Hans Rosling on HIV: New facts and stunning data visuals

譯者: Geoff Chen 審譯者: Celia Yeung

(Applause)

(掌聲)

AIDS was discovered 1981; the virus, 1983.

愛滋病是在1981年被發現的，而HIV病毒是在1983年

These Gapminder bubbles show you

這張 Gapminder 氣泡圖會顯示

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

於1983年病毒在世界各地擴散的情況

or how we estimate that it was.

或者說是我們對它的估計

What we are showing here is --

今天我們要展示的是

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

這條（Y）軸，是被感染的成年人比例

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

而這條（X）軸，是人均收入（美元）

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

而這些氣泡的大小

that shows how many are infected in each country,

代表每個國家被感染的人數

and the color is the continent.

而顏色代表不同洲分

Now, you can see United States, in 1983,

現在來看看1983年的美國

had a very low percentage infected,

當時的感染率還非常低

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

但因為人口基數大，這個氣泡還是很大

There were quite many people infected in the United States.

也就是說在美國有很多人被感染

And, up there, you see Uganda.

在上面是烏干達

They had almost five percent infected,

感染率接近百分之五

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

雖然國家不大，但氣泡也不小

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

他們可能是全世界感染率最高的國家

Now, what has happened?

為什麼會這樣？

Now you have understood the graph

我想大家現在都能看明白這個圖表了

and now, in the next 60 seconds,

在接下來的60秒裏

we will play the HIV epidemic in the world.

我們會展示愛滋病疫情在世界各地蔓延的過程

But first, I have a new invention here.

但在這之前，我要先拿出我的新發明

(Laughter)

(笑聲)

I have solidified the beam of the laser pointer.

我把鐳射筆的光線變成固體了

(Laughter)

(笑聲)

(Applause)

(掌聲)

So, ready, steady, go!

好，準備，坐穩了，開始！

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

最開始是烏干達和辛巴威的感染率飆升

They went upwards like this.

像這樣一直上升

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

在亞洲，第一個受嚴重感染的國家是泰國

they reached one to two percent.

感染率達到百分之一至二

Then, Uganda started to turn back,

然後烏干達開始回落

whereas Zimbabwe skyrocketed,

而辛巴威一飛沖天

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

幾年後南非的HIV感染率急劇上升

Look, India got many infected,

看這裏，印度也有很多人被感染

but had a low level.

但整體比率還很低

And almost the same happens here.

這裏也一樣

See, Uganda coming down, Zimbabwe coming down,

看，烏干達下降了，辛巴威下降了

Russia went to one percent.

俄羅斯上升到百分之一

In the last two to three years,

在過去的兩三年裏

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

世界HIV疫情進入了穩定期

25 years it took.

這個穩定期需時25年

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

但穩定並不意味著情況開始好轉

it's just that they have stopped getting worse.

只是不再惡化而已

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

穩定情況就是說

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

世界成年人口的百分之一感染了HIV病毒

It means 30 to 40 million people,

也就是說大約3000萬到4000萬人

the whole of California -- every person,

相當於加利福尼亞州的所有人口

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

這就是現在全世界愛滋病患者的大概數量

Now, let me make a fast replay of Botswana.

現在我們再快速看一下波札那的情況

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

波札那是為於非洲南部中上收入國家

democratic government, good economy,

民主政府，經濟也不俗

and this is what happened there.

來看看這裏的情況

They started low, they skyrocketed,

他們的感染率一開始很低，然後火箭般竄升

they peaked up there in 2003,

在2003年達到頂峰

and now they are down.

現在有所下降

But they are falling only slowly,

但下降的速度很慢

because in Botswana, with good economy and governance,

因為波札那的經濟政治環境不錯

they can manage to treat people.

可以治療愛滋病患者

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

感染者只要接受治療就不會輕易死於愛滋病

These percentages won't come down

所以這個比例不會下降

because people can survive 10 to 20 years.

因為病毒帶菌者可以繼續活上10年到20年

So there's some problem with these metrics now.

所以這個計算方法現在有點問題

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

但一些非洲的窮國，像下面的這些低收入國家

there the rates fall faster, of the percentage infected,

感染比例下降得很快

because people still die.

因為感染者在不斷死亡

In spite of PEPFAR, the generous PEPFAR,

儘管有慷慨的"總統愛滋病緊急防治救援計畫"（PEPFAR）

all people are not reached by treatment,

卻不是所有人都能得到治療

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

在這些貧窮國家中，即使是受到治療的那些病人

only 60 percent are left on treatment after two years.

兩年後也只剩下60%的人還在治療計畫中

It's not realistic with lifelong treatment

對窮國中的每一個患者

for everyone in the poorest countries.

進行終身治療是不切實際的

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

但畢竟這些工作已經很好

But focus now is back on prevention.

但現在的關注點已經回到了防預工作上

It is only by stopping the transmission

只有阻止傳播

that the world will be able to deal with it.

我們的世界才會有機會對抗愛滋病

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

藥物太貴了 -- 要是有疫苗就好了

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

或者知道什麼時候會有疫苗，這樣會有效得多

but the drugs are very costly for the poor.

但藥物對窮人來說太貴了

Not the drug in itself, but the treatment

並不是藥物本身貴，而是整個治療過程

and the care which is needed around it.

以及所需的看護很貴

So, when we look at the pattern,

所以，我們看看整個圖表

one thing comes out very clearly:

有一件事非常清楚：

you see the blue bubbles

你看那些藍色的氣泡

and people say HIV is very high in Africa.

人們會說非洲的HIV比率很高

I would say, HIV is very different in Africa.

我必須說，HIV在非洲也是非常不同的

You'll find the highest HIV rate in the world

你們會發現世界上最高的HIV感染率

in African countries,

是在非洲國家

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

但這裏也有塞內加爾，在下面

the same rate as United States.

感染率和美國一樣

And you'll find Madagascar,

也有馬達加斯加

and you'll find a lot of African countries

而其他很多非洲國家

about as low as the rest of the world.

和世界其他地方的感染率一樣低

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

所以認為非洲的所有事情都是一個樣

and things go on in one way in Africa.

將非洲簡單地同一化是很可怕的

We have to stop that.

我們不能再這麼想

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

這麼想很不尊重他們

to think that way.

也很不明智

(Applause)

(掌聲)

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

我有幸在美國生活和工作過一段時間

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

我發現鹽湖城和舊金山就很不一樣

(Laughter)

(笑聲)

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

非洲也是一樣 -- 各地有很多不同

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

那，為什麼比率會這麼高呢？是因為戰爭的關係？

No, it's not. Look here.

不是的。看這裏

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

飽經戰火的剛果在下面 -- 百分之二、三、四的樣子

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

而和平的鄰國赞比亚 -- 百分之十五

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

有人研究過剛果難民的感染率

they have two, three percent infected,

也在百分之二到三之間

and peaceful Zambia -- much higher.

而和平的赞比亚要高得多

There are now studies clearly showing

現在有研究明確岀指出

that the wars are terrible, that rapes are terrible,

雖然有很多戰爭，很多強暴事件發生

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

但這並不是非洲HIV病毒高比率的主要原因

So, is it poverty?

所以，是因為貧窮嗎？

Well if you look at the macro level,

如果我們從宏觀角度看看

it seems more money, more HIV.

好像錢越多，HIV就越多

But that's very simplistic,

但這過於簡單化了

so let's go down and look at Tanzania.

我們來仔細看看坦桑尼亞的情況

I will split Tanzania in five income groups,

我把坦桑尼亞人按收入分成五組

from the highest income to the lowest income,

從最高收入到最低收入

and here we go.

我們來看看

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

收入最高的人，處境較好的人，我不會叫他們富人

they have higher HIV.

他們的HIV感染率更高

The difference goes from 11 percent down to four percent,

感染率最高有百分之十一，最低的到百分之四

and it is even bigger among women.

婦女中這個差距更大

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

許多我們以前的想法，被現在許多由

done by African institutions and researchers

非洲及國際機構和研究人員所做的研究

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

證實是錯誤的

So, this is the difference within Tanzania.

這是坦桑尼亞的例子

And, I can't avoid showing Kenya.

我必須再舉一下肯亞的例子

Look here at Kenya.

來看看肯亞

I've split Kenya in its provinces.

我按省份劃分肯亞

Here it goes.

來看看

See the difference within one African country --

在同一個非洲國家裏的差別

it goes from very low level to very high level,

從很低的水平到很高的水平

and most of the provinces in Kenya is quite modest.

而肯亞大部分的省份感染率並不高

So, what is it then?

那到底是什麼原因呢？

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

為什麼有些國家的感染率那麼高？

Well, it is more common with multiple partners,

其中因素包括有多個性伴侶，

there is less condom use,

或不愛用避孕套

and there is age-disparate sex --

或有年齡差異大的性愛因素

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

就是大年紀男人喜歡跟年輕女人做愛

We see higher rates in younger women than younger men

所以我們發現在很多感染率較高的國家裏

in many of these highly affected countries.

年輕女性的感染率要高於年輕男性

But where are they situated?

那地理上的分佈又是怎麼樣呢？

I will swap the bubbles to a map.

我把氣泡轉移到地圖上

Look, the highly infected are four percent of all population

看，感染率高的國家佔世界人口的百分之四

and they hold 50 percent of the HIV-infected.

但卻有全球百分之五十的HIV感染者

HIV exists all over the world.

HIV在世界各地都存在

Look, you have bubbles all over the world here.

看，氣泡分佈在所有地方

Brazil has many HIV-infected.

巴西有很多HIV感染者

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

阿拉伯國家不多，但伊朗很高

They have heroin addiction and also prostitution in Iran.

伊朗的問題是海洛因和賣淫

India has many because they are many.

印度有很多因為它本身人口多

Southeast Asia, and so on.

以及東南亞等等

But, there is one part of Africa --

但非洲有一部分 --

and the difficult thing is, at the same time,

同時要注意的是

not to make a uniform statement about Africa,

不要說到非洲就想到整個非洲

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

一方面不要認為出現現在的情況是因為單一的原因

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

另一方面要承認現在的情況很嚴重

because there is a scientific consensus about this pattern now.

現在科學界已經對這個分佈圖達成了共識

UNAIDS have done good data available, finally,

UNAIDS終於提供了HIV傳播的

about the spread of HIV.

詳細數據

It could be concurrency.

可能是由於多重性伴

It could be some virus types.

也可能是某些病毒種類

It could be that there is other things

也可能是有別的原因

which makes transmission occur in a higher frequency.

使病毒傳播到這樣高的比例

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

不管怎樣，如果你完全健康並且是異性戀

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

每次性交被感染的機會是千分之一

Don't jump to conclusions now on how to

但別輕易得出結論

behave tonight and so on.

今晚就去胡混

(Laughter)

(笑聲)

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

但是，如果你處於不利情況

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

通過性傳染的疾病機會可以達到百分之一

But what we think is that it could be concurrency.

但我們認為多個性伴可能是主要原因

And what is concurrency?

什麼是多重性伴侶？

In Sweden, we have no concurrency.

在瑞典我們沒有多重性伴侶

We have serial monogamy.

我們是連續的單一性伴侶

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

喝伏特加，除夕夜 -- 春天有新性伴了

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

喝伏特加，仲夏夜 -- 秋天有新性伴了

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

喝伏特加 -- 繼續這樣子，你們明白了嗎？

And you collect a big number of exes.

這樣你會有很多“前”男、女朋友

And we have a terrible chlamydia epidemic --

有一種可怕的衣原體傳染病

terrible chlamydia epidemic which sticks around for many years.

這種可怕的衣原體傳染病持續多年

HIV has a peak three to six weeks after infection

而HIV是在感染後的三到六周有一個活動高峰

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

因此，在一個月裏有多個性夥伴

is much more dangerous for HIV than others.

對HIV傳播是特別危險的

Probably, it's a combination of this.

很可能，這是原因之一

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

還有令我高興的是,當我們在考慮這些因素的時候

towards fact when we look at this.

我們也不斷地向真相邁步

You can get this chart, free.

大家可以免費取得這份圖表

We have uploaded UNAIDS data on the Gapminder site.

我們把UNAIDS的資料上傳到Gapminder.org

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

並且希望將來在解決全球性問題時

we will not only have the heart,

我們不僅帶著一顆心

we will not only have the money,

不僅帶著錢

but we will also use the brain.

也多用腦子

Thank you very much.

謝謝大家

(Applause)

(掌聲)