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（ ...

Ladies and gentlemen,

女士们、先生们，

At the very least, the Ebola outbreak in West Africa provides dramatic proof of the importance of having minimum capacities and infrastructures in place before a severe disease becomes established in a population.

至少这次西非埃博拉疫情给人们带来了大量证据，以此证明当某种严重疾病在人群中扎下根之前具备最低限度的能力和基础设施十分重要。

Ebola in Guinea, Liberia, and Sierra Leone was an extreme stress test that saw the virtual collapse of health services.

在几内亚、利比里亚和塞拉利昂发生的埃博拉是一次极端强度测试，这使人看到了卫生服务几近崩溃的一面。

The national responses in Nigeria, Senegal, and Mali show the good results possible when health officials are on high alert and the health system is well-prepared. But overall, national and international responses show how far the world is from achieving global health security. Overall, these experiences provide a stunning example of all that was missing, all that can go wrong.

尼日利亚、塞内加尔和马里作出的国家性反应表明，当卫生官员处于高度戒备，卫生系统作出良好准备时就可能取得良好结果。但总体而言，国家和国际应对情况表明，这个世界离实现全球健康保障的距离有多远。总之，这些经验用例证很好地说明了所缺失的一切，可能会出错的一切。

The IHR call for national capacity “to detect events involving disease or death above expected levels for the particular time and place in all areas within the territory”.

《国际卫生条例》要求具备“发现领土内所有地区与特定时间和地点发生的超过预期水平的涉及疾病或死亡的事件”的国家能力。

But how can countries that routinely experience deaths from diseases like malaria, Lassa fever, yellow fever, typhoid fever, dengue, and cholera recognize an unusual event in the midst of all this background noise from difficult and demanding diseases?

而面临困难和棘手疾病这类背景噪音时，平常遇有因疟疾、拉沙热、黄热病、伤寒、登革热和霍乱等疾病造成的死亡的国家如何才能看到不寻常事件？

Maybe this is another truly fundamental problem that keeps the IHR from working as intended.

也许这是另一个真正使《国际卫生条例》无法按照预想情况正常运转的根本性问题。

The Ebola virus circulated in Guinea for three months, undetected, off every radar screen, with no alarms sounding, misdiagnosed as cholera, then thought to be Lassa fever.

埃博拉病毒在没有被发现的情况下在几内亚流行了三个月，它没有出现在雷达防线上，没有发出警报，被误诊为霍乱，又想到了拉沙热。

Even in Sierra Leone, where health officials were on high alert, the virus spread undetected for at least a month, sparking numerous chains of transmission that rapidly multiplied.

塞拉利昂的卫生官员保持着高度警惕，即便如此该病毒在没有被发现的情况下至少传播了一个月，触发了多个很快成倍数增长的传播链。

The earliest cases to reach the health system were managed as gastroenteritis, again with a diagnosis of cholera presumed.

最早抵达卫生系统的病例按照胃肠炎做了处置，又一次被假定诊断为霍乱。

Within six weeks, three hotspots of intense virus transmission were firmly established.

病毒严重传播的三个热点在六个星期之内就稳稳的扎下根来。

As we learned, cases at the start of an outbreak, when containment has the best chance of success, will be missed in the absence of sensitive surveillance, rapid laboratory support, and good information systems shared by the public health and clinical sectors. If the two arms of the health system are not talking or sharing information to raise awareness and take rapid action, we have seen what can happen

正如我们所学到的，在疫情之初对病例实施控制就有很大的可能取得成功，在缺少敏感性监测系统，没有快速实验室支持和由公共卫生和临床部门共享的良好信息系统的情况下就会错失这些病例。当卫生系统的这两个部门不能够以提高认识和采取快速行动为目的而相互交流并分享信息，我们已经看到了可能会出现什么情况。

As I always say, what gets measured gets done. What can’t be seen can’t be measured or managed.

我总在说，能衡量，始能执行。无法看到的东西就不能得到衡量或者处理。

As we learned, when new cases occur that cannot be linked to a known chain of transmission, an outbreak is out of control.

正如我们所学到的，当病例的发生不能与已知传播链建立联系时，疫情就会失控。

Ladies and gentlemen,

女士们、先生们，

As a second weakness, many countries imposed measures, such as restrictions on travel or trade, that went well beyond the temporary recommendations issued by the Emergency Committee last August.

第二个弱点就是许多国家采取了旅行或者贸易限制等措施，这大大超出了去年八月突发事件委员会发布的临时建议。

These measures isolated the three countries and vastly increased economic hardship for some of the world’s poorest people. All three ran short of food and fuel.

这些措施使这三个国家与外界隔绝，大大增加了世界上最为贫穷的一部分人的经济困难。三个国家都缺少食物和燃料。

Just as important, travel restrictions, including the many airlines that suspended flights to West Africa, impeded the arrival of desperately needed response teams and equipment.

同样重要的是，这些旅行限制，包括许多航空公司暂停了前往西非的航班，使前往灾区的急需应对团队和设备遭受了困难。

If countries are punished in this way, where is the incentive for rapid and transparent reporting?

如果国家受到这等惩罚，哪有动力作出快速且透明的疫情报告？

Whether and under what circumstances countries should be permitted to implement health measures beyond those recommended by WHO was a politically charged issue when the IHR were negotiated.

各国是否并且在何种情况下应当被准予在世卫组织提出的建议之外采取卫生措施，这是在《国际卫生条例》谈判过程中一个带有政治敏感性的问题。

At present, WHO does not have a mechanism for enforcing compliance with its recommended measures. This has to change.

目前，世卫组织并没有一种强行遵守其所提建议措施的机制。这必须做出改变。

A third weakness is the absence of a formal alert level of health risk other than the declaration of a public health emergency of international concern, or PHEIC. This is a recommendation from the Stocking report for you to consider.

第三个弱点就是除了宣布为国际关注的突发公共卫生事件之外，尚缺少一种针对卫生危险的正式警报等级。这是Stocking报告中提出的供你们审议的一项建议。

Establishing a formal intermediate level of alert of health risk would require an amendment to the IHR.

对卫生危险设立一个正式的过渡性警报等级就需要对《国际卫生条例》做出修订。

Another option is illustrated by the Emergency Committee convened to assess the MERS situation.

另一个选择方案由评估中东呼吸综合征疫情的突发事件委员会作了阐述。

Although many meetings under this Committee were held, none declared a PHEIC, yet their reports consistently set out advice aimed at reducing the number of cases and preventing further international spread.

尽管已经以该委员会名义召开了多次会议，但没有一次将其宣布为国际关注的突发公共卫生事件。而会议发表的报告一直在提出建议，目的是减少病例数并防止进一步出现国际传播。