介绍： 1 The next outbreak? We're not ready
下一次疫情爆发？我们还没有准备好

TED：2015年3月
Speaker：Bill Gates ，比尔·盖茨，技术专家、慈善家

00:00
When I was a kid, the disaster we worried about most was a nuclear war. That's why we had a barrel like this down in our basement, filled with cans of food and water. ...

介绍： 1 The next outbreak? We're not ready
下一次疫情爆发？我们还没有准备好

TED：2015年3月
Speaker：Bill Gates ，比尔·盖茨，技术专家、慈善家

00:00
When I was a kid, the disaster we worried about most was a nuclear war. That's why we had a barrel like this down in our basement, filled with cans of food and water. When the nuclear attack came, we were supposed to go downstairs, hunker down, and eat out of that barrel.
当我还是小孩时, 我们最担心的灾害是核战争。所以我们在地下室有个这样的筒子，装满了罐头食物和水。当核战争爆发时，我们就要躲到地下室去，蹲低身子并靠那个筒子维生。

00:22
Today the greatest risk of global catastrophe doesn't look like this. Instead, it looks like this. 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. Not missiles, but microbes. Now, part of the reason for this is that we've invested a huge amount in nuclear deterrents. But we've actually invested very little in a system to stop an epidemic. We're not ready for the next epidemic.
今天全球灾难最大的危险看起来已不像这样了。事实上会像这样。如果有什么东西在未来几十年里可以杀掉上千万人，那比较有可能是个高度传染的病毒，而不是战争。不是导弹，而是微生物。部分的理由是因为我们在核威慑上投注了很大的精力和金钱。但是我们在防止疫情的系统上却投资很少。我们还没有准备好预防下一场大疫情的发生。

01:04
Let's look at Ebola. I'm sure all of you read about it in the newspaper, lots of tough challenges. I followed it carefully through the case analysis tools we use to track polio eradication. 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. In fact, there's some pretty obvious key missing pieces.
让我们看看埃博拉病毒。我相信大家在报纸上都有读到这样的新闻，充满了许多艰难的挑战。 用我们追踪消灭脊髓灰质炎（小儿麻痹）的案例分析工具， 我仔细地追踪这病毒的发展。随着疫情的发展我们可以看到，问题不在于我们没有一套可以使用的系统，而是我们根本没有任何系统。事实上我们可以看到有几个很明显的不足。

01:35
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. The case reports came in on paper. It was very delayed before they were put online and they were extremely inaccurate. We didn't have a medical team ready to go. We didn't have a way of preparing people. Now, Médecins Sans Frontières did a great job orchestrating volunteers. But even so, we were far slower than we should have been getting the thousands of workers into these countries. And a large epidemic would require us to have hundreds of thousands of workers. There was no one there to look at treatment approaches. No one to look at the diagnostics. No one to figure out what tools should be used. As an example, we could have taken the blood of survivors, processed it, and put that plasma back in people to protect them. But that was never tried.
我们找不到一群准备好了的流行病学家，能去疫区看看病理和病情发展。病例都是由纸上报道传来的。信息传上线时已经很晚了，此外还很不准确。我们也找不到训练有素的医护小组。 我们没有一套让人们严阵以待的方法。目前，“无国界医生”在动员志愿者上做了很大的贡献。但即使如此，我们调动数千名工作者到疫区的速度还是十分差强人意的。大的疫情会需要我们动员数十万的人员，但我们没有任何人在研究治疗的方向。也没有人在看诊断的方法。 没有人在想该用什么工具。举个例子来说，我们也许可以抽取生还者的血液，处理过后，再将血浆注入人体内来保护没得病的人。但是这个方法从来没有试过，

02:37
So there was a lot that was missing. And these things are really a global failure. The WHO is funded to monitor epidemics, but not to do these things I talked about. Now, in the movies it's quite different. There's a group of handsome epidemiologists ready to go, they move in, they save the day, but that's just pure Hollywood.
所以有很多事都还没来得及做。而这的确是全球性的失败。世界卫生组织的目的是来监视流行病，而不是来做我刚讲的事。但是在电影中演的剧情又是另一回事。有一群很英俊的流行病学家准备就绪，他们到了疫区拯救了大家，但这是纯好莱坞的剧情。

03:06
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. About 10,000 people died, and nearly all were in the three West African countries. There's three reasons why it didn't spread more. The first is that there was a lot of heroic work by the health workers. They found the people and they prevented more infections. The second is the nature of the virus. Ebola does not spread through the air. And by the time you're contagious, most people are so sick that they're bedridden. Third, it didn't get into many urban areas. And that was just luck. If it had gotten into a lot more urban areas, the case numbers would have been much larger.
我们的准备不足，可能会导致下一场疫情，比埃博拉病毒的危害更严重。让我们看看埃博拉病毒在过去一年中的发展。大约死了一万人，所有的死者都在西非的三个国家里。之所以没有扩散的原因有三个。第一个是卫生工作人员做的许多英雄事迹。他们找到很多病人并防止了更多人得病。第二个是病毒的特性，埃博拉病毒不是靠空气传染的。等到你有足够的传染力时，大部分的人已经病得卧床不起了。第三个是因为病毒没有传到都会区。这纯粹是运气好。如果病毒传到了都会区，那么死亡的人数绝对不止于此。

04:00
So next time, we might not be so lucky. 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. The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism. So there are things that would literally make things a thousand times worse.
所以下一次我们可能不会这么幸运了。有的病毒可能让你毫无察觉，但当感染病毒的人乘飞机或者去逛商场，他们其实已经具有一定的传染力了。此外病毒的来源可以是天然的，像埃博拉病毒，或是由生物恐怖攻击产生的。所以可以让疫情惨上千倍的病毒是存在的。