世卫组织总干事陈冯富珍博士在执委会第134届会议上的报告（中英对照）

英文版：Report by the Director-General to the Executive Board at its 134th Session.doc

中文版：世卫组织总干事在执委会第134届会议上的报告.doc

Report to the Executive Board at its 134th Session

在执委会第134届会议上的报告

 

Dr Margaret Chan, Director-General of the World Health Organization

世界卫生组织总干事陈冯富珍博士

 

Geneva, Switzerland

瑞士 日内瓦

 

20 January 2014

2014年1月20日

 

Madam chairperson, distinguished members of the Executive Board, colleagues in the UN system and sister agencies, Excellencies, ladies and gentlemen,

 

主席女士、尊敬的执行委员会委员们、联合国系统和姊妹机构的同仁、各位阁下、女士们、先生们：

 

I wish you all a happy and healthy 2014.

 

首先祝各位2014年幸福健康。

 

I will be brief. This session of the Executive Board has 67 items on its agenda, with 17 resolutions. This is by far the highest number of items ever scheduled for a non-budget year. We will all need to use our time with discipline and efficiency.

 

我的讲话会很简短。本届执行委员会议程上有67个项目，其中涉及17项决议。这是非预算年度安排议程项目最多的一届。我们大家都需要严格、高效地利用时间。

 

We have a crowded agenda and a crowded room, with a record-breaking number of registered participants.

 

我们的日程很紧，会议室里人也很多，因为注册与会者的数量又创下了历史记录。

 

The heavy agenda for this session shows the diversity of your concerns and also some measure of confidence that WHO is the right agency to address those concerns. I interpret the large number of participants as an indication of the high level of interest in global health.

 

本届会议的紧张议程表明，各位关心的议题非常多样化，而且你们也相信世卫组织正是处理这些关切的机构。我认为，与会者数量众多这一点也表明各国对全球卫生非常感兴趣。

 

Both are good, but outstrip the capacity of the Secretariat to prepare for this session and serve it well. And there are other, more serious problems.

 

这两件事都是好事，不过确实也超出了秘书处筹备本届会议并为其做好服务的能力。而且，还有其它更为严重的问题。

 

A lean, effective, and flexible WHO must be strategic and highly selective in the work it undertakes. I would rather see outstanding performance in a limited number of high-impact areas than a full menu approach that dilutes our energy and resources.

 

精简、有效、灵活的世卫组织必须具有战略性，其所开展的工作必须具有高度选择性。我更愿意看到我们在少数高影响领域表现出众，而不是面面俱到，使精力和资源无法集中。

 

This is an easy trap to fall into, and it is dangerous. If this happens, WHO will have a lot to say, but little to show, especially in terms of health outcomes in your countries.

 

这是个很容易落入的陷阱，而且非常危险。如果发生这种情况，世卫组织可能会说的太多而做的太少，特别是对各国的卫生成果而言。

 

Keep in mind: one reason for the success of the Millennium Development Goals was their limited number. Keep in mind: the Twelfth General Programme of Work, which you approved last May, includes just six leadership priorities.

 

请记住：千年发展目标取得成功的原因之一是目标数量有限。请记住：各位去年五月批准的第十二个工作总规划只有六个领导重点。

 

Part of the problem stems from the simple fact that the determinants of health have become broader and much more complex in a world where not only countries, but also policy spheres are closely interconnected.

 

部分问题来源于这样一个简单事实：当今世界，各国和各政策领域之间相互关联密切，因而健康的决定因素也更为广泛、更为复杂。

 

We are all aware that some new challenges, especially those driven by the globalization of unhealthy lifestyles, can only be addressed through collaboration with multiple sectors, including some industries.

 

我们都知道，只有通过多部门合作包括与企业界合作才能应对一些新挑战，特别是那些不健康生活方式的全球化所带来的挑战。

 

But WHO and its Member States must resist the temptation to cover every issue in the vast domain of public health. Please help us stick to those high-impact areas where we can get and measure results. Doing so becomes all the more important as the international community transitions to the post-2015 era.

 

但是，世卫组织及其会员国必须抵制覆盖公共卫生广泛领域内每个问题的诱惑。请帮助我们坚守我们可以取得并且衡量结果的高影响领域。随着国际社会转向2015年以后的时代，这样做越发重要。

 

The demands on WHO and ministries of health will only grow as noncommunicable diseases increase, populations age, cities become more crowded, and the climate changes.

 

随着非传染性疾病增加、人口老龄化、城市更为拥挤、气候发生变化，对世卫组织和各国卫生部的需求只会越来越多。

 

Public expectations for health care are rising and costs are soaring. Some new medicines and medical devices are unaffordable, even for the wealthiest countries in the world.

 

公众对于卫生保健的期望值越来越高，而卫生保健成本也在飙升。一些新药和医疗器械价格让人负担不起，即使对于世界上最富裕的国家也是如此。

 

Last year’s G8 summit on dementia, organized by the United Kingdom, made it clear that some major and very costly health problems have virtually no effective interventions for their prevention, early detection, or cure.

 

去年英国组织了有关痴呆症问题的八国集团峰会。会议清楚地表明，一些重大且费用昂贵的健康问题最终并没有有效的预防、早期发现或治愈措施。

 

WHO will need to perform extremely well in order to steer countries through these challenges.

 

要指导各国迎接这些挑战，世卫组织需要表现极为出色才行。

 

Ladies and gentlemen,

 

女士们、先生们，

 

In recent years, the Health Assembly has approved a number of global strategies and action plans for addressing specific diseases or needs. This is good. All have clearly defined objectives, targets, and indicators, and this helps ensure that countries and their partners align activities in a tightly focused and coordinated way.

 

近年来，卫生大会批准了一些针对具体疾病或需求的全球战略和行动计划。这很好。所有有关战略和计划都有明确的总体和具体目标以及指标，这有助于确保各国及其伙伴重点明确、相互协调地开展活动。

 

As we all know, the large number of health initiatives and actors has led to fragmentation, duplication of efforts, high transaction costs, and heavy reporting and monitoring requirements for countries.

 

众所周知，大量卫生行动和行动者的存在导致工作分散、重复，交易成本高以及各国面临沉重的报告和监测要求。

 

All of these global strategies and plans set out highly ambitious goals. This is also good, as it helps maintain the momentum for better health. But it has a downside.

 

所有这些全球战略和计划都列出了雄心勃勃的目标。这也是件好事，有助于为实现更好的卫生保持住势头。但它也有不利的一面。

 

Like the many partnerships and health initiatives, these strategies and plans impose a heavy burden on health system capacities and carry heavy expectations for monitoring and reporting.

 

与众多伙伴关系与卫生行动一样，这些战略和计划给卫生系统的能力带来沉重负担，而且带有监测和报告的沉重期望。

 

Last year, the Regional Committees discussed their capacity to implement the recently approved Global monitoring framework and targets for the prevention and control of noncommunicable diseases. In one region, not one single country was routinely producing the data needed to monitor some of the indicators.

 

去年，各区域委员会讨论了其落实预防控制非传染性疾病全球监测框架和具体目标的能力。在其中一个区域，没有一个国家定期产生监测有关指标所需的数据。

 

We should be ambitious with these strategies and plans, but also pragmatic and realistic. As we have learned since the start of this century, sustainable health improvements depend on a well-functioning health system. We must build the capacities of countries, not overburden them.

 

我们需要有雄心的战略和计划，但同时也要务实和切合实际。自本世纪初以来，我们已经认识到，可持续的卫生改进取决于运转良好的卫生系统。我们必须建设各国的能力，而不是给它们过重的负担。

 

I welcome the attention our governing bodies have given to the strengthening of health systems. Initiatives such as the International Health Partnership Plus are especially important as they help build capacity and self-reliance, which is the foundation for true country ownership.

 

我欢迎理事机构关注加强卫生系统问题。国际卫生伙伴关系后续程序等倡议尤为重要，因为它们有助于能力建设和自力更生，而那正是真正实现国家自主的基础。

 

We have much work to do.

 

我们有许多工作要做。

 

According to our latest estimates, only 81 of our 194 Member States regularly submit useable death registration data. Of these 81 countries, only 34 submit data of high quality.

 

根据最近的估算，194个会员国中只有81个国家定期提交可用的死亡登记数据。这81个国家中，只有34个国家提供的数据质量较高。

 

The need for stronger systems for regulatory control and enforcement runs like a common thread through many of your documents, whether concerning antimicrobial resistance, the mandatory notification of diseases, or access to opioid analgesics for palliative care.

 

不论是在抗菌素耐药性、疾病法定通报还是为姑息治疗获得阿片类镇痛药领域，你们的许多文件都提到有必要建立更强大的监管控制和执法体系。

 

For medicines, only around 20% of our Member States have a well-functioning regulatory authority, 50% have variable regulatory quality, and 30% have virtually no or only very limited capacity.

 

对于药品而言，只有约20%的会员国建立了运转良好的监管当局，50% 的会员国监管质量参差不齐，还有30%几乎没有或者只有非常有限的监管能力。

 

Worldwide, an estimated 2.7 billion people live in countries with no safety net to cover health care costs. In such a situation, how can health work as a poverty-reduction strategy, especially as the costly burden of NCDs shifts to the developing world?

 

全世界约有27亿人生活在没有社会安全网覆盖卫生保健费用的国家。在这种情况下，特别是随着非传染性疾病的昂贵负担向发展中国家转移，卫生怎么能发挥减贫的作用呢？

 

When I think about these statistics, I also think about people, the many millions of people being left behind in our highly unequal world. I thank Member States and partner agencies for their strong commitment to universal health coverage. In my view, this is one of the most positive and powerful trends in global health.

 

每当我想起这些数据，我想到的是人，在我们这个高度不平等的世界上被抛在后面的人。我要感谢会员国和伙伴机构致力于实现全民健康覆盖。在我看来，这是全球卫生领域最积极、最有力的趋势之一。