hepatitis c: a crisis in the african american community, findings and recommendations, october 2013

8/14/2019 HEPATITIS C: A CRISIS IN THE AFRICAN AMERICAN COMMUNITY, Findings and Recommendations, October 2013

1/40JMPHVOVOY I; H ITOYOY OL VJM HETOIHL HGMTOIHL INGG]LOV_ | 8

H PMMT-TMUOMSMF INLYMLY]Y PHPMT | NIVNDMT 4089

JMPHVOVOY IH ITOYOYOL VJMHETOIHL HGMTOIHLINGG]LOV_

Eolfolcs hlf Tminggmlfhtonls


2/404 | LHVONLHA GMFOIHA HYYNIOHVONL

Thjl B. Dhoamy, GF, EHPH

In-Ijhor ne tjm Inlsmlsus Phlma889tj Prmsofmlt ne tjm Lhtonlha Gmfoiha HssniohtonlIjhorghl ne tjm Fmphrtgmlt ne PsyijohtryGmjhrry Gmfoiha InaamcmLhsjvoaam, L

Imfroi Drocjt, GF, EHIP

In-Ijhor ne tjm Inlsmlsus Phlma884tj Prmsofmlt ne tjm Lhtonlha Gmfoiha HssniohtonlHssosthlt Fmhl, Gmfoiha Mfuihtonl hlf HfgossonlsHssniohtm Prnemssnr ne Oltmrlha Gmfoiolm

]lovmrsoty ne Lnrtj Ihrnaolh Yijnna ne GmfoiolmIjhpma Joaa, LI

Ijhrams F. Jnwmaa, GF, HCHE

In-Ijhor ne tjm Inlsmlsus PhlmaPrnemssnr ne GmfoiolmFormitnr, Jmphtnancy Tmsmhrij]lovmrsoty ne Ghryahlf Yijnna ne GmfoiolmDhatognrm, GF

Hlfrmw K. Guor, GF, GJY

In-Ijhor ne tjm Inlsmlsus PhlmaFormitnr, Chstrnmltmrnancy/Jmphtnancy Tmsmhrij

Fubm Iaoloiha Tmsmhrij OlstotutmHssniohtm Prnemssnr ne GmfoiolmFovosonl ne ChstrnmltmrnancyFubm ]lovmrsoty Yijnna ne GmfoiolmFurjhg, LI

Hzmah I. Inaaols, GYL, TL, PTP

Lhtonlha Dahib Lursms HssniohtonlNhb Phrb, OA

Yhfym D. Iurry, GF

Hssniohtm Prnemssnr ne Gmfoiolm, MgmrothJnwhrf ]lovmrsoty Inaamcm ne GmfoiolmShsjolctnl, FI

Inurtlmy G. Knjlsnl, GF/PjF Ihlfofhtm

Shrrml Hapmrt Gmfoiha Yijnna ne Drnwl ]lovmrsotyLhtonlha PrmsofmltYtufmlt Lhtonlha Gmfoiha HssniohtonlPrnvofmlim, TO

Soadmrt Knrfhl, GF

Hssniohtm Prnemssnr ne Oltmrlha GmfoiolmIjhrams Frmw ]lovmrsotyFormitnr, NHYOY Iaoloi GAB-GHIIAns Hlcmams, IH

Pjoaop T. Tnhlm, PjF

Hssniohtm Prnemssnr ne GoirndonancyJnwhrf ]lovmrsoty Yijnna ne GmfoiolmShsjolctnl, FI

Myhsu msjham, GF

Gmfoiha MpofmgonancostLhtonlha Imltmr enr JOU, Jmphtotos hlf YF PrmvmltonlImltmrs enr Fosmhsm Inltrna hlf Prmvmltonl

Htahlth, CH

Yjhrnl F. Haaosnl-Nttmy, GF

Jmhatj YtrhtmcostLGH Jmphtotos I Prnkmit FormitnrDnwom, GF

INLYMLY]Y PHLMAPHTVOIOPHLVY

Fosiahogmr; Vos wnrb os h prnfuit ne tjm Lhtonlha Gmfoiha Hssniohtonl, tjm mxpmrts hlf phrtoiophlts hrm lnt hutjnrs. Vm olfovofuhas phrtoiophtolc

lnr tjmor nrchlozhtonls lmimsshroay mlfnrsm mvmrytjolc ol tjm fniugmlt hs tjos os h inaahdnrhtovm/inaamitovm wnrb.



VJM LHVONLHA GMFOIHAHYYNIOHVONLY

JMPHVOVOY I VHYB ENTIMVm Jmphtotos I hsb Enrim whs enrgmf dy tjm LGH ol 4088 tn enrghaay hffrmss hlf irmhtm hl hitonl pahl hrnulf tjm irosos ne Jmphtotos I ol tjm

Heroihl Hgmroihl Ingguloty. Nlm ne tjm hsb Enrims olotoha rminggmlfhtonls whs tn inlvmlm h Inlsmlsus Phlma. Ghly ne tjm gmgdmrs ne tjm

hsb Enrim smrvm hs mxpmrts nl tjm Inlsmlsus Phlma. Vmor hssosthlim os olvhauhdam tn tjm nlcnolc wnrb ne tjm LGH ol ingdhtolc Jmphtotos I.

LGH Gmfoiha Hssniohtonl Ythff hlf InlsuathltsFhrrya T. Ghttjmws, Yr., Mxmiutovm FormitnrTnsayl Fnucahs, GH, Prncrhg FormitnrLoinam Ihltnl, Prncrhg FormitnrKuiolfh Emll-Jnfsnl, EhioaothtnrYjhrtryh Inaaomr, Mf.F, Jmhatj Mfuihtnr/Tmsmhrijmr

Khlmm Inngds, PjF, Jmhatj YthtostoiohlDmtty Durstnl, PjF, EhabnlXwmst Oli.Ghroh Y. Dnmfolc, MfotnrPhtroib Ihafmr, Crhpjoi Fmsoclmr

Vos Inlsmlsus Phpmr whs ghfm pnssodam, ol phrt, dy mfuihtonlha crhlts hlf/nr inltrodutonls erng HddUom, KhlssmlPjhrghimutoihas, hlf NrhYurm mijlnancoms. Vm LGH hasn hiblnwamfcms tjm suppnrt ne Umrtmx hlf Coamhf Yiomlims enr tjmorsuppnrt ne tjm LGHs Jmphtotos I prnkmits.

Thjl B. Dhoamy, GF, EHPH

In-Ijhor ne tjm Jmphtotos I hsb Enrim889tj Prmsofmlt ne tjm Lhtonlha Gmfoiha HssniohtonlIjhorghl ne tjm Fmphrtgmlt ne PsyijohtryGmjhrry Gmfoiha InaamcmLhsjvoaam, L

Imfroi Drocjt, GF, EHIP

In-Ijhor ne tjm Jmphtotos I hsb Enrim884tj Prmsofmlt ne tjm Lhtonlha Gmfoiha HssniohtonlHssosthlt Fmhl, Gmfoiha Mfuihtonl hlf HfgossonlsFormitnr ne Ypmioha PrncrhgsHssniohtm Prnemssnr ne Oltmrlha Gmfoiolm]lovmrsoty ne Lnrtj Ihrnaolh Yijnna ne GmfoiolmIjhpma Joaa, LI

Ijhrams F. Jnwmaa, GF, HCHE

In-Ijhor ne tjm Jmphtotos I hsb EnrimPrnemssnr ne Gmfoiolm

Formitnr, Jmphtnancy Tmsmhrij]lovmrsoty ne Ghryahlf Yijnna ne GmfoiolmDhatognrm, GF

Hlfrmw K. Guor, GF, GJY

In-Ijhor ne tjm Jmphtotos I hsb EnrimFormitnr, Chstrnmltmrnancy/Jmphtnancy TmsmhrijFubm Iaoloiha Tmsmhrij OlstotutmHssniohtm Prnemssnr ne GmfoiolmFovosonl ne ChstrnmltmrnancyFubm ]lovmrsoty Yijnna ne GmfoiolmFurjhg, LI

Yhfym D. Iurry, GF

Hssniohtm Prnemssnr ne Gmfoiolm, MgmrothJnwhrf ]lovmrsoty Inaamcm ne GmfoiolmShsjolctnl, FI

Soadmrt Knrfhl, GF

Hssniohtm Prnemssnr ne Oltmrlha GmfoiolmIjhrams Frmw ]lovmrsotyFormitnr, NHYOY Iaoloi GAB-GHIIAns Hlcmams, IH

Ijhrams Pmtmr Gnutnl, GF

Ymlonr Uoim Prmsofmlt enr Jmhatj HffhorsGmjhrry Gmfoiha InaamcmLhsjvoaam, L

Ytmpjml Hudrmy I. Phrlmaa, GF

ChstrnmltmrnancostInhst Chstrn Mltmrnancy Gmfoiha Crnup OliAns Hlcmams, IH

Pjoaop T. Tnhlm, PjF

Hssniohtm Prnemssnr ne GoirndonancyJnwhrf ]lovmrsoty Inaamcm ne GmfoiolmShsjolctnl, FI

Yjhrnl F. Haaosnl-Nttmy, GF

Jmhatj YtrhtmcostLGH Jmphtotos I Prnkmit FormitnrDnwom, GF



MZMI]VOUM Y]GGHT_YVHVMGMLV NE

VJM PTNDAMG

Ol 8??:, tjm Imltmrs enr Fosmhsm Inltrna hlf Prmvmltonlturlmf tjm pudaoi jmhatj inggulotys httmltonl tn tjmogpmlfolc tjrmht ne jmphtotos I (JIU) hlf tjm urcmlt lmmftn mlchcm ol JIU rosb-dhsmf sirmmlolc hs h rst stmp olprntmitolc tjm lhtonl erng ots rosbs.8Sotj tjm 4000 pudaoihtonlne tjm Olstotutm ne GmfoiolmsJmphtotos hlf Aovmr Ihlimr; H

Lhtonlha Ytrhtmcy enr Prmvmltonl hlf Inltrna ne Jmphtotos

D hlf I,4tjm pudaoi jmhatj ingguloty hiblnwamfcmf tjmmgmrcmlim ne ymt hlntjmr olemitonus fosmhsm tjht whs amhfolctn foshdoaoty hlf mhray gnrthaoty hgnlc Hgmroihls. Ol Ghy4088, wotj tjm rmamhsm ne tjm Fmphrtgmlt ne Jmhatj hlfJughl Tmsnurims rmpnrt, Ingdhtolc tjm Yoamlt Mpofmgoi ne

Uorha Jmphtotos; Hitonl Pahl enr tjm Prmvmltonl hlf Inltrna ne

Jmphtotos D hlf I,9tjm lhtonl enrghaay fmiahrmf whr hcholsth vorus wjnsm hsygptnghtoi sthtus mxpnlmltohaay olirmhsmstjm pntmltohaoty enr smvmrm gnrdofoty hlf mhray gnrthaoty.Gnrm rmimltay, tjm Kulm 40896rmamhsm ne tjm ].Y. PrmvmltovmYmrvoim hsb Enrims Yirmmlolc enr Jmphtotos I Uorus Olemitonlol Hfuats; Tminggmlfhtonl Ythtmgmltmlfnrsmf tjm IFIsrminggmlfhtonl tjht pmrsnls dnrl dmtwmml 8?6= hlf 8?5= dmprnvofmf nlm togm JIU injnrt-dhsmf sirmmlolc. Hs h rmsuat, hlmw tnna whs hffmf tn tjm hrsmlha ne prhitoims tjht ihl dm usmftn hffrmss tjos fosmhsm.

Fmspotm suij gmhsurms, gnrm mffnrts hrm lmmfmf. H lugdmr ne

trmlfs suppnrt tjos inliausonl. Eorst, tjm sjmmr ghclotufm nepmrsnls olemitmf dy tjos fosmhsm succmsts tjht gnrm rmsnurimsgust dm formitmf tnwhrfs ots rmgmfohtonl. Vm Imltmrsenr Fosmhsm Inltrna hlf Prmvmltonl,=iotolc fhth erng tjmgnst sthtostoihaay rndust stufy tn fhtm ne JIU (Hrgstrnlcmt ha., 4005)5, mstoghtms tjht 9.4 goaaonl ne tjm mstoghtmf6,050,000 pmrsnls mvmr olemitmf wotj JIU hrm ijrnloihaayolemitmf. Hs h pnolt ne ingphrosnl, tjos shgm IFI fovosonlmstoghtms tjht 8,86:,400 pmrsnls hcmf 89 hlf nafmr hrmaovolc wotj JOU olemitonl.3Gnrmnvmr, wjoam ot os mstoghtmftjht 403,500 nr 8:.8% ne pmrsnls olemitmf wotj JOU hrmulhwhrm ne tjmor olemitonl, hl mstoghtmf 3=% ne JIU olemitmfpmrsnls fn lnt blnw ne tjmor olemitonl.:Vus, hs wotj JOU,

tjm ogpamgmlthtonl ne strhtmcoms tn inlthol hlf rmfuim tjmoliofmlim hlf prmvhamlim ne tjos fosmhsm gust dm inltoluha.

Uorha jmphtotos os lnt, jnwmvmr, hl mtjloihaay-lmutrha olemitonl.JIU jhs h fosphrhtm gnrdofoty hlf gnrthaoty ogphit hgnlcimrthol mtjloi crnups. Ol 4080, tjmrm wmrm 94,=:3 lmwayrmpnrtmf ihsms ne jmphtotos I.?Hpprnxoghtmay 83,60: pmrsnlsfof lnt rmpnrt rhim/mtjloioty. Ne tjm 8=,83? pmrsnls wjn fofrmpnrt rhim/mtjloioty, 940? nr 48.8% wmrm Heroihl Hgmroihlhcrnup tjht os nlay 86% ne tjm Hgmroihl pnpuahtonl. Tmimltayrmamhsmf fhth mstoghtms rmvmha tjht tjmrm wmrm 94,636rmpnrtmf ihsms ne JIU ol 4088.80Sjoam =6.4% ne tjmsm ihsms

ehoamf tn rmpnrt rhim/mtjloioty, 86,:38 ne tjmsm ihsms fof sn.Hpprnxoghtmay 4,5:8 ne tjm ihsms tjht fof rmpnrt rhim wmrmHeroihl Hgmroihl. Vus, Heroihl Hgmroihls wmrm 8:.8% ne tjmlmw ihsms tjht rmpnrtmf rhim.88

Vos shgm IFI fhthsmt hasn rmvmhamf tjht ol 400:, tjm fmhtjrhtm pmr 800,000 erng JIU whs 6.93 enr Ihuihsohls hlf3.:4 enr Heroihl Hgmroihls.84Vus, Heroihl Hgmroihls fomferng JIU 3:.?% gnrm netml tjhl fof Ihuihsohls.89Vosfosphroty rmprmsmltmf hl ogprnvmgmlt erng 4006 wjml tjmfmhtj rhtms enr Heroihl Hgmroihls hlf Ihuihsohls wmrm 5.=8hlf 9.65 rmspmitovmay olfoihtolc tjht Heroihl Hgmroihlsfomf erng JIU ::.4% gnrm netml tjhl Ihuihsohls. Ol 4088,jnwmvmr, rmpnrtmf JIU fmhtj rhtms frnppmf tn 6.0 pmr 800,000Ihuihsohls hlf 3.34 pmr 800,000 Heroihl Hgmroihls. Jnwmvmr,Heroihl Hgmroihls fomf erng JIU ?8.5% gnrm netml ol4088 tjhl ol 4080.86Vus, tjm aogotmf fhth hvhoahdam succmst

tjht tjm fosphroty ol JIU fmhtj rhtms ghy jhvm olirmhsmf. Olhffotonl, Heroihl Hgmroihls hrm hasn amss rmspnlsovm tn tjmpjhrghinancoi hcmlts iurrmltay usmf ol tjm trmhtgmlt ne tjosolemitonl. _mt, fmspotm suij lfolcs, tjm crnwolc gnvmgmlt tnhffrmss tjos fosmhsm jhs rmgholmf guij tnn soamlt rmchrfolcHeroihl Hgmroihls hlf JIU fosphrotoms.

Inclozhlt ne h crnwolc dnfy ne rmsmhrij wjoij rmvmhas tjht tjmingpamxotoms oljmrmlt ol JIU hlf Heroihl Hgmroihls rmquormmauiofhtonl hlf mxpaoihtonl, tjm Lhtonlha Gmfoiha Hssniohtonl(LGH) fmiofmf tn thbm hitonl hlf, msthdaosjolc tjm LhtonlhaJmphtotos I Prnkmit ol 4088. Nlm ne tjm ghly thsbs hssugmfdy tjos olotohtovm whs hl JIU ol Heroihl Hgmroihls Inlsmlsus

Phlma Phpmr. Erng Ghy 65, 4089, LGH inlvmlmf hInlsmlsus Phlma ne tjm lhtonls amhfolc mxpmrts nl HeroihlHgmroihls hlf jmphtotos I. Vos Inlsmlsus Phlma Phpmr os tjmrmsuat ne tjos fosiussonl hlf fohancum.

GMVJNFY

H crnup inlsostolc ne pjysoiohl/rmsmhrijmrs, emfmrhacnvmrlgmlt rmprmsmlthtovms, pnaoiy hlhaysts, jmhatjmfuihtonl mxpmrts, ingguloty hfvnihtms, hlf provhtm smitnrrmprmsmlthtovms hffrmssmf smvmrha bmy qumstonls utoaozolc tjminlsmlsus phlma enrght.

8. Sjht os tjm prmvhamlim hlf oliofmlim ne jmphtotos I ol tjmHeroihl Hgmroihl ingguloty>

4. Sjht hrm sngm ne tjm uloqum rosb ehitnrs hssniohtmf wotjjmphtotos I ol tjm Heroihl Hgmroihl ingguloty>

9. Jnw ihl fosphrotoms ol JIU sirmmlolc hlf fohclnsos,trmhtgmlt hlf trmhtgmlt nutingms dm fmirmhsmf>

6. Soaa tjmsm fosphrotoms pmrsost hs lmw tjmrhpoms mgmrcm>


5/40JMPHVOVOY I; H ITOYOY OL VJM HETOIHL HGMTOIHL INGG]LOV_ | =

=. Sjht strhtmcoms ihl dm hfnptmf tn suppnrt rmfuitonls olofmltomf JIU fosphrotoms>

5. Jnw ihl uloqum ossums ne Heroihl Hgmroihls dm oltmcrhtmfgnrm euaay oltn tjm crnwolc inlsionuslmss ne tjm pudaoijmhatj ingguloty rmchrfolc tjm iurrmlt hlf prnspmitovmJIU irosos>

EOLFOLCY HLFTMINGGMLFHVONLY

Vrnucj h rmvomw ne aotmrhturm, tjm pmrsnlha rmsmhrij ne tjmprmsmltmrs, hlf tjm npolonls ne tjm Inlsmlsus Phlma gmgdmrs,h lugdmr ne lfolcs rmsuatmf.

Heroihl Hgmroihls hlf JIUPrmvhamlim hlf Oliofmlim

Vm Inlsmlsus Phlma enulf tjht tjm twn proghry snurims nefhth nl tjm ghclotufm ne JIU ol tjm ]Y - tjm Lhtonlha Jmhatjhlf Lutrotonl Mxhgolhtonl Yurvmy (LJHLMY), 8?:5?6hlf 8???4004ghy ulfmrmstoghtm tjm prmvhamlim ne JIUhgnlc Heroihl Hgmroihls. Eorst, ln fhth erng tjm LhtonlhaJmhatj hlf Lutrotonl Mxhgolhtonl Yurvmy (LJHLMY) nlrhioha/mtjloi prmvhamlim rhtms hlf JIU jhvm dmml hlhayzmfhlf rmpnrtmf solim 4005. Yminlf, dmihusm tjos survmyihpturms fhth nl nlay tjm lnl-olstotutonlhaozmf pnpuahtonl,ot dyphssms jngmamss pnpuahtonls hlf tjm olihrimrhtmf, wotjfosprnpnrtonlhtm lugdmrs ne Heroihl Hgmroihls hlf ntjmrsudpnpuahtonls ht jocjmr rosb enr JIU.

Ol inltrhst, JIU oliofmlim fhth hrm ihaiuahtmf dhsmf upnlrmpnrtmf ihsms erng tjm Imltmrs enr Fosmhsm Prmvmltonl hlfInltrna, Uorha Jmphtotos Yurvmoaahlim Yystmg. Jnwmvmr, gnrmtjhl =0% ne tjm ihsms rmpnrtmf ehoa tn ihpturm rhim/mtjloioty.

Vm Inlsmlsus Phlma tjmrmenrm ofmltomf hl urcmlt lmmftn ogprnvm fhth inaamitonl hlf hlhaysos enr tjm mstoghtonlne JIU prmvhamlim hlf oliofmlim rhtms. Hffotonlhaay,rminggmlfhtonls wmrm ghfm rmchrfolc ijhlcms ol tjmLJHLMY fhthsmt. Vm Inlsmlsus Phlma hasn ofmltomfstrhtmcoms tjht ihl dm usmf tn mffmit ijhlcms ol IFIs LhtonlhaLntohdam Fosmhsm Yurvmoaahlim Yystmg rmahtovm tn JIU.

]loqum Tosb Ehitnrs Hssniohtmfwotj JIU hlf Heroihl Hgmroihls

Netml vomwmf hs h jocjay stocghtozmf fosmhsm tjht rmsuats erngpmrsnlha dmjhvonrha ijnoims, tjm Inlsmlsus Phlma enulf tjhtghly ne tjm rosb ehitnrs hssniohtmf wotj JIUs prmvhamlim hlfoliofmlim hrm sniohaay fmtmrgolmf. Vm Ynioha Fmtmrgolhltsne Jmhatj erhgmwnrb os dhsmf upnl tjm prmgosm tjht wjoampmrsnlha dmjhvonrs suij hs fomt, gmfoihtonl hfjmrmlim, hlfntjmr hrmhs ne ijnoim dmjhvonr ogphit jmhatj nutingms,mlvornlgmltha, minlngoi, hlf pnaotoiha vhrohdams jhvm strnlc

olformitogphits upnl jmhatj-rmahtmf olfovofuha ijnoims (Bnj,Nppmljmogmr, hlf Ghssol-Yjnrt, 4080)8=. Enr mxhgpam, nlmehitnr tjht inrrmspnlfs tn tjm jocjmr rhtm ne JIU hgnlcpmrsnls dnrl dmtwmml 8?6= hlf 8?5= os h jocj rhtm ne oaaoiotfruc usm, ol cmlmrha, hlf olkmitonl fruc usm spmioihaay. Olfmmf,tjm rhtm ne phst gnltj oaaoiot fruc usm hgnlc pmrsnls hcm =0tn =? crmw erng 4.3 pmrimlt ol 4004 tn 5.9 pmrimlt ol 4088 hstjm dhdy dnng injnrt crnup hcmf. Jnwmvmr, oaaoiot fruc usm

whs olotohaozmf ol tjos crnup hs tjm snion-iuaturha rmvnautonlne tjm 8?50s hlf 8?30s niiurrmf. Yogoahray, hpprnxoghtmay80% ne Heroihl Hgmroihls usm oaaoiot frucs rmahtovm tn :.3% neIhuihsohls (YHGYJH, 4084).85Vus, Heroihl Hgmroihls hrmht crmhtmr rosb ne JIU.

Olkmitonl fruc usmrs ingprosm h prmpnlfmrhlim ne pmnpamwotj JIU olemitonls. Jnwmvmr, Amautou-Smoldmrcmr mt ha(400?)83, ol h gmth-hlhaysos ne fhth erng 4? prmvhamlim hlf88 oliofmlim stufoms, fosinvmrmf tjht tjm prmsmlim ne JIUolemitonl ghy dm jocjmr hgnlc dntj Heroihl Hgmroihl hlfAhtoln olkmitonl fruc usmrs tjhl hgnlc Ihuihsohl olkmitonlfruc usmrs. Dmihusm tjos pnssodam trmlf foffmrs cmncrhpjoihaay,

hffotonlha rmsmhrij os lmmfmf tn fmlotovmay fmtmrgolmwjmtjmr tjm rosb ehitnrs enr JIU hgnlc olkmitonl fruc usmrsfoffmr dy rhim/mtjloioty.

]solc fhth erng tjm Yudsthlim Hdusm hlf Gmltha JmhatjYmrvoims Hfgolostrhtonl (YHGJYH) hlf tjm Fmphrtgmlt neAhdnr, tjm Inlsmlsus Phlma enulf tjht oaaoiot fruc usm os jocjmrhgnlc tjnsm wotj emwmr ymhrs ne mfuihtonl hlf jocjmr rhtmsne ulmgpanygmlt. Heroihl Hgmroihls hrm fosprnpnrtonlhtmayrmprmsmltmf ol dntj ne tjmsm ihtmcnroms. Ntjmr rosb ehitnrs enrJIU ghy hasn foffmr dy rhim/mtjloioty.

Fosphrotoms ol JIU Yirmmlolc,Fohclnsos hlf Vrmhtgmlt

JIU Yirmmlolc

Guatopam stufoms jhvm enulf tjht =03=% ne pmnpam wotj hlJIU olemitonl hrm ulhwhrm ne tjmor sthtus. Vus, olfmpmlfmltne rhim/mtjloioty, tjmrm os hl urcmlt lmmf enr pjysoiohls tnrmvosm tjmor sirmmlolc prnimssms. Ol phrtoiuahr, tjmrm os h lmmfenr hiimssodam sirmmlolc enr Heroihl Hgmroihls hlf ntjmrpmrsnls dnrl dmtwmml 8?6= hlf 8?5=. Vm IFI rminggmlfstjm usm ne dntj rosb-dhsmf hlf injnrt-dhsmf sirmmlolc.Vm ].Y. Prmvmltovm Ymrvoims hsb Enrim (]YPYE) rmimltay

mlfnrsmf IFIs rminggmlfhtonl ne nlm-togm injnrtsirmmlolc tn rmhij tjm 4 goaaonl nr sn ihsms ne JIU ol pmrsnlsdnrl dmtwmml 8?6=8?5=. Tosb-dhsmf sirmmlolc woaa fmtmit tjmprmsmlim ne JIU ol ntjmr crnups. Jnwmvmr, tjm InlsmlsusPhlma hasn rminggmlfmf tjht pjysoiohls iansmay hfjmrm tnIFIs rminggmlfhtonl tn sirmml haa JOU pnsotovm pmrsnlsenr JIU. Vm Phlma hasn succmstmf tjht haa pmrsnls wjn tmstpnsotovm enr JIU dm sirmmlmf enr hl JOU in-olemitonl.

Vm Phlma rminggmlfmf ghlfhtnry sirmmlolc enr olghtmsol khoas hlf prosnls. Hs os blnwl, Smoldhug, Aymrah, hlfGhrcnaos (4009) erng tjm Imltmrs enr Fosmhsm Inltrna hlf



Prmvmltonl enulf tjht hpprnxoghtmay 84% tn 9=% ne haa ].Y.olghtms ghy jhvm h ijrnloi JIU olemitonl. Ne phrtoiuahroltmrmst, IFI succmstmf tjht hs ghly hs 4?% tn 69% ne haapmrsnls wjn wmrm JIU pnsotovm ht tjm togm ne tjm stufy ghyjhvm dmml olghtms ht nlm togm.

Eolhaay, tjm Phlma rminggmlfs tjm drnhfmr usm ne rhpof tmstolctn mxphlf sirmmlolcs hgnlc ulfmrsmrvmf pnpuahtonls. Vm usm

ne rhpof tmstolc ogprnvms, crmhtay, tjm prndhdoaoty tjht pnsotovmrmsuats hrm rmimovmf. Ot sogpaoms tjm nvmrhaa sirmmlolc mffnrt.Ytufoms jhvm sjnwl tjht crmhtmr tjhl ?0% ne tmst rmsuats hrmfmaovmrmf tn phtomlts wotj rhpof tmstolc ol inltrhst wotj amsstjhl =0% ne phtomlts wjn rmturl tn fosinvmr tjmor sthtus wotjahd-dhsmf tmstolc.

Nlm stufy hasn enulf tjht Heroihl Hgmroihls hrm amss aobmaytn dm sirmmlmf enr JIU ol tjm prmsmlim ne blnwlrosbehitnrs, hlf amss aobmay tn dm rmemrrmf tn h sud-spmiohaost enrinlsofmrhtonl ne trmhtgmlt. Vus, systmgoi vhrohdams ghyinltolum tn dm npmrhtovm ol irmhtolc JIU fosphrotoms hgnlcHeroihl Hgmroihls. Vmrm os h lmmf tn olirmhsm tjm blnwamfcmne dntj phtomlts hlf prnvofmrs hdnut tjm trhfotonlha rosb ehitnrstjht hrm hssniohtmf wotj tjm JIU olemitonl.

JIU rmhtgmlt Maocodoaoty

Yocloihlt foffmrmlims mxost ol tjm fmcrmm ne trmhtgmltmaocodoaoty dmtwmml Heroihl Hgmroihls hlf Ihuihsohls. VmOFMHA stufy enulf tjht 60.4% ne Heroihl Hgmroihls ehoamftjm maocodoaoty sirmmlolc ingphrmf wotj 4:% ne lnl-HeroihlHgmroihls. Foffmrmltohas hasn mxost dmtwmml tjm twn mtjloicrnups ol tmrgs ne tjm pmrimlt ne tjnsm wjn hrm JIU-olemitmfhlf wjn fmiofm lnt tn hiimpt trmhtgmlt. Vm Inlsmlsus Phlmaghfm rminggmlfhtonls hogmf ht rmfuiolc fosphrotoms ht mhij

ne tjmsm pnolts.

JIU Vrmhtgmlt Tmspnlsovmlmss

Ingphrmf wotj Ihuihsohls, Heroihl Hgmroihls hrm olemitmffosprnpnrtonlhtmay wotj JIU cmlntypm 8 hlf, hs h rmsuat, tjmyhrm amss rmspnlsovm tn hltovorha trmhtgmlts tjhl JIU cmlntypms4 hlf 9. Jnwmvmr, hgnlc phtomlts wotj JIU cmlntypm 8,Heroihl Hgmroihls jhvm h socloihltay anwmr sustholmf

vornancoi rmspnlsm (YUT) tn pmcoltmremrnl haeh hlf rodhvoroltjhl os tjm ihsm wotj Ihuihsohls. Enr mxhgpam, nlm stufy enulftjht h sustholmf vornancoi rmspnlsm (YUT) tn pmcoltmremrnl haehhlf rodhvorol whs =4% enr Ihuihsohls dut nlay 4:% enr HeroihlHgmroihls. Guatopam prnspmitovm stufoms jhvm inlrgmf tjmsmlfolcs. H JIU prntmhsm oljodotnr ingdolmf wotj PMCOELhlf rodhvorol jhs dmml sthlfhrf tjmrhpy enr JIU cmlntypm8 solim 4088.8?Fmspotm nvmrhaa ogprnvmgmlt ol YUT, HeroihlHgmroihls stoaa jhvm h anwmr YUT. Yuij fhth suppnrt tjm tjmsosne h iurrmlt hlf ogpmlfolc irosos ne mvml crmhtmr ghclotufm olHeroihl Hgmroihl inggulotoms covml tjm anwmr rmspnlsovmlmsstn trmhtgmlt.

Vm anwmr rmspnlsm tn JIU trmhtgmlt wotjol cmlntypm 8 enrHeroihl Hgmroihls os mxpaholmf phrtay dy solcam luiamntofm

pnaygnrpjosgs (YLPs) lmhr tjm OA4:D cmlm. OA4:D YLPcmlntypms prmfoit tjm aobmaojnnf ne iurm enr haa rhioha hlfmtjloi crnups rmimovolc JIU trmhtgmlt rmcogmls tjht oliaufmoltmremrnl haeh. Heroihl Hgmroihls hrm amss aobmay tn jhvm tjmehvnrhdam OA4:D YLP (rs84?3?:50) I/I cmlntypm rmahtovmtn Ihuihsohls. Vm OA4:D cmlntypm os tjnucjt tn mxpaholhpprnxoghtmay =0% ne tjm fosphroty ol trmhtgmlt nutingmsenr Heroihl Hgmroihls. Ntjmr stufoms jhvm sjnwl h strnlc

inrrmahtonl dmtwmml rodhvorol fruc mxpnsurm hlf YUT. Kol mt ha(4084)40rmpnrtmf rmimltay anwmr rodhvorol mxpnsurm ol HeroihlHgmroihls ingphrmf wotj Ihuihsohls tjht whs mxpaholmf dyhdmrrhlt rodhvorol pjhrghinbolmtois. Vmsm stufoms succmsttjht Heroihl Hgmroihls rmquorm h jocjmr olotoha rodhvorol fnsm.Vm Inlsmlsus Phlma rminggmlfmf tjht eurtjmr rmsmhrij dminlfuitmf tn ulfmrsthlf tjm anwmr trmhtgmlt rmspnlsm tjht osndsmrvhdam hirnss foffmrmlt sudsmts ne Heroihl Hgmroihls.

Vjm Mgmrcmlim ne Lmw Vjmrhpoms

Vm Inlsmlsus Phlma rmvomwmf rmimlt JIU iaoloiha trohas

wotj formit hitolc hltovorha trmhtgmlts motjmr ingdolmf wotjpmcoltmremrnl hlf rodhvorol hlf/nr oltmremrnl-ermm rmcogmls.Vmsm stufoms sjnw ogprnvmf iurm rhtms hlf dmttmr sofmmffmit prnams tjhl iurrmlt sthlfhrfs ne ihrm. Vm InlsmlsusPhlma ihaamf enr crmhtmr phrtoiophtonl ne Heroihl Hgmroihlsol iaoloiha trohas sn tjht mihiy hlf shemty ol tjos phtomltcrnup ihl dm gnrm rocnrnusay stufomf hlf ulfmrstnnf. Sotjtjm fmvmanpgmlt ne lnvma JIU frucs, rmsmhrij os lmmfmf tnfmtmrgolm wjmtjmr tjm mihiy ne tjmrhpy (o.m. iurm rhtms) woaainltolum tn olirmhsm ol Heroihl Hgmroihls.

Ytrhtmcoms Vjht Ihl Dm

]smf tn Tmfuim Fosphrotoms

Vm Inlsmlsus Phlma inliaufmf tjht h lugdmr ne strhtmcomsihl dm usmf tn rmfuim fosphrotoms dmtwmml Heroihl Hgmroihlshlf Ihuihsohls wotj ijrnloi JIU. Ht tjm rst amvma, hl HeroihlHgmroihl-spmioi ihgphocl os lmmfmf tn irmhtm hwhrmlmssrmchrfolc tjm drnhf rhlcm ne lmwmr rosbs hssniohtmf wotj JIUolemitonl ol Heroihl Hgmroihls. Yminlf, prnvofmrs ne haa rhimshlf mtjloiotoms rmquorm hfmquhtm mfuihtonl hlf trhololc hdnutrhioha fosphrotoms ol JIU mpofmgonancy, iaoloiha inursm hlftrmhtgmlt nutingms, hlf dhrromrs tn ihrm hlf trmhtgmlt.

Vm Inlsmlsus Phlma enulf tjht tjm rmimlt olirmhsms ol JIU

prncrhgs, pnaoioms hlf olotohtovms hasn mgdnfy h lugdmr nenppnrtulotoms tn rmfuim tjm JIU rosbs tjht iurrmltay mxostol tjm Heroihl Hgmroihl ingguloty. Lmvmrtjmamss, lmwgmhsurms hrm hasn lmmfmf.

Y]GGHT_

Vos mxmiutovm sugghry prnvofms nlay h emw ne tjm lfolcshlf rminggmlfhtonls erng tjm euaa rmpnrt, wjoij enaanws.



VJM JMPHVOVOY IITOYOY OL VJM HETOIHL

HGMTOIHL INGG]LOV_

DHIBCTN]LF

Vm mpostmgnancoiha enulfhtonls ne gmfoiolm jhvm lnwdmml mxphlfmf tn oliaufm h lnrghtovm inggotgmlt tntjm ijhrhitmrozhtonl, hlhaysos, hlf rmgmfohtonl ne jmhatjfosphrotoms. Fmspotm tjos phrhfocghtoi sjoet, jnwmvmr, tjmhituhaozhtonl ne tjos cnha os h ingpamx prnimss. Enr mxhgpam,jmphtotos I (JIU), h dannf-dnrlm vorha olemitonl tjht hffmitshpprnxoghtmay enur goaaonl Hgmroihls hlf wjoij hiinultsenr hpprnxoghtmay =0% ne aovmr trhlspahlts, os h inlfotonltjht os lnt gmrmay fosphrhtmay ghloemstmf hgnlc HeroihlHgmroihls, fosphrotoms hrm ndsmrvhdam hirnss tjm inltoluugerng sirmmlolc hlf fohclnsos tn trmhtgmlt gnfhaotoms hlftrmhtgmlt nutingms.

Yuij ioriugsthlims hrm ehr erng dmlocl. Hgmroihs iurrmltcandha sthtus hs tjm inultry wjnsm Crnss Fngmstoi Prnfuitne $8=.:=8 troaaonl pahims ot rst ol ghtmroha wmhatj jhs dmmlfrovml dy tjm quhaoty ne ots jughl ihpotha.48Vm prnfuitovoty

ne h inultrys jughl ihpotha os h eulitonl ne mfuihtonl hlftrhololc hs wmaa hs tjm jmhatj sthtus ne ots iotozmls. Mhraygnrthaoty hgnlc hly crnup rmfuims tjm prnfuitovoty netjm mltorm lhtonl. _mt, JIU os iansmay hssniohtmf wotj mhraygnrthaoty. Ay, Zolc, mt ha (4084),44ol hl hlhaysos ne fhth erng44 goaaonl fmhtj imrtoihtms erng 8??? tn 4003, ofmltomf8=,805 tntha fmhtjs erng jmphtotos I ol 4003. Hpprnxoghtmay4,59: nr 83.=% ne tjmsm fmhtjs wmrm Heroihl Hgmroihls. _mt,Heroihl Hgmroihls wmrm nlay 89% ne tjm ].Y. pnpuahtonl.Vus, Heroihl Hgmroihls jhf socloihltay jocjmr nffs nefmhtj fum tn JIU tjhl Sjotms. Yocloihltay, tjos stufyenulf tjht fmhtjs erng JIU ol 4003 mximmfmf tjm lugdmrne fmhtjs erng JOU. Dhsmf upnl tjmsm lfolcs, tjm hutjnrsinliaufmf tjht ijrnloi jmphtotos I, h fosmhsm tjht whsinlsmrvhtovmay rmpnrtmf hs hffmitolc hpprnxoghtmay 9.4 goaaonlpmrsnls ol 4004 (Hrgstrnlc, 4005),49os pnosmf tn durfmlHgmroihs jmhatjihrm systmg eurtjmr hs tjmsm olemitonls amhftn hl olirmhsm ol tjm oliofmlim ne iorrjnsos hlf jmphtnimaauahrihriolngh. Hatjnucj tjm Imltmrs enr Fosmhsm Inltrna hlfPrmvmltonl hlf JIU rmsmhrijmrs ol cmlmrha inltolum tn iotmtjos curm tnfhy, tjm prmvhamlim ne JIU ghy lnw dm mvmlahrcmr.46Vus, jmphtotos I os h pntmltohaay mxpansovm jmhatjinlfotonl tnwhrfs wjoij olsuiomlt httmltonl jhs dmmlformitmf. Snlc (4000)4=, utoaozolc minlngmtroi gnfmaolc,

mstoghtmf tjht erng 4080 tn 408?, formit mxpmlfoturms enrJIU gmfoiha smrvoims woaa rmhij $5.3 doaaonl. Sjml tjmolformit insts hssniohtmf wotj anst prnfuitovoty hrm oliaufmf,tjm insts woaa dm mvml gnrm sthccmrolc.

Jnwmvmr, wjoam ijrnloi jmphtotos I olemitonl ingprosmsh jocjay smronus jmhatj prndamg tjht jhs tjm pntmltoha nermfuiolc nr maogolhtolc tjm ahdnr enrim phrtoiophtonl rhtms neahrcm lugdmrs ne Hgmroihls, h sudsthltoha dnfy ne rmsmhrijsuccmsts tjht tjm fosphrhtm lhturm ne JIU ghcloms tjmpntmltoha jughl hlf lhlioha anssms hssniohtmf wotj tjosfosmhsm ol Heroihl Hgmroihl inggulotoms. Gmthpjnroihaayspmhbolc, rmahtovm tn Heroihl Hgmroihls hlf JIU, tjm jnusmos, olfmmf, nl rm, dut emw hrm thbolc lntoim ne tjm sgnbm hlftjm hsj.

Vm Lhtonlha Gmfoiha Hssniohtonl (LGH) inlvmlmf rmspmitmfgmfoiha hlf pudaoi jmhatj mxpmrt tn mfuihtm pnaoiyghbmrs,rmsmhrijmrs, pudaoi jmhatj niohas, inggulotoms, tjm gmfoh,hlf tjm cmlmrha pudaoi rmchrfolc tjm iurrmlt hlf ogpmlfolc

irosos ne jmphtotos I hgnlc Heroihl Hgmroihls.

VJM LHVONLHA GMFOIHAHYYNIOHVONL (LGH)

Vm Lhtonlha Gmfoiha Hssniohtonl (LGH) os tjm ahrcmsthlf nafmst lhtonlha nrchlozhtonl ol tjm wnraf rmprmsmltolcHeroihl-Hgmroihl pjysoiohls hlf tjm phtomlts tjmy smrvm.Vm LGH, nl dmjhae ne ots 90,000 gmgdmrs hlf ots phrtlmrs,os smmbolc tn fmvmanp h ingprmjmlsovm smt ne strhtmcoms tjht,wotj tjm suppnrt ne pjysoiohls hlf haaomf jmhatj prnemssonlhas,

woaa rmsuat ol gnrm inliausovm mvofmlim rmchrfolc rhioha/mtjloi jmphtotos I fosphrotoms hs wmaa hs rminggmlf fostolitstrhtmcoms enr tjmor rmfuitonl.

Vm LGH, h =08(i)(9) nrchlozhtonl jmhfquhrtmrmf ol Yoavmr Yprolc,Ghryahlf, os ingprosmf ne 890 aniha, sthtm, hlf rmconlha LGHhaohtms nr ijhptmrs anihtmf ol 65 sthtms. Gmgdmr pjysoiohlsprhitoim ol 46 spmiohaty hrmhs. Vm nrchlozhtonl os inggottmftn ogprnvolc tjm jmhatj sthtus hlf nutingms ne golnroty hlffoshfvhlthcmf pnpuahtonls tjrnucj prnemssonlha fmvmanpgmlt,ingguloty jmhatj mfuihtonl, hfvnihiy, hlf rmsmhrij, olphrtlmrsjop wotj emfmrha hlf provhtm hcmlioms hlf inrpnrhtonls.


8/40: | LHVONLHA GMFOIHA HYYNIOHVONL

Vm gmgdmrsjop ne tjm LGH os prmfngolhltay HeroihlHgmroihl pjysoiohls. Vm LGH os ingprosmf ne pjysoiohlsol tjm proghry ihrm spmiohatoms, hs wmaa hs ol haa ntjmr gmfoihahlf surcoiha sud- spmiohatoms, hihfmgoi gmfoiolm, goaothrygmfoiolm, hlf gmfoiha hfgolostrhtonl. LGH gmgdmrs smrvmh jocj lugdmr ne phtomlts wjn hrm Heroihl-Hgmroihl hlf/nr gmgdmrs ne ntjmr golnroty crnups. Pnnr, ulolsurmf,ulfmrolsurmf, hlf/nr phtomlts wjn hrm dmlmiohroms ne

Gmfoihof nr Gmfoihrm hrm nvmr-rmprmsmltmf hgnlc tjmphtomlts smrvmf dy LGHs gmgdmrsjop.

Vm LGH jhs hl mxtmlsovm lhtonlha, rmconlha, hlf anihaolerhstruiturm tn suppnrt hfvnihiy, jmhatj prngntonl hlffosmhsm prmvmltonl, trmhtgmlt, hlf rmsmhrij olotohtovms. LGHs890 sthtm hlf aniha haohtmf sniomtoms hirnss tjm inultry hrmnrchlozmf oltn sox rmconls prnvofolc hl nptogug struiturm enrtjm ogpamgmlthtonl ne prncrhgs tjht jhvm lhtonlha ogphit.

LGH gmgdmrs hrm hvhoahdam tn prnvofm spmiohaty mxpmrtosmenr siomltoi rmvomw, mvhauhtonl, hlf vhaofhtonl ne prnkmitprnpnshas hlf mffnrts tjrnucj 46 siomltoi smitonls. Vmsmsmitonls hrm; (8) Hmrnsphim hlf Goaothry Gmfoiolm2 (4) Haamrcy,Oggulnancy hlf Hstjgh2 (9) Hlmstjmsonancy2 (6) DhsoiYiomlim2 (=) Ingguloty Gmfoiolm hlf Pudaoi Jmhatj2 (5)Fmrghtnancy2 (3) Mgmrcmliy Gmfoiolm2 (:) Ehgoay Gmfoiolm2(?) Oltmrlha Gmfoiolm2 (80) Gmfoiha Lmurnsurcmry2 (88)Gmfoiha Hfgolostrhtonl2 (84) Ndstmtrois hlf Cylminancy2(89) Npjtjhagnancy2 (86) Nrtjnpmfois2 (8=) Ntnahrylcnancy2(85) Phtjnancy2 (83) Pmfohtrois2 (8:) Pjysoiha Gmfoiolm hlfTmjhdoaothtonl2 (8?) Pahstoi hlf Tminlstruitovm Yurcmry2 (40)Psyijohtry hlf Dmjhvonrha Yiomlims2 (48) Thfonancy2 (44)Yurcmry2 (49) ]rnancy2 hlf (46) Sngml Ol Gmfoiolm. Sotjolmhij ne tjm twmlty-enur smitonls, tjmrm os socloihlt ihphiotyhlf oltmrmst tn suppnrt hlf inlfuit ingguloty fosmhsm

prmvmltonl hlf mfuihtonlha nutrmhij prnkmits oliaufolc tjmprmvmltonl hlf trmhtgmlt ne JIU.

Vm nrchlozhtonlha struiturm ne tjm LGH prnvofms hlmsthdaosjmf erhgmwnrb ne inaahdnrhtovm aolbhcms wotjol wjoijpjysoiohls, hs LGHs proliopha crnup ne jmhatj prnemssonlhas,ihl dm gndoaozmf. Vrnucj tjos olerhstruiturm, pjysoiohls ihlhffrmss ghknr jmhatj ossums hlf ogpamgmlt lhtonlha jmhatjprncrhg olotohtovms hssniohtmf wotj JIU hlf ots rmahtmf in-gnrdofotoms. Vmsm pjysoiohls, hlf tjm jmhatj olstotutonls wotjwjoij tjmy hrm haohtmf, enrg h lhturha struiturm hlf gmfoihajngm enr hffrmssolc inlimrls tjht fosprnpnrtonlhtmay ogphitHeroihl-Hgmroihls hlf ntjmr ulfmrsmrvmf pnpuahtonls.

GMVJNFY;

LGHY JIU INLYMLY]YPHLMA PTNIMYY

Vm LGH ofmltomf bmy mxpmrts nl JIU olemitonl ernghihfmgoi imltmrs, provhtm prhitoims, hssniohtonls, rmsmhrijimltmrs, hlf pudaoi jmhatj mltotoms hlf olvotmf tjmg tn knol tjmJIU Inlsmlsus Phlma. Vm purpnsm ne tjm Inlsmlsus Phlma

whs tn rmvomw tjm lhtonlha ijhaamlcm ne jmphtotos I, mxhgolmtjm mvofmlim dhsm nl rhioha hlf minlngoi fosphrotoms ol tjoshrmh, hlf prnpnsm h lhtonlha rmspnlsm tn suij fosphrotoms tjhtihl dm ogpamgmltmf dy iaoloiohls, pnaoiyghbmrs, rmsmhrijmrs,pudaoi jmhatj hfvosnrs, ingguloty nrchlozhtonls, hlf tjmcmlmrha pudaoi. Vus, tjm thrcmtmf hufomlim enr tjos InlsmlsusPhlma Phpmr os quotm drnhf.

Vm npmrhtonlha struiturm enr tjm Inlsmlsus Phlma whsfmsoclmf tn hssmgdam h inaamitovm dnfy ne prhitotonlmrs,rmsmhrijmrs, hlf tjnucjt amhfmrs wotj mxtmlsovm blnwamfcm hlfmxpmromlim ol tjm hrmh ne JIU olemitonl. Vm sijnahrs smamitmfjhvm h fmgnlstrhtmf inggotgmlt tn phtomlt hlf pjysoiohlmfuihtonl. LGH sthff hlf inlsuathlts prnvofmf hfgolostrhtovm,ghlhcmgmlt, hlf fmvmanpgmlt suppnrt. Vm iaoloiha hlfhihfmgoi inlimrls ne prhitoiolc pjysoiohls wmrm rmprmsmltmf,hs wmaa hs tjm lmmfs hlf inlimrls ne Heroihl-Hgmroihlphtomlts. Vm dnfy ne tjm Inlsmlsus Phlma oliaufmf lhtonlhaayrminclozmf mxpmrts wjn prnvofmf blnwamfcm hlf mxpmrtosm nlbmy iaoloiha, rmsmhrij, hlf pnaoiy ossums ol tjm hrmh ne JIU. VmJIU Inlsmlsus Phlma woaa usm lfolcs erng tjos siomltoihaay

ingprmjmlsovm phpmr hlf ghbm pnaoiy rminggmlfhtonls tntjm LGH Jnusm ne Fmamchtms.

Vm Inlsmlsus Phpmr hlf ots rminggmlfhtonls woaa dmfossmgolhtmf tn LGH gmgdmr pjysoiohls, ntjmr jmhatj ihrmprnvofmrs, cnvmrlgmltha hlf lnl- cnvmrlgmltha hcmlioms,pnaoiy-ghbmrs hlf tjm gmfoh. Ot inlthols rminggmlfhtonlstjht ihl dm hfnptmf dy mhij bmy sthbmjnafmr.

JMPHVOVOY I;OVY PTMUHAMLIM

HLF OLIOFMLIM

JIU Prmvhamlim Thtms

Vm irosos ne jmphtotos I os mgdmffmf, ol phrt, ol tjm hdsmlimne vhaof hlf rmaohdam mstoghtms ne ots ghclotufm wotjol tjm]lotmf Ythtms. Enr mxhgpam, tjm Imltmrs enr Fosmhsm Inltrnahlf Prmvmltonl, Lhtonlha Imltmr enr Jmhatj Ythtostois, utoaozmstjm Lhtonlha Jmhatj hlf Lutrotonl Mxhgolhtonl Yurvmy(LJHLMY) tn mstoghtm tjm prmvhamlim ne vorha jmphtotos H,D, I, F, hlf M. Jnwmvmr, wjoam LJHLMY OOO, wjoij whs

ingpamtmf erng 8?::?6, rmpnrtmf tjm rst smt ne lfolcserng smrnancoi tmstolc, mvml tjm lfolcs erng tjos fhthsmt ghyjhvm ulfmr-rmpnrtmf tjm prmvhamlim ne tjos olemitonl solimJIU whs lnt fosinvmrmf mhray mlnucj enr ots oliausonl ol tjmLJHLMY OOO survmy pahllolc prnimss. LJHLMY OOO rmvmhamftjht hpprnxoghtmay 8.:% ne survmy rmspnlfmlts wmrm pnsotovmenr JIU enr tjm pmronf 8?::8??6.45Covml tjm lhtonlspnpuahtonl ne hpprnxoghtmay 450.9 goaaonl olfovofuhas ol 8??6,tjos rmprmsmltmf gnrm tjhl 6 goaaonl pmrsnls. Hl mstoghtmf 3=pmrimlt ne tjmsm pmrsnls fof lnt mxpmromlim spnlthlmnus JIUiamhrhlim hlf, hs h rmsuat, wmrm ijrnloihaay olemitmf.


9/40JMPHVOVOY I; H ITOYOY OL VJM HETOIHL HGMTOIHL INGG]LOV_ | ?

H sudsmqumlt hlhaysos ne JIU prmvhamlim rhtms usolcLJHLMY 8???4004 fhth rmvmhamf tjht 6.8 goaaonl Hgmroihlswmrm olemitmf wotj JIU hlf tjht 3=% nr 9.4 goaaonl ne tjmsmpmrsnls wmrm ijrnloihaay olemitmf. Yuij fhth msthdaosjmfJIU hs tjm lhtonls lugdmr nlm dannf-dnrlm vorha olemitonl.Olfmmf, tjos ponlmmr stufy dy Hrgstrnlc (4005)43os iotmfnetml hs h proghry snurim ne proghry fhth enr tjm prmvhamlimne JIU fmspotm tjm ehit tjht tjmsm lfolcs rmfflmit fhth enr

8???-4004. Enr mxhgpam, Tmol, Ygotj, Sottmldnrl mt ha (4084)4:utoaozm tjmsm sthtostois hs dhibcrnulf fhth enr tjmor iaoloihastufy. Yogoahray, Inlkmmvhrhg, Eromf, Kmffmrs mt ha (4005)4?usmftjm shgm mstoghtms ol msthdaosjolc tjm ghclotufm ne JIU.Aobmwosm, Gmaoh, Guor, GiInrm mt ha (4088)90msthdaosj tjmghclotufm ne ijrnloi jmphtotos I hs h ghknr jmhatj prndamgusolc tjm shgm iothtonl.

Olfmmf, mvml tjm IFI, Lhtonlha Imltmr enr JOU/HOFY, UorhaJmphtotos, YF & D Prmvmltonl, Fovosonl ne Uorha Jmphtotosiotms tjm lfolcs erng tjm lnw jostnroi Hrgstrnlc stufyhs tjm lhtonls nioha gmhsurm ne tjm prmvhamlim ne JIU.98Yuij rmaohlim upnl h lnw fhtmf stufy fnms lnt rmfflmit pnnrsijnahrsjop. Thtjmr, ot fniugmlts tjm pnvmrty ne fhth usmf olmsthdaosjolc vhaof hlf rmaohdam mstoghtms ne tjm drmhftj ne JIUhs h pudaoi jmhatj prndamg. Vm shturhtmf usm ne tjm Hrgstrnlc

stufy fmlms hl urcmlt lmmf enr tjm fmvmanpgmlt ne hiiurhtmhlf iurrmlt fhth nl tjm prmvhamlim nl JIU oliofmlim rhtms.Lmvmrtjmamss, tjos ponlmmr hlhaysos prnvofms dhsmaolm fhth enreuturm stufoms tjht gmhsurm tjm prmvhamlim ne JIU ol tjmHgmroihl pnpuahtonl.

Vm hlhaysos dy Hrgstrnlc mt ha (4005)94ne prmvhamlim rhtms ol4004 rmvmhas tjm phttmrls aostmf ol hdam 8.99

Vm Hrgstrnlc stufy enulf tjht JIU rhtms wmrm 800%gnrm prmvhamlt hgnlc Heroihl Hgmroihls (9.0%) tjhlhgnlc Ihuihsohls (8.=%).

Ne tjm mstoghtmf 6,050,000 pmrsnls mvmr olemitmf wotjJIU, 4,=30,000 nr 56.9% wmrm Ihuihsohls.

Ol inltrhst, ?40,000 ne tjm 6,050,000 pmrsnls, nr 44.3% netjnsm mvmr olemitmf wotj JIU wmrm Heroihl Hgmroihl.

Hpprnxoghtmay 450,000 nr 5.6% ne tjnsm mvmr olemitmf wotjJIU wmrm Gmxoihl-Hgmroihls.

Hpprnxoghtmay 89% ne tjm ]Y pnpuahtonl whs HeroihlHgmroihl erng 8???4004, dut Heroihl Hgmroihls wmrm44.3% ne JIU ihsms. Vus, Heroihl Hgmroihls wmrm 36.5%gnrm aobmay tn jhvm mvmr dmml olemitmf wotj JIU rmahtovmtn tjmor rmprmsmlthtonl ol tjm nvmrhaa pnpuahtonl.

Yogoahray, ?.6% ne Heroihl Hgmroihls 606? ymhrs naf jhfmvmr dmml olemitmf wotj ijrnloi JIU ingphrmf tn 9.:%ne Ihuihsohls. Vus, Heroihl Hgmroihls ol tjos hcm crnupwmrm 895.:% gnrm aobmay tn dm olemitmf wotj JIU.

Ynioha fmtmrgolhlts ne jmhatj pahy hl ogpnrthlt rnamol tjm jocjmr (p1.0=) JIU prmvhamlim rhtms ne HeroihlHgmroihls. Enr mxhgpam;

m prmvhamlim ne JIU hltodnfoms whs 9.4% enr pmrsnls

wotj olingms dmanw 800% ne tjm pnvmrty tjrmsjnaf hlf

nlay 8% enr pmrsnls wotj ehgoay olingms mquha tn nrcrmhtmr tjhl 400% ne tjm emfmrhaay fmlmf pnvmrty aolm.

us, tjm prndhdoaoty tjht hl ogpnvmrosjmf pmrsnl

wnuaf tmst pnsotovm enr JIU whs 440% jocjmr tjhl enrtjmor lnl-ogpnvmrosjmf inultmrphrt.

Ol 4004, tjm ahst ymhr ne tjm LJHLMY survmy usmf dy

Hrgstrnlc, tjm pnvmrty rhtm enr Heroihl Hgmroihls whs46.8%. Ihuihsohls jhf h pnvmrty rhtm ne 80.4%.

m prmvhamlim ne JIU hltodnfoms whs 4.:% enr pmrsnls

wotj emwmr tjhl twmavm ymhrs ne mfuihtonl dut nlay 8.9%

enr pmrsnls wotj gnrm tjhl 84 ymhrs ne mfuihtonl.

os rmprmsmltmf h 88=.6% fomrmlim.

Ol 4004, 40.:% ne Heroihl Hgmroihls hcm 4= hlf

nvmr jhf lnt crhfuhtmf erng jocj sijnna ingphrmftn 88.9% ne Ihuihsohls.

Ynurim; Ihaiuahtmf erng fhth enulf ol Hrgstrnlc CA, mt ha.Hll Oltmrl Gmf.40052 866(80);30=386, pcs 303:.

Ynurim; ].Y. Imlsus Durmhu, Iurrmlt Pnpuahtonl Yurvmy, 4004hlf 4009 Hlluha Ynioha hlf Minlngoi Yuppamgmlts.

Ynurim; ].Y. Imlsus Durmhu, Mfuihtonlha Httholgmlt ol tjm ].Y. 4004. Fmthoamf thdams. Vhdam 8h; Pmrimlt ne Jocj Yijnna hlf

Inaamcm Crhfuhtms ne tjm Pnpuahtonl 8= ymhrs hlf nvmr dy hcm,smx, rhim, hlf Josphloi nrocol, Ghrij 4004.

Ynurim; ].Y. Imlsus Durmhu, Ghrij 4008 hlf Ghrij 4004 IurrmltPnpuahtonl Yurvmy. Oltmrlmt Tmamhsm fhtm; Ghrij 48, 4009.

VHDAM 8; CTMHVMT JIU D]TFML OL HETOIHL HGMTOIHLY

Covml suij fosphrotoms ol prmvhamlim rhtms dy rhim/mtjloioty,pnvmrty sthtus, hlf mfuihtonl, nlm gust hsb Fn sogoahr trmlfshppmhr ol oliofmlim rhtms>



JIU Oliofmlim Thtms

Vm Lhtonlha Imltmr enr JOU/HOFY, Uorha Jmphtotos, YF, hlf D Prmvmltonl, Fovosonl ne Uorha Jmphtotos inaamits fhth nl tjm oliofmlimne JIU. Vm rhtm ne hiutm JIU whs 0.9 ihsms pmr 800,000 pnpuahtonls ol 4080, 96h rhtm tjht jhf dmml inlsthlt solim 4005. Jnwmvmr, tjm4088 fhthsmt rmpnrts tjht tjm oliofmlim ne hiutm JIU jhf olirmhsmf tn 0.6 ihsms pmr 800,000.9=hdam 4 sugghrozms tjos fhth.

VHDAM 4; TMPNTVMF IHYMY NE HI]VM JMPHVOVOY I,LHVONLHAA_ HLF D_ YVHVM ]LOVMF YVHVMY, 40034088

Ythtm 4080 4003 400: 400? 4080 4088% Heroihl Thtm (Ln.) Thtm (Ln.) Thtm (Ln.) Thtm (Ln.) Thtm (Ln.)Hgmroihl

Hahdhgh 45.4 0.4 (80) 0.9 (89) 0.4 (80) 0.8 (3) 0.= (49)

Hahsbh 9.9 0.8 (8) ] ] ] ] ] ] ] ]

Hroznlh 6.8 ] ] ] ] ] ] ] ] ] ]

Hrbhlshs 8=.6 0 (0) 0 (8) 0.8 (4) 0 (8) 0 (0)

Ihaoenrloh 5.4 0.4 (34) 0.8 (90) 0.8 (69) 0.8 (94) 0.8 (6:)

Inanrhfn 6.0 0.6 (40) 0.9 (86) 0.5 (4:) 0.6 (40) 0.= (4:)

Inllmitoiut 80.8 0.5 (40) 0.= (8?) 8.= (=9) 8.0 (93) 8.9 (63)

Fmahwhrm 48.6 ] ] ] ] ] ] ] ] ] ]

Fostroit ne Inaugdoh =0.3 ] ] ] ] 0.4 (8) 0.9 (4) ] ]Eanrofh 85.0 0.8 (85) 0.4 (94) 0.9 (=9) 0.9 (=5) 0.9 (56)

Cmnrcoh 90.= 0.4 (8:) 0.4 (85) 0.9 (98) 0.9 (94) 0.= (=9)

Jhwhoo 8.5 ] ] ] ] ] ] ] ] ] ]

Ofhjn .5 0.9 (6) 0.4 (9) 0.= (3) 0.3 (88) 0.: (84)

Oaaolnos 86.= 0.8 (85) 0.8 (80) 0 (5) 0 (8) 0 (5)

Olfohlh ?.8 0.4 (86) 0.4 (89) 0.9 (44) 0.6 (43) 8.9 (:6)

Onwh 4.? 0 (0) 0 (0) 0.6 (88) 0 0 0 (0)

Bhlshs =.? 0 (0) 0 (8) 0 (8) 0.8 (4) 0.9 (:)

Bmltuiby 3.: 0.3 (4?) 8.5 (5:) 8.= (56) 4.= (80?) 9.4 (864)

Anuosohlh 94.0 0.8 (6) 0.4 (?) 0.4 (?) 0.8 (6) 0.4 (3)

Gholm 8.4 0.8 (8) 0.4 (9) 0.4 (4) 0.4 (4) 0.? (84)

Ghryahlf 4?.6 0.9 (8=) 0.6 (44) 0.6 (49) 0.6 (46) 0.5 (9=)

Ghsshijusmtts 5.5 0.4 (80) 0.4 (89) 0.4 (80) 0.4 (89) 0.9 (49)

Goijochl 86.4 0.? (:?) 8.9 (84?) 0.6 (9=) 0.= (6=) 0.9 (94)

Gollmsnth =.4 0.= (4:) 0.6 (44) 0.9 (8=) 0.9 (85) 0.9 (83)

Gossossoppo 93.0 0.= (85) ] ] ] ] ] ] ] ]

Gossnuro 88.5 0.8 (9) 0 (4) 0 (0) 0.8 (5) 0.8 (:)

Gnlthlh .6 0.8 (8) 0.5 (5) 0.8 (8) 0.6 (6) 0.? (?)

Lmdrhsbh 6.= 0.8 (8) 0.8 (4) 0.4 (9) 0.8 (4) 0.8 (4)

Lmvhfh :.8 0.6 (?) 0.: (44) 0.4 (=) 0.9 (3) 0.6 (80)

Lmw Jhgpsjorm 8.8 ] ] ] ] ] ] ] ] ] ]

Lmw Kmrsmy 89.3 8.8 (?=) 0.3 (58) 0.8 (3) 0.9 (4:) 0.5 (=9)

Lmw Gmxoin 4.8 0.9 (=) 0.9 (=) 0.9 (5) 0.3 (86) 0.3 (86)

Lmw _nrb 8=.? 0.4 (6=) 0.4 (69) 0.9 (=9) 0.9 (=0) 0.9 (=4)

Lnrtj Ihrnaolh 48.= 0.4 (83) 0.= (65) 0.9 (46) 0.6 (9?) 0.5 (50)

Lnrtj Fhbnth 8.4 0 (0) 0 (0) 0.9 (4) 0 (0) 0 (0)

Njon 84.4 0.4 (40) 0.9 (60) 0.4 (45) 0.8 (80) 0.8 (5)

Nbahjngh 3.6 8.6 (6?) 0.= (40) 0.3 (43) 8.8 (68) 8.6 (=9)

Nrmcnl 8.: 0.6 (85) 0.5 (49) 0.= (8?) 0.= (8?) 0.= (40)

Pmllsyavhloh 80.: 0.9 (96) 0.4 (43) 0.9 (9?) 0.4 (45) 0.9 (9=)

Tjnfm Osahlf =.3 0.: (:) ] ] ] ] ] ] ] ]

Ynutj Ihrnaolh 43.? 0 (0) 0.8 (6) 0 (8) 0 (8) 0 (8)

Ynutj Fhbnth 8.9 ] ] ] ] ] ] ] ] ] ]Vmllmssmm 85.3 0.5 (93) 0.6 (4:) 0.= (99) 0.3 (65) 8.9 (:9)

Vmxhs 88.: 0.9 (53) 0.4 (=?) 0.8 (95) 0.8 (9=) 0.8 (93)

]thj 8.8 0.4 (=) 0.6 (84) 0.4 (5) 0.6 (80) 0.6 (80)

Umrgnlt 8.0 8.= (?) 0.4 (8) 0.4 (8) 0.9 (4) 8.0 (5)

Uorcoloh 8?.6 0.8 (:) 0.8 (:) 0.8 (80) 0.4 (89) 0.9 (4=)

Shsjolctnl 9.5 0.9 (8:) 0.6 (4=) 0.9 (44) 0.6 (4=) 0.5 (68)

Smst Uorcoloh 9.6 8.0 (8:) 8.4 (44) 8.3 (98) 8.8 (48) 4.= (65)

Sosinlsol 5.9 0 (8) 0.8 (9) 0.8 (9) 0.4 (80) 0.9 (8=)

Syngolc .: 0 (0) 0 (0) 0 (0) 0 (0) 0.6 (4)

Vntha 84.5 0.9 (:6?) 0.9 (:33) 0.9 (3:8) 0.9 (:=0) 0.6 (8,44?)

Ynurim; IFI Lhtonlha Imltmr enr JOU/HOFY, Uorha Jmphtotos, YVF & VD Prmvmltonl, Yurvmoaahlim enr Uorha Jmphtotos ]lotmf Ythtms 4088,Vhdam 6.82 hlf tjm ].Y. Durmhu ne tjm Imlsus, Xuoib Ehits dy Ythtm (hiimssmf Ympt. 4089).



Hatjnucj tjm 4088 fhthsmt os olingpamtm, imrthol trmlfsol tmrgs ne ijhlcms ol tjm rmpnrtmf ihsms ne hiutm JIUhrm succmstmf. Enr mxhgpam, ot hppmhrs tjht tjm lugdmr nermpnrtmf hiutm ihsms ne JIU olirmhsmf. Jnwmvmr, tjos lfolcos olinliausovm solim mocjt sthtms fof lnt sudgot hiutm JIUrmpnrts hlf ntjmr sthtms sudgottmf nlay phrtoha fhth. Yminlf,tjm lfolc ne h 66.3% olirmhsm ol tjm lugdmr ne JIU ihsmsghy ulfmrsthtm hiutm JIU trmlfs hgnlc Heroihl Hgmroihls

dmihusm ghly ne tjm sthtms tjht fof lnt sudgot rmpnrts, hlf/nr nlay sudgottmf phrtoha rmpnrts, oliaufm socloihlt lugdmrsne Heroihl Hgmroihls. Enr mxhgpam, tjm Fostroit ne Inaugdoh,hl hrmh tjht os =0.3% Heroihl Hgmroihl, jhs olingpamtm fhth.Gossossoppo, h sthtm tjht os 93.0% Heroihl Hgmroihl hasn jhsolingpamtm fhth. Ol hffotonl, jocj pmrimlthcms ne HeroihlHgmroihls aovm ol gnst ne tjnsm sthtms ol wjoij tjm oliofmlimrhtm ne hiutm jmphtotos olirmhsmf, o.m. Hahdhgh, Cmnrcoh,Ghryahlf, Lnrtj Ihrnaolh, Uorcoloh, mllmssmm, mti. Vmsmfhth wmhblmssms succmst hl urcmlt lmmf enr hiiurhtm hlfingpamtm hiutm JIU rmpnrtolc erng haa sthtms. Ol hffotonl, ot osogpnrthlt tjht mtjloioty dm oliaufmf ol haa rmpnrtmf hiutm ihsmsne JIU sn tjht fosphrotoms ihl dm ofmltomf.

Ihsms ne JIU hrm fmlmf enr rmpnrtolc purpnsms usolctwn irotmroh. Sjml ijrnloi aovmr fosmhsm os fohclnsmf hlfsudsmqumlt tmstolc rmvmhas tjm prmsmlim ne JIU, h iaoloihairotmroh os usmf enr ihsm fmlotonl. Ol inltrhst, h ahdnrhtnry

irotmroh os shof tn dm hppaomf wjml hly ne tjm enur hatmrlhtovmJIU sirmmlolc tmsts hrm usmf. Jnwmvmr, tjmsm tmsts fn lntfostolcuosj iurrmlt JIU olemitonls erng tjnsm tjht jhvmdmml rmsnavmf. Vus, IFI hasn inaamits fhth nl iurrmlt nrphst JIU. Vos fhth hrm usmf hs h prnxy enr ijrnloi jmphtotos.Hiinrfolc tn IFIs gnst rmimlt rmpnrt,958:=,?3? ijrnloiJIU rmpnrts wmrm rmimovmf dy IFI ol 4088 dhsmf upnltjm 96 sthtms phrtoiophtolc ol IFIs survmoaahlim mffnrts.

Jnwmvmr, enr h rhlcm ne rmhsnls, nlay tml sthtms Ihaoenrloh,Anuosohlh, Gossnuro, Gnlthlh, Nrmcnl, Pmllsyavhloh, YnutjIhrnaolh, Ynutj Fhbnth, Umrgnlt hlf Syngolc prnvofmftjmor inlsmlt enr tjmor fhth tn dm oliaufmf ol IFIs phst nrprmsmlt JIU fhth inaamitonl mffnrts. Hffotonlhaay, sngm sthtmssudgottmf rmpnrts nl JIU phst nr prmsmlt dut fof lnt covmtjmor inlsmlt enr tjmsm ihsms tn dm usmf enr IFIs ijrnloiJIU rmpnrtolc. Vos fmiosonl dy tjm ntjmr 46 sthtms rmfuimftjm lugdmr ne ijrnloi jmphtotos ihsm rmpnrts hvhoahdam enrtjm purpnsm ne trhibolc JIU trmlfs erng 8:=,?3? rmpnrtstn h gmrm =4,4:5 rmpnrts. Dhsmf upnl hl hlhaysos ne tjos fhthsn tjht prmvonusay rmpnrtmf ihsms inuaf dm fmamtmf, ot whsfmtmrgolmf tjht 94,636 lmway rmpnrtmf ihsms ne ijrnloi JIU

niiurrmf ol 4088. Jnwmvmr, h euaa =6.4% ne tjmsm rmpnrts wmrmolingpamtm rmahtovm tn rhim/mtjloioty. (Nlay 8/80 nr 8% wmrmolingpamtm rmahtovm tn cmlfmr hlf hcm crnup). hdam 9 os hrmpaoihtonl ne IFIs lfolcs erng tjos hlhaysos.


12/40



Vm fhth rmpnrtmf wmrm erng nlay : sotmsInanrhfn,Inllmitoiut, Lmw _nrb, Lmw _nrb Ioty, Nrmcnl, hlf YhlErhliosin. Vmrmenrm, tjm fhth ol hdam 9 hdnvm ghy hasn ulfmr-rmpnrt tjm oliofmlim ne JIU, phst nr prmsmlt, dy rhim/mtjloiotydmihusm, mximpt enr Lmw _nrb hlf Yhl Erhliosin, HeroihlHgmroihls hrm fosprnpnrtonlhtmay ulfmr- rmprmsmltmf ol tjmntjmr cmncrhpjoi hrmhs.

Gnrmnvmr, hdam 9 succmsts tjht Heroihl Hgmroihls wmrm nlay:.9% ne tjm tntha rmpnrtmf ihsms ne ahdnrhtnry inlrgmf JIU,phst nr prmsmlt. Jnwmvmr, dmihusm =6.4% ne rhim/mtjloiotyfhth hrm gossolc, tjm gnst hpprnprohtm fmlngolhtnr enr suij hihaiuahtonl os lnt tjm 94,636 tntha lmway rmpnrtmf ihsms. Thtjmr,ot os tjm 86,:38 ihsms enr wjoij rhim/mtjloioty whs rmpnrtmf.Vus, Heroihl Hgmroihls, tjm mtjloioty fmsoclhtmf nl 4,5:8ihsms, wmrm 8:.8% ne tjm lmway rmpnrtmf ihsms ne JIU, phstnr prmsmlt. Fmspotm tjm prndamgs tjht httmltuhtm tjos fhthsmt, Heroihl Hgmroihls wmrm nvmr-rmprmsmltmf hgnlc tjnsmpmrsnls wotj JIU, phst nr prmsmlt. Ol 4080, jnwmvmr, Heroihl

Hgmroihls wmrm 48.8% ne tjm 8=,83? ihsms ne jmphtotos, phstnr prmsmlt, enr wjoij rhim/mtjloioty whs rmpnrtmf.93Oliofmlimrhtms enr ijrnloi jmphtotos tjht wmrm ihaiuahtmf erng tjm hdnvmthdam ghy dm ol lmmf ne rmvosonl. Vm Olstotutm ne Gmfoiolmslnw iahssoi rmpnrt, Jmphtotos hlf Aovmr Ihlimr; H LhtonlhaYtrhtmcy enr Prmvmltonl hlf Inltrna ne Jmphtotos D hlf I,prnvofms h fosiussonl ne sngm ne tjm ehitnrs tjht rmfuim tjmquhaoty ne vorha jmphtotos rmpnrtolc dy sthtms hlf aniha jmhatj

fmphrtgmlts (4080).9:

JIU Fmhtj Thtmsdy Thim/Mtjloioty

Fhth erng tjm Yurvmoaahlim enr Uorha Jmphtotos ]lotmf Ythtms,4080, hasn rmvmha tjht Heroihl Hgmroihls fomf erng JIU ol4006, 400=, 4005, 4003, hlf 400: hlf 400?, hlf 4080 ht rhtmstjht wmrm socloihltay crmhtmr tjhl haa ntjmr rhioha crnups enrwjng fhth wmrm inaamitmf.9?hdam 6 fmsirodms tjmsm trmlfs.

VHDAM 6; JIU FMHVJY

Fmgncrhpjoi 4005 4003 400: 400? 4080

ijhrhitmrostoi Ln. Thtm Ln. Thtm Ln. Thtm Ln. Thtm Ln. Thtm

Hcm Crnup (ymhrs)

096 84: 0.0? 898 0.0? 846 0.0? 885 0.0: 883 0.0:

9=66 8,0:9 4.6? ??? 4.94 :3: 4.03 :4: 8.?? 384 8.39

6==6 =,:04 89.69 =,?93 89.=9 =,3=: 84.?: =,65? 84.45 =,838 88.6?

==56 6,8?8 89.4: =,86= 8=.34 =,?53 83.38 5,5:9 8?.48 3,698 40.93

5=36 8,=00 3.?9 8,548 :.93 8,30? :.6? 8,:46 :.33 8,?08 :.3=



Ol 400:, Heroihl Hgmroihls fomf erng JI U ht h rhtm tjhtwhs 3:.?% jocjmr tjhl tjmor Ihuihsohl inultmrphrts.Jnwmvmr, hdam 6 olfoihtms tjht wjoam JIU fmhtj rhtms pmr800,000 pmrsnls fmirmhsmf enr dntj Ihuihsohls hlf HeroihlHgmroihls erng 400: tn 4080, tjm fosphroty ol JIU rhtmsolirmhsmf. Heroihl Hgmroihls wmrm ?8.5% gnrm aobmay tnfom erng JIU ol 4088 tjhl ol 400: wjml tjm fosphrotywhs nlay 3:.?% jocjmr. Hffotonlhaay, tjm mljhlimf rhim/

mtjloioty rmpnrtolc olfoihtms tjht Hgmroihl Olfohls/HahsbhlLhtovms wmrm mvml gnrm aobmay tn fom erng JIU tjhl HeroihlHgmroihls ol 4088. Sotj h fmhtj rhtm ne ?.?0 pmr 800,000,Lhtovm Hgmroihls fomf erng JIU 86=.3% gnrm netml tjhlIhuihsohls. Hffotonlhaay, Ahtolns fomf erng JIU 5?.=%gnrm netml tjhl Ihuihsohls. Vmrm ghy dm hrmhs ol wjoijinaahdnrhtonls tn hffrmss JI U fosphrotoms ihl niiur hirnsstjmsm jocjay hffmitmf rhioha/mtjloi crnups.

OGPTNUOLC VJMHII]THI_ NE JIU

PTMUHAMLIM HLFOLIOFMLIM THVMY

H lugdmr ne rminggmlfhtonls ihl dm ghfm ol tmrgs ne tjmirmhtonl ne crmhtmr hiiurhiy ol JIU prmvhamlim hlf oliofmlimfhth. Eorst, JIUs sthtus hs tjm gnst inggnl dannf dnrlmfosmhsm rminggmlfs ots oliausonl ol ntjmr pudaoiay inaamitmffhthsmts sn tjht fhth hrm hvhoahdam enr trohlcuahtonl. Enrmxhgpam, tjm IFI Tosb Ehitnr Yurvmoaahlim Yurvmy gocjtinaamit fhth nl JIU. Yogoahray, IFIs Lhtonlha JmhatjOltmrvomws Yurvmy inuaf hasn inaamit suij fhth.

Yminlf, tjm Inlsmlsus Phlma rminggmlfs tjht tjm IFIsLhtonlha Lntohdam Fosmhsms Yurvmoaahlim Yystmg ossum lmwcuofmaolms enr usm dy jmhatj fmphrtgmlts ht tjm sthtm hlfaniha amvma enr tjm rmpnrtolc ne dntj ijrnloi jmphtotos D hlfI. Ihphioty-duoafolc crhlts ghy dm lmmfmf ht tjm sthtm hlfaniha amvmas sn tjht gnrm hiiurhtm hlf gnrm ingpamtm fhth hrminaamitmf hlf trhlsgottmf tn IFIs systmg.

Vorf, wjoam tjm Inlsmlsus Phlma os hwhrm tjht IFI jhsharmhfy thbml lmw gmhsurms tn olvmstochtm JIU nutdrmhbs,nutdrmhbs rmghol ulfmrrmpnrtmf hlf rmpnrtmf nut-drmhbs nejmphtotos I hrm lnt hawhys olvmstochtmf tjnrnucjay.

Vm rnam ne nutdrmhb olvmstochtonl ol ofmltoeyolc hlfogprnvolc hiiurhiy ol JIU rmpnrtolc os wmaa-blnwl. Ol4088, enr mxhgpam, tjmrm wmrm 8,44? ihsm rmpnrts ne hiutm

JIU. Jnwmvmr, h euaa 663 nr 95.93% ne tjmsm ihsm rmpnrts amettjm qumroms rmchrfolc rosb dmjhvonrs hlf pnssodam mxpnsurmsulhlswmrmf. Olfmmf, nlay =89 nr 68.3% ne tjmsm ihsmsofmltomf nlm nr gnrm rosb dmjhvonrs/mxpnsurms. Gnrmnvmr,ne tjm 3:4 rmpnrts tjht oliaufmf rosb ehitnr rmspnlsms, 45?nr 96.6% olfoihtmf h 800% hdsmlim ne blnwl rosb dmjhvonrs/mxpnsurms. Hffotonlhaay, fhth wmrm lnt foshccrmchtmf dy rhim/mtjloioty.60Vus, olvmstochtonls haanw IFI tn aolb hiutm JIU

rhtms wotj tjmor ihusms hlf tn fmtmrgolm tjm fmcrmm tn wjoijntjmr pmrsnls erng tjmsm shgm mlvornlgmlts ghy dm hffmitmf.Vmsm olvmstochtonls ghy dm hs sogpam hs oltmrvomwolc tjmolfmx phtomlt nr tjmy ghy niiur tjrnucj gnrm ingpamx gmhls.Lmvmrtjmamss, tjm iurrmlt phuioty ne fhth nl rosb dmjhvonrs/nutdrmhbs oaaustrhtm h lmmf tn rmvomw hlf strmlctjml tjos hrmh.

Vm LGH rminggmlfs tjm usm ne trhololc hlf mfuihtonl tnolirmhsm hwhrmlmss ne tjm ogpnrthlim ne nutdrmhb rmpnrtolc hswmaa hs drnhf mfuihtonl hdnut JIU rosb ehitnrs, trhlsgossonl,prmvmltonl, ihusms ne smronus aovmr fosmhsm, sirmmlolc hlffohclnsos, hlf ntjmr tnpois. Aniha hlf sthtm jmhatj fmphrtgmltsghy ahulij nlaolm ghrbmtolc mffnrt tn olirmhsm usm ne tjmor

lmw tnnas enr tjm suppnrt ne jmphtotos olvmstochtonls. Gmhsurmshrm lmmfmf tjht mlsurm tjht rhim/mtjloioty os hawhys rmpnrtmf,hs wmaa.

Enurtj, hffotonlha rmsmhrij os oggmfohtmay lmmfmf tjht upfhtmstjm Hrgstrnlc stufy.

Eolhaay, mxostolc fhth tjht hrm vhaof hlf rmaohdam ihl dm usmf tnfrhw httmltonl tn tjm urcmliy ne pronrotozolc JIU hs h jmhatjossum. Enr mxhgpam, Ay mt ha (4084)68enulf tjht tjmrm wmrm8=,405 fmhtjs erng jmphtotos I ol 4003 dut nlay 84,395 fmhtjserng JOU olemitonl. Vus, ol 4003, hl olfovofuha rhlfngaysmamitmf whs 8:.5% gnrm aobmay tn fom erng JIU tjhl erngJOU. Ol hffotonl, wjoam IFI mstoghtms tjht 8,86:,400 pmrsnlshcm 89 hlf nafmr hrm aovolc wotj JOU olemitonl, 9.4 goaaonlpmrsnls hrm aovolc wotj JIU olemitonl.64Sjoam IFI mstoghtmstjht 403,500, nr 8:.8% ne pmrsnls aovolc wotj JOU hrm ulhwhrmne tjmor olemitonl, 3=% ne pmrsnls aovolc wotj JIU fn lnt blnwtjht tjmy hrm olemitmf. Drnhfmr pudaoioty ne tjmsm typms ne fhthos rmquormf tn olenrg tjm pudaoi hlf jmhatjihrm inggulotomsne tjm urcmliy ne prncrhgs tn hffrmss JIU ol cmlmrha hlfstrhtmcoms tn fmirmhsm JIU rhioha/mtjloi fosphrotoms.

JIU; YITMMLOLCHLF FOHCLNYOY

Iurrmlt cuofmaolms hasn rminggmlf JIU sirmmlolc hlffohclnsos ne tjm ht-rosb pnpuahtonls aostmf ol hdam =.


15/40JMPHVOVOY I; H ITOYOY OL VJM HETOIHL HGMTOIHL INGG]LOV_ | 8=

Ne tjm 565 ihsm rmpnrts tjht jhf olenrghtonl hdnutolkmitonl-fruc usm, =?.?% (l79:3) lntmf usm ne tjmsmfrucs.

Ne tjm 546 ihsm rmpnrts tjht inltholmf olenrghtonl hdnutniiuphtonlha mxpnsurms, 8.6% (l7?) olvnavmf pmrsnlsmgpanymf ol h gmfoiha, fmltha, nr ntjmr maf olvnavolcinlthit wotj jughl dannf.

Ne tjm =56 ihsm rmpnrts tjht jhf olenrghtonl hdnutrmimopt ne fohaysos nr h boflmy trhlspahlt, 0.6% (l74)olfoihtmf phtomlt rmimopt ne fohaysos nr h boflmy trhlspahlt.

Ne tjm =48 ihsm rmpnrts tjht jhf olenrghtonl hdnut

surcmry, 88.?% (l754) wmrm hgnlc pmrsnls wjn jhfulfmrcnlm surcmry.

Ne tjm =4= ihsm rmpnrts tjht oliaufmf olenrghtonl hdnutlmmfam stoibs, ?.0% (l763) olfoihtmf hiiofmltha lmmfamstoib/puliturm.

Ne tjm 63: ihsm rmpnrts tjht jhf olenrghtonl hdnutlugdmr ne smx phrtlmrs, 98.6% (l78=0) olvnavmf pmrsnlswotj 4 smx phrtlmrs.

Ne tjm 86= ihsm rmpnrts erng ghams tjht oliaufmfolenrghtonl hdnut smxuha prmemrmlims/prhitoims, 6.8%(l75) olfoihtmf smx wotj hlntjmr ghl.

Ne tjm 885 ihsm rmpnrts tjht jhf olenrghtonl hdnutsmxuha inlthit, 84.?% (l78=) olvnavmf pmrsnls rmpnrtolcsmxuha inlthit wotj h pmrsnl wotj inlrgmf nr suspmitmfjmphtotos I olemitonl

Ne tjm 885 ihsm rmpnrts tjht jhf olenrghtonl hdnut

jnusmjnaf inlthit, 5.?% (l7:) olfoihtmf jnusmjnafinlthit wotj sngmnlm wotj inlrgmf nr suspmitmfjmphtotos I olemitonl.

Ynurim; IFI, Lhtonlha Imltmr enr JOU/HOFY/Uorha Jmphtotos, YVF,hlf VD Prmvmltonl, Fovosonl ne Uorha Jmphtotos, Uorha JmphtotosYurvmoaahlim, ]lotmf Ythtms, 4088

Vm gnrm tjhl 9=0,000 pmrsnls wjn iurrmltay rmimovmjmgnfohaysos69 hs wmaa hs tjnsm wjn jhvm rmimovmfjmgnfohaysos ol tjm phst2

Ijoafrml dnrl tn JIU-pnsotovm gntjmrs (tn hvnoffmtmitolc ghtmrlha hltodnfy, ijoafrml sjnuaf lnt dmtmstmf dmenrm hcm 8: gnltjs)2

Pmrsnls wotj hdlnrgha tmst rmsuats nl tjm aovmr wjmltmstmf enr hlntjmr rmhsnl2

Haa pmrsnls wotj JOU olemitonl2 hlf

Phtomlts wotj socls nr sygptngs ne aovmr fosmhsm2 (m.c.,hdlnrgha aovmr mlzygm tmsts).

Pmrsnls dnrl dmtwmml 8?6= hlf 8?5=2

Olkmitonl fruc usmrs ingprosm 50% ne haa lmway fohclnsmfihsms ne JIU2

Oltrhlhsha fruc usmrs2

Pmrsnls olihrimrhtmf2

Pmrsnls wjn mlchcm ol jocj-rosb smxuha dmjhvonrsoliaufolc; guatopam phrtlmrs, smx wotj hl JIU-olemitmfpmrsnl2 jhvolc ulprntmitmf smx2 nr hl olkmitonl fruc usmr2

Pmrsnls wotj blnwl mxpnsurms tn JIU, suij hs;

Jmhatjihrm wnrbmrs hetmr lmmfam stoibs olvnavolc JIU-

pnsotovm dannf2

Tmiopomlts ne dannf nr nrchls erng h fnlnr wjn ahtmr

tmstmf JIU-pnsotovm2

Ynurim; IFI EHXs enr Jmhatj Prnemssonlhas, Ahst upfhtmf Kulm?, 400? Hvhoahdam ht jttp;//www.ifi.cnv/jmphtotos/JIU/JIUehq.

jtg. Hiimssmf 03/4?/80.

VHDAM =; PMTYNLY SJN YJN]AF DM TN]VOLMA_ IJMIBMFENT JIU OLEMIVONL

Vm lmmf enr sirmmlolc crnups suij hs tjnsm aostmf os eurtjmr jocjaocjtmf dy IFIs hlhaysos ne hituha ihsm rmpnrts erng tjmYurvmoaahlim enr Uorha Jmphtotos ]lotmf Ythtms, 4088. hdam 5 rmpnrts lfolcs nl hiutm jmphtotos I dy rosb ehitnrs.

VHDAM 5; TMPNTVMF IHYMY NE HI]VM JMPHVOVOY I D_ TOYBEHIVNT/MZPNY]TM ]LOVMF YVHVMY, 4088



Pmrsnls Dnrl Erng 8?6= tn 8?5=; HgmroihsGnst Ht-Tosb Crnup

Vm IFI ossumf rminggmlfhtonls enr dortj injnrt sirmmlolcol 4084. Vm ].Y. Prmvmltovm Ymrvoims hsb Enrim suppnrtmfIFIs rminggmlfhtonl tjht jmhatjihrm pahls hlf tjmorprnvofmrs nffmr nlm-togm JIU tmstolc tn haa pmrsnls oltjm hcm injnrt 8?6=- 8?5= ol 4089.66Vm Inlsmlsus Phlma

strnlcay suppnrts tjos rminggmlfhtonl hlf urcms oggmfohtmingpaohlim wotj tjos formitovm. Tmol mt ha (4084)6=succmsttjht dortj-injnrt rhtjmr tjhl rosb-dhsmf sirmmlolc nlay, wjmlingdolmf wotj sthlfhrf trmhtgmlt enr JIU-olemitmf pmrsnls,ihl pntmltohaay prmvmlt :4,900 fmhtjs nvmr tjm lmxt smvmrha

ymhrs hlf, hs h rmsuat, cmlmrhtm inst-shvolcs.

Vmrm hrm rhioha/mtjloi fosphrotoms wotjol tjm 8?6= tn 8?5=injnrt crnups. Hs tjm fhth iotmf erng tjm Hrgstrnlc stufyolfoihtm, ?.6% ne Heroihl Hgmroihls hcm 606? jhf dmmlolemitmf wotj JIU, dut nlay 9.:% ne Ihuihsohls. Hiinrfolcay,Heroihl Hgmroihls ol tjos hcm crnup wmrm 895.:% gnrmaobmay tn dm JIU olemitmf. Vus, tjmrm os h phrtoiuahr lmmf

tn gnlotnr dortj injnrt sirmmlolc utoaozhtonl hlf ogphit nlJIU ihsm ofmltoihtonl, gnrdofoty, hlf gnrthaoty hgnlcHeroihl Hgmroihls.

Olkmitonl Fruc ]smrs

Hs ihl dm smml ol hdam =, iurrmlt prhitoim cuofmaolms rminggmlfJIU sirmmlolc enr haa pmrsnls wjn jhvm olkmitmf oaaoiot frucsht hlytogm, oliaufolc tjnsm wjn hrm iurrmlt usmrs hlf tjnsmwjn ghy jhvm olkmitmf sudsthlims nlay nlim nr rmgntmay oltjmor aoemtogm. Vht os, tjos irotmronl os hppaoihdam tn tjnsm wjnsmolkmitonl fruc usm niiurrmf fmihfms hcn hs wmaa hs rmimltay.

Fhth erng tjm 4088 Lhtonlha Yurvmy nl Fruc ]sm hlf Jmhatjrmvmhamf tjht ol 4088, 645,000 Hgmroihls wmrm jmrnolfmpmlfmlt.65Vos rmprmsmlts hl olirmhsm ne 8:% erng tjm958,000 jmrnol fmpmlfmlt pmrsnls ofmltomf ol 4080 hlf h5:.8%olirmhsm erng tjm 486,000 jmrnol fmpmlfmlt pmrsnlsol 4003.63Vos crnwtj ol tjm jmrnol fmpmlfmlt pnpuahtonlsuccmsts h irotoiha lmmf enr crmhtmr hiimss JIF tmstolc tjrnucjphrtlmrsjops wotj trmhtgmlt imltmrs, jngmamss sjmatmrs, hlfntjmr olstotutonls tjht smrvm olkmitolc fruc usmrs (OF]). Yuijphrtlmrsjops ihl dm usmf tn mxphlf JIU sirmmlolc enr OUfruc usmrs ol cmlmrha. Vm lmway hvhoahdam rhpof JIU hltodnfytmsts ghy dm phrtoiuahray hppaoihdam enr tmstolc foiuat tnhiimss hlf trhlsomlt pnpuahtonls suij hs OU fruc usmrs.

Jnwmvmr, tjm Inlsmlsus Phlma rminggmlfs tjht olkmitonlfruc usmrs hs wmaa hs pmrsnls wjn jhvm mvmr mlchcmf olhly fruc usm ntjmr tjhl ghrokuhlh dm inlsofmrmf jocjrosb pnpuahtonls. Hs gmltonlmf, tjm Hrgstrnlc stufy hasnfosinvmrmf tjht ntjmr fruc usmrs, mximpt ghrokuhlh jhf hlJIU prmvhamlim rhtm ne 9.=% rmahtovm tn 3/80 ne 8% enr pmrsnlswjn jhf ln fruc usm nr nlay ghrokuhlh fruc usm.6:Vus,tjos crnup whs 600% gnrm aobmay tn jhvm hl JIU olemitonltjhl pmrsnls wjn fof lnt usm hly frucs nr wjn nlay usmfghrokuhlh. Vos prmvhamlim rhtm trhlsahtmf tn hl mstoghtmf?50,000 mvmr olemitmf pmrsnls lhtonlwofm.

JIU hlf Dannf Vrhlseusonls

Hs os blnwl, jmgnpjoaoh hlf haaomf inlfotonls, dammfolcfosnrfmrs sminlfhry tn pahtmamt hdlnrghaotoms, fossmgolhtmfoltrhvhsiuahr inhcuahtonl, hlf ntjmr inlfotonls ghy rmquormtjm usm ne ianttolc ehitnr inlimltrhtms. Oe tjmsm prnfuits wmrmrmimovmf dmenrm 8?:3, prm-sirmmlolc enr JIU whs lnt usmf.Vus, ot os rminggmlfmf tjht pjysoiohls oltrnfuim qumstonlstn tjmor phtomlts rmchrfolc rmimopt ne dannf ianttolc ehitnrinlimltrhtms, dannf trhlseusonls, hlf snaof nrchl trhlspahltsdmenrm 8?:3. Vmsm prm-sirmmlolc qumstonls woaa haanw enrproghry ihrm pjysoiohls tn quoibay hlf miomltay hssmsswjmtjmr tmstolc enr JIU olemitonl ghy dm ol nrfmr.

Olghtms ne Inrrmitonlha Ehioaotoms

Smoldhug, Aymrah hlf Ghrcnaos (4009)6?erng tjm Imltmrs enrFosmhsm Inltrna hlf Prmvmltonl oltrnfuimf sthrtaolc mvofmlimtjht suppnrts tjm lmmf tn strmlctjml dntj JIU sirmmlolc hlftrmhtgmlt hgnlc iurrmlt hlf phst olghtms. Vos stufy enulftjht hpprnxoghtmay 85% tn 68% ne pmrsnls ol Hgmroihs khoashlf prosnls jhf dmml mxpnsmf tn tjm JIU vorus hlf 84% tn9=% wmrm ijrnloihaay olemitmf. Ymvml goaaonl pmrsnls mltmrmf,wmrm rmtholmf, hlf/nr amet tjm irogolha kustoim systmg mhij ymhrfurolc tjm ahttmr ymhrs ne tjm 8??0s. Vmsm mx-olghtms irmhtmf htrmgmlfnus rmsmrvnor enr tjm trhlsgossonl ne tjm JIU vorus.

Yphuafolc hlf Vnghs (4084)=0olfoihtm tjht furolc tjmiurrmlt fmihfm, gnrm tjhl ? goaaonl pmrsnls mltmr hlf mxoterng khoas hlf prosnls mhij ymhr. Vos irogolha kustoim trhieurtjmr olirmhsms nppnrtulotoms enr tjm trhlsgossonl ne tjmJIU olemitonl tn tjm lnlolstotutonlhaozmf pnpuahtonl. VmInlsmlsus Phlma rminggmlfs tjht haa pmrsnls dm tmstmf enrJIU ht hfgossonl hlf fosijhrcm erng h inrrmitonlha ehioaoty.

Ntjmr Yirmmlolc Ossums

JIU sirmmlolc os h amss aolmhr prnimss tjhl os tjm ihsm enrntjmr gmfoiha inlfotonls. Enr mxhgpam, wjml JIU hltodnfysirmmlolc os pnsotovm, ot os hasn lmimsshry tn inlrg JIUolemitonl wotj hl JIU TLH tmst hlf tn ofmltoey JIUcmlntypm (C). Fohs, Jhjl, Fmawhrt mt ha (4088),=8ol hlhlhaysos ne JIU cmlntypms ol h shgpam ne 6500 pmrsnls wotjJIU olemitonl, fosinvmrmf tjht wjoam JIU C8 rmgholmf tjmgnst inggnl hgnlc Heroihl Hgmroihls hlf pmrsnls dnrldmenrm 8?30, tjos whs lnt tjm ihsm wotj ynulc, JIU-olemitmfpmrsnls lnr wotj Ihuihsohls. Vht os, ntjmr cmlntypms wmrmndsmrvhdam ol tjmsm sudpnpuahtonls.

Yogoahray, JIU tmstolc sjnuaf dm usmf ol inlkulitonl wotjsirmmlolc tn fmtmrgolm wjmtjmr hl JOU in-olemitonl mxosts oe JOUsthtus os ulblnwl. Jhfochl, hlf Bnttoaoa (4088)=4succmst tjht suijsirmmlolc os lmmfmf dmihusm tjm prncrmssonl hlf ghloemsthtonl neJIU foffmrs wjml JOU/JIU in-olemitonl mxosts. Yolim HeroihlHgmroihls ingprosm =0.9% ne haa JOU- olemitmf pmrsnls, fuhasirmmlolc os phrtoiuahray ogpnrthlt enr tjos pnpuahtonl.

Vmsm lfolcs succmst tjht ollnvhtovm prncrhgs hlfstrhtmcoms hrm lmmfmf tn olirmhsm JIU sirmmlolcs. Ol



hffotonl, tjm Inlsmlsus Phlma rminggmlfs tjht mxostolcingguloty-dhsmf prncrhgs tjht smrvm ht-rosb sud-pnpuahtonlsnffmr JIU mfuihtonl hlf sirmmlolc tn oliaufm jngmamsslmssprncrhgs, hainjna hlf ntjmr fruc trmhtgmlt prncrhgs,nrchlozhtonls tjht prnvofm jmgnfohaysos, prncrhgs tn rmfuimrosby smxuha dmjhvonrs, hlf ntjmr smrvoims. Dntj iaomlts hlfsthff ne prncrhgs enr tjmsm ht-rosb pnpuahtonls rmquormdmttmr mfuihtonl. Eolhaay, Dhdy Dnngmrs, Hgmroihs gnst

hffmitmf hcm injnrts, ihl dm thrcmtmf tjrnucj hl oltmlsovmhwhrmlmss ihgphocl tjht frovms tjmg tn hiimss tjm nlm-togmtmstolc fmsirodmf ol tjm Kulm 4089 ].Y. Prmvmltovm hsb EnrimTminggmlfhtonl Ythtmgmlt.

Vmsm rminggmlfhtonls hrm ogpnrthlt mspmiohaay wjml tjmsud-pnpuahtonl ne oltmrmst os Heroihl Hgmroihls. rnnsbol,Lhvhrrn, Soll mt ha (4003),=9ol h stufy ne 6,603 ijhrts erngenur proghry ihrm sotms, twn ingguloty iaolois, hlf twnhihfmgoihaay- nromltmf proghry ihrm prhitoims ol tjm Iotyne Pjoahfmapjoh, enulf socloihlt rhioha/mtjloi fosphrotomsol JIU sirmmlolc. Ypmioihaay, ln fniugmlthtonl whspahimf ol tjm gmfoiha rminrfs enr gnrm tjhl :0% ne phtomlts

rmchrfolc wjmtjmr tjmy jhf mvmr mlchcmf ol olkmitonl frucusm. Hffotonlhaay, ?=% ne phtomlts wmrm lnt qumromf rmchrfolcwjmtjmr tjmy jhf mvmr rmimovmf h trhlseusonl. Oltmrmstolcay,Heroihl Hgmroihls wmrm gnrm aobmay tn jhvm suij olenrghtonlol tjmor ams tjhl whs tjm ihsm wotj tjmor Ihuihsohlinultmrphrts. Jnwmvmr, wjml Heroihl Hgmroihls tmstmfpnsotovm enr JIU olemitonl, tjmy wmrm amss aobmay tn dm rmemrrmftn h sud- spmiohaost enr trmhtgmlt. Yuij lfolcs olfoihtm hlmmf enr pjysoiohls tn dm mfuihtmf hdnut JIU rosb ehitnrs hlfsirmmlolc cuofmaolms.

HETOIHL HGMTOIHLYHLF JIU VTMHVGMLV

Hl mxhgolhtonl ne iurrmlt aotmrhturm rmvmhas tjht JIUfosphrotoms hasn mxtmlf oltn tjm hrmh ne trmhtgmlt. Kmffmrs(4003)=6prnvofms h ingprmjmlsovm rmvomw ne tjm aotmrhturmnl JIU trmhtgmlt fosphrotoms enr tjm pmronf 8??0400=. Hinltmlt hlhaysos ne tjm aotmrhturm rmvmhamf tjht foffmrmltohanutingms dy rhim/mtjloioty mxost ol smvmrha hrmhs. Eorst, tjmsthtm ne tjm olemitonl ht prmsmlthtonl hlf ots prncrmssonl nvmrtjm aoem iyiam ghy foffmr. Yminlf, hiutm jmphtotos I iamhrs amssnetml ol Heroihl Hgmroihls rmlfmrolc tjos sud-pnpuahtonlsudkmit tn h jocjmr ijrnloioty rhtm. Vorf, Heroihl Hgmroihls

hrm gnrm aobmay tn jhvm inlfotonls tjht inltrholfoihtmtrmhtgmlt. Enurtj, Heroihl Hgmroihls hrm hasn amss rmspnlsovmtn oltmremrnl-dhsmf trmhtgmlt.

Heroihl Hgmroihls hlfJIU Iamhrhlim Thtms

Jmphtotos I, aobm h lugdmr ne ntjmr fosmhsms, sngmtogmsspnlthlmnusay iamhrs. Ymmff (4004)==, enulf tjht hpprnxoghtmay90% ne pmrsnls wotj hiutm jmphtotos I olemitonl mxpmromlim

spnlthlmnus iamhrhlim. Vus, ot dmingms ogpnrthlt tn hsbFn rhioha/mtjloi fosphrotoms mxost ol JIU spnlthlmnusiamhrhlim rhtms>

Vnghs (4000)=5enulf tjht lhturha iamhrhlim rhtms hrmhpprnxoghtmay 95.6% ol lnl-Heroihl Hgmroihls hlf ?.9% olHeroihl Hgmroihls. Vus, hl JIU olemitonl lhturhaay iamhrs4?8.6% gnrm netml ol Ihuihsohls. Vnghs sudsmqumltay

rmpnrtmf tjht tjos foffmrmlim os mxpaholmf tn h ahrcm mxtmltdy cmlmtoi vhrohtonl ol h solcam luiamntofm pnaygnrpjosglmhr tjm OA4:D cmlm anius nl ijrngnsngm 8? (400?) =3. VmOA4:D YLP I/I cmlntypm whs hssniohtmf wotj jocjmr rhtms nespnlthlmnus iamhrhlim dut whs socloihltay amss ermqumlt olHeroihl Hgmroihls tjhl ol Ihuihsohls. Eoety-tjrmm pmrimlt nepmrsnls wotj tjm I/I cmlntypm mxpmromlimf spnlthlmnus JIUiamhrhlim ingphrmf tn 4:% enr pmrsnls wotj ntjmr cmlntypmcrnups. Sjml Heroihl Hgmroihls wmrm enulf tn ehaa wotjol tjmI/I cmlntypm crnup, tjmor JIU vorha iamhrhlim rhtms wmrm hasnjocjmr tjhl Heroihl Hgmroihls ol ntjmr cmlntypm crnups. Vmhutjnrs inliaufmf tjht suij lfolcs succmst tjht tjm OA4:Dcmlm os h proghry fmtmrgolhlt ne JIU iamhrhlim rhtms wjmtjmr

tjm iamhrhlim prnimss os lhturha hlf/nr gmfoihaay olfuimf.

Fuccha, Von, Snkiob mt ha. (4089)=:hasn snucjt tn ofmltoeyh cmlmtoi dhsos enr pmrsnls wjnsm JIU olemitonls fof lntspnlthlmnusay rmsnavm. Vmsm rmsmhrijmrs usmf h shgpamne ?8? pmrsnls wotj spnlthlmnus rmsnautonl, hlf 86:4olfovofuhas wjnsm JIU olemitonls pmrsostmf. Vmy inlrgmftjm jypntjmsos tjht doncmlmtoi vhrohdams wmrm npmrhtovm.Ijrngnsngms 8?q89.89 lmhr tjm OA4:D cmlm anius hlf5p48.94 hrnulf JAH iahss OO cmlms jhf haamam ermqumliy

vhrohtonls tjht mxpaholmf 86.?% hlf 8=.:%, rmspmitovmay, ne tjmfosphrotoms ol JIU rmsnautonl dmtwmml Heroihl Hgmroihlshlf Ihuihsohls.

Cm, Emaahy, Vngpsnl mt ha (400?)=?inlfuitmf h stufyne JIU vorha iamhrhlim hetmr pmcoltmremrnl hlf rodhvoroltrmhtgmlt enr JIU cmlntypm 8. Uhrohtonl ol tjm ermqumliyne tjm OA4:D YLP I/I cmlntypm inuaf mxpahol hpprnxoghtmay=0% ne tjm fovmrsoty ol JIU iamhrhlim rhtms dmtwmml HeroihlHgmroihls hlf Ihuihsohls hetmr trmhtgmlt. Hchol, eurtjmrrmsmhrij os lmmfmf tn hffrmss, gnrm euaay, tjm ogpaoihtonls nefoffmrmlims ol tjm trmhtgmlt ne JIU ol Heroihl Hgmroihls hslmwmr tjmrhpoms mgmrcm.

VTMHVGMLV

MEEMIVOUMLMYY;40084088

Dntj tjm typm ne trmhtgmlt hlf trmhtgmlt mffmitovmlmss hsgmhsurmf dy sustholmf vorha rmspnlsm (YUT) jhvm ijhlcmfinlsofmrhday nvmr togm. hdam 3 fmsirodms tjos prncrmss.


18/408: | LHVONLHA GMFOIHA HYYNIOHVONL

H bmy qumstonl dmingms, Jhvm tjmsm hatmrlhtovmpjhrghinancoi hpprnhijms rmsuatmf ol fosphrhtm trmhtgmltnutingms dy rhim/mtjloioty>

Sjoam Heroihl Hgmroihls hrm netml ulfmr-rmprmsmltmf ol tjmiaoloiha trohas usmf tn hssmss tjm mihiy ne JIU gmfoihtonls,h crnwolc dnfy ne fhth succmsts tjht fosphroty ol trmhtgmltrmspnlsms fn niiur dy rhim. Enr mxhgpam, furolc tjm togmpmronf 4008 tn 4088 wjml wmmbay fnshcms ne h PmcOELhaeh- 4h(60bf) nr PmcOEL haeh-4d(84bf) ol inlkulitonl wotjnrha TDU whs tjm hiimptmf sthlfhrf ne ihrm enr cmlntypm8 olemitonl (tjm cmlntypm tjht os gnst inggnl ol Heroihl

Hgmroihls), YUT rhtms wmrm anwmr tjhl tjm 64-65% tjhtprmvhoamf hgnlc ntjmr trmhtgmlt-lhvm phtomlts.50,58Olfmmf,rmsmhrij dy Guor, Dnrlstmol, hlf Boaamldmrc (4006) inlrgmfanwmr trmhtgmlt rmspnlsm rhtms enr Heroihl Hgmroihls.54

Ol tjm UOTHJMP-I stufy Inlkmmvhrhg, Eromf, Kmffmrs, mt ha(4005)59snucjt tn rm-hssmss prmvonus lfolcs tjht sustholmf

vornancoi rmspnlsms wotj pmcoltmremrnl hlf rodhvorol foffmrmfdy rhim/mtjloioty. Vos rm-hssmssgmlt whs prngptmf dy twnehitnrs; 8) tjm ulfmr-rmprmsmlthtonl ne Heroihl Hgmroihls oltjm olotoha iaoloiha trohas olvnavolc pmcoltmremrnl hlf rodhvoroltrmhtgmlt, hlf 4) tjm ehit tjht twn ahrcmr trohasKmffmrs, Jnwmaa

mt ha, (4006)56hlf Guor mt ha (4006)5=wmrm fmsiroptovm nerhioha/mtjloi rmspnlsm rhtm fosphrotoms wotjnut hl hlhaysos neihusm. UOTHJMP-I mlrnaamf 8?5 Heroihl Hgmroihls hlf 40=Ihuihsohls wotj JIU cmlntypm O ht guatopam stufy sotms hlfenulf h sustholmf vornancoi rmspnlsm ne =4% enr Ihuihsohlshlf 4:% enr Heroihl Hgmroihls (P1.0008). Vus, Ihuihsohlswotj JIU wmrm :=.3% gnrm aobmay tn hijomvm gmfoihtonl-dhsmf vorha iamhrhlim tjhl wmrm tjmor sogoahray trmhtmf HeroihlHgmroihl inultmrphrts.

Kol mt ha (4084)55hlhayzmf nutingms enr smvmlty-nlm (38)Heroihl Hgmroihls hlf 36 Ihuihsohls wjn wmrm olemitmf

wotj JIU cmlntypm 8. Dntj crnups ne phtomlts wmrm jocjayhfjmrmlt tn dntj pmcoltmremrnl hlf wmocjt-dhsmf rodhvorol.Lmvmrtjmamss, tjm Heroihl Hgmroihls jhf socloeoihltayanwmr rodhvorol pahsgh inlimltrhtonls ht wmmbs 8, 4, hlf6 furolc trmhtgmlt wotj pmcoltmremrnl hlf rodhvorol. Hpnpuahtonl pjhrghinbolmtoi stufy sjnwmf tjht tjm anwmrrodhvorol mxpnsurm ol Heroihl Hgmroihls whs httroduthdamtn h ahrcmr vnaugm ne fostrodutonl. Hlntjmr stufy dytjmsm hutjnrs rmvmhamf tjht Heroihl Hgmroihls wmrm amssaobmay tjhl Ihuihsohls tn hijomvm tjm tjrmsjnaf rodhvorolmxpnsurm amvmas hssniohtmf wotj tjm YUT gnrm inggnlwotj pmcoltmremrnl hlf rodhvorol trmhtgmlt. jmor rmsuats

VHDAM 3; HL NUMTUOMS NE IJHLCMY OL JIU VTMHVGMLV

_mhr Vjmrhpy YUT

8??88??: Ythlfhrf

OEL Gnlntjmrhpy enr 5 gnltjs 5%

OEL Gnlntjmrhpy enr 84 gnltjs 85%

8??:4008 OEL+TDU enr 5 gnltjs 96%

OEL+TDU enr 84 gnltjs 64%

40084088 PMC-OEL enr 84 gnltjs 9?%

PMC-OEL+TDU enr 84 gnltjs =?%

4088prmsmlt Formit-hitolc hltovorhas+PMC- OEL+TDU 30%+

Euturm Vjmrhpoms Vjmrhpoms Mxpmitmf Dmlmts

Yminlf cmlmrhtonl JIU POs Jocjmr YUT rhtms Emwmr sofm mffmits

Luiamnsofm/ Luiamntofms oliaufolc amss hlmgoh

hlf lmutrnpmloh Lnl-luiamnsofm/lnl-luiamntofms pnaygmrhsm oljodotnrs

Lnlstruiturha prntmol =h oljodotnrs Ogprnvmf YUT rhtms oldntj trmhtgmlt hlf

Lnvma OELs trmhtgmlt lhvm phtomlts

Iyianpjoaol oljodotnrs Ntjmr

Ynurim; Inlstruitmf dy LGH erng fhth enulf ol tjm enaanwolc snurims; 8) Snraf Chstrnmltmrnancy Nrchlozhtonl Candha Cuofmaolms,Fohclnsos, ghlhcmgmlt hlf prmvmltonl ne jmphtotos I, Hproa 4089, pc 862 4) _mm JY, Ijhlc GE, Pnijh I2 mt ha. ]pfhtm nl tjm ghlhcmgmlthlf trmhtgmlt ne jmphtotos I vorus olemitonl; Tminggmlfhtonls erng tjm Fmphrtgmlt ne Umtmrhls Hffhors Jmphtotos I Tmsnurim ImltmrPrncrhg hlf tjm Lhtonlha Jmphtotos I Prncrhg Nim,Hgmroihl Knurlha ne Chstrnmltmrnancy. Khl. 4084, Una 806, pcs. =84


19/40JMPHVOVOY I; H ITOYOY OL VJM HETOIHL HGMTOIHL INGG]LOV_ | 8?

succmstmf tjht iurrmlt wmocjt-dhsmf rodhvorol cuofmaolmswmrm lnt nptogug enr Heroihl Hgmroihls wjn hppmhr tnrmquorm h jocjmr rodhvorol fnsm. jos ghy mxpahol tjm anwmrmeeoihiy ne JIU prntmhsm oljodotnr tropam tjmrhpy enr JIUcmlntypm 8 ol Heroihl Hgmroihls.

VTMHVGMLV YHEMV_

OYY]MY; 4008-4088HLF DM_NLF

Sjoam nlm proghry trmhtgmlt ossum furolc tjm 40084088pmronf imltmrmf nl trmhtgmlt mffmitovmlmss hs gmhsurmf dyrmspnlsm rhtms, hlntjmr trmhtgmlt ossum whs shemty. Vht os,wjml tmstolc rmvmhamf tjm prmsmlim ne JIU olemitonl, phtomltswmrm rmemrrmf enr eurtjmr mvhauhtonl hlf trmhtgmlt dy hprnvofmr wotj mxpmrtosm ol tjmsm hrmhs tn fmtmrgolm wjmtjmrphtomlts inuaf dm shemay trmhtmf.

Gmaoh, Guor, GiInlm, mt ha (4088),53usolc fhth erng tjmOlfovofuhaozmf Fnsolc Mihiy Umrsus Eaht Fnsolc tn HssmssNptogha Pmcyahtmf Oltmremrnl Vmrhpy (OFMHA) iaoloiha troha,enulf tjht 60.4% (l7?54), nr 9:3 Heroihl Hgmroihls ehoamftjm sirmmlolc mvhauhtonl. Nlay 4:% ne lnl- Heroihl Hgmroihlphrtoiophlts fof sn. Heroihl Hgmroihls wmrm gnrm aobmay tjhlwjotms tn dm olmaocodam fum tn lmutrnpmloh (86% vmrsus 9%, P 10.008), hlmgoh (3% vmrsus 6%, P 1 0.04), mamvhtmf cauinsm (:%

vmrsus 9%, P 1 0.008), hlf mamvhtmf irmhtololm (=% vmrsus 8%,P 1 0.008).

Vm inlstotutonlha lmutrnpmloh ndsmrvmf ol Heroihl Hgmroihlsjhs dmml ofmltomf hs h dhrromr tn phrtoiophtonl ol iaoloiha trohasne JIU wotj ghly stufoms mxiaufolc olfovofuhas wotj hdsnautmlmutrnpjoas 1 8=00. n nvmringm tjos dhrromr, ntjmr stufomsjhvm anwmrmf tjm iut nff tn 1 8400 wotjnut hly hpphrmltolirmhsm ol hfvmrsm mvmlts furolc trmhtgmlt. Vus, rmemrrhaenr eurtjmr mvhauhtonl hlf ghlhcmgmlt sjnuaf lnt dm fmlomffum tn lmutrnpmloh hlf ntjmr pmropjmrha dannf iynpmlohs(tjrngdniytnpmloh, hlmgoh). Olfmmf, ot ghy olfoihtm gnrmhfvhlimf aovmr fosmhsm hlf hl mvml crmhtmr lmmf enr gmfoihahttmltonl.

Jnwmaa, Kmffmrs, Ihssofy mt ha (4005)5:hlhayzmf fhth erng 3:Heroihl Hgmroihl phtomlts wotj JIU cmlntypm 8 olemitonl.Vm phttmrl ne gmfoihtonl ingpaoihtonl whs hl oltmrmstolc nlm.Ihrmeua gmfoihtonl gnlotnrolc rmsuatmf ol fnshcm hfkustgmlts

enr pmcoltmremrnl haeh-4h wjml lmutrnpmloh niiurrmf ol hprnpnrtonl ne tjnsm phtomlts trmhtmf wotj rodhvorol wjmlhlmgoh whs fohclnsmf. Jnwmvmr, tjm olvmstochtnrs inliaufmftjht tjos trmhtgmlt gmt shemty hlf tnamrhdoaoty sthlfhrfswjml usmf wotj Heroihl Hgmroihls wotj JIU olemitonls.Inlkmmvhrhg mt ha (4005)5?hasn enulf ln fosphrotoms ol tjmoliofmlim ne fnshcm gnfoihtonls, gmfoihtonl fosinltoluhtonlhlf/nr ntjmr shemty ossums hs gmhsurmf dy tjm niiurrmlim nehfvmrsm nutingms dy rhim/mtjloioty.

JIU VTMHVGMLV;4088 HLF DM_NLFLMSMT VJMTHPOMY

Ol Ghy 4088, tjm EFH hpprnvmf tjm usm ne twn JIUprntmhsm oljodotnrs paus PmcOEL hlf TDU hs tjm gnst rmimlt

ingdolhtonls tn dm inlsofmrmf hs tjm sthlfhrf ne ihrm enr haaihtmcnroms ne JIU cmlntypms 8-olemitmf phtomlts wjn jhvmharmhfy fmvmanpmf ingpmlshtmf aovmr fosmhsm. Sjml fhtherng iaoloiha trohas ne tjmsm lmwmr trmhtgmlts hrm hlhayzmf,ot rmvmhas tjht tjm YUT rhtms hrm socloihltay jocjmr wjml haaenrgs ne tropam tjmrhpy hrm usmf. Jhs tjm mffmitovmlmss ne JIUtrmhtgmlt enr Heroihl Hgmroihls hs wmaa hs ntjmr pnpuahtonlsdmml olirmhsmf hs h rmsuat ne tjmsm lmwmr tjmrhpoms>

VHDAM :; PTNCTMYYOL JIU VTMHVGMLV;

YUTY D_ VTMHVGMLV V_PM

Ynurim; Guor, Hlfrmw, Inlsmlsus Phlma Gmmtolc Prmsmlthtonl, 4089

Tmsmhrij dy Pnnrfhf, GiInlm, hlf Dhinl (4088)30rmvmhastjht sngm ne tjm lmwmr tjmrhpoms socloihltay hffmit YUT rhtmshirnss h rhlcm ne phtomlt typms. ]solc h fnudam-daolf stufytjht oliaufmf ?9: lnl-Heroihl Hgmroihl phrtoiophlts hlf 8=?Heroihl Hgmroihls, Pnnrfhf, GiInlm, Dhinl mt ha. (4088),38hssmssmf tjm ogphit ne hffolc dnimprmvor tn pmcoltmremrnl haeh-4d hlf rodhvorol upnl trmhtgmlt nutingms enr pmrsnls wotjultrmhtmf ijrnloi JIU cmlntypm 8 olemitonl.

Ol hffotonl, tjos stufytjm Ymrolm Prntmhsm Oljodotnr Vmrhpy4 nr Yprolt-4 trohahasn hssmssmf wjmtjmr hatmrolc tjmtrmhtgmlt pmronf hffmitmf trmhtgmlt nutingms hs gmhsurmf dysustholmf vornancoi rmspnlsm rhtm. hdam ? fmsirodms lfolcs dyrhim/mtjloioty enr mhij crnup.

Smmbs

:0

50

60

40

0

OEL 46 SBY OEL 6: SBY OEL TDU PMC/TDU PMC/TDU +POs

Oltmremrnl Oltmremrnl Oltmremrnl Pmcoltmremrnl/ Pmcoltmremrnl/



VHDAM ?; VJM OGPHIV NE DNIMPTMUOT ]PNL VTMHVGMLVN]VINGMY D_ THIM/MVJLOIOV_

Lnl-HeroihlHgmroihls HeroihlHgmroihlsYUT YUT

Crnup 8 (Inltrna Crnup)Pahimdn+Pmcoltmr- emrnl rodhvorol enr66 wmmbs 60% 49%Crnup 4Dnimprmvor paus,pmcoltmremrnl-rodhvorol enr 46 wmmbs 53% 64%Crnup 9Dnimprmvor+Pmcoltmr-emrnl enr 66wmmbs 5:% =9%

Hs hdam ? rmvmhas, tjm hffotonl ne Dnimprmvor tn tjm trmhtgmltrmcogm jhs socloihltay ogprnvmf sustholmf vornancoi rmspnlsmrhtms enr lnl-Heroihl Hgmroihls hlf enr Heroihl Hgmroihls.Hatjnucj Heroihl Hgmroihl rmspnlsm rhtms rmghol anwmrtjhl enr tjmor inultmrphrts erng ntjmr mtjloi crnups, tjm

ogprnvmgmlt ol rmspnlsm rhtms jhs dmml crmhtmr enr HeroihlHgmroihls. Enr mxhgpam, Crnup 9 jhf rmspnlsm rhtms tjht wmrm30% jocjmr tjhl Crnup 8 enr lnl-Heroihl Hgmroihls. EnrHeroihl Hgmroihls, tjmsm rmspnlsm rhtms wmrm 890.6% jocjmr.Vm hutjnrs fof lnt foshccrmchtm fhth nl hfvmrsm nutingms oltjos stufy dy rhim/mtjloioty.

mahprmvor, aobm dnimprmvor, os hlntjmr ne tjm lmw prntmhsmoljodotnrs tjht fmaovmrs ogprnvmf nutingms (Aou mt ha. 4084)34.hdam 80 ingphrms rmspnlsm rhtms enr dnimprmvor hlf tmahprmvor

VHDAM 80; DNIMPTMUOT HLF

VMAHPTMUOT YUT (%)

Ynurim; Pnnrfhf, E, Khindsnl, OG, mt ha. LMKG 4088

Hs tjm hdnvm lfolcs olfoihtm, tjm usm ne dntj Dnimprmvor hlfmahprmvor ol ingdolhtonl wotj PMC/TDU os hssniohtmf wotj hlYUT rhtm hfvhlthcm. hdam 88 fmsirodms nutingms erng dntjdnimprmvor hlf tmahprmvor wjml goaf hlf/nr hfvhlimf drnsos

hrm prmsmlt.

Ot os ogpnrthlt tn lntm tjht Heroihl Hgmroihl rmspnlsm rhtmshasn ogprnvmf wjml mahprmvor whs usmf ol ingdolhtonlwotj PMC/TDU. Vm HFUHLIM trohas wmrm fmsoclmf tn tmsttjm mihiy ne tjm tropam ingdolhtonl-UT+PmcOEL+TDUnvmr tjrmm foffmrmlt rmcogmls: wmmbs ne UT+46 wmmbsne PmcOEL hlf TDU2 84 wmmbs ne UT+46 -6: wmmbs ne

:0

50

60

40

0

Dnimprmvor Vmahprmvor

PMC/TDU PMC/TDU + PO

VHDAM 88

Ytrhtmcy YUT %

Dhsm Ihsm (dnimprmvor simlhron)

Goaf drnsosYthlfhrf Vjmrhpy . . . . . . . . . . . . . . . . . . . . . . . 9:OA4:D-cuofmf tropam tjmrhpy . . . . . . . . . . . . . . =3]lovmrsha tropam tjmrhpy . . . . . . . . . . . . . . . . . . 58

Hfvhlimf drnsos

Ythlfhrf tjmrhpy . . . . . . . . . . . . . . . . . . . . . . . . 94OA4:D-cuofmf tropam tjmrhpy . . . . . . . . . . . . . .6:]lovmrsha tropam tjmrhpy . . . . . . . . . . . . . . . . . . =8

Vmahprmvor simlhron

Goaf drnsosYthlfhrf tjmrhpy . . . . . . . . . . . . . . . . . . . . . . . . 9:OA4:D-cuofmf tropam tjmrhpy . . . . . . . . . . . . . .59]lovmrsha tropam tjmrhpy . . . . . . . . . . . . . . . . . .30

Hfvhlimf drnsosYthlfhrf tjmrhpy . . . . . . . . . . . . . . . . . . . . . . . . 94OA4:D-cuofmf tropam tjmrhpy . . . . . . . . . . . . . .=6]lovmrsha tropam tjmrhpy . . . . . . . . . . . . . . . . . .50

Ynurim; Aou Y, Ioprohln, AM, Jnanfloy G, mt ha. LmwPrntmhsm Oljodotnrs enr tjm Vrmhtgmlt ne Ijrnloi JmphtotosI; H Inst- Mffmitovmlmss Hlhaysos.Hllhas ne OltmrlhaGmfoiolm, 4084 p. 4:=.



PmcOEL hlf TDU2 hlf PmcOEL+TDU+pahimdn enr 6: wmmbs.Vm rmspnlsm rhtms enr haa HFUHLIM phrtoiophlts wmrm 5?%,3=%, hlf 66%. Heroihl Hgmroihls, aobm Ihuihsohls, wmrmgnst rmspnlsovm tn tjm 84 wmmb trmhtgmlt rmcogml. SjoamIhuihsohls hijomvmf hl YUT ne 3=% rmahtovm tn 66% enrtjnsm rmimovolc PmcOEL/TDU+pahimdn, Heroihl Hgmroihlshijomvmf h YUT ne 54% rmahtovm tn 4=-99% enr tjnsm wjn tnnbPmcOEL+TDU+pahimdn.39 Vus, tjm rmspnlsm rhtm ogprnvmf

dy 30.=% enr haa phrtoiophlts hlf 86:% tn :3.?% enr HeroihlHgmroihl troha phrtoiophlts.

Vm rmsuats erng Pjhsm 9 trohas jhvm dmml mvml gnrmmlinurhcolc rmahtovm tn YUT rhtms. Jnwmvmr, wjoam HeroihlHgmroihls, Ahtolns, hlf Hsohls wmrm oliaufmf ol tjmsm stufomsht rhtms tjht rnucjay hpprnxoghtm tjmor rmprmsmlthtonl oltjm ahrcmr pnpuahtonls8=%, 88%, hlf 6% rmspmitovmay, tjmdhsmaolm lugdmr ne phrtoiophlts whs sn sghaa tjht rndusthlhaysos os ogpnssodam.36

Ol cmlmrha, tjm ogprnvmgmlts ol YUT rhtms wotj JIUprntmhsm tropam tjmrhpoms jhvm dmml hiingphlomf dy hlolirmhsm ol ermqumliy hlf smvmroty ne sngm sofm mffmits(lnthday hlmgoh, lmutrnpmloh, fyscumsoh, sbol rhsj, hlnrmithasygptngs). Enltholm, Jmznfm, hlf Fnrovha (4089),3=ofmltoeysngm ne tjmsm nutingms.

Gnrm rmsmhrij os lmmfmf tjht spmioihaay hssmssms tjm ogphit

ne tjm tropam tjmrhpy hcmlts wotj Heroihl Hgmroihls. Enrmxhgpam, Durtnl, Phsshrmaah, hlf GiCuorm (4084)35succmsttjht ln rmaohdam fhth hrm truay hvhoahdam nl tjm ogphit ne tjmsmlmwmr hcmlts upnl Heroihl Hgmroihls dmihusm ne tjmor ulfmr-rmprmsmlthtonl ol tjm iaoloiha trohas enr tjmsm ogpnrthlt frucs.

Ol hffotonl tn tjm lmwmr tjmrhpoms enr tjm trmhtgmlt necmlntypm 8, lmwmr hcmlts hrm hasn dmolc usmf ol tjm trmhtgmltne cmlntypms 4 hlf 9.



VHDAM 84; YNE+TDU UY PMC+TDU D_ CMLNV_PM; EOYYONL YV]F_YUT84 TMY]AVY

Ynurim; Chlm mt ha, Hdstrhit h=. MHYA, Hproa 40892 Ahurotz mt ha., L Mlca K Gmf 4089. FNO; 80.80=5/LMKGnh8486:=9:9

Chlm, Ahwotz, Tnfrocumz-nrrms mt ha (4089)33 hijomvmf supmronr YUT rmsuats enr JIU olemitmf pmrsnls wotj cmlntypm 4 dyingdololc Ynensduvor wotj Todhvorol rhtjmr tjhl dy usolc PMC+Todhvorol hanlm. Jnwmvmr, PMC+TDU gholtholmf h saocjt hfvhlthcmenr tjnsm wotj cmlntypm 9.

Vm Ynensduvor/Todhvorol rmsuats wmrm hasn supmronr tn tjm Pmcoltmremrnl Haeh- 4h/Todhvorol nutingms ol tmrgs ne shemty. hdam 89aosts tjm fhth enr bmy gmhsurms ne shemty.

3:%PMC+TDU

=5%YNE+TDU

YUT84(%)

800

:0

50

60

40

0Cmlntypm 4 Cmlntypm 9

YNE + TDU

PMC + TDU

?3%(YNE+TDU)

59%PMC+TDU

VHDAM 89; YNE + TDU UY PMC + TDU; YHEMV_ Y]GGHT_

YNE + TDU PMC + TDU

Crhfm 9-6 hfvmrsm mvmlts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3% . . . . . . . . . . . . . . 8?%

Ymronus hfvmrsm mvmlts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9% . . . . . . . . . . . . . . . 8%

F/I fum tn hfvmrsm mvmlts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8% . . . . . . . . . . . . . . 88%

Jmgncandol 180 cg/fa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ?% . . . . . . . . . . . . . . 8=%

Lmutrnpjoas 13=0/gg9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0% . . . . . . . . . . . . . . 8=%

Pahtmamts 1=0,000/gg9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0% . . . . . . . . . . . . . . .3%

Ynurim; Chlm mt ha, Hdstrhit =. MHYA, Hproa 40892 Ahurotz mt ha., L Mlca K Gmf4089:9

Vm Lmutroln Ytufy hasn hssmssmf nutingms hssniohtmf wotjYnensduvor + Pmcoltmremrnl + Todhvorol nvmr h twmavm-wmmbtrmhtgmlt iyiam enr JIU-olemitmf pmrsnls wotj cmlntypms8, 6, =, nr 5. Ahwotz, Syams, Fhvos mt ha (4089)3:enulf tjht

Ynensduvor os jocjay mffmitovm wotj cmlntypms 6, =, hlf 5 hswmaa hs wotj cmlntypm 8. Jnwmvmr, crmhtmr Heroihl Hgmroihloliausonl ol iaoloiha trohas enr tjmsm hlf ntjmr lmwmr tjmrhpomsos lmmfmf.



VHDAM 86; YNENYD]UOT/PMCOLVMTEMTNL + TODHUOTOL N]VINGMYD_ CMLNV_PM

Ynurim; Khindsnl OG, Fnrm, Khindsnl OG, Fnrm CK, Enstmr CA, Eromf GS, Thfu G, Thehasboy UU, Gnrnz A, Irhxo H, Pmmtmrs G, Amlz N, Nuwmrbmrb-Ghjhfmvhl Y, Bhagmokmr T, Dmugnlt-Ghuvoma G, Yogmprmvoh (VGI69=) wotj pmcoltmremrnl/rodhvorol enr ijrnloi JIU cmlntypm 8 olemitonl ol trmhtgmltlhvm phtomlts; rmsuats erng X]MYV-8, h Pjhsm OOO Vroha MHYA4089 :=

:?%

?5% 800%

YUT84(%)

800

:0

50

60

40

0

Cmlntypm Cmlntypm Cmlntypm

8 6 =,5

Hchol, dmihusm tjos iaoloiha troha whs spmioi tn cmlntypm 8,ot jhs rmamvhlim enr Heroihl Hgmroihls. Jnwmvmr, HeroihlHgmroihls wmrm pnnray rmprmsmltmf ol tjmsm trohas.

Emrmlio, Hssmahj, Enstmr mt ha (4089):0hssmssmf tjm ogphitne tjm lmxt cmlmrhtonl PO, Ehafhprmvor, ol ingdolhtonl wotjpmcyahtmf oltmremrnl haeh-4h hlf rodhvorol vmrsus PMC/TDUhanlm. Hs hdam 85 olfoihtms, phtomlts trmhtmf wotj Ehafhprmvoringdolhtonl jhf jocjmr YUT84 rhtms.

Uhijnl (4088):8fmsirodms tjmsm gmfoihtonls hs usjmrolc olh lmw mrh. Vm lmmf enr hfmquhtm rmprmsmlthtonl ne HeroihlHgmroihls ol tjm iaoloiha trohas ne tjm lmw hcmlts os h prmssolcnlm dmihusm ne tjm hdsmlim ne fhth nl tjmsm nutingms tjht osspmioi tn Heroihl Hgmroihls. (Enr mxhgpam, nlay Ihuihsohlshlf Hsohls wmrm usmf ol tjm iaoloiha trohas enr Ehafhprmvor).

VHDAM 8=; INGPHTOLC YUT84 THVMY D_ PMC+TDU+YOGMPTMUOT UYPMC+TDU+PAHIMDN

Ynurim; Khindsnl OG, Fnrm, Khindsnl OG, Fnrm CK, Enstmr CA, Eromf GS, Thfu G, Thehasboy UU, Gnrnz A, Irhxo H, Pmmtmrs G, Amlz N, Nuwmrbmrb-Ghjhfmvhl Y, Bhagmokmr T, Dmugnlt-Ghuvoma G, Yogmprmvoh (VGI69=) wotj pmcoltmremrnl/rodhvorol enr ijrnloi JIU cmlntypm 8 olemitonl ol trmhtgmltlhvm phtomlts; rmsuats erng X]MYV-8, h Pjhsm OOO Vroha MHYA4089:=

:0%

=0%

YU

T84(%)

P10.0008

:0

50

60

40

0

PMC+TDU+YOGMPTMUOT

PMC+TDU+PAHIMDN



VHDAM 85; PMC/TDU UY EHAFHPTMUOT (ENU)840 + PT HLFEHAFHPTMUOT (ENU)460 + PT

Ynurim; P. Emrmlio mt ha, Hdstrhit 8685. MHYA, Hproa 4089:5

YUT84(%

) =4%

3?% :0%:0

50

60

40

0

PMC/TDU

EFU 840 + PT

EFU 460 + PT

Vm HAHY Ytufy (4080):4, rmvmhamf pnsotovm rmsuats dhsmfupnl tjm usm ne nrha fhlnprmvor (TC3443) ol ingdolhtonl

wotj PMCOEL-4h+rodhvorol. Eaosohb, Phwantsby, Irhddm mt ha(4088):9hlhayzmf tjm ogphit ne haospnrovor (FMD04=) hs h tropamtjmrhpy. Chlm mt ha (4080):6, ol tjm OLENTG-8 troha, ingdolmfh luiamnsofm pnaygmrhsm oljodotnr hlf fhlnprmvor hlf jhfmlinurhcolc rmsuats.

JIU HLF HETOIHL

HGMTOIHLY; GNTDOFOV_HLF GNTVHAOV_ OYY]MY

Fosphrotoms lnt nlay mxost ol JIU trmhtgmlt nutingms,dut ol tjm prncrmssonl tn aovmr fosmhsm hlf/nr tn proghryjmphtnimaauahr ihriolngh hlf aovmr-rmahtmf gnrthaoty. Fhvoah(4005):=hlf Yanhlm mt ha (4005):5ofmltoey sngm ne tjmfosphrotoms. hdam 83 fmsirodms h emw ne tjm trmlfs tjht jhvmmxostmf nvmr tjm ymhrs.


25/40JMPHVOVOY I; H ITOYOY OL VJM HETOIHL HGMTOIHL INGG]LOV_ | 4=

VHDAM 83; H YHGPAM NE FOYPHTOVOMY OL JIU GNTDOFOV_ HLFGNTVHAOV_

Fosphrotoms; Proghry Jmphtnimaauahr Ihriolngh

JIU oliofmlim olirmhsmf dy 400% erng 8?3=-4000.

Oliofmlim rhtms hlf gnrthaoty rhtms enr jmphtnimaauahr ihriolngh hrm 400% jocjmr ol Heroihl Hgmroihls.

Heroihl Hgmroihls hlf Josphlois hrm gnrm aobmay tn jhvm JIU hs h rosb ehitnr enr jmphtnimaauahr ihriolngh.

Heroihl Hgmroihls jhvm gnrm hfvhlimf JIU tugnr sthcm ht fohclnsos.

Heroihl Hgmroihls hrm amss aobmay tn rmimovm aniha nr surcoiha (rmsmitonl, aovmr trhlspahlthtonl) tjmrhpy tjhl Ihuihsohls,mvml wotj tugnrs tjht hrm anihaozmf tn tjm aovmr.

Fosphrotoms; Aovmr Vrhlspahlthtonl enr JIU; 4004-4005

Aovmr fosmhsm os gnrm smvmrm wjml Heroihl Hgmroihls hrm pahimf nl tjm whot aost. Vos os h dhrromr tn rmemrrha.Jnwmvmr, tjmrm hrm ln foffmrmlims ol rmgnvha erng tjm whotaost dmihusm ne fmhtj nr dmihusm tjm phtomlt os tnn soib enr htrhlspahlt.

Vmrm hrm ln rhioha/mtjloi foffmrmlims ol rmimovolc h aovmr trhlspahlt wotjol tjrmm ymhrs.

Heroihl Hgmroihls hrm gnrm aobmay tn ulfmrcn h trhlspahlthtonl enr JIU dut amss aobmay tn jhvm h aovm aovmr fnlnr.

Heroihl Hgmroihls jhvm anwmr survovha rhtms hetmr trhlspahlthtonl. Jnwmvmr, tjmsm foffmrmlims hrm hdnaosjmf dy hfkustolcenr tjm jocjmr GMAF sinrm hlf nafmr hcm.

Aovmr crhet anss os gnrm ermqumlt ol Heroihl Hgmroihls.

Heroihl Hgmroihls hrm gnrm aobmay tn jhvm rmiurrmlt JIU hlf haancrhet rmkmitonl hs ihusms enr crhet anss tjhl Ihuihsohls.

Heroihl Hgmroihls wotj crhet anss hrm amss aobmay tn ulfmrcn rmpmht aovmr trhlspahlthtonl.

Fosphrotoms; JIU Fmhtjs; 4084

Fmhtjs erng JIU lnw mximmf tjnsm erng JOU olemitonl. Heroihl Hgmroihls hrm gnrm aobmay tn fom erng JIU (Ay mt ha,4084):3

Ynurim; Fhvoah KH, Ma-Ymrhc JD. Thioha foffmrmlims ol survovha ne jmphtnimaauahr ihriolngh ol tjm ]lotmf Ythtms; h pnpuahtonl-dhsmf stufy.Iaol Chstrnmltmrna Jmphtna. 400526 (8;806880).3?

Yanhlm F, Ijml Jmchlc, Jnwmaa I. Thioha fosphroty ol proghry jmphtnimaauahr ihriolngh; tugnr sthcm ht prmsmlthtonl, surcoiha trmhtgmlthlf survovha.K Lhta Gmf Hssni. 40052?:(84);8?96-8?9?. :0

Ntjmr foffmrmltoha trmlfs hasn mxost rmchrfolc HeroihlHgmroihls hlf JIU. Hs olfoihtmf, JIU hlf JOU in-olemitonls hrm gnrm aobmay tn mxost hgnlc Heroihl Hgmroihls.Gurpjy, Jmrrghll, Nsoluso, mt ha (4088)::snucjt tn rmfuimtjm mgmrcmlim ne aovmr drnsos tjht niiurs ol JIU/JOUin- olemitmf phtomlts dy oltmlsoeyolc tjm fnshcms ne dntjpmcoltmremrnl hlf rodhvorol. Vm trmhtgmlt hppmhrmf tnsanw tjm prncrmssonl tn aovmr drnsos wotjnut olirmhsolc sofmmffmits. Jnwmvmr, tjm hutjnrs mgpjhsozm tjm lmmf tn hssmss,gnrm ihrmeuaay, tjm rosbs ne fnudam fnsolc tjrnucj h ihrmeuaay

fmsoclmf iaoloiha troha. Vm lmmf enr suij h stufy os ogpnrthltsolim Tnfrocumz-nrrms mt ha (4084):?enulf tjht ln ijhlcmsniiurrmf ol rmspnlsovmlmss wjml Heroihl Hgmroihls oltjmor iaoloiha troha tjm Prncrmss Ytufy wmrm mxpnsmf tnoltmlsomf pmcoltmremrnl haeh-4h paus rodhvorol fnshcms.

Ol hffotonl tn JOU/JIU in-olemitonl, Heroihl Hgmroihlshrm hasn gnrm aobmay tn jhvm in-niiurrolc fohdmtms, hlf/nrinlfotonls tjht inrrmspnlf tn prm-fohdmtms. Gubjthr, Hyhah,Ghjmr mt ha (4089)?0ofmltomf h prm-fohdmtms prmvhamlim rhtm



ne hpprnxoghtmay 30% enr Ahtolns, 84% enr Ihuihsohls, hlf=0% enr Heroihl Hgmroihls ol h shgpam ne ?3 JIU-olemitmfpmrsnls. Vm rminclotonl ne dntj prm-fohdmtms hlf fohdmtmsos ogpnrthlt dmihusm tjmsm inlfotonls ihl hffmit trmhtgmltrmspnlsovmlmss. Kol mt ha. (4084),?8ol h stufy ne tjm usm newmocjt-dhsmf fnshcolc enr rodhvorol, hasn enulf tjht tjm amvm

hepatitis c: a crisis in the african american community, findings and recommendations, october 2013

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