How the pandemic will shape the near future | Bill Gates

Chris Anderson: Welcome, Bill Gates.

翻译人员: Grace Yang 校对人员: Yolanda Zhang

克里斯·安德森（Chris Anderson）： 欢迎，比尔·盖茨！

Bill Gates: Thank you.

比尔·盖茨：谢谢。

CA: Alright. It's great to have you here, Bill.

克里斯：好的， 欢迎你加入这场谈话，比尔。

You know, we had a TED conversation about three months ago

大概三个月之前，

我们有过一次 关于新冠病毒的对话。

about this pandemic,

and back then, I think fewer than -- I think that was the end of March --

大概是三月底吧，

back then, fewer than 1,000 people in the US had died

当时在美国只有不到 1000 人 因为感染而死亡，

and fewer than 20,000 worldwide.

而全球的死亡人数还不到 2 万。

I mean, the numbers now are, like, 128,000 dead in the US

然而现在，死亡人数 已经达到了 12 万 8 千人，

and more than half a million worldwide,

全球死亡人数超过了 50 万，

in three months.

只用了

In three months.

短短三个月。

What is your diagnosis of what is possible for the rest of this year?

你对下半年的疫情有什么判断呢？

You look at a lot of models.

你了解了很多预测模型，

What do you think best- and worst-case scenarios might be?

你觉得最坏和最好的情况是什么呢？

BG: Well, the range of scenarios, sadly, is quite large,

比尔： 其实有非常多的可能性，

including that, as we get into the fall,

比如到了秋季的时候，

we could have death rates that rival the worst of what we had

死亡率可能会比四月份

in the April time period.

最严重的时候还要高。

If you get a lot of young people infected,

如果有许多年轻人感染了，

eventually, they will infect old people again,

最终他们就会再把 病毒传染给老年人，

and so you'll get into the nursing homes,

所以在养老院里，

the homeless shelters,

和流浪汉的收容所里，

the places where we've had a lot of our deaths.

死亡人数就会大大增加。

The innovation track, which probably we'll touch on --

在科技创新方面，

diagnostics, therapeutics, vaccines --

包括诊断、治疗、疫苗等，

there's good progress there,

都有了很大的进展，

but nothing that would fundamentally alter the fact

但是这并不能改变一个事实，

that this fall in the United States could be quite bad,

那就是这个秋季美国的 疫情可能会很严重，

and that's worse than I would have expected a month ago,

并且比我上个月预测的还要严重。

the degree to which we're back at high mobility,

因为我们逐步复工，

not wearing masks,

人们不戴口罩，

and now the virus actually has gotten into a lot of cities

所以新冠病毒正在许多城市蔓延，

that it hadn't been in before in a significant way,

而这种传播速度是前所未有的，

so it's going to be a challenge.

所以这将是一个挑战。

There's no case where we get much below the current death rate,

让死亡率降低到

which is about 500 deaths a day,

每天 500 人以下是不太可能的。

but there's a significant risk we'd go back up

但是二次爆发的几率却很大，

to the even 2,000 a day that we had before,

死亡率甚至会攀升到 一天 2000 人，

because we don't have the distancing,

这都是因为我们 没有保持社交距离，

the behavior change,

没有像四五月份的时候那样

to the degree that we had in April and May.

居家隔离。

And we know this virus is somewhat seasonal,

并且我们知道，这个病毒 在一定程度上是季节性的，

so that the force of infection,

所以包括温度、湿度、 更多的室内活动等影响，

both through temperature, humidity, more time indoors,

会导致感染率

will be worse as we get into the fall.

在秋季有所增长。

CA: So there are scenarios where in the US,

克里斯：所以如果 按照这个增长速度

like, if you extrapolate those numbers forward,

推断美国的疫情情况，

we end up with, what,

到最后，

more than a quarter of a million deaths, perchance,

如果我们没有控制好，

even this year if we're not careful,

仅在今年就会有 超过 25 万人死亡。

and worldwide, I guess the death toll could, by the end of the year,

而到了今年年底，

be well into the millions, with an "s."

全球会有超过百万人死亡。

Is there evidence that the hotter temperatures of the summer

有没有证据表明高温

actually have been helping us?

其实会帮助我们抑制病毒？

BG: They're not absolutely sure,

比尔：这个我们还不能确定，

but certainly, the IHME model definitely wanted to use the season,

但是健康指标和评估研究所（IHME） 确实曾尝试用环境因素，

including temperature and humidity,

像温度和湿度，

to try and explain why May wasn't worse than it was.

来解释为什么五月的疫情 并没有之前那么严重。

And so as we came out and the mobility numbers got higher,

当我们开始出行，

the models expected more infections and deaths to come out of that,

这个模型显示， 感染和死亡人数也会增加。

and the model kept wanting to say,

并且这个模型 也一直希望能够表明，

"But I need to use this seasonality

是否能够用季节性来解释，

to match why May wasn't worse,

为什么五月份没有那么严重，

why June wasn't worse than it was."

为什么六月份 并没有之前那么严重。

And we see in the Southern Hemisphere,

并且我们也观察到，在南半球，

you know, Brazil,

像巴西，

which is the opposite season,

那里目前是冬季，

now all of South America is having a huge epidemic.

现在所有的南美洲国家 都已经有了大规模的传染。

South Africa is having a very fast-growing epidemic.

病毒也在南非迅速传播。

Fortunately, Australia and New Zealand,

幸运的是，澳大利亚和新西兰

the last countries in the Southern Hemisphere,

是仅有的几个 没有很多确诊人数的

are at really tiny case counts,

南半球国家。

and so although they have to keep knocking it down,

即使他们在很努力地防疫，

they're talking about, "Oh, we have 10 cases,

也仍然会说， “我们又确诊了 10 例，

that's a big deal, let's go get rid of that."

这可不是个小数目， 我们得严格防控。”

So they're one of these amazing countries that got the numbers so low

所以他们才成为了能把确诊人数 降到最低的那几个国家。

that test, quarantine and trace

这些测试、隔离和追踪

is working to get them, keep them at very near zero.

都能帮助他们 把感染人数降到接近 0。

CA: Aided perhaps a bit by being easier to isolate

克里斯： 更方便的隔离促使

and by less density, less population density.

和更低的人口密度 可能会帮助他们控制疫情。

But nonetheless, smart policies down there.

当然还有明智的政策。

BG: Yeah, everything is so exponential

比尔：是的， 所有数字都在飞快增长，

that a little bit of good work goes a long way.

一点点努力都会有很大的帮助。

It's not a linear game.

这不是一个简单的局面。

You know, contact tracing, if you have the number of cases we have in the US,

拿美国的确诊人数来说，

it's super important to do,

追踪接触者是尤其重要的，

but it won't get you back down to zero.

但这并不会直接把感染率降到 0，

It'll help you be down,

只是会把确诊人数降低一点，

but it's too overwhelming.

但目前确诊人数实在是太多了。

CA: OK, so in May and June in the US,

克里斯：在五六月份的时候，

the numbers were slightly better than some of the models predicted,

美国的确诊人数 比预估的要好一些，

and it's hypothesized that that might be partly because of the warmer weather.

这有可能是因为天气转暖。

你会把我们现在所看到的局面

Now we're seeing, really, would you describe it

as really quite alarming upticks in case rates in the US?

当作一个爆发的预警吗？

BG: That's right, it's --

比尔：是的，

In, say, the New York area,

比如像纽约地区，

the cases continue to go down somewhat,

确诊人数在持续下降。

but in other parts of the country,

但是在其他地方，

primarily the South right now,

比如美国南部，

you have increases that are offsetting that,

确诊人数在持续增加。

and you have testing-positive rates in young people

并且年轻人的确诊率

that are actually higher than what we saw even in some of the tougher areas.

甚至要比一些疫情 严重的地区还要高。

And so, clearly, younger people have come out of mobility

很明显，年轻人开始外出活动，

more than older people have increased their mobility,

并且比老年人外出频率要高，

so the age structure is right now very young,

所以现在感染的 主要人群是年轻人。

but because of multigenerational households,

但是有的家里有不同年龄的人，

people work in nursing care homes,

有人在养老院工作，

unfortunately, that will work its way back,

不幸的是， 这些人都很容易被感染。

both the time lag and the transmission,

而这样就会

back up into the elderly,

导致很多老年人确诊。

will start to push the death rate back up,

所以死亡率就会开始增长。

which, it is down --

而现在的死亡率已经

way down from 2,000 to around 500 right now.

从每天 2000 人 降低到差不多 500 人了。

CA: And is that partly because there's a three-week lag

克里斯：这是不是因为 在确诊人数和死亡人数中

between case numbers and fatality numbers?

有三个星期的时间差？

And also, perhaps, partly because

也有可能是因为

there have been some effective interventions,

一些有效的防护

and we're actually seeing the possibility

让死亡率

that the overall fatality rate is actually falling a bit

下降了一点点，

now that we've gained some extra knowledge?

并且我们对病毒了解更多了？

BG: Yeah, certainly your fatality rate is always lower

比尔：是的，如果医院 没有超负荷运转的话，

when you're not overloaded.

死亡率一定会低一些。

And so Italy, when they were overloaded,

当意大利的医院超负荷的时候，

Spain, even New York at the start,

还有西班牙， 甚至是纽约初期的时候，

certainly China,

还有中国，

there you weren't even able to provide the basics,

医院甚至都不能提供 基本的医疗设施，

the oxygen and things.

像氧气等等。

A study that our foundation funded in the UK

我们在英国的基金会发现，

found the only thing other than remdesivir

除了瑞德西韦，

that is a proven therapeutic,

唯一被证明有一定疗效的

which is the dexamethasone,

就是地塞米松，

that for serious patients,

而且是给重症病人用的。

is about a 20 percent death reduction,

这个药会减少大概 百分之二十的死亡率。

and there's still quite a pipeline of those things.

所以这些药物的需求也很大。

You know, hydroxychloroquine never established positive data,

现在没有数据证明 羟化氯喹有效，

so that's pretty much done.

所以这个试验基本上 就不会再进行了。

There's still a few trials ongoing,

现在还有少数几个实验在进行。

but the list of things being tried,

但是所有我们尝试过的东西，

including, eventually, the monoclonal antibodies,

包括单克隆抗体，

we will have some additional tools for the fall.

我们在秋季的时候 将会有更多的手段。

And so when you talk about death rates,

所以说到死亡率，

the good news is, some innovation we already have,

好消息是我们已经 取得了一定的进展，

and we'll have more, even in the fall.

并且在秋季的时候 会有更多进展，

We should start to have monoclonal antibodies,

到时候我们应该 会有单克隆抗体，

which is the single therapeutic that I'm most excited about.

这是我最期待的疗法。

CA: I'll actually ask you to tell me a bit more about that in one sec,

克里斯：其实我想让你 再详细地说说

but just putting the pieces together on death rates:

关于死亡率的问题。

so in a well-functioning health system,

在一个正常运转的医疗系统里，

so take the US when places aren't overcrowded,

像是在美国，如果 没有那么多人的话，

what do you think

现在的死亡率大概会是

the current fatality numbers are, approximately, going forward,

全部确诊人数的 1%？

like as a percentage of total cases?

你是怎么想的？

Are we below one percent, perhaps?

会低于百分之一吗？

BG: If you found every case, yes,

比尔：如果你把每一个 病例都统计上，是的。

you're well below one percent.

死亡率会低于 1%。

People argue, you know, 0.4, 0.5.

有的人会说 0.4%，0.5%。

By the time you bring in the never symptomatics,

当你把无症状感染者 也计入考量的话，

it probably is below 0.5,

死亡率就会低于 0.5%，

and that's good news.

这是个好消息。

This disease could have been a five-percent disease.

新冠病毒本可能是一个 死亡率 5% 的病毒。

The transmission dynamics of this disease

这个病毒的传播性

are more difficult than even the experts predicted.

比许多专家预料的还要强。

The amount of presymptomatic and never symptomatic spread

无症状和轻度症状感染者 也会传染很多人，

and the fact that it's not coughing,

因为他们不咳嗽，

where you would kind of notice, "Hey, I'm coughing" --

完全没有任何预兆，

most respiratory diseases make you cough.

但许多的呼吸道疾病 都有咳嗽的症状。

This one, in its early stages, it's not coughing,

在潜伏期， 新冠感染者是不会咳嗽的，

it's singing, laughing, talking,

还能正常唱歌、大笑、说话。

actually, still, particularly for the super-spreaders,

尤其是这些超级传染者，

people with very high viral loads,

携带很多病毒的人，

causes that spread,

造成的传播

and that's pretty novel,

这是比较惊人的。

and so even the experts have to say, "Wow, this caught us by surprise."

所以专家们也不得不承认。 “哇，这是我们没有预料到的。”

The amount of asymptomatic spread

因为无症状感染者的高传播率

and the fact that there's not a coughing element

和没有咳嗽等症状，

is not a major piece like the flu or TB.

所以这和普通流感 或者肺结核并不太一样。

CA: Yeah, that is devilish cunning by the virus.

克里斯：是的，这就是 新冠病毒的狡猾之处。

I mean, how much is that nonsymptomatic transmission

我想知道无症状感染者的传播率

as a percentage of total transmission?

占总传播率的多少呢？

I've heard numbers it could be as much as half of all transmissions

我听说仅仅轻症状感染者

are basically presymptomatic.

就占了一半的传播率。

BG: Yeah, if you count presymptomatics,

比尔：是的，如果你考虑 轻症状和无症状感染者，

then most of the studies show that's like at 40 percent,

那么大部分的研究都会表明，

and we also have never symptomatics.

他们的传染率大概占 百分之四十左右。

The amount of virus you get in your upper respiratory area

在上呼吸道的病毒

is somewhat disconnected.

跟下呼吸道是没有关联的。

Some people will have a lot here and very little in their lungs,

有些人的上呼吸道感染很严重， 但肺部却不太受影响。

and what you get in your lungs causes the really bad symptoms --

而在肺部里的病毒会 让你感到非常的不适，

and other organs, but mostly the lungs --

其他器官也会，但主要是肺部。

and so that's when you seek treatment.

所以你就会去医院寻求治疗。

And so the worst case in terms of spreading

传染方面最坏的情形，

is somebody who's got a lot in the upper respiratory tract

就是那些 上呼吸道感染较重的人，

but almost none in their lungs,

但是肺部基本上没有感染，

so they're not care-seeking.

所以他们就不会去医院。

CA: Right.

克里斯：是的。

And so if you add in the never symptomatic

如果把所有的无症状感染者

to the presymptomatic,

都计入轻症状感染者里，

do you get above 50 percent of the transmission

会有超过 50% 的传染率

is actually from nonsymptomatic people?

来自无症状感染者吗？

BG: Yeah, transmission is harder to measure.

比尔：是的，传染率其实更难评估。

You know, we see certain hotspots and things,

我们已经看到一些爆发地，

but that's a huge question with the vaccine:

所以对疫苗还有很大的疑问：

Will it, besides avoiding you getting sick,

除了自己做好防护，

which is what the trial will test,

实验要证明的就是

will it also stop you from being a transmitter?

疫苗会不会防止你传染给别人？

CA: So that vaccine,

克里斯：这个疫苗

it's such an important question, let's come on to that.

是一个很关键问题， 我们还会深入聊一下。

但是在这之前，

But before we go there,

在过去的几个月里，

any other surprises in the last couple months

有没有任何其他的发现，

that we've learned about this virus

that really impact how we should respond to it?

需要我们对新冠病毒 采取不同的措施？

BG: We're still not able to characterize who the super-spreaders are

比尔：我们还不能确定 谁是这些超级传染者，

in terms of what that profile is,

像是具体的个人信息之类的，

and we may never.

有可能我们永远都不能确定，

That may just be quite random.

因为这个人可能是任何人。

If you could identify them,

如果你能找到他们，

they're responsible for the majority of transmission,

他们就是主要的传染病携带者。

a few people who have very high viral loads.

而只有少数人会携带 这样致命的病毒。

But sadly, we haven't figured that out.

但是遗憾的是，我们无法找到他们。

This mode of transmission,

如果你们在一个房间里，

if you're in a room and nobody talks,

没有人说话，

there's way less transmission.

传染率就会大大降低。

That's partly why, although planes can transmit,

这就是为什么，虽然 在飞机上可以传染病毒，

it's less than you would expect just in terms of time proximity measures,

但被传染的概率比你想象的要小。

because unlike, say, a choir or a restaurant,

因为这不像合唱团或者餐厅，

you're not exhaling in loud talking

你不会在说话的时候大口喘息，

quite as much as in other indoor environments.

就像很多室内环境一样。

CA: Hmm.

克里斯：嗯。

What do you think about the ethics of someone who would go on a plane

你怎么看待不戴口罩

and refuse to wear a mask?

坐飞机的人？

BG: If they own the plane, that would be fine.

比尔：如果飞机是他们家的， 那就没有任何问题。

If there's other people on the plane,

如果飞机上有别人，

that would be endangering those other people.

这就是对别人的健康不负责任了。

CA: Early on in the pandemic,

克里斯：在疫情的前期，

the WHO did not advise that people wear masks.

世卫组织并没有建议人们戴口罩，

They were worried about taking them away from frontline medical providers.

他们担心在一线工作的 医护人员会没有口罩用。

In retrospect, was that a terrible mistake that they made?

现在看来，这是不是 一个巨大的错误？

BG: Yes.

比尔：是的。

All the experts feel bad that the value of masks --

所有的专家都对此感到难过，

which ties back somewhat to the asymptomatics;

而这与无症状感染者有关。

if people were very symptomatic,

如果人们表现出强烈的症状，

like an Ebola,

像是埃博拉，

then you know it and you isolate,

你就会知道自己生病了， 并且主动自我隔离，

and so you don't have a need for a masklike thing.

那么你就不会戴口罩外出了。

The value of masks,

而对于口罩的重要性，

the fact that the medical masks was a different supply chain

所谓医用口罩和普通口罩

than the normal masks,

有不同的生产链，

the fact you could scale up the normal masks so well,

或者我们能把普通的 口罩进行大规模生产，

the fact that it would stop that presymptomatic,

又或者口罩能防止轻症状感染者

never symptomatic transmission,

和无症状感染者的传播，

it's a mistake.

这些都是错的。

But it's not a conspiracy.

但是这不是一个阴谋论。

It's something that, we now know more.

只是我们现在更了解这个病毒了。

And even now, our error bars on the benefit of masks

甚至现在，我们在 口罩的好处上所犯的错误

are higher than we'd like to admit,

也比我们愿意承认的要高，

but it's a significant benefit.

但这确实是一个显著的好处。

CA: Alright, I'm going to come in with some questions

克里斯：好的，我想问几个

from the community.

观众提出的问题。

Let's pull them up there.

我们一起来看看。

Jim Pitofsky, "Do you think reopening efforts in the US have been premature,

吉姆·皮托夫斯基问： “你觉得现在复工是不是为时过早，

and if so, how far should the US go to responsibly confront this pandemic?"

如果是的，美国应该 继续抗疫到什么阶段？”

BG: Well, the question of how you make trade-offs

比尔：问题在于利弊之间的平衡。

between the benefits, say, of going to school

其中有一些好处，比如开学。

versus the risk of people getting sick because they go to school,

但是风险就是人们可能 会因为上学而受到感染。

those are very tough questions

这些问题都是很难决策的。

that I don't think any single person can say,

并且我认为没有人可以说，

"I will tell you how to make all these trade-offs."

“我知道怎样权衡利弊。”

The understanding of where you have transmission,

要了解疫情传播在哪里发生，

and the fact that young people do get infected

以及年轻人确实会被感染，

and are part of the multigenerational transmission chain,

而且他们是多代传播链的一部分，

we should get that out.

我们应该把这个弄清楚。

If you just look at the health aspect,

如果只是从医疗方面看，

we have opened up too liberally.

我们确实复工太早了。

Now, opening up in terms of mental health

但是在精神上的“复工”，

and seeking normal health things like vaccines or other care,

接受正常医疗救治，像是疫苗，

there are benefits.

是有好处的。

I think some of our opening up has created more risk than benefit.

我觉得一部分复工是弊大于利的。

Opening the bars up as quickly as they did,

这么快让酒吧恢复营业，

you know, is that critical for mental health?

对心理健康有那么重要吗？

Maybe not.

也许没有。

So I don't think we've been as tasteful about opening up

所以我觉得复工并没有 我们想象的那么美好。

as I'm sure, as we study it,

并且我确信，随着我们 对病毒的深入了解，

that we'll realize some things we shouldn't have opened up as fast.

就会发现我们不应该这么快复工。

But then you have something like school,

但是像学校等地方，

where even sitting here today,

甚至今天，

the exact plan, say, for inner-city schools for the fall,

一些内城区的学校，

I wouldn't have a black-and-white view

我对这样利弊的权衡

on the relative trade-offs involved there.

也不是非黑即白的。

There are huge benefits to letting those kids go to school,

让孩子们重新回到学校 上学是一件极大的好事。

and how do you weigh the risk?

但是其中的风险呢？

If you're in a city without many cases,

如果是在一个 确诊人数没那么多的地方，

I would say probably the benefit is there.

我认为在那利是大于弊的。

Now that means that you could get surprised.

你们也可能会感到惊讶——

The cases could show up, and then you'd have to change that,

确诊病例如果持续增加的话， 学校可能会重新关闭，

which is not easy.

要做到这一点并不容易。

But I think around the US,

不过我认为在整个美国，

there will be places where that won't be a good trade-off.

肯定会有一些地方 是不值得冒这个风险的。

So almost any dimension of inequity,

对于任何一个不平等的方面，

this disease has made worse:

这场病毒都更加恶化了这个情况：

job type, internet connection,

行业种类、是否有互联网、

ability of your school to do online learning.

学校上网课的能力。

White-collar workers,

对于白领们，

people are embarrassed to admit it,

人们很不情愿承认，

some of them are more productive

其中的一些人在家里

and enjoying the flexibility that the at-home thing has created,

就是会更有效率些， 并且能享受更加自由的时间。

and that feels terrible

当你知道很多人还在挣扎，

when you know lots of people are suffering in many ways,

他们的孩子们没法回去上学，

including their kids not going to school.

这种感觉也的确很糟糕。

CA: Indeed. Let's have the next question.

克里斯：确实。让我们 看看下一个问题。

[Nathalie Munyampenda] "For us in Rwanda,

[ 娜塔丽·明尼潘达 ] “在卢旺达，

early policy interventions have made the difference.

早期的政府干预是很有效的。

你建议美国政府 现在采取哪些措施呢？”

At this point, what policy interventions do you suggest for the US now?"

Bill, I dream of the day where you are appointed

比尔，我梦想着有一天你能

the coronavirus czar

成为抗疫的领导者，

with authority to actually speak to the public.

有能力说服大众。

What would you do?

你会怎么做？

BG: Well, the innovation tools

比尔：这些科技创新

are where I and the foundation probably has the most expertise.

就是我跟基金会最擅长的地方。

Clearly, some of the policies on opening up have been too generous,

很明显，一部分 复工的政策过于急躁了，

but I think everybody

但是我认为大家

could engage in that.

可以一起努力。

We need leadership

我们需要领导力。

in terms of admitting that we've still got a huge problem here

并且能承认我们还有 许多问题需要去解决，

and not turning that into almost a political thing

而不是把它变成一个政治问题。

of, "Oh, isn't it brilliant what we did?"

“我们做得真好，不是吗？”

No, it's not brilliant,

不，我们做得不好。

but there's many people, including the experts --

但是还有很多事情是很多人，

there's a lot they didn't understand,

包括专家们既然没搞清楚的。

and everybody wishes a week earlier whatever action they took,

大家都希望要是能早一点 实施这个计划就好了，

they'd taken that a week earlier.

比如早一个星期。

The innovation tools,

这些科技创新，

that's where the foundation's work

就是基金会在研究的，

on antibodies, vaccines,

抗生素、疫苗等等。

we have deep expertise,

我们有深厚的专业知识，

and it's outside of the private sector,

并且这都是私营部门所没有的，

and so we have kind of a neutral ability to work with all the governments

所以我们可以 以中立的态度和政府

and the companies to pick.

以及目标公司合作。

Particularly when you're doing break-even products,

特别是如果你是非赢利机构，

which one should get the resources?

谁应该拿到资源？

There's no market signal for that.

没有市场信息能指明这一点。

Experts have to say, "OK, this antibody deserves the manufacturing.

专家们说：“好吧， 这个抗生素可以批量生产。

This vaccine deserves the manufacturing,"

这个疫苗可以批量生产。”

because we have very limited manufacturing for both of those things,

因为我们很难 同时生产这两个东西，

and it'll be cross-company, which never happens in the normal case,

而且是跨公司生产的， 这是以前从未出现过的情况，

where one company invents it

比如一个公司发明了疫苗，

and then you're using the manufacturing plants of many companies

之后许多公司将效果最好的疫苗

to get maximum scale of the best choice.

以最大规模投入生产。

So I would be coordinating those things,

所以我可能会重点协调这些事项。

but we need a leader who keeps us up to date,

但是我们需要 一个对民众开诚布公的领导者，

能够实事求是，

is realistic

and shows us the right behavior,

以身作则，

as well as driving the innovation track.

并且推动创新。

CA: I mean, you have to yourself be a master diplomat

克里斯：在谈论这些话题的时候，

in how you talk about this stuff.

你必须能够服众。

So I appreciate, almost, the discomfort here.

我真的很佩服你。

But I mean, you talk regularly with Anthony Fauci,

但是当你跟安东尼·福奇谈话的时候，

who is a wise voice on this by most people's opinion.

许多人都认为福奇是个很聪明的人。

But to what extent is he just hamstrung?

但是有哪些事是他也无能为力的，

He's not allowed to play the full role

在这种情况下

that he could play in this circumstance.

他无法履行全部职责的？

BG: Dr. Fauci has emerged where he was allowed to have some airtime,

比尔：福奇博士在他力所能及的时候 都会尽可能发表一些意见。

and even though he was stating things that are realistic,

即使他说的事情都很现实，

his prestige has stuck.

他的威望已经根深蒂固。

He can speak out in that way.

他可以按照他的方式来说话。

Typically, the CDC would be the primary voice here.

通常情况下，疾控中心 应该是主要的发声机构。

It's not absolutely necessary,

这并不是绝对的，

but in previous health crises,

但是在以前的流行病爆发期间，

you let the experts inside the CDC

疾控中心里的专家

be that voice.

起到了主要的领导作用。

They're trained to do these things,

他们的专业就是这个。

and so it is a bit unusual here how much we've had to rely on Fauci

所以当我们说我们能不能依靠福奇， 而不是疾控中心，

as opposed to the CDC.

是有点奇怪的。

It should be Fauci, who's a brilliant researcher,

福奇是个非常棒的研究人员。

so experienced, particularly in vaccines.

特别是在疫苗方面，他很有经验。

In some ways, he has become, taking the broad advice

有时候他会听取别人的意见，

that's the epidemiology advice

关于传染病学的意见，

and explaining it in the right way,

并且解释得很清楚。

where he'll admit,

他会承认，

"OK, we may have a rebound here,

“我们可能会有二次爆发，

and this is why we need to behave that way."

这就是为什么我们要这么做。”

But it's fantastic that his voice has been allowed to come through.

他的建议能被说出来是一件好事。

CA: Sometimes.

克里斯：有时候吧。

Let's have the next question.

让我们来看看下一个问题。

Nina Gregory, "How are you and your foundation

妮娜·格雷戈里问， “如果新冠疫苗研发成功了，

addressing the ethical questions about which countries get the vaccine first,

你和你的基金会将如何解决 哪些国家优先得到疫苗等

assuming you find one?"

伦理问题？“

And maybe, Bill, use this as a moment

比尔，正好可以借这个机会

to just talk about where the quest for the vaccine is

跟我们说说疫苗实验 进行到哪个阶段了，

and what are just some of the key things we should all be thinking about

以及我们在关注新闻时，

as we track the news on this.

我们应该想到哪些问题。

BG: There's three vaccines that are,

比尔：目前有三种疫苗，

如果的确有效的话， 那就是最早的几个了：

if they work, are the earliest:

the Moderna, which unfortunately, won't scale very easily,

Moderna，很遗憾的是， 大规模生产比较困难。

so if that works, it'll be mostly a US-targeted thing;

如果能做到的话， 大概率美国会是其主要市场。

then you have the AstraZeneca, which comes from Oxford;

然后还有牛津的 阿斯利康（AstraZeneca），

and the Johnson and Johnson.

最后是强生。

Those are the three early ones.

这是最早的几个疫苗。

And we have animal data

我们还有动物实验的数据，

that looks potentially good but not definitive,

虽然看起来很好，但还不能 百分百确定是否可靠。

particularly will it work in the elderly,

尤其是对老年人有没有效；

and we'll have human data over the next several months.

在接下来的几个月里 我们也会有人体实验数据。

Those three will be gated by the safety and efficacy trial.

这三个疫苗都会通过 安全性和药效试验。

That is, we'll be able to manufacture those,

虽然不能百分百满足我们的需求，

although not as much as we want.

但是我们也会尽量大规模生产。

We'll be able to manufacture those before the end of the year.

今年年底之前， 我们就可以大规模生产了。

无论第三阶段是否能成功，

Whether the Phase 3 will succeed

and whether it'll complete before the end of the year,

无论今年年底能不能完成实验，

I wouldn't be that optimistic about.

我都不抱太大希望。

Phase 3 is where you need to really look at all the safety profile

在第三阶段会测试安全性

and efficacy,

和药效，

but those will get started.

这些实验也会逐渐开始。

And then there's four or five vaccines that use different approaches

之后三到四个月，

可能会有四到五个 不同种类的疫苗出现：

that are maybe three or four months behind that:

Novavax, Sanofi, Merck.

诺瓦瓦克斯（Novavax）， 赛诺菲（Sanofi），默克（Merck）。

And so we're funding factory capacity for a lot of these --

我们为很多这类疫苗 都投入了资金以支持大规模生产——

some complex negotiations are taking place right now on this --

目前还在进行一些复杂的讨论——

to get factories that will be dedicated to the poorer countries,

为了让这些工厂为贫穷的国家生产，

what's called low- and middle-income.

也就是所谓的中低收入国家的国家。

And the very scalable constructs

那些能大规模生产的工厂，

that include AstraZeneca and Johnson and Johnson,

像是阿斯利康和强生，

we'll focus on those,

我们会关注

the ones that are inexpensive

那些低成本的疫苗，

and you can build a single factory to make 600 million doses.

这样一个工厂 可以生产 6 亿支疫苗。

So a number of the vaccine constructs

疫苗的大批量生产

are potential.

是可行的，

I don't see anything before the end of the year.

但是我觉得在今年年底 还不太可能实现。

That's really the best case,

这已经是最好的情况了，

and it's down to a few constructs now,

现在只有几个疫苗在实验中，

which, typically, you have high failure rates.

通常失败率会很高。

CA: Bill, is it the case

克里斯：比尔，

that if you and your foundation weren't in the picture here

如果你和你的基金会 并没有参与其中，

that market dynamics would likely lead to a situation

市场形势会不会因此而改变？

where, as soon as a promising vaccine candidate emerged,

比如，一旦有效的疫苗 可以投入生产，

the richer countries would basically snap up, gobble up

富有的国家就会蜂拥而至，

all available initial supply --

抢夺最初的少量产品——

it just takes a while to manufacture these,

毕竟疫苗生产也需要时间。

and there would be nothing for the poorer countries --

那么那些贫穷的国家就没有疫苗了。

but that what, effectively, you're doing

但是你现在

by giving manufacturing guarantees and capability

为很多候选疫苗

to some of these candidates,

保证了工厂的产量，

you're making it possible that at least some of the early vaccine units

你也在想办法让那些贫穷的国家

will go to poorer countries?

能够分到一些疫苗，

Is that correct?

是这样吧？

BG: Well, it's not just us, but yes,

比尔：并不只有我们，不过没错。

we're in the central role there,

我们处在中心的位置，

along with a group we created called CEPI, Coalition for Epidemic Preparedness,

和另外一个组织合作建立了CEPI, 即联合流行病预备中心，

and the European leaders agree with this.

欧洲的领导者们也表示了赞同。

Now we have the expertise to look at each of the constructs

现在有专家去一一查看每一个疫苗，

and say, "OK, where is there a factory in the world

然后评估，“在哪有能力生产

that has capacity that can build that?

这样的疫苗的工厂呢？”

Which one should we put the early money into?

我们该怎么分配这笔初始资金？

What should the milestones be

我们可以把钱投资到其他地方的

where we'll shift the money over to a different one?"

时间点是什么？”

Because the kind of private sector people

私营部门里

who really understand that stuff,

这方面的一些专家

some of them work for us,

也在为我们工作。

and we're a trusted party on these things,

我们在疫苗方面是有一定权威的，

we get to coordinate a lot of it, particularly that manufacturing piece.

有能力协调资源和生产。

Usually, you'd expect the US to think of this as a global problem

通常情况下，美国会 把这当作一个国际问题，

and be involved.

并且参与其中。

So far, no activity on that front has taken place.

不过目前为止， 政府对此还没有任何举动。

I am talking to people in the Congress and the Administration

我在跟国会和行政部的人讨论，

about when the next relief bill comes along

等下一波救助金发放的时候，

that maybe one percent of that could go for the tools

是不是可以用这笔钱中的百分之一

to help the entire world.

来帮助全世界。

And so it's possible,

这是有可能的。

but it's unfortunate,

但是很遗憾，

and the vacuum here,

这个方案还不成熟，

the world is not that used to,

世界还没有就此达成共识。

and a lot of people are stepping in, including our foundation,

很多人都在参与， 包括我们的基金会，

to try and have a strategy,

尝试找到一种新的策略，

including for the poorer countries,

包括针对贫穷国家的策略，

who will suffer a high percentage of the deaths and negative effects,

这些国家的死亡率 和受到的冲击程度比较高，

including their health systems being overwhelmed.

它们的医疗系统都在超负荷运转。

Most of the deaths will be in developing countries,

除了在欧洲和美国 有这么高的死亡率，

despite the huge deaths we've seen in Europe and the US.

大部分的死亡病例 都出现在发展中国家。

CA: I mean, I wish I could be a fly on the wall

克里斯：我希望自己能够

and hearing you and Melinda talk about this,

偷听你和梅琳达是怎么说的。

because of all of the ethical ... "crimes," let's say,

因为这些领导人知道的更多，

executed by leaders who should know better,

而他们犯下的“罪行”， 就这么说吧，

I mean, it's one thing to not model mask-wearing,

当我们有一个共同的敌人的时候，

but to not play a role in helping the world

不戴口罩

when faced with a common enemy,

就是抛弃了整个世界。

respond as one humanity,

我们应该一起抗疫，

and instead ...

而不是

you know, catalyze a really unseemly scramble between nations

在不同国家之间挑起冲突，

to fight for vaccines, for example.

比如哄抢疫苗。

That just seems -- surely, history is going to judge that harshly.

当然，历史会证明一切，

That is just sickening.

这简直让人忍无可忍。

Isn't it? Am I missing something?

对吧？我没漏掉什么吧？

BG: Well, it's not quite as black-and-white as that.

比尔：事情并不是这么简单的。

The US has put more money out

到现在为止， 美国比任何一个国家

to fund the basic research on these vaccines

都投入了更多的资金

than any country by far,

来研究疫苗。

and that research is not restricted.

而这个研究并不是限制性的。

There's not, like, some royalty that says, "Hey, if you take our money,

这并不是说， “如果你拿了我们的钱，

you have to pay the US a royalty."

你就得给美国付使用费。”

They do, to the degree they fund research,

他们确实给基金会投入了很多钱，

it's for everybody.

但是为了所有人的利益。

To the degree they fund factories, it's just for the US.

但是目前他们之投资了美国的工厂。

The thing that makes this tough is that in every other global health problem,

让这个问题变得棘手的是， 在所有其他全球卫生问题上，

the US totally leads smallpox eradication,

美国在根除天花方面完全领先，

the US is totally the leader on polio eradication,

在根除脊髓灰质炎方面也一样， 有着关键的合作伙伴：

with key partners -- CDC, WHO, Rotary, UNICEF, our foundation.

疾控中心、世卫组织、扶轮社、 联合国儿童基金会，以及我们的基金会。

So the world -- and on HIV,

那么在艾滋病方面， 在布什总统的领导下，

under President Bush's leadership, but it was very bipartisan,

通过两党的携手合作， 我们启动了令人难以置信的

this thing called PEPFAR was unbelievable.

总统防治艾滋病 紧急救援计划（PEPFAR），

That has saved tens of millions of lives.

拯救了上千万条生命。

And so it's that the world always expected the US

所以整个世界都在期盼着美国

to at least be at the head of the table,

至少能在资金和方法上做领头羊。

financially, strategy, OK, how do you get these factories for the world,

像是如何让这些工厂为全世界运作，

even if it's just to avoid the infection coming back to the US

或只是防止美国输入性感染，

or to have the global economy working,

或者是让全球经济运转起来。

which is good for US jobs

能有海外的需求

to have demand outside the US.

对于美国的工人们来说是好事。

And so the world is kind of --

所以现在全世界

you know, there's all this uncertainty about which thing will work,

对到底哪些方法有效， 依然没有明确的答案。

and there's this, "OK, who's in charge here?"

于是都很好奇， “究竟是谁在领导这一切？”

And so the worst thing, the withdrawal from WHO,

最差的状况就是 我们退出了世卫组织，

that is a difficulty that hopefully will get remedied

而我希望能够在某处程度上

at some point,

撤回这个决定。

because we need that coordination

因为我们需要和世卫组织

through WHO.

一起协调合作。

CA: Let's take another question.

克里斯：一起来看看下一个问题。

Ali Kashani, "Are there any particularly successful models

阿里-卡沙尼问道： “有没有一些手段

of handling the pandemic that you have seen around the world?"

能有效处理这个全球危机？”

BG: Well, it's fascinating that, besides early action,

比尔：除了及早行动，

there are definitely things where you take people who have tested positive

我们还可以监测这些 核酸检测阳性患者的

and you monitor their pulse ox,

血氧饱和度，

which is the oxygen saturation level in their blood,

就是血液里的氧气含量。

which is a very cheap detector,

只需要一个非常廉价的检测仪，

and then you know to get them to the hospitals fairly early.

然后尽早把他们转入就近的医院。

Weirdly, patients don't know things are about to get severe.

奇怪的是，病人们并不知道 自己的病情要恶化了，

It's an interesting physiological reason that I won't get into.

这涉及到了有些有趣的病理学知识， 但我不打算深入介绍。

And so Germany has quite a low case fatality rate

德国的死亡率是比较低的，

that they've done through that type of monitoring.

而他们就是这样监视病人的。

And then, of course, once you get into facilities,

当然，当你去到这些地方的时候，

we've learned that the ventilator, actually, although extremely well-meaning,

你就会了解到，即使这些 呼吸机是非常有帮助的，

was actually overused and used in the wrong mode

但在前期却被过度使用了，

in those early days.

而且使用不当。

So the health -- the doctors are way smarter about treatment today.

所以当前，医生们的 治疗手段都是非常先进的。

Most of that, I would say, is global.

大部分策略都是全球适用的。

Using this pulse ox as an early indicator,

用血氧饱和度 作为前期监测的指标，

that'll probably catch on broadly,

这样就可以大范围掌握病情。

but Germany was a pioneer there.

但是在这一点上， 德国是第一个做到的。

And now, of course, dexamethasone -- fortunately, it's cheap, it's oral,

当然，地塞米松 也很便宜，是口服的，

we can ramp up manufacture.

所以我们可以大量生产，

That'll go global as well.

并推广到全世界。

CA: Bill, I want to ask you something about

比尔，我很想知道，

what it's been like for you personally through this whole process.

当你自己经历 这些事情的时候是什么感受。

因为，很奇怪的是， 如果有人接触过你，

Because, weirdly, even though your passion and good intent on this topic

seems completely bloody obvious to anyone who has spent a moment with you,

就会知道你对公共健康研究的 热情和善心，

there are these crazy conspiracy theories out there about you.

但是还是有一些人在传播 非常夸张的阴谋论。

I just checked in with a company called Zignal

我刚刚和一个 监管社交媒体的公司

that monitors social media spaces.

Zignal 交流过。

They say that, to date, I think on Facebook alone,

他们说，我觉得仅仅是在脸书上，

more than four million posts have taken place

就有超过 400 万的帖子，

that associate you with some kind of conspiracy theory around the virus.

是关于你和新冠病毒阴谋论的。

I read that there was a poll that more than 40 percent of Republicans

我看到一个投票显示， 百分之四十的共和党

believe that the vaccine that you would roll out

觉得你们推出的疫苗

would somehow plant a microchip in people to track their location.

将会在人们的身体里植入 芯片来追踪他们的位置。

I mean, I can't even believe that poll number.

我想说，这个数字简直难以置信。

And then some people are taking this seriously enough,

有的人对此十分认同，

and some of them have even been recirculated on "Fox News" and so forth,

有的人在福克斯新闻上 不断提到这个话题，

some people are taking this seriously enough

也有的人对此深信不疑，

to make really quite horrible threats and so forth.

甚至把它当成一种威胁。

You seem to do a good job sort of shrugging this off,

你好像总是对此一笑了之，

but really, like, who else has ever been in this position?

不过说真的， 又有谁经历过这些呢？

How are you managing this?

你是怎么做到的？

What on earth world are we in

现在是什么世道，

that this kind of misinformation can be out there?

竟然让这种流言到处散播？

What can we do to help correct it?

我们该怎么做才能改变这种风气？

BG: I'm not sure.

比尔：我也不知道。

And it's a new thing

阴谋论

that there's conspiracy theories.

是一个比较新的东西。

I mean, Microsoft had its share of controversy,

我是说，微软也有这种言论，

but at least that related to the real world, you know?

但是这至少是跟 现实生活相关的，对吧？

Did Windows crash more than it should?

Windows 系统崩溃得 是不是太频繁了？

We definitely had antitrust problems.

我们肯定面临着 一些反垄断的问题,

But at least I knew what that was.

但是至少我知道这是什么。

When this emerged, I have to say,

当这种情况发生，我得说,

my instinct was to joke about it.

我的直觉就是， 开个玩笑就过去了。

People have said that's really inappropriate,

有人认为这么说不太好,

because this is a very serious thing.

因为这是一件很严肃的事情,

It is going to make people less willing to take a vaccine.

会导致人们对接种疫苗更加抗拒。

And, of course, once we have that vaccine,

当然，当我们有了疫苗,

it'll be like masks,

就像口罩一样，

where getting lots of people,

就会有很多人去接种，

particularly when it's a transmission-blocking vaccine,

特别是可以阻止传染的疫苗，

there's this huge community benefit

这个巨大的群体福利

to widespread adoption of that vaccine.

会驱使人们大量的接种疫苗。

So I am caught a little bit,

所以我有一点不确定

unsure of what to say or do,

自己该说什么，或者做什么。

because the conspiracy piece is a new thing for me,

因为对我来说， 阴谋论是一个新事物。

and what do you say

所以对于一个 我太不相信的东西，

that doesn't give credence to the thing?

我能说什么呢？

The fact that a "Fox News" commentator, Laura Ingraham,

事实上福克斯新闻的解说员 劳拉-英格拉姆（Laura Ingraham）

was saying this stuff about me microchipping people,

说过这个植入芯片的事情，

that survey isn't that surprising because that's what they heard

这个调查结果 并不是很出乎意料，

因为这就是人们在电视上听到的，

on the TV.

It's wild.

是毫无根据的。

And people are clearly seeking simpler explanations

人们通常只会去寻求 一个简单的解释，

than going and studying virology.

而不是去仔细研究病理学知识。

CA: I mean,

克里斯：我想说，

TED is nonpolitical,

TED 的政治立场是中立的。

but we believe in the truth.

但是我们相信真理。

I would say this:

我想说：

Laura Ingraham, you owe Bill Gates an apology and a retraction.

劳拉·英格拉姆，你欠比尔·盖茨 一个道歉，并且应该撤回你的言论。

You do.

你应该跟他道歉。

And anyone who's watching this

在观看这个视频的人，

who thinks for a minute that this man is involved in some kind of conspiracy,

如果你认为这个人 跟某个阴谋论有关，

you want your head examined.

你需要好好反省一下，

You are crazy.

这种想法简直不可理喻。

Enough of us know Bill over many years

我们很多人都认识比尔很多年了，

and have seen the passion and engagement in this to know

并且也见证了他对 公共卫生保护的决心。

that you are crazy.

我们可以告诉你， 你的想法很疯狂。

So get over it,

别再执迷不悟了，

and let's look at the actual problem of solving this pandemic.

去专注于抗击病毒 过程中的一些困难吧。

Honestly.

老实说，

If anyone in the chat here has a suggestion,

如果观众中的任何人

a positive suggestion for how you can,

在摆脱阴谋论方面

how do you get rid of conspiracies,

有任何积极的建议，

because they feed on each other.

因为这背后有一个连锁效应。

Now, "Oh, well I would say that, because I'm part of the conspiracy,"

你会有“哦，我这么说是因为 我就是这个阴谋论中的一部分。”

or whatever.

或者之类的想法。

Like, how do we get back to a world

我们如何才能回到一个

where information can be trusted?

信息可靠的世界呢？

We have to do better on it.

我们需要做得更好。

Are there any other questions out there from the community?

我们还有别的问题吧？

Aria Bendix from New York City:

来自纽约的 阿里·班迪克斯问：

"What are your personal recommendations for those who want to reduce

“你对那些想在 疫情越来越严重的地方

their risk of infection amid an uptick in cases?"

保护自己的人有什么建议？”

BG: Well, it's great if you have a job

比尔：如果你 有一份工作，那很好。

你可以呆在家里， 通过网上会议工作，

that you can stay at your house and do it through digital meetings,

and even some of your social activities,

甚至一些社交活动 也可以在网上进行。

you know, I do video calls with lots of friends.

我会跟很多朋友通视频电话。

I have friends in Europe that, who knows when I'll see them,

我有一些在欧洲的朋友， 谁知道我什么时候才能见到他们，

but we schedule regular calls to talk.

但我们还是会时常打电话。

If you stay fairly isolated,

如果你把自己隔离起来的话，

you don't run much risk,

感染的几率并不是很大。

and it's when you're getting together with lots of other people,

但是如果你跟很多人 聚在一起的时候，

either through work or socialization,

无论是同事还是朋友，

that drives that risk,

感染的几率就会高很多，

and particularly in these communities where you have increased cases,

特别是在这些疫情高发的地方。

even though it's not going to be mandated,

即使政府不会强制隔离你，

hopefully, the mobility numbers will show people responding

希望出行的人数也会少一点，

and minimizing those kind of out-of-the-house contacts.

并且尽量减少 在外与人接触的机会。

CA: Bill, I wonder if I could just ask you

克里斯：比尔， 我还想问问你

just a little bit about philanthropy.

关于慈善的事情。

Obviously, your foundation has played a huge role in this,

很明显，你的基金会 在这其中起到了巨大的作用。

but philanthropy more generally.

但是说到整个慈善领域，

You know, you've started this Giving Pledge movement,

你发起了这个“赠予誓言”活动。

recruited all these billionaires

将这些保证会在去世前

who have pledged to give away half their net worth

把自己一半的财产 捐赠出去的亿万富翁

before or after their death.

聚集起来。

But it's really hard to do.

但这是很难做到的，

It's really hard to give away that much money.

一下子捐出去那么多钱 是很难做到的。

You yourself, I think,

我觉得，你自己

since The Giving Pledge was started --

从“赠予誓言”活动开始的时候——

what? 10 years ago or something, I'm not sure when --

大概十年之前吧， 我也记不太清了——

but your own net worth, I think, has doubled since that period

你的身价从那时候就翻了一倍，

despite being the world's leading philanthropist.

尽管你还是世界上 最主要的慈善家之一。

Is it just fundamentally hard to give away money effectively

把这些钱有效地捐出去

to make the world better?

来改变这个世界，是不是很难？

Or should the world's donors,

还是说，这些捐赠者，

and especially the world's really rich donors,

尤其是这些非常富裕的捐献者们，

start to almost commit to a schedule,

开始形成了一个捐赠的习惯，

like, "Here's a percentage of my net worth each year

好比说，“这是我 每年身价的百分之几。

that, as I get older,

当我慢慢老了，

maybe that goes up.

捐赠的钱款有可能增加。

If I'm to take this seriously,

如果我认真做这件事的话，

I have to give away -- somehow, I've got to find a way

我得找到一个

能有效实现目标的方法。”

of doing that effectively."

Is that an unfair and crazy question?

这个问题听起来合理吗？

BG: Well, it'd be great to up the rate,

比尔：多捐赠当然是件好事。

and our goal, both as the Gates Foundation or through The Giving Pledge,

贝茨基金会和“赠予誓言”的目的都是

is to help people find causes they connect to.

去帮助人们找到自己的目标。

People give through passion.

人们都有助人为乐的善心

Yes, numbers are important,

是的，钱款很重要，

but there's so many causes out there.

但是有那么多人需要帮助。

The way you're going to pick is you see somebody who's sick,

当你看到有个人生病了， 你可以去帮助他。

you see somebody who's not getting social services.

或是有个人没有得到社会帮助， 你可以去帮助他。

You see something that helps reduce racism.

或者你看到一个能减少 种族歧视的事物，

And you're very passionate, and so you give to that.

你非常热心， 就会全身心投入进去。

And, of course,

当然，

some philanthropic gifts won't work out.

有的慈善家的贡献 并不会解决问题。

We do need to up the ambition level of philanthropists.

我们确实需要把慈善家的 目标设高一些。

Now, collaborative philanthropy

通过 TED 的“大胆项目”

that you're helping to facilitate through Audacious,

组织起来的合作性慈善，

there's four or five other groups that are getting philanthropists together,

还有另外四到五个慈善家组织，

that is fantastic,

这些都是非常棒的实践。

because then they learn from each other,

他们可以彼此学习，

they get confidence from each other,

通过彼此来树立自信。

they feel like, "Hey, I put in x, and the four other people put money in,

他们就会觉得，“每个组织， 包括我自己，都投入了一部分资金，

so I'm getting more impact,"

这样我的影响力也会随之提升，”

and hopefully, it can be made fun for them even when they find out,

即使他们发现其中 一项捐献的效果并不是太好，

OK, that particular gift didn't work out that well,

我也希望他们能觉得开心，

but let's keep going.

而且想要继续合作下去。

So philanthropy, yes,

所以慈善事业，是的，

I would like to see the rate go up,

我想让捐款率上升。

and people who do get going,

而捐献者也可以

it is fun,

乐在其中，

it's fulfilling,

很有成就感。

you pick which of the family members are partnered in doing it.

你可以和家人一起做。

In my case, Melinda and I love doing this stuff together,

比如我，梅琳达和我 非常喜欢一起做这些事情，

learning together.

一起学习。

Some families, it will even involve the kids in the activities.

在一些家庭里，孩子们 甚至也会参与进来。

Sometimes the kids are pushing.

有时候孩子们也可以推动进展。

When you have lots of money,

当你有很多钱的时候，

you still think of a million dollars as a lot of money,

你仍然会觉得一百万是很多钱。

but if you have billions,

但是如果你有几十亿，

you should be giving hundreds of millions.

你可能就会捐出上亿的财富。

So it's kind of charming that, in terms of your personal expenditure,

有趣的是，就你个人支出来说，

you stay at the level you were at before.

你本身的财富地位 并没有什么改变，

That's societally quite appropriate.

对社会地位也没什么影响。

But on your giving, you need to scale up

但是当你捐赠的时候， 你需要放大规模，

or else it will be your will,

要不然就成了你自己的心愿。

and you won't get to shape it and enjoy it quite that same way.

那样你所带来的影响和 个人体验也会不太一样。

And so without --

所以不是——

we don't want to mandate it,

我们不想强制要求，

but yes, both you and I want to inspire philanthropists

但是的确， 我们都想启发慈善家们

to see that passion, to see those opportunities

去发现这些梦想， 发现这些机会，

significantly faster than in the past,

而且要以比以往更快的速度。

because whether it's race or disease, or all the other social ills,

无论是因为种族、疾病， 还是其他的社会问题，

the innovation of what philanthropy can go to and do quickly

慈善事业的创新 都可以发展得很快，

that, if it works, government can come in behind it and scale it up,

如果效果不错，政府 也很可能会介入，并扩大规模。

God knows we need solutions,

上帝知道我们需要解决办法，

we need that kind of hope and progress

我们需要这种希望和过程，

that expectations are high

我们对此的期望很高，

that will solve very tough problems.

希望许多难题可以得到解决。

CA: I mean, most philanthropists, even the best of them,

克里斯：大部分的慈善家， 甚至是最有名望的那几位，

find it hard to give away more than about a percent of their net worth every year,

也会觉得每年把身价的 百分之一捐出去很难。

and yet the world's richest often have access

而世界上最富裕的几个人

to great investment opportunities.

也和政府的投资项目有联系。

Many of them are gaining wealth at seven to 10 percent plus per year.

他们其中的很多人每年的 财富增长速度达到了百分之七到十。

Isn't it the case that to have a real chance

是不是可以这样说，

of giving away half your fortune,

要想把一半的财产捐出去，

at some point you have to plan to give away five, six, seven, eight,

你将来可能迟早得每年

捐出你的净资产的 百分五到百分之十？

10 percent of your net worth annually?

And that is, isn't that the logic of what should be happening?

这样理解没错吧？

BG: Yeah, there are people like Chuck Feeney,

比尔：是的，有些人， 像恰克 · 弗里尼（ Chuck Feeney），

who set a good example and gave away all of his money.

把所有的财产都捐了出去， 而且给我们做了一个好榜样。

Even Melinda and I are talking about, should we up the rate that we give at?

就连我和梅琳达也讨论过这个事情， 我们是不是也应该捐多一点？

As you say, we've been very lucky on the investment side

就像你说的，我们很幸运，

through a variety of things.

可以投资不同的领域。

Tech fortunes in general have done well,

总体而言， 科技行业的财富很表现不错，

even this year,

即便是在今年，

which is one of those great contrasts

在这个特殊时期，

in what's going on in the world.

和其他行业形成了鲜明对比。

And I do think there's an expectation that we should speed up,

我的确认为我们应该 加快这一进程，

and there's a reason to speed up,

我们也有理由这么做，

and government is going to miss a lot of needs.

而政府则会错过很多机会。

Yes, there's tons of government money out there,

是的，政府有很多很多钱，

but helping it be spent well,

但是帮助他们花在对的地方，

helping find places it's not stepping up,

帮忙他们找到那些 需求还没有被满足的地方。

and if people are willing to give to the developing world,

如果人们愿意为发展中国家捐款，

they don't have governments

而他们的政府无法提供

that can print checks for 15 percent of GDP,

相当于本国 GDP 的 15% 的资金，

and so the suffering there broadly, just the economic stuff alone,

那么所带来的负面影响， 仅仅从经济情况来看——

put aside the pandemic,

撇开大流行疫情不谈——

is tragic.

也是很糟糕的。

It's about a five-year setback

这些国家在发展的道路上

in terms of these countries moving forward,

相当于要经历五年的衰退，

and in a few cases, it's tough enough that the very stability of the country

在一些情况下，其严重程度

甚至会导致一些国家 连维持自身的稳定都成了问题。

is in question.

CA: Well, Bill,

克里斯：那么比尔，

I'm in awe of what you and Melinda have done.

我对你和梅琳达 所做的一切表示敬意——

You walk this narrow path

你走上的一条少有人走的路，

of trying to juggle so many different things,

去尝试不同的东西，

and the amount of time that you dedicate to the betterment of the world at large,

你为了改变世界而付出的时间，

and definitely the amount of money

当然还有财富，

and the amount of passion you put into it --

以及你对此付出的一腔热忱——

I mean, it's pretty awesome,

真的太了不起了。

and I'm really grateful to you for spending this time with us now.

非常感谢你抽出时间来 参与这场对话。

Thank you so much,

非常感谢。

and honestly, the rest of this year,

我相信，下半年，

your skills and resources are going to be needed more than ever,

这个世界会比以往任何时候 都更需要你的能力和资源。

so good luck.

祝你好运。

BG: Well, thanks.

比尔：谢谢你。

It's fun work and I'm optimistic, so thanks, Chris.

我很热爱我的工作，对未来也很乐观。 谢谢你，克里斯。