世卫组织总干事陈冯富珍博士在英国药品监管局的演讲（中英对照）

MHRA have offered to support WHO, as needed, in the evaluation of candidate Zika products. NIBSC responded immediately to the WHO request to develop and evaluate reference preparations for anti-Zika antibodies.

药品和健康保健产品监管局向世卫组织提供了在评估候选寨卡产品所需要的支持。国家生物标准和控制研究所立即回应了世卫组织开发和评估抗寨卡抗体参考制品的要求。

These reference preparations will provide researchers, product developers, and regulatory authorities with a single standard that can be used to benchmark the multiple diagnostic tests for Zika that are currently under development.

这些参考制品为研究人员、产品开发商和监管部门提供了一个统一的标准，可以用来测试当前正在研发的寨卡多项诊断检测。

Better diagnostic tools are urgently and desperately needed. The current PCR test can detect the virus only during the brief window of viraemia. This weakness is further compounded by the fact that the illness is so mild. Many people infected with Zika will not be prompted to seek a test during this brief window of just a few days.

迫切急需的，是更好的诊断工具。当前的聚合酶链反应试剂只有在病毒血症特定的时间内才可检测出病毒。这一弱点又加上病症很轻微。许多人感染了寨卡后，没有在仅有几天的短暂时间内及时去进行检查。

Moreover, the Zika virus frequently co-circulates with dengue and chikungunya viruses. These viruses cross-react in tests for IgM antibodies against Zika virus, making them imprecise.

此外，寨卡病毒经常是与登革热和基孔肯雅病毒共同传播的。这些病毒在对寨卡病毒进行的免疫球蛋白M抗体的测试中有交叉反应，使得检测不够精确。

Imagine the anguish of a pregnant woman living in or returning from an affected country, with no way of knowing whether she and her fetus have been affected. Ultrasound detection of microcephaly is possible only late in pregnancy.

可以想象得出，一名生活在或从一个受到疫情影响的国家归来的孕妇，在对她和其胎儿是否受到影响一无所知的情况下是何等悲痛。只有在怀孕晚期使用超声波才有可能检测出小头症。

As with Ebola, Zika has caught the medical and scientific communities largely empty-handed, with WHO left to promote mosquito control as the most immediate line of defence.

如同埃博拉一样，医疗和科学界对付寨卡总体上是一无所获，而世卫组织可以做的只能是推广控制蚊子作为最紧急的防线。

For both of these diseases, we are in the 21st century and yet cannot immediately tap the power of modern medical tools.

对待这两种疾病，虽然我们身处21世纪，但还是不能立刻发掘现代医疗工具的力量。

For Ebola, it was early detection, contact tracing, quarantine, and infection control. For Zika, right now, it is mosquito control at a time when more and more insecticides have been rendered ineffective by the development of resistance.

对于埃博拉，要做到早期检查、追踪接触者、检疫和控制感染。对于寨卡，当越来越多的杀虫剂由于抗药性使之无效而放弃的时候，当前更应控制蚊子。

Zika is a tricky virus that continues to astonish scientists. Who could have imagined that a mosquito bite would be linked to severe birth defects and other serious neurological complications?

寨卡是一种诡异的病毒，不断使科学家感到吃惊不已。有谁能想象得到，一次蚊子叮咬会与严重的出生缺陷和其它严重的神经并发症有关联呢？

More than half of the world’s population lives in an area where Aedes aegypti mosquitoes are present. Who knows what the next nasty surprise will be?

世界上有一半以上的人口生活在有埃及伊蚊的地方。谁知道下一次严重的意外事件会是什么样的情景？

We know there will be more nasty surprises, if not from the volatile microbial world, then from some of the other complex threats in this era of global perils.

我们知道会有更多的严重意外事件发生，如果不是发生在一个反复无常充满微生物的世界，那么也会在这个充满全球风险时代的某些其它复杂的威胁中发生。

Ladies and gentlemen,

女士们，先生们：

The world has changed dramatically since the start of this century, when the Millennium Development Goals became the focus of international efforts to reduce human misery.

自本世纪伊始以来，世界发生了戏剧性的变化，千年发展目标成为进行国际努力减少人类痛苦的重点。

At that time, human misery was thought to have a discrete set of principal causes, like poverty, hunger, poor water and sanitation, several infectious diseases, and lack of essential care during pregnancy, childbirth, and childhood.

当时，人类的苦难被认为是由一组抽象的主要原因造成的，例如贫困、饥饿、不良水源和卫生、多种传染性疾病以及在怀孕、分娩和童年期间缺少基本的护理。

The results of that focus, and all the energy, resources, and innovations it unleashed, exceeded the wildest dreams of many. It demonstrated the power of solidarity and brought out the best in human nature.

那个重点的结果，以及释放的能量、资源和创造力，超越了许多人最强烈的梦想。它展示出团结的力量，揭示出人性中的真谛。

Last year, the United Nations General Assembly finalized the new 2030 Agenda for Sustainable Development. The factors that now govern the well-being of the human condition, and of the planet that sustains it, are no longer so discrete. The new agenda, with its 17 goals and 169 targets, will try to shape a very different world.

去年，联合国大会出台了新的2030年可持续发展议程。人类福祉条件的治理的种种因素，以及支撑人类福祉条件的星球，再也不是抽象的。这项包含17个目标和169个具体目标的新议程将努力打造出一个崭新的世界。

More and more we are seeing the worst in human nature: international terrorism, senseless mass shootings, bombings in markets and places of worship, ancient and priceless archaeological sites reduced to rubble, and seemingly endless armed conflicts that have contributed to the worst refugee crisis since the end of the second World War.

我们越来越能看清人性中最丑陋的一面：国际恐怖主义、市场和祈祷地点无情的大规模的枪击和爆炸、古老和价值连城的遗迹变成了废墟、看来无休止的武装冲突造成了自第二次世界大战以来最为严重的难民危机。

Our world is profoundly interconnected and this, too, has consequences. The refugee crisis in Europe shattered the notion that wars in faraway lands will stay remote.

我们的世界是相互紧密相联的，而且这也产生了后果。难民危机打破了那种远方发生的战争且可隔岸观火的概念。

The Ebola outbreak shattered the notion that a disease of small African nations will have no consequences elsewhere.

埃博拉疫情打破了那种非洲小国的疾病不会殃及其他的概念。

The explosive spread of Zika virus disease throughout Latin America and the Caribbean shattered the notion that a disease long considered a medical curiosity will stay that way.

暴发寨卡病毒疫情蔓延了整个拉丁美洲和加勒比，打破了那种早有定论的罕见病例的疾病不可逆转的概念。

And there are other perils. Inequalities, in income levels, opportunities, life expectancy, and access to health care have reached their highest levels seen in more than half a century. Some wealthy nations are losing their middle classes, the backbone of stability for democratic societies.

并且还有其它危害，在半个多世纪，收入水平、机会、预期寿命和获得健康保健方面存在的不平等，达到了最为严重的程度。一些富裕国家正在失去民主社会稳定的支柱——中产阶级。

The climate is changing, with numerous consequences for health. These consequences are also profoundly unfair. The countries that contributed least to greenhouse gas emissions will be the hardest hit.

气候正在发生变化，对健康造成了众多后果。这些后果也是非常不公平的。对温室气体排放贡献最小的国家受到的冲击最大。

Chronic noncommunicable diseases have overtaken infectious diseases as the number one killers worldwide. Treatment for chronic conditions vastly increases the need for medical products and raises questions about their constantly rising prices.

慢性非传染性疾病取代了传染病，成为世界范围的头号杀手。慢性病人口的治疗对医药产品的需求量大幅度增加，因而出现了药品价格不断攀升的问题。

With most newly approved cancer treatments costing more than $120,000 per patient per year, treatment is becoming unaffordable even for the wealthiest countries in the world. In some developing countries, the management of diabetes alone absorbs more than a third of the entire health budget.

随着最新的癌症治疗方法的认可，每个患者每年需花费超过12万美元，这种治疗即便是世界上最富有的国家也难以承受。在一些发展中国家，仅糖尿病管理一项就占全部卫生预算的三分之一以上。

We are losing our vital but fragile antimicrobials. The detection last year by Chinese scientists of a new resistance mechanism, the MCR-1 gene, sent shockwaves through the medical and scientific communities.

我们正在失去极其重要的但却是脆弱的抗微生物药物。去年中国科学家进行的新的耐药性检查机制轰动了整个医疗和科学界。

The gene is located on a mobile plasmid that transfers easily from one bacterial strain to others. This is a horizontal transfer of resistance, and it is frightening.

基因位于流动的质粒中，很容易从一个菌株转移到另一个菌株。这是一次横向的耐药性转移，是令人恐惧的。

In the Chinese study, the MCR-1 gene conferred resistance to colistin, the last-resort antibiotic used to treat several life-threatening infections caused by Gram-negative bacteria.

在中国的研究中，MCR-1基因赋予粘菌素耐药性，是治疗由革兰氏阴性菌引起危及生命感染时使用抗生素的最后手段。

Colistin is a 50-year-old antibiotic that was shelved in the 1970s because of its toxic effects on the kidneys. It was brought back into clinical use when all newer antibiotics began to fail.

粘菌素是一个有50年之久的抗生素，在1970年代被停用，因为它对肾有毒性作用。在所有更新的抗生素开始失败时，粘菌素重新在临床中使用。

As colistin had not been widely used, it was still effective. It was also cheap, which encouraged its massive use as a growth promoter in food production in several countries, including China.

由于粘菌素一直未被广泛使用，所以它仍然有效。粘菌素还很便宜，在包括中国在内的一些国家的粮食生产中，鼓励将其作为一种促生长剂加以大规模使用。

The Chinese findings, which have been replicated in several other countries, solidify the links between the agricultural use of antibiotics, resistance in slaughtered animals, resistance in food, and resistance in humans. All of the dots are connected.

已由一些其它国家仿效中国的研究成果，将农用抗生素、被屠宰牲畜的耐药性，粮食中的耐药性和人类耐药性之间的联系具体化了。

If we lose colistin, as several experts are predicting, we lose our last medicine for fighting a number of serious infections.

正如一些专家预测的那样，如果我们失去了粘菌素，我们就失去了抵抗一些严重感染的最后药品。

Last month, British treasury minister Lord Jim O’Neill, who heads the UK panel reviewing antimicrobial resistance, likened current trends to a “slow-motion car crash” and singled out vaccines as a crucial part of the solution.

上个月，英国财政部国务大臣吉姆•尼尔勋爵带领了一个专家小组审查了抗微生物药物的耐药性，把当前的趋势比作一次“慢镜头的撞车动作”并挑选出疫苗作为解决方案中一个重要的组成部分。

As noted, widespread vaccination against bacterial infections would reduce the need for antibiotics, thus reducing a key driver of resistance at source.

正如前面所说的，广泛采用疫苗接种防止细菌感染，将减少对抗生素的需求，因此从源头上减少了耐药性的一个主要动因。

The panel will publish its final report in May. I am very pleased to know that your Prime Minister, David Cameron, is committed to pushing its recommendations through the UN General Assembly and the G7 group of countries.

专家小组将在五月发布它的最后报告。我非常高兴地得知，你们的首相戴维·卡梅伦承诺通过联合国大会和七国集团采纳专家组的建议。

Ladies and gentlemen,

女士们，先生们：

The health targets in the new 2030 Sustainable Development Agenda are supremely ambitious.

在新的2030年可持续发展议程中的卫生目标是极为宏伟的目标。

They aim at nothing less than the elimination of AIDS, tuberculosis, and malaria and an end to preventable maternal and childhood deaths. They also explicitly call on governments to support R&D for new vaccines and medicines.

这些目标并不亚于消除艾滋病毒、结核病和疟疾的目标，以及防止孕产妇和儿童死亡的目标。这些目标明确呼吁各国政府支持研发新的疫苗和药品。

Yes, we can aim for the moon and, yes, we will have to have new tools to get there. All global strategies, approved by our Member States, for reaching the 2030 health targets stress that success depends on specific R&D breakthroughs.

是的，我们可以制定登月计划，当然我们必须拥有踏上月球的工具。我们的会员国批准的所有实现2030年卫生目标的全球战略都强调，成功取决于具体研发的重大突破。

Many of these breakthroughs are broadly beneficial. For example, having reliable and affordable point-of-care diagnostics is another way to make prescribing more precise and thus reduce the overuse of antimicrobials.

这些重要的新发现中许多是受益面很广泛的。例如，提供可靠的和可承受的现场即时诊断是另外一种使开具处方更加准确、减少过量使用抗微生物药物的方法。

The MenAfriVac vaccine, developed and priced specifically for use in Africa, provides a good example of the impact a new vaccine can have.

A群脑膜炎球菌结合疫苗，专门为在非洲使用而开发和定价的疫苗，是一个展示了一种新的疫苗可以产生影响的良好典范。

Since 2010, more than 230 million people in 16 countries in Africa’s meningitis belt have been vaccinated against meningococcal meningitis serogroup A, with support from GAVI and the Bill and Melinda Gates Foundation.

自2010年以来，在全球疫苗和免疫联盟以及比尔和梅林达·盖茨基金会的支持下，在非洲脑膜炎发病地带的16个国家逾2.3亿人为防止患上A群脑膜炎球菌性脑膜炎接种了疫苗。

Given the added impact of herd immunity, the recurring outbreaks of meningitis A that have devastated 26 African countries for decades have been virtually eliminated.

鉴于人群免疫屏障的附加影响，在过去几十年里毁掉了26个非洲国家的频繁暴发的甲型脑膜炎实际上已经灭绝了。

Aiming for the moon at a time when most budgets for domestic and international health are shrinking also calls for approaches that use what already exists more wisely. Finding more creative uses for existing vaccines can change patterns of use, with multiple spillover benefits for health.

当用于本国和国际卫生方面的大部分预算正在缩减的那一刻，却瞄准了月球，即使如此，也需要有一个合理利用现有资源的方法。探索更加有创造性地使用现有疫苗可以改变使用的格局，这对卫生具有多个溢出效应。

In July 2013, WHO created a stockpile of oral cholera vaccines in response to a critical situation. Cholera epidemics were raging, yet the demand for vaccines was low and manufacturers had little incentive to increase supplies.

2013年7月，为了应对严峻的局势，世卫组织建立了口服疫苗储存。尽管霍乱流行肆虐，但是对疫苗的需求不高，制造商对增加供应量毫无积极性。

Establishing the stockpile, WHO made a commitment to buy and use 2 million doses a year in order to stimulate demand and convince industry that a stable market exists.

世卫组织建立了储存，承诺每年购买和使用200万剂疫苗，以刺激需求和说服企业，稳定的市场是视而可见的。

Although the cholera vaccine stockpile is essentially a vaccine procurement and distribution mechanism, it has generated multiple health benefits well beyond saving lives.

尽管有了霍乱疫苗储存，基本上是一个疫苗采购和分配的机制，但它带来的多方面的卫生益处远远超过了挽救生命的意义。

It improved reporting. In public health, the promise of assistance is one of the strongest incentives to report epidemic-prone diseases immediately and transparently.

它改进报告程序。在公共卫生方面，提供援助的许诺是对快速和公开报告有流行倾向疾病最强有力的激励之一。

As long experience shows, the temptation to cover up a cholera outbreak is great, given the potential impact on trade and tourism.

正如长期经验显示的那样，鉴于对贸易和旅游带来的潜在影响，那种掩盖霍乱疫情的诱惑是巨大的。

It improved the speed needed for an emergency response, especially in the context of humanitarian crises. Following receipt of a request, vaccines arrive in the country within a maximum of 10 days.

它提高了紧急反应所需要的速度，特别是在人道主义危机的环境下亦是如此。在接到要求后，疫苗最多在10天之内运达该国。

It increased supplies. Three producers have now been prequalified by WHO, with vaccine supply set to double this year. These vastly increased supplies have opened the first opportunity for pre-emptive campaigns in “hot spots” with repeated outbreaks.

它增加了供应量。世卫组织已经确定了三个预审合格的生产商，疫苗供应量确定翻一番。大量增加供应量为在疫情频发的“热点地区”开展先发制人的运动创造了先机。

It increased access in underserved populations. More cholera vaccines have been deployed to affected areas over the past two years than in the previous 15 years combined.

它为缺医少药的人口增加了获取服务的渠道。过去两年调往受影响地区的霍乱疫苗数量超过了前15年的总和。

It decreased costs as more producers entered the market.

由于有更多的生产商进入了市场，成本降低了。

It generated data on vaccine safety, efficacy, and the duration of immunity, thus strengthening the case for further investment.

它建立了疫苗安全、功效数据，以及免疫期，因此增强了进一步投资的理由。

And it has stimulated the development of better vaccines offering greater protection, a longer shelf life, and fewer logistical challenges.

并且它刺激了开发具有更强的保护、更长的保质期和更少的后勤拖累的更好的疫苗。

In short, a seemingly simple thing, like creating a stockpile, has transformed a vicious cycle of low demand, low production, high price, and inequitable distribution to a virtuous cycle of increased demand, increased production, reduced price, and greater equity of access.

简而言之，表面看起来是件简单的事情，如建立储存，但却将低需求、低产量、高昂的价格和不公平分配的恶性循环转变成需求增加、生产增加、调低价格和更公平合理的获得疫苗的良性循环。

A stockpile of rabies vaccine is a logical next step to follow.

下一步是储存狂犬病疫苗。