陈冯富珍总干事在世界卫生组织执行委员会第136届会议上的报告（中英对照）

Ladies and gentlemen,

女士们、先生们，

As the international development community transitions into the post-2015 era, we can celebrate some extremely encouraging trends and achievements. The Millennium Development Goals have been good for public health.

随着国际发展共同体进入2015年后时代，我们可以为一些极其鼓舞人心的趋势和成就而庆贺。公共卫生因《千年发展目标》而受益良多。

Last year, especially good news came from a report showing that child mortality rates are falling faster than ever before. In 2013, 17 000 fewer children died each day than in 1990. Maternal deaths have also fallen, but not far or fast enough. While these efforts continue, WHO’s additional objectives include ending neonatal deaths and doing more to improve adolescent health.

去年，一份报告披露了一个极好的消息，显示儿童死亡率的下降要比以往任何时候都更快。2013年，每日死亡的儿童比1990年少1.7万人。孕产妇的死亡率也在下降，但却不够快。这些努力仍在继续中，世卫组织的新目标包括终止新生儿死亡，再接再厉来增进青少年健康。

Of all the health-related MDGs, reducing maternal mortality has been the most problematic. Doing so depends not on the delivery of a single intervention, like vaccines, bednets, and cocktails of medicine, but on a well-functioning health system, with access to skilled birth attendants and emergency obstetric care. Ending neonatal deaths likewise depends on multiple health system functions.

在所有卫生相关千年发展目标中，降低孕产妇死亡率是最困难的一个。要做到这一点，依赖的不是交付单一干预措施，例如疫苗、蚊帐以及混合药物，而是依赖运转良好的卫生系统，获得熟练接生人员的帮助，接受紧急产科护理服务。终结新生儿死亡同样依赖卫生系统的多重功能。

Many AIDS experts believe the epidemic reached a tipping point last year. At the end of 2013, close to 13 million people worldwide had received antiretroviral therapy, nearly 12 million of them in low- and middle-income countries. The AIDS experts will also tell you how much WHO’s public health approach to this disease and streamlined and simplified clinical guidelines contributed to this monumental achievement.

许多艾滋病专家相信，这一流行病在去年达到了临界点。2013年底，全世界有将近1300万人接受了抗逆转录病毒治疗，其中将近1200万人生活在低收入和中等收入 国家。艾滋病专家还将告诉你，世卫组织对这一疾病的公共卫生方针，以及对临床指南的梳理和简化为这一里程碑式的成就作出了多大贡献。

The Global Programme on Malaria issued its most encouraging report to date. Progress has been real and substantial, supported by large-scale distribution of treated mosquito nets. Progress has also benefitted from WHO’s work to prequalify medicines and diagnostics, to keep a close watch over the development of resistance to medicines and insecticides, and to tailor control strategies to the local context.

全球遏制疟疾规划发表了迄今为止最鼓舞人心的报告。进展是真实的和巨大的，得到了大规模分发经杀虫剂处理的蚊帐工作的支持。进展还缘于世卫组织在以下方面的工作，即对药物和诊断方法进行资格预审，密切监督药物和杀虫剂耐药性的发展，以及采取因地制宜的战略。

Building on past success, ambitions for tuberculosis rose, with WHO targeting more than 30 countries for elimination of the disease. That goal was supported by improvements in diagnosing TB’s multidrug-resistant forms.

在以往成功的基础上，遏制结核病的雄心也高涨起来，世卫组织确认了消除这一疾病的30多个目标国家。这一目标得到了在诊断结核病广泛耐药性方面进展的支持。

Like many other programmes at WHO, the ones for AIDS, TB, and malaria have been good at stimulating innovation and seizing the advantages of new technologies.

如同世卫组织的其它许多规划一样，艾滋病、结核病和疟疾规划也都有助于激励创新，利用新技术的好处。

Next month WHO will launch a report on the global status of the neglected tropical diseases. As you know, these diseases anchor more than a billion people in poverty. Just 3 statistics from that report give you an idea of the results achieved, and their scale.

下个月，我们将发表一份关于被忽视的热带病全球状况的报告。大家知道，这些疾病拖累10多亿民众沦入贫困境地。该报告只用三个统计数据即向你说明了所取得的成果，以及它们的规模。

Verification that lymphatic filariasis has been eliminated has begun in 6 countries. Sustained efforts by a network of African countries have reduced the incidence of African sleeping sickness by 90%. Since 2006, over 5 billion anti-parasitic treatments have been delivered to some of the poorest people on earth.

对消除淋巴丝虫病的核查已在六个国家展开。非洲一个国家网络的持续努力将非洲昏睡病的发病率减少了90%。2006年以来，向地球上一些最贫穷的人交付了50多亿次抗寄生虫治疗。

This initiative is paving the way for an exodus from poverty.

这一举措为摆脱贫困铺平了道路。

Ladies and gentlemen,

女士们、先生们，

The health challenges we will face in the post-2015 era are considerable. With the rise of chronic noncommunicable diseases, the sharp divide between health problems in wealthy and developing countries is dissolving.

我们将在2015年后时代面临的卫生挑战是巨大的。随着慢性非传染性疾病的渐趋猖獗，富国与发展中国家卫生问题之间的明显分野消失了。

Health everywhere is being shaped by universal pressures, like the globalized marketing of unhealthy products, population ageing, and rapid urbanization. These forces have created multiple health burdens that need to be addressed at the same time, but with different strategies.

世界各地的健康都受制于普遍的压力，例如不健康产品的全球化营销、人口老龄化，以及迅速的城市化。这些力量造成了多种卫生负担，需要同时以不同的战略来加以解决。

The ancient burden of deaths from infectious diseases has been joined by a newer burden of even more deaths from NCDs. Rapid unplanned urbanization has added a third burden: deaths from road traffic crashes and the mental disorders, substance abuse, and violence that thrive in impoverished urban settings.

伴随古往今来传染病带来的死亡负担，又有更多人死于非传染性疾病的新的负担。迅速的无计划的城市化增添了第三个负担：死于道路交通事故和精神疾患、物质滥用，以及城市贫民区盛行的暴力。

The report on adolescent health gives a good indication about how these burdens vary from one WHO region to another.

关于青少年健康问题的报告清楚指明了这些负担如何从世卫组织一个区域到另一个区域而互有不同。

In the Americas, interpersonal violence is responsible for 1 in every 3 deaths among adolescent males in low- and middle-income countries. In wealthy countries, most adolescent deaths follow traffic injuries.

在美洲，人际暴力造成的死亡占低收入和中等收入国家男性青少年死亡的三分之一。在富余国家，大多数青少年死亡来自交通伤害。

In the Eastern Mediterranean, war or conflict is the leading cause of deaths in youth. For girls in South-East Asia, it is suicide. In sub-Saharan Africa, it is HIV/AIDS.

在东地中海区域，战争或冲突是青年人死亡的主要原因。对东南亚区域的女童来说，死亡的主要原因是自杀。在撒哈拉以南非洲，主要原因是艾滋病毒/艾滋病。

Last year’s second International Conference on Nutrition underscored another dual burden. The extremes of undernutrition and overnutrition increasingly coexist in the same countries, communities, and even households. Once again, that conference showed how international systems, such as those that govern trade, have a major, sometimes detrimental impact on health.

去年召开的第二次国际营养大会强调了另外一个双重负担。在同一些国家、社区甚至家庭中，极端的营养不足和营养过剩越来越多的同时并存。该次大会再度表明，国际制度，例如国际贸易制度如何对健康产生重大、有时是决定性的影响。

Such non-health drivers of disease underscore the need for governments to establish coherent policies that avoid a situation where strategies that are good for one sector have costly adverse consequences for health.

疾病的此类非卫生驱动因素强调需要各国政府制定协调一致的政策，避免在某个部门效果很好的战略，却给健康带来极其严重的后果。

The nutrition conference gave WHO many urgent assignments, as did the UN General Assembly’s review of progress in controlling NCDs. We also have a heavy workload ahead as programmes transition into the post-2015 era and adjust their goals and strategies.

营养大会如同联合国大会审查非传染性疾病的控制进展情况的会议一样，赋予了世卫组织许多紧迫的使命。我们在今后也有大量工作有待去做，因为各个规划都转入了2015年后时代，都在调整其目标和战略。

As guidance, we have a growing number of global action plans and technical strategies approved by our governing bodies. You will be reviewing one for malaria during this session.

各理事机构批准了越来越多的全球行动计划和基础战略，指导我们的工作。在本届会议上，大家将审议关于疟疾问题的一项。

WHO reform is also on your agenda. I am confident you will go through reform-related reports and proposals with your usual care and eye to the future roles and responsibilities of WHO.

世卫组织改革也在大家的议程上。我相信，大家将像往常一样，认真审视与改革相关的报告和建议，并着眼于世卫组织今后的作用和职责。

Ladies and gentlemen,

女士们、先生们，

The challenges ahead are more complex than they were at the start of this century. For many of them, delivering medical commodities will not be enough, as reducing several major health threats requires action from multiple non-health sectors.

我们今后面对的挑战要比本世纪发轫之初更为复杂。就许多挑战而言，仅仅提供医疗产品是不够的，因为削除若干重大卫生威胁，要求多个非卫生部门采取行动。

It also requires behavioural change. This includes changes in human behaviours, one of the hardest jobs in public health, but also changes in the behaviours of powerful economic operators.

这还需要行为改变，其中包括公共卫生中最艰巨的任务之一——改变人类行为，但也包括改变强大的经济运营者的行为。

Public health, with its emphasis on population-wide prevention and fairness in access to health-promoting and life-saving interventions, increasingly operates in a world fraught with dangers around every corner. Many arise from human mismanagement of our crowded planet’s environment, systems for food production, and resources, including fragile antimicrobial medicines.

公共卫生，强调全体人口的防范以及在享有增进健康和拯救生命的干预措施方面的公正性，它的运作日益处在危机四伏的世界背景下。这些危险，许多是源于人类对我们人满为患的星球环境、粮食生产体系、资源，包括脆弱的抗菌药物管理不善。

Some dangers, like obesity, are highly visible. Others come from the invisible and volatile microbial world. Still others are made visible by WHO’s watchdog functions that monitor global trends and sound the alarm when these trends turn ominous.

一些危险，例如肥胖症，是触目可见的。其它则来自隐密和活跃的微生物世界。还有一些危险，端赖世卫组织的监督职能，才引起人们注意，世卫组织监测全球趋势，当这些趋势显露不祥苗头时，随即发出警示。

The fact that the price of essential medicines more than doubles as economies grow is one. The harm caused by air pollution is another. In calls to reduce that harm, we can see how much the world depends on WHO’s monitoring functions and trusts the safe standards we set.

随着经济的增长，基本药物价格翻了一番还多，即是危险之一。空气污染导致的伤害是另一个危险。通过呼吁减轻这一伤害，我们可以看到世界在多大程度上依赖世卫组织的监测职能，相信我们所制定的标准。

You noted many other dangers during yesterday’s special session on Ebola. Let me close with a brief description of another current outbreak that is receiving very little attention: plague in Madagascar.

在昨日关于埃博拉问题的特别会议上，大家指出了其它许多危险。请允许我在结束发言时简单描述一下当下人们很少注意的另一场疫情：马达加斯加的鼠疫。

This is the kind of geographically focused and readily manageable outbreak that WHO was designed to contain. Plague is endemic in Madagascar, where seasonal outbreaks are amplified by the dual forces of poverty and unplanned urbanization. Detected early, the disease responds well to treatment. Researchers at the country’s Institut Pasteur, supported by WHO, have developed a cheap and reliable diagnostic test that delivers results in 15 minutes.

这是一场地理上集中，不难管理的疫情，世卫组织决意加以遏制。鼠疫在马达加斯加很流行，季节性疫情因贫穷和无计划的城市化这双重因素而加剧。早期发现疾病，治疗将是有效的。该国由世卫组织支助的巴斯德研究所的研究人员，开发了廉价和可靠的诊断检测方法，在15分钟内即可得出结果。

But the outbreak that started last November has some disturbing dimensions. The fleas that transmit this ancient disease from rats to humans have developed resistance to the first-line insecticide. Plague established a foothold in the capital city, affecting densely populated slums. This is alarming, as around 8% of cases progress to the lethal pneumonic form, which transmits directly from person to person.

但去年11月暴发疫情有一些令人不安的情况。将这一古老疾病从老鼠身上传播给人类的跳蚤对一线杀虫剂产生了耐药性。鼠疫在首都城市立足，肆虐于人口密集的贫民窟。这很令人担忧，因为大约8%的病例将发展为致死性的肺鼠疫，并在人与人之间直接传播。

Last week, floods from a tropical storm in the Indian Ocean and a cyclone hit Madagascar, displacing tens of thousands of people and untold numbers of rats, raising the risk of more rodent-borne epidemics.

上个星期，印度洋热带风暴引发的洪水和一场龙卷风袭击了马达加斯加，成千上万的民众流离失所，数不胜数的老鼠也四散奔逃，加剧了有更多啮齿类动物传播流行病的风险。

As you discuss the items on the draft programme budget 2016–2017 and WHO reform, I ask that you keep in mind the need for a strong and flexible WHO well-equipped to respond to these kinds of surprises, setbacks, and complex dangers.

在大家讨论2016-2017年规划预算方案和世卫组织改革等项目时，我请大家牢记需要一个强大和灵活的世卫组织，随时准备应对此类种种意外、挫折和错综复杂的危险。

Thank you.

谢谢大家。