双语|比尔·盖茨:新冠肺炎可能成为百年不遇的大流行病(附视频)
英语演讲视频,第一时间观看
面对正在全球蔓延的新冠肺炎疫情,世界领袖承担着重要责任:既要加速创新研发拯救更多生命,也要联合起来从长远改善全球大流行病应对机制。为此,比尔·盖茨发表文章,呼吁“全球领导人应当立即行动,刻不容缓。”
In any crisis, leaders have two equally important responsibilities: solve the
immediate problem and keep it from happening again. The Covid-19 pandemic is a
case in point. We need to save lives now while also improving the way we respond
to outbreaks in general. The first point is more pressing, but the second has
crucial long-term consequences.
The long-term challenge — improving our ability to respond to outbreaks —
isn’t new. Global health experts have been saying for years that another
pandemic whose speed and severity rivaled those of the 1918 influenza epidemic
was a matter not of if but of when.1 The Bill and Melinda Gates Foundation has
committed substantial resources in recent years to helping the world prepare for
such a scenario.
Now we also face an immediate crisis. In the past week, Covid-19 has started
behaving a lot like the once-in-a-century pathogen we’ve been worried about. I
hope it’s not that bad, but we should assume it will be until we know
otherwise.
There are two reasons that Covid-19 is such a threat. First, it can kill
healthy adults in addition to elderly people with existing health problems. The
data so far suggest that the virus has a case fatality risk around 1%; this rate
would make it many times more severe than typical seasonal influenza, putting it
somewhere between the 1957 influenza pandemic (0.6%) and the 1918 influenza
pandemic (2%).2
Second, Covid-19 is transmitted quite efficiently. The average infected
person spreads the disease to two or three others — an exponential rate of
increase. There is also strong evidence that it can be transmitted by people who
are just mildly ill or even presymptomatic.3 That means Covid-19 will be much
harder to contain than the Middle East respiratory syndrome or severe acute
respiratory syndrome (SARS), which were spread much less efficiently and only by
symptomatic people. In fact, Covid-19 has already caused 10 times as many cases
as SARS in a quarter of the time.
National, state, and local governments and public health agencies can take
steps over the next few weeks to slow the virus’s spread. For example, in
addition to helping their own citizens respond, donor governments can help low-
and middle-income countries (LMICs) prepare for this pandemic.4 Many LMIC health
systems are already stretched thin, and a pathogen like the coronavirus can
quickly overwhelm them. And poorer countries have little political or economic
leverage, given wealthier countries’ natural desire to put their own people
first.
By helping African and South Asian countries get ready now, we can save lives
and slow the global circulation of the virus. (A substantial portion of the
commitment Melinda and I recently made to help kickstart the global response to
Covid-19 — which could total up to $100 million — is focused on LMICs.)
The world also needs to accelerate work on treatments and vaccines for
Covid-19.5 Scientists sequenced the genome of the virus and developed several
promising vaccine candidates in a matter of days, and the Coalition for Epidemic
Preparedness Innovations is already preparing up to eight promising vaccine
candidates for clinical trials. If some of these vaccines prove safe and
effective in animal models, they could be ready for larger-scale trials as early
as June. Drug discovery can also be accelerated by drawing on libraries of
compounds that have already been tested for safety and by applying new screening
techniques, including machine learning, to identify antivirals that could be
ready for large-scale clinical trials within weeks.
All these steps would help address the current crisis. But we also need to
make larger systemic changes so we can respond more efficiently and effectively
when the next epidemic arrives.
It’s essential to help LMICs strengthen their primary health care systems.
When you build a health clinic, you’re also creating part of the infrastructure
for fighting epidemics. Trained health care workers not only deliver vaccines;
they can also monitor disease patterns, serving as part of the early warning
systems that alert the world to potential outbreaks.
We also need to invest in disease surveillance, including a case database
that is instantly accessible to relevant organizations, and rules requiring
countries to share information. Governments should have access to lists of
trained personnel, from local leaders to global experts, who are prepared to
deal with an epidemic immediately, as well as lists of supplies to be stockpiled
or redirected in an emergency.
In addition, we need to build a system that can develop safe, effective
vaccines and antivirals, get them approved, and deliver billions of doses within
a few months after the discovery of a fast-moving pathogen. That’s a tough
challenge that presents technical, diplomatic, and budgetary obstacles, as well
as demanding partnership between the public and private sectors. But all these
obstacles can be overcome.
One of the main technical challenges for vaccines is to improve on the old
ways of manufacturing proteins, which are too slow for responding to an
epidemic. We need to develop platforms that are predictably safe, so regulatory
reviews can happen quickly, and that make it easy for manufacturers to produce
doses at low cost on a massive scale. For antivirals, we need an organized
system to screen existing treatments and candidate molecules in a swift and
standardized manner.
Another technical challenge involves constructs based on nucleic acids. These
constructs can be produced within hours after a virus’s genome has been
sequenced; now we need to find ways to produce them at scale.
Beyond these technical solutions, we’ll need diplomatic efforts to drive
international collaboration and data sharing. Developing antivirals and vaccines
involves massive clinical trials and licensing agreements that would cross
national borders. We should make the most of global forums that can help achieve
consensus on research priorities and trial protocols so that promising vaccine
and antiviral candidates can move quickly through this process. These platforms
include the World Health Organization R&D Blueprint, the International
Severe Acute Respiratory and Emerging Infection Consortium trial network, and
the Global Research Collaboration for Infectious Disease Preparedness. The goal
of this work should be to get conclusive clinical trial results and regulatory
approval in 3 months or less, without compromising patients’ safety.
Then there’s the question of funding. Budgets for these efforts need to be
expanded several times over. Billions more dollars are needed to complete phase
3 trials and secure regulatory approval for coronavirus vaccines, and still more
funding will be needed to improve disease surveillance and response.
Government funding is needed because pandemic products are extraordinarily
high-risk investments; public funding will minimize risk for pharmaceutical
companies and get them to jump in with both feet. In addition, governments and
other donors will need to fund — as a global public good — manufacturing
facilities that can generate a vaccine supply in a matter of weeks. These
facilities can make vaccines for routine immunization programs in normal times
and be quickly refitted for production during a pandemic. Finally, governments
will need to finance the procurement and distribution of vaccines to the
populations that need them.
Billions of dollars for antipandemic efforts is a lot of money. But that’s
the scale of investment required to solve the problem. And given the economic
pain that an epidemic can impose — we’re already seeing how Covid-19 can disrupt
supply chains and stock markets, not to mention people’s lives — it will be a
bargain.
Finally, governments and industry will need to come to an agreement: during a
pandemic, vaccines and antivirals can’t simply be sold to the highest bidder.
They should be available and affordable for people who are at the heart of the
outbreak and in greatest need. Not only is such distribution the right thing to
do, it’s also the right strategy for short-circuiting transmission and
preventing future pandemics.
These are the actions that leaders should be taking now. There is no time to
waste.
提高疫情应对能力是世界长期面临的挑战。全球健康专家近年来多次提醒,传播速度和严重程度都堪比1918年大流感的大流行病势必会发生,只是时间早晚的问题。比尔及梅琳达·盖茨基金会近年来已经投入大量的资源,帮助世界做好应对此类疫情的准备。
▲我们还没有为应对下一次大流行病做好准备(图源:GatesNotes)
如今,我们还面临着眼下的危机。在过去一周,2019新型冠状病毒开始表现出百年不遇的病原体的迹象,这是我们一直担心的。我希望情况不会这么糟糕,但我们应该做好充分准备。
新冠肺炎的威胁主要基于两点原因。首先,除了已经存在健康问题的老年人以外,新冠肺炎还能造成健康成年人的死亡。目前的数据表明,2019新型冠状病毒的病死率在1%左右,这一数据介于1957年大流感(病死率0.6%)和1918年大流感(病死率2%)之间,说明它比典型的季节性流感要严重好几倍。
其次,新冠肺炎传播力很强。平均一个感染者会传染两到三个人,形成指数级增长。另有确切证据表明,它可以通过轻症甚至无症状的患者传播。这意味着新冠肺炎将比中东呼吸综合征(MERS)和非典型性肺炎(SARS)更难控制,因为MERS和SARS只通过已经出现症状的患者传播,且传播力低很多。事实上,新冠肺炎在短短四分之一的时间内就已经造成了十倍于SARS的确诊病例。
关于疫苗的一项主要技术挑战,是改善生产蛋白质的方式,传统方式对于应对传染病疫情实在太慢了。我们需要开发安全可靠的平台,确保监管审查可以迅速进行,也能让制造商以低成本进行量产。对于抗病毒药物,我们需要有一个有组织的系统以快速和标准化的方式筛选已有的治疗方法和候选分子。
2016年比尔●盖茨TED演讲
上下滑动,阅读完整版
When I was a kid, the disaster we worried about most was a nuclear war. That's why we had a barrel(桶)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(蹲下), and eat out of that barrel.
当我还是小孩时, 我们最担心的灾害是核战争。所以我们在地下室有个这样的筒子, 装满了罐头食物和水。当核战争爆发时, 我们就要躲到地下室去, 蹲低身子并靠那个筒子维生。
Today the greatest risk of global catastrophe(灾难)doesn'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(传染性的) virus rather than a war. Not missiles(导弹), but microbes(细菌).
今天的全球灾难最大的危险 看起来已不像这样了。事实上,会像这样。如果有什么东西在未来几十年里 可以杀掉上千万人, 那比较有可能是个高度传染的病毒, 而不是战争。不是导弹,而是微生物。
Now, part of the reason for this is that we've invested a huge amount in nuclear deterrents(威慑物). But we've actually invested very little in a system to stop an epidemic(传染病). We're not ready for the next epidemic.
部分的理由是因为我们在核威慑上投注了很大的精力和金钱。但是我们在防止疫情的 系统上却投资很少。我们还没有准备好预防 下一场大疫情的发生。
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 tools we use to track polio(脊髓灰质炎)eradication.
让我们看看埃博拉病毒。我相信大家在报纸上 都有读到这样的新闻, 充满了许多艰难的挑战。用我们追踪消灭脊髓灰质炎(小儿麻痹)的 案例分析工具, 我仔细地追踪这病毒的发展。
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.
随着疫情的发展我们可以看到, 问题不在于我们没有一套 可以使用的系统, 而是我们根本没有任何系统。事实上我们可以看到有几个 很明显的不足。
We didn't have a group of epidemiologists(流行病学家)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 online and they were extremely inaccurate. We didn't have a medical team ready to go. We didn't have a way of preparing people.
我们找不到一群准备好了的流行病学家,能去疫区看看病因和病情发展。病例都是由纸上报道传来的。信息传上线时已经很晚了,此外还很不准确。我们也找不到训练有素的医护小组。我们没有一套让人们严阵以待的方法。
Now, Médecins Sans Frontières(无国界医生)did a great job orchestrating(安排) volunteers. But even so, we were far slower than we should have been getting the thousands of workers into these countries.
目前,“无国界医生” 在动员志愿者上做了很大的贡献。但即使如此,我们调动数千名 工作者到疫区的速度 还是十分差强人意的。
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(诊断学). No one to figure out(想出;弄明白) what tools should be used.
大的疫情会需要我们动员 数十万的人员, 但我们没有任何人在研究治疗的方向。也没有人在看诊断的方法。没有人在想该用什么工具。
As an example, we could have taken the blood of survivors, processed it, and put that plasma(血浆)back in people to protect them. But that was never tried.
举个例子来说, 我们也许可以抽取生还者的血液, 处理过后,再将血浆注入 人体内来保护没得病的人。但是这个方法从来没有试过,
So there was a lot that was missing. And these things are really a global failure. The WHO is funded to monitor(监测)epidemics, but not to do these things I talked about.
所以有很多事都还没来得及做。而这的确是全球性的失败。世界卫生组织的目的是来监视流行病, 而不是来做我刚讲的事。
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.
但是在电影中演的剧情又是另一回事。有一群很英俊的流行病学家准备就绪, 他们到了疫区拯救了大家, 但这是纯好莱坞的剧情。
The failure to prepare could allow the next epidemic to be dramatically more devastating than Ebola. Let's look at the progression(进展)of Ebola over this year. About 10,000 people died, and nearly all were in the three West African countries.
我们的准备不足 , 可能会导致下一场疫情, 比埃博拉病毒的危害更严重。让我们看看埃博拉病毒在 过去一年中的发展。大约死了一万人, 所有的死者都在西非的三个国家里。
There's three reasons why it didn't spread more. The first is that there was a lot of heroic(英雄的;勇敢的)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(卧床不起的). 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.
之所以没有扩散的原因有三个。第一个是卫生工作人员作的很多英雄事迹。他们找到很多病人 并防止了更多人得病。第二个是病毒的特性, 埃博拉病毒不是靠空气传染的。等到你有足够的传染力时, 大部分的人已经病得卧床不起了。第三个是因为病毒没有传到都会区。这纯粹是运气好。如果病毒传到了都会区, 那么死亡的人数绝对不止于此。
So next time, we might not be so lucky. You can have a virus where people feel well enough while they're infectious that 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(生物恐怖主义). So there are things that wouldliterally make things a thousand times worse.
所以下一次我们可能不会这么幸运了。有的病毒可能让你毫无察觉, 但当感染病毒的人乘飞机或者去逛商场, 他们其实已经具有一定的传染力了。此外病毒的来源可以是 天然的,像埃博拉病毒, 或是由生物恐怖攻击产生的。所以可以让疫情惨上千倍的病毒是存在的。
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.
事实上,让我们来看看一个病毒 由空气传染的模型, 像1918年的西班牙流感。疫情有可能像这样发展:病毒会以很快的速度向全世界蔓延。你可以看到全球有三千万人死于这个疾病。这是个很严重的问题。我们绝不应该忽视。
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 phones to get information from the public and get information out to them. We have satellite maps(卫星地图)where we can see where people are and where they're moving.
但事实上我们可以建立一个很好的反应系统。我们可以利用所有发展至今的科技和科学。我们可以用手机来收集信息和发布信息。我们有卫星地图可以看到人们在哪里和往哪移动。
We have advances in biology that should dramatically change the turnaround time to look at a pathogen(病原体)and 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.
我们在生物学上也有进展, 这可以大幅缩短我们找到病原的时间, 并可以在很短的时间里找出解药和疫苗。所以我们是有工具的, 但这些工具必须统合在一个全球健康系统下。此外我们必须处在准备好的状态。
The best lessons, I think, on how to get prepared are again, what we do for war. For soldiers, we have full-time, waiting to go. We have reserves that can scale us up(提高;增加)to large numbers.
而我们如何做好准备,最好的例子还是来自于备战。对军人来说,他们是随时随地 都准备好要投入战争的。我们还有预备军人, 能使备战人口大量增加。
NATO has a mobile unit that can deploy(部署;展开)very rapidly. NATO does a lot of war games to check, are people well trained? Do they understand about fuel and logistics(后勤)and 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.
北约组织有个机动小组,可以很快地行动起来。北约组织有很多战争游戏可以测试人员是否已训练有素?他们是否了解燃油,补给和相同的收音机频率?是的话,那么他们就已准备好了。这些就是面对疫情时我们该准备的事。
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.
关键的项目有哪些?第一,在贫穷的国家里 必须有发达的卫生系统。母亲们可以安全地生小孩, 小孩们可以接种疫苗。我们也可以在很早的阶段侦查到疫情的爆发。
We need a medical reserve corps(部队): lots of people who've got the training and background who are ready to go, with the expertise(专业技能). And then we need to pair those medical people with the military. taking advantage of the military's ability to move fast, do logistics and secure areas.
我们需要后备的医疗部队:还有很多训练有素的专业人员,随时准备好能带着他们专长到疫区。我们可以用军队来配合医护人员, 利用军队移动迅速的特性, 来进行后勤运输和维持安全。
We need to do simulations(模拟), germ(病菌)games, not war games, so that we see where the holes are. The last time a germ game was done in the United States was back in 2001, and it didn't go so well. So far the score is germs: 1, people: 0.
我们也需要进行一些情境模拟, 不是进行战争游戏而是进行病菌游戏 , 看看防卫漏洞在哪。上一次的病菌游戏是在美国进行的, 那是在2001年了, 进行得也不是很顺利。目前病菌得一分人类零分。
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.
最后我们在疫苗和病理学上 还需要很多的研发工作。在某些方面例如腺相关病毒上, 我们已经有了相当的突破, 这可以在很短的时间内生效。
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 dollars and we'd have millions and millions of deaths. These investments offer significant(重要的)benefits beyond just being ready for the epidemic. The primary healthcare, the R&D, those things would reduce global health equity and make the world more just as well as more safe.
我目前没有明确的预算 这到底需要多少钱, 但是我确信跟损失比起来是比较便宜的。根据世界银行的估算, 如果我们有流感的疫情暴发, 全球经济会损失三万多亿美元。我们还会可能有千百万人员的死亡。跟仅仅只是准备好比起来,这些额外的投资会带来显著的益处。基础的卫生保健,研发,可以促进全球健康的平衡发展,让这个世界更健康更安全。
So I think this should absolutely be a priority(重点;优先). There's no need to panic(恐慌). We don't have to hoard(贮藏货物)cans of spaghetti or go down into the basement. But we need to get going, because time is not on our side.
所以我觉得这非常重要、刻不容缓。也不需要惊慌。我们不需要囤积面罐头或是躲到地下室去, 但是我们必须急起直追,因为时间有限。
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(叫早电话;让人警醒的事), to get ready. If we start now, we can be ready for the next epidemic.
事实上,要说这场埃博拉病毒的疫情 带来了什么正面影响的话, 那就是提早响起了警报, 让我们觉醒并做好准备。我们如果即刻开始准备,那么在 下一场疫情来临前我们是可以准备好的。
往期精彩英语演讲集
防止未来失联
请长按识别二维码关注备用号
想第一时间接收英语演讲文章&视频?把精彩英语演讲设置为星标就对了!操作办法就是:进入公众号——点击右上角的●●●——找到“设为星标”点击即可。
点击阅读原文查看更多精彩英语演讲!
最新评论
推荐文章
作者最新文章
你可能感兴趣的文章
Copyright Disclaimer: The copyright of contents (including texts, images, videos and audios) posted above belong to the User who shared or the third-party website which the User shared from. If you found your copyright have been infringed, please send a DMCA takedown notice to [email protected]. For more detail of the source, please click on the button "Read Original Post" below. For other communications, please send to [email protected].
版权声明:以上内容为用户推荐收藏至CareerEngine平台,其内容(含文字、图片、视频、音频等)及知识版权均属用户或用户转发自的第三方网站,如涉嫌侵权,请通知[email protected]进行信息删除。如需查看信息来源,请点击“查看原文”。如需洽谈其它事宜,请联系[email protected]。
版权声明:以上内容为用户推荐收藏至CareerEngine平台,其内容(含文字、图片、视频、音频等)及知识版权均属用户或用户转发自的第三方网站,如涉嫌侵权,请通知[email protected]进行信息删除。如需查看信息来源,请点击“查看原文”。如需洽谈其它事宜,请联系[email protected]。