We Can Make COVID-19 the Last Pandemic | Bill Gates | TED

譯者: 至磊Zi Le 黃Ng 審譯者: Helen Chang

In the year 6 CE,

公元 6 年，

a fire devastated Rome.

一場火災肆虐羅馬。

In response,

作為回應，

Emperor Augustus did something that had never been done before

奧古斯都皇帝做了一件 帝國歷史上從未做過的事，

in the history of the Empire.

He created a permanent team of firefighters

他創立了一個永久性的消防隊，

who used buckets just like this one.

用這種水桶滅火。

Augustus understood that individuals alone can't protect themselves from fires.

奧古斯都理解到單獨的個人 無法自我保護免於火災，

They need help from the community.

而是需要社群的幫助。

When one person's house is on fire,

當一人的房子失火，

that creates a risk for everyone else's homes.

就會對其他所有人的房子構成風險。

And so what we've had these last few years is like a horrific global fire.

我們最近幾年遇到的 就像一場可怕的全球性火災。

The COVID pandemic has killed millions and upended economies,

新型冠狀病毒疫情 殺死了數百萬人，破壞了經濟，

and we want to stop that from happening again.

我們想要阻止這種事再度發生。

COVID, it's hard to overstate how awful it's been.

說新冠病毒有多糟都不為過。

It's increased the health inequities between the rich and the poor.

它加深了富人和窮人的健康不平等。

Survival depended partly on your income, your race,

存活與否有一部分取決於 你的收入、種族、你住在哪個社區。

the neighborhood you lived in.

And so we should seize this opportunity

我們應該把握這個機會

to create a world where everyone has a chance

讓世界上人人都可以活得健康多彩，

to live a healthy and productive life.

Also a life free from the fear of the next COVID-19.

也不必恐懼下一場 如同新冠病毒的事件。

When I was on this stage in 2015,

2015 年我站在這個講臺，

I was one of many people who said

跟很多人一樣，

我說我們還沒準備好， 而且我們必須準備好。

we weren't ready and we needed to get ready.

We didn't.

但我們還是沒有。

The speech actually was watched by a lot of people.

那場演講其實很多人看過。

But 90 percent of the views were after it was too late.

但九成的點閱數是在 為時已晚的時候。

(Laughter)

（笑聲）

So now I hope the need is clear.

現在，我希望這個必要性夠清楚了。

And of course, we've learned a lot.

當然，我們學到了很多。

During this pandemic,

在這次疫情期間，

a lot of things worked well, a lot of things didn't work well.

許多事辦得很好， 也有許多事辦不好。

And so we have all that knowledge to build a prevention system.

我們全都有了建構預防系統的知識。

COVID-19 can be the last pandemic if we take the right steps.

如果我們踏出正確的步伐， 新冠病毒可以是最後的疫情大流行。

So how, what are these steps?

所以該怎麼做？踏出什麼步伐？

Well, let's go back and look at what the Romans did.

那我們回頭看看古羅馬人怎麼做。

Think about how, over time, we've gotten good at preventing big fires.

想想我們是怎麼 漸漸擅長預防大火的。

Fire prevention is kind of this pervasive thing.

火災預防很普遍。

It's well funded.

它獲得很多資助，

It's well understood.

被很好地理解。

If an alarm went off right now,

如果現在警報響起，

everyone here would know we're supposed to calmly gather,

所有人都知道我們應該冷靜地集結，

go out and wait instructions.

走出出口等待指示。

We'd know that help would be on the way

我們知道援助已經上路，

because we have lots of trained firefighters who practice.

因為我們有很多 訓練有素的消防員在工作。

The United States alone has 370,000 full-time firefighters,

單單美國就有 37 萬名全職消防員，

even more than I guessed that number would be.

比我預估的人數還多。

We also have access to water.

我們也有途徑取得水。

The United States, for example, has almost nine million fire hydrants.

例如美國有近九百萬個消防栓。

And so that type of investment, that type of practice,

這種投資、措施、系統

that type of system is what we need to stop pandemics.

就是阻止疫情所需要的。

Now, often in movies, we'll have pandemics.

我們常會在電影裡看到疫情，

And I'm always impressed with what takes place.

我總是對這些故事印象深刻。

Let's look at an example of this rapid response.

讓我們看看這個快速反應的例子。

[Motaba River Valley, Zaire]

［莫塔巴河谷，薩伊］

(Helicopter rotors whirring)

（直升機旋翼呼呼作響）

Well, that's quite impressive.

那十分令人印象深刻。

We don't need the music,

我們不需要音樂，

but otherwise we saw exactly what should happen.

但我們確切看到了事情應該是怎麼樣。

An outbreak’s detected.

偵測到疫情爆發；

Very quickly, literally within days,

非常快速地，在僅僅幾天內，

doctors are dispatched.

就派了醫師過來；

They have a helicopter to get into exactly ground zero.

他們搭乘直升機到達精確的爆發點；

They go in there, and they’ve got the right tools.

他們進入房內，並帶著正確的工具。

And this is what should happen when an outbreak is spotted.

這就是發現疫情爆發時該發生的事。

But we don't have that team, we don't have those resources.

但我們沒有那種團隊， 我們沒有那些資源。

And if an outbreak took place in a low-income country,

如果一場疫情爆發於低所得國家，

it could be literally months

可能需要足足幾個月 我們才會準備好那些資源。

before we started to orchestrate those resources.

So despite what you see in movies,

所以不同於你們在電影看到的，

there is no group of experts standing by to prevent this disaster.

我們沒有準備就緒的專家團隊 來預防這場災難。

So we have to create a new team.

因此我們需要創立一個新的團隊。

I believe we should create what I call the GERM team.

我相信我們應該創立 GERM 團隊，

Germ stands for Global Epidemic Response and Mobilization.

GERM 代表「全球疫情反應與動員」。

This group is full-time.

這個團隊是全職的，

Their only priority is pandemic prevention.

他們唯一的要務是預防疫情。

It's made up of a diverse set of specialists

這個團隊由各式各樣的專家所組成，

with a lot of different realms of expertise:

在很多領域各有專精：

epidemiologists, data scientists,

流行病學家、資料科學家、 物流管理專家。

logistics experts.

And it's not just scientific and medical knowledge.

他們不只有科學和醫學知識，

They also have to have communication and diplomacy skills.

還有溝通和協商技能。

The cost of this team is significant.

這個團隊的開銷很巨大，

It's over a billion a year

每年超過新臺幣 300 億元，

to support the 3,000 people who would be on this team.

以維持 3000 名團隊成員。

And its mission is to stop outbreaks before they become pandemics.

這個團隊的任務是 阻止疫病爆發演變成大流行。

The work would be coordinated by the WHO.

這項工作需要世界衛生組織的協同，

They'd be present in many locations around the world,

他們會在世界上許多地點

stationed in public health agencies.

進駐公共衛生機構，

They'd work closely with the national teams,

與各國團隊緊密合作，

depending on the income level.

視該地的所得多寡而定，

They'd have more in the lower-income countries.

在低所得國家駐紮較多的人。

You know, for example, we could have GERM members

舉例來說，我們可以請 GERM 成員，

say an epidemiologist, working out of the Africa CDC office in Abuja.

例如一位流行病學家，

在非洲疾病管制預防中心的 阿布加辦公室工作。

And a very important thing is that like firefighters,

一件非常重要的事情是 就如同消防隊員，

a GERM team would do drills.

GERM 團隊會進行演習。

When you want to have quick response,

若要快速地反應，

when you want to make sure you have all the pieces there

若要確保所需的一切物件齊備 且能很快速地行動，

and you can move very quickly, practice is key.

演練就是關鍵。

That's how you make sure everyone knows what to do.

這是確保所有人 都知道該做什麼的方法。

Now, this team, there could be periods where there's no risky outbreak

在沒有傳染病爆發風險的時期

and they can keep their skills strong

這個團隊仍可藉處理其他的傳染病 來保持強大的能力，

by working on some of the other infectious diseases,

but that would be a second priority.

不過這只會是第二優先。

They would work with countries to strengthen their health systems.

他們會和各國合作， 強化那些國家的醫療系統。

The health systems are the front line.

醫療系統是第一線。

You need to know if, say,

得要明白，舉例來說，

a lot of people show up with a new kind of cough,

如果很多人出現一種新型的咳嗽，

that’s when GERM needs to look into it and say, is this an outbreak?

這就是 GERM 團隊要調查的時候， 判斷這是不是傳染病的爆發，

Is there a new pathogen here?

有沒有新的病原體，

What is the sequence of that?

後果會是什麼？

And so for all of this, the first 100 days are key.

對這些工作而言， 前一百天會是關鍵。

Viruses spread exponentially.

病毒以指數性成長在傳播。

And so if you get in there when the infection rate is fairly small,

如果能在感染率還很低時抵達那裡，

you can actually stop the spread.

其實就可以阻斷傳播。

You know, in this epidemic,

要知道在這場疫情裡，

if we'd been able to stop it within 100 days,

如果我們得以在一百天內阻止它，

we would have saved over 98 percent of the lives.

我們就可以拯救超過 98% 的生命。

Now, we did have countries that did a good job.

我們有看到一些國家做得很好。

Australia is an example.

澳大利亞是一個範例。

They orchestrated diagnostic capacity.

他們細緻規劃檢驗量能，

They came up with distancing policies and quarantine policies.

構思出社交距離和隔離政策，

And so their overall death rate per capita will be well less

所以他們的整體人均死亡率 不到其他國家的十分之一。

than a 10th of other countries.

But we did not, as a world, contain it.

但在全世界，我們沒有控制住疫情，

And that's what we have to do next time.

這就是我們下次必須要做的。

When COVID struck, we were almost like Rome

新冠病毒來襲時，

我們就像沒有滅火桶 和消防隊員的羅馬。

before they had fire buckets and firefighters.

We didn't have the people, the systems or the tools we need.

我們沒有所需的人力、系統或器具。

Now, with the right investments,

現在，如果正確投資，

we can have a whole new generation of tools,

我們可以有全新一代的工具、

better diagnostics, therapeutics and vaccines.

更好的篩檢、治療和疫苗。

A good example in the diagnostic area is this little machine,

在檢測方面這臺小機器 是一個很好的範例，

this is called the Lumira.

它叫「 Lumira 」。

We can have these all over the world that can test for any number of diseases.

我們可在全世界設置這種機器 檢測任意數量的疾病，

It’s a 10th as expensive as PCR,

要價是聚合酶連鎖反應的十分之一，

it’s absolutely as accurate, and it’s simple.

它絕對一樣準確、簡單易用，

So it can be used anywhere.

所以可以使用於任何地方。

We need other R&D investments.

我們需要投資於其他研發。

One that I'm very excited about is the idea of a drug

其中一個讓我非常興奮的點子

that you inhale that blocks you from getting infected.

是一種吸入就能 為你阻斷感染的藥物。

It can be pathogen-independent and trigger your immune system

它可以是不限病原體的， 會刺激你的免疫系統，

so that you'll be protected.

你就能獲得保護。

A lot of the tools, the diagnostic tools

很多器具很重要， 例如檢測和感染阻斷器材，

and those infection-blocking tools are important

because they can be staged in advance.

因為它們可以超前部署。

Now, we also need vaccines,

我們也需要疫苗，

but we want to stop the outbreak

但我們希望在需要全球性施打行動前 阻斷疫情的爆發。

before we have to do a global vaccination campaign.

And so vaccines can play a couple of different roles,

所以疫苗可以扮演很多不同角色，

but not the primary role.

不限於主要功能。

We have to invest in more than just that.

我們必須投資不只那樣。

When we look at vaccines, they were the miracle of this epidemic.

疫苗可說是這次大流行的奇跡。

They saved millions of lives, but they can be far better.

疫苗拯救了數百萬人的性命， 但它可以做得更好。

We need to invent easier-to-deliver vaccines

我們必須發明便於運輸的疫苗，

that are just a patch you put on your arm

只是一塊貼在手臂上的貼布 或可以吸入的東西。

or something that you inhale.

We need vaccines that actually block infections.

我們需要可以確實阻斷感染的疫苗。

In this case, there were lots of breakthrough infections.

在這方面，目前有很多突破性感染。

We need vaccines that are broad spectrum,

我們需要廣效性的疫苗

so they work against most of the emerging variants,

來對抗絕大多數新生的變種病毒，

which we did not have this time.

這是我們這次所沒有的。

And we also need factories that are standing by

我們也需要待命的工廠，

so we can build enough vaccines for the entire world

讓我們可以在六個月內 生產足夠全世界使用的疫苗，

within six months

and achieve far better equity.

達到更平等。

The vaccines can also do something that would be super helpful,

這些疫苗可以辦到非常有用的事情，

which is to help us eradicate entire families of viruses.

那就是幫助我們消滅整個病毒家族。

Innovative new vaccines used properly could get rid of the flu family,

如果正確使用創新的疫苗， 就能消除流感病毒、冠狀病毒家族。

the coronavirus family.

And there's a huge burden of those,

這些病毒是很大的負擔，

even in non-pandemic years,

即便是沒有大流行的年分，

and if we get rid of it, it can never cause a pandemic.

如果我們將其消滅， 它們就永遠不會引發大流行了。

So I'm talking about investments in three broad areas:

我在談論的是投資於三個大領域：

Disease monitoring,

疾病偵測，

that's GERM.

就是 GERM 團隊；

The R and D tools that are far better.

更好的研發工具；

And finally, and the most expensive, is improved health systems.

最後，也是最昂貴的， 就是改善醫療系統。

This won't be cheap, but it'll save lives.

這不便宜，但會拯救生命，

And even it'll save money in the long run.

長期下來甚至能節省資金。

It's like an insurance policy.

它就像買一份保險。

The cost to prevent the next pandemic will be tens of billions of dollars.

預防下一場大流行的開銷 是新臺幣數千億元，

But let's compare that to what we just went through.

但我們跟這次做個比較。

The IMF estimates that COVID has cost nearly 14 trillion dollars.

國際貨幣基金組織估計新冠病毒 用掉了新臺幣近 420 兆元。

And so we need to spend billions in order to save trillions.

為了省下幾百兆， 我們需要付出幾千億。

And here's the best part of this.

這些事情最棒的部分是這樣的。

Even when we're not having an outbreak, these investments like the Lumira,

即使在沒有大流行的時期，

這些投資，例如 Lumira 、新疫苗，

those new vaccines,

they will make people healthier.

仍然會讓人類更健康。

They'll shrink the gap, the health equity gap,

它們可以縮小健康不平等的差距，

which is gigantic, between rich and poor countries.

富國和窮國之間的差距很巨大。

For example, we can detect more HIV cases and do a better job of treatment.

例如，我們能偵測到 更多愛滋個案，更好地治療；

We can reduce deaths from malaria.

我們能降低瘧疾的死亡人數；

We can get more people high-quality care.

我們能讓更多人獲得高品質的照護。

And so this is not just a downer

所以這不只是 消極地防止事情變得更糟，

about how to stop things from getting worse,

but also a chance to make things better.

還是一個讓事情更好的機會。

If we take the right steps,

如果我們採取正確的行動，

we can make COVID-19 the last pandemic,

就能讓新冠病毒 成為最後一次大流行，

and we can build a healthier, more equitable world for everyone.

我們就可以為所有人 建立更健康公平的世界。

Thank you.

謝謝你們。

(Applause)

（掌聲）

Helen Walters: Thank you so much.

海倫‧華特斯：非常感謝您。

I have a few follow-up questions

我有幾個後續的問題，

and one is really about the formal status of GERM.

其中一個和 GERM 的 正式地位非常有關。

So you mentioned this would cost a billion dollars,

您提到這會花費 300 億元，

you mentioned it comes through the WHO,

您提到這會由世界衛生組織來實踐，

but exactly who's running this, how does this work,

但具體上誰負責營運？ 它怎麼運作？

how do we make this happen?

我們要怎麼實現它？

BG: Well, GERM does not exist.

比：嗯， GERM 並不存在。

It's a proposal I'm putting forward that hopefully over the next year,

它是我的一項提議，

希望可以趁著明年 大家還記得疫情的傷痛，

while the pain of the pandemic is still clear in people's minds,

will get a global consensus.

能得到全球性的共識。

The rich-world governments will have to step up

富國的政府就會必須採取行動，

like they do with all the aid things and come up with that money.

就像他們在援助窮國時一樣， 並拿出所需的款項。

The way the personnel systems works, so that it's under WHO,

考慮到人事部門的運作方式， GERM 隸屬於世界衛生組織，

but a really top-notch team,

但它是一個一流的團隊，

there will be a lot of debate about how to do that well.

需要很多討論才能知道怎麼做得好。

So, you know, I'm putting it forward

所以我將它提出來，

and hopefully within the next year we'll get that consensus.

希望明年我們就能取得共識。

HW: Who do you need to pick that up next?

海：你需要誰來承擔這項任務？

BG: Well, it's really the rich-world governments.

比：那很需要富國的政府。

The WHO has this big yearly meeting, the World Health Assembly,

世界衛生組織每年舉辦 盛大的世界衛生大會，

and at some point somebody will put forward a resolution

未來的某個時間點 將會有人提出解方，

and we'll see if the extra resources can be put in for that.

我們就觀察能否 有更多資源投入其中。

After World War II, we did a lot.

第二次世界大戰後，我們做了很多。

You know, we created the United Nations, we talked a lot about war.

我們創立聯合國， 討論很多關於戰爭的事。

So I'd be stunned, although, you know,

所以雖然目前的行動 仍然少於我的預期，

so far the action has been less than I would have expected,

I'd be stunned if we don't go forward with something pretty close

但若未朝類似我所描述的方向前進， 我還是會很訝異。

to what I'm laying out there.

HW: This has been pretty personal for you.

海：這是一道個人意見的問題。

You know, the anti-vaxxers are out there, they are loud,

你知道，有反疫苗人士， 他們聲量很大，

and this has become personal.

所以這變得很個人。

I just wanted to ask, like, how are you managing that?

我只是想問，你會怎麼處理？

BG: Well, it's kind of weird.

比：嗯，這有點詭異。

(Laughter)

（笑聲）

(Applause)

（掌聲）

Now, our foundation, the Gates Foundation, is very involved in vaccines,

現在我們的蓋茲基金會 對疫苗有很多投入，

the invention of new vaccines, funding vaccines.

支持新疫苗的發明、資助疫苗。

And we're very proud that through joint efforts like GAVI,

我們很自豪在共同努力下， 例如全球疫苗免疫聯盟，

that saved tens of millions of lives.

拯救了幾千萬條生命。

So it's somewhat ironic to have somebody turn around and say, no, you know,

因此很諷刺的是有人說不是這回事，

we're using vaccines to kill people or to make money or, you know,

說我們用疫苗殺人或賺錢，

說我們挑起了疫情，

we started the pandemic,

even some strange things like, that I somehow want to track, you know,

還有更怪異的 說我想要追蹤人們的位置，

the location of individuals

because I'm so deeply desirous to know where everybody is.

因為我深深渴望知道大家在哪裡。

(Laughter)

（笑聲）

I'm not sure what I'm going to do with that information.

我不知道拿那些位置資訊做什麼。

(Laughter)

（笑聲）

You know, does this turn into something where, you know,

難道會一直有瘋狂的人出現嗎？

there's constantly crazy people showing up?

Who knows?

誰知道？

But, you know, hopefully, as the pandemic calms down,

希望隨著疫情降溫，

people are more rational about, hey,

人們變得更為理智，

vaccines are a miracle and there's a lot more we can do.

知道疫苗是一個奇跡， 以及我們還有很多事可做。

HW: So the future is in our hands in the present.

海：所以此刻未來正在我們手中。

Bill Gates, thank you so much for being here.

比爾‧蓋茲，非常感謝您來到這裡。

BG: Thank you.

比：謝謝你。

(Applause)

（掌聲）