Hans Rosling on HIV: New facts and stunning data visuals

翻译人员: Yunqing Fei 校对人员: Zachary Lin Zhao

(Applause)

(掌声)

AIDS was discovered 1981; the virus, 1983.

艾滋病发现于1981年，HIV病毒是1983年

These Gapminder bubbles show you

这张气泡图会展示

how the spread of the virus was in 1983 in the world,

1983年后病毒在世界范围内扩散的情况

or how we estimate that it was.

这是我们估计的状况

What we are showing here is --

我们今天要展示的是

on this axis here, I'm showing percent of infected adults.

这条（Y）轴，是被感染的成年人比例

And on this axis, I'm showing dollars per person in income.

而这条（X）轴，是人均收入（美元）

And the size of these bubbles, the size of the bubbles here,

而这些气泡的大小，这些气泡

that shows how many are infected in each country,

代表每个国家被感染的人数

and the color is the continent.

各大洲用颜色区分

Now, you can see United States, in 1983,

现在来看看美国，在1983年

had a very low percentage infected,

感染率还非常低

but due to the big population, still a sizable bubble.

但因为人口基数大，这个气泡还是很大

There were quite many people infected in the United States.

也就是说在美国有很多人被感染

And, up there, you see Uganda.

再上面是乌干达

They had almost five percent infected,

感染率接近百分之五

and quite a big bubble in spite of being a small country, then.

虽然国家不大，但气泡也不小

And they were probably the most infected country in the world.

他们可能是全世界感染率最高的国家

Now, what has happened?

为什么会这样？

Now you have understood the graph

我想大家现在都能看明白这个图表了

and now, in the next 60 seconds,

在接下来的60秒里

we will play the HIV epidemic in the world.

我们会演示HIV病毒在世界上的传染过程

But first, I have a new invention here.

但在这之前，我要先拿出我的新发明

(Laughter)

(笑声)

I have solidified the beam of the laser pointer.

我把激光笔的光线变成固体了

(Laughter)

(笑声)

(Applause)

(掌声)

So, ready, steady, go!

好，准备，坐稳了，开始！

First, we have the fast rise in Uganda and Zimbabwe.

最开始是乌干达和津巴布韦的感染率飙升

They went upwards like this.

像这样一直上升

In Asia, the first country to be heavily infected was Thailand --

在亚洲，第一个受严重传染的国家是泰国

they reached one to two percent.

感染率达到百分之一到二

Then, Uganda started to turn back,

然后乌干达开始回落

whereas Zimbabwe skyrocketed,

而津巴布韦一飞冲天

and some years later South Africa had a terrible rise of HIV frequency.

几年后南非的HIV感染率急剧上升

Look, India got many infected,

看这里，印度也有很多人被感染

but had a low level.

但总体比率还很低

And almost the same happens here.

这里也一样

See, Uganda coming down, Zimbabwe coming down,

看，乌干达下降了，津巴布韦下降了

Russia went to one percent.

俄罗斯上升到百分之一

In the last two to three years,

在过去的两三年里

we have reached a steady state of HIV epidemic in the world.

世界HIV传染进入了稳定期

25 years it took.

从开始到现在花了25年

But, steady state doesn't mean that things are getting better,

但稳定并不意味着情况开始好转

it's just that they have stopped getting worse.

而只是不再恶化而已

And it has -- the steady state is, more or less,

稳定情况就是说或多或少

one percent of the adult world population is HIV-infected.

世界成年人口的百分之一感染了HIV病毒

It means 30 to 40 million people,

也就是说大约3000万到4000万人

the whole of California -- every person,

相当于加利福尼亚的所有人口

that's more or less what we have today in the world.

这就是现在全世界艾滋病患者的大概数量

Now, let me make a fast replay of Botswana.

我们再快速看一下博茨瓦纳的传染过程

Botswana -- upper middle-income country in southern Africa,

博茨瓦纳 - 南部非洲中上收入国家

democratic government, good economy,

民主政府，经济也不错

and this is what happened there.

来看看这里的情况

They started low, they skyrocketed,

（感染率）开始很低，然后火箭般窜升

they peaked up there in 2003,

在2003年达到顶峰

and now they are down.

现在有所下降

But they are falling only slowly,

但下降的速度很慢

because in Botswana, with good economy and governance,

因为博茨瓦纳的经济政治环境不错

they can manage to treat people.

可以治疗艾滋病患者

And if people who are infected are treated, they don't die of AIDS.

感染者只要接受治疗就不会轻易死于艾滋病

These percentages won't come down

所以这个比例不会下降

because people can survive 10 to 20 years.

因为病毒携带者可以继续活上10年到20年

So there's some problem with these metrics now.

所以这个测量方法现在有点问题

But the poorer countries in Africa, the low-income countries down here,

但非洲的穷国，下面的这些低收入国家

there the rates fall faster, of the percentage infected,

感染比例下降的很快

because people still die.

因为感染者在不断死亡

In spite of PEPFAR, the generous PEPFAR,

尽管有总统艾滋病紧急防治救援计划（PEPFAR），慷慨的PEPFAR

all people are not reached by treatment,

并不是所有人都能得到治疗

and of those who are reached by treatment in the poor countries,

贫穷国家中，即使是受到治疗的那些人

only 60 percent are left on treatment after two years.

两年后也只剩下60%的人还在治疗计划中

It's not realistic with lifelong treatment

对穷国中的每一个患者

for everyone in the poorest countries.

进行终身治疗是不现实的

But it's very good that what is done is being done.

但已经做的这些治疗毕竟是件好事

But focus now is back on prevention.

但现在的关注点已经回到了预防上

It is only by stopping the transmission

只有阻止了传播

that the world will be able to deal with it.

我们的世界才会有办法解决艾滋病

Drugs is too costly -- had we had the vaccine,

药物太贵了 -- 要有疫苗就好了

or when we will get the vaccine, that's something more effective --

或者知道什么时候会有疫苗，疫苗会有效的多

but the drugs are very costly for the poor.

但药物对穷人来说太贵了

Not the drug in itself, but the treatment

并不是药物本身贵，而是整个治疗过程

and the care which is needed around it.

以及所需的看护很贵

So, when we look at the pattern,

所以，我们看看整个图表

one thing comes out very clearly:

有一件事非常清楚：

you see the blue bubbles

你看那些蓝色的气泡

and people say HIV is very high in Africa.

人们会说非洲的HIV携带率很高

I would say, HIV is very different in Africa.

我得说，HIV在非洲也是不同的

You'll find the highest HIV rate in the world

世界上最高的HIV感染率

in African countries,

在非洲国家

and yet you'll find Senegal, down here --

但这里也有塞内加尔，下面这里

the same rate as United States.

感染率和美国一样

And you'll find Madagascar,

也有马达加斯加

and you'll find a lot of African countries

和其它很多非洲国家

about as low as the rest of the world.

和世界其它地方的感染率一样低

It's this terrible simplification that there's one Africa

将非洲简单地同一化是很可怕的

and things go on in one way in Africa.

认为非洲的所有事情都是一个样

We have to stop that.

我们不能再这么想

It's not respectful, and it's not very clever

这么想很不尊重

to think that way.

也很不明智

(Applause)

(掌声)

I had the fortune to live and work for a time in the United States.

我有幸在美国生活和工作过一段时间

I found out that Salt Lake City and San Francisco were different.

我发现盐湖城和旧金山就很不一样

(Laughter)

(笑声)

And so it is in Africa -- it's a lot of difference.

非洲也是一样 -- 各地有很多不同

So, why is it so high? Is it war?

那，为什么会这么高？因为战争？

No, it's not. Look here.

不是的。看这里

War-torn Congo is down there -- two, three, four percent.

饱经战火的刚果在下面 -- 百分之二、三、四的样子

And this is peaceful Zambia, neighboring country -- 15 percent.

而和平的邻国赞比亚 -- 百分之十五

And there's good studies of the refugees coming out of Congo --

有人研究过刚果难民的感染率

they have two, three percent infected,

也在百分之二到三之间

and peaceful Zambia -- much higher.

而和平的赞比亚要高得多

There are now studies clearly showing

现在有研究明确表明

that the wars are terrible, that rapes are terrible,

虽然有很多战争，很多强奸

but this is not the driving force for the high levels in Africa.

但并不是非洲HIV病毒高携带率的主要原因

So, is it poverty?

那，是因为贫穷吗？

Well if you look at the macro level,

如果我们看看宏观水平

it seems more money, more HIV.

好像钱越多，HIV就越多

But that's very simplistic,

但这过于简单化了

so let's go down and look at Tanzania.

我们来仔细看看坦桑尼亚的情况

I will split Tanzania in five income groups,

我把坦桑尼亚人按收入分成五组

from the highest income to the lowest income,

从最高收入到最低

and here we go.

我们来看看

The ones with the highest income, the better off -- I wouldn't say rich --

收入最高的人，处境较好的人，我不会叫他们富人

they have higher HIV.

他们的HIV感染率更高

The difference goes from 11 percent down to four percent,

感染率最高有百分之十一，最低的到百分之四

and it is even bigger among women.

妇女中这个差距更大

There's a lot of things that we thought, that now, good research,

我们现在的想法，被很多研究

done by African institutions and researchers

非洲及国际机构和研究人员所做的研究

together with the international researchers, show that that's not the case.

证实是错误的

So, this is the difference within Tanzania.

那么，这是坦桑尼亚的例子

And, I can't avoid showing Kenya.

我必须再举一下肯尼亚的例子

Look here at Kenya.

来看看肯尼亚

I've split Kenya in its provinces.

我按省份划分肯尼亚

Here it goes.

来看看

See the difference within one African country --

在同一个非洲国家里的差别

it goes from very low level to very high level,

从很低的水平到很高的水平

and most of the provinces in Kenya is quite modest.

而肯尼亚大部分的省份感染率并不高

So, what is it then?

那到底是什么原因呢？

Why do we see this extremely high levels in some countries?

为什么有些国家的感染率那么高？

Well, it is more common with multiple partners,

有多个性伴侣的因素

there is less condom use,

有不爱用避孕套的因素

and there is age-disparate sex --

有异龄性爱因素 --

that is, older men tend to have sex with younger women.

就是老男人喜欢跟年轻女人做爱

We see higher rates in younger women than younger men

在很多感染率较高的国家里

in many of these highly affected countries.

年轻女性的感染率要高于年轻男性

But where are they situated?

那地理上的分布又是怎么样呢？

I will swap the bubbles to a map.

我把气泡转移到地图上

Look, the highly infected are four percent of all population

看，高感染率的国家占世界人口的百分之四

and they hold 50 percent of the HIV-infected.

但却有全球百分之五十的HIV感染者

HIV exists all over the world.

HIV在世界各地都存在

Look, you have bubbles all over the world here.

看，气泡分布在所有地方

Brazil has many HIV-infected.

巴西有很多HIV感染者

Arab countries not so much, but Iran is quite high.

阿拉伯国家不多，但伊朗很高

They have heroin addiction and also prostitution in Iran.

伊朗的问题是海洛因和卖淫

India has many because they are many.

印度有很多因为它本身人口多

Southeast Asia, and so on.

东南亚，等等

But, there is one part of Africa --

但非洲有一部分 --

and the difficult thing is, at the same time,

同时要注意的是

not to make a uniform statement about Africa,

不要说到非洲就想到整个非洲

not to come to simple ideas of why it is like this, on one hand.

一方面不要认为出现现在的情况是因为单一的原因

On the other hand, try to say that this is not the case,

另一方面要承认现在的情况很严重

because there is a scientific consensus about this pattern now.

现在对这个分布图科学界已经达成了共识

UNAIDS have done good data available, finally,

UNAIDS终于提供了HIV传播的

about the spread of HIV.

详细数据

It could be concurrency.

可能是同时拥有多重性伴侣

It could be some virus types.

可能是某些病毒种类

It could be that there is other things

可能是有别的原因

which makes transmission occur in a higher frequency.

使得传播到这样高的比例

After all, if you are completely healthy and you have heterosexual sex,

不管怎样，如果你完全健康并且是异性恋

the risk of infection in one intercourse is one in 1,000.

每次性交被传染的概率是千分之一

Don't jump to conclusions now on how to

别轻易得出结论

behave tonight and so on.

今晚就去胡搞

(Laughter)

(笑声)

But -- and if you are in an unfavorable situation,

但是，如果你的状况不那么好

more sexually transmitted diseases, it can be one in 100.

更多通过性传染的疾病几率可以达到百分之一

But what we think is that it could be concurrency.

但我们认为同时拥有多个性伴可能是主要原因

And what is concurrency?

什么是同时拥有多重性伴侣？

In Sweden, we have no concurrency.

在瑞典我们没有多重性伴侣

We have serial monogamy.

我们是连续的单一性伴侣

Vodka, New Year's Eve -- new partner for the spring.

喝伏特加，除夕夜 -- 春天有新伙伴了

Vodka, Midsummer's Eve -- new partner for the fall.

喝伏特加，仲夏夜 -- 秋天有新伙伴了

Vodka -- and it goes on like this, you know?

喝伏特加 -- 继续这样子，你们明白了吗？

And you collect a big number of exes.

这样你会有很多“前”女友

And we have a terrible chlamydia epidemic --

有一种可怕的衣原体传染病

terrible chlamydia epidemic which sticks around for many years.

这种可怕的衣原体传染病持续多年

HIV has a peak three to six weeks after infection

而HIV是在感染后的三到六周有一个活动高峰

and therefore, having more than one partner in the same month

因此，在一个月里有多个性伙伴

is much more dangerous for HIV than others.

对HIV传播是特别危险的

Probably, it's a combination of this.

很可能，这是原因之一

And what makes me so happy is that we are moving now

让我高兴的是我们在考虑这些因素的时候

towards fact when we look at this.

在不断地向真相进步

You can get this chart, free.

大家可以免费来拿这份图表

We have uploaded UNAIDS data on the Gapminder site.

我们把UNAIDS的数据上传到Gapminder.org

And we hope that when we act on global problems in the future

并且希望将来在解决全球性问题时

we will not only have the heart,

我们不仅带着一颗心

we will not only have the money,

不仅带着钱

but we will also use the brain.

也多用脑子

Thank you very much.

谢谢大家

(Applause)

(掌声)