The next outbreak? We’re not ready | Bill Gates | TED

Translator: Rongxin Liu Reviewer: Alan Watson

When I was a kid,

當我仲係一個細路仔

the disaster we worried about most was a nuclear war.

核戰係我哋最擔心嘅災難

That's why we had a barrel like this down in our basement,

於是我哋喺地下室擺咗一個桶

filled with cans of food and water.

桶裡面裝住好多罐頭同埋水

When the nuclear attack came,

假如核戰爆發

we were supposed to go downstairs, hunker down, and eat out of that barrel.

我哋就落去地下室匿埋 然後靠果個桶維生

Today the greatest risk of global catastrophe

當今世上風險最大既災難

doesn't look like this.

唔係呢個

Instead, it looks like this.

而係呢個

If anything kills over 10 million people in the next few decades,

假如有樣野可以係喺未來幾十年 殺死超過一千萬人

it's most likely to be a highly infectious virus

最有可能嘅就係傳染性極高嘅病毒

rather than a war.

而並非戰爭

Not missiles, but microbes.

唔係導彈，而係微生物

Now, part of the reason for this is that

部分原因係因為我哋投入左

we've invested a huge amount in nuclear deterrents.

巨大嘅資源喺核武

相比之下，我哋投放好少資源落去 一個預防疫情爆發嘅機制上

But we've actually invested very little in a system to stop an epidemic.

我哋仲未準備好應對 下一次嘅疫情

We're not ready for the next epidemic.

Let's look at Ebola.

睇下伊波拉

I'm sure all of you read about it in the newspaper,

我相信你哋所有人都喺報紙上面 睇過關於佢嘅報道

lots of tough challenges.

對付病毒嗰陣出現過好多好嚴峻嘅挑戰

I followed it carefully through the case analysis tools

我曾經用一個用嚟追查 脊髓灰質炎根治情況嘅方法

we use to track polio eradication.

去分析伊波拉疫情

And as you look at what went on,

從事件嘅發展我哋睇度

the problem wasn't that there was a system that didn't work well enough,

問題唔係機制運作唔好

the problem was that we didn't have a system at all.

而係我哋根本冇一個機制去應對伊波拉

In fact, there's some pretty obvious key missing pieces.

事實上係有一啲幾明顯嘅漏洞

We didn't have a group of epidemiologists ready to go, who would have gone,

我們冇一班隨時候命嘅流行病學家

seen what the disease was, seen how far it had spread.

喺傳染病爆發嗰陣去研究 個病毒本身屬性係點，傳播規模有幾大

The case reports came in on paper.

病例報告雖然以書面形式發表

It was very delayed before they were put online

但好耐之後佢哋先至放上網

and they were extremely inaccurate.

啲報告仲要係好唔準確

We didn't have a medical team ready to go.

我哋冇一班隨時候命嘅醫療隊伍

We didn't have a way of preparing people.

我哋冇辦法招募到人員

Now, Médecins Sans Frontières did a great job orchestrating volunteers.

無國界醫生喺組織志願者方面 貢獻咗好多

But even so, we were far slower than we should have been

即使係咁，我哋仍然比應有嘅步伐慢

getting the thousands of workers into these countries.

我哋宜家喺呢啲有疫情嘅國家度 應該要有幾千個人員

And a large epidemic would require us to have hundreds of thousands of workers.

當有大規模疫情嘅時候 更加需要幾十萬嘅人員

There was no one there to look at treatment approaches.

冇人試過睇下治療方法

No one to look at the diagnostics.

冇人留意過診斷方式

No one to figure out what tools should be used.

冇人試過探討用咩工具

As an example, we could have taken the blood of survivors,

舉例，我哋可以抽取康復者嘅血液

processed it, and put that plasma back in people to protect them.

處理過之後 將血清注入番佢哋度去保護佢哋

But that was never tried.

但冇人試過咁做

So there was a lot that was missing.

所以，真係有好多地方做得不足

And these things are really a global failure.

呢啲就係全球既失敗

The WHO is funded to monitor epidemics, but not to do these things I talked about.

世界衛生組織本身就係去監控疫情 但偏偏佢哋從來都冇做過

Now, in the movies it's quite different.

喺電影裡面，情況就唔一樣

There's a group of handsome epidemiologists ready to go,

裡面有一班隨時準備就緒嘅流行病學家

they move in, they save the day, but that's just pure Hollywood.

佢哋介入，拯救咗全世界 不過呢啲只係電影情節

The failure to prepare could allow the next epidemic

準備不足可以令下一個傳染病隨時爆發

to be dramatically more devastating than Ebola

傷害程度可能比伊波拉更大

Let's look at the progression of Ebola over this year.

睇下今年伊波拉疫情嘅演變

About 10,000 people died,

有大約一萬人死亡

and nearly all were in the three West African countries.

幾乎全部都係黎自西非三個國家

There's three reasons why it didn't spread more.

疫情之所以冇進一步擴大 原因有三個

The first is that there was a lot of heroic work by the health workers.

第一個原因係 有好多英勇既醫護人員喺度奮鬥

They found the people and they prevented more infections.

佢哋發現患者之後 就第一時間阻止疫情傳開

The second is the nature of the virus.

第二就係病毒本身嘅特性

Ebola does not spread through the air.

伊波拉唔會經空氣傳播

And by the time you're contagious,

當你具備高傳染性嘅時候

most people are so sick that they're bedridden.

大多數人因為病得好嚴重 要訓喺張床度

Third, it didn't get into many urban areas.

第三，病毒冇傳到去多個城市

And that was just luck.

呢個只係好彩

If it had gotten into a lot more urban areas,

如果病毒擴散到更多城市

the case numbers would have been much larger.

病例數目就會多好多

So next time, we might not be so lucky.

下次我哋未必會咁好彩

You can have a virus where people feel well enough while they're infectious

一個人可以帶住病毒但又冇事

that they get on a plane or they go to a market.

只要呢個人上機或者去街市 都可以將病毒傳開去

The source of the virus could be a natural epidemic like Ebola,

病毒嘅源頭可以係自然既流行病 好似伊波拉咁

or it could be bioterrorism.

亦可以係黎自生物恐怖主義

So there are things that would literally make things a thousand times worse.

所以，事情往往可以造成千倍更大嘅傷害

In fact, let's look at a model of a virus spread through the air,

我地一齊黎睇一個 病毒經空氣傳播嘅模型

like the Spanish Flu back in 1918.

就好似 1918 年西班牙流感病毒咁

So here's what would happen:

當時係嘅

It would spread throughout the world very, very quickly.

嗰次流感喺世界傳播得非常之快

And you can see over 30 million people died from that epidemic.

大約有三千萬死於呢場疫症

So this is a serious problem.

嗰次疫症真係好嚴重

We should be concerned.

我哋必須多加關注

But in fact, we can build a really good response system.

不過，其實 我哋係可以建立一個完善嘅應變系統

We have the benefits of all the science and technology that we talk about here.

科學同科技帶比大家嘅好處 我哋已經喺度講過

We've got cell phones

我哋都有手機

to get information from the public and get information out to them.

可以接收大眾資訊 亦可以向公眾發放訊息

We have satellite maps where we can see where people are and where they're moving.

我哋可以透衛星地圖睇到 啲人嘅位置同佢哋行緊去邊

We have advances in biology

人類喺生物學上取得嘅成果

that should dramatically change the turnaround time to look at a pathogen

應該可以俾人 有更多時間去尋找致病源

and be able to make drugs and vaccines that fit for that pathogen.

去研製藥物同疫苗黎對付致病源

So we can have tools,

因此，我哋係有工具

but those tools need to be put into an overall global health system.

但呢啲工具需要用喺全球衛生體系嗰度

And we need preparedness.

仲有一樣野，就係我哋需要準備

The best lessons, I think, on how to get prepared

我認為，所謂嘅準備好

are again, what we do for war.

其實就同打仗冇分別

For soldiers, we have full-time, waiting to go.

士兵整束待發

We have reserves that can scale us up to large numbers.

大批後備軍隊支援

NATO has a mobile unit that can deploy very rapidly.

北約有一個可以迅速部署嘅部隊

NATO does a lot of war games to check, are people well trained?

北約舉行好多嘅演習 確保軍隊訓綀有素

Do they understand about fuel and logistics

例如佢哋熟唔熟悉燃料同行動

and the same radio frequencies?

通訊用嘅頻率係唔係一樣

So they are absolutely ready to go.

務求佢哋係準備就緒

So those are the kinds of things we need to deal with an epidemic.

所以呢啲都係我哋應對疫情既問題

What are the key pieces?

咁關鍵係嘜？

First, we need strong health systems in poor countries.

首先，貧窮國家需要有規模嘅衛生體系

That's where mothers can give birth safely,

可以俾母親安全生產

kids can get all their vaccines.

細路可以接種疫苗

But, also where we'll see the outbreak very early on.

但係，喺我哋將會見到 最先出現疫情既地方

我哋需要一支醫療嘅後備團隊

We need a medical reserve corps:

lots of people who've got the training and background

由大量從事醫療行業 受過相關訓綀

who are ready to go, with the expertise.

同時有經驗、可以隨時就緒嘅人擔當職務

And then we need to pair those medical people with the military.

跟住需要醫護人員同軍隊合作

taking advantage of the military's ability to move fast, do logistics

借助軍隊去快速應變

去支援成個行動，以及封鎖疫區

and secure areas.

We need to do simulations,

我哋需要進行模擬運算

我指嘅係細菌模擬爆發嘅測試 而唔係軍事演習

germ games, not war games, so that we see where the holes are.

咁樣先可以發現邊度有漏洞

The last time a germ game was done in the United States

最近一次喺美國進行嘅細菌模擬爆發測試

was back in 2001, and it didn't go so well.

係喺 2001 年 不過嗰次進行嘚得唔係好順利

So far the score is germs: 1, people: 0.

嗰次，細菌同人類嘅比分係 1:0

Finally, we need lots of advanced R&D in areas of vaccines and diagnostics.

最後，我哋喺疫苗同診斷方面需要有大量嘅研發

There are some big breakthroughs, like the Adeno-associated virus,

例如喺腺相關嘅病毒研究方面就有 一啲重大嘅突破

that could work very, very quickly.

研究出黎嘅疫苗可以快速起到作用

Now I don't have an exact budget for what this would cost,

雖然我唔知確實既預算將會係幾多

but I'm quite sure it's very modest compared to the potential harm.

但我可以好肯定咁話

相比於潛在危害，呢個開支係細好多

The World Bank estimates that if we have a worldwide flu epidemic,

世界銀行預測，假如全球流感大爆發

global wealth will go down by over three trillion dollars

全球財富將會唔見三兆億美元

and we'd have millions and millions of deaths.

會有幾百萬人死亡

These investments offer significant benefits

健康科學嘅投資會帶黎好多好處

beyond just being ready for the epidemic.

唔單止係預防疫情爆發

The primary healthcare, the R&D,

基本醫療、研發

those things would reduce global health equity

呢啲都會減低全球衛生嘅平等性

and make the world more just as well as more safe.

令世界變得更公平更安全

So I think this should absolutely be a priority.

所以我認為呢樣野絕對係首要考慮既事情

There's no need to panic.

大家冇必要恐慌

We don't have to hoard cans of spaghetti or go down into the basement.

我哋其實唔需要喺地下室 囤積好多意大利麵嘅罐頭

But we need to get going, because time is not on our side.

但係我哋要立即行動 因為時間唔到我哋控制

In fact, if there's one positive thing that can come out of the Ebola epidemic,

事實上，假如我哋要正面睇伊波拉疫情

it's that it can serve as an early warning, a wake-up call, to get ready.

就會知道伊波拉其實係一個警號 話俾人類知要未雨綢謬

If we start now, we can be ready for the next epidemic.

如果大家從宜家就開始行動

我哋就可以準備好 迎接下一個可能發生嘅症情

Thank you.

多謝

(Applause)

（掌聲）