We are here today because [the] United Nations have defined goals for the progress of countries. They're called Millennium Development Goals. And the reason I really like these goals is that there are eight of them. And by specifying eight different goals, the United Nations has said that there are so many things needed to change in a country in order to get the good life for people. Look here -- you have to end poverty, education, gender, child and maternal health, control infections, protect the environment and get the good global links between nations in every aspect from aid to trade.
今天我们因联合国 为各国发展 所定下之目标 而齐聚于此。 这些目标被称为千年发展目标。 我喜欢此目标之原因 在于联合国把它一分为八。 通过细化这八项目标, 联合国认为 我们尚要完成更多事情 来为一国之民 创造更好的生活。 看看这里,我们须消灭极端贫困、 普及小学教育、促进两性平等、 降低儿童死亡率、改善产妇保健、 与疾病對抗、确保环境的可持续能力 和加强全球合作 以促进各方面 从援助到贸易上的发展。
There's a second reason I like these development goals, and that is because each and every one is measured. Take child mortality; the aim here is to reduce child mortality by two-thirds, from 1990 to 2015. That's a four percent reduction per year -- and this, with measuring. That's what makes the difference between political talking like this and really going for the important thing, a better life for people. And what I'm so happy about with this is that we have already documented that there are many countries in Asia, in the Middle East, in Latin America and East Europe that [are] reducing with this rate. And even mighty Brazil is going down with five percent per year, and Turkey with seven percent per year. So there's good news. But then I hear people saying, "There is no progress in Africa. And there's not even statistics on Africa to know what is happening." I'll prove them wrong on both points.
另外还有一个原因促使我喜欢这些发展目标。 那就是这些目标皆可具体量化。 以儿童死亡率为例, 千年发展目标计划于1990年始 至2015年止,儿童死亡率 要降低三分之二, 每年需减少百分之四的死亡率。 这是可衡量的。 这就是政治空谈 与为人民 创造更好生活目标 所具有的差别。 我现在很高兴, 因为已有很多 亚洲、中东、拉丁美洲 和东欧国家行动起来了, 它们国家的儿童死亡率皆有所下降, 这些成果都已被记录在案。 就连强大的巴西每年也减少了百分之五的儿童死亡率, 土耳其则每年减少百分之七。 这些都是好消息。 但我却听到有人说:“非洲情况还未改善。 我们根本看不到非洲的统计数据。 我们不知道非洲发生了什么事。” 我要证明这些都是谬论。
Come with me to the wonderful world of statistics. I bring you to the webpage, ChildMortality.org, where you can take deaths in children below five years of age for all countries -- it's done by U.N. specialists. And I will take Kenya as an example. Here you see the data. Don't panic -- don't panic now, I'll help you through this. It looks nasty, like in college when you didn't like statistics. But first thing, when you see dots like this, you have to ask yourself: from where do the data come? What is the origin of the data? Is it so that in Kenya, there are doctors and other specialists who write the death certificate at the death of the child and it's sent to the statistical office? No -- low-income countries like Kenya still don't have that level of organization. It exists, but it's not complete because so many deaths occur in the home with the family, and it's not registered. What we rely on is not an incomplete system. We have interviews, we have surveys. And this is highly professional female interviewers who sit down for one hour with a woman and ask her about [her] birth history. How many children did you have? Are they alive? If they died, at what age and what year? And then this is done in a representative sample of thousands of women in the country and put together in what used to be called a demographic health survey report. But these surveys are costly, so they can only be done [in] three- to five-year intervals. But they have good quality. So this is a limitation. And all these colored lines here are results; each color is one survey. But that's too complicated for today, so I'll simplify it for you, and I give you one average point for each survey.
来,让我们一起进入美妙的数据世界。 你可以上这个网页:ChildMortality.org, 在这上面列有各国 五岁以下儿童的死亡率。 这是由联合国专家统计的。 以肯尼亚为例, 看看这个数据。 别紧张,别紧张,我来帮助你们解读这些数据。 这看起来很乱,正如你在大学里 不喜欢上统计学课一样。 首先,当你看到这些点时, 你得先问问自己: 这些数据来源何处? 原始数据是怎么来的? 在肯尼亚有没有 医生或其他专员 会在孩童死去时填写一张死亡证明 且寄送至统计局呢? 没有。像肯尼亚这样的低收入国家 尚没有健全的这类机构。 就算有,设备也不齐全, 因为许多孩童 是死于家中, 而且不会被登记在案。 我们不能依靠这种缺陷重重的系统。 我们进行访谈,深入调查。 这是一位极为专业的女性访问员, 她和一位女士 坐了一个小时, 询问对方的生育史。 你生了几个小孩? 全都活着吗? 假若死了,是于何年几岁死的? 这就会成为该国 成千上万妇女的代表性样本, 这些样本会被收集起来 来放进人口健康调查报告里。 但这种调查花费甚巨, 所以只能每隔三到五年做一次。 但调查质量很高。 只是经费有限制。 这些有颜色的线就是调查结果。 每一种颜色代表一次调查。 但这样看起来太复杂了,所以我会为你们简化这些数据, 所以我就把这些数据平均一下。
This was 1977, 1988, 1992, '97 and 2002. And when the experts in the U.N. have got these surveys in place in their database, then they use advanced mathematical formulas to produce a trend line, and the trend line looks like this. See here -- it's the best fit they can get of this point. But watch out -- they continue the line beyond the last point out into nothing. And they estimated that in 2008, Kenya had per child mortality of 128. And I was sad, because we could see this reversal in Kenya with an increased child mortality in the 90s. It was so tragic. But in June, I got a mail in my inbox from Demographic Health Surveys, and it showed good news from Kenya. I was so happy. This was the estimate of the new survey. Then it just took another three months for [the] U.N. to get it into their server, and on Friday we got the new trend line -- it was down here. Isn't it nice -- isn't it nice, yeah? I was actually, on Friday, sitting in front of my computer, and I saw the death rate fall from 128 to 84 just that morning. So we celebrated.
这是1977年、1988年、 1992年、1997年 和2002年。 当联合国专家们 把这些数据存进资料库时, 他们就会用先进的数学公式 来画出一条趋势线,如这一条趋势线。 看这里。这就是体现这数据资料的最佳趋势线。 注意看。 他们还将这条线 往后延伸 延伸至未来。 他们估计于2008年 肯尼亚的儿童死亡率是每千个孩童有一百二十八个会死。 我感到悲伤, 因为我们能看到 在90年代的肯尼亚 儿童死亡率呈上升,应该会有逆转性。 这是如此的糟糕。 但在六月我在邮箱收到一封 来自于人口健康调查的信, 从肯尼亚那儿传来好消息。 我很高兴。 这是新调查的评估。 随后联合国却又花了3个月时间 把这数据呈现在他们的数据服务器上, 在周五我们有了新的趋势线。 这儿呈下降趋势。 它是不是很棒?很棒,对吧? 在周五的那个早上,我确实坐在我电脑前, 我看到死亡率 从128降到84. 我们为此庆祝了一下。
But now, when you have this trend line, how do we measure progress? I'm going into some details here, because [the] U.N. do it like this. They start [in] 1990 -- they measure to 2009. They say, "0.9 percent, no progress." That's unfair. As a professor, I think I have the right to propose something differently. I would say, at least do this -- 10 years is enough to follow the trend. It's two surveys, and you can see what's happening now. They have 2.4 percent. Had I been in the Ministry of Health in Kenya, I may have joined these two points. So what I'm telling you is that we know the child mortality. We have a decent trend. It's coming into some tricky things then when we are measuring MDGs. And the reason here for Africa is especially important, because '90s was a bad decade, not only in Kenya, but across Africa. The HIV epidemic peaked. There was resistance for the old malaria drugs, until we got the new drugs. We got, later, the mosquito netting. And there was socio-economic problems, which are now being solved at a much better scale. So look at the average here -- this is the average for all of sub-Saharan Africa. And [the] U.N. says it's a reduction with 1.8 percent.
但现在,你有这趋势线, 我们怎样衡量进步呢? 这儿我讲些细节, 因为联合国是像这样做的。 他们是从1990年到2009年进行衡量。 他们说,“0.9%,没有进步。” 这不合理。 做为一个教授,我认为我有权提出一些不同的东西。 我要说,至少做到这个。 10年来的趋势是足够长的。 这有2个调查,你可以看到现在发生的事。 他们有2.4%的进步。 我要是在肯尼亚的卫生部, 我或许会为这两点进步而努力。 所以我会告诉你 我们了解这儿童死亡率。 我们有了一个相当不错的趋势。 当我们衡量千年发展目标时, 一些棘手的事随之而来。 对于非洲这儿的理由是非常重要的, 因为90年代是个糟糕的10年, 不仅仅是在肯尼亚,而是遍布非洲 艾滋病毒肆意泛滥。 以前的抗疟疾药物有抗体不顶用,除非我们研发新药。 之后,我们有了蚊帐。 还有社会经济问题, 我们现在才以一个更好地方式解决这些问题。 所以看看这平均值。 撒哈拉以南非洲国家的平均值在这儿。 联合国说 这平均值下降了1.8%。
Now this sounds a little theoretical, but it's not so theoretical. You know, these economists, they love money, they want more and more of it, they want it to grow. So they calculate the percent annual growth rate of [the] economy. We in public health, we hate child death, so we want less and less and less of child deaths. So we calculate the percent reduction per year, but it's sort of the same percentage. If your economy grows with four percent, you ought to reduce child mortality four percent; if it's used well and people are really involved and can get the use of the resources in the way they want it. So is this fair now to measure this over 19 years? An economist would never do that. I have just divided it into two periods. In the 90s, only 1.2 percent, only 1.2 percent. Whereas now, second gear -- it's like Africa had first gear, now they go into second gear. But even this is not a fair representation of Africa, because it's an average, it's an average speed of reduction in Africa.
这个现在听起来有点理论化, 但这不是特理论的。 大家知道,这些经济学家 他们喜欢金钱,他们想要很多的钱,他们想让钱生钱。 所以他们计算经济年均增长百分比。 而我们关注公共卫生,我们不希望儿童死亡, 所以我们期望越来越少的儿童死亡。 所以我们每年计算降低率。 但这是相同的百分比排序。 如果经济增长率为4%, 儿童死亡率就降低4%, 如果适当应用,人们很好地参与其中 人们可以以他们想要的方式来使用资源。 那么现在用19年来衡量这千年发展目标是合理的吗? 一个经济学家决不会这样做。 我会把它分为2个阶段。 在90年代,只有1.2%, 只有1.2%降低率。 而现在,第二阶段 好比非洲有第一阶段, 现在非洲进入第二阶段。 但甚至这个 都不能完全代表非洲, 因为这只是平均值, 在非州降低率的平均值。
And look here when I take you into my bubble graphs. Still here, child death per 1,000 on that axis. Here we have [the] year. And I'm now giving you a wider picture than the MDG. I start 50 years ago when Africa celebrated independence in most countries. I give you Congo, which was high, Ghana -- lower. And Kenya -- even lower. And what has happened over the years since then? Here we go. You can see, with independence, literacy improved and vaccinations started, smallpox was eradicated, hygiene was improved, and things got better. But then, in the '80s, watch out here. Congo got into civil war, and they leveled off here. Ghana got very ahead, fast. This was the backlash in Kenya, and Ghana bypassed, but then Kenya and Ghana go down together -- still a standstill in Congo. That's where we are today. You can see it doesn't make sense to make an average of this zero improvement and this very fast improvement. Time has come to stop thinking about sub-Saharan Africa as one place. Their countries are so different, and they merit to be recognized in the same way, as we don't talk about Europe as one place. I can tell you that the economy in Greece and Sweden are very different -- everyone knows that. And they are judged, each country, on how they are doing.
看看这儿我的泡状图形。 还是这儿, 纵轴每1000个孩子里的儿童死亡人数。 这儿看到的是年数。 我现在呈现给你比千年发展目标视角更宏观的数据图。 我从50年前举例 非洲大多数国家庆祝独立。 我给大家举例,刚果的儿童死亡数很高, 加纳的较低,肯尼亚的更低点。 自那以后发生了什么事呢?我们在这儿 大家能看到,随着国家独立,人们读写能力的提高, 人们接种疫苗接种,天花被消灭, 卫生保健得到改善,一切都好起来。 但随后,在80年代,看看这里。 刚果经历内战, 它们在这里持稳。 加纳以非常快的速度领先着。 肯尼亚数据也激烈变化着,加纳超过了肯尼亚, 随后肯尼亚和加纳的儿童死亡人数都在下降。 刚果的还没变化。 这就是现在我们所处的境地。 各位ikeyi看到,这个 零改善和这个非常快速的改善的 平均值不具有任何意义。 时间加以证明 不要把撒哈拉以南非洲国家当作一个区域来混淆。 这些国家是如此不同, 他们理应被正确地认识, 正如我们不会说欧洲是一个地方。 我可以告诉你在希腊和瑞典的经济是截然不同的。 大家都晓得。 这得按各国情况来做评估。
So let me show the wider picture. My country, Sweden: 1800, we were up there. What a strange personality disorder we must have, counting the children so meticulously in spite of a high child death rate. It's very strange. It's sort of embarrassing. But we had that habit in Sweden, you know, that we counted all the child deaths, even if we didn't do anything about it. And then, you see, these were famine years. These were bad years, and people got fed up with Sweden. My ancestors moved to the United States. And eventually, soon they started to get better and better here. And here we got better education, and we got health service, and child mortality came down. We never had a war; Sweden was in peace all this time. But look, the rate of lowering in Sweden was not fast. Sweden achieved a low child mortality because we started early. We had primary school actually started in 1842. And then you get that wonderful effect when we got female literacy one generation later. You have to realize that the investments we do in progress are long-term investments. It's not about just five years -- it's long-term investments. And Sweden never reached [the] Millennium Development Goal rate, 3.1 percent when I calculated. So we are off track -- that's what Sweden is. But you don't talk about it so much. We want others to be better than we were, and indeed, others have been better.
然后我给大家看看这更宏观的数据图。 拿我的国家瑞典来说: 1800年我们的儿童死亡数在这儿。 尽管有高儿童死亡率,我们那时得需要多么奇怪的心理 来仔细地统计儿童死亡数。 这非常奇怪,也令人尴尬。 但大家知道,我们在瑞典有个风俗 我们记录所有儿童死亡数 即使我们为此做不了什么。 然后大家看到,这是饥荒年, 糟糕的年代,人们在瑞典混不下去了。 我的祖先移民到美国。 不久之后,他们生活变好起来。 这儿我们得到良好的教育,公共医疗保健服务, 儿童死亡数才降下来。 我们没有战争,瑞典一直以来处于和平年代。 但看一下, 在瑞典的降低率 变化不是非常快。 瑞典达到低儿童死亡数 由于我们早期开始的工作。 我们实际 在1842年开始有小学教育。 随后在一代人之后 当女性有识字能力 这才有了显著作用。 大家得意识到我们所取得的进步投资 是个长远投资。 这不仅仅是5年的, 而是个长远投资。 我计算时发现瑞典还没达到千年发展目标的 儿童死亡率3.1%。 我们还没达到这目标。这就是瑞典的现状。 但我们不经常谈这个。 我们想让其他国家比我们瑞典做得更好。的确,其他国家已经做得很好了。
Let me show you Thailand, see what a success story, Thailand from the 1960s -- how they went down here and reached almost the same child mortality levels as Sweden. And I'll give you another story -- Egypt, the most hidden, glorious success in public health. Egypt was up here in 1960, higher than Congo. The Nile Delta was a misery for children with diarrheal disease and malaria and a lot of problems. And then they got the Aswan Dam. They got electricity in their homes, they increased education and they got primary health care. And down they went, you know. And they got safer water, they eradicated malaria. And isn't it a success story. Millennium Development Goal rates for child mortality is fully possible. And the good thing is that Ghana today is going with the same rate as Egypt did at its fastest. Kenya is now speeding up. Here we have a problem. We have a severe problem in countries which are at a standstill.
让我给大家展示下泰国的数据, 看看泰国自从1960年取得了多么成功的进步, 他们是怎样降低这数据 几乎到达和瑞典一样的儿童死亡率水平上。 我会给大家另一个例子,埃及, 在公共卫生上常常被人忽视,但取得辉煌的成就。 在1960年埃及在这儿的数据 比刚果的还要高。 尼罗河三角洲的儿童过着苦难的生活, 他们得腹泻性痢疾 疟疾和面对很多问题。 然后埃及建有阿斯旺大坝。家中通电了。 他们普及教育。 也普及基本的医疗保健。 大家都晓得,他们的儿童死亡率在下降。 他们有安全饮用水,消灭了疟疾。 这难道不是个成功的故事吗? 儿童死亡率的千年发展目标 是完全有可能实现的。 好消息是 今天的加纳在以 埃及所取得成功的最快速率变化着。 肯尼亚现在也加快速率。 我们这儿还有问题。 在没任何变化的国家身上,我们面临很严重的问题。
Now, let me now bring you to a wider picture, a wider picture of child mortality. I'm going to show you the relationship between child mortality on this axis here -- this axis here is child mortality -- and here I have the family size. The relationship between child mortality and family size. One, two, three, four children per woman: six, seven, eight children per woman. This is, once again, 1960 -- 50 years ago. Each bubble is a country -- the color, you can see, a continent. The dark blue here is sub-Saharan Africa. And the size of the bubble is the population. And these are the so-called "developing" countries. They had high, or very high, child mortality and family size, six to eight. And the ones over there, they were so-called Western countries. They had low child mortality and small families. What has happened? What I want you [to do] now is to see with your own eyes the relation between fall in child mortality and decrease in family size. I just want not to have any room for doubt -- you have to see that for yourself. This is what happened. Now I start the world. Here we come down with the eradication of smallpox, better education, health service. It got down there -- China comes into the Western box here. And here Brazil is in the Western Box. India is approaching. The first African countries coming into the Western box, and we get a lot a new neighbors. Welcome to a decent life. Come on. We want everyone down there. This is the vision we have, isn't it. And look now, the first African countries here are coming in. There we are today.
现在我带大家看一个更宏观的数据图, 儿童死亡率的泡状图形。 我展示给大家 这儿纵轴儿童死亡率 如这纵轴儿童死亡率所示 和这儿家庭规模之间的关系。 在儿童死亡率和家庭规模之间的关系。 每个女人有一个,两个,三个,四个孩子 六个,七个,八个孩子。 这是50年前,1960年 那时的数据。 每个泡泡代表一个国家。 大家看到的颜色是指一个洲。 这儿深蓝色代表撒哈拉以南非洲国家。 泡泡的面积代表人口。 这些国家是 所谓的“发展中”国家。 他们有高的,极高的儿童死亡率 家庭规模是6到8人。 在这儿的国家 是西方国家 他们有低儿童死亡率 和小家庭。 接下来会发生什么呢? 我现在想让大家亲眼看看 在儿童死亡率的降低 和家庭规模缩小上的变化。 我想这没有什么好质疑的。 你亲自看这些变化。 这就是所发生的事实。我现在展开世界的数据图。 这儿我们消灭了 天花,提供良好的教育 和保健服务。 数据在这儿呈下降--中国进入西方阵营。 随后巴西也加入西方阵营。 印度在追赶。第一批非洲国家加入到西方阵营。 我们有了很多新伙伴。 欢迎来过上一种体面的生活。 来吧,我们想让每个人都加入我们。 这是我们的愿景,不是吗? 看看现在,这儿的第一批非洲国家纷纷而至。 这儿就是我们现在的事实。
There is no such thing as a "Western world" and "developing world." This is the report from [the] U.N., which came out on Friday. It's very good -- "Levels and Trends in Child Mortality" -- except this page. This page is very bad; it's a categorization of countries. It labels "developing countries," -- I can read from the list here -- developing countries: Republic of Korea -- South Korea. Huh? They get Samsung, how can they be [a] developing country? They have here Singapore. They have the lowest child mortality in the world, Singapore. They bypassed Sweden five years ago, and they are labeled a developing country. They have here Qatar. It's the richest country in the world with Al Jazeera. How the heck could they be [a] developing country? This is crap. (Applause) The rest here is good -- the rest is good.
这儿没有特别划分 “西方国家”和“发展中国家”。 这是一份来自联合国 2月份的报告。 它非常棒--“儿童死亡率水平及发展趋势” 除了这一页。 这一页很糟糕。 它给各国分类了。 它还分类“发展中国家”--我这儿读到的列表-- 发展中国家:大韩民国--韩国。 啊? 韩国有三星品牌,他们怎么会是发展中国家呢? 这列表里有新加坡。 新加坡在全球有最低的儿童死亡率。 它们在5年前就超过瑞典, 它们被归为发展中国家。 这儿还有卡塔尔。 它是全球最富有的国家,还有阿拉伯半岛新闻电视台。 真见鬼把它们都归为发展中国家? 这就是垃圾。 (掌声) 这儿的其它报告都是好的。
We have to have a modern concept, which fits to the data. And we have to realize that we are all going to into this, down to here. What is the importance now with the relations here. Look -- even if we look in Africa -- these are the African countries. You can clearly see the relation with falling child mortality and decreasing family size, even within Africa. It's very clear that this is what happens. And a very important piece of research came out on Friday from the Institute of Health Metrics and Evaluation in Seattle showing that almost 50 percent of the fall in child mortality can be attributed to female education. That is, when we get girls in school, we'll get an impact 15 to 20 years later, which is a secular trend which is very strong. That's why we must have that long-term perspective, but we must measure the impact over 10-year periods. It's fully possible to get child mortality down in all of these countries and to get them down in the corner where we all would like to live together.
我们得有现代观念 来理解这数据。 我们得知道 我们都会朝这个儿童低死亡率趋势发展。 重要的是了解这之间的关系。 看看。我们拿非洲举例。 这些是非洲国家。 甚至在非洲国家里,你就能很清楚地看到儿童死亡率的下降 和家庭规模的缩小 之间的关系。 这发生的变化是很明显的。 在周五有个非常重要的研究资料 它来自西雅图卫生测量与评价研究所 表明 儿童死亡率下降的一半 可能归功于女性教育。 这就是,当我们在学校教育女孩, 15到20年后我们会得到其影响, 这是个非常棒的长远趋势。 这也是我们须有长远观点的原因, 但我们必须衡量 在10年间的变化影响。 让所有这些国家的 儿童死亡率降低 并让他们都加入我们所处的这一阵营 这是完全有可能的。
And of course, lowering child mortality is a matter of utmost importance from humanitarian aspects. It's a decent life for children, we are talking about. But it is also a strategic investment in the future of all mankind, because it's about the environment. We will not be able to manage the environment and avoid the terrible climate crisis if we don't stabilize the world population. Let's be clear about that. And the way to do that, that is to get child mortality down, get access to family planning and behind that drive female education. And that is fully possible. Let's do it.
当然,儿童死亡率的降低 是人道主义方面最最重要的 一件事。 这是为了让孩子过上一种有尊严的体面生活, 如我们所谈到的。 但这也是一个着眼于所有人类未来的 战略投资, 因为这涉及环境。 如果我们不能稳定全球人口数,我们就不能作用于环境 并避免可怕的 气候危机。 这一点我们大家都明白。 要做到这一点的方法, 它就是降低儿童死亡率,实行计划生育, 随后带动女性教育。 这些都是完全可行的。让我们大家努力做吧。
Thank you very much.
十分感谢。
(Applause)
(掌声)