演講MP3+雙語文稿:下次的疫情暴發(fā)？我們還沒準(zhǔn)備好

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【演講人】比爾·蓋茨

【演講主題】《下次的疫情暴發(fā)？我們還沒準(zhǔn)備好》

【演講文稿-中英文】

翻譯者Wang-Ju Tsai校對(duì)Min Wang

00:18

When I was a kid,the disaster we worried about most was a nuclear war.That's why we had a barrel like this down in our basement,filled with cans of food and water.When the nuclear attack came,we were supposed to go downstairs, hunker down, and eat out of that barrel.

當(dāng)我還是小孩時(shí),我們最擔(dān)心的災(zāi)害是核戰(zhàn)爭。所以我們?cè)诘叵率矣袀€(gè)這樣的筒子，裝滿了罐頭食物和水。當(dāng)核戰(zhàn)爭爆發(fā)時(shí)，我們就要躲到地下室去， 蹲低身子并靠那個(gè)筒子維生。

00:38

Today the greatest risk of global catastrophedoesn't look like this.Instead, it looks like this.If anything kills over 10 million people in the next few decades,it's most likely to be a highly infectious virusrather than a war.Not missiles, but microbes.Now, part of the reason for this is thatwe've invested a huge amount in nuclear deterrents.But we've actually invested very little in a system to stop an epidemic.We're not ready for the next epidemic.

今天的全球?yàn)?zāi)難最大的危險(xiǎn)看起來已不像這樣了。事實(shí)上，會(huì)像這樣。如果有什么東西在未來幾十年里 可以殺掉上千萬人，那比較有可能是個(gè)高度傳染的病毒，而不是戰(zhàn)爭。不是導(dǎo)彈，而是微生物。部分的理由是因?yàn)槲覀冊(cè)诤送厣贤蹲⒘撕艽蟮?精力和金錢。但是我們?cè)诜乐挂咔榈?系統(tǒng)上卻投資很少。我們還沒有準(zhǔn)備好預(yù)防 下一場(chǎng)大疫情的發(fā)生。

01:20

Let's look at Ebola.I'm sure all of you read about it in the newspaper,lots of tough challenges.I followed it carefully through the case analysis toolswe use to track polio eradication.And as you look at what went on,the problem wasn't that there was a system that didn't work well enough,the problem was that we didn't have a system at all.In fact, there's some pretty obvious key missing pieces.

讓我們看看埃博拉病毒。我相信大家在報(bào)紙上 都有讀到這樣的新聞，充滿了許多艱難的挑戰(zhàn)。用我們追蹤消滅脊髓灰質(zhì)炎（小兒麻痹）的 案例分析工具，我仔細(xì)地追蹤這病毒的發(fā)展。隨著疫情的發(fā)展我們可以看到，問題不在于我們沒有一套 可以使用的系統(tǒng)，而是我們根本沒有任何系統(tǒng)。事實(shí)上我們可以看到有幾個(gè) 很明顯的不足。

01:51

We didn't have a group of epidemiologists ready to go, who would have gone,seen what the disease was, seen how far it had spread.The case reports came in on paper.It was very delayed before they were put onlineand they were extremely inaccurate.We didn't have a medical team ready to go.We didn't have a way of preparing people.Now, Médecins Sans Frontières did a great job orchestrating volunteers.But even so, we were far slower than we should have beengetting the thousands of workers into these countries.And a large epidemic would require us to have hundreds of thousands of workers.There was no one there to look at treatment approaches.No one to look at the diagnostics.No one to figure out what tools should be used.As an example, we could have taken the blood of survivors,processed it, and put that plasma back in people to protect them.But that was never tried.

我們找不到一群準(zhǔn)備好了的流行病學(xué)家，能去疫區(qū)看看病理和病情發(fā)展。病例都是由紙上報(bào)道傳來的。信息傳上線時(shí)已經(jīng)很晚了，此外還很不準(zhǔn)確。我們也找不到訓(xùn)練有素的醫(yī)護(hù)小組。我們沒有一套讓人們嚴(yán)陣以待的方法。目前，“無國界醫(yī)生”在動(dòng)員志愿者上做了很大的貢獻(xiàn)。但即使如此，我們調(diào)動(dòng)數(shù)千名 工作者到疫區(qū)的速度還是十分差強(qiáng)人意的。大的疫情會(huì)需要我們動(dòng)員 數(shù)十萬的人員，但我們沒有任何人在研究治療的方向。也沒有人在看診斷的方法。沒有人在想該用什么工具。舉個(gè)例子來說， 我們也許可以抽取生還者的血液，處理過后，再將血漿注入 人體內(nèi)來保護(hù)沒得病的人。但是這個(gè)方法從來沒有試過。

02:54

So there was a lot that was missing.And these things are really a global failure.The WHO is funded to monitor epidemics, but not to do these things I talked about.Now, in the movies it's quite different.There's a group of handsome epidemiologists ready to go,they move in, they save the day, but that's just pure Hollywood.

所以有很多事都還沒來得及做。而這的確是全球性的失敗。世界衛(wèi)生組織的目的是來監(jiān)視流行病， 而不是來做我剛講的事。但是在電影中演的劇情又是另一回事。有一群很英俊的流行病學(xué)家準(zhǔn)備就緒，他們到了疫區(qū)拯救了大家， 但這是純好萊塢的劇情。

03:22

The failure to prepare could allow the next epidemicto be dramatically more devastating than EbolaLet's look at the progression of Ebola over this year.About 10,000 people died,and nearly all were in the three West African countries.There's three reasons why it didn't spread more.The first is that there was a lot of heroic work by the health workers.They found the people and they prevented more infections.The second is the nature of the virus.Ebola does not spread through the air.And by the time you're contagious,most people are so sick that they're bedridden.Third, it didn't get into many urban areas.And that was just luck.If it had gotten into a lot more urban areas,the case numbers would have been much larger.

我們的準(zhǔn)備不足 ， 可能會(huì)導(dǎo)致下一場(chǎng)疫情，比埃博拉病毒的危害更嚴(yán)重。讓我們看看埃博拉病毒在 過去一年中的發(fā)展。大約死了一萬人，所有的死者都在西非的三個(gè)國家里。之所以沒有擴(kuò)散的原因有三個(gè)。第一個(gè)是衛(wèi)生工作人員作的 很多英雄事跡。他們找到很多病人 并防止了更多人得病。第二個(gè)是病毒的特性，埃博拉病毒不是靠空氣傳染的。等到你有足夠的傳染力時(shí)，大部分的人已經(jīng)病得臥床不起了。第三個(gè)是因?yàn)椴《緵]有傳到都會(huì)區(qū)。這純粹是運(yùn)氣好。如果病毒傳到了都會(huì)區(qū)，那么死亡的人數(shù)絕對(duì)不止于此。

04:18

So next time, we might not be so lucky.You can have a virus where people feel well enough while they're infectiousthat they get on a plane or they go to a market.The source of the virus could be a natural epidemic like Ebola,or it could be bioterrorism.So there are things that would literally make things a thousand times worse.

所以下一次我們可能不會(huì)這么幸運(yùn)了。有的病毒可能讓你毫無察覺， 但當(dāng)感染病毒的人乘飛機(jī)或者去逛商場(chǎng)，他們其實(shí)已經(jīng)具有一定的傳染力了。此外病毒的來源可以是 天然的，像埃博拉病毒，或是由生物恐怖攻擊產(chǎn)生的。所以可以讓疫情慘上千倍的病毒是存在的。

04:40

In fact, let's look at a model of a virus spread through the air,like the Spanish Flu back in 1918.So here's what would happen:It would spread throughout the world very, very quickly.And you can see over 30 million people died from that epidemic.So this is a serious problem.We should be concerned.

事實(shí)上，讓我們來看看一個(gè)病毒 由空氣傳染的模型，像1918年的西班牙流感。疫情有可能像這樣發(fā)展：病毒會(huì)以很快的速度向全世界蔓延。你可以看到全球有三千萬人 死于這個(gè)疾病。這就是個(gè)很嚴(yán)重的問題。我們絕不應(yīng)該忽視。

05:05

But in fact, we can build a really good response system.We have the benefits of all the science and technology that we talk about here.We've got cell phonesto get information from the public and get information out to them.We have satellite maps where we can see where people are and where they're moving.We have advances in biologythat should dramatically change the turnaround time to look at a pathogenand be able to make drugs and vaccines that fit for that pathogen.So we can have tools,but those tools need to be put into an overall global health system.And we need preparedness.

但事實(shí)上我們可以建立 一個(gè)很好的反應(yīng)系統(tǒng)。我們可以利用所有發(fā)展至今的科技和科學(xué)。我們可以用手機(jī)來收集信息和發(fā)布信息。我們有衛(wèi)星地圖可以看到 人們?cè)谀睦锖屯囊苿?dòng)。我們?cè)谏飳W(xué)上也有進(jìn)展，這可以大幅縮短我們找到病原的時(shí)間，并可以在很短的時(shí)間里找出解藥和疫苗。所以我們是有工具的，但這些工具必須統(tǒng)合在 一個(gè)全球健康系統(tǒng)下。此外我們必須處在準(zhǔn)備好的狀態(tài)。

05:42

The best lessons, I think, on how to get preparedare again, what we do for war.For soldiers, we have full-time, waiting to go.We have reserves that can scale us up to large numbers.NATO has a mobile unit that can deploy very rapidly.NATO does a lot of war games to check, are people well trained?Do they understand about fuel and logisticsand the same radio frequencies?So they are absolutely ready to go.So those are the kinds of things we need to deal with an epidemic.

而我們?nèi)绾巫龊脺?zhǔn)備，最好的例子還是來自于備戰(zhàn)。對(duì)軍人來說，他們是隨時(shí)隨地 都準(zhǔn)備好要投入戰(zhàn)爭的。我們還有預(yù)備軍人， 能使備戰(zhàn)人口大量增加。北約組織有個(gè)機(jī)動(dòng)小組， 可以很快地行動(dòng)起來。北約組織有很多戰(zhàn)爭游戲可以測(cè)試 人員是否已訓(xùn)練有素？他們是否了解燃油，補(bǔ)給和相同的收音機(jī)頻率？是的話，那么他們就已準(zhǔn)備好了。這些就是面對(duì)疫情時(shí)我們?cè)摐?zhǔn)備的事。

06:13

What are the key pieces?First, we need strong health systems in poor countries.That's where mothers can give birth safely,kids can get all their vaccines.But, also where we'll see the outbreak very early on.We need a medical reserve corps:lots of people who've got the training and backgroundwho are ready to go, with the expertise.And then we need to pair those medical people with the military.taking advantage of the military's ability to move fast, do logisticsand secure areas.We need to do simulations,germ games, not war games, so that we see where the holes are.The last time a germ game was done in the United Stateswas back in 2001, and it didn't go so well.So far the score is germs: 1, people: 0.Finally, we need lots of advanced R&D in areas of vaccines and diagnostics.There are some big breakthroughs, like the Adeno-associated virus,that could work very, very quickly.

關(guān)鍵的項(xiàng)目有哪些？第一，在貧窮的國家里 必須有發(fā)達(dá)的衛(wèi)生系統(tǒng)。母親們可以安全地生小孩，小孩們可以接種疫苗。我們也可以在很早的階段 偵查到疫情的爆發(fā)。我們需要后備的醫(yī)療部隊(duì)：還有很多訓(xùn)練有素的專業(yè)人員，隨時(shí)準(zhǔn)備好能帶著他們專長到疫區(qū)。我們可以用軍隊(duì)來配合醫(yī)護(hù)人員，利用軍隊(duì)移動(dòng)迅速的特性，來進(jìn)行后勤運(yùn)輸和維持安全。我們也需要進(jìn)行一些情境模擬，不是進(jìn)行戰(zhàn)爭游戲而是進(jìn)行病菌游戲 ， 看看防衛(wèi)漏洞在哪。上一次的病菌游戲是在美國進(jìn)行的，那是在2001年了， 進(jìn)行得也不是很順利。目前病菌得一分人類零分。最后我們?cè)谝呙绾筒±韺W(xué)上 還需要很多的研發(fā)工作。在某些方面例如腺相關(guān)病毒上， 我們已經(jīng)有了相當(dāng)?shù)耐黄疲@可以在很短的時(shí)間內(nèi)生效。

07:21

Now I don't have an exact budget for what this would cost,but I'm quite sure it's very modest compared to the potential harm.The World Bank estimates that if we have a worldwide flu epidemic,global wealth will go down by over three trillion dollarsand we'd have millions and millions of deaths.These investments offer significant benefitsbeyond just being ready for the epidemic.The primary healthcare, the R&D,those things would reduce global health equityand make the world more just as well as more safe.

我目前沒有明確的預(yù)算 這到底需要多少錢，但是我確信跟損失比起來是比較便宜的。根據(jù)世界銀行的估算， 如果我們有流感的疫情暴發(fā)，全球經(jīng)濟(jì)會(huì)損失三萬多億美元。我們還會(huì)可能有千百萬人員的死亡。跟僅僅只是準(zhǔn)備好比起來，這些額外的投資會(huì)帶來顯著的益處。基礎(chǔ)的衛(wèi)生保健，研發(fā)，可以促進(jìn)全球健康的平衡發(fā)展，讓這個(gè)世界更健康更安全。

07:56

So I think this should absolutely be a priority.There's no need to panic.We don't have to hoard cans of spaghetti or go down into the basement.But we need to get going, because time is not on our side.

所以我覺得這非常重要重要?？滩蝗菥?。不需要驚慌。我們不需要囤積面罐頭 或是躲到地下室去，但是我們必須急起直追，因?yàn)闀r(shí)間有限。

08:10

In fact, if there's one positive thing that can come out of the Ebola epidemic,it's that it can serve as an early warning, a wake-up call, to get ready.If we start now, we can be ready for the next epidemic.

事實(shí)上，要說這場(chǎng)埃博拉病毒的疫情 帶來了什么正面影響的話，那就是提早響起了警報(bào)， 讓我們覺醒并做好準(zhǔn)備。我們?nèi)绻纯涕_始準(zhǔn)備，那么在 下一場(chǎng)疫情來臨前我們是可以準(zhǔn)備好的。

08:27

Thank you.

謝謝大家。

08:29

(Applause)

（掌聲）