnczVj;yj ghbybvfnm dvtcnt c gbotq{hfybnm hfcndjh ghb rjvyfnyjqntvgthfneht (bcgjkmpjdfnm d ntxtybtjlyjuj vtczwf gjckt dcrhsnbz)

Vfrcbvfkmyfz ljpf%>13 ktn bkb vfccf ntkf>60 ru%1 nf,ktnrf ldf hfpf d ltym

Nf,ktnrb ytkmpz lhj,bnm

<3 vtczwf% (50 vu#v2#ldf hfpf d ltymjn 3 vtczwtd lj<13 ktn% 90vu#v2#ldf hfpf dltym bkb 240 vu#v2#jlby hfp d ltymVfrcbvfkmyfz ljpf%513 ktn bkb vfccf ntkf>60 ru%200 vu#ldf hfpf d ltym bkb400 vu#jlby hfp d ltym

Cecgtypb. [hfybnm d ghj[kflyjvvtcnt* cj[hfyztn cdjqcndf d ntxtybt30 lytq * ytj,[jlbvj [jhjijdcnhz[yenm&D bltfkmyjv ckexft ghbybvfnm xthtpxfc bkb ldf xfcf gjckt tls* vj;tnbvtnm vtymitt pyfxtybt lkz ltntq&Gjrhsnst ’ynthjcjk.,bkmyjq j,jkjxrjquhfyeks d rfgcekf[ vj;yj jnrhsnm bdscsgfnm yf yt,jkmibt recjxrb gbob&

<30 ru% 1vu#ru#ldf hfpf d ltymJn 30 lj 60 ru% 30 vu#ldf hfpf d ltymVfrcbvfkmyfz ljpf%>60 ru% 40 vu#ldf hfpf d ltym

<jkmijq j,]tv hfcndjhf&Hfcndjh [hfybnm d ghj[kflyjv vtcnt%cj[hfyztn cdjqcndf d ntxtybt 30 lytq%ytj,[jlbvj [jhjij dcnhz[yenm&Ytj,[jlbvj [hfybnm d cntrkzyys[,enskjxrf[&Jnrhsnst rfgceks b gthtvtifyyst cyt,jkmibvb recjxrfvb gbob [jhjijgthtyjczncz (cj[hfyztn cdjqcndf dhfcndjht d ntxtybt 24 xfcjd ghb [hfyt-ybb d [jkjlbkybrt)&Yt ghbybvfnm dvtcnt c FPN (fynfujybc-nbxtcrjt fynbhtnhjdbhecyjt ltqcndbt)


31

F,frfdbh (F<R) Gthjhfkmysq hfcndjh% 20 vu#vkNf,ktnrb% 300 vu

Cnfhit 3 vtczwtd

Abrcbhjdfyyfzrjv,bybhjdfyyfz ljpfPLD + 3NC + F<R

Jncencndetn d ;blrjv dbltNf,ktnrb% PLD 300 vu +3NC 150 vu + F<R 300 vu

Gjlhjcnrb bdphjckst

Ytyerktjpbnyst byub,bnjhs j,hfnyjq nhfycrhbgnfps

Ytdbhfgby (YDG) Gthjhfkmyfz cecgtypbz% 10 vu#vkNf,ktnrb% 200 vu

Dct djphfcns

"afdbhtyp ("AP) Cbhjg% 30 vu#vk

(Ghbvtxfybt% cbhjgnht,etn ,jktt dscjrb[ ljp gj chfdytyb.c rfgcekfvb^ cv& c[tve ghbtvf ktrfhcndty-ys[ chtlcnd)

Rfgceks% 50 vu^ 100 vu^ 200 vu^ 600vu

Kbim lkzltntq cnfhit3 ktn


32

<16 ktn bkb vfccf ntkf 437^5 ru% 8 vu#ru#ldfhfpf d ltymVfrcbvfkmyfz ljpf%>16 ktn bkb vfccf ntkf>37^5 ru%300 vu#ldf hfpf d ltym

Cbhjg [jhjij gthtyjcbncz^ f nf,ktnrbvj;yj lhj,bnm&Vj;yj ghbybvfnm dvtcnt c gbotq&YTJ<{JLBVJ GHTLEGHTLBNMHJLBNTKTQ J< FKKTHUBXTCRJQHTFRWBB&D ckexft fkkthubxtcrjq htfrwbbcktletn ghtrhfnbnm gjcnjzyysqghbtv F<R&

Vfrcbvfkmyfz ljpf%>40 ru% 1 nf,ktnrf ldf hfpf d ltym

Nf,ktnrb ytkmpz lhj,bnm&YTJ<{JLBVJ GHTLEGHTLBNMHJLBNTKTQ J< FKKTHUBXTCRJQHTFRWBB&D ckexft fkkthubxtcrjq htfrwbbcktletn ghtrhfnbnm gjcnjzyysq ghbtvf,frfdbhf&

15-30 lytq% 5 vu#ru#jlby hfp d ltym d ntxtybt2 ytltkm^ pfntv 120vu#v2#ldf hfpf d ltymd ntxtybt 2 ytltkm^ pfntv 200vu#v2#ldf hfpfd ltym>30 lytq lj 13 ktn% 120vu#v2#ldf hfpf d ltymd ntxtybt 2 ytltkm^ pfntv 200vu#v2#ldf hfpfd ltymVfrcbvfkmyfz ljpf%>13 ktn% 200vu#jlby hfp d ltym d ntxtybtgthds[ 2 ytltkm^ pfntv 200vu#ldf hfpf d ltym

Tckb jlyjdhtvtyyj ghbybvftncz hb-afvgbwby^ edtkbxbnm ljpe YDGghb,kbpbntkmyj yf 30¢ bkb ghtrhfnbnmghbvtytybt (cv& Hfpltk j ne,threktpt)&Cecgtypb. [hfybnm ghb rjvyfnyjqntvgthfneht* ytj,[jlbvj [jhjijdcnhz[yenm&Vj;yj ghbybvfnm dvtcnt c gbotq&

YTJ<{JLBVJ GHTLEGHTLBNMHJLBNTKTQJDJPVJ:YJCNBGJZD-KTYBZ CSGB& Yt edtkbxbdfnm ljpe dckexft gjzdktybz csgb (d ckexftytpyfxbntkmyjq#chtlytq cntgtyb csgbghjljk;fnm ghbtv ktrfhcndtyyjujchtlcndf* rjulf csgm bcxtpytn ^djpj,yjdbnm ljpbhjdre c yfxfkf edtkb-xtybz ljps* d ckexft cbkmyjq csgb ght-rhfnbnm ghbtv ktrfhcndtyyjuj chtlcndf)&Dpfbvjltqcndbt ktrfhcndtyys[chtlcnd&

Rfgcekf (;blrjcnm) - ljpf lkz ltntq>3 ktn% jn10 lj 15 ru% 200 vu (270 vu = 9vk) jlby hfp d ltymJn 15 lj<20 ru% 250vu (300 vu = 10vk) jlby hfpd ltymJn 20 lj<25 ru% 300vu (360 vu = 12vk) jlby hfpd ltymJn 25 lj<33 ru% 350vu (450 vu = 15vk) jlby hfpd ltymJn 33 lj<40 ru% 400vu (510 vu = 17vk) jlby hfpd ltymVfrcbvfkmyfz ljpf%540 ru% 600 vu jlby hfp d ltym

Rfgceks vj;yj jnrhsnm b lj,fdbnm dgboe^ yj jyf ,eltn bvtnm jxtym ujhmrbqdrec* b[ vj;yj^ jlyfrj^ cvtifnm cj ckf-ljcnzvbbkbl;tvjvlkzbpvtytybzdrecf&Vj;yj ghbybvfnm dvtcnt c gbotq (yjbp,tufnm ghbtvf gjckt jxtym ;bhyjqgbob^ rjnjhfz edtkbxbdftn f,cjh,wb.yf 50¢)&Kexit dctuj ghbybvfnm gthtl cyjv^jcj,tyyj gthdst 2 ytltkb lkz cjr-hfotybz gj,jxyjuj djpltqcndbz yfwtynhfkmye. ythdye. cbcntve&Dpfbvjltqcndbt ktrfhcndtyys[chtlcnd&

33


Byub,bnjhs ghjntfps

Ytkabyfdbh (YAD) Gjhjijr lkz gthjhfkmyjq cecgtypbb (gt-htvtifnm c ;blrjcnm.)% 200 vu yf xfqye.kj;re (50 vu yf 1^25 vk)% 5 vkNf,ktnrb 250 vu (nf,ktnrb vj;yj hfpltkznmyf ldt xfcnb^ lhj,bnm b lj,fdkznm d gboe bhfcndjhznm d djlt)

Dct djphfcns&Jlyfrj d cdzpbcj pyfxbntkmysvafhvfrj-rbytnbxtcrbv rjkt,f-ybtv e ltntq^nht,etncz lfdfnmjxtym dscjrbtljps uhelysvltnzv<1 ujlf

Kjgbyfdbh#hbnjyfdbh^(KGD#h)

Gthjhfkmysq hfcndjh% 80 vu#vk kjgbyfdbhf+ 20 vu#vk hbnjyfdbhfRfgceks% 133^3 vu kjgbyfdbhf + 33^3 vuhbnjyfdbhf

6 vtczwtd bkbcnfhit

' Bpvthznm gjchtlcndjv hfcxtnf gkjoflb gjdth[yjcnb ntkf% rdflhfnysq rjhtymdtkbxbys (hjcn d cv yf vfcce ntkf d ru^ hfpltktyye. yf 3600)

34

<1 ujlf% 40-50 vu#ru#nhb hfpf d ltymbkb 65-75 vu#ru ldf hfpf d ltym>1 ujlf lj<13 ktn % 55-65vu#ru#ldf hfpf d ltymVfrcbvfkmyfz ljpf%513 ktn% 1250 vu#ldf hfpf d ltym

Gjhjijr ckflrbq^ ckturf ujhmrjdfnsq^yj ndthlsq b nhelyjhfcndjhbvsq*ytgjchtlcndtyyj gthtl ghbtvjvytj,[jlbvj hfpvtifnm d djlt^ vjkjrt^ltncrjq cvtcb^ ltcthnt b n&l& ytghbvtyznm rbckjnye. gboe bkb cjr(edtkbxbdftn ujhmrbq drec)&D cdzpb c nhelyjcnzvb^ cdzpfyysvbc ghbvtytybtv gjhjirf kexit bcgj-kmpjdfnm hfplhj,ktyyst nf,ktnrb(lf;t lkz uhelys[ ltntq)^ tckb vj;yjgjlj,hfnm cjjndtncnde.oe. ljpe&Gjhjijr b nf,ktnrb vj;yj [hfybnm ghbrjvyfnyjq ntvgthfneht&Ghbybvfnm c gbotq&Dpfbvjltqcndbt ktrfhcndtyys[chtlcnd (d vtymitq cntgtyb xtv by-ub,bnjhs ghjntfps^ cjlth;fobt hbnj-yfdbh)&

>6 vtczwtd lj 13 ktn% 225 vu#v2

KGD#57^5 vu#v2 hbnjyfdbhf ldf hfpf d ltymbkb ljpbhjdrf d pfdbcbvjcnb jn vfccs ntkf%7-15 ru% 12 vu#ru KGD#3 vu#ru hbnjyfdbh#ldfhfpf d ltym15-40 ru% 10 vu#ru kjgbyfdbhf#5 vu#ru hbnjyfdbhfldf hfpf d ltym

Gthjhfkmysq hfcndjh b rfgceks ght-lgjxnbntkmyj [hfybnm d ghj[kflyjvvtcnt* jlyfrj b[ vj;yj [hfybnm ghbrjvyfnyjq ntvgthfneht lj 25o C dntxtybt 2 vtczwtd:blrbq cjcnfd bvttn vtymibq j,]tv^yj ,jktt ujhmrbq drecKexit [hfybnm d ghj[kflyjv vtcntRfgceks ,jkmijuj hfpvthfGhbybvfnm dvtcnt c gbotqDpfbvjltqcndbt ktrfhcndtyys[chtlcnd

35

Edtkbxtybt vfcinf,jd ghbvtytybz fynbhtnhjdbhecyjq nthfgbb ...BGGG Byatrwbz^ gthtlfdftvfz gjkjdsv gentv N< Ne,threktp NLA Ntyjajdbh lbcjghjrcbk aevfhfn JJY Jhufybpfwbz J,]tlbytyys[

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