世卫总干事陈冯富珍博士阐述非传染性疾病在战略和议程中的位置（中英对照）

英文版：WHO Director-General addresses the place of noncommunicable diseases in strategi.doc

中文版：陈冯富珍博士阐述非传染性疾病在战略和议程中的位置.doc 

Opening Remarks at a Dialogue on How to Encourage the Continued Inclusion of Noncommunicable Diseases in Development Cooperation Agendas and Initiatives, Internationally Agreed Development Goals, Economic Development Policies, Sustainable Development Frameworks and Poverty Reduction Strategies

在关于如何鼓励继续将非传染性疾病纳入发展合作议程和倡议、国际商定的发展目标、经济发展政策、可持续发展框架和减贫战略的对话上的开幕词

 

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

 

21 April 2015

2015年4月21日

 

Ambassadors, invited speakers, experts in public health, representatives of sister UN agencies, professional associations, civil society, and philanthropies, ladies and gentlemen,

 

各位大使、特邀发言者、公共卫生专家,以及姊妹联合国机构、专业协会、民间社会和慈善机构的代表们、女士们、先生们，

 

Welcome to this high-level dialogue where you will be discussing the response to noncommunicable diseases as an issue for development cooperation and a route to poverty reduction.

 

欢迎参加本次高级别对话，大家将在这里讨论作为一个发展合作问题以及减贫路径对非传染性疾病的应对。

 

The challenges facing public health have changed dramatically in character and complexity since the start of this century, when NCDs were not included among the Millennium Development Goals.

 

本世纪开端时，非传染性疾病并没有纳入千年发展目标，但此后，公共卫生所面临挑战的特点和复杂性发生了极大变化。

 

Since then, a number of events and reports, and a host of research studies and economic estimates have increased the visibility of NCDs as a development issue and caused several long-standing assumptions to crumble.

 

自那以来，一系列的事件和报告，以及许多研究报告和经济统计数字彰显了非传染性疾病作为一个发展问题的存在，导致若干长期存在的假设崩溃。

 

Fifteen years into the 21st century, the health community is grappling with some game-changing statistics.

 

进入二十一世纪这15年，卫生界一直在与一些改变游戏规则的统计数字相纠缠。

 

Worldwide, NCDs have overtaken infectious diseases as the leading cause of mortality. This shift challenges traditional development thinking, which has long focused primarily on infectious diseases and maternal and child mortality as priorities for international action. We continue to support this focus, but need to make space for additional challenges.

 

在世界范围，非传染性疾病超过传染病，成为死亡率的主要原因。这一转换改变了主要注重传染病和母婴死亡率，将之作为国际行动优先考虑的传统发展思维。我们继续支持这一侧重点，但需要为种种新的挑战留出空间。

 

Around 70% of the world’s poor now live in middle-income countries, where economic growth and modernization have opened wide the entry point for the spread of unhealthy lifestyles. This is likely the first time in history that economic growth threatens to damage health rather than improve it.

 

世界上有大约70%的穷人生活在中等收入国家，在这些国家，经济增长和现代化开启了传播不健康生活方式的大门。这很可能是历史上的第一次，经济增长有可能损害健康，而不是增进健康。

 

NCDs can no longer be conceptualized as a rich-country problem. WHO estimates that 80% of the burden from NCDs now falls on low- and middle-income countries, where people develop these diseases earlier, fall sicker, and unfortunately die sooner than their counterparts in wealthy nations.

 

非传染性疾病不再被视为富国的麻烦。世卫组织估计，非传染性疾病负担的80%落在低收入和中等收入国家的身上，人们早早患上此类疾病，病情渐趋加重，不幸的是，他们要比富裕国家的同类患者死得更快。

 

Nor can we continue to think of NCDs as the killers of the old and frail. WHO estimates that NCDs are responsible for 14 million premature deaths in the developing world each year.

 

我们也不能再认为，非传染性疾病是老年人和羸弱者的杀手。世卫组织估计，非传染性疾病每年在发展中世界造成1400万例过早死亡。

 

In some developing countries in Asia, the number of deaths from cardiovascular disease before the age of 55 is twice that in wealthy countries. The reference to type 2 diabetes as “adult onset diabetes” is no longer apt, as so many children are now being diagnosed with this disease. Just two decades ago, type 2 diabetes was almost never seen in children.

 

在亚洲一些发展中国家，55岁之前心血管疾病的死亡数字两倍于富裕国家。将II型糖尿病称为“成人型糖尿病”已经不再贴切，因为为数众多的儿童现在被诊断患有这种疾病。仅仅20年前，II型糖尿病在儿童中间几乎闻所未闻。

 

The responsibility for the rise in NCDs does not fall on individuals who choose to eat, smoke, and drink too much or opt for a sedentary lifestyle. The responsibility falls on the environments in which these choices are made.

 

非传染性疾病的兴起，不应归咎于个人贪食、酗酒或吸烟过多，或选择了久坐不动的生活方式，而应归咎于造成了这些选择的环境。

 

Can children be blamed for an addiction to nicotine when single cigarettes are sold at the gates of their schoolhouse? Can parents be blamed for their overweight children when cities have no green spaces or the crime rate is so high that children are not safe playing outdoors? For the millions of people living in so-called “urban food deserts”, healthy eating is simply not an option.

 

难道可以责怪儿童尼古丁成瘾，却不问学校门口就有单支香烟在售卖？难道可以为儿童超重责怪其父母，却不问城市中没有绿地，或犯罪率过高，儿童不能在户外安全玩耍？对生活在所谓的“城市食品荒漠”中的千百万人来说，健康饮食根本就不是一个选项。

 

Ladies and gentlemen,

 

女士们，先生们，

 

This is the first big challenge. The evidence, statistics, and arguments you put forward for international cooperation must stress the need for policy solutions that shape social environments. These solutions must be supported at the highest level of government, and they need to be put in place through a whole-of-government approach.

 

这是第一个巨大挑战。你们就国际合作提出的证据、统计数字和论据都应强调需要制定塑造社会环境的政策解决办法。这些解决办法必须得到政府高层的支持，并通过整个政府的方针加以推行。

 

A second big challenge is competition. With 17 goals and 169 targets currently proposed for the post-2015 development agenda, this is competition for a sliver or some crumbs from the pie, not a piece.

 

第二个巨大挑战是竞争。2015年后发展议程，目前有17个目标和169个具体目标，这中间的竞争，关乎能从蛋糕中分得一片还是只有几粒残渣，且不要说一大块了。

 

You are being asked to sharpen the evidence showing the two-way links between NCDs and poverty. You are being asked to make a stronger case for viewing the prevention and control of NCDs as an explicit poverty-reduction strategy.

 

我们请大家拿出更确凿的证据，显示非传染性疾病与贫穷之间的双向联系。我请大家更有力地论证为何要将预防和控制非传染性疾病视为一项明确的的减贫战略。

 

You are being asked to provide an inventory of international agencies that have integrated NCDs into their development policies and extract the lessons learned. We want to hear your proposals about how official development assistance can be used to strengthen prevention and control, yet without compromising funding for other health priorities.

 

我们请大家提供一份将非传染性疾病纳入其发展政策并从中汲取经验教训的国际机构名单。我们希望从你们那里听到有关建议，说明国际发展援助如何可用于防控工作，同时不会影响其它卫生重点的资金筹供。

 

We ask you to do all of these things because of your expertise, knowledge, and experience.

 

所以要请大家做所有这些事情，是因为你们的专长、知识和经验。

 

A third big challenge is the opposition. This is opposition from powerful economic operators who strongly oppose any regulatory control or restrictions on their marketing of health-harming products.

 

第三个巨大挑战是反对力量。反对来自那些势力强大的经济运营者，他们强烈反对就他们销售的有害健康的产品进行任何管控或限制。

 

This is a formidable obstacle to prevention. Economic power readily translates into political power. We rely on civil society for support in many areas, but most especially in this one.

 

这是预防工作面对的一个可怕障碍。经济实力随时可转化为政治势力。我们在许多领域依赖民间社会的支持，在这一领域，情况尤其如此。

 

The public health community has some tools in hand to respond to these challenges. The 2011 UN Political Declaration on NCDs sets out some compelling arguments.

 

公共卫生界掌握一些应对这些挑战的手段。2011年的《联合国非传染性疾病政治宣言》载有一些令人信服的说法。

 

It positions these diseases as one of the major challenges for development in the 21st century. It points out their threat to economies and their contribution to inequalities.

 

该宣言将这些疾病列为二十一世纪的发展面临的主要挑战之一。它指出了其对经济的威胁，以及其对不平等的助长。

 

It gives the primary role and responsibility of responding to these challenges to governments. And it underscores how strongly prevention and control depend on the engagement of multiple non-health sectors.

 

它指出，政府负有应对这些挑战的基本作用和责任。它强调了强有力的预防和控制依赖多个非卫生部门的参与。

 

To guide work, we have an action plan through 2020, a monitoring framework with 9 global targets, and a set of effective and affordable interventions, known as “best buys”, that can make a difference in any resource setting.

 

为指导工作，我们有一个直至2020年的行动计划，一个有9项全球目标的监测框架，以及一整套切实和可负担的干预措施，称为“最合算的”干预措施，可在任何资源背景下都产生影响。

 

As the root causes of NCDs lie beyond the direct purview and responsibility of the health sector, combatting these diseases is a complex task involving multiple sectors. Here, too, we have support from the Global Coordination Mechanism and a UN Interagency Task Force.

 

非传染性疾病的根本原因超出了卫生部门的职能和责任范围，因此，与这些疾病的斗争是一项涉及多个部门的复杂任务。这里，我们同样有全球协调机制和联合国机构间工作队的支持。

 

Ladies and gentlemen,

 

女士们，先生们，

 

Let me conclude by repeating two points made in the discussion paper prepared for this meeting.

 

最后，让我重复为本次会议准备的讨论文件中的两点。

 

First, the UN General Assembly’s 2014 progress review found no lack of high-level government commitment to NCDs. But it witnessed, in far too many countries, a lack of capacity to act, largely because of insufficient national expertise in low- and middle-income countries. International cooperation can provide this expertise.

 

第一，联合国大会2014年的进展审查认为，对非传染性疾病，不缺乏高级别的政府承诺。但它看到有太多国家缺乏行动能力，这主要是由于在低收入和中等收入国家，国家专门知识不足。国际合作可提供这类知识。

 

Second, efforts to prevent and control NCDs depend on a well-functioning health system, ideally one that aims to reach universal health coverage. Any look at the interactions between NCDs and poverty must also look at ways to increase access to care and reduce the catastrophic medical bills that push so many millions of families below the poverty line each year.

 

其次，对非传染性疾病的预防和控制取决于运转良好的卫生系统，最好是意在实现全民健康覆盖的卫生系统。对非传染性疾病与贫穷之间相互作用的任何检视，都必须同时检视如何增进保健的获取，减少灾难性的医疗费用，正是此类费用，每年将数百万家庭推入贫困线以下。

 

Thank you.

 

谢谢大家。