陈冯富珍在关于《国际卫生条例》在埃博拉疫情应对中的作用问题审查委员会上的开幕词（ ...

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Opening Remarks at the Review Committee on the Role of the International Health Regulations in the Ebola Outbreak and Response

在关于《国际卫生条例》在埃博拉疫情和应对中的作用问题审查委员会上的开幕词

 

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

世卫组织总干事 陈冯富珍博士

 

Geneva, Switzerland

瑞士 日内瓦

 

24 August 2015

 2015年8月24日

 

Mr Chair, distinguished members of the Review Committee, ladies and gentlemen,

 

主席先生，尊敬的审查委员会各位成员，女士们、先生们：

 

Good morning, and a very warm welcome to Geneva. Thank you for giving us your time and your expertise.

 

上午好！非常欢迎大家来到日内瓦。谢谢你们拿出时间并凭借专门技能前来参会。

 

You are asked to provide a critical review of how the International Health Regulations performed during the outbreak of Ebola virus disease in West Africa.

 

你们受邀对《国际卫生条例》在西非埃博拉病毒病疫情期间的实施情况开展严格审查。

 

The review takes place at a time of nearly universal agreement that the international response to the outbreak was inadequate. When the number of cases in Guinea, Liberia, and Sierra Leone began to increase exponentially, all responders, including WHO, were overwhelmed.

 

这次审查是在几乎普遍认为对这次疫情的国际反应不够充分的时刻进行的。当几内亚、利比里亚和塞拉利昂的病例数量开始呈几何级数上升时，包括世卫组织在内的所有应对方都不堪负重。

 

Since Ebola first emerged in 1976, WHO and its partners have responded to 22 previous outbreaks of this disease. Even the largest were contained within four to six months.

 

自从埃博拉于1976年首次出现以来，世卫组织及其伙伴对该病以往出现的22次疫情做出了应对。即使是最大的疫情也在四至六个月内得到控制。

 

In West Africa, WHO, and many others, were late in recognizing the potential of the outbreak to grow so explosively. Some warning signals were missed. Why?

 

这次在西非，世卫组织和许多其它方面很晚才意识到本次疫情可能会如此急剧上升。错失了一些预警信号。这是为什么？

 

Our challenge now is to look for improvements that leave the world better prepared for the next inevitable outbreak.

 

我们现在的挑战是找到改进办法，使这个世界在下一次不可避免的疫情面前做出更好准备。

 

Managing the global regime for controlling the international spread of disease is a central and historical responsibility of the World Health Organization. We need to pinpoint the reasons why the response fell short. We need to learn the lessons. We need to put in place corrective strategies just as quickly as possible.

 

为控制疾病的国际传播而掌管全球制度，这是世界卫生组织的一项历史性核心责任。我们需要确定这次反应功亏一篑的原因所在。我们需要汲取经验教训。我们需要尽快提出纠正策略。

 

The IHR is a principal instrument for doing so. These regulations are the only internationally-agreed set of rules governing the timely and effective response to outbreaks of infectious diseases and other public health emergencies.

 

《国际卫生条例》是实现这一目标的一个主要工具。这些条例仅仅是国际商定的一套规则，对及时有效应对传染病疫情和其它突发公共卫生事件作了规定。

 

If its legally-binding obligations on States Parties are not being met, change is urgently needed. If WHO is not exercising its full authority under the regulations, change is urgently needed.

 

当缔约国没有履行其法定义务时，就迫切需要作出改变。当世卫组织不能履行条例规定的所有权限时，就迫切需要作出改变。

 

Your job is not an easy one. Emerging and re-emerging infectious diseases have become a much larger menace under the unique conditions of the 21st century, with its unprecedented volume and speed of international travel and the radically increased interdependence among nations.

 

你们的任务并非轻而易举。新出现和再现的传染病在21世纪这种特定条件下已经变得更具威胁性，国际旅行的数量和速度达到了前所未有的程度，各国之间的相互依存关系大大加深。

 

Every day, nearly 100,000 flights carry 8.6 million passengers and $17.5 billion of goods to their destinations.

 

每天约有10万个航班运载着860万乘客，另有价值175亿的货物被运往其目的地。

 

The dynamics of virus spread in West Africa had many exceptional features. But it would be a mistake to forget that many other countries also have extremely weak health systems and infrastructures, a history of conflict and civil unrest, highly mobile populations, and entrenched high-risk cultural practices.

 

该病毒在西非的传播态势具有多个很不寻常的特点。但忽略以下情况也是不对的：许多国家的卫生系统和基础设施也极为薄弱，冲突和内乱历史、人口流动性大并且一些高度危险性文化做法根深蒂固。

 

Ebola in West Africa was the largest, longest, and most deadly event in the nearly four-decade history of this disease. But it was not a worst-case scenario.

 

西非埃博拉是该病近40年历史上最大规模、最为漫长、最为致命的事件。而这还不是最坏情况。

 

Preparedness for the future means preparedness for a very severe disease that spreads via the airborne route or can be transmitted during the incubation period, before an infected person shows tell-tale signs of illness.

 

对将来做出防备就意味着对一种十分严重的疾病做出准备，这种疾病可以通过空气传播方式蔓延开来，或者在感染者出现种种患病体征之前在潜伏期就能引起传播。

 

Ladies and gentlemen,

 

女士们、先生们，

 

As you undertake this review, you have the views and recommendations of three expert groups as guidance.

 

在你们开展审查时，三个专家小组提出的意见和建议对你们会有所指导。

 

First, the review committee that assessed IHR performance during the 2009 influenza pandemic. Second, the review committee that looked at IHR core capacities. And most recently, the report of the Ebola interim assessment panel, chaired by Dame Barbara Stocking. These expert groups have identified three main weaknesses in the performance of the IHR.

 

首先是对2009年流感大流行期间《国际卫生条例》的实施情况作出评估的审查委员会。其次是对《国际卫生条例》核心能力作过审视的审查委员会。还有最近由Barbara Stocking夫人主持的埃博拉中期评估小组提出的报告。这些专家小组提出了在实施《国际卫生条例》方面存在的三个主要弱点。

 

First, compliance with the obligation to build core capacities for event detection and response has been dismal. Eight years after the IHR entered into force, fewer than a third of WHO Member States meet the minimum requirements for core capacities to implement the IHR.

 

首先，在根据要求建设事件发现和应对核心能力方面不尽人意。《国际卫生条例》生效八年以来，尚不足三分之一的世卫组织会员国达到了实施《国际卫生条例》核心能力的最低要求。

 

Why? Is this because health security is not a priority for governments and the international community? Is this because SARS was contained within less than four months, and the long-dreaded influenza pandemic turned out to be so mild? Did everyone relax?

 

这是为什么呢？是由于卫生安全不是政府和国际社会的工作重点？是否因为SARS在不到四个月的时间内得到了控制，长期以来令人担惊受怕的流感大流行到头来是这样温和？是否所有人都松了懈？

 

Or is it a matter of not having sufficient financial and human resources? As you know, the IHR wording, that “States Parties shall utilize existing national structures and resources to meet their core capacity requirements,” places resource responsibilities squarely on the shoulders of individual governments.

 

或者是否因为没有足够的资金和人力资源？正如你们所知道的那样，《国际卫生条例》“缔约国应当利用现有的国家机构和资源，满足核心能力要求”这一措词明确将资源责任放在了各个国家政府的身上。

 

Are the minimum requirements set out in the IHR too demanding? Should we lower the bar? Surely not.

 

是不是《国际卫生条例》阐明的最低要求过高？我们是否需要降低这些限制性规定？当然不是。

        

But perhaps we should change our whole approach to the way progress is supported and monitored.

 

然而我们可能需要改变用来支持和监测进展的整个工作方式。

 

I have heard broad agreement that the practice of relying on self-assessments needs to be replaced with a more rigorous and objective mechanism. You may want to further explore options for doing so.

 

我听到的多数一致意见是，依靠自我评估的做法需要由更加强有力的目标机制来替换。你们可以就这样做的可选方案进一步进行探讨。

 

Many factors have been cited as contributing to this poor compliance with core capacities.

 

人们提到了多个造成这种没有很好的遵守核心能力要求的促成因素。

 

In a number of countries, implementation of the IHR is regarded as the sole responsibility of ministries of health, with very little engagement from other relevant ministries, such as those responsible for finance, trade, tourism, agriculture, and animal health.

 

多个国家将《国际卫生条例》的实施仅仅视为卫生部的责任，极少会涉及到其它相关部门，比如负责财政、贸易、旅游、农业和动物卫生的部门。

 

National focal points often have limited authority and very little access to a country’s true power base. Misunderstanding of the IHR as a rigid, legal process further constrains compliance.

 

国家归口单位的权限往往十分有限，极少可以接近国家的真正权力基础。将《国际卫生条例》误解为一种僵硬的法律程序，这进一步限制了其遵守程度。