TEDxPlaceDesNations
Bruce Aylward: Humanity vs. Ebola. How we could win a terrifying war
布鲁斯•艾尔沃德: 人类对战埃博拉：骇人战争中的制胜法宝
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“埃博拉病毒威胁着我们的人性，”世界卫生组织的布鲁斯·艾尔沃德说。他用平静的手法带领我们重走埃博拉疫情爆发的过程 ﹣以及国际报警如何仅仅导致了问题以指数般增长。他分享四大关键性战略，以击败埃博拉病毒 ﹣ 以及它们是如何成功。这四大战略开始在利比理亚的洛法镇开始奏效，那是在爆发的中心，但已经几周内没有新的病例记录在案。布鲁斯·艾尔沃德强调，我们并未赢得对埃博拉病毒的斗争，但是如果我们做正确的事情，就能更乐观地看待我们的反击流行病的能力。
Bruce Aylward - Epidemiologist
As the Assistant Director-General of the World Health Organization’s Polio and Emergencies Cluster, Bruce Aylward works to ensure that polio stays under control and that the world is prepared to respond to health crises. Full bio
As the Assistant Director-General of the World Health Organization’s Polio and Emergencies Cluster, Bruce Aylward works to ensure that polio stays under control and that the world is prepared to respond to health crises. Full bio
Double-click the English transcript below to play the video.
00:12
When I was invited to give this talk
a couple of months ago,
a couple of months ago,
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几周前，我受邀来进行这场演讲时
00:17
we discussed a number
of titles with the organizers,
of titles with the organizers,
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我们与主办方探讨了几个题目
00:21
and a lot of different items were
kicked around and were discussed.
kicked around and were discussed.
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从各个角度考虑并讨论了
很多不同的可能性。
很多不同的可能性。
00:24
But nobody suggested this one,
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但没有人提议
“击败埃博拉”这个话题，
“击败埃博拉”这个话题，
00:26
and the reason for that
was two months ago,
was two months ago,
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而其原因正是在两个月前，
00:29
Ebola was escalating exponentially
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埃博拉病毒以指数般滋生，
00:32
and spreading over wider geographic areas
than we had ever seen,
than we had ever seen,
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蔓延到了前所未见的广大地区，
00:36
and the world was terrified,
concerned and alarmed
concerned and alarmed
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而全世界都为之惊恐、担忧、警惕，
00:40
by this disease, in a way we've not
seen in recent history.
seen in recent history.
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其紧张程度在近代历史上都不曾见到。
00:44
But today, I can stand here
and I can talk to you about beating Ebola
and I can talk to you about beating Ebola
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但今天，我能够站在这裡，
与大家讨论击败埃博拉这个话题，
与大家讨论击败埃博拉这个话题，
00:51
because of people
whom you've never heard of,
whom you've never heard of,
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多亏了那些你们从未听说过的人们，
00:54
people like Peter Clement, a Liberian
doctor who's working in Lofa County,
doctor who's working in Lofa County,
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比如彼特•克莱蒙德，
利比理亚洛法镇的一名医生，
利比理亚洛法镇的一名医生，
01:02
a place that many of you have
never heard of, probably, in Liberia.
never heard of, probably, in Liberia.
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你们当中许多人可能从未听说过
利比理亚的洛法镇。
利比理亚的洛法镇。
01:07
The reason that Lofa County
is so important
is so important
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洛法镇如此重要的原因
01:09
is because about five months ago,
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就是因为在大约五个月前，
01:12
when the epidemic was
just starting to escalate,
just starting to escalate,
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当埃博拉疫情刚刚开始蔓延时，
01:16
Lofa County was right at the center,
the epicenter of this epidemic.
the epicenter of this epidemic.
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洛法镇正是这场疫情的中心。
01:21
At that time, MSF
and the treatment center there,
and the treatment center there,
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那时，驻扎在那里的
无国界医生组织和治疗中心，
无国界医生组织和治疗中心，
01:25
they were seeing dozens of patients
every single day,
every single day,
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每天都要见到数十位病人，
01:28
and these patients, these communities
were becoming more and more terrified
were becoming more and more terrified
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而这些病人，这些社区
在变得愈发恐惧，
在变得愈发恐惧，
01:32
as time went by, with this disease
and what it was doing to their families,
and what it was doing to their families,
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随着时间流逝，这场疾病
给他们的家人带来了灭顶之灾，
给他们的家人带来了灭顶之灾，
01:36
to their communities,
to their children, to their relatives.
to their children, to their relatives.
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还有他们的社区，他们的孩子，
以及他们的亲戚。
以及他们的亲戚。
01:40
And so Peter Clement was charged with
driving that 12-hour-long rough road
driving that 12-hour-long rough road
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因此彼特•克莱蒙德卯足了劲，
在颠簸的公路上开了12个小时，
在颠簸的公路上开了12个小时，
01:45
from Monrovia, the capital,
up to Lofa County,
up to Lofa County,
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从利比理亚首都蒙洛威尔
开到了洛法镇，
开到了洛法镇，
01:49
to try and help bring control
to the escalating epidemic there.
to the escalating epidemic there.
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他要试着帮助控制
正在此逐渐蔓延的疫情。
正在此逐渐蔓延的疫情。
01:53
And what Peter found when he arrived was
the terror that I just mentioned to you.
the terror that I just mentioned to you.
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而彼特到达洛法镇时，
发现了我之前提到的恐慌。
发现了我之前提到的恐慌。
01:59
So he sat down with the local chiefs,
and he listened.
and he listened.
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于是他和当地领袖们坐下，
聆听他们发言。
聆听他们发言。
02:03
And what he heard was heartbreaking.
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他听到的是令人心碎的消息。
02:07
He heard about the devastation
and the desperation
and the desperation
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他听说了那些灭顶之灾，
以及受埃博拉感染的人们
有多么绝望。
有多么绝望。
02:11
of people affected by this disease.
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02:14
He heard the heartbreaking stories
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他听说了那些令人心碎的故事，
02:16
about not just the damage
that Ebola did to people,
that Ebola did to people,
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不仅仅是关于埃博拉对人们
所造成的破坏，
所造成的破坏，
02:20
but what it did to families
and what it did to communities.
and what it did to communities.
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还有它对家庭、社区造成的影响。
02:24
And he listened to the local chiefs there
and what they told him --
and what they told him --
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他听着当地领袖们诉说的故事，
02:29
They said, "When our children are sick,
when our children are dying,
when our children are dying,
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他们说：“当我们的孩子生病时，
当我们的孩子正在死去，
当我们的孩子正在死去，
02:32
we can't hold them at a time when
we want to be closest to them.
we want to be closest to them.
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我们在最想靠近他们的时刻
却不能保住他们。
却不能保住他们。
02:36
When our relatives die, we can't take care
of them as our tradition demands.
of them as our tradition demands.
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当我们的亲人死去，我们无法
像传统惯例般照料他们的遗体。
像传统惯例般照料他们的遗体。
02:41
We are not allowed to wash
the bodies to bury them
the bodies to bury them
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我们被禁止洗梳他们的身体，
为他们下葬，
为他们下葬，
02:43
the way our communities and
our rituals demand.
our rituals demand.
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正如我们的社区和惯例
所要求的那样。
所要求的那样。
02:47
And for this reason, they were
deeply disturbed, deeply alarmed
deeply disturbed, deeply alarmed
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正因如此，他们身心不宁，高度警惕，
02:50
and the entire epidemic
was unraveling in front of them.
was unraveling in front of them.
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而整场瘟疫就在他们面前拉开帷幕。
02:54
People were turning on the healthcare
workers who had come,
workers who had come,
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人们开始攻击那些
来到镇上的医务人员，
来到镇上的医务人员，
02:57
the heroes who had come to try
and help save the community,
and help save the community,
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那些来试着帮助拯救
这个社区的英雄们，
这个社区的英雄们，
03:00
to help work with the community,
and they were unable to access them.
and they were unable to access them.
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那些来与社区协作的英雄们，
让他们无法接近镇上的人。
让他们无法接近镇上的人。
03:05
And what happened then was
Peter explained to the leaders.
Peter explained to the leaders.
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接下来，彼特为当地领袖们
进行了解释。
进行了解释。
03:10
The leaders listened.
They turned the tables.
They turned the tables.
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领袖们聆听着。
他们扭转了局面。
他们扭转了局面。
03:13
And Peter explained what Ebola was.
He explained what the disease was.
He explained what the disease was.
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彼特解释了埃博拉病毒是什么。
他解释了这种疾病是怎么回事。
他解释了这种疾病是怎么回事。
03:16
He explained what it did
to their communities.
to their communities.
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他解释了埃博拉
对他们社区造成的影响。
对他们社区造成的影响。
03:19
And he explained that Ebola threatened
everything that made us human.
everything that made us human.
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然后他还解释了，
埃博拉病毒威胁着我们的人性。
埃博拉病毒威胁着我们的人性。
03:24
Ebola means you can't hold your children
the way you would in this situation.
the way you would in this situation.
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埃博拉意味着你不能在孩子们
奄奄一息时保住他们。
奄奄一息时保住他们。
03:28
You can't bury your dead
the way that you would.
the way that you would.
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你无法按照传统惯例安葬他们的遗体。
03:31
You have to trust these people
in these space suits to do that for you.
in these space suits to do that for you.
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你必须相信那些身着“太空服”的人，
相信他们会为你做这些事情。
相信他们会为你做这些事情。
03:35
And ladies and gentlemen, what
happened then was rather extraordinary:
happened then was rather extraordinary:
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女士们先生们，接下来发生的
相当非比寻常：
相当非比寻常：
03:39
The community and the health workers,
Peter, they sat down together
Peter, they sat down together
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整个社区和医护人员，还有彼特
一起坐了下来，
一起坐了下来，
03:42
and they put together a new plan
for controlling Ebola in Lofa County.
for controlling Ebola in Lofa County.
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他们共同规划了新方案，
以在洛法镇控制埃博拉病毒。
以在洛法镇控制埃博拉病毒。
03:47
And the reason that this is such
an important story, ladies and gentlemen,
an important story, ladies and gentlemen,
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而这个故事重要的原因，
女士们先生们，
女士们先生们，
03:51
is because today, this county, which is
right at the center of this epidemic
right at the center of this epidemic
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就在于今天，这个位于疫情中心的镇，
03:56
you've been watching,
you've been seeing in the newspapers,
you've been seeing in the newspapers,
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你一直在关注的疫情，
你一直在报纸上见到的疫情，
你一直在报纸上见到的疫情，
03:59
you've been seeing on
the television screens,
the television screens,
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你一直在电视屏幕上看到的疫情，
04:03
today Lofa County is nearly eight weeks
without seeing a single case of Ebola.
without seeing a single case of Ebola.
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在今天的洛法镇，已经有将近八周
没有新病例产生了。
没有新病例产生了。
04:09
(Applause)
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（掌声）
04:16
Now, this doesn't mean that
the job is done, obviously.
the job is done, obviously.
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显然，这并不意味着大功告成。
04:20
There's still a huge risk
that there will be additional cases there.
that there will be additional cases there.
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那里会产生更多病例的风险仍然很大。
04:23
But what it does teach us
is that Ebola can be beaten.
is that Ebola can be beaten.
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但这个故事教给我们的是
埃博拉病毒是能够被击败的。
埃博拉病毒是能够被击败的。
04:26
That's the key thing.
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那才是关键。
04:28
Even on this scale,
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甚至是在这么大的规模下，
04:29
even with the rapid kind of growth
that we saw in this environment here,
that we saw in this environment here,
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甚至是以我们在这个环境中
所看到的这般蔓延速度，
所看到的这般蔓延速度，
04:33
we now know Ebola can be beaten.
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如今我们知道埃博拉是能被击败的。
04:36
When communities come together
with health care workers, work together,
with health care workers, work together,
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当社区聚到一起，再加上医护人员，
大家共同努力，
大家共同努力，
04:40
that's when this disease can be stopped.
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此时，这场疫情就能被终止。
04:43
But how did Ebola end up
in Lofa County in the first place?
in Lofa County in the first place?
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但埃博拉在最初是如何
在洛法镇出现的呢？
在洛法镇出现的呢？
04:47
Well, for that, we have to go back
12 months, to the start of this epidemic.
12 months, to the start of this epidemic.
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要回答这个问题，我们必须回到
12个月前，回到这场疫情的开端。
12个月前，回到这场疫情的开端。
04:51
And as many of you know,
this virus went undetected,
this virus went undetected,
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你们当中许多人都知道，
这种病毒当时没有被检测到，
这种病毒当时没有被检测到，
04:55
it evaded detection for three
or four months when it began.
or four months when it began.
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疫情爆发前，这个病毒
已经潜伏了三到四个月。
已经潜伏了三到四个月。
04:59
That's because this is not
a disease of West Africa,
a disease of West Africa,
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那是因为埃博拉并非西非的疾病，
05:01
it's a disease of Central Africa,
half a continent away.
half a continent away.
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而是来自相距半块大陆之远的中非。
05:04
People hadn't seen the disease before;
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人们之前从未见过这种病；
05:06
health workers hadn't seen
the disease before.
the disease before.
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医护人员之前也从未见过这种病。
05:09
They didn't know what
they were dealing with,
they were dealing with,
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他们不知道自己面对的是什么，
05:11
and to make it
even more complicated,
even more complicated,
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而令事情更为复杂的是，
05:13
the virus itself was causing a symptom,
a type of a presentation
a type of a presentation
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病毒本身引起了一种症状，
一种这种病非典型的表现。
05:18
that wasn't classical of the disease.
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05:20
So people didn't even recognize
the disease, people who knew Ebola.
the disease, people who knew Ebola.
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所以知道埃博拉的人
也并未认出这种疾病。
也并未认出这种疾病。
05:24
For that reason it evaded detection
for some time,
for some time,
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由于这个原因，它潜伏了一段时间。
05:28
But contrary to public belief
sometimes these days,
sometimes these days,
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但与如今公众所相信的
恰恰相反的是，
恰恰相反的是，
05:31
once the virus was detected,
there was a rapid surge in of support.
there was a rapid surge in of support.
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当病毒被检测到时，
有一大批支援涌入了疫情中心。
有一大批支援涌入了疫情中心。
05:37
MSF rapidly set up an Ebola treatment
center, as many of you know, in the area.
center, as many of you know, in the area.
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无国界医生组织在这片地区
迅速设置起了埃博拉治疗中心。
迅速设置起了埃博拉治疗中心。
05:42
The World Health Organization
and the partners that it works with
and the partners that it works with
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世界卫生组织和其合作伙伴们
05:45
deployed eventually hundreds of people
over the next two months
over the next two months
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在接下来的两个月内
逐步部署了几百人，
逐步部署了几百人，
05:49
to be able to help track the virus.
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以帮助追踪病情的发展。
05:51
The problem, ladies and gentlemen,
is by then, this virus,
is by then, this virus,
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问题是，女士们先生们，
当时这个病毒，
当时这个病毒，
05:55
well known now as Ebola,
had spread too far.
had spread too far.
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这个如今以“埃博拉”之名
闻名于世的病毒，早已蔓延开来。
闻名于世的病毒，早已蔓延开来。
05:59
It had already outstripped what was
one of the largest responses
one of the largest responses
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它的规模早已超越了当时
为埃博拉爆发所做出的最大准备。
为埃博拉爆发所做出的最大准备。
06:02
that had been mounted so far
to an Ebola outbreak.
to an Ebola outbreak.
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06:06
By the middle of the year,
not just Guinea
not just Guinea
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年中时，不仅仅是几内亚，
06:08
but now Sierra Leone and Liberia
were also infected.
were also infected.
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还有塞拉利昂和利比理亚也遭受感染。
06:12
As the virus was spreading geographically,
the numbers were increasing
the numbers were increasing
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随着病毒大面积扩散，
受感染人数不断增加，
受感染人数不断增加，
06:17
and at this time, not only were
hundreds of people infected
hundreds of people infected
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此时，不仅有几百人受到埃博拉感染，
06:22
and dying of the disease,
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并死于此病，
06:24
but as importantly,
the front line responders,
the front line responders,
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而且同样重要的是，
在前线抗争的响应者们，
在前线抗争的响应者们，
06:27
the people who had gone to try and help,
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那些来试着帮忙的人，
06:29
the health care workers, the other
responders
responders
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医护人员和其他响应者
06:33
were also sick and dying by the dozens.
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也有数十人因此病倒，
并死于埃博拉病毒。
并死于埃博拉病毒。
06:36
The presidents of these countries
recognized the emergencies.
recognized the emergencies.
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这些国家的总统
意识到了问题的紧急性。
意识到了问题的紧急性。
06:39
They met right around that time,
they agreed on common action
they agreed on common action
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他们就在那时进行了会见，
并一致同意共同采取行动，
并一致同意共同采取行动，
06:42
and they put together an emergency
joint operation center in Conakry
joint operation center in Conakry
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然后他们在柯那克里（几内亚首都）
成立了一个应急联合行动中心，
成立了一个应急联合行动中心，
06:46
to try and work together to finish this
disease and get it stopped,
disease and get it stopped,
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来试着通过合作消灭这场疾病，
阻止它的蔓延，
阻止它的蔓延，
06:51
to implement the strategies
we talked about.
we talked about.
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并执行我们探讨过的战略。
06:54
But what happened then was something
we had never seen before with Ebola.
we had never seen before with Ebola.
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但当时我们在埃博拉面前
所面临的情况是前所未见的。
所面临的情况是前所未见的。
06:58
What happened then was the virus,
or someone sick with the virus,
or someone sick with the virus,
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当时埃博拉病毒，或者是携带着
这个病毒的某个人，
这个病毒的某个人，
07:01
boarded an airplane,
flew to another country,
flew to another country,
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登上了飞机，飞到了另一个国家，
07:05
and for the first time,
we saw in another distant country
we saw in another distant country
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而有史以来第一次，
我们在另一个遥远的国度看到
我们在另一个遥远的国度看到
07:09
the virus pop up again.
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埃博拉病毒再度出现。
07:12
This time it was in Nigeria,
in the teeming metropolis of Lagos,
in the teeming metropolis of Lagos,
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这一次，是在尼日利亚，
在热闹的大都市拉各斯，
在热闹的大都市拉各斯，
07:16
21 million people.
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此处分布着两千一百万人口。
07:18
Now the virus was in that environment.
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病毒到了那样一个环境中。
07:21
And as you can anticipate,
there was international alarm,
there was international alarm,
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正如你所预计的，国际警报就此拉响，
07:24
international concern on a scale that
we hadn't seen in recent years
we hadn't seen in recent years
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引发了一场我们近年来都不曾见到的
大规模国际性关注，
大规模国际性关注，
07:28
caused by a disease like this.
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正是由这样的一场疾病所导致的。
07:31
The World Health Organization immediately
called together an expert panel,
called together an expert panel,
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世界卫生组织立即召集了
一只专家小组，
一只专家小组，
07:35
looked at the situation,
declared an international emergency.
declared an international emergency.
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研究了当下情况，并宣布
这是一场国际性紧急状况。
这是一场国际性紧急状况。
07:39
And in doing so, the expectation would be
that there would be a huge outpouring
that there would be a huge outpouring
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这样做的预期是之后会涌现一大批
07:44
of international assistance
to help these countries
to help these countries
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国际援助，来帮助这些国家，
07:47
which were in so much trouble
and concern at that time.
and concern at that time.
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他们深陷埃博拉的泥潭，
当时十分担忧自己的处境。
当时十分担忧自己的处境。
07:51
But what we saw was
something very different.
something very different.
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但我们所见到的却十分不同。
07:54
There was some great response.
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反响十分强烈。
07:58
A number of countries came to assist --
many, many NGOs and others, as you know,
many, many NGOs and others, as you know,
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许多国家前来支援 ﹣ 许多许多
非政府组织，正如你所了解的，
非政府组织，正如你所了解的，
08:02
but at the same time, the opposite
happened in many places.
happened in many places.
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但与此同时，恰恰相反的回应
在许多地区也在发生。
在许多地区也在发生。
08:06
Alarm escalated, and very soon
these countries found themselves
these countries found themselves
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警报逐步升级，很快这些国家
发现自己没有收到他们所需的援助，
发现自己没有收到他们所需的援助，
08:10
not receiving the support they needed,
but increasingly isolated.
but increasingly isolated.
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反而变得愈发孤立。
08:14
What we saw was commercial airlines
started flying into these countries
started flying into these countries
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我们见到商业航线
开始飞入这些国家，
开始飞入这些国家，
08:19
and people who hadn't even been
exposed to the virus
exposed to the virus
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而那些甚至没有接触过
埃博拉病毒的人们
埃博拉病毒的人们
08:22
were no longer allowed to travel.
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被禁止旅行。
08:24
This cause not only problems, obviously,
for the countries themselves,
for the countries themselves,
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很显然，这不仅为
那些国家本身引起了问题，
那些国家本身引起了问题，
08:28
but also for the response.
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还对援助回应造成了麻烦。
08:30
Those organizations that were
trying to bring people in,
trying to bring people in,
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那些正试着将人带入这些国家的组织，
08:33
to try and help them
respond to the outbreak,
respond to the outbreak,
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那些想要帮助他们响应
埃博拉病毒爆发的组织，
埃博拉病毒爆发的组织，
08:35
they could not get
people on airplanes,
people on airplanes,
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他们无法将人送上飞机，
08:37
they could not get them into the
countries to be able to respond.
countries to be able to respond.
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无法将人带入那些国家，
以对埃博拉进行响应。
以对埃博拉进行响应。
08:40
In that situation,
ladies and gentleman,
ladies and gentleman,
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在那样的情况下，女士们先生们，
08:42
a virus like Ebola takes advantage.
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像埃博拉这样的病毒就会趁虚而入。
08:45
And what we saw then was something
also we hadn't seen before.
also we hadn't seen before.
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我们所面临的局面前所未见。
08:50
Not only did this virus
continue in the places
continue in the places
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埃博拉病毒不仅仅
在这些地方继续存在，
在这些地方继续存在，
08:53
where they'd already become infected,
but then it started to escalate
but then it started to escalate
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而这些地方的人已经受到感染，
然后病毒开始升级，
然后病毒开始升级，
08:57
and we saw the case numbers
that you see here,
that you see here,
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而我们也看到了
你们在这里所见到的病例数量，
你们在这里所见到的病例数量，
08:59
something we'd never seen before
on such a scale,
on such a scale,
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这种规模是前所未见的，
09:02
an exponential increase of Ebola cases
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埃博拉病例以指数般增长，
09:05
not just in these countries or the areas
already infected in these countries
already infected in these countries
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不仅仅是在这些国家
或是这些国家中已受感染的地区，
或是这些国家中已受感染的地区，
09:10
but also spreading further and
deeper into these countries.
deeper into these countries.
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并且它在这些国家扩散得更广更深。
09:14
Ladies and gentleman,
this was one of the most concerning
this was one of the most concerning
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女士们先生们，
这是我们所见过的最令人担忧的
国际性公共健康紧急状况之一。
国际性公共健康紧急状况之一。
09:17
international emergencies in public health
we've ever seen.
we've ever seen.
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09:22
And what happened in these countries then,
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而之后在这些国家发生的事情，
09:24
many of you saw, again, on the television,
read about in the newspapers,
read about in the newspapers,
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正如你们许多人在电视上所看到的，
或是在报纸上所读到的，
或是在报纸上所读到的，
09:28
we saw the health system start to collapse
under the weight of this epidemic.
under the weight of this epidemic.
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这些国家的健康体系开始崩溃，
不堪这场流行病的重压。
不堪这场流行病的重压。
09:34
We saw the schools begin to close,
markets no longer started,
markets no longer started,
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学校开始关闭，市场不再开张，
09:38
no longer functioned the way
that they should in these countries.
that they should in these countries.
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也不再如往常般在这些国家运行。
09:42
We saw that misinformation and
misperceptions started to spread
misperceptions started to spread
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误报和误解在这些社区
开始以更快的速度流传，
开始以更快的速度流传，
09:46
even faster through the communities,
which became even more alarmed
which became even more alarmed
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令他们对局势变得愈发紧张。
09:49
about the situation.
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09:51
They started to recoil from those people
that you saw in those space suits,
that you saw in those space suits,
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他们开始疏远那些
被称为“身着太空服的人”，
被称为“身着太空服的人”，
09:55
as they call them,
who had come to help them.
who had come to help them.
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而那些人是来帮助当地社区的。
09:57
And then the situation
deteriorated even further.
deteriorated even further.
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然后局势进一步恶化。
10:00
The countries had to declare
a state of emergency.
a state of emergency.
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这些国家不得不宣告
本国处于紧急状况。
本国处于紧急状况。
10:03
Large populations needed to be quarantined
in some areas, and then riots broke out.
in some areas, and then riots broke out.
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这些地区的大量人口要被隔离，
然后骚乱便爆发了。
然后骚乱便爆发了。
10:08
It was a very, very terrifying situation.
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此时的局势非常非常可怕。
10:12
Around the world,
many people began to ask,
many people began to ask,
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在全球各地，许多人开始发问，
10:15
can we ever stop Ebola
when it starts to spread like this?
when it starts to spread like this?
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当埃博拉病毒开始如此疯狂扩散时，
我们还能阻止它吗？
我们还能阻止它吗？
10:19
And they started to ask, how well
do we really know this virus?
do we really know this virus?
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他们开始发问，我们对这个病毒
了解有多透彻呢？
了解有多透彻呢？
10:23
The reality is we don't know
Ebola extremely well.
Ebola extremely well.
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事实上，我们对埃博拉病毒
了解的并不多。
了解的并不多。
10:26
It's a relatively modern disease
in terms of what we know about it.
in terms of what we know about it.
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它是一种相对现代的疾病，
就我们所了解的而言。
就我们所了解的而言。
10:30
We've known the disease only for 40 years,
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我们知道这种病仅仅 40 年，
10:33
since it first popped up
in Central Africa in 1976.
in Central Africa in 1976.
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它第一次出现是在 1976 年的中非。
10:36
But despite that, we do know many things:
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但除此之外，我们的确知道许多事情：
10:39
We know that this virus
probably survives in a type of a bat.
probably survives in a type of a bat.
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我们知道这种病毒很有可能
存活于一种蝙蝠体内。
存活于一种蝙蝠体内。
10:44
We know that it probably enters
a human population
a human population
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我们知道它很有可能会
进入人类社会，
进入人类社会，
10:47
when we come in contact with a wild animal
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当我们接触受埃博拉感染
或是已遭受此病侵袭的野生动物时；
或是已遭受此病侵袭的野生动物时；
10:49
that has been infected with the virus
and probably sickened by it.
and probably sickened by it.
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3558
10:53
Then we know that the virus
spreads from person to person
spreads from person to person
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我们还知道这种病毒
在人与人之间的扩散
在人与人之间的扩散
10:56
through contaminated body fluids.
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是通过体液感染。
10:58
And as you've all seen,
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正如你们已经都见到的，
11:00
we know the horrific disease
that it then causes in humans,
that it then causes in humans,
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我们也知道这种病毒
在人体内所造成的可怕疾病，
在人体内所造成的可怕疾病，
11:03
where we see this disease cause
severe fevers, diarrhea, vomiting,
severe fevers, diarrhea, vomiting,
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这种疾病会导致
严重发热、腹泻、呕吐，
严重发热、腹泻、呕吐，
11:08
and then unfortunately, in 70 percent
of the cases or often more, death.
of the cases or often more, death.
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不幸的是，在超过70％的病例中，
患者会死亡。
患者会死亡。
11:14
This is a very dangerous,
debilitating, and deadly disease.
debilitating, and deadly disease.
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这是一种十分危险、令人逐步衰竭、
并且置人于死地的疾病。
并且置人于死地的疾病。
11:20
But despite the fact that we've not known
this disease for a particularly long time,
this disease for a particularly long time,
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然而，尽管我们了解
这种疾病的时间并不长，
这种疾病的时间并不长，
11:24
and we don't know everything about it,
we do know how to stop this disease.
we do know how to stop this disease.
185
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4877
也并没有了解它的一切，
但我们的确知道如何阻止埃博拉。
但我们的确知道如何阻止埃博拉。
11:29
There are four things
that are critical to stopping Ebola.
that are critical to stopping Ebola.
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有四件事对阻止埃博拉
是十分关键的。
是十分关键的。
11:32
First and foremost, the communities
have got to understand this disease,
have got to understand this disease,
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首先，社区必须要去理解这种疾病，
11:37
they've got to understand
how it spreads and how to stop it.
how it spreads and how to stop it.
188
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3521
他们必须要理解埃博拉
是如何扩散、如何阻止的。
是如何扩散、如何阻止的。
11:40
And then we've got to be able to have
systems that can find every single case,
systems that can find every single case,
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然后我们必须建立一个体系，
能够找到每一宗病例，
能够找到每一宗病例，
11:44
every contact of those cases,
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2006
以及那些病例的所有联系人，
11:46
and begin to track the transmission chains
so that you can stop transmission.
so that you can stop transmission.
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4157
并且开始追踪传播链，
这样才能阻止传播。
这样才能阻止传播。
11:50
We have to have treatment centers,
specialized Ebola treatment centers,
specialized Ebola treatment centers,
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我们必须要建立治疗中心，
专门研究埃博拉的治疗中心，
专门研究埃博拉的治疗中心，
11:54
where the workers can be protected
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2513
在那里，医疗工作者们能得到保护，
11:57
as they try to provide support
to the people who are infected,
to the people who are infected,
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4872
在他们努力为那些
受感染的人提供帮助时，
受感染的人提供帮助时，
12:01
so that they might survive the disease.
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2445
这样他们才能够活下来。
12:04
And then for those who do die,
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2200
而对于那些逝者，
12:06
we have to ensure there is a safe, but at
the same time dignified, burial process,
the same time dignified, burial process,
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5858
我们必须确保有一个安全
而又保有尊严的埋葬流程，
而又保有尊严的埋葬流程，
12:12
so that there is no spread
at that time as well.
at that time as well.
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以确保在此流程中
也不会造成病毒的扩散。
也不会造成病毒的扩散。
12:16
So we do know how to stop Ebola, and these
strategies work, ladies and gentlemen.
strategies work, ladies and gentlemen.
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4501
我们知道该如何阻止埃博拉，
而这些策略是有效的，女士们先生们。
而这些策略是有效的，女士们先生们。
12:21
The virus was stopped in Nigeria
by these four strategies
by these four strategies
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埃博拉病毒在尼日利亚
已经通过这四个策略被成功阻止，
已经通过这四个策略被成功阻止，
12:25
and the people implementing
them, obviously.
them, obviously.
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也多亏了执行这四个策略的人们，
这是当然的。
这是当然的。
12:27
It was stopped in Senegal, where it had
spread, and also in the other countries
spread, and also in the other countries
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4022
该病毒也在塞尔内加被阻止，
此前它一直在此扩散，
此前它一直在此扩散，
同时，其他在这次疫情爆发中
受感染的国家也阻止了埃博拉。
受感染的国家也阻止了埃博拉。
12:31
that were affected by this virus,
in this outbreak.
in this outbreak.
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3593
12:35
So there's no question that
these strategies actually work.
these strategies actually work.
204
743177
3841
因此，毋庸置疑，
这些策略的确奏效。
这些策略的确奏效。
12:39
The big question, ladies and gentlemen,
was whether these strategies could work
was whether these strategies could work
205
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5308
而最大的问题在于，女士们先生们，
这些策略是否能在这样的规模下，
这样的情况中奏效，
这样的情况中奏效，
12:44
on this scale, in this situation,
with so many countries affected
with so many countries affected
206
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已有这么多国家受到感染，
扩散的速度如你所见以指数增加。
扩散的速度如你所见以指数增加。
12:48
with the kind of exponential
growth that you saw.
growth that you saw.
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那就是我们在两到三个月前
所面临的大问题。
所面临的大问题。
12:52
That was the big question that we were
facing just two or three months ago.
facing just two or three months ago.
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4551
12:56
Today we know the answer to that question.
209
764757
4044
今天，我们知道了
解决这个问题的答案。
解决这个问题的答案。
13:01
And we know that answer
because of the extraordinary work
because of the extraordinary work
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而我们之所以知道答案，
就是因为一群人的杰出努力，
就是因为一群人的杰出努力，
13:03
of an incredible group of NGOs,
of governments, of local leaders,
of governments, of local leaders,
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包括一群了不起的非政府组织，
一群政府，当地领袖，
一群政府，当地领袖，
13:08
of U.N. agencies and many humanitarian
and other organizations
and other organizations
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联合国机构，以及
许多人道主义组织，
许多人道主义组织，
13:13
that came and joined the fight
to try and stop Ebola in West Africa.
to try and stop Ebola in West Africa.
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他们前来加入了阻止
埃博拉在西非扩散的抗争中。
埃博拉在西非扩散的抗争中。
13:17
But what had to be done there
was slightly different.
was slightly different.
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但在那里要完成的有稍许不同。
13:20
These countries took those strategies
I just showed you;
I just showed you;
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这些国家采取了我刚刚
为大家展示的那些策略；
为大家展示的那些策略；
13:23
the community engagement,
the case finding, contact tracing, etc.,
the case finding, contact tracing, etc.,
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社区联合，寻找病例，
追踪联系人，等等。
追踪联系人，等等。
13:28
and they turned them on their head.
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然后他们改变了策略。
13:30
There was so much disease,
they approached it differently.
they approached it differently.
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疾病已扩散得如此猖獗，
他们要用不同的手法来解决。
他们要用不同的手法来解决。
13:33
What they decided to do was they would
first try and slow down this epidemic
first try and slow down this epidemic
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他们决定先试试延缓
这场传染病的传播速度，
这场传染病的传播速度，
13:39
by rapidly building as many beds as
possible in specialized treatment centers
possible in specialized treatment centers
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通过在专治埃博拉的治疗中心
快速搭建儘可能多的床位，
快速搭建儘可能多的床位，
13:44
so that they could prevent the disease
from spreading from those were infected.
from spreading from those were infected.
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这样一来他们就能阻止疾病
从已感染的人身上扩散开来。
从已感染的人身上扩散开来。
13:49
They would rapidly build out
many, many burial teams
many, many burial teams
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他们会快速成立许多安葬队伍，
13:51
so that they could safely
deal with the dead,
deal with the dead,
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这样一来他们就能安全地
解决病人的尸体，
解决病人的尸体，
13:54
and with that, they would try
and slow this outbreak
and slow this outbreak
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从而减缓这场传染病的传播速度，
13:56
to see if it could actually then
be controlled using the classic approach
be controlled using the classic approach
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看看是否真的能够控制埃博拉扩散，
通过利用这种“寻找病例
和追踪联系人”的经典手法。
和追踪联系人”的经典手法。
14:00
of case finding and contact tracing.
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14:03
And when I went to West Africa
about three months ago,
about three months ago,
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当我三个月前去西非时，
14:06
when I was there
what I saw was extraordinary.
what I saw was extraordinary.
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我在那儿看到了一副超凡景象。
14:09
I saw presidents opening emergency
operation centers themselves against Ebola
operation centers themselves against Ebola
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我看到总统们亲自创立
紧急指挥中心以对抗埃博拉，
紧急指挥中心以对抗埃博拉，
14:14
so that they could personally coordinate
and oversee and champion
and oversee and champion
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如此一来他们就能够亲自
协调、监督、支持
协调、监督、支持
14:18
this surge of international support
to try and stop this disease.
to try and stop this disease.
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大量涌入的国际支援，
以对抗这场疾病的肆虐。
以对抗这场疾病的肆虐。
14:22
We saw militaries from within
those countries and from far beyond
those countries and from far beyond
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我们看到来自那些国家
甚至其他国家的军队
甚至其他国家的军队
14:26
coming in to help build
Ebola treatment centers
Ebola treatment centers
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来到这裡帮助搭建埃博拉治疗中心，
14:28
that could be used to isolate
those who were sick.
those who were sick.
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用以隔离那些病人。
14:32
We saw the Red Cross movement working with
its partner agencies on the ground there
its partner agencies on the ground there
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我们看到红十字会运动在那里
与它的伙伴机构一起合作，
与它的伙伴机构一起合作，
14:36
to help train the communities so that
they could actually safely bury their dead
they could actually safely bury their dead
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来帮助训练社区成员，从而使得
他们能够安全地安葬死去的亲友，
他们能够安全地安葬死去的亲友，
14:41
in a dignified manner themselves.
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并且以有尊严的方式
亲自为死者下葬。
亲自为死者下葬。
14:44
And we saw the U.N. agencies,
the World Food Program,
the World Food Program,
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我们还看到联合国机构
和世界粮食计划署
和世界粮食计划署
14:47
build a tremendous air bridge
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搭建了一架巨大的空运桥樑，
14:49
that could get responders to every single
corner of these countries rapidly
corner of these countries rapidly
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将响应者们快速送达
这些国家的各个角落，
这些国家的各个角落，
14:52
to be able to implement the strategies
that we just talked about.
that we just talked about.
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以实施我们刚刚提到的策略。
14:56
What we saw, ladies and gentlemen,
which was probably most impressive,
which was probably most impressive,
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我们看到，女士们先生们，
或许最为令人影响深刻的，
或许最为令人影响深刻的，
14:59
was this incredible work
by the governments,
by the governments,
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是这些国家的政府和领导人
与社区一起做出的惊人努力，
与社区一起做出的惊人努力，
15:02
by the leaders in these countries,
with the communities,
with the communities,
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15:05
to try to ensure people
understood this disease,
understood this disease,
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来试图确保人们理解这场疾病，
15:08
understood the extraordinary things they
would have to do to try and stop Ebola.
would have to do to try and stop Ebola.
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理解为了阻止埃博拉的传播，
他们必须做出非凡的努力。
他们必须做出非凡的努力。
15:14
And as a result, ladies and gentlemen,
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结果，女士们先生们，
15:16
we saw something that we did not know
only two or three months earlier,
only two or three months earlier,
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我们就看到了在两三个月前
我们甚至不知道是否可能的事情
我们甚至不知道是否可能的事情
15:21
whether or not it would be possible.
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15:23
What we saw was
what you see now in this graph,
what you see now in this graph,
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我们看到的正是你现在
在这张图表上看到的，
在这张图表上看到的，
15:26
when we took stock on December 1.
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我们在 12 月 1 日评估状况时
制作了这张表格。
制作了这张表格。
15:29
What we saw was we could
bend that curve, so to speak,
bend that curve, so to speak,
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打个比喻来说，我们看到的是
我们能够压制这条曲线，
我们能够压制这条曲线，
15:32
change this exponential growth,
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改变指数型增长模式，
15:35
and bring some hope back
to the ability to control this outbreak.
to the ability to control this outbreak.
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并且对控制这场病毒爆发的能力
重新增添希望。
重新增添希望。
15:39
And for this reason, ladies and gentlemen,
there's absolutely no question now
there's absolutely no question now
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由于这个原因，女士们先生们，
毋庸置疑，我们能够追上这场疾病
在西非爆发的步伐，
在西非爆发的步伐，
15:43
that we can catch up with this outbreak
in West Africa and we can beat Ebola.
in West Africa and we can beat Ebola.
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并且我们能够击败埃博拉。
然而最大的问题在于，
许多人都在问，
许多人都在问，
15:49
The big question, though,
that many people are asking,
that many people are asking,
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15:53
even when they saw this curve, they said,
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940958
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甚至当他们看到了这张曲线图，
他们还会说，
他们还会说，
15:55
"Well, hang on a minute --
that's great you can slow it down,
that's great you can slow it down,
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「嘿，等会儿 ﹣ 你能把传播速度减慢，
这很赞，
这很赞，
15:58
but can you actually
drive it down to zero?"
drive it down to zero?"
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945845
2051
可是你真的能够把病例数
下降为零吗？」
下降为零吗？」
16:00
We already answered that question
back at the beginning of this talk,
back at the beginning of this talk,
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3541
我们已经在这场演讲的开头
回答过这个问题了，
回答过这个问题了，
16:03
when I spoke about Lofa County in Liberia.
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当我谈到利比理亚的洛法镇时。
16:07
We told you the story
how Lofa County got to a situation
how Lofa County got to a situation
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我们告诉你洛法镇
如何到达他们如今的局面，
如何到达他们如今的局面，
16:11
where they have not seen
Ebola for eight weeks.
Ebola for eight weeks.
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他们已经八周没有出现
埃博拉的新病例了。
埃博拉的新病例了。
16:14
But there are similar stories from
the other countries as well.
the other countries as well.
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但其他国家也有类似的故事。
16:17
From Gueckedou in Guinea,
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从几内亚的盖凯杜，
16:19
the first area where the first case was
actually diagnosed.
actually diagnosed.
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也就是第一个埃博拉病例
真正得到确诊的地方。
真正得到确诊的地方。
16:24
We've seen very, very few cases
in the last couple of months,
in the last couple of months,
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我们在过去的几个月内
见到非常非常少量的新病例，
见到非常非常少量的新病例，
16:27
and here in Kenema, in Sierra Leone,
another area in the epicenter,
another area in the epicenter,
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而在塞拉利昂的凯内马，
也就是另一个疫情中心，
也就是另一个疫情中心，
16:32
we have not seen the virus
for more than a couple of weeks --
for more than a couple of weeks --
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我们已经好几周都没有看到
埃博拉病毒出现了 ﹣
埃博拉病毒出现了 ﹣
16:35
way too early to declare
victory, obviously,
victory, obviously,
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当然啦，要宣告胜利还为时过早，
16:38
but evidence, ladies and gentlemen,
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但证据表明，女士们先生们，
16:40
not only can the response
catch up to the disease,
catch up to the disease,
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我们的响应不仅能够
赶上疾病肆虐的步伐，
赶上疾病肆虐的步伐，
16:43
but this disease can be driven to zero.
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还能将这场疾病彻底消灭。
16:46
The challenge now, of course,
is doing this on the scale needed
is doing this on the scale needed
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当然啦，目前的挑战在于
在这三个国家所需的规模上
实施这些策略，
实施这些策略，
16:51
right across these three countries,
and that is a huge challenge.
and that is a huge challenge.
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而那真是个巨大的挑战。
16:56
Because when you've been at something
for this long, on this scale,
for this long, on this scale,
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因为当你对抗大规模的事物
如此之久时，
如此之久时，
17:01
two other big threats
come in to join the virus.
come in to join the virus.
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另外两个巨大的威胁
会令这场病毒灾难雪上加霜。
会令这场病毒灾难雪上加霜。
17:05
The first of those is complacency,
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首先是自鸣得意，
17:08
the risk that as this
disease curve starts to bend,
disease curve starts to bend,
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风险在于，
随着疾病曲线图开始弯曲，
随着疾病曲线图开始弯曲，
17:11
the media look elsewhere,
the world looks elsewhere.
the world looks elsewhere.
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媒体开始关注其他事情，
全世界开始关注其他事情。
全世界开始关注其他事情。
17:14
Complacency always a risk.
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自鸣得意永远都是一个风险。
17:16
And the other risk, of course, is when
you've been working so hard for so long,
you've been working so hard for so long,
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当然，另一个风险则是
当你这么努力了这么久，
当你这么努力了这么久，
17:20
and slept so few hours
over the past months,
over the past months,
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过去几个月睡眠时间这么少时，
17:24
people are tired, people become fatigued,
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大家都会很疲惫，
大家变得全身乏力，
大家变得全身乏力，
17:26
and these new risks
start to creep into the response.
start to creep into the response.
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而这些新风险开始偷偷
进入对埃博拉的响应中。
进入对埃博拉的响应中。
17:30
Ladies and gentlemen, I can tell you today
I've just come back from West Africa.
I've just come back from West Africa.
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女士们先生们，我今天能告诉大家，
我刚刚从西非回来。
我刚刚从西非回来。
17:35
The people of these countries,
the leaders of these countries,
the leaders of these countries,
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这些国家的人民和领导者们，
17:38
they are not complacent.
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1496
他们并没有自鸣得意。
17:40
They want to drive Ebola to zero
in their countries.
in their countries.
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1048136
3743
他们想要将埃博拉
在自己的国家彻底消灭。
在自己的国家彻底消灭。
17:44
And these people, yes, they're tired,
but they are not fatigued.
but they are not fatigued.
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而这些人们，他们的确很疲惫，
但他们并没有感到乏力。
但他们并没有感到乏力。
17:47
They have an energy, they have a courage,
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他们充满精力与勇气，
17:50
they have the strength
to get this finished.
to get this finished.
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他们有力量完成这个使命。
17:52
What they need, ladies
and gentlemen, at this point,
and gentlemen, at this point,
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1060399
2754
女士们先生们，他们在此刻需要的
17:55
is the unwavering support of the
international community,
international community,
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是来自国际社区的
坚定不移的支持，
坚定不移的支持，
17:58
to stand with them,
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坚定地与他们同在，
18:00
to bolster and bring even more support
at this time, to get the job finished.
at this time, to get the job finished.
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4858
在此时此刻支持甚至是带来
更多支持，以完成这项使命。
更多支持，以完成这项使命。
18:05
Because finishing Ebola right now
means turning the tables on this virus,
means turning the tables on this virus,
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因为战胜埃博拉在此刻意味着
人类对埃博拉从劣势扭转为优势，
并且开始反击它。
18:10
and beginning to hunt it.
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1735
18:12
Remember, this virus, this whole crisis,
rather, started with one case,
rather, started with one case,
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1079817
5187
记住，这个病毒，
这整场开始于一个病例的灾难，
这整场开始于一个病例的灾难，
18:17
and is going to finish with one case.
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2699
也将以一个病例结束。
18:19
But it will only finish if those countries
have got enough epidemiologists,
have got enough epidemiologists,
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4324
但它的结束只有靠着那些国家
拥有足够多的流行病学家，
拥有足够多的流行病学家，
18:24
enough health workers, enough logisticians
and enough other people working with them
and enough other people working with them
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足够多的医护人员，
足够多的物流人员，
足够多的物流人员，
以及足够多的其他人来一起合作，
18:28
to be able to find every one
of those cases, track their contacts
of those cases, track their contacts
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3482
才能找到那些病例所有的相关人，
并追踪他们的联系人。
并追踪他们的联系人。
18:32
and make sure that this disease
stops once and for all.
stops once and for all.
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4094
确保这场疾病永远消失。
18:36
Ladies and gentleman, Ebola can be beaten.
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3337
女士们先生们，
埃博拉是能够被击败的。
埃博拉是能够被击败的。
18:39
Now we need you to take this story out
to tell it to the people who will listen
to tell it to the people who will listen
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4688
我们需要你们把这个故事
讲给那些愿意听的人，
讲给那些愿意听的人，
18:44
and educate them
on what it means to beat Ebola,
on what it means to beat Ebola,
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1112245
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并教育他们，
击败埃博拉意味著什么，
击败埃博拉意味著什么，
18:47
and more importantly,
we need you to advocate with the people
we need you to advocate with the people
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1115457
3732
更重要的是，我们需要你们
鼓动那些能够帮助我们
把资源送到这些国家的人们，
把资源送到这些国家的人们，
18:51
who can help us bring the resources we
need to these countries,
need to these countries,
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3554
18:54
to beat this disease.
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1122743
1774
以击败这场疾病。
18:56
There are a lot of people out there
who will survive and will thrive,
who will survive and will thrive,
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4182
有许多人能够从这场疾病中活下来，
并且从此茁壮成长，
并且从此茁壮成长，
19:00
in part because of what you do
to help us beat Ebola.
to help us beat Ebola.
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其中一部份原因就是因为
你能够为击败埃博拉所做的。
你能够为击败埃博拉所做的。
19:04
Thank you.
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谢谢大家。
19:05
(Applause)
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（掌声）
ABOUT THE SPEAKER
Bruce Aylward - EpidemiologistAs the Assistant Director-General of the World Health Organization’s Polio and Emergencies Cluster, Bruce Aylward works to ensure that polio stays under control and that the world is prepared to respond to health crises.
Why you should listen
A Canadian physician and epidemiologist who has authored some 100 peer-reviewed articles and chapters, Bruce Aylward is an expert on infectious diseases. He joined the World Health Organization in 1992 and worked in the field for seven years on national immunization programs for measles, tetanus and hepatitis in the Middle East, Africa and Asia.
Aylward has overseen and managed the scale-up of the Global Polio Eradication Initiative since 1998, during which time the program expanded to operate in every country of the world, the annual global budget increased to $700 million a year, polio-funded staff deployed by WHO grew to over 3,500 people worldwide, and new monovalent oral poliovirus vaccines were developed for the programme. In 2014, only three countries remained polio-endemic.
He says: "It's been estimated that our investment in smallpox eradication pays off every 26 days."
Since 2011, Aylward has also led WHO’s work in preparedness, readiness and response to health emergencies. By developing global strategies, analyzing health trends and advising on policies and country collaboration, the WHO helps make sure that outbreaks — like the 2014 ebola epidemic — stay under control.
Bruce Aylward | Speaker | TED.com