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When I was a kid, the disaster we worried about most was a nuclear war.
當我還是個孩子的時候，我們最擔心的災難是核戰爭。
That's why we had a barrel like this down in our basement, filled with cans of food and water.
這就是為什麼我們在地下室有這樣一個桶，裝滿了罐頭食品和水。
When the nuclear attack came, we were supposed to go downstairs, hunker down, and eat out of that barrel.
當核攻擊來臨時，我們應該下樓，蹲下，從那個桶裡吃東西。
Today the greatest risk of global catastrophe doesn't look like this.
今天全球災難的最大風險看起來不像這樣。
Instead, it looks like this.
相反，它看起來像這樣。
If anything kills over 10 million people in the next few decades, it's most likely to be a highly infectious virus rather than a war.
如果未來幾十年有什麼會殺死超過 1000 萬人，最有可能是一種高度傳染性的病毒，而不是戰爭。
Not missiles, but microbes.
不是導彈，而是微生物。
Now, part of the reason for this is that we've invested a huge amount in nuclear deterrents.
現在，部分原因是我們在核威懾上投入了大量資金。
But we've actually invested very little in a system to stop an epidemic.
但我們實際上在阻止流行病的系統上投資很少。
We're not ready for the next epidemic.
我們還沒有為下一次流行病做好準備。
Let's look at Ebola.
讓我們看看伊波拉。
I'm sure all of you read about it in the newspaper, lots of tough challenges.
我相信你們都在報紙上讀到過它，有很多艱難的挑戰。
I followed it carefully through the case analysis tools we use to track polio eradication.
我通過我們用來追蹤小兒麻痺症根除的病例分析工具仔細跟蹤了它。
And as you look at what went on, the problem wasn't that there was a system that didn't work well enough, the problem was that we didn't have a system at all.
當你看到發生了什麼時，問題不是有一個運作不夠好的系統，問題是我們根本沒有系統。
In fact, there's some pretty obvious key missing pieces.
事實上，有一些非常明顯的關鍵缺失部分。
We didn't have a group of epidemiologists ready to go, who would have gone, seen what the disease was, seen how far it had spread.
我們沒有一組準備好的流行病學家，他們本應該去，看看疾病是什麼，看看它傳播了多遠。
The case reports came in on paper.
病例報告是用紙張提交的。
It was very delayed before they were put online and they were extremely inaccurate.
在它們上網之前延遲很長，而且極不準確。
We didn't have a medical team ready to go.
我們沒有一支準備好的醫療團隊。
We didn't have a way of preparing people.
我們沒有準備人員的方法。
Now, Médecins Sans Frontières did a great job orchestrating volunteers.
現在，無國界醫生在組織志願者方面做得很好。
But even so, we were far slower than we should have been getting the thousands of workers into these countries.
但即便如此，我們將數千名工作人員送入這些國家的速度遠比應該的要慢。
And a large epidemic would require us to have hundreds of thousands of workers.
大規模流行病需要我們有數十萬名工作人員。
There was no one there to look at treatment approaches.
沒有人在那裡研究治療方法。
No one to look at the diagnostics.
沒有人研究診斷方法。
No one to figure out what tools should be used.
沒有人弄清楚應該使用什麼工具。
As an example, we could have taken the blood of survivors, processed it, and put that plasma back in people to protect them.
例如，我們本可以取倖存者的血液，處理它，然後將血漿放回人們體內以保護他們。
But that was never tried.
但這從未嘗試過。
So there was a lot that was missing.
所以有很多缺失的東西。
And these things are really a global failure.
這些事情真的是全球性的失敗。
The WHO is funded to monitor epidemics, but not to do these things I talked about.
WHO 的資金用於監測流行病，但不是用於做我談到的這些事情。
Now, in the movies it's quite different.
現在，在電影中情況完全不同。
There's a group of handsome epidemiologists ready to go, they move in, they save the day, but that's just pure Hollywood.
有一群英俊的流行病學家準備出發，他們進駐，他們拯救了這一天，但這只是純粹的好萊塢。
The failure to prepare could allow the next epidemic to be dramatically more devastating than Ebola Let's look at the progression of Ebola over this year.
準備的失敗可能使下一次流行病比伊波拉更具破壞性。讓我們看看今年伊波拉的進展。
About 10,000 people died, and nearly all were in the three West African countries.
約有 10,000 人死亡，幾乎所有人都在三個西非國家。
There's three reasons why it didn't spread more.
有三個原因為什麼它沒有傳播得更廣。
The first is that there was a lot of heroic work by the health workers.
首先是衛生工作人員做了很多英勇的工作。
They found the people and they prevented more infections.
他們找到了人們，並防止了更多感染。
The second is the nature of the virus.
第二是病毒的性質。
Ebola does not spread through the air.
伊波拉不會通過空氣傳播。
And by the time you're contagious, most people are so sick that they're bedridden.
當你具有傳染性時，大多數人都病得很重，以至於臥床不起。
Third, it didn't get into many urban areas.
第三，它沒有進入許多城市地區。
And that was just luck.
那只是運氣。
If it had gotten into a lot more urban areas, the case numbers would have been much larger.
如果它進入更多城市地區，病例數會大得多。
So next time, we might not be so lucky.
所以下次，我們可能不會這麼幸運。
You can have a virus where people feel well enough while they're infectious that they get on a plane or they go to a market.
你可能有一種病毒，人們在具有傳染性時感覺足夠好，以至於他們上飛機或去市場。
The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism.
病毒的來源可能是像伊波拉這樣的自然流行病，也可能是生物恐怖主義。
So there are things that would literally make things a thousand times worse.
所以有些事情會使情況惡化一千倍。
In fact, let's look at a model of a virus spread through the air, like the Spanish Flu back in 1918.
事實上，讓我們看看一個通過空氣傳播的病毒模型，比如 1918 年的西班牙流感。
So here's what would happen: It would spread throughout the world very, very quickly.
所以這會發生什麼：它會非常、非常快速地傳播到全世界。
And you can see over 30 million people died from that epidemic.
你可以看到超過 3000 萬人死於那次流行病。
So this is a serious problem.
所以這是一個嚴重的問題。
We should be concerned.
我們應該擔心。
But in fact, we can build a really good response system.
但事實上，我們可以建立一個非常好的應對系統。
We have the benefits of all the science and technology that we talk about here.
我們擁有我們在這裡談論的所有科學和技術的好處。
We've got cell phones to get information from the public and get information out to them.
我們有手機從公眾那裡獲取資訊並向他們傳遞資訊。
We have satellite maps where we can see where people are and where they're moving.
我們有衛星地圖，可以看到人們在哪裡以及他們在哪裡移動。
We have advances in biology that should dramatically change the turnaround time to look at a pathogen and be able to make drugs and vaccines that fit for that pathogen.
我們在生物學方面取得了進展，應該會大幅改變研究病原體並能夠製造適合該病原體的藥物和疫苗的週轉時間。
So we can have tools, but those tools need to be put into an overall global health system.
所以我們可以有工具，但這些工具需要納入整體的全球衛生系統。
And we need preparedness.
我們需要準備。
The best lessons, I think, on how to get prepared are again, what we do for war.
我認為，關於如何準備的最佳教訓再次是我們為戰爭所做的。
For soldiers, we have full-time, waiting to go.
對於士兵，我們有全職人員，等待出發。
We have reserves that can scale us up to large numbers.
我們有後備力量，可以擴展到大量人員。
NATO has a mobile unit that can deploy very rapidly.
NATO 有一個可以非常快速部署的機動單位。
NATO does a lot of war games to check, are people well trained?
NATO 進行很多戰爭遊戲來檢查，人們是否訓練有素？
Do they understand about fuel and logistics and the same radio frequencies?
他們是否了解燃料、後勤和相同的無線電頻率？
So they are absolutely ready to go.
所以他們絕對準備出發。
So those are the kinds of things we need to deal with an epidemic.
所以這些是我們需要應對流行病的那種事情。
What are the key pieces?
關鍵部分是什麼？
First, we need strong health systems in poor countries.
首先，我們需要在貧窮國家建立強大的衛生系統。
That's where mothers can give birth safely, kids can get all their vaccines.
在那裡，母親可以安全分娩，孩子可以接種所有疫苗。
But, also where we'll see the outbreak very early on.
但是，也是我們會很早看到爆發的地方。
We need a medical reserve corps: lots of people who've got the training and background who are ready to go, with the expertise.
我們需要一個醫療後備隊：很多有訓練和背景、準備出發、有專業知識的人。
And then we need to pair those medical people with the military.
然後我們需要將這些醫療人員與軍隊配對。
taking advantage of the military's ability to move fast, do logistics and secure areas.
利用軍隊快速移動、進行後勤和保護地區的能力。
We need to do simulations, germ games, not war games, so that we see where the holes are.
我們需要進行模擬，細菌遊戲，而不是戰爭遊戲，這樣我們才能看到漏洞在哪裡。
The last time a germ game was done in the United States was back in 2001, and it didn't go so well.
美國最後一次進行細菌遊戲是在 2001 年，進展並不順利。
So far the score is germs: 1, people: 0.
到目前為止，比分是細菌：1，人類：0。
Finally, we need lots of advanced R&D in areas of vaccines and diagnostics.
最後，我們需要在疫苗和診斷領域進行大量先進的研發。
There are some big breakthroughs, like the Adeno-associated virus, that could work very, very quickly.
有一些重大突破，比如腺相關病毒，可以非常、非常快速地工作。
Now I don't have an exact budget for what this would cost, but I'm quite sure it's very modest compared to the potential harm.
現在我沒有確切的預算來計算這會花費多少，但我很確定與潛在危害相比，這是非常適度的。
The World Bank estimates that if we have a worldwide flu epidemic, global wealth will go down by over three trillion dollars and we'd have millions and millions of deaths.
世界銀行估計，如果我們發生全球性流感流行病，全球財富將下降超過三兆美元，我們將有數百萬人死亡。
These investments offer significant benefits beyond just being ready for the epidemic.
這些投資提供了重大好處，不僅僅是為流行病做好準備。
The primary healthcare, the R&D, those things would reduce global health equity and make the world more just as well as more safe.
初級醫療保健、研發，這些事情會減少全球衛生公平，使世界更加公正和安全。
So I think this should absolutely be a priority.
所以我認為這絕對應該是一個優先事項。
There's no need to panic.
沒有必要恐慌。
We don't have to hoard cans of spaghetti or go down into the basement.
我們不必囤積義大利麵罐頭或下到地下室。
But we need to get going, because time is not on our side.
但我們需要開始行動，因為時間不在我們這邊。
In fact, if there's one positive thing that can come out of the Ebola epidemic, it's that it can serve as an early warning, a wake-up call, to get ready.
事實上，如果伊波拉流行病能帶來一件積極的事情，那就是它可以作為早期警告、警鐘，讓我們做好準備。
If we start now, we can be ready for the next epidemic.
如果我們現在開始，我們可以為下一次流行病做好準備。
點擊句子跳轉到對應位置
When I was a kid, the disaster we worried about most was a nuclear war.
當我還是個孩子的時候，我們最擔心的災難是核戰爭。
That's why we had a barrel like this down in our basement, filled with cans of food and water.
這就是為什麼我們在地下室有這樣一個桶，裝滿了罐頭食品和水。
When the nuclear attack came, we were supposed to go downstairs, hunker down, and eat out of that barrel.
當核攻擊來臨時，我們應該下樓，蹲下，從那個桶裡吃東西。
Today the greatest risk of global catastrophe doesn't look like this.
今天全球災難的最大風險看起來不像這樣。
Instead, it looks like this.
相反，它看起來像這樣。
If anything kills over 10 million people in the next few decades, it's most likely to be a highly infectious virus rather than a war.
如果未來幾十年有什麼會殺死超過 1000 萬人，最有可能是一種高度傳染性的病毒，而不是戰爭。
Not missiles, but microbes.
不是導彈，而是微生物。
Now, part of the reason for this is that we've invested a huge amount in nuclear deterrents.
現在，部分原因是我們在核威懾上投入了大量資金。
But we've actually invested very little in a system to stop an epidemic.
但我們實際上在阻止流行病的系統上投資很少。
We're not ready for the next epidemic.
我們還沒有為下一次流行病做好準備。
Let's look at Ebola.
讓我們看看伊波拉。
I'm sure all of you read about it in the newspaper, lots of tough challenges.
我相信你們都在報紙上讀到過它，有很多艱難的挑戰。
I followed it carefully through the case analysis tools we use to track polio eradication.
我通過我們用來追蹤小兒麻痺症根除的病例分析工具仔細跟蹤了它。
And as you look at what went on, the problem wasn't that there was a system that didn't work well enough, the problem was that we didn't have a system at all.
當你看到發生了什麼時，問題不是有一個運作不夠好的系統，問題是我們根本沒有系統。
In fact, there's some pretty obvious key missing pieces.
事實上，有一些非常明顯的關鍵缺失部分。
We didn't have a group of epidemiologists ready to go, who would have gone, seen what the disease was, seen how far it had spread.
我們沒有一組準備好的流行病學家，他們本應該去，看看疾病是什麼，看看它傳播了多遠。
The case reports came in on paper.
病例報告是用紙張提交的。
It was very delayed before they were put online and they were extremely inaccurate.
在它們上網之前延遲很長，而且極不準確。
We didn't have a medical team ready to go.
我們沒有一支準備好的醫療團隊。
We didn't have a way of preparing people.
我們沒有準備人員的方法。
Now, Médecins Sans Frontières did a great job orchestrating volunteers.
現在，無國界醫生在組織志願者方面做得很好。
But even so, we were far slower than we should have been getting the thousands of workers into these countries.
但即便如此，我們將數千名工作人員送入這些國家的速度遠比應該的要慢。
And a large epidemic would require us to have hundreds of thousands of workers.
大規模流行病需要我們有數十萬名工作人員。
There was no one there to look at treatment approaches.
沒有人在那裡研究治療方法。
No one to look at the diagnostics.
沒有人研究診斷方法。
No one to figure out what tools should be used.
沒有人弄清楚應該使用什麼工具。
As an example, we could have taken the blood of survivors, processed it, and put that plasma back in people to protect them.
例如，我們本可以取倖存者的血液，處理它，然後將血漿放回人們體內以保護他們。
But that was never tried.
但這從未嘗試過。
So there was a lot that was missing.
所以有很多缺失的東西。
And these things are really a global failure.
這些事情真的是全球性的失敗。
The WHO is funded to monitor epidemics, but not to do these things I talked about.
WHO 的資金用於監測流行病，但不是用於做我談到的這些事情。
Now, in the movies it's quite different.
現在，在電影中情況完全不同。
There's a group of handsome epidemiologists ready to go, they move in, they save the day, but that's just pure Hollywood.
有一群英俊的流行病學家準備出發，他們進駐，他們拯救了這一天，但這只是純粹的好萊塢。
The failure to prepare could allow the next epidemic to be dramatically more devastating than Ebola Let's look at the progression of Ebola over this year.
準備的失敗可能使下一次流行病比伊波拉更具破壞性。讓我們看看今年伊波拉的進展。
About 10,000 people died, and nearly all were in the three West African countries.
約有 10,000 人死亡，幾乎所有人都在三個西非國家。
There's three reasons why it didn't spread more.
有三個原因為什麼它沒有傳播得更廣。
The first is that there was a lot of heroic work by the health workers.
首先是衛生工作人員做了很多英勇的工作。
They found the people and they prevented more infections.
他們找到了人們，並防止了更多感染。
The second is the nature of the virus.
第二是病毒的性質。
Ebola does not spread through the air.
伊波拉不會通過空氣傳播。
And by the time you're contagious, most people are so sick that they're bedridden.
當你具有傳染性時，大多數人都病得很重，以至於臥床不起。
Third, it didn't get into many urban areas.
第三，它沒有進入許多城市地區。
And that was just luck.
那只是運氣。
If it had gotten into a lot more urban areas, the case numbers would have been much larger.
如果它進入更多城市地區，病例數會大得多。
So next time, we might not be so lucky.
所以下次，我們可能不會這麼幸運。
You can have a virus where people feel well enough while they're infectious that they get on a plane or they go to a market.
你可能有一種病毒，人們在具有傳染性時感覺足夠好，以至於他們上飛機或去市場。
The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism.
病毒的來源可能是像伊波拉這樣的自然流行病，也可能是生物恐怖主義。
So there are things that would literally make things a thousand times worse.
所以有些事情會使情況惡化一千倍。
In fact, let's look at a model of a virus spread through the air, like the Spanish Flu back in 1918.
事實上，讓我們看看一個通過空氣傳播的病毒模型，比如 1918 年的西班牙流感。
So here's what would happen: It would spread throughout the world very, very quickly.
所以這會發生什麼：它會非常、非常快速地傳播到全世界。
And you can see over 30 million people died from that epidemic.
你可以看到超過 3000 萬人死於那次流行病。
So this is a serious problem.
所以這是一個嚴重的問題。
We should be concerned.
我們應該擔心。
But in fact, we can build a really good response system.
但事實上，我們可以建立一個非常好的應對系統。
We have the benefits of all the science and technology that we talk about here.
我們擁有我們在這裡談論的所有科學和技術的好處。
We've got cell phones to get information from the public and get information out to them.
我們有手機從公眾那裡獲取資訊並向他們傳遞資訊。
We have satellite maps where we can see where people are and where they're moving.
我們有衛星地圖，可以看到人們在哪裡以及他們在哪裡移動。
We have advances in biology that should dramatically change the turnaround time to look at a pathogen and be able to make drugs and vaccines that fit for that pathogen.
我們在生物學方面取得了進展，應該會大幅改變研究病原體並能夠製造適合該病原體的藥物和疫苗的週轉時間。
So we can have tools, but those tools need to be put into an overall global health system.
所以我們可以有工具，但這些工具需要納入整體的全球衛生系統。
And we need preparedness.
我們需要準備。
The best lessons, I think, on how to get prepared are again, what we do for war.
我認為，關於如何準備的最佳教訓再次是我們為戰爭所做的。
For soldiers, we have full-time, waiting to go.
對於士兵，我們有全職人員，等待出發。
We have reserves that can scale us up to large numbers.
我們有後備力量，可以擴展到大量人員。
NATO has a mobile unit that can deploy very rapidly.
NATO 有一個可以非常快速部署的機動單位。
NATO does a lot of war games to check, are people well trained?
NATO 進行很多戰爭遊戲來檢查，人們是否訓練有素？
Do they understand about fuel and logistics and the same radio frequencies?
他們是否了解燃料、後勤和相同的無線電頻率？
So they are absolutely ready to go.
所以他們絕對準備出發。
So those are the kinds of things we need to deal with an epidemic.
所以這些是我們需要應對流行病的那種事情。
What are the key pieces?
關鍵部分是什麼？
First, we need strong health systems in poor countries.
首先，我們需要在貧窮國家建立強大的衛生系統。
That's where mothers can give birth safely, kids can get all their vaccines.
在那裡，母親可以安全分娩，孩子可以接種所有疫苗。
But, also where we'll see the outbreak very early on.
但是，也是我們會很早看到爆發的地方。
We need a medical reserve corps: lots of people who've got the training and background who are ready to go, with the expertise.
我們需要一個醫療後備隊：很多有訓練和背景、準備出發、有專業知識的人。
And then we need to pair those medical people with the military.
然後我們需要將這些醫療人員與軍隊配對。
taking advantage of the military's ability to move fast, do logistics and secure areas.
利用軍隊快速移動、進行後勤和保護地區的能力。
We need to do simulations, germ games, not war games, so that we see where the holes are.
我們需要進行模擬，細菌遊戲，而不是戰爭遊戲，這樣我們才能看到漏洞在哪裡。
The last time a germ game was done in the United States was back in 2001, and it didn't go so well.
美國最後一次進行細菌遊戲是在 2001 年，進展並不順利。
So far the score is germs: 1, people: 0.
到目前為止，比分是細菌：1，人類：0。
Finally, we need lots of advanced R&D in areas of vaccines and diagnostics.
最後，我們需要在疫苗和診斷領域進行大量先進的研發。
There are some big breakthroughs, like the Adeno-associated virus, that could work very, very quickly.
有一些重大突破，比如腺相關病毒，可以非常、非常快速地工作。
Now I don't have an exact budget for what this would cost, but I'm quite sure it's very modest compared to the potential harm.
現在我沒有確切的預算來計算這會花費多少，但我很確定與潛在危害相比，這是非常適度的。
The World Bank estimates that if we have a worldwide flu epidemic, global wealth will go down by over three trillion dollars and we'd have millions and millions of deaths.
世界銀行估計，如果我們發生全球性流感流行病，全球財富將下降超過三兆美元，我們將有數百萬人死亡。
These investments offer significant benefits beyond just being ready for the epidemic.
這些投資提供了重大好處，不僅僅是為流行病做好準備。
The primary healthcare, the R&D, those things would reduce global health equity and make the world more just as well as more safe.
初級醫療保健、研發，這些事情會減少全球衛生公平，使世界更加公正和安全。
So I think this should absolutely be a priority.
所以我認為這絕對應該是一個優先事項。
There's no need to panic.
沒有必要恐慌。
We don't have to hoard cans of spaghetti or go down into the basement.
我們不必囤積義大利麵罐頭或下到地下室。
But we need to get going, because time is not on our side.
但我們需要開始行動，因為時間不在我們這邊。
In fact, if there's one positive thing that can come out of the Ebola epidemic, it's that it can serve as an early warning, a wake-up call, to get ready.
事實上，如果伊波拉流行病能帶來一件積極的事情，那就是它可以作為早期警告、警鐘，讓我們做好準備。
If we start now, we can be ready for the next epidemic.
如果我們現在開始，我們可以為下一次流行病做好準備。