Ladies and gentlemen,
女士们、先生们，
All of these trends are certain
to increase the world’s inequalities even more. They define the tremendous job
that lies ahead for public health. They also shape expectations for the
performance of WHO, and the support countries, and the international community,
will need from this Organization.
所有这些趋势当然都加剧了世界的不平等。它们决定了公共卫生任重而道远。它们引出了人们对世卫组织工作的期待，表明了各国，还有国际社会将需要本组织提供哪些支持。
Health has an obligatory place on
any post-2015 development agenda. I think this is clear.
卫生在任何2015年后发展议程中都占有必不可少的一席之地。我想这一点是清楚的。
The global strategies and action
plans recently approved by Health Assemblies are already giving the
health-related Millennium Development
Goals a second life. The Global
Vaccine Action Plan aims to exceed the target set for reducing child
mortality. During this session, you will be considering some highly ambitious
new goals for tuberculosis and neonatal mortality.
卫生大会最近通过的全球战略和行动计划已经赋予卫生相关千年发展目标新的生命。《全球疫苗行动计划》旨在超越为降低儿童死亡率而确定的指标。在本届会议期间，大家将审议关于肺结核和新生儿死亡率的一些雄心勃勃的新目标。
We can move forward on very solid
ground. Pursuit of the MDGs has saved many millions of lives and spared untold
human misery. Health is blessed with a legacy of lessons, best practices, and
innovative instruments for securing funds, purchasing life-saving
interventions, and developing new products for diseases of the poor.
我们可以在一个极其坚实的基础上继续前行。对千年发展目标的追求已经拯救了数以百万计的生命，消除了种种难以描述的人类苦难。卫生受惠于前人的遗产，这些遗产包括经验教训，最佳做法，以及确保资金筹供、采购救死扶伤的干预工具和开发新的产品用以治疗穷人疾病的创新性手段。
The Global Fund, GAVI, UNITAID,
multiple partnerships for product development, and the International Health
Partnership Plus are part of this legacy.
抗击艾滋病、结核和疟疾全球基金，全球疫苗免疫联盟，国际药品采购机制，产品开发多边伙伴关系，以及国际卫生伙伴关系后续程序都是这一遗产的一部分。
We learned that high ambitions
pay off. The response to AIDS proved that seemingly impossible goals are
entirely feasible. Who could have imagined, at the start of this century, that
well over 12 million people would be receiving antiretroviral therapy today?
我们知道，有志者，事竟成。对艾滋病的应对就证明，看去不可能的目标完全是有可能的。在本世纪初，谁又能想象，今天已有超过1200万人接受了抗逆转录病毒治疗？
The WHO consolidated guidelines
for the treatment and prevention of HIV put the response on a solid footing
that readily accommodates even higher goals for the future. India’s eradication
of polio tells us there is no such thing as impossible.
世卫组织整合了治疗和预防艾滋病毒的指导方针，脚踏实地，制定了有关对策，完全适应今后更远大的目标。印度消除脊髓灰质炎告诉我们，没有什么事情是不可能的。
We learned that health is a smart
investment. It brings measurable results, sometimes remarkable results. In
fact, last year’s Lancet Commission on Investing in Health shows that the
returns on health investments are even higher than previously calculated.
我们知道，卫生是一项睿智的投资。它带来的成果是可以计量的，有些时候是很辉煌的。实际上，去年的柳叶刀卫生投资委员会表明，卫生投资的回报甚至高于以往的计算。
We learned that markets cannot
sell something to people who cannot pay. Childhood immunization programmes
deliver vaccines at no cost to recipients. The massive free distribution of
bednets coincided with dramatic drops in malaria cases and deaths.
我们知道，市场不会向无力付钱的人出售东西。儿童免疫规划向接受者提供免费疫苗。伴随蚊帐的大规模无偿分发，疟疾病例和死亡率也同步下降了。
The bottom billion receive
medicines for neglected tropical diseases at no cost. Universal health coverage
goes hand-in-hand with financial risk protection, especially for the poor.
底层的10亿人免费接受药物，治疗被忽视的热带病的。全民健康覆盖与财务风险保护，尤其是对穷人的保护齐头并进。
But we also learned that policies
matter as much as money. Countries with the same level of resources achieve
strikingly different health outcomes. The right policies, especially when they
make equity an explicit objective, make the difference. This underscores the
decisive role of domestic leadership, and is one reason why appreciation for
country ownership has deepened.
但我们也知道，政策与金钱同等重要。资源水平相当的国家，卫生成果可能截然不同。正确的政策，尤其是在以平等为明确目标时，导致了这一不同。这就凸显出国内领导层的决定性作用，这也是为什么人们愈发重视国家所有权。
We learned, too, how much the
world needs an organization like WHO. Within the framework of our leadership
priorities, WHO is shaping the health agenda as needs evolve, and using
multiple mechanisms and partnerships to meet these needs. If anything, the
relevance of this Organization has increased.
我们还了解到世界多么需要像世卫组织这样的一个组织。在我们领导作用优先事项的框架内，卫生组织正在随着需求的演变调整卫生议程，并利用多种机制和伙伴关系来满足这些需求。无论如何，本组织的相关性得到了加强。
WHO leads in line with need. The
leadership role given to WHO by the 2011 UN political declaration on NCDs came
with a number of time-bound responsibilities, which we continue to fulfil.
世卫组织根据需求进行引导。 2011年《联合国大会关于预防和控制非传染性疾病问题高级别会议政治宣言》为世卫组织指定的领导作用包含若干有时限的责任，我们正在继续履行这些责任。
Much of our work has direct
relevance in countries. We identified “best buys” for NCD prevention and
control. We used our authority to alert the world to the need to reduce daily
sugar consumption, based on evidence of the association with dental caries and
obesity.
我们的许多工作对国家具有直接相关性。为非传染疾病的预防和控制确认了“最合算的”干预措施。我们利用权威提请世界注意，根据与龋齿和肥胖症相关的证据，必须减少每日的糖摄取量。
We continue to support the health
needs of the elderly: their need to stay in their homes as long as possible,
their need for people-centred care that looks after co-morbidities, including
mental problems like dementia.
我们继续支持老年人的卫生需求：他们需要尽可能长期住在家里，他们需要以人为本的医疗以便处理各种合并症，包括痴呆症等精神问题。
WHO shapes policies. The growing
commitment to universal health coverage can act as a counterweight to many of
the trends I have described. UHC is one of the most powerful social equalizers
among all policy options.
世卫组织制定各方面的政策。对全民健康覆盖日益增长的承诺可以作为一种力量，以便抵消我所描绘的许多趋势。在所有政策方案中，全民健康覆盖是实现社会公正的最强大工具之一。
The World Bank is now a welcome
partner in helping countries make their health systems more inclusive. This
engagement sends a strong signal that UHC is financially feasible and makes
good economic sense.
世界银行现在已成为一个受欢迎的伙伴，它帮助各国使其卫生系统更具包容性。这种参与发出了一个有力的信号，即全民健康覆盖在财政方面是可行的，并具有很好的经济意义。
WHO gets the prices of
commodities down, helping countries and donors get more from their investments.
The prequalification programme makes supplies of medical products more plentiful,
predictable, and affordable. Pooled procurement gains economies of scale.
世卫组织使商品价格降低，从而帮助国家和捐者获得更高的投资效益。资格预审规划使医疗产品的供应更加丰富、更可预测并更可负担得起。集中采购实现了规模经济。
WHO facilitates negotiations with
industry for concessional prices. For drugs for diseases of the poor, WHO
negotiations have cut prices by as much as 90%. For the neglected tropical
diseases, WHO negotiates and manages very large drug donations from multiple
industry partners, amounting to 900 million doses last year. This is a huge
undertaking with huge benefits.
世卫组织促进与制药业谈判以获得优惠价格。针对用于穷人疾病的药物，世卫组织的谈判使价格降低了多达90%。针对被忽视的热带病，世卫组织争取和管理来自众多制药业伙伴的大量药物捐赠，去年达9亿剂。这是一项具有巨大效益的巨大任务。
WHO constantly monitors evolving
trends and sounds the alarm when needed. For communicable diseases, one of the
most alarming crises is the rise of antimicrobial resistance, which WHO
documented in a report last month. This is a crisis that now affects every
region of the world, and it is only getting worse. The new report on adolescent
health is another alert to neglected needs.
世卫组织不断监测演变的趋势并在必要时发出警报。关于传染性疾病，最令人震惊的危机之一是抗菌剂耐药性的上升，世卫组织在上个月的一份报告中有这方面的记载。这一危机现在影响世界上的每个区域，而且情况越来越严重。关于青少年健康的新报告是针对被忽视的需求的另一个警报。
WHO takes up the cause for orphan
problems, and gives them a home. When I took office, I was told that
strengthening health systems has zero appeal, zero glamour for donors, and low
priority on the development agenda. This has thankfully changed.
世卫组织处理孤儿问题，为他们提供家庭。当我开始任职时，我得知加强卫生系统对捐助者的吸引力为零，
魅力为零，而且在发展议程中不受重视。值得庆幸的是，这种情况已经改观。
We are now arguing for similar
attention to regulatory capacity. Countries must have well-functioning
regulatory authorities to protect their populations, whether from tainted food,
unsafe medical products, tobacco, drink-driving, air pollution, notifiable
infectious diseases, or the marketing of unhealthy foods and beverages to
children.
我们现在正争取使管制能力获得同等重视。国家必须有运行良好的管制当局来保护其人口，无论是针对受污染的食品、不安全的医疗产品、烟草、酒后驾驶、空气污染、应通报的传染病或者向儿童营销不健康的食品和饮料
。
Countries also need
well-functioning information systems. The new accountability frameworks for
results-driven initiatives depend on reliable information.
国家还需要运行良好的信息系统。针对以结果为导向的行动制定的问责制新框架依赖于可靠的信息。
Overall, only around one third of
all deaths worldwide are recorded in civil registries along with cause-of-death
information. Think about what this means: we are investing in black holes. WHO
has repeatedly stressed the urgent need to tackle that data gap and make
systems for civil registration and vital statistics a top priority.
在整体上，全世界所有死亡案例中只约三分之一纪录在民事登记册并提供死因信息。请想一想这意味着什么：我们正在投资于黑洞。世卫组织反复强调迫切需要解决这种数据空白并使民事登记和人口动态统计系统成为一项首要优先重点。
Fortunately, some Member States
with excellent civil registries have taken a leadership role in making this
happen elsewhere. It is this spirit of solidarity that makes me proud to work
for WHO and contributes to my optimism about the future.
幸运的是，具有完备民事登记册的一些会员国发挥了领导作用，使这项工作在其它地方得以开展。这种团结精神使我为能够在世卫组织工作感到自豪，并推动了我对未来的乐观态度。
Ladies and gentlemen,
女士们、先生们，
For health, the previous century
largely relied on the technology-driven medical model to combat communicable
diseases. With NCDs now the biggest killers worldwide, this century must be an
era where prevention receives at least as much priority as cure.
关于卫生，上个世纪主要依靠技术推动的医疗模式来应对传染性疾病。非传染性疾病现在是全世界最主要的杀手，所以本世纪必须是预防至少得到与治疗同等重视的一个时代。
Last year, I attended an
international conference that looked at strategies for a tobacco end-game, that
is, strategies that could end tobacco use altogether.
去年，我参加了一次国际会议，会上审议了烟草尾声战略，即可完全终止烟草使用的战略。
Thirty years ago, who could have
imagined that health could take such a firm stand against such an economically
and politically powerful industry?
三十年以前，有谁能够想象卫生界会采取如此坚定的立场来抗衡经济和政治上这么强大的一个行业？
Given the importance of
prevention to protect healthy human capital, we will need to argue for the
supremacy of health concerns over economic interests with other industries.
This will not be easy.
鉴于预防对保护健康人力资本的重要性，我们将需要争取使卫生方面关注的问题获得高于其它行业经济利益的至高地位。这并不容易。
As recent experience shows, even
the very best scientific evidence can have less persuasive power than corporate
lobbies.
最近的经验显示，即便是最佳的科学证据也可能比不过企业游说的鼓动力。
For the post-2015 agenda, I see
many signs of a desire to aim ever higher, with ambitious yet feasible goals.
Many more end-games are already on the table. End preventable maternal,
neonatal, and childhood deaths. Eliminate a large number of the neglected
tropical diseases. End the TB epidemic.
关于2015 年后的议程，我看到很多迹象表明希望有更高的目标，既要有雄心，又要可行。更多的尾声战略已提交讨论。要停止发生可预防的孕产妇、新生儿和童期死亡。要消除许多被忽视的热带病。要终止结核病流行。
We have at our disposal a host of
strategies for pursuing ever higher goals. Some of these strategies have been
refined by two large programmes that are marking their 40th anniversaries this
year: the Expanded Programme on Immunization, or EPI, and the Special Programme
for Research and Training in Tropical Diseases, or TDR.
为了追求更高的目标，我们有许多可用的战略。两大规划完善了其中有些战略。今年将庆祝这两个规划成立四十周年：扩大免疫规划，即EPI，以及热带病研究和培训特别规划，即TDR 。
From the outset, EPI has been a
paradigm of prevention and a pathfinder for universal access to services. EPI
showed how a constant simplification of operational demands on programmes
promotes country ownership. In other words, make things easy to own. This was
done through several innovations, including profiles of ideal products that
encourage the pharmaceutical industry to develop and package new vaccines that
are easy to use under harsh conditions.
从一开始，扩大免疫规划就是一个预防范式和普遍获取服务的探路者。扩大免疫规划表明持续简化对规划的业务需求可如何促进国家自主决策权。换言之，使事情更容易掌握。通过若干创新做到了这一点，包括确定理想产品的概要情况，鼓励制药业开发和包装在艰苦条件下便于使用的新疫苗。
The establishment of GAVI in 2000
helped launch the most innovative EPI decade to date. Tomorrow, GAVI is meeting
development ministries of the European Union to launch a drive to extend access
to vaccines even further. I join fellow GAVI partners in offering my full
support to this launch and a successful GAVI replenishment.
在2000年建立了全球疫苗和免疫联盟，帮助发起了迄今最具创新性的扩大免疫规划十年。明天，全球疫苗和免疫联盟将与欧洲联盟各国发展部委举行会议，发起进一步扩大疫苗普及面的运动。我与全球疫苗和免疫联盟各伙伴一起，完全支持这一行动以及全球疫苗和免疫联盟的成功充实。
In recent years, TDR has moved
away from its initial focus on product discovery and development to concentrate
more on implementation research for communicable diseases of the poor. TDR now
uses the tools of scientific investigation to understand why good drugs, good
diagnostic tests, and good preventive strategies fail to reach people in need.
In other words, to find the barriers to access and break them down.
近年来，热带病研究和培训特别规划从最初侧重于产品发现和开发转向更注重于针对穷人的传染性疾病的实施研究。特别规划现在使用科学调查工具了解为什么良好的药物、良好的诊断测试法以及良好的预防战略不能达及有需求的人们。换言之，要找到阻止获取服务的障碍并清除这些障碍。
TDR also innovates to help
countries get the most out of their resources. One example stands out. The original
strategy of community-directed treatment to deliver ivermectin for river
blindness was expanded to support integrated delivery of a range of critical
health interventions.
特别规划还开展创新，帮助国家发挥其资源的最大效益。有一个例子特别突出。对社区督导下提供伊维素治疗河盲症的战略进行了扩大，以便支持综合地提供一系列关键性卫生干预措施。
Coverage more than doubled, also
for malaria interventions, at lower costs than conventional parallel delivery
systems. Success draws on the great desire of communities to manage their own
priority health problems, taking us back to the basics of the primary health
care approach.
覆盖率翻了一番以上，疟疾干预措施的情况也同样，成本低于传统的平行服务提供系统。成功来自社区管理自身重点卫生问题的巨大愿望，这使我们又回到了初级卫生保健方法的基本原则。
Health also benefits from WHO’s
ability to tap the world’s best expertise. I am deeply concerned by the
increasing prevalence of childhood obesity in every region of the world, with
the increase fastest in low- and middle-income countries. In the African region
alone, the number of overweight children increased from 4 million in 1990 to 10
million in 2012. This is worrisome. As the 2014 World Health Statistics report
bluntly states, “Our children are getting fatter.”
卫生工作也受益于世卫组织利用世界上最佳专门技术的能力。我深切关注儿童期肥胖症在世界上每个区域不断上升的患病率，上升速度最快的是低收入和中等收入国家。仅在非洲区域，体重过重的儿童人数就从1990年的400万增加到2012年的1000万。这很令人担忧。2014年的世界卫生统计报告直截了当地指出，“我们的儿童正在变得更加肥胖”。
To gather the best possible
advice on dealing with this crisis, I have established a high-level Commission
on Ending Childhood Obesity. Fortunately, science defines several opportunities
for intervention.
为了收集关于应对这一危机的尽可能最佳意见，我建立了一个高级别的终止儿童期肥胖症委员会。幸运的是，科学确定了若干干预机会。
What I expect from the Commission
is a state-of-the-art consensus report on which specific interventions, and
which combinations, are likely to be most effective in different contexts
around the world. I have asked the Commission to deliver its report to me in
early 2015 so that I can convey its recommendations to next year’s Health
Assembly.
我期望该委员会提供一份最先进的共识报告，说明哪些具体干预措施以及哪些组合在世界各地不同的环境中可能会最有效。我要求该委员2015年初向我提交报告，使我能够向明年的卫生大会转达其建议。
Ladies and gentlemen,
女士们、先生们，
As I conclude, let me thank
Member States, the owners and shareholders of this Organization, and their
Geneva missions, for taking us so far on the road to WHO reform. The two
financing dialogues held to date proposed solutions to problems that have hindered
our performance for years.
在我结束讲话时，让我感谢各会员国，即本组织的主人和股东，以及它们驻日内瓦的代表团，它们使我们在世卫组织改革的道路上前进。迄今为止举行的两次筹资对话针对多年来影响我们绩效的问题建议了解决办法。
Given the challenges that lie
ahead, and the high expectations for health, WHO’s dedicated and committed
staff will need to perform better than ever. We are well-motivated to do so.
鉴于前进路上的挑战以及对卫生的高度期望，世卫组织全体具有献身精神的忠诚职员将需要比以往任何时候表现得更好。我们有积极性做到这一点。
Better health is a good way to
track the world’s true progress in poverty elimination, inclusive growth, and
equity.
衡量健康改善的情况是跟踪世界在消除贫穷、包容性增长和公平性方面所取得真实进展的一个良好方法。
Thank you.
谢谢。 |
