In the year 6 CE, a fire devastated Rome. In response, Emperor Augustus did something that had never been done before in the history of the Empire. He created a permanent team of firefighters who used buckets just like this one. Augustus understood that individuals alone can't protect themselves from fires. They need help from the community. When one person's house is on fire, that creates a risk for everyone else's homes.
公元 6 年, 一場火災肆虐羅馬。 作為回應, 奧古斯都皇帝做了一件 帝國歷史上從未做過的事, 他創立了一個永久性的消防隊, 用這種水桶滅火。 奧古斯都理解到單獨的個人 無法自我保護免於火災, 而是需要社群的幫助。 當一人的房子失火, 就會對其他所有人的房子構成風險。
And so what we've had these last few years is like a horrific global fire. The COVID pandemic has killed millions and upended economies, and we want to stop that from happening again. COVID, it's hard to overstate how awful it's been. It's increased the health inequities between the rich and the poor. Survival depended partly on your income, your race, the neighborhood you lived in. And so we should seize this opportunity to create a world where everyone has a chance to live a healthy and productive life. Also a life free from the fear of the next COVID-19.
我們最近幾年遇到的 就像一場可怕的全球性火災。 新型冠狀病毒疫情 殺死了數百萬人,破壞了經濟, 我們想要阻止這種事再度發生。 說新冠病毒有多糟都不為過。 它加深了富人和窮人的健康不平等。 存活與否有一部分取決於 你的收入、種族、你住在哪個社區。 我們應該把握這個機會 讓世界上人人都可以活得健康多彩, 也不必恐懼下一場 如同新冠病毒的事件。
When I was on this stage in 2015, I was one of many people who said we weren't ready and we needed to get ready. We didn't. The speech actually was watched by a lot of people. But 90 percent of the views were after it was too late.
2015 年我站在這個講臺, 跟很多人一樣, 我說我們還沒準備好, 而且我們必須準備好。 但我們還是沒有。 那場演講其實很多人看過。 但九成的點閱數是在 為時已晚的時候。
(Laughter)
(笑聲)
So now I hope the need is clear. And of course, we've learned a lot. During this pandemic, a lot of things worked well, a lot of things didn't work well. And so we have all that knowledge to build a prevention system.
現在,我希望這個必要性夠清楚了。 當然,我們學到了很多。 在這次疫情期間, 許多事辦得很好, 也有許多事辦不好。 我們全都有了建構預防系統的知識。
COVID-19 can be the last pandemic if we take the right steps. So how, what are these steps? Well, let's go back and look at what the Romans did. Think about how, over time, we've gotten good at preventing big fires. Fire prevention is kind of this pervasive thing. It's well funded. It's well understood. If an alarm went off right now, everyone here would know we're supposed to calmly gather, go out and wait instructions. We'd know that help would be on the way because we have lots of trained firefighters who practice. The United States alone has 370,000 full-time firefighters, even more than I guessed that number would be. We also have access to water. The United States, for example, has almost nine million fire hydrants. And so that type of investment, that type of practice, that type of system is what we need to stop pandemics.
如果我們踏出正確的步伐, 新冠病毒可以是最後的疫情大流行。 所以該怎麼做?踏出什麼步伐? 那我們回頭看看古羅馬人怎麼做。 想想我們是怎麼 漸漸擅長預防大火的。 火災預防很普遍。 它獲得很多資助, 被很好地理解。 如果現在警報響起, 所有人都知道我們應該冷靜地集結, 走出出口等待指示。 我們知道援助已經上路, 因為我們有很多 訓練有素的消防員在工作。 單單美國就有 37 萬名全職消防員, 比我預估的人數還多。 我們也有途徑取得水。 例如美國有近九百萬個消防栓。 這種投資、措施、系統 就是阻止疫情所需要的。
Now, often in movies, we'll have pandemics. And I'm always impressed with what takes place. Let's look at an example of this rapid response.
我們常會在電影裡看到疫情, 我總是對這些故事印象深刻。 讓我們看看這個快速反應的例子。
[Motaba River Valley, Zaire]
[莫塔巴河谷,薩伊]
(Helicopter rotors whirring)
(直升機旋翼呼呼作響)
Well, that's quite impressive. We don't need the music, but otherwise we saw exactly what should happen. An outbreak’s detected. Very quickly, literally within days, doctors are dispatched. They have a helicopter to get into exactly ground zero. They go in there, and they’ve got the right tools. And this is what should happen when an outbreak is spotted.
那十分令人印象深刻。 我們不需要音樂, 但我們確切看到了事情應該是怎麼樣。 偵測到疫情爆發; 非常快速地,在僅僅幾天內, 就派了醫師過來; 他們搭乘直升機到達精確的爆發點; 他們進入房內,並帶著正確的工具。 這就是發現疫情爆發時該發生的事。
But we don't have that team, we don't have those resources. And if an outbreak took place in a low-income country, it could be literally months before we started to orchestrate those resources.
但我們沒有那種團隊, 我們沒有那些資源。 如果一場疫情爆發於低所得國家, 可能需要足足幾個月 我們才會準備好那些資源。
So despite what you see in movies, there is no group of experts standing by to prevent this disaster. So we have to create a new team. I believe we should create what I call the GERM team. Germ stands for Global Epidemic Response and Mobilization. This group is full-time. Their only priority is pandemic prevention. It's made up of a diverse set of specialists with a lot of different realms of expertise: epidemiologists, data scientists, logistics experts. And it's not just scientific and medical knowledge. They also have to have communication and diplomacy skills. The cost of this team is significant. It's over a billion a year to support the 3,000 people who would be on this team. And its mission is to stop outbreaks before they become pandemics. The work would be coordinated by the WHO. They'd be present in many locations around the world, stationed in public health agencies. They'd work closely with the national teams, depending on the income level. They'd have more in the lower-income countries. You know, for example, we could have GERM members say an epidemiologist, working out of the Africa CDC office in Abuja. And a very important thing is that like firefighters, a GERM team would do drills. When you want to have quick response, when you want to make sure you have all the pieces there and you can move very quickly, practice is key. That's how you make sure everyone knows what to do.
所以不同於你們在電影看到的, 我們沒有準備就緒的專家團隊 來預防這場災難。 因此我們需要創立一個新的團隊。 我相信我們應該創立 GERM 團隊, GERM 代表「全球疫情反應與動員」。 這個團隊是全職的, 他們唯一的要務是預防疫情。 這個團隊由各式各樣的專家所組成, 在很多領域各有專精: 流行病學家、資料科學家、 物流管理專家。 他們不只有科學和醫學知識, 還有溝通和協商技能。 這個團隊的開銷很巨大, 每年超過新臺幣 300 億元, 以維持 3000 名團隊成員。 這個團隊的任務是 阻止疫病爆發演變成大流行。 這項工作需要世界衛生組織的協同, 他們會在世界上許多地點 進駐公共衛生機構, 與各國團隊緊密合作, 視該地的所得多寡而定, 在低所得國家駐紮較多的人。 舉例來說,我們可以請 GERM 成員, 例如一位流行病學家, 在非洲疾病管制預防中心的 阿布加辦公室工作。 一件非常重要的事情是 就如同消防隊員, GERM 團隊會進行演習。 若要快速地反應, 若要確保所需的一切物件齊備 且能很快速地行動, 演練就是關鍵。 這是確保所有人 都知道該做什麼的方法。
Now, this team, there could be periods where there's no risky outbreak and they can keep their skills strong by working on some of the other infectious diseases, but that would be a second priority. They would work with countries to strengthen their health systems. The health systems are the front line. You need to know if, say, a lot of people show up with a new kind of cough, that’s when GERM needs to look into it and say, is this an outbreak? Is there a new pathogen here? What is the sequence of that? And so for all of this, the first 100 days are key. Viruses spread exponentially. And so if you get in there when the infection rate is fairly small, you can actually stop the spread.
在沒有傳染病爆發風險的時期 這個團隊仍可藉處理其他的傳染病 來保持強大的能力, 不過這只會是第二優先。 他們會和各國合作, 強化那些國家的醫療系統。 醫療系統是第一線。 得要明白,舉例來說, 如果很多人出現一種新型的咳嗽, 這就是 GERM 團隊要調查的時候, 判斷這是不是傳染病的爆發, 有沒有新的病原體, 後果會是什麼? 對這些工作而言, 前一百天會是關鍵。 病毒以指數性成長在傳播。 如果能在感染率還很低時抵達那裡, 其實就可以阻斷傳播。
You know, in this epidemic, if we'd been able to stop it within 100 days, we would have saved over 98 percent of the lives. Now, we did have countries that did a good job. Australia is an example. They orchestrated diagnostic capacity. They came up with distancing policies and quarantine policies. And so their overall death rate per capita will be well less than a 10th of other countries. But we did not, as a world, contain it. And that's what we have to do next time.
要知道在這場疫情裡, 如果我們得以在一百天內阻止它, 我們就可以拯救超過 98% 的生命。 我們有看到一些國家做得很好。 澳大利亞是一個範例。 他們細緻規劃檢驗量能, 構思出社交距離和隔離政策, 所以他們的整體人均死亡率 不到其他國家的十分之一。 但在全世界,我們沒有控制住疫情, 這就是我們下次必須要做的。
When COVID struck, we were almost like Rome before they had fire buckets and firefighters. We didn't have the people, the systems or the tools we need. Now, with the right investments, we can have a whole new generation of tools, better diagnostics, therapeutics and vaccines. A good example in the diagnostic area is this little machine, this is called the Lumira. We can have these all over the world that can test for any number of diseases. It’s a 10th as expensive as PCR, it’s absolutely as accurate, and it’s simple. So it can be used anywhere. We need other R&D investments. One that I'm very excited about is the idea of a drug that you inhale that blocks you from getting infected. It can be pathogen-independent and trigger your immune system so that you'll be protected. A lot of the tools, the diagnostic tools and those infection-blocking tools are important because they can be staged in advance. Now, we also need vaccines, but we want to stop the outbreak before we have to do a global vaccination campaign. And so vaccines can play a couple of different roles, but not the primary role. We have to invest in more than just that.
新冠病毒來襲時, 我們就像沒有滅火桶 和消防隊員的羅馬。 我們沒有所需的人力、系統或器具。 現在,如果正確投資, 我們可以有全新一代的工具、 更好的篩檢、治療和疫苗。 在檢測方面這臺小機器 是一個很好的範例, 它叫「 Lumira 」。 我們可在全世界設置這種機器 檢測任意數量的疾病, 要價是聚合酶連鎖反應的十分之一, 它絕對一樣準確、簡單易用, 所以可以使用於任何地方。 我們需要投資於其他研發。 其中一個讓我非常興奮的點子 是一種吸入就能 為你阻斷感染的藥物。 它可以是不限病原體的, 會刺激你的免疫系統, 你就能獲得保護。 很多器具很重要, 例如檢測和感染阻斷器材, 因為它們可以超前部署。 我們也需要疫苗, 但我們希望在需要全球性施打行動前 阻斷疫情的爆發。 所以疫苗可以扮演很多不同角色, 不限於主要功能。 我們必須投資不只那樣。
When we look at vaccines, they were the miracle of this epidemic. They saved millions of lives, but they can be far better. We need to invent easier-to-deliver vaccines that are just a patch you put on your arm or something that you inhale. We need vaccines that actually block infections. In this case, there were lots of breakthrough infections. We need vaccines that are broad spectrum, so they work against most of the emerging variants, which we did not have this time. And we also need factories that are standing by so we can build enough vaccines for the entire world within six months and achieve far better equity. The vaccines can also do something that would be super helpful, which is to help us eradicate entire families of viruses. Innovative new vaccines used properly could get rid of the flu family, the coronavirus family. And there's a huge burden of those, even in non-pandemic years, and if we get rid of it, it can never cause a pandemic.
疫苗可說是這次大流行的奇跡。 疫苗拯救了數百萬人的性命, 但它可以做得更好。 我們必須發明便於運輸的疫苗, 只是一塊貼在手臂上的貼布 或可以吸入的東西。 我們需要可以確實阻斷感染的疫苗。 在這方面,目前有很多突破性感染。 我們需要廣效性的疫苗 來對抗絕大多數新生的變種病毒, 這是我們這次所沒有的。 我們也需要待命的工廠, 讓我們可以在六個月內 生產足夠全世界使用的疫苗, 達到更平等。 這些疫苗可以辦到非常有用的事情, 那就是幫助我們消滅整個病毒家族。 如果正確使用創新的疫苗, 就能消除流感病毒、冠狀病毒家族。 這些病毒是很大的負擔, 即便是沒有大流行的年分, 如果我們將其消滅, 它們就永遠不會引發大流行了。
So I'm talking about investments in three broad areas: Disease monitoring, that's GERM. The R and D tools that are far better. And finally, and the most expensive, is improved health systems. This won't be cheap, but it'll save lives. And even it'll save money in the long run. It's like an insurance policy.
我在談論的是投資於三個大領域: 疾病偵測, 就是 GERM 團隊; 更好的研發工具; 最後,也是最昂貴的, 就是改善醫療系統。 這不便宜,但會拯救生命, 長期下來甚至能節省資金。 它就像買一份保險。
The cost to prevent the next pandemic will be tens of billions of dollars. But let's compare that to what we just went through. The IMF estimates that COVID has cost nearly 14 trillion dollars. And so we need to spend billions in order to save trillions. And here's the best part of this. Even when we're not having an outbreak, these investments like the Lumira, those new vaccines, they will make people healthier. They'll shrink the gap, the health equity gap, which is gigantic, between rich and poor countries. For example, we can detect more HIV cases and do a better job of treatment. We can reduce deaths from malaria. We can get more people high-quality care. And so this is not just a downer about how to stop things from getting worse, but also a chance to make things better.
預防下一場大流行的開銷 是新臺幣數千億元, 但我們跟這次做個比較。 國際貨幣基金組織估計新冠病毒 用掉了新臺幣近 420 兆元。 為了省下幾百兆, 我們需要付出幾千億。 這些事情最棒的部分是這樣的。 即使在沒有大流行的時期, 這些投資,例如 Lumira 、新疫苗, 仍然會讓人類更健康。 它們可以縮小健康不平等的差距, 富國和窮國之間的差距很巨大。 例如,我們能偵測到 更多愛滋個案,更好地治療; 我們能降低瘧疾的死亡人數; 我們能讓更多人獲得高品質的照護。 所以這不只是 消極地防止事情變得更糟, 還是一個讓事情更好的機會。
If we take the right steps, we can make COVID-19 the last pandemic, and we can build a healthier, more equitable world for everyone.
如果我們採取正確的行動, 就能讓新冠病毒 成為最後一次大流行, 我們就可以為所有人 建立更健康公平的世界。
Thank you.
謝謝你們。
(Applause) Helen Walters: Thank you so much. I have a few follow-up questions and one is really about the formal status of GERM. So you mentioned this would cost a billion dollars, you mentioned it comes through the WHO, but exactly who's running this, how does this work, how do we make this happen?
(掌聲) 海倫‧華特斯:非常感謝您。 我有幾個後續的問題, 其中一個和 GERM 的 正式地位非常有關。 您提到這會花費 300 億元, 您提到這會由世界衛生組織來實踐, 但具體上誰負責營運? 它怎麼運作? 我們要怎麼實現它?
BG: Well, GERM does not exist. It's a proposal I'm putting forward that hopefully over the next year, while the pain of the pandemic is still clear in people's minds, will get a global consensus. The rich-world governments will have to step up like they do with all the aid things and come up with that money. The way the personnel systems works, so that it's under WHO, but a really top-notch team, there will be a lot of debate about how to do that well. So, you know, I'm putting it forward and hopefully within the next year we'll get that consensus.
比:嗯, GERM 並不存在。 它是我的一項提議, 希望可以趁著明年 大家還記得疫情的傷痛, 能得到全球性的共識。 富國的政府就會必須採取行動, 就像他們在援助窮國時一樣, 並拿出所需的款項。 考慮到人事部門的運作方式, GERM 隸屬於世界衛生組織, 但它是一個一流的團隊, 需要很多討論才能知道怎麼做得好。 所以我將它提出來, 希望明年我們就能取得共識。
HW: Who do you need to pick that up next?
海:你需要誰來承擔這項任務?
BG: Well, it's really the rich-world governments. The WHO has this big yearly meeting, the World Health Assembly, and at some point somebody will put forward a resolution and we'll see if the extra resources can be put in for that. After World War II, we did a lot. You know, we created the United Nations, we talked a lot about war. So I'd be stunned, although, you know, so far the action has been less than I would have expected, I'd be stunned if we don't go forward with something pretty close to what I'm laying out there.
比:那很需要富國的政府。 世界衛生組織每年舉辦 盛大的世界衛生大會, 未來的某個時間點 將會有人提出解方, 我們就觀察能否 有更多資源投入其中。 第二次世界大戰後,我們做了很多。 我們創立聯合國, 討論很多關於戰爭的事。 所以雖然目前的行動 仍然少於我的預期, 但若未朝類似我所描述的方向前進, 我還是會很訝異。
HW: This has been pretty personal for you. You know, the anti-vaxxers are out there, they are loud, and this has become personal. I just wanted to ask, like, how are you managing that?
海:這是一道個人意見的問題。 你知道,有反疫苗人士, 他們聲量很大, 所以這變得很個人。 我只是想問,你會怎麼處理?
BG: Well, it's kind of weird.
比:嗯,這有點詭異。
(Laughter)
(笑聲)
(Applause)
(掌聲)
Now, our foundation, the Gates Foundation, is very involved in vaccines, the invention of new vaccines, funding vaccines. And we're very proud that through joint efforts like GAVI, that saved tens of millions of lives. So it's somewhat ironic to have somebody turn around and say, no, you know, we're using vaccines to kill people or to make money or, you know, we started the pandemic, even some strange things like, that I somehow want to track, you know, the location of individuals because I'm so deeply desirous to know where everybody is.
現在我們的蓋茲基金會 對疫苗有很多投入, 支持新疫苗的發明、資助疫苗。 我們很自豪在共同努力下, 例如全球疫苗免疫聯盟, 拯救了幾千萬條生命。 因此很諷刺的是有人說不是這回事, 說我們用疫苗殺人或賺錢, 說我們挑起了疫情, 還有更怪異的 說我想要追蹤人們的位置, 因為我深深渴望知道大家在哪裡。
(Laughter)
(笑聲)
I'm not sure what I'm going to do with that information.
我不知道拿那些位置資訊做什麼。
(Laughter)
(笑聲)
You know, does this turn into something where, you know, there's constantly crazy people showing up? Who knows? But, you know, hopefully, as the pandemic calms down, people are more rational about, hey, vaccines are a miracle and there's a lot more we can do.
難道會一直有瘋狂的人出現嗎? 誰知道? 希望隨著疫情降溫, 人們變得更為理智, 知道疫苗是一個奇跡, 以及我們還有很多事可做。
HW: So the future is in our hands in the present.
海:所以此刻未來正在我們手中。
Bill Gates, thank you so much for being here.
比爾‧蓋茲,非常感謝您來到這裡。
BG: Thank you.
比:謝謝你。
(Applause)
(掌聲)