Our 2021 Annual Letter文章源自英文巴士-https://www.en84.com/10706.html
我们的2021年度公开信文章源自英文巴士-https://www.en84.com/10706.html
文章源自英文巴士-https://www.en84.com/10706.html
The year global health went local文章源自英文巴士-https://www.en84.com/10706.html
这一年，全球健康与你我休戚与共文章源自英文巴士-https://www.en84.com/10706.html
文章源自英文巴士-https://www.en84.com/10706.html
By Bill and Melinda Gates文章源自英文巴士-https://www.en84.com/10706.html
比尔和梅琳达·盖茨文章源自英文巴士-https://www.en84.com/10706.html
文章源自英文巴士-https://www.en84.com/10706.html
January 27, 2021文章源自英文巴士-https://www.en84.com/10706.html
2021年1月27日
We are writing this letter after a year unlike any other in our lifetimes.
写下这封信时，我们刚刚经历了前所未有的一年。
Two decades ago, we created a foundation focused on global health because we wanted to use the returns from Microsoft to improve as many lives as possible. Health is the bedrock of any thriving society. If your health is compromised – or if you’re worried about catching a deadly disease – it’s hard to concentrate on anything else. Staying alive and well becomes your priority to the necessary detriment of everything else.
二十年前，我们创办了盖茨基金会，聚焦全球健康，希望用从微软获得的收益尽可能改善更多人的生活。健康是任何社会繁荣发展的基石。如果你的健康受到威胁，总是担心染上什么可能致命的疾病，那就很难全心投入到任何其他事情中，因为生存和健康会成为你的首要任务。
Over the last year, many of us have experienced that reality ourselves for the first time. Almost every decision now comes with a new calculus: How do you minimize your risk of contracting or spreading COVID-19? There are probably some epidemiologists reading this letter, but for most people, we’re guessing that the past year has forced you to reorient your lives around an entirely new vocabulary – one that includes terms like “social distancing” and “flattening the curve” and the “R0” of a virus. (And for the epidemiologists reading this, we bet no one is more surprised than you that we now live in a world where your colleague Anthony Fauci has graced the cover of InStyle magazine.)
过去一年中，许多人第一次对此有了切身体会。现在，我们做出任何一个决定之前都要考虑一个新的因素：如何将感染或传播新冠肺炎的风险降到最低？
这封信可能会被一些流行病学家读到，但对于大多数人来说，我们猜想大家都在过去一年被迫学习了一套全新的词汇，并努力调整，以适应这样的生活，比如“社交距离”、“拉平曲线”和某种病毒的“R0值”，等等。（对于正在读这封信的各位流行病学家来说，你们恐怕从来不会相信自己的同事安东尼•福奇竟然登上了时尚杂志《InStyle》的封面。）
When we wrote our last Annual Letter, the world was just starting to understand how serious a novel coronavirus pandemic could get. Even though our foundation had been concerned about a pandemic scenario for a long time – especially after the Ebola epidemic in West Africa—we were shocked by how drastically COVID-19 has disrupted economies, jobs, education, and well-being around the world.
撰写去年的年信时，世界才刚刚开始了解新型冠状病毒大流行可能造成的严重影响。尽管我们基金会一直对全球暴发大流行病的可能保持警惕——尤其在西非埃博拉疫情之后——但新冠肺炎疫情对世界各地的经济、就业、教育和社会生活造成的冲击之大还是让我们始料未及。
Only a few weeks after we first heard the word “COVID-19,” we were closing our foundation’s offices and joining billions of people worldwide in adjusting to radically different ways of living. For us, the days became a blur of video meetings, troubling news alerts, and microwaved meals.
在第一次听到“新冠肺炎（COVID-19）”这个词仅仅数周之后，我们就关闭了基金会在各地的办公室，与全球几十亿人一起开始适应完全不同的生活方式。对我们而言，日子变成了一次次视频会议、一条条令人担忧的新闻推送和一顿顿微波快餐组成的混沌时光。
But the adjustments the two of us have made are nothing compared to the impact the pandemic has had on others. COVID-19 has cost lives, sickened millions, and thrust the global economy into a devastating recession. One and a half billion children lost time in the classroom, and some may never return. Essential workers are doing impossible jobs at tremendous risk to themselves and their families. Stress and isolation have triggered far-reaching impacts on mental health. And families in every country have had to miss out on so many of life’s most important moments – graduations, weddings, even funerals. (When Bill Sr. died last September, it was made even more painful by the fact we couldn’t all come together to mourn.)
但和疫情对其他人造成的影响相比，我们俩所做的妥协简直微不足道。新冠肺炎夺走了人们的生命，数百万人受到了病痛的折磨，全球经济也因此陷入严重的衰退。15亿儿童被迫停课，有些孩子甚至再无可能回到课堂。坚守在关键岗位的工作人员做着常人难以想象的工作，他们自己和家人都承受着巨大的风险。压力和隔离对心理健康也产生了深远影响。
每个国家都有许多家庭遗憾地错过了许多生命中最重要的时刻——毕业典礼、婚礼，甚至是葬礼。（我们的父亲，老比尔·盖茨，在去年9月去世了，我们却不能聚在一起悼念他，让这场离别倍添感伤。）
History will probably remember these last couple of months as the most painful point of the entire pandemic. But hope is on the horizon. Although we have a long recovery in front of us, the world has achieved some significant victories against the virus in the form of new tests, treatments, and vaccines. We believe these new tools will soon begin bending the curve in a big way.
过去几个月可能会在历史上留下沉重的一笔，这是整个疫情期间最痛苦的一段时间，但希望就在眼前。虽然复苏之路仍然漫长，但在这场抗击病毒的战役中，全球在开发新型检测工具、药物和疫苗等方面已经取得了重大胜利。我们相信这些工具很快便能大幅拉平疫情曲线。
The moment we now find ourselves in calls to mind a quote from Winston Churchill. In the fall of 1942, he gave a famous speech marking a military victory that he believed would be a turning point in the war against Nazi Germany. “This is not the end,” he warned. “It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”
此时此刻，我们不禁想起温斯顿·丘吉尔的一句话。1942年秋，英国在对纳粹德国的一场战役中取得胜利。丘吉尔认为这是战争的转折点，在为纪念这场胜利发表的著名演讲中，他发出了警告：“这不是结束，甚至不是结束的序章，但这可能是序章的结束。”
When it comes to COVID-19, we are optimistic that the end of the beginning is near. We are also realistic about what it’s taken to get here: the largest public health effort in the history of the world – one involving policymakers, researchers, healthcare workers, business leaders, grassroots organizers, religious communities, and so many others working together in new ways.
而就目前的新冠肺炎疫情而言，我们乐观地相信“序章的结束”就在眼前。我们也清醒地看到，为了走到今天，全世界在公共卫生方面做出了史无前例的努力，政策制定者、研究人员、医护人员、商业领袖、基层组织人员、宗教团体和许多其他各界人士正在以全新的方式通力协作。
That kind of shared effort is important, because in a global crisis like this one, you don’t want companies making decisions driven by a profit motive or governments acting with the narrow goal of protecting only their own citizens. You need a lot of different people and interests coming together in goodwill to benefit all of humanity.
这种合作至关重要，因为当我们面临这种全球危机时，我们不希望看到企业的决策仅仅出于商业利益的考量，也不愿看到各国政府只顾狭隘地保护本国公民。我们需要的，是不同的人群和利益团体以良善之心聚四方之力，以团结合作谋人类福祉。
Philanthropy can help facilitate that cooperation. Because our foundation has been working on infectious diseases for decades, we have strong, long-standing relationships with the World Health Organization, experts, governments, and the private sector. And because our foundation is specifically focused on the challenges facing the world’s poorest people, we also understand the importance of ensuring that the world is considering the unique needs of low-income countries, too.
慈善事业可以促成这样的合作。盖茨基金会在传染病方面已经有二十年的工作经验，我们与世界卫生组织、公共卫生专家、政府和私营部门都保持着长期、深入的合作关系。同时，由于盖茨基金会着重关注全球最贫困人口所面临的挑战，我们也深知世界需要充分考虑到低收入国家的独特需求，这一点尤为重要。
To date, our foundation has invested $1.75 billion in the fight against COVID-19. Most of that funding has gone toward producing and procuring crucial medical supplies. For example, we backed researchers developing new COVID-19 treatments including monoclonal antibodies, and we worked with partners to ensure that these drugs are formulated in a way that’s easy to transport and use in the poorest parts of the world so they benefit people everywhere.
迄今为止，盖茨基金会已经为抗击新冠肺炎投入了17.5亿美元。大多数资金都用于生产和采购重要的医疗用品。例如，我们为开发单克隆抗体等新冠肺炎新型药物的研究人员提供支持。我们还与合作伙伴携手，确保这些药物的配方能方便它们在最贫穷的地区运送和使用，让世界各地的人们都能受益。
We’ve also supported efforts to find and distribute safe and effective vaccines against the virus. Over the last two decades, our resources backed the development of 11 vaccines that have been certified as safe and effective, and our partners have been applying the lessons we learned along the way to the development of vaccines against COVID-19.
我们还支持研发和交付安全有效的新冠肺炎疫苗。在过去的20年间，我们提供资源支持了11种疫苗的研发，这些疫苗的安全性和有效性都得到了验证。我们的合作伙伴正将在此过程中积累的经验应用于新冠肺炎疫苗的研发工作中。
It’s possible that by the time you read this, you or someone you know may have already received a COVID-19 vaccine. The fact that these vaccines are already becoming available is, we think, pretty remarkable – especially considering that COVID-19 was a virtually unknown pathogen at the beginning of 2020 and how rigorous the process is for proving a vaccine’s safety and efficacy. (It’s important that people understand that even though these vaccines were developed on an expedited timeline, they still had to meet strict guidelines before being approved.)
当你读到这封信的时候，你或者你身边的一些人可能已经接种了新冠肺炎疫苗。我们认为，这些疫苗能如此快速地问世是十分了不起的——因为仅仅在2020年初，人们对新冠肺炎的病原体还几乎一无所知，而验证一款疫苗的安全性和有效性也需要遵循非常严格的流程。（大家一定要明白，虽然这些疫苗的研发被提速了，但还需要遵循严格的审评才能最终获批。）
No one country or company could have achieved this alone. Funders around the world pooled resources, competitors shared research findings, and everyone involved had a head start thanks to many years of global investment in technologies that have helped unlock a new era in vaccine development. If the novel coronavirus had emerged in 2009 instead of 2019, the road to a vaccine would have been much longer.
没有任何一个国家或企业能独立实现这一目标。世界各地的资助方慷慨解囊，竞争对手共享研究成果，而全球多年以来对科技的投资开启了疫苗开发的新纪元，这一切让每位参与者都能把握先机。如果新冠病毒不是在2019年、而是2009年出现，那疫苗的研发过程会漫长许多。
Of course, creating safe and effective vaccines in a laboratory is only the beginning of the story. Because the world needs billions of doses in order to protect everyone threatened by this disease, we helped partners figure out how to manufacture vaccines at the same time as they were being developed (a process that usually happens sequentially).
当然，在实验室中开发安全有效的疫苗还只是一切的开始。因为全世界需要数十亿剂的疫苗才能保护所有人免受这种疾病的威胁，所以我们帮助合作伙伴探索如何能够在研发疫苗的过程中同步推动后续的生产工作（通常来说，这个过程是有先后顺序的）。
Now, the world has to get those doses out to everyone who needs them – starting with frontline health workers and other high-risk groups. Our foundation has worked with manufacturers and partners to deliver other vaccines cheaply and on a very large scale in the past (including to 822 million kids in low-income countries through Gavi, the Vaccine Alliance), and we’re doing the same with COVID-19.
现在，我们需要从一线的医务工作者和其他高风险人群开始，让世界上每个有需要的人都得到这些疫苗。盖茨基金会之前也与疫苗生产企业和伙伴合作，以低廉的价格大规模交付其他疫苗（包括通过全球疫苗免疫联盟向低收入国家的8.22亿儿童提供疫苗），而我们在交付新冠肺炎疫苗时也采取了相同的方式。
Our foundation and its partners have pivoted to meet the challenges of COVID-19 in other ways as well. When our friend Warren Buffett donated the bulk of his fortune to double our foundation’s resources in 2006, he urged us to stay focused on the issues that have always been central to our mission. Tackling COVID-19 was an essential part of any global health work in 2020, but it hasn’t been our sole focus over the last year. Our colleagues continue to make progress across all of our program areas.
我们的基金会和合作伙伴也在以其他方式应对新冠肺炎带来的挑战。2006年，我们的好朋友沃伦·巴菲特将他的大部分财产捐给基金会，让我们的资源翻了一倍。他那时督促我们聚焦于那些对达成我们的使命至关重要的核心问题。抗击新冠肺炎无疑是2020年全球健康事业中的一个关键工作，但它绝不是我们去年唯一的工作。我们的同事们在基金会的各个项目领域都在积极推动进展。
The malaria team has had to rethink how to distribute bed nets in a time when it’s no longer safe to hold an event to give them to a lot of people at once. We’re helping partners understand COVID-19’s impact on pregnant women and babies and making sure that they continue to receive essential health services. Our education partners are helping teachers adjust to a world where their laptop is their classroom. In other words, we remain trained on the same goal we’ve had since our foundation opened its doors: making sure every single person on the planet has the chance to live a healthy and productive life.
受疫情影响，通过举办一次活动向大批民众集中发放蚊帐的做法不太安全，因此疟疾团队需要重新考虑怎样分发蚊帐。我们还帮助合作伙伴了解新冠肺炎对孕妇和婴儿的影响，并保证他们能持续获得必需的医疗服务。
我们在教育领域的合作伙伴则帮助教师进行调整，让他们习惯通过笔记本电脑进行远程教学。换句话说，我们仍然在向着基金会成立以来的既定愿景迈进：让世界上每个人都有机会过上健康而富有成效的生活。
If there’s a reason we’re optimistic about life on the other side of the pandemic, it’s this: While the pandemic has forced many people to learn a new vocabulary, it’s also brought new meaning to old terms like “global health.”
In the past, “global health” was rarely used to mean the health of everyone, everywhere. In practice, people in rich countries used this term to refer to the health of people in non-rich countries. A more accurate term probably would have been “developing country health.”
This past year, though, that changed. In 2020, global health went local. The artificial distinctions between rich countries and poor countries collapsed in the face of a virus that had no regard for borders or geography.
如果有什么理由可以让我们对疫情后的世界保持乐观，那就是：虽然疫情迫使很多人去学习全新的词汇，它也为老生常谈的“全球健康”赋予了全新的含义。过去，“全球健康”很少真正用于描述全球各个地区每个人的健康状况。实际上，富裕国家的人们常常会用这个词指代贫困国家人口的健康状况，虽然形容这一情况更准确的用词或许应该是“发展中国家健康”。但这种情况在去年发生了改变。2020年，全球健康和本土健康融为一体。面对无视国界或地理边界的病毒，富裕国家和贫穷国家之间人为设置的区隔瞬间坍塌。
We all saw firsthand how quickly a disease you’ve never heard of in a place you may have never been can become a public health emergency right in your own backyard. Viruses like COVID-19 remind us that, for all our differences, everyone in this world is connected biologically by a microscopic network of germs and particles – and that, like it or not, we’re all in this together.
We hope the experience we’ve all lived through over the last year will lead to a long-term change in the way people think about global health – and help people in rich countries see that investments in global health benefit not only low-income countries but everyone. We were thrilled to see the United States include $4 billion for Gavi in its latest COVID-19 relief package. Investments like these will put all of us in a better position to defeat the next set of global challenges.
我们亲眼见证了这样一幕：一种你闻所未闻的疾病在某个你或许从未踏足的地方暴发，迅速地形成一场你身边的公共卫生紧急事件。像新冠肺炎这样的病毒提醒着我们，无论我们有多么不同，从生物学的角度来看，世界上的每个人都被微生物和微粒组成的微观网络紧紧相连——无论你愿不愿意接受，我们都在一条船上。我们希望去年一起走过的经历能深远地改变人们对全球健康的看法，也让富裕国家的人们看到，对全球健康的投资不仅能惠及低收入国家的人民，更能让所有人受益。我们非常兴奋地看到美国最新的新冠肺炎援助计划涵盖了一项40亿美元的投入，用于支持全球疫苗免疫联盟。这类投资能让我们在应对下一次全球挑战时准备得更好。
Just as World War II was the defining event for our parents’ generation, the coronavirus pandemic we are living through right now will define ours. And just as World War II led to greater cooperation between countries to protect the peace and prioritize the common good, we think that the world has an important opportunity to turn the hard-won lessons of this pandemic into a healthier, more equal future for all.
In the rest of this letter, we write about two areas we see as essential to building that better future: prioritizing equity and getting ready for the next pandemic.
正如第二次世界大战是我们父母那一代的决定性事件，我们正在经历的这场新冠肺炎疫情也将重新定义我们这代人的生活。二战促使各国加强合作，维护和平、实现共同利益。现在，我们也有机会将应对这场疫情危机中来之不易的经验教训转化成一个人人更加健康和平等的未来。在接下来的内容中，我们将阐述对构建一个更加美好未来至关重要的两个领域：优先解决公平问题，和为下一场大流行病做好准备。
Can we emerge from this pandemic more equal than we entered it?
疫情结束时，我们在公平问题上能比以前有所进步么？
Melinda: One of the things I’ve missed most over the last year is traveling to see our foundation’s work in action. I have photos all over our house of the women I’ve met on these trips. Now that I’m working from home, I see their faces all the time.
梅琳达：过去一年我最怀念的事情就是去实地看看我们基金会的工作情况。我家到处都能看到我在这些旅程中遇见的女性的照片。即使现在在家办公，我也能时常看到她们的面孔。
I often wonder what the pandemic looks like through their eyes and how they’re coping. When I’m on videocalls with experts and world leaders, I try to imagine how the decisions being made in these conversations will affect these women and their families. They’re a daily reminder of the importance of ensuring that the world’s COVID-19 response leaves no one behind.
我常常在想她们眼中的疫情是怎样的，她们又在如何应对。在与世界各地的专家和领导者视频通话时，我也会想象这些对话中做出的决策将如何影响这些女性和她们的家人。她们时刻提醒我，在新冠疫情的全球应对行动中不能让任何人掉队。
From AIDS to Zika to Ebola, disease outbreaks tend to follow a grim pattern. They hurt some people more than others – and who they hurt most is not random. As they infect societies, they exploit pre-existing inequalities.
从艾滋病到寨卡病毒再到埃博拉，这些疾病的暴发都呈现出一种残酷的模式。它们对一些人的伤害远大于其他人，而受到最大冲击的往往是同一群人。在它们影响整个社会的同时，还会加剧原本就已存在的不平等。
The same is true of COVID-19. People with less are faring worse than those with more. Essential workers are facing greater risks than those who can work from home. Students without internet access are falling behind students who are learning remotely. In the United States, communities of color are more likely to get sick and die than other Americans. And all around the world, women who have been fighting for power and influence over their lives are seeing decades of fragile progress shattered in a matter of months.
新冠肺炎造成的影响也是如此。资源匮乏的人群比资源丰沛的人群受到疫情的冲击更大；关键岗位的工作人员比可以居家办公的人面临更大风险；无法上网的学生比能够远程学习的学生在课业上落后更多。在美国，有色人种的患病和死亡率都更高。而在世界各地，那些一直在为生命的权力和影响力而抗争的女性眼看着过去几十年取得的微小进步在短短几个月内便付之一炬。
From the beginning of the pandemic, our foundation has worked with partners in the United States and around the world to address the uneven social and economic impacts of COVID-19 and keep those pre-existing inequalities from growing deeper.
盖茨基金会自疫情伊始便与美国及世界各地的伙伴通力协作，应对新冠肺炎对社会和经济造成的不平等，并阻止早已存在的不平等问题进一步加剧。
In the United States, many of our anti-COVID efforts overlap with our work on racial equity. For example, the data tell us that Black Americans are three times as likely as white Americans to get COVID-19, and they are also more likely to live in an area with limited access to COVID-19 testing. To help meet the demand for local community testing, our foundation partnered with historically Black colleges and universities to expand diagnostic testing capacity on their campuses.
在美国，我们在抗击新冠疫情方面的很多努力与我们推动种族平等的工作息息相关。例如，数据显示，美国黑人感染新冠肺炎的几率是白人的三倍，并且他们更有可能生活在缺乏新冠肺炎检测能力的地区。为满足当地社区的检测需求，盖茨基金会与传统黑人学院和大学合作，提高校园内的新冠诊断检测能力。
We’re also addressing the pandemic’s disproportionate impact on people of color in other ways, including through our foundation’s U.S. education work. We’re concerned about students falling behind at all levels (when schools closed last spring, the average student lost months of learning), but we’re especially troubled that COVID-19 could exacerbate long-standing barriers to higher education, particularly for students who are Black, Latino, or from low-income households. Median lifetime earnings of college graduates are twice those of high school graduates, so the stakes for these young people are high. To help students navigate COVID-19 roadblocks, our foundation expanded our partnerships with three organizations that have a proven track record of using digital tools to help students stay on the path to a college degree. We think the models and approaches these organizations are honing now will continue to expand opportunities for students post-pandemic, too.
我们还通过其他方式，包括基金会在美国教育领域的工作，应对疫情对有色人种造成的不平等影响。我们担心各个年级的学生都可能落下课业（去年春天学校停课时，学生平均失去了几个月的学习时间），但我们尤其担心新冠疫情会加剧高等教育中长期存在的壁垒，特别是对于黑人、拉丁裔和来自低收入家庭的学生。大学毕业生终生收入的中位数是高中毕业生的两倍，因此这一问题会对这些年轻人产生深远的影响。
为帮助学生克服新冠疫情造成的阻碍，盖茨基金会扩大了与三个组织的合作关系，它们一直以来都在利用数字工具帮助学生坚持学习并取得大学学位。我们认为这些组织正在探索的模式和方法会在疫情后继续为学生们带来更多机会。
When it comes to our work outside the United States, my major focus has been calling on world leaders to put women at the center of their COVID-19 response. If governments ignore the fact that the pandemic and resulting recession are affecting women differently, it will prolong the crisis and slow economic recovery for everyone.
谈到美国以外的工作，我的主要工作重点是呼吁世界领导人在应对新冠疫情时应重点考虑女性。这场疫情和由其造成的衰退对女性的影响更大。如果政府忽略这个事实，这场危机还会进一步延长，经济复苏的延缓也势必影响每一个人。
For example, because of the economic shutdowns over the last year, hundreds of millions of people in low-income countries have needed help from their government to meet basic needs. But the cruel irony is that the women who most need these economic lifelines tend to be invisible to their governments. It’s hard to send cash safely and swiftly to a woman who doesn’t appear in the tax rolls, have a formal identification, or own a mobile phone. Unless financial systems are specifically designed to include these women, these systems are likely to exclude them, pushing them even further to the economic margins. Our foundation has worked with the World Bank to help countries overcome these hurdles and create digital cash transfer programs with women’s needs in mind.
例如，由于去年经济停摆，低收入国家的数亿人口需要政府的帮助才能勉强度日。但讽刺的是，政府常常会对最迫切需要这些经济援助的女性视而不见。向没有缴税记录、缺少正式身份证明，或没有手机的女性安全快捷地转账汇款非常困难。
除非这些金融系统是专门为女性设计的，否则很可能忽视她们的需求，将她们进一步推向经济体系的边缘。我们的基金会还与世界银行合作，帮助各国克服障碍，建立起真正考虑到女性需求的数字转账项目。
More broadly, we’re supporting efforts to design economic response plans targeted at women and low-wage workers. In low- and middle-income countries, the poorest people tend to be self-employed in the informal sector – as farmers or street vendors, for example. Policymakers often overlook these workers, and traditional stimulus measures don’t meet their needs. (Tax rebates don’t really help people who don’t pay taxes – and who pays for your paid leave if you work for yourself?) Our foundation helped fund research into how governments can repair these holes in the safety net by prioritizing measures like cash grants, food relief, and moratoriums on rent and utilities.
从更广泛的意义上说，我们正在支持设计针对女性和低收入工作者的经济应对计划。在中低收入国家，最贫穷的人通常是非正规部门的个体经营者，例如农民或街头小贩。政策制定者常常忽视这些人，而传统的经济刺激措施也无法满足他们的需求。（税费减免措施无法帮助那些不纳税的人，而给自己打工的人又如何实现带薪休假呢？）盖茨基金会也在资助研究政府如何通过优先采取现金资助、食品救济与延付租金和水电费等措施，来修补社会保障体系中的漏洞。
This past year has also shined a spotlight on women’s unpaid labor, an issue I’ve written about in this letter before. With billions of people now staying home, the demand for unpaid care work – cooking, cleaning, and childcare – has surged. Women already did about three-quarters of that work. Now, in the pandemic, they’ve taken on even more of it. This work may be unpaid, but it comes at an enormous cost: Globally, a two-hour increase in women’s unpaid care work is correlated with a 10 percentage point decrease in women’s labor force participation. As governments rebuild their economies, it’s time to start treating child care as essential infrastructure – just as worthy of funding as roads and fiber optic cables. In the long term, this will help create more productive and inclusive post-pandemic economies.
去年，女性无偿劳动成为人们关注的焦点，我在过去的年信里也谈到了这个问题。现在，几十亿人都隔离在家，对做饭、打扫、育儿等无偿护理工作的需求激增。女性已经承担了其中四分之三的工作。疫情之中，她们肩上的担子更重了。这类工作虽然是无偿的，但却要付出巨大的代价：全球范围内，女性无偿护理工作每增加2小时，就会使得女性劳动参与率降低10%。在政府重振经济之时，我们也应该开始将育儿视作一项重要的基础设施，像修建道路和铺设光缆一样值得资助。长远看来，这有利于创建更具生产力和包容性的后疫情经济。
Bill and I are deeply concerned, though, that in addition to shining a light on so many old injustices, the pandemic will unleash a new one: immunity inequality, a future where the wealthiest people have access to a COVID-19 vaccine, while the rest of the world doesn’t.
然而，比尔和我最为担心的是，这场疫情不仅会暴露很多已经存在的不平等，还会引发一个全新的问题：免疫不平等，即未来只有最富裕的人可以接种新冠肺炎疫苗，而其他人却无法接种。
Already, wealthy nations have spent months prepurchasing doses of vaccine to start immunizing their people the moment those vaccines are approved. But as things stand now, low- and middle-income countries will only be able to cover about one out of five people who live there over the next year. In a world where global health is local, that should concern all of us.
From the beginning of the pandemic, we have urged wealthy nations to remember that COVID-19 anywhere is a threat everywhere. Until vaccines reach everyone, new clusters of disease will keep popping up. Those clusters will grow and spread. Schools and offices will shut down again. The cycle of inequality will continue. Everything depends on whether the world comes together to ensure that the lifesaving science developed in 2020 saves as many lives as possible in 2021.
富裕国家早在数月之前就已经开始大量预购疫苗，确保这些疫苗获批后能立即为其公民接种。从目前状况看来，中低收入国家在未来一年内只能为其五分之一的人口提供疫苗。在一个全球健康与本土健康融为一体的世界中，我们每个人都应该为此深感担忧。从疫情开始，我们就在提醒富裕国家谨记一点：任何一处的新冠疫情都会对整个世界构成威胁。在每个人都能接种疫苗之前，还会有一批批病患不断出现。这些病患群体会扩大、蔓延。学校和企业会再度停工停学。不平等的恶性循环也将持续下去。一切都取决于全世界能否齐心协力，保证2020年取得的科学成果能在2021年尽可能挽救更多生命。
Existential crises such as these leave no facet of life untouched. But solutions that are worthy of these historic moments also have ripples. Demanding an inclusive response will save lives and livelihoods now – and create a foundation for a post-pandemic world that is stronger, more equal, and more resilient.
此类关乎人类存亡的危机会影响生活的方方面面。而随着这些历史性时刻应运而生的解决方案也必将产生涟漪效应。包容性的应对措施不仅能挽救生命、改善生计，还能为建设一个更强大、更平等、更坚韧的后疫情世界打下坚实的基础。
It’s not too soon to start thinking about the next pandemic.
防范下一场大流行病，并非言之过早。
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.
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。
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.
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。
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。
A healthier, brighter future for all
一个全民更健康的光明未来
As hard as it is to imagine right now while so many people are still suffering from COVID-19, this pandemic will come to an end someday. When that moment comes, it will be a testament to the remarkable leaders who have emerged over the last year to steer us through this crisis.
在新冠肆虐的当下，还有很多人深受其害，我们很难预计疫情何时才会终结。而当那一刻终于来临的时候，历史会铭记那些在疫情中涌现的卓越领导者，因为正是他们带领我们走出了这次危机。
When we say “leaders,” we don’t just mean the policymakers and elected officials who are in charge of the official government response. We’re also talking about the healthcare workers who are enduring unimaginable trauma on the frontlines. The teachers, parents, and caregivers who are going above and beyond to make sure kids don’t fall behind in school. The scientists and researchers who are working around the clock to stop this virus. Even the neighbors who are cooking extra meals to make sure no one in their community goes hungry.
我们说的“领导者”不仅包括那些负责组织政府抗疫行动的政策制定者或政府官员，也包括历经艰辛、奋战在一线的医护人员；确保孩子不会落下功课的老师、家长和保育员；夜以继日地研究如何阻止病毒的科学家和研究者；还包括那些愿意多做几份饭，让邻居不会挨饿的好心人。
Their leadership will get us through this pandemic, and we owe it to them to recover in a way that leaves us stronger and more prepared for the next challenge. Over the last year, a global threat touched nearly every person on the planet. By next year, we hope an equitable, effective COVID-19 response will have reached the whole world, too.
他们展现出的领导力将带领我们走出疫情。多亏了他们，世界才能复苏。而复苏后的世界将变得更加坚强，并为下一次挑战做好更充分的准备。在过去一年中，疫情几乎威胁到了世界上的每个人。我们希望，在明年结束之前，公平、有效的抗疫举措也可以惠及每个人。
We hope that you and your loved ones are staying safe and healthy in these difficult times.
祝福你和你的家人、朋友在这段困难的日子里平安、健康。
