It’s not too soon to start thinking about the next pandemic.
文章源自英文巴士-https://www.en84.com/10706.html
防范下一场大流行病，并非言之过早。文章源自英文巴士-https://www.en84.com/10706.html
文章源自英文巴士-https://www.en84.com/10706.html
Bill: One of the questions I get asked the most is when I think the world will get back to normal. I understand why. We all want to return to the way things were before COVID-19. But there’s one area where I hope we never go back: our complacency about pandemics.文章源自英文巴士-https://www.en84.com/10706.html
文章源自英文巴士-https://www.en84.com/10706.html
比尔：我被问到最多的一个问题是世界何时会恢复正常。我理解为什么大家会问这个问题。我们都想回到新冠疫情之前的世界。但是有一个领域我希望我们永远不要回到过去，那就是我们对于大流行病的轻敌自满。文章源自英文巴士-https://www.en84.com/10706.html
文章源自英文巴士-https://www.en84.com/10706.html
The unfortunate reality is that COVID-19 might not be the last pandemic. We don’t know when the next one will strike, or whether it will be a flu, a coronavirus, or some new disease we’ve never seen before. But what we do know is that we can’t afford to be caught flat-footed again. The threat of the next pandemic will always be hanging over our heads – unless the world takes steps to prevent it.文章源自英文巴士-https://www.en84.com/10706.html
文章源自英文巴士-https://www.en84.com/10706.html
残酷的现实是，新冠疫情恐怕不会是我们面临的最后一场大流行病。我们不知道下一次疫情何时到来，也不知道它是一种流感、冠状病毒还是其他前所未见的新疾病。但我们必须做好准备，不能再被打得措手不及。除非全世界行动起来，防患于未然，否则下一场大流行病的威胁依然会笼罩人类。文章源自英文巴士-https://www.en84.com/10706.html
The good news is that we can get ahead of infectious disease outbreaks. Although the world failed to prepare for COVID-19 in many ways, we’re still benefiting from actions taken in response to past outbreaks. For example, the Ebola epidemic made it clear that we needed to accelerate the development of new vaccines. So, our foundation partnered with governments and other funders to create the Coalition for Epidemic Preparedness Innovations. CEPI helped fund a number of COVID-19 candidates – including the Moderna and Oxford AstraZeneca vaccines – and is deeply involved in the vaccine equity work that Melinda wrote about.
所幸，我们可以在传染病暴发前未雨绸缪。尽管世界在很多方面都没能为新冠疫情做好充足准备，但我们依然受益于过去抗击其他传染病的经验。例如，埃博拉疫情让我们认识到需要加速新疫苗的研发。因此，盖茨基金会与政府和其他资助者合作，创立了流行病防范创新联盟（CEPI）。CEPI资助了多个新冠候选疫苗的研发，包括Moderna研发的疫苗以及牛津大学与阿斯利康（AstraZeneca）合作研制的疫苗。CEPI也深度参与了梅琳达提到的疫苗公平分配的工作。
To prevent the hardship of this last year from happening again, pandemic preparedness must be taken as seriously as we take the threat of war. The world needs to double down on investments in R&D and organizations like CEPI that have proven invaluable with COVID-19. We also need to build brand-new capabilities that don’t exist yet.
为了防止去年的艰难形势重演，我们必须像对待战争威胁那样重视大流行病的防范工作。世界必须加倍投资于研发和像CEPI这样有助于抗击新冠疫情的组织，并且需要加强建设我们尚未具备的能力。
Stopping the next pandemic will require spending tens of billions of dollars per year – a big investment, but remember that the COVID-19 pandemic is estimated to cost the world $28 trillion. The world needs to spend billions to save trillions (and prevent millions of deaths). I think of this as the best and most cost-efficient insurance policy the world could buy.
预防下一次全球大流行病需要每年数百亿美元的投入，这确实是一笔庞大的开销。但是请不要忘记，新冠肺炎疫情在全球预计会造成28万亿美元的经济损失。全球花费的这数百亿美元，可以节省几十万亿美元并避免数百万死亡，我认为这是全世界可以买到的最好、最划算的保险了。
The bulk of this investment needs to come from rich countries. Low- and middle-income countries and foundations like ours have a role to play, but governments from high-income nations need to lead the charge here because the benefits for them are so huge. If you live in a rich country, it’s in your best interest for your government to go big on pandemic preparedness around the world. Melinda wrote that COVID-19 anywhere is a threat to health everywhere; the same is true of the next potential pandemic. The tools and systems created to stop pathogens in their tracks need to span the globe, including in low- and middle-income countries.
这笔投资大部分来自富裕国家。中低收入国家和我们这样的基金会可以发挥一定的作用，但是高收入国家的政府更需要带头行动，因为他们将因此受益良多。如果你来自富裕国家，那你的政府为全球流行病防范工作做出的巨大贡献也将惠及于你。正如梅琳达提到的，世界上任何一处发生新冠肺炎疫情，整个世界都会受到威胁；下一次全球大流行病也是一样。用于切断病毒传播的工具和系统需要在全球普及，包括在那些中低收入国家。
To start, governments need to continue investing in the scientific tools that are getting us through this current pandemic – even after COVID-19 is behind us. New breakthroughs will give us a leg up the next time a new disease emerges. It took months to get enough testing capacity for COVID-19 in the United States. But it’s possible to build up diagnostics that can be deployed very quickly. By the next pandemic, I’m hopeful we’ll have what I call mega-diagnostic platforms, which could test as much as 20 percent of the global population every week.
首先，政府要继续投资于此次疫情中不可或缺的科学工具——即便是在我们战胜新冠肺炎疫情以后。新的突破可以帮我们在下一次抗击新的疾病时抢占先机。美国花了几个月的时间才建立起足够的检测能力，但其实在短时间内提升快速检测能力是有可能的。在下一次大流行病到来之前，我希望我们能建立一个全球的超大型诊断平台，每周可以检测多达20%的全球人口。
I’m confident that we will have better treatments next time, too. One of the most promising COVID-19 therapeutics is monoclonal antibodies. If a patient gets them early enough, you can potentially reduce the death rate by as much as 80 percent.
我相信下次面对大流行病时，我们会有更好的治疗方法。单克隆抗体是新冠疗法里最被寄予厚望的治疗方法之一。如果病人能够及时获得这种治疗，死亡率就有望下降80%。
Our foundation has funded research into monoclonal antibodies as a potential treatment for flu and malaria for over a decade. These antibodies can be used to treat any number of diseases. The downside is that they’re time-consuming to develop and manufacture. It will likely take another five years of perfecting the technology before we can quickly churn them out in response to new pathogens.
十多年来，盖茨基金会一直在资助单克隆抗体疗法的研究，探寻其治疗流感和疟疾的潜能。这些抗体可以用来治疗多种疾病，而其劣势在于研发和生产非常耗时。我们恐怕还需要五年的时间改进技术，才能快速将其应用于抗击新的病原体上。
I also expect we’ll see huge advances over the next five years in our ability to develop new vaccines – in large part due to the success of mRNA vaccines for COVID-19. I wrote about this at length in my Year in Review, but the short version is that mRNA vaccines are a new type of vaccine that delivers instructions to teach your body to fight off a pathogen. Although our foundation has been funding research into this new platform since 2014, no mRNA vaccine had been approved for use before last month. This pandemic has massively sped up the platform’s development process.
未来五年，我们研发新疫苗的能力也会突飞猛进——这主要得益于新冠肺炎mRNA疫苗的研发成功。我在自己的年度总结《2021，世界势必取得进步》一文中详细地介绍过mRNA疫苗。简单而言，mRNA疫苗属于一种新型疫苗，它可以给人的身体发出指令，教会它如何抵御一种病原体。尽管基金会自2014年起就一直在资助这一新技术平台的研究，但直到上个月才有一种mRNA疫苗首次获批。这次疫情大大加速了mRNA疫苗平台的研发进程。
Just as I think we’ll see huge improvements in diagnostics and monoclonal antibodies, I predict that mRNA vaccines will become faster to develop, easier to scale, and more stable to store over the next five to ten years. That would be a huge breakthrough, both for future pandemics and for other global health challenges. mRNA vaccines are a promising platform for diseases like HIV, tuberculosis, and malaria. The R&D progress made as a result of COVID-19 might one day give us the tools we need to finally end these deadly diseases.
正如我相信检测方法和单克隆抗体疗法将取得巨大进展一样，我认为在未来5-10年间，mRNA疫苗的研发速度会更快，生产更易规模化，储存性能更稳定。这对于未来的全球大流行病以及其他全球健康挑战来说都是巨大的突破。mRNA疫苗的技术平台在艾滋病、结核病和疟疾等疾病防治研究领域也存在很大的潜力。也许新冠肺炎疫苗的研发进展将会成为我们终结这些致命疾病的利器。
When it comes to preventing pandemics, scientific tools alone aren’t enough. The world also needs field-based capabilities that constantly monitor for troubling pathogens and can be spun up as soon as they’re needed. There is still a lot to be figured out in terms of specifics, including where these capabilities would be housed and how exactly they’d be structured. But here is my broad thinking:
要防范全球大流行病，光靠科学工具是不够的。全球还需要可以实时监测危险病原体的基层能力，以及在紧急情况下可以快速启动的基层卫生力量。这方面的细节还有待考量，包括应该在哪些地点建立这种基层卫生力量，组织架构怎样设计，等等。但我现在有一些初步的想法：
First, we need to spot disease outbreaks as soon as they happen, wherever they happen. That will require a global alert system, which we don’t have at large scale today. The backbone of this system would be diagnostic testing. Let’s say you’re a nurse at a rural health clinic. You notice that more patients are showing up with coughs than you’d expect for this time of year, or maybe even that more people are dying than normal. So, you test for common pathogens. If none of them test positive, your sample is sent elsewhere to get sequenced for further investigation.
首先，我们需要在第一时间发现疾病的暴发，不管何时何地。这就需要建立一个全球预警系统，现在我们的系统规模还不够大。这一系统的基石是诊断测试。假设你是一名农村卫生诊所的护士，你注意到咳嗽的病人比往年这个时候要多，或者病患死亡数量高于往常。于是，你做了常见病原体检测。如果检测结果都是阴性，你的样本就会被送往其他地方进行测序和进一步调查。
If your sample turns out to be some super infectious – or entirely new – pathogen, a group of infectious disease first responders springs into action. Think of this corps as a pandemic fire squad. Just like firefighters, they’re fully trained professionals who are ready to respond to potential crises at a moment’s notice. When they aren’t actively responding to an outbreak, they keep their skills sharp by working on diseases like malaria and polio. I estimate that we need somewhere around 3,000 responders throughout the world.
如果你的样本被发现是某种有超级传染力或是前所未见的病原体，传染性疾病的应急 人员就会开始行动。这些人就好比应对大流行病的消防队。和消防员一样，他们是训练有素的专业人士，随时准备应对在短时间内出现的潜在危机。当没有疫情暴发时，这些人可以进行疟疾和脊髓灰质炎等传染病防控方面的工作，以维持高技能水平。我估计全球共需要大约3000名应急人员。
To learn how to best use these first responders, the world needs to regularly run germ games – simulations that let us practice, analyze, and improve how we respond to disease outbreaks, just as war games let the military prepare for real-life warfare. Speed matters in a pandemic. The faster you act, the faster you cut off exponential growth of the virus. Places that had recent experiences with respiratory outbreaks – such as Taiwan with SARS and South Korea with MERS – responded to COVID-19 more quickly than other places because they already knew what to do. Running simulations will make sure everyone is ready to act quickly next time.
为了学习如何最好地使用这些应急人员，全球需要经常进行情景模拟演习，在模拟中演练、 分析、提高应对疫情暴发的能力，就像用军事演习来提高实战能力一样。速度在大流行病期间是关键。速度越快，越能尽早切断病毒的指数级传播。
那些近年来抗击过呼吸道疾病暴发的地方，比如遭遇过非典（SARS）的台湾地区和遭遇过中东呼吸综合征（MERS）的韩国，在这次疫情当中的反应速度要快过其他地区，因为他们已经有经验了。演习可以确保所有人在下次疫情到来时迅速展开行动。
Ultimately, the thing that makes me the most optimistic that we’ll be ready next time is also the simplest: The world now understands how seriously we should take pandemics. No one needs to be convinced that an infectious disease could kill millions of people or shut down the global economy. The pain of this past year will be seared into people’s thinking for a generation. I am hopeful that we’ll see broad support for efforts that make sure we never have to experience this hardship again. We’re already seeing new pandemic preparedness strategies emerge, including from this year’s UK-led G7, and I expect to see more in the months and years to come.
归根结底，我之所以乐观地相信我们下次能够做好准备的最重要、也是最简单的原因是：世界已经明白应该严肃对待大流行病。世人已经深刻地意识到传染性疾病可以夺去数百万人的性命或令全球经济陷入瘫痪。过去一年的苦难将在一代人的记忆当中留下永久的烙印。我相信所有可以确保悲剧不再重演的努力都会得到广泛支持。我们已经看到不断有新的大流行病防范战略出台，包括去年由英国主导的七国集团提出的战略。我预计未来的数月和数年内还会涌现越来越多的举措。
The world wasn’t ready for the COVID-19 pandemic. I think next time will be different.
当此次新冠肺炎大流行病来袭时，世界没有做好准备。我相信下一次会大有不同。
