Bruce Aylward: How we'll stop polio for good

譯者: Joyce Chou 審譯者: Ann Lee

I want to share with you

在接下來的18分鐘裡

over the next 18 minutes

我想和大家說

a pretty incredible idea.

一個不可思議的想法

Actually, it's a really big idea.

事實上，這是一個很大的想法

But to get us started,

但在我們開始之前

I want to ask if everyone

我想請在座各位

could just close your eyes for two seconds

閉上眼睛，花兩秒的時間

and try and think of a technology or a bit of science

試著去思考一項你認為

that you think has changed the world.

是改變世界的科技或科學

Now I bet, in this audience,

我敢說，在座各位

you're thinking of some really incredible technology,

你們想到的確實是些很驚人的科技

some stuff that I haven't even heard of,

有些我甚至從未聽聞

I'm absolutely sure.

我非常確信是如此

But I'm also sure, pretty sure,

但我也相當確定

that absolutely nobody is thinking of this.

在座沒有任何人有想過這樣東西

This is a polio vaccine.

這是小兒麻痺症疫苗

And it's a great thing actually

這是一項偉大的發明

that nobody's had to think about it here today

但今天在這個場合不會有人想到

because it means that we can take this for granted.

因為我們認為這件事是理所當然的

This is a great technology.

這是一項偉大的科技

We can take it completely for granted.

我們當然會這樣想

But it wasn't always that way.

但事情不是總是這樣的

Even here in California,

即便在加州

if we were to go back just a few years,

如果我們回到過去幾年前

it was a very different story.

事情的發展是完全不同的

People were terrified of this disease.

人們非常害怕這種疾病

They were terrified of polio, and it would cause public panic.

小兒麻痺症讓大眾感到恐懼，造成社會恐慌

And it was because of scenes like this.

也因為這樣的景象

In this scene,

這張照片裡

people are living in an iron lung.

人要依賴鐵肺才能存活

These are people who were perfectly healthy two or three days before,

這些人兩三天前都還是相當健康的

and then two days later,

但兩天後

they can no longer breathe,

他們無法呼吸

and this polio virus has paralyzed

小兒麻痺病毒

not only their arms and their legs,

不僅是讓他們四肢癱瘓

but also their breathing muscles.

更讓他們的呼吸肌無法作用

And they were going to spend the rest of their lives, usually,

通常他們的後半生

in this iron lung to breathe for them.

必須仰賴鐵肺，幫助他們呼吸

This disease was terrifying.

這種疾病令人聞之喪膽

There was no cure,

當時沒有治癒的方法

and there was no vaccine.

也沒有疫苗

The disease was so terrifying

這種疾病令人惶恐不安

that the president of the United States

當時的美國總統

launched an extraordinary national effort

發了特令動用國家資源

to find a way to stop it.

企圖找到治療方法

Twenty years later, they succeeded

二十年後，他們成功了

and developed the polio vaccine.

研發出小兒麻痺症疫苗

It was hailed as a scientific miracle

這在50年代後期

in the late 1950s.

被譽為是科學奇蹟

Finally, a vaccine that could stop this awful disease,

終於有疫苗可以終止這種可怕的疾病

and here in the United States

在美國

it had an incredible impact.

疫苗有驚人的效應

As you can see, the virus stopped,

大家可以看到，疫情止住了

and it stopped very, very fast.

而且是迅速地終止

But this wasn't the case

但在世界上的其他地方

everywhere in the world.

就並非如此了

And it happened so fast in the United States, however,

這在美國發生的太快了

that even just last month Jon Stewart said this:

而就在上個月，Jon Stewart這樣說

(Video) Jon Stewart: Where is polio still active?

Jon Stewart：哪些地區仍然有小兒麻痺症？

Because I thought that had been eradicated

我以為小兒麻痺症已經被根絕

in the way that smallpox had been eradicated.

就像天花那樣已經完全根絕了

Bruce Aylward: Oops. Jon, polio's almost been eradicated.

Bruce Aylward：喔，Jon，小兒麻痺是幾乎要被根絕

But the reality is

事實上

that polio still exists today.

小兒麻痺症到今天仍然存在

We made this map for Jon to try to show him exactly where polio still exists.

我們製作了地圖讓Jon了解至今哪些地區仍存在有小兒麻痺症

This is the picture.

就是這張圖

There's not very much left in the world.

雖然世界上只有少數地區仍有此問題

But the reason there's not very much left

至於大部分地區沒有這項問題

is because there's been an extraordinary public/private partnership

是因為背後有傑出的公共/私人的組織機構

working behind the scenes, almost unknown,

持續為這項問題在努力

I'm sure to most of you here today.

我想今天在座各位是不知道的

It's been working for 20 years

他們已經努力了二十年

to try and eradicate this disease,

嘗試要根絕這種疾病

and it's got it down to these few cases

從這張圖表上可以看到

that you can see here on this graphic.

這種疾病依然存在這少數幾個區域

But just last year,

但就在去年

we had an incredible shock

我們發現一樁令人驚駭的事

and realized that almost just isn't good enough

然後我們意識到就小兒麻痺病毒而言

with a virus like polio.

"幾乎"根絕是還不夠的

And this is the reason:

原因是：

in two countries

在地球另一端有兩個國家

that hadn't had this disease for more than probably a decade,

已經有超過將近十年的時間

on opposite sides of the globe,

沒有再出現過小兒麻痺症病例

there was suddenly terrible polio outbreaks.

卻突然爆發嚴重的小兒麻痺症疫情

Hundreds of people were paralyzed.

數百人癱瘓

Hundreds of people died --

數百人死亡

children as well as adults.

有兒童，也有成人

And in both cases,

在這兩個國家

we were able to use genetic sequencing to look at the polio viruses,

我們利用基因測序檢查小兒麻痺病毒

and we could tell these viruses were not from these countries.

發現這些病毒並非原先就存在該地區

They had come from thousands of miles away.

病毒是由千里之外的地區傳過來的

And in one case, it originated on another continent.

其中一個病例，病毒是從另一個大陸傳來的

And not only that, but when they came into these countries,

不僅如此，病毒到這些國家

then they got on commercial jetliners probably

可能是藉由商業客機所傳遞

and they traveled even farther

也可能傳遞的更遠

to other places like Russia,

到其他地區去，例如俄羅斯

where, for the first time in over a decade last year,

在超過十年的時間，就在去年

children were crippled and paralyzed

又有兒童受到這已長時間未出現的病毒

by a disease that they had not seen for years.

感染而變成殘廢和癱瘓

Now all of these outbreaks that I just showed you,

我剛提到所有爆發的疫情

these are under control now,

目前都在控制中

and it looks like they'll probably stop very, very quickly.

而且應該會迅速地終止

But the message was very clear.

但這件事很清楚地告訴我們

Polio is still

小兒麻痺症

a devastating, explosive disease.

依然是一種駭人且會爆發傳染的疾病

It's just happening in another part of the world.

這就發生在世界的另一個區域

And our big idea

而我們的想法是

is that the scientific miracle of this decade

在眼前這十年的科學奇蹟

should be the complete eradication

應該是要徹底根除

of poliomyelitis.

小兒麻痺症

So I want to tell you a little bit

我想多跟你們說

about what this partnership, the Polio Partnership,

有關小兒麻痺症夥伴關係

is trying to do.

正嘗試在做的事

We're not trying to control polio.

我們不想只控制住疫情

We're not trying to get it down to just a few cases,

我們不希望還有少數地區會出現病例

because this disease is like a root fire;

因為這種疾病像是星星之火

it can explode again if you don't snuff it out completely.

如果不把它完全根除的話，它可能會再次爆發

So what we're looking for

所以我們希望找到

is a permanent solution.

永久的解決辦法

We want a world in which every child, just like you guys,

我們希望世界上所有的孩童，如同在座各位

can take for granted

能理所當然的

a polio-free world.

生活在沒有小兒麻痺症的世界

So we're looking for a permanent solution,

我們想找到永久的解決之道

and this is where we get lucky.

我們很幸運的是

This is one of the very few viruses in the world

小兒麻痺病毒是世界上

where there are big enough cracks in its armor

少見能被治癒的病毒

that we can try to do something truly extraordinary.

我們能試著做些真正特別的事

This virus can only survive in people.

這種病毒只會靠人類傳染

It can't live for a very long time in people.

在人體也無法存活很久

It doesn't survive in the environment hardly at all.

也不能在嚴厲的環境中存活

And we've got pretty good vaccines, as I've just showed you.

如同我剛展示的，我們有相當好的疫苗

So we are trying

所以我們嘗試

to wipe out this virus completely.

要完全根除這種病毒

What the polio eradication program is trying to do

小兒麻痺症根絕計畫要做的事

is to kill the virus itself

是消滅世界各地

that causes polio

會引發

everywhere on Earth.

小兒麻痺症的病毒

Now we don't have a great track record

當我們開始做這樣的事時

when it comes to doing something like this,

我們不曾有過根絕疾病的

to eradicating diseases.

良好紀錄

It's been tried six times in the last century,

在上一個世紀中，已經嘗試過六次

and it's been successful exactly once.

僅僅只有一次成功過

And this is because disease eradication,

是因為根除疾病

it's still the venture capital of public health.

是大眾健康的一種風險投資

The risks are massive,

雖然風險甚大

but the pay-off --

但是各方面的回報

economic, humanitarian, motivational --

像是經濟，人道主義，激勵作用

it's absolutely huge.

也絕對是龐大的

One congressman here in the United States

一位美國的國會議員

thinks that the entire investment

認為美國投注在

that the U.S. put into smallpox eradication

根除天花的全部資源中

pays itself off every 26 days --

每二十六天就能在放棄治療的費用

in foregone treatment costs

和接種疫苗的費用上

and vaccination costs.

得到回饋

And if we can finish polio eradication,

如果我們能完成小兒麻痺症的防治

the poorest countries in the world

世界上最窮困的國家

are going to save over 50 billion dollars

將可以在未來的二十五年

in the next 25 years alone.

省下500億美金

So those are the kind of stakes that we're after.

這才是我們在追求的利益

But smallpox eradication was hard;

根除天花是件困難的事

it was very, very hard.

是非常困難的

And polio eradication, in many ways, is even tougher,

而根除小兒麻痺症，在很多方面又更加困難

and there's a few reasons for that.

有幾個原因

The first is that,

第一

when we started trying to eradicate polio

當我們在二十多年前

about 20 years ago,

開始嘗試要根除小兒麻痺症時

more than twice as many countries were infected

有疫情的國家總數

than had been when we started off with smallpox.

是我們開始根除天花時的兩倍

And there were more than 10 times as many people

這些國家的人口數

living in these countries.

則是十倍以上

So it was a massive effort.

這需要龐大的資源

The second challenge we had was --

第二個難處是

in contrast to the smallpox vaccine,

比較起來

which was very stable, and a single dose protected you for life --

天花疫苗非常穩定，單劑就有終生保護作用

the polio vaccine is incredibly fragile.

而小兒麻痺症疫苗相較脆弱

It deteriorates so quickly in the tropics

在熱帶地區會快速的敗壞

that we've had to put this special vaccine monitor

我們必須在每一瓶疫苗

on every single vial

都設置特殊的疫苗監控

so that it will change very quickly

因為疫苗暴露在高溫時

when it's exposed to too much heat,

變化會相當快速

and we can tell that it's not a good vaccine to use on a child --

變成不能在兒童身上使用的疫苗

it's not potent; it's not going to protect them.

沒有保護作用，不能讓他們免於病毒

Even then, kids need many doses of the vaccine.

此外，孩童需要很多的疫苗

But the third challenge we have --

第三個難處是

and probably even bigger one, the biggest challenge --

或許這是最困難的部分

is that, in contrast to smallpox where you could always see your enemy --

相較天花，你能輕易看出症狀

every single person almost who was infected with smallpox

每個感染到天花的人

had this telltale rash.

身上都有清楚的皮疹

So you could get around the disease;

所以能夠找到疾病

you could vaccinate around the disease and cut it off.

可以及時注射疫苗，讓疾病治癒

With polio it's almost completely different.

但小兒麻痺症是完全不同的情況

The vast majority of people who are infected with the polio virus

絕大多數感染小兒麻痺病毒的人

show absolutely no sign of the disease.

幾乎看不出任何該疾病的病症

So you can't see the enemy most of the time,

大部分時間，你不清楚敵人位在何方

and as a result,

因此

we've needed a very different approach to eradicate polio

我們需要一種相當不同於天花的方法

than what was done with smallpox.

來根除小兒麻痺症

We've had to create

我們發動了

one of the largest social movements in history.

有史以來最大規模的社會運動

There's over 10 million people,

有超過一千萬人

probably 20 million people,

也許是兩千萬人

largely volunteers,

眾多的志工

who have been working over the last 20 years

在過去二十年來

in what has now been called

在現在和平時期所說的

the largest internationally-coordinated operation in peacetime.

參與這最大的國際合作行動

These people, these 20 million people,

這些人，這兩千萬人

vaccinate over 500 million children

在我們的任務最高峰的時期

every single year,

一年替五億名孩童

multiple times

注射疫苗

at the peak of our operation.

而且不只一次

Now giving the polio vaccine is simple.

現在注射小兒麻痺症疫苗很簡單

It's just two drops, like that.

只要像這樣滴兩滴

But reaching 500 million people

但替五億人注射疫苗

is much, much tougher.

這是更困難的

And these vaccinators, these volunteers,

這些注射疫苗的人，也就是這些志工

they have got to dive headlong

他們必須深入到世界上

into some of the toughest, densest

一些最艱困，人口最密集的

urban slums in the world.

貧民窟城市

They've got to trek under sweltering suns

他們得在炎熱的太陽下跋涉到

to some of the most remote, difficult to reach places in the world.

一些最偏遠且難以到達的地方

And they also have to dodge bullets,

而且他們還必須躲避子彈

because we have got to operate

因為我們必須要在

during shaky cease-fires and truces

混亂的停火和停戰的情況下

to try and vaccinate children,

嘗試為兒童接種疫苗

even in areas affected by conflict.

即便是有衝突影響的地區也一樣

One reporter

一位記者

who was watching our program in Somalia about five years ago --

觀看我們五年前在索馬利亞的任務

a place which has eradicated polio,

該地區已經根絕小兒麻痺症

not once, but twice, because they got reinfected.

不只一次，是兩次，因為他們遭受二次感染

He was sitting outside of the road,

他就坐在馬路旁

watching one of these polio campaigns unfold,

觀看這些宣傳小兒麻痺症的資訊

and a few months later he wrote:

幾個月後他寫道：

"This is foreign aid at its most heroic."

「這是最英雄式的外援‧」

And these heroes, they come from every walk of life,

這些英雄來自來自各行各業

all sorts of backgrounds.

有著不同的生活背景

But one of the most extraordinary is Rotary International.

其中最特別的是國際扶輪社

This is a group

這個團體

whose million-strong army of volunteers

上百萬的志工們

have been working to eradicate polio

已經有超過20年

for over 20 years.

致力於根除小兒麻痺症的工作

They're right at the center of the whole thing.

他們就在這整件事情的核心

Now it took years to build up the infrastructure

現在花了相當多年的時間建立了

for polio eradication --

根除小兒麻痺症的基礎建設

more than 15 years, much longer than it should have --

花了十五年的時間，遠多於預期

but once it was built, the results were striking.

但一旦建立完成，將會有驚人的結果

Within a couple of years,

幾年之內

every country that started polio eradication

每一個實行根除小兒麻痺症計畫的國家

rapidly eradicated all three of their polio viruses,

都迅速根除了三種小兒麻痺症的病毒

with the exception of four countries that you see here.

除了你在這裡看到的這四個國家

And in each of those, it was only part of the country.

在這四個國家裡，只有一部分的地區還有此問題

And then, by 1999,

在1999年當時

one of the three polio viruses

其中一種我們試圖要根除的

that we were trying to eradicate

小兒麻痺病毒

had been completely eradicated worldwide --

已經完全從世界上根除了

proof of concept.

這已經證實了

And then today,

到今天

there's been a 99 percent reduction --

受到小兒麻痺症

greater than 99 percent reduction --

此種可怕病毒

in the number of children

感染的兒童人數

who are being paralyzed by this awful disease.

已減少了99%--甚至是99%以上--

When we started, over 20 years ago,

從二十年前，我們開始執行

1,000 children were being paralyzed

每一天就有1,000名兒童

every single day by this virus.

受到病毒感染而癱瘓

Last year, it was 1,000.

去年，感染人數是1,000人

And at the same time,

同時

the polio eradication program

小兒麻痺症根除計畫

has been working to help with a lot of other areas.

已經幫助了很多地區

It's been working to help control pandemic flu,

也同時幫助控制了流感大流行

SARS for example.

例如SARS(傳染性非典型肺炎)

It's also tried to save children by doing other things --

他們也試圖給予孩童其他幫助 --

giving vitamin A drops, giving measles shots,

給予維他命A滴劑，注射麻疹疫苗

giving bed nets against malaria even

甚至在其中一些活動中

during some of these campaigns.

提供蚊帳防治瘧疾

But the most exciting thing

但最令人振奮的事

that the polio eradication program has been doing

是小兒麻痺症根除計畫

has been to force us,

迫使我們

the international community,

國際間的社會團體

to reach every single child, every single community,

去到每一個社區，聯繫上每一名孩童

the most vulnerable people in the world,

他們是世界上最脆弱的族群

with the most basic of health services,

提供他們最基本的保健服務

irrespective of geography, poverty,

不論地理位置，貧困

culture and even conflict.

文化，甚至衝突

So things were looking very exciting,

原先這一切令人振奮

and then about five years ago,

但在五年前

this virus, this ancient virus, started to fight back.

這種古老的病毒又捲土重來

The first problem we ran into

我們碰到的第一個問題是

was that, in these last four countries, the strongholds of this virus,

在這最後的四個國家，病毒的大本營

we just couldn't seem to get the virus rooted out.

我們似乎就是沒辦法讓病毒完全根除

And then to make the matters even worse,

更糟糕的情況是

the virus started to spread out of these four places,

病毒開始蔓延到這四個國家以外的地區

especially northern India and northern Nigeria,

自印度北部和奈及利亞北部

into much of Africa, Asia, and even into Europe,

進入非洲許多地區，亞洲，甚至到歐洲

causing horrific outbreaks

造成可怕的疫情

in places that had not seen this disease for decades.

這些地方已經幾十年沒有出現過病例

And then,

然後

in one of the most important, tenacious

在一個最重要，最頑強的

and toughest reservoirs of the polio virus in the world,

小兒麻痺病毒的傳染窩

we found that our vaccine was working

我們發現我們的疫苗

half as well as it should have.

功效只有原先的一半

In conditions like this,

在這樣的條件下

the vaccine just couldn't get the grip it needed to

疫苗無法有效作用

in the guts of these children

給予這些孩子

and protect them the way that it needed to.

他們所需要的保護

Now at that time,

在當時

there was a great, as you can imagine,

各位可以想像的到，一股非常大的

frustration -- let's call it frustration --

挫敗 --我們認為是挫敗--

it started to grow very, very quickly.

這種氣氛擴散的非常快

And all of a sudden, some very important voices

突然，非常多來自

in the world of public health

世界公衛組織的聲音

started to say, "Hang on.

開始說「等等。」

We should abandon this idea of eradication.

「我們該放棄根除病毒的想法了。」

Let's settle for control -- that's good enough."

「我們就試圖控制住疫情--這樣就很好了。」

Now as seductive as the idea of control sounds,

現在，控制疫情的想法的確吸引人

it's a false premise.

但這是個錯誤的想法

The brutal truth is,

殘酷的事實是

if we don't have the will or the skill,

如果我們沒有意願或技能

or even the money that we need

甚至所需要的經費

to reach children, the most vulnerable children in the world,

運用簡單的

with something as simple

口服小兒麻痺症疫苗

as an oral polio vaccine,

去保護這些世界上最脆弱的孩童們

then pretty soon,

那麼很快

more than 200,000 children

未來每年將會有

are again going to be paralyzed by this disease

超過二十萬的兒童

every single year.

會因此疾病變成癱瘓

There's absolutely no question.

這是毫無疑問的

These are children like Umar.

這些孩童就像Umar一樣

Umar is seven years old,

Umar現年七歲

and he's from northern Nigeria.

他住在奈及利亞北部

He lives in a family home there

他和八個兄弟姊妹

with his eight brothers and sisters.

同住在一起

Umar also has polio.

Umar罹患小兒麻痺症

Umar was paralyzed for life.

Umar後半生都會是癱瘓

His right leg was paralyzed

他的右腿

in 2004.

在2004年時癱瘓了

This leg, his right leg,

他的右腿

now takes an awful beating

現在有嚴重的挫傷

because he has to half-crawl,

因為他必須半爬

because it's faster to move that way

這樣移動的速度會快些

to keep up with his friends, keep up with his brothers and sisters,

好跟上他的朋友，他的兄弟姊妹

than to get up on his crutches and walk.

這比起拿拐杖行走的速度要快

But Umar is a fantastic student. He's an incredible kid.

但Umar是位了不起的學生，他令人讚嘆

As you probably can't see the detail here,

各位可能沒辦法看清楚這上頭的字

but this is his report card,

但這是他的成績單

and you'll see, he's got perfect scores.

可以看出來，他的成績相當好

He got 100 percent in all the important things,

他在所有重要的項目都拿滿分

like nursery rhymes, for example there.

例如這邊寫的，像是童謠

But you know I'd love to be able to tell you

各位也許認為我會說

that Umar is a typical kid with polio these days,

Umar是這些年來典型罹患小兒麻痺症的孩子

but it's not true.

但不是

Umar is an exceptional kid

Umar是例外

in exceptional circumstances.

他是在特殊情況下感染的

The reality of polio today

事實上今天的小兒麻痺症

is something very different.

是非常不一樣的

Polio strikes the poorest communities in the world.

小兒麻痺症擊垮世界上最窮困的地區

It leaves their children paralyzed,

它讓該地區的孩童癱瘓

and it drags their families

拖垮他們的家庭

deeper into poverty,

讓全家陷入更貧困的境地

because they're desperately searching

因為他們的家庭拼命地尋找

and they're desperately spending the little bit of savings that they have,

不顧一切地支出他們僅存的積蓄

trying in vain

妄圖尋找

to find a cure for their children.

治癒他們的孩子的解藥

We think children deserve better.

我們認為兒童該過更好的生活

And so when the going got really tough

所以在兩年前

in the polio eradication program

根除小兒麻痺症計畫

about two years ago,

最瓶頸的時候

when people were saying, "We should call it off,"

當人們都在說「我們應該停止」

the Polio Partnership

小兒麻痺症夥伴關係

decided to buckle down once again

決定再一次傾全力

and try and find innovative new solutions,

嘗試找尋新的解決方法

new ways to get to the children

以新的方式去聯繫上

that we were missing again and again.

我們一次又一次錯過的孩童們

In northern India, we started mapping the cases

在印度的北部，我們運用衛星圖

using satellite imaging like this,

定位出每一個病例

so that we could guide our investments and vaccinator shelters,

我們就能通知資方，還有疫苗接種站

so we could get to the millions of children

然後就能聯繫上位在

on the Koshi River basin

戈西河流域的數百萬名兒童

where there are no other health services.

那裏沒有其他的醫療服務

In northern Nigeria,

在奈及利亞北部

the political leaders and the traditional Muslim leaders,

政治領導人和傳統的穆斯林領袖

they got directly involved in the program

他們直接參與了該計劃

to help solve the problems of logistics

幫助解決後勤的問題

and community confidence.

和建立社會信心

And now they've even started using these devices --

現在他們甚至已經開始使用這些設備

speaking of cool technology --

談一點新的科技

these little devices, little GIS trackers like this,

這些小型全球地理資訊系統的裝置

which they put into the vaccine carriers of their vaccinators.

讓疫苗接種人員放在疫苗載具上

And then they can track them,

然後就能追蹤他們

and at the end of the day, they look and see,

並在結束日查看

did these guys get every single street, every single house.

看他們是否有走完每一條街道，去過每一棟房子

This is the kind of commitment now we're seeing

這是我們想做到的承諾

to try and reach all of the children we've been missing.

試圖幫助所有我們錯過的每一名孩子

And in Afghanistan, we're trying new approaches --

而在阿富汗，我們正嘗試新的方法

access negotiators.

進入談判

We're working closely with the International Committee of the Red Cross

我們密切與國際紅十字會合作

to ensure that we can reach every child.

以確保我們能聯繫上每一名孩童

But as we tried these extraordinary things,

當我們嘗試做這些特別的事

as people went to this trouble

當其他人重新檢視問題

to try and rework their tactics,

重新修正戰術

we went back to the vaccine -- it's a 50-year-old vaccine --

我們也檢討了這支50歲的疫苗

and we thought, surely we can make a better vaccine,

然後我們想，我們當然可以研發一支很好的疫苗

so that when they finally get to these kids,

讓志工們聯繫上這些孩童們時

we can have a better bang for our buck.

能提供更好的防疫效果

And this started an incredible collaboration with industry,

因此就展開一場與產業的驚奇合作

and within six months,

六個月內

we were testing a new polio vaccine

我們測試了新的小兒麻痺症疫苗

that targeted, just two years ago,

就在兩年前，針對的是

the last two types of polio in the world.

世界上最後兩種小兒麻痺病毒

Now June the ninth, 2009,

2009年六月九日

we got the first results from the first trial with this vaccine,

我們得到了疫苗第一次測試的結果

and it turned out to be a game-changer.

局面馬上改觀

The new vaccine

新的疫苗

had twice the impact on these last couple of viruses

在對付這兩種病毒的功效

as the old vaccine had,

是舊疫苗的兩倍

and we immediately started using this.

我們立即開始使用新的疫苗

Well, in a couple of months we had to get it out of production.

幾個月內，我們必須開始生產

And it started rolling off the production lines

讓疫苗進入生產線然後完成

and into the mouths of children around the world.

進到世界各地每一位孩子的口中

And we didn't start with the easy places.

我們沒有從疫情輕微的地方開始

The first place this vaccine was used

新的疫苗首次使用

was in southern Afghanistan,

是在阿富汗南部

because it's in places like that

因為目的本該是

where kids are going to benefit the most

運用科技讓孩童們

from technologies like this.

獲益更多

Now here at TED, over the last couple of days,

在TED這裡，過去幾天

I've seen people challenging the audience again and again

許多人一次又一次不斷地宣揚

to believe in the impossible.

企圖讓人相信不可能的發生

So this morning at about seven o'clock,

今天早上大約七點左右

I decided that we'd try to drive Chris

我決定我們要讓Chris

and the production crew here berserk

還有製作團隊再麻煩一次

by downloading all of our data from India again,

把我們在印度的數據重新下載

so that you could see something

所以你可以看到

that's just unfolding today,

這些數據是今天才發表

which proves that the impossible is possible.

這證明了不可能是能達成的

And only two years ago, people were saying that this is impossible.

就在兩年前，大家都在說這是不可能的

Now remember, northern India is the perfect storm

還記得每當提及小兒麻痺症

when it comes to polio.

印度北部總是令人頭痛

Over 500,000 children

有超過五十萬名兒童

are born in the two states that have never stopped polio --

出生在這小兒麻痺症肆虐的

Uttar Pradesh and Bihar --

北方邦和比哈爾邦

500,000 children every single month.

每個月有五十萬名兒童感染

Sanitation is terrible,

衛生條件相當糟糕

and our old vaccine, you remember,

你們應該有印象

worked half as well as it should have.

我們的舊疫苗功效只有一半

And yet, the impossible is happening.

然而不可能的事發生了

Today marks exactly six months --

今天剛好滿六個月

and for the first time in history,

史上第一次

not a single child has been paralyzed

在北方邦和比哈爾邦

in Uttar Pradesh or Bihar.

沒有任何一位孩童感染

(Applause)

(掌聲)

India's not unique.

印度並不是唯一

In Umar's home country of Nigeria,

在Umar的家鄉，奈及利亞

a 95 percent reduction

去年兒童因感染

in the number of children paralyzed by polio last year.

小兒麻痺而癱瘓的比率下降了95%

And in the last six months,

在過去半年

we've had less places reinfected by polio

二次感染小兒麻痺的地區

than at any other time in history.

也比過去來的更少

Ladies and gentlemen, with a combination

各位女士們，先生們

of smart people, smart technology

在結合優秀人力，優良科技

and smart investments,

以及優質發明

polio can now be eradicated anywhere.

任何地區都能根除小兒麻痺症

We have major challenges, you can imagine,

你們可以想像，要完成這項任務

to finish this job,

是種巨大的挑戰

but as you've also seen,

但各位也看到了

it's doable,

這是可行的

it has great secondary benefits,

它的次要效益是很大的

and polio eradication is a great buy.

根絕小兒麻痺症是值得投資的

And as long as any child anywhere

只要任何地方

is paralyzed by this virus,

有兒童受到病毒侵襲而癱瘓

it's a stark reminder

這是清楚的告訴我們

that we are failing, as a society, to reach children

我們的社會沒辦法

with the most basic of services.

提供每一位孩童最基本的保障

And for that reason, polio eradication:

因此，根絕小兒麻痺症

it's the ultimate in equity

是最終的公平

and it's the ultimate in social justice.

也是最終的社會正義

The huge social movement

這場根除小兒麻痺症的

that's been involved in polio eradication

大型社會運動

is ready to do way more for these children.

已經準備好為這些孩童們做更多的事

It's ready to reach them with bed nets, with other things.

提供他們蚊帳和其他事物

But capitalizing on their enthusiasm,

運用他們的熱情

capitalizing on their energy

善用他們的精力

means finishing the job

要完成這項

that they started 20 years ago.

他們二十年前就開始的工作

Finishing polio is a smart thing to do,

根除小兒麻痺症是明智的

and it's the right thing to do.

更是正確的

Now we're in tough times economically.

我們現在處在財政困難的時期

But as David Cameron of the United Kingdom

但如同一個月前英國首相David Cameron

said about a month ago when he was talking about polio,

在他談到小兒麻痺症時所說的

"There's never a wrong time

「只要是做對的事

to do the right thing."

時間永遠不會是錯的。」

Finishing polio eradication

根除小兒麻痺症

is the right thing to do.

就是對的事

And we are at a crossroads right now

我們正處在關鍵時刻

in this great effort over the last 20 years.

經過二十年來的眾多努力

We have a new vaccine,

我們有了新的疫苗

we have new resolve,

我們有新的解決方法

and we have new tactics.

我們也有新的策略

We have the chance

我們有機會

to write an entirely new polio-free chapter

在人類歷史上

in human history.

寫下無小兒麻痺症的新頁

But if we blink now,

但如果我們現在疏忽

we will lose forever

我們將永遠失去

the chance to eradicate an ancient disease.

可以根除這個古老疾病的機會

Here's a great idea to spread:

這個偉大的想法要傳遞出去

End polio now.

現在就終結小兒麻痺症

Help us tell the story.

幫助我們傳遞這故事

Help us build the momentum

幫助我們宣揚這股動力

so that very soon

然後很快的

every child, every parent

每一個孩子，每一對父母

everywhere

每一個地方

can also take for granted

都能理所當然永遠地

a polio-free life forever.

過著沒有小兒麻痺症的生活

Thank you.

謝謝各位

(Applause)

(掌聲)

Bill Gates: Well Bruce, where do you think the toughest places are going to be?

Bill Gates：Bruce，你覺得未來最困難的事情會是什麼？

Where would you say we need to be the smartest?

你覺得我們最該注意的什麼地方？

BA: The four places where you saw, that we've never stopped --

BA：剛看過的四個地區是我們一直沒辦法終止疫情

northern Nigeria, northern India,

奈及利亞北部，印度北部

the southern corner of Afghanistan

阿富汗南方一角

and bordering areas of Pakistan --

以及巴基斯坦邊界地區

they're going to be the toughest.

這四個區域會是最困難的

But the interesting thing is, of those three,

但有趣的是，其中三個地區

India's looking real good, as you just saw in the data.

印度目前情況很好，像各位剛在數據上看到的

And Afghanistan, Afghanistan, we think

至於阿富汗，我們認為

has probably stopped polio repeatedly.

可能已經終止小兒麻痺再現

It keeps getting reinfected.

但仍然有病例傳出

So the tough ones: going to get the top of Nigeria finished

因此困難的地方是：首要終止奈及利亞的疫情

and getting Pakistan finished.

接著是巴基斯坦

They're going to be the tough ones.

這些區域是困難的

BG: Now what about the money?

BG：那有關經費呢？

Give us a sense of how much the campaign costs a year.

跟我們談談一年需要的宣傳經費是多少？

And is it easy to raise that money?

是否容易獲取更多的經費？

And what's it going to be like the next couple of years?

在未來幾年，經費的運用會是如何？

BA: It's interesting.

BA：這很有趣

We spend right now about 750 million

我們目前每年約花費

to 800 million dollars a year.

7.5億到8億美金

That's what it costs to reach 500 million children.

這是要幫5億名孩童注射疫苗的花費

It sounds like a lot of money; it is a lot of money.

這聽起來很多錢；不過這的確是非常多錢

But when you're reaching 500 million children multiple times --

但你想想，要幫5億名孩童多次注射疫苗

20, 30 cents to reach a child --

每個孩子花20，30分錢

that's not very much money.

這樣其實不多

But right now we don't have enough of that.

但現在我們的經費不太夠

We have a big gap in that money. We're cutting corners,

我們需要很多經費，有時我們減少疫苗注射的次數

and every time we cut corners,

但每當我們減少疫苗注射的次數

more places get infected that shouldn't have, and it just slows us down.

有更多地區又出現新的病例，這讓我們的工作延宕

And that great buy costs us a little bit more.

因此又得花費更多經費

BG: Well, hopefully we'll get the word out,

BG：希望這消息能傳遞出去

and the governments will keep their generosity up.

然後政府能再補助更多的經費

So good luck. We're all in this with you.

祝福你，我們都支持這項計畫

Thank you. (BA: Thank you.)

謝謝你 (BA：謝謝你)

(Applause)

(掌聲)