This week global leaders are coming together at the UN General Assembly, which presents an opportunity to refocus energy and commitment on ending the crisis phase of this pandemic and to make sure we’re better prepared for the next one. In this piece I talk about how we can apply what we have learned since early 2020 and embrace a set of global actions that chart an equitable course out of the pandemic—vaccinate now, contain the disease, and coordinate the global response.
上周，全球领导人齐聚联合国大会，为终结新冠疫情危机群策群力、做出承诺，也为我们提供了机会，确保我们可以为防范下一场大流行病做更充分的准备。在这篇文章中，我想谈一谈如何利用自2020年以来学到的经验教训来指导我们以公平的方式走出新冠疫情危机。这需要全球采取一系列行动——立即接种疫苗、遏制疫情蔓延、协调全球响应。
We’ve reached the 18th month of the COVID-19 pandemic, a somber milestone marked by yet another surge of cases and deaths fueled by the Delta variant. This global crisis has been a health, economic and moral disaster playing out in waves in every geography, sparing none. While the pandemic has been a shared experience, the experience has not been the same everywhere.
现在已经是新冠肺炎大流行的第18个月，德尔塔变异株引发的病例和死亡人数又一次激增，这是一个令人沮丧的“里程碑”。这场全球危机是一场健康、经济和道德的灾难，波及世界各地，无一幸免。不过，这场大流行虽然影响到所有人，但不同地方的人受影响的程度却不尽相同。
In the past year-and-a-half, we have witnessed scientific breakthroughs with multiple safe and effective vaccines developed in record time, incredible multilateral cooperation resulting in billions of dollars raised for the response, and heroic efforts by healthcare and frontline workers in communities worldwide. But at the same time, we have also seen widening gaps in equity that go against everything our foundation and its partners have worked for over the past 20 years. The advent of vaccines was an opportunity to bend the curve in the direction of a global recovery. It turned out that unequal distribution and a lack of funding and supply meant the recovery has been precarious and halting.
在过去一年半的时间里，我们见证了重大的科学突破，多款安全有效的疫苗以史无前例的速度研发成功；也开展了令人难以置信的多边合作，为抗击疫情筹集了数十亿美元；更目睹了世界各地一线工作者们的英勇付出。但与此同时，我们也看到不平等现象仍在加剧，这与盖茨基金会及合作伙伴们在过去20年里所做出的一切努力背道而驰。疫苗的出现为全球经济复苏提供了一个契机。然而事实证明，疫苗的分配不公、资金不足和供应短缺，意味着经济复苏岌岌可危、停滞不前。
In last year’s Goalkeepers report, Melinda and I shared modeling that warned that globally deaths would be higher if doses went predominantly to high income countries. To date, less than 2% of people in low-income countries have received a dose of a COVID-19 vaccine, compared to more than 60% of people in the U.S. The pull of the inequity we’re seeing isn’t only on the here and now—the economic recovery of low-income countries that are slow to be vaccinated is stuck in the starting blocks. These countries can expect to experience between 2-4% GDP losses through 2025 (averaging 3% per year in sub-Saharan Africa).
在去年的《目标守卫者报告》中，梅琳达和我分享了数据模型并发出警告：如果疫苗主要流向高收入国家，全球新冠死亡人数将更高。迄今为止，低收入国家中只有不到2%的人口接种了新冠疫苗，而在美国，这一比例超过了60%。这种不平等带来的影响将极为深远，接种率落后的低收入国家的经济复苏陷入停滞。到2025年，这些国家的国内生产总值（GDP）预计下降2-4%（撒哈拉以南非洲地区的GDP则将每年下降3%）。
After 18 months of surprises around every corner with variants fueling new waves of disease there’s a tendency to say one cannot predict what will happen next. To some extent that’s true—nature is wily, and the virus will continue to mutate if it can transmit unchecked. But it’s also defeatist and incorrect to suggest that the acute phase of the pandemic will spiral on from one variant to the next. Just as the virus can change, so can the world’s response to it. Whether the world can finally turn the corner, however, will be determined by what we do next and how it’s done.
过去18个月以来，层出不穷的变异毒株在各地引发了一轮又一轮疫情，以至于让人们觉得完全无法预测接下来会发生什么。从某种程度上讲，这个说法有道理。因为病毒是狡猾的，如果不受控制地传播，它将继续变异。但因此就认为变异毒株会不断涌现、疫情的危机阶段将无休止地循环往复，显然是一种错误的、失败主义观点。病毒会变异，全球抗击病毒的方式也会不断改进。因此，世界能否最终转危为安，将取决于我们下一步做什么以及如何做。
Our path out of the pandemic has always required one thing—a commitment to equity. A willingness to see that what happens in lower-income countries affects high-income countries. There is no nationalistic solution to this global problem. We’ve seen countries try and fail in that pursuit as variants emerge and threaten progression from the acute phase of the pandemic. There are three things that can be done in the coming months that can bring about the end of the acute phase of the pandemic and set the world on a different timeline in preparation for the next. I hope that leaders meeting virtually this week at the COVID Summit commit to actions that meet these needs:
带领我们走出新冠疫情危机的关键是对公平性的承诺，也就是意识到低收入国家与高收入国家的利益息息相关。面对疫情这个全球性的问题，并没有民族主义的解决方案。我们看到，某些国家曾试图用这个狭隘的办法解决问题，但随着变异毒株的不断涌现和疫情的反复，这些努力都以失败告终。接下来的几个月，需要做好三件事才能终结疫情的危机阶段，让世界进入一个新阶段：立即接种疫苗、遏制疾病传播、协调全球响应。
01
  Vaccinate Now
立即接种疫苗
Governments and the private sector must work together to build a more transparent system to accelerate the global supply of vaccines. While a shortage of supply was a major issue in the first half of the year, recently 41 million doses per day have been distributed globally. It’s progress, but there’s a long way to go. The WHO/Gavi-led COVAX AMC, Africa CDC-led African Vaccine Acquisition Task Team (AVATT) and other channels can move vaccines, but they need more doses, visibility to supply, and sufficient money to acquire and deliver them. This is quickly turning into a logistics and financing challenge, and we know how to solve those types of problems. A consolidated global dashboard that provides real-time vaccine production and availability data will enable countries and global institutions to collaborate on filling access gaps. While donations to COVAX were slow to arrive, current funding can support delivery to about 30% of the population in lower- and middle-income countries. It’s a good start, and funding for 70% coverage in the lowest income countries needs to be made available by mid-2022 along with enhanced delivery capacity at the country level.
各国政府和私营部门必须共同努力，建立一个更加透明的系统以加速全球疫苗供应。疫苗供应短缺是今年上半年的主要问题，最近全球每天分发4100万剂疫苗。这是一个长足的进步，但仍然远远不能满足需求。由世界卫生组织和全球疫苗免疫联盟（Gavi）领导的新冠肺炎疫苗实施计划（COVAX）的预先市场承诺（AMC）机制、非洲疾控中心领导的非洲疫苗获取工作组（AVATT）和其他渠道都可以完成疫苗交付，但他们还需要更多的疫苗，更可见的供应信息，以及足够的资金来购买和交付疫苗。这些需求很快构成了物流和融资方面的诸多挑战，但我们知道如何解决这类问题。通过整合并提供实时更新的全球疫苗生产和可用数据，各个国家和国际组织能够通过合作填补疫苗缺口。虽然对COVAX的捐款姗姗来迟，但目前的资金已足够支持向低收入和中等收入国家约30%的人口提供疫苗。这是一个好的开端，世界需要在2022年上半年内为最不发达国家提供资金，使其疫苗覆盖率达到70%，并在国家层面提高疫苗接种能力。
02
   Contain the Disease
 遏制疫情蔓延
In addition to getting vaccines out to close the global equity gap we also must contain outbreaks as they happen. This can help keep countries out of the cycle of lockdowns that has left schools and businesses in constant flux. To reduce the risk of variants jumping from border to border, the world must invest in readily available rapid testing, a system for sharing genetic sequences, and a mechanism to deliver expertise and commodities (like oxygen, PPE, and life-saving drugs) quickly where they are needed. We’ve seen this done successfully with diseases like polio and malaria—using data to inform actions that bring outbreaks under control. We need to have expert support and response materials like oxygen, PPE, and life-saving drugs ready to deploy in the event of major outbreaks. The private sector has a role to play, using its expertise in logistics to reduce lead times and fill supply gaps.
除了尽可能快地弥合全球在疫苗接种率上的差距，我们还必须在新的疫情暴发之初及时遏制病毒传播。这可以帮助各国解除封锁措施，避免学校和企业的反复关停。为了降低变异毒株的跨境传播风险，世界必须投资于便捷的快速检测工具、一个可以共享基因序列的系统，以及一个能在有需要的地方快速提供专业建议和产品（如氧气、个人防护装备和挽救生命的药品）的机制。我们已经在诸如脊髓灰质炎和疟疾等疾病上成功地做到了这一点：用数据为遏制疫情的行动提供信息。我们需要专家的支持并备好氧气、个人防护装备和药品等应对物资，可以在发生重大疫情时随时部署。私营部门也可以发挥作用，利用其在物流方面的专长，缩短交货时间、填补供应缺口。
03
  Coordinate the Global Response
协调全球响应
The establishment of the Access to COVID-19 Tools Accelerator (ACT-A) in early 2020 was a milestone: governments, international organizations and the private sector came together in response to the crisis. We now need all governments to appoint a COVID-19 global lead, reporting to the head of state, and for these leads to regularly convene through 2022. With the support of independent monitoring this globally coordinated, time-limited task force can complement ACT-A and take us from aspiration to ending the pandemic through collective action and provide a model for the long-term coordination needed to prevent future pandemics.
2020年初建立的“全球合作加速开发、生产、公平获取新冠防控新工具”倡议（ACT-A）是一个里程碑，它标志着各国政府、国际组织和私营部门共同应对危机。我们现在需要各国政府任命一名新冠疫情全球应对负责人，这些负责人可以直接向国家元首汇报，并在2022年底前定期召开会议。这个独立的全球临时协调机制可作为ACT-A的有力补充，帮助我们达成用集体行动终结疫情的目标，并为未来疫情防控所需的长期协调机制提供一个可供参考的模式。
For people involved in global health, what happened during the pandemic is disappointing, but not a surprise. The system whereby lower-income countries rely on the generosity of high-income country donors broke down when those donor countries were experiencing the same struggles. The next 18 months do not have to look like the past 18 months. But we cannot turn the page on this pandemic until we’ve addressed the fundamental inequity that stands in our way.
对于在全球健康领域工作的人来说，新冠疫情期间发生的很多事都令人失望，却并不让人意外。一直以来，低收入国家依赖高收入国家的捐赠，但这一次，这个系统在捐赠国本身也遭遇同样困境的时刻失效了。未来的18个月不必重复过去18个月的老路，但是，除非我们从根本上解决阻碍前进的不平等问题，否则我们将无法开启新的篇章。
I’m optimistic about the potential of this moment. Health is not a zero-sum game—we can meet everyone’s needs through planning, investment, collaboration, and applying lessons learned. The cost of this pandemic has already been unacceptably high. Ending it cannot come at the cost of progress on other global health and development priorities. Reducing poverty, advancing gender equality, and finishing the job of eradicating polio are all possible through the same collective action that is needed to end this pandemic.
现在的我依然对世界的潜力充满乐观，健康不是一场零和博弈——我们可以通过规划、投资、合作和吸取经验教训来满足每个人的需求。这场大流行病的代价已经高得令人无法承受。终结新冠疫情不能以牺牲其他全球健康与发展工作的进展为代价。终结新冠疫情所需的集体行动，也将在减贫、促进性别平等以及根除脊髓灰质炎等方面发挥同样的重要作用。
For those that want to go deeper, Gargee Ghosh who heads up the policy and advocacy division at the Gates Foundation has shared a white paper with more details on actions the world could take to end the COVID crisis.
如需了解更多，欢迎阅读盖茨基金会政策和倡导部门的负责人加吉·戈什（Gargee Ghosh）分享的白皮书，其中有更多世界可以为终结新冠危机采取的行动。
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