Let's put birth control back on the agenda | Melinda Gates

譯者: Regina Chu 審譯者: Marssi Draw

Today, I'd like to talk with you

今天，我想跟大家談談

about something that should be a totally uncontroversial topic.

本來應該完全沒有爭議的話題。

But, unfortunately, it's become incredibly controversial.

但不幸的是，這話題大受爭議。

This year, if you think about it,

今年，如果你想一下，

over a billion couples will have sex with one another.

超過百萬對伴侶會有性行為。

Couples like this one,

像這對，

and this one,

這一對，

and this one,

還有這一對。

and, yes,

是的，

even this one.

甚至這一對。

(Laughter)

（笑聲）

And my idea is this --

我的信念是這樣，

all these men and women should be free to decide

所有男人女人 都應該可以自由決定

whether they do or do not want to conceive a child.

他們要不要懷孕生子。

And they should be able to use one of these birth control methods

他們應該可以用這些避孕法

to act on their decision.

按著自己的決定行事。

Now, I think you'd have a hard time

現在，我想你大概很難找到

finding many people who disagree with this idea.

太多不同意這個想法的人。

Over one billion people use birth control without any hesitation at all.

超過十億人毫不猶豫地避孕。

They want the power to plan their own lives

他們想要有計畫自己人生的權力，

and to raise healthier, better educated and more prosperous families.

及撫養更健康、教育程度更高、 更富有的家庭。

But, for an idea that is so broadly accepted in private,

然而，節育這個在私底下 如此廣為接受的想法，

birth control certainly generates a lot of opposition in public.

在公眾顯然遭受很大反對。

Some people think when we talk about contraception

有些人認為我們談的避孕，

that it's code for abortion,

是墮胎的代碼，

which it's not.

事實並非如此。

Some people -- let's be honest --

有些人 ──我們就打開天窗說亮話吧──

they're uncomfortable with the topic because it's about sex.

覺得這個話題令他們不自在， 因為這在談性行為。

Some people worry

有些人擔心

that the real goal of family planning is to control populations.

家庭計畫的真正目的 是控制人口。

These are all side issues

但這些都是枝節的問題，

that have attached themselves to this core idea that men and women

攀附在這個核心信念上，

即男人女人都應該 能決定什麼時候要有小孩。

should be able to decide when they want to have a child.

And as a result, birth control has almost completely and totally disappeared

結果是，節育幾乎已完全

自全球衛生綱領上消失。

from the global health agenda.

The victims of this paralysis are the people of sub-Saharan Africa

這個癱瘓政策的受害者， 是撒哈拉沙漠以南的非洲人

and South Asia.

及南亞人。

Here in Germany, the proportion of people that use contraception

在德國這裡， 大眾使用避孕法的比例

is about 66 percent.

約為 66%。

That's about what you'd expect.

這數字跟預期差不多。

In El Salvador, very similar, 66 percent.

在薩爾瓦多也很類似，66%。

Thailand, 64 percent.

泰國，64%，

But let's compare that to other places,

但將此數字與其他地方相較，

like Uttar Pradesh, one of the largest states in India.

如印度的大省「北方邦」。

In fact, if Uttar Pradesh was its own country,

事實上，如果北方邦獨立，

it would be the fifth largest country in the world.

會是世界上第五大國家。

Their contraception rate -- 29 percent.

他們的避孕率，29%。

Nigeria, the most populous country in Africa, 10 percent.

奈及利亞，非洲人口 最密集的國家，10%。

Chad, 2 percent.

查德，2%。

Let's just take one country in Africa, Senegal.

就拿非洲的塞內加爾為例。

Their rate is about 12 percent.

他們的避孕率約為 12%。

But why is it so low?

但為什麼會這麼低？

One reason is that the most popular contraceptives are rarely available.

原因之一是拿不到 最普遍使用的避孕用品。

Women in Africa will tell you over and over again

非洲女人會一再地告訴你，

that what they prefer today is an injectable.

她們現在比較喜歡用注射法。

They get it in their arm -- and they go about four times a year,

她們在手臂上打一針， 一年打四次，

they have to get it every three months -- to get their injection.

她們必須每三個月打一次。

The reason women like it so much in Africa is they can hide it from their husbands,

非洲婦女這麼喜歡這種方法的原因 是她們可以向丈夫隱瞞，

who sometimes want a lot of children.

丈夫有時候想要很多小孩。

The problem is every other time a woman goes into a clinic in Senegal,

問題是塞內加爾的女人去診所時，

that injection is stocked out.

常常發現注射劑缺貨。

It's stocked out 150 days out of the year.

每年有 150 天缺貨。

So can you imagine the situation --

你可以想像這種情況嗎？

she walks all this way to go get her injection.

她走了好長一段路去打避孕針。

She leaves her field, sometimes leaves her children,

她得丟下她的田， 有時候還得丟下孩子，

and it's not there.

卻發現沒有藥。

And she doesn't know when it's going to be available again.

她也不知道 什麼時候才會再進貨。

This is the same story across the continent of Africa today.

這樣的故事 每天都在非洲大陸上演。

And so what we've created as a world has become a life-and-death crisis.

我們全體共創的問題 已經變成生死存亡的危機。

There are 100,000 women [per year] who say they don't want to be pregnant

每年有十萬名婦女說 她們不想要懷孕，

and they die in childbirth -- 100,000 women a year.

結果死於難產。 每年十萬名婦女！

There are another 600,000 women [per year]

每年還有六十萬名婦女

who say they didn't want to be pregnant in the first place,

說她們其實不想懷孕，

and they give birth to a baby

但還是生下小孩，

and her baby dies in that first month of life.

小孩卻在頭一個月內死亡。

I know everyone wants to save these mothers and these children.

我知道每個人都想拯救 這些母親及孩子，

But somewhere along the way, we got confused by our own conversation.

但是在拯救之路上， 我們卻被自己的爭論困惑。

And we stopped trying to save these lives.

然後我們就停止拯救這些生命。

So if we're going to make progress on this issue,

所以，如果我們要在 這項議題上有進展，

we have to be really clear about what our agenda is.

我們必須很清楚明瞭 我們的意圖是什麼。

We're not talking about abortion.

我們不是在談墮胎。

We're not talking about population control.

我們不是在談人口控制。

What I'm talking about is giving women the power to save their lives,

我在談的是給女性拯救 自己生命的權力，

to save their children's lives

拯救自己孩子的生命，

and to give their families the best possible future.

並且給她們的家庭最好的未來。

Now, as a world,

那麼，從世界整體看，

there are lots of things we have to do in the global health community

我們要為全球健康做很多事，

if we want to make the world better in the future --

如果我們想讓這個世界 有更美好的未來，

things like fight diseases.

像對抗疾病這種就是要做的。

So many children today die of diarrhea, as you heard earlier, and pneumonia.

你們之前聽到了， 今天有太多孩子死於腹瀉及肺炎。

They kill literally millions of children a year.

這兩種病一年會殺死 數百萬名孩童。

We also need to help small farmers --

我們也必須幫助非洲小農，

farmers who plow small plots of land in Africa --

他們耕種小塊土地，

so that they can grow enough food to feed their children.

如此他們才能種植 足夠的食物餵養孩子。

And we have to make sure that children are educated around the world.

我們必須確保 全世界孩童都能受教育。

But one of the simplest and most transformative things we can do

但是還有一件既簡單 又能帶來改變的事，

is to give everybody access to birth control methods

就是讓每一個人 都能取得節育的方法，

that almost all Germans have access to and all Americans, at some point,

就像幾乎每位德國人、 美國人能拿到一樣，

他們在人生的某個階段 使用這些用品。

they use these tools during their life.

And I think as long as we're really clear about what our agenda is,

我認為只要我們真的很清楚 我們的意圖是什麼，

there's a global movement waiting to happen

就會產生全球性的運動，

and ready to get behind this totally uncontroversial idea.

準備好支持這項 完全沒有爭議的想法。

When I grew up, I grew up in a Catholic home.

我在天主教家庭長大。

I still consider myself a practicing Catholic.

我仍然視自己 為虔誠的天主教徒。

My mom's great-uncle was a Jesuit priest.

我母親的伯公是耶穌會修士。

My great-aunt was a Dominican nun.

我的姑婆是道明會修女。

She was a schoolteacher and a principal her entire life.

她教鞭執了一輩子。

In fact, she's the one who taught me as a young girl how to read.

事實上，她是我小時候 教我認字的人。

I was very close to her.

我跟她非常親。

And I went to Catholic schools for my entire childhood

我整個童年都讀天主教學校，

until I left home to go to university.

直到我離家去讀大學。

In my high school, Ursuline Academy,

在我的高中，聖吳甦樂學園，

the nuns made service and social justice a high priority in the school.

修女高度重視服務及社會正義。

Today, in the [Gates] Foundation's work,

今天，我在蓋茲基金會的工作，

I believe I'm applying the lessons that I learned in high school.

我相信那正是在 應用高中所學之道。

So, in the tradition of Catholic scholars,

在天主教學者的傳統風氣下，

the nuns also taught us to question received teachings.

修女也教導我們 要質疑接受到的教誨。

And one of the teachings that we girls and my peers questioned

我們女孩子及同學 常質疑的一項教條，

was is birth control really a sin?

就是節育真的是罪嗎？

Because I think one of the reasons

因為我認為

we have this huge discomfort talking about contraception

我們對談論避孕會這麼不自在，

is this lingering concern

是因為這個想法在作怪，

that if we separate sex from reproduction, we're going to promote promiscuity.

即如果我們把性與繁衍後代分開， 我們就在鼓勵淫亂。

And I think that's a reasonable question to be asked about contraception --

我想要談避孕的話， 接下來這個問題就得提出來談──

what is its impact on sexual morality?

避孕對性道德會產生什麼影響？

But, like most women,

但是，就像大多數女性，

my decision about birth control had nothing to do with promiscuity.

我決定要節育與淫亂完全無關。

I had a plan for my future. I wanted to go to college.

我對未來有計畫。 我想去上大學。

I studied really hard in college,

我在大學非常認真讀書，

and I was proud to be one of the very few female computer science graduates

我也很自傲自己是校內 電腦科學系少數女性畢業生之一。

at my university.

I wanted to have a career, so I went on to business school

我想要發展事業， 所以我進了商學院，

and I became one of the youngest female executives at Microsoft.

我也成為微軟的 年輕女性高級主管一員。

I still remember, though, when I left my parents' home

但是我仍然記得在我離家，

to move across the country to start this new job at Microsoft.

橫跨美國大陸到微軟 開始新工作時的一景。

They had sacrificed a lot to give me five years of higher education.

他們犧牲了很多 讓我接受五年的高等教育。

But they said, as I left home --

但我離家時他們對我說

and I literally went down the front steps, down the porch at home --

──真的就在我走下前門 台階的時候──

and they said,

他們說：

"Even though you've had this great education,

「即使妳受了這麼好的教育，

if you decide to get married and have kids right away,

如果妳馬上就想結婚生小孩，

that's OK by us, too."

我們也不會反對。」

They wanted me to do the thing that would make me the very happiest.

他們想要我去做 讓自己最幸福的事。

I was free to decide what that would be.

我可以自由決定要做什麼。

It was an amazing feeling.

這感覺真好。

In fact, I did want to have kids --

事實上，我的確想要孩子，

but I wanted to have them when I was ready.

但我想在我準備好時再要。

And so now, Bill and I have three.

所以現在， 比爾和我有三個孩子。

And when our eldest daughter was born,

我的大女兒出生時，

we weren't, I would say, exactly sure how to be great parents.

我必須說我們不太清楚 怎麼當好父母。

Maybe some of you know that feeling.

可能在座有些人了解那種感覺。

And so we waited a little while before we had our second child.

所以我們等了一陣子 才懷第二個孩子。

And it's no accident that we have three children

我們有三個孩子，

that are spaced three years apart.

每個間隔三年並非偶然。

Now, as a mother, what do I want the very most for my children?

現在，身為母親， 我最想要給我的孩子什麼？

I want them to feel the way I did --

我想要他們 跟我當時的感覺一樣，

like they can do anything they want to do in life.

就是他們能做任何想做的事。

And so, what has struck me

所以，我很驚訝，

as I've travelled the last decade for the foundation around the world

當我過去十年為基金會 在全世界奔走時，

is that all women want that same thing.

看到所有的女性都有同樣的心願。

Last year, I was in Nairobi, in the slums, in one called Korogocho --

去年，我在奈洛比 一個叫科羅哥丘的貧民窟，

which literally means when translated, "standing shoulder to shoulder."

翻譯出來就是 「比肩繼踵 」的意思。

And I spoke with this women's group that's pictured here.

我與這張照片上的 當地婦女團體談話。

And the women talked very openly about their family life in the slums,

這些婦女非常公開地談論 她們在貧民窟中的生活

what it was like.

是什麼樣子。

And they talked quite intimately about what they did for birth control.

她們也很親密地談論 她們如何節育。

Marianne, in the center of the screen in the red sweater,

瑪莉安，螢幕中間穿紅色毛衣的，

she summed up that entire two-hour conversation

她總結這場兩小時的對話，

in a phrase that I will never forget.

說了句我永遠忘不了的話。

She said, "I want to bring every good thing to this child

她說：「我想先給這個孩子最好的一切，

再生下一個孩子。」

before I have another."

And I thought -- that's it.

我就想，就是這樣。

That's universal.

這是普世皆然的想法。

We all want to bring every good thing to our children.

我們都想給孩子最好的一切。

But what's not universal is our ability to provide every good thing.

但是怎麼給他們最好的 卻非普世皆然。

So many women suffer from domestic violence.

許多婦女遭受家暴。

And they can't even broach the subject of contraception,

她們甚至無法提出避孕的話題，

even inside their own marriage.

即使已經結婚了也不行。

There are many women who lack basic education.

很多女性沒有受過基本教育。

Even many of the women who do have knowledge and do have power

甚至許多受過教育、 有能力的女性

don't have access to contraceptives.

也無法拿到避孕品。

For 250 years, parents around the world

250 年來，全世界的父母

have been deciding to have smaller families.

都決定要小一點的家庭。

This trend has been steady for a quarter of a millennium,

這種潮流在過去 250 年來都是如此，

across cultures and across geographies,

無論文化、無論地理位置，

with the glaring exception of sub-Saharan Africa and South Asia.

只有一個很明顯的例外， 就是撒哈拉以南的非洲及南亞。

The French started bringing down their family size in the mid-1700s.

法國自 18 世紀中 開始減少家庭人口。

And over the next 150 years, this trend spread all across Europe.

接下來 150 年 這個潮流席捲歐洲。

The surprising thing to me, as I learned this history,

我在讀這段歷史時很驚訝

was that it spread not along socioeconomic lines but around cultural lines.

這不是以社經地位傳播， 而是以文化為基礎傳播。

People who spoke the same language made that change as a group.

說同樣語言的人 以團體的形式做出改變。

They made the same choice for their family,

他們為了家庭做出相同的決定，

whether they were rich or whether they were poor.

無論他們是富是貧。

The reason that trend toward smaller families spread

小家庭趨勢能廣傳的原因，

was that this whole way was driven by an idea --

是整件事受這個想法驅使，

the idea that couples can exercise conscious control

就是夫婦能實行節育，

over how many children they have.

自行決定他們要有多少孩子。

This is a very powerful idea.

這是很有影響力的想法。

It means that parents have the ability to affect the future,

這意味著父母能影響未來，

not just accept it as it is.

而非被動的接受。

In France, the average family size went down every decade

在法國，平均家庭人口數 每十年就縮小一次，

for 150 years in a row until it stabilized.

持續了 150 年，直到穩定為止。

It took so long back then because the contraceptives weren't that good.

要花這麼長的時間是因為 過去的避孕效果不太好。

In Germany, this transition started in the 1880s, and it took just 50 years

德國於 1880 年代開始轉變， 然後只花了 50 年

for family size to stabilize in this country.

就使這個國家的家庭人數達到穩定。

And in Asia and Latin America, the transition started in the 1960s,

在亞洲及南美， 轉變始於 1960 年代，

and it happened much faster because of modern contraception.

由於現代化的避孕法， 這種轉變發展更快。

I think, as we go through this history, it's important to pause for a moment

我認為，在我們討論歷史的同時， 我們必須暫停一下，

and to remember why this has become such a contentious issue.

並回想為什麼這會變成 如此受爭論的議題。

It's because some family planning programs

這是因為某些家庭計畫

resorted to unfortunate incentives and coercive policies.

使出不適宜的誘因和高壓政策。

For instance, in the 1960s, India adopted very specific numeric targets

例如在 1960 年代， 印度採用非常具體的數字目標，

and they paid women to accept having an IUD placed in their bodies.

而且他們還付錢給女性， 讓她們在體內裝上子宮環。

Now, Indian women were really smart in this situation.

印度女性在這方面真的很精明。

When they went to get an IUD inserted, they got paid six rupees.

她們每次去裝子宮環， 就會得到六盧比。

And so what did they do?

所以她們怎麼做呢？

They waited a few hours or a few days,

她們會等幾小時或幾天，

and they went to another service provider and had the IUD removed for one rupee.

然後去另一家醫院 付一盧比取出子宮環。

For decades in the United States,

美國曾有數十年的歷史，

African-American women were sterilized without their consent.

非裔女性未經同意 就被強迫絕育。

The procedure was so common

這項手術普遍到

it became known as the Mississippi appendectomy --

被稱為「密西西比闌尾切除術」，

a tragic chapter in my country's history.

真是我國歷史上悲慘的一章。

And as recently as the 1990s, in Peru,

即使近如 1990 年代，

women from the Andes region were given anesthesia

秘魯安地斯區域的女性 還被施以麻醉，

and they were sterilized without their knowledge.

在不知情的狀況下被絕育。

The most startling thing about this

這樣的事件最令人驚訝的，

is that these coercive policies weren't even needed.

是這些高壓政策其實是不必要的。

They were carried out in places

實施這些政策的地方，

where parents already wanted to lower their family size.

那裡的父母 老早就想減少家庭人數。

Because in region after region, again and again,

因為我們在世界各地， 一次又一次地看見，

parents have wanted to have smaller families.

父母都想要小一點的家庭。

There's no reason to believe

沒有理由相信

that African women have innately different desires.

非洲婦女有天生不同的要求。

Given the option, they will have fewer children.

給她們選擇， 她們會少生幾個孩子。

The question is:

問題是，

will we invest in helping all women get what they want now?

我們現在就會投資幫助 所有女性得到她們想要的嗎？

Or, are we going to condemn them to some century-long struggle,

還是，我們要迫使她們 困在過去數百年的掙扎中，

as if this was still revolutionary France

好像我們還在法國大革命時期，

and the best method was coitus interruptus?

最好的避孕法是體外射精？

Empowering parents -- it doesn't need justification.

授予父母自主權， 這不需要理由。

But here's the thing -- our desire to bring every good thing to our children

重點是，想把最好的都給孩子的願望，

is a force for good throughout the world.

是促使世界各地「求善」的力量。

It's what propels societies forward.

這是推動社會前進的力量。

In that same slum in Nairobi, I met a young businesswoman,

在奈洛比同一所貧民窟， 我遇見一名年輕的女生意人，

and she was making backpacks out of her home.

她在家裡製作背包。

She and her young kids would go to the local jeans factory

她和年幼的孩子 會去當地的牛仔褲工廠

and collect scraps of denim.

收集丹寧碎布。

She'd create these backpacks and resell them.

她製作成這些背包然後轉售。

And when I talked with her, she had three children,

我跟她談的時候， 她有三個小孩，

and I asked her about her family.

我問她家裡的情況。

And she said she and her husband decided

她說她和丈夫決定

that they wanted to stop having children after their third one.

他們生三個以後就不要再生了。

And so when I asked her why, she simply said,

我問她為什麼， 她的回答很簡單：

"Well, because I couldn't run my business if I had another child."

「嗯，如果我再生孩子， 就不能做生意了。」

And she explained the income that she was getting out of her business

她解釋她從生意賺到的收入

afforded her to be able to give an education to all three of her children.

足以讓她的三個小孩都受教育。

She was incredibly optimistic about her family's future.

她對她家的前景非常樂觀。

This is the same mental calculus

同樣的想法

that hundreds of millions of men and women have gone through.

在千千萬萬男女的心中盤算著。

And evidence proves that they have it exactly right.

證據顯示他們算的很對。

They are able to give their children more opportunities

他們透過控制何時要小孩， 就能給孩子更好的機會。

by exercising control over when they have them.

In Bangladesh,

在孟加拉共和國

there's a district called Matlab.

有個行政區稱為麥特拉伯。

It's where researchers have collected data on over 180,000 inhabitants since 1963.

研究人員自 1963 年起已從 超過十八萬居民收集數據。

In the global health community,

在全球健康圈內，

we like to say it's one of the longest pieces of research that's been running.

我們都說那是 史上最長的研究。

我們得到很多 很棒的健康統計數字。

We have so many great health statistics.

In one of the studies, what did they do?

其中一項研究， 你猜他們做什麼？

Half the villagers were chosen to get contraceptives.

給予半數村民一些避孕用品。

They got education and access to contraception.

他們能拿到避孕用品， 並學會如何使用。

Twenty years later, following those villages,

二十年後，追蹤這些村莊，

what we learned is that they had a better quality of life than their neighbors.

我們發現他們的生活品質 比鄰居更好。

The families were healthier.

家人更健康。

The women were less likely to die in childbirth.

婦女比較不會因難產而死。

Their children were less likely to die in the first thirty days of life.

他們的孩子比較不會 在滿月前夭折。

The children were better nourished.

孩童營養較好。

The families were also wealthier.

家庭更富有。

The adult women's wages were higher.

成年女性的薪水較高。

Households had more assets -- things like livestock or land or savings.

每戶人家擁有較多資產， 像是更多家畜、土地或儲蓄。

Finally, their sons and daughters had more schooling.

最後，他們的兒女就學機會更大。

So when you multiply these types of effects over millions of families,

所以當你把這些效應 乘上數百萬家庭，

the product can be large-scale economic development.

其結果就是大規模的經濟發展。

People talk about the Asian economic miracle of the 1980s --

大家都在談論 1980 年代 亞洲經濟奇蹟，

but it wasn't really a miracle.

但這其實不是奇蹟。

One of the leading causes of economic growth across that region

那塊區域經濟成長的 主要原因之一，

was this cultural trend towards smaller families.

是小家庭文化的潮流。

Sweeping changes start at the individual family level --

要徹底改變， 必須從各個家庭開始，

the family making a decision about what's best for their children.

每個家庭自己決定 什麼對他們的孩子最好。

When they make that change and that decision,

當他們做出這樣的改變、 這樣的決定，

those become sweeping regional and national trends.

就會變成席捲區域及國家的潮流。

When families in sub-Saharan Africa are given the opportunity

當撒哈拉沙漠以南的 非洲家庭有了這樣的機會，

to make those decisions for themselves,

能為自己做出這樣的決定，

I think it will help spark a virtuous cycle of development

我想這就會在 整個非洲大陸的社區內

in communities across the continent.

激發良性發展循環。

We can help poor families build a better future.

我們能幫助貧窮家庭 創造更好的前景。

We can insist that all people have the opportunity

我們能堅決主張 所有人都有機會

to learn about contraceptives

學到避孕法，

and have access to the full variety of methods.

並能取得各式各樣的避孕用品。

I think the goal here is really clear:

我想這裡的目標非常明確：

universal access to birth control that women want.

全面普及女性想要的節育。

And for that to happen, it means that both rich and poor governments alike

要實現這點， 意味著無論貧富，

所有的政府 都必須將避孕列為優先。

must make contraception a total priority.

We can do our part, in this room and globally,

無論在這裡或在全球， 我們都要盡自己的力量去告訴大家，

by talking about the hundreds of millions of families

這世界還有數不清的家庭

that don't have access to contraception today

到今天仍無法取得避孕用品，

and what it would do to change their lives if they did have access.

以及如果他們能拿到， 生活會有什麼樣的改變。

I think if Marianne and the members of her women's group

我想如果瑪莉安 及她的婦女團體成員

can talk about this openly

能公開談論這件事，

and have this discussion out amongst themselves and in public,

能在她們之間 及在公眾前談這件事，

we can, too.

我們也可以。

And we need to start now.

而且我們必須現在就開始。

Because like Marianne, we all want to bring every good thing to our children.

因為就像瑪莉安， 我們都想給孩子最好的一切。

And where is the controversy in that?

這有什麼爭議呢？

Thank you.

謝謝。

(Applause)

（掌聲）

Chris Anderson: Thank you.

克里斯·安德森：謝謝妳。

I have some questions for Melinda.

我有一些問題想問梅琳達。

(Applause ends)

（掌聲結束）

Thank you for your courage and everything else.

謝謝妳的勇氣和所作所為。

So, Melinda, in the last few years

梅琳達，過去幾年

I've heard a lot of smart people say something to the effect of,

我聽到很多自以為是的人說， 大概是這個意思，

"We don't need to worry about the population issue anymore.

「我們不用再擔心人口問題了。

Family sizes are coming down naturally all over the world.

世界各地家庭人數正在自然減少。

We're going to peak at nine or 10 billion. And that's it."

我們在 90 億或 100 億 達到高峰。就這樣。」

Are they wrong?

他們說錯了嗎？

Melinda Gates: If you look at the statistics across Africa,

梅琳達·蓋茲： 如果你看非洲的統計數字，

他們的確說錯了。

they are wrong.

And I think we need to look at it, though, from a different lens.

但我認為我們其實 要從不同的角度看這件事。

We need to look at it from the ground upwards.

我們需要從底部向上看。

I think that's one of the reasons we got ourselves in so much trouble

我想這就是我們讓自己在避孕議題上 陷入這麼大麻煩的原因之一。

on this issue of contraception.

We looked at it from top down

我們從上向下看，

and said we want to have different population numbers over time.

然後說隨著時間 我們想要有不同的人口數。

Yes, we care about the planet. Yes, we need to make the right choices.

是，我們是很關心地球。 是，我們需要做正確的決定。

But the choices have to be made at the family level.

但是選擇必須是從家庭層面。

And it's only by giving people access and letting them choose what to do

只有給大家管道 及讓他們選擇要做什麼，

that you get those sweeping changes that we have seen globally --

結果才是我們 在全球看到的徹底改變，

except for sub-Saharan Africa and those places in South Asia and Afghanistan.

除了撒哈拉沙漠以南的非洲 及南亞幾個地方和阿富汗。

CA: Some people on the right in America

克：有些右翼美國人

and in many conservative cultures around the world

及全球許多保守派文化

might say something like this:

可能會說：

"It's all very well to talk about saving lives and empowering women and so on.

「要談拯救生命 及賦權女性等等是很好。

But, sex is sacred.

但是，性是神聖的。

What you're proposing is going to increase the likelihood

妳所提出的可能會增加

that lots of sex happens outside marriage.

婚外性行為。

And that is wrong."

這是不對的。」

What would you say to them?

妳對他們有什麼要說的嗎？

MG: I would say that sex is absolutely sacred.

梅：我要說性絕對是神聖的。

And it's sacred in Germany, and it's sacred in the United States,

性在德國是神聖的， 性在美國也是神聖的，

and it's sacred in France and so many places around the world.

在法國也是， 在全世界許多地方都是。

And the fact that 98 percent of women in my country who are sexually experienced

在我國，98% 有性行為的女性 說她們節育

say they use birth control doesn't make sex any less sacred.

並不會讓性行為變得不神聖。

It just means that they're getting to make choices about their lives.

這只代表她們要選擇 怎樣過生活。

And I think in that choice,

而且我覺得這樣的選擇，

we're also honoring the sacredness of the family

也讓我們尊榮家庭的神聖，

and the sacredness of the mother's life

當母親的神聖，

and the childrens' lives by saving their lives.

及孩子的生活， 因為這拯救了他們的生命。

To me, that's incredibly sacred, too.

對我而言，這也非常神聖。

CA: So what is your foundation doing to promote this issue?

克：那麼妳的基金會 如何宣導這項議題？

And what could people here and people listening on the web --

在座的人及網路上聽的人 又可以做什麼？

what would you like them to do?

妳希望他們做什麼？

MG: I would say this -- join the conversation.

梅：我會這麼說，參與對話。

We've listed the website up here. Join the conversation.

我們在上面列了幾個網站。 參與對話。

Tell your story about how contraception has either changed your life

告訴大家避孕 如何改變了妳的生活，

or somebody's life that you know.

或是你知道誰的生活因此而改變。

And say that you're for this.

表達你的支持。

We need a groundswell of people saying, "This makes sense.

我們需要高漲的輿論說： 「這很有道理。

We've got to give all women access -- no matter where they live."

我們要給所有女性取得的管道。 無論她們住在哪裡。」

And one of the things that we're going to do

而且有件我們即將要做的事，

is do a large event July 11 in London,

就是七月十一日在倫敦 舉辦一場大型活動，

with a whole host of countries, a whole host of African nations,

許多國家，許多非洲國家都要參加，

to all say we're putting this back on the global health agenda.

宣告我們要把這個 放回全球健康議題。

We're going to commit resources to it,

我們承諾要找出資源，

and we're going to do planning from the bottom up with governments

我們會與政府一起從下而上計畫，

to make sure that women are educated --

要確保婦女要受教育，

so that if they want the tool, they have it,

所以如果她們想要用品就會得到，

and that they have lots of options available

而且她們還會有很多選擇，

either through their local healthcare worker

透過當地醫療人員

or their local community rural clinic.

或當地的社區診所拿到。

CA: Melinda, I'm guessing that some of those nuns who taught you at school

克：梅琳達， 我猜某些在學校教過妳的修女

are going to see this TED Talk at some point.

可能也有機會看到這場 TED 演講。

Are they going to be horrified, or are they cheering you on?

她們會嚇壞了， 或是為妳加油打氣？

MG: I know they're going to see the TED Talk

梅：我知道她們會看這場 TED 演講，

because they know that I'm doing it and I plan to send it to them.

因為她們知道我在做這個， 而且我也計畫要送一份給她們。

And, you know, the nuns who taught me were incredibly progressive.

你知道，教過我的幾位修女 想法都非常先進，

I hope that they'll be very proud of me

我很希望她們會以我為榮，

for living out what they taught us about social justice and service.

因為我身體力行 她們教導的社會正義及服務。

I have come to feel incredibly passionate about this issue

我逐漸領悟到 我對這項議題的熱情，

because of what I've seen in the developing world.

來自我在發展中國家看到的現象，

And for me, this topic has become very close to heart

對我而言，這項議題 已成為我全心關注的重點，

because you meet these women and they are so often voiceless.

因為妳與這些婦女接觸， 她們常常沒有發言權。

And yet they shouldn't be --

但她們不應如此，

they should have a voice, they should have access.

她們應該要有發言權， 她們應該要有管道。

And so I hope they'll feel

所以我希望她們會覺得

that I'm living out what I've learned from them

我身體力行 從她們身上學到的東西，

and from the decades of work that I've already done at the foundation.

還有這數十年我在基金會的經驗。

CA: So, you and your team brought together today an amazing group of speakers

克：妳和妳的團隊今天 為我們帶來非常棒的講員。

to whom we're all grateful.

我們都很感謝。

Did you learn anything?

妳有學到什麼嗎？

(Laughter)

（笑聲）

MG: Oh my gosh, I learned so many things. I have so many follow-up questions.

梅：天啊，我學到好多東西。 我有好多後續問題想問。

And I think a lot of this work is a journey.

我想這工作 很大部分是心路歷程。

You heard the discussion about the journey through energy,

你聽人談過能源的心路歷程，

or the journey through social design,

社會設計的心路歷程，

or the journey in the coming and saying,

可能馬上就有這樣的心路歷程說：

"Why aren't there any women on this platform?"

「為什麼沒有女性站在這個講台上？」

And I think for all of us who work on these development issues,

我想對我們這些 從事發展議題的人而言，

you learn by talking to other people.

你從對話中學習。

You learn by doing. You learn by trying and making mistakes.

你從做中學， 從嘗試、從錯中學，

And it's the questions you ask.

還有你問的問題。

Sometimes it's the questions you ask that helps lead to the answer

有時候你問的問題，

the next person that can help you answer it.

下一個人能幫你回答。

So I have lots of questions for the panelists from today.

所以我有很多問題 想問今天的講員。

And I thought it was just an amazing day.

我認為今天真是太棒了。

CA: Melinda, thank you for inviting all of us on this journey with you.

克：梅琳達， 謝謝妳邀我們與妳同行。

Thank you so much. MG: Great. Thanks, Chris.

謝謝妳。 梅：謝謝克里斯。