TED2011
Bruce Aylward: How we'll stop polio for good
Bruce Aylward：如何永遠根絕小兒麻痺症
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小兒麻痺症幾乎完全根絕了。但正如Bruce Aylward說的：對付這種可怕的疾病這樣做是不夠的。Aylward要延續終結世界上大多數地區小兒麻痺症發生的這項科學奇蹟，並讓此一疾病永遠地消失。
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.
00:15
I want to share with you
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在接下來的18分鐘裡
00:17
over the next 18 minutes
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我想和大家說
00:19
a pretty incredible idea.
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一個不可思議的想法
00:21
Actually, it's a really big idea.
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事實上，這是一個很大的想法
00:23
But to get us started,
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但在我們開始之前
00:25
I want to ask if everyone
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我想請在座各位
00:27
could just close your eyes for two seconds
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閉上眼睛，花兩秒的時間
00:29
and try and think of a technology or a bit of science
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試著去思考一項你認為
00:32
that you think has changed the world.
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是改變世界的科技或科學
00:38
Now I bet, in this audience,
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我敢說，在座各位
00:40
you're thinking of some really incredible technology,
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你們想到的確實是些很驚人的科技
00:42
some stuff that I haven't even heard of,
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有些我甚至從未聽聞
00:44
I'm absolutely sure.
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我非常確信是如此
00:46
But I'm also sure, pretty sure,
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但我也相當確定
00:49
that absolutely nobody is thinking of this.
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在座沒有任何人有想過這樣東西
00:53
This is a polio vaccine.
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這是小兒麻痺症疫苗
00:56
And it's a great thing actually
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這是一項偉大的發明
00:58
that nobody's had to think about it here today
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但今天在這個場合不會有人想到
01:00
because it means that we can take this for granted.
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因為我們認為這件事是理所當然的
01:02
This is a great technology.
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這是一項偉大的科技
01:04
We can take it completely for granted.
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我們當然會這樣想
01:06
But it wasn't always that way.
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但事情不是總是這樣的
01:09
Even here in California,
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即便在加州
01:12
if we were to go back just a few years,
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如果我們回到過去幾年前
01:14
it was a very different story.
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事情的發展是完全不同的
01:16
People were terrified of this disease.
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人們非常害怕這種疾病
01:18
They were terrified of polio, and it would cause public panic.
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小兒麻痺症讓大眾感到恐懼，造成社會恐慌
01:21
And it was because of scenes like this.
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也因為這樣的景象
01:24
In this scene,
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這張照片裡
01:26
people are living in an iron lung.
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人要依賴鐵肺才能存活
01:28
These are people who were perfectly healthy two or three days before,
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這些人兩三天前都還是相當健康的
01:31
and then two days later,
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但兩天後
01:33
they can no longer breathe,
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他們無法呼吸
01:35
and this polio virus has paralyzed
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小兒麻痺病毒
01:37
not only their arms and their legs,
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不僅是讓他們四肢癱瘓
01:39
but also their breathing muscles.
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更讓他們的呼吸肌無法作用
01:41
And they were going to spend the rest of their lives, usually,
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通常他們的後半生
01:44
in this iron lung to breathe for them.
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必須仰賴鐵肺，幫助他們呼吸
01:46
This disease was terrifying.
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這種疾病令人聞之喪膽
01:48
There was no cure,
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當時沒有治癒的方法
01:50
and there was no vaccine.
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也沒有疫苗
01:52
The disease was so terrifying
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這種疾病令人惶恐不安
01:54
that the president of the United States
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當時的美國總統
01:56
launched an extraordinary national effort
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發了特令動用國家資源
01:59
to find a way to stop it.
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企圖找到治療方法
02:02
Twenty years later, they succeeded
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二十年後，他們成功了
02:05
and developed the polio vaccine.
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研發出小兒麻痺症疫苗
02:07
It was hailed as a scientific miracle
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這在50年代後期
02:09
in the late 1950s.
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被譽為是科學奇蹟
02:11
Finally, a vaccine that could stop this awful disease,
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終於有疫苗可以終止這種可怕的疾病
02:14
and here in the United States
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在美國
02:16
it had an incredible impact.
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疫苗有驚人的效應
02:18
As you can see, the virus stopped,
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大家可以看到，疫情止住了
02:20
and it stopped very, very fast.
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而且是迅速地終止
02:23
But this wasn't the case
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但在世界上的其他地方
02:26
everywhere in the world.
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就並非如此了
02:28
And it happened so fast in the United States, however,
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這在美國發生的太快了
02:31
that even just last month Jon Stewart said this:
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而就在上個月，Jon Stewart這樣說
02:34
(Video) Jon Stewart: Where is polio still active?
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Jon Stewart：哪些地區仍然有小兒麻痺症？
02:36
Because I thought that had been eradicated
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我以為小兒麻痺症已經被根絕
02:39
in the way that smallpox had been eradicated.
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就像天花那樣已經完全根絕了
02:41
Bruce Aylward: Oops. Jon, polio's almost been eradicated.
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Bruce Aylward：喔，Jon，小兒麻痺是幾乎要被根絕
02:45
But the reality is
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事實上
02:47
that polio still exists today.
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小兒麻痺症到今天仍然存在
02:49
We made this map for Jon to try to show him exactly where polio still exists.
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我們製作了地圖讓Jon了解至今哪些地區仍存在有小兒麻痺症
02:52
This is the picture.
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就是這張圖
02:54
There's not very much left in the world.
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雖然世界上只有少數地區仍有此問題
02:57
But the reason there's not very much left
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至於大部分地區沒有這項問題
02:59
is because there's been an extraordinary public/private partnership
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是因為背後有傑出的公共/私人的組織機構
03:02
working behind the scenes, almost unknown,
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持續為這項問題在努力
03:05
I'm sure to most of you here today.
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我想今天在座各位是不知道的
03:07
It's been working for 20 years
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他們已經努力了二十年
03:09
to try and eradicate this disease,
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嘗試要根絕這種疾病
03:11
and it's got it down to these few cases
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從這張圖表上可以看到
03:13
that you can see here on this graphic.
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這種疾病依然存在這少數幾個區域
03:16
But just last year,
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但就在去年
03:18
we had an incredible shock
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我們發現一樁令人驚駭的事
03:20
and realized that almost just isn't good enough
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然後我們意識到就小兒麻痺病毒而言
03:23
with a virus like polio.
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"幾乎"根絕是還不夠的
03:26
And this is the reason:
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原因是：
03:28
in two countries
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在地球另一端有兩個國家
03:30
that hadn't had this disease for more than probably a decade,
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已經有超過將近十年的時間
03:33
on opposite sides of the globe,
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沒有再出現過小兒麻痺症病例
03:35
there was suddenly terrible polio outbreaks.
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卻突然爆發嚴重的小兒麻痺症疫情
03:38
Hundreds of people were paralyzed.
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數百人癱瘓
03:40
Hundreds of people died --
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數百人死亡
03:43
children as well as adults.
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有兒童，也有成人
03:45
And in both cases,
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在這兩個國家
03:47
we were able to use genetic sequencing to look at the polio viruses,
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我們利用基因測序檢查小兒麻痺病毒
03:50
and we could tell these viruses were not from these countries.
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發現這些病毒並非原先就存在該地區
03:53
They had come from thousands of miles away.
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病毒是由千里之外的地區傳過來的
03:56
And in one case, it originated on another continent.
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其中一個病例，病毒是從另一個大陸傳來的
03:59
And not only that, but when they came into these countries,
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不僅如此，病毒到這些國家
04:02
then they got on commercial jetliners probably
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可能是藉由商業客機所傳遞
04:05
and they traveled even farther
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也可能傳遞的更遠
04:07
to other places like Russia,
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到其他地區去，例如俄羅斯
04:09
where, for the first time in over a decade last year,
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在超過十年的時間，就在去年
04:12
children were crippled and paralyzed
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又有兒童受到這已長時間未出現的病毒
04:15
by a disease that they had not seen for years.
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感染而變成殘廢和癱瘓
04:19
Now all of these outbreaks that I just showed you,
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我剛提到所有爆發的疫情
04:22
these are under control now,
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目前都在控制中
04:24
and it looks like they'll probably stop very, very quickly.
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而且應該會迅速地終止
04:27
But the message was very clear.
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但這件事很清楚地告訴我們
04:30
Polio is still
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小兒麻痺症
04:32
a devastating, explosive disease.
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依然是一種駭人且會爆發傳染的疾病
04:35
It's just happening in another part of the world.
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這就發生在世界的另一個區域
04:39
And our big idea
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而我們的想法是
04:42
is that the scientific miracle of this decade
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在眼前這十年的科學奇蹟
04:46
should be the complete eradication
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應該是要徹底根除
04:48
of poliomyelitis.
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小兒麻痺症
04:50
So I want to tell you a little bit
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我想多跟你們說
04:52
about what this partnership, the Polio Partnership,
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有關小兒麻痺症夥伴關係
04:54
is trying to do.
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正嘗試在做的事
04:56
We're not trying to control polio.
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我們不想只控制住疫情
04:58
We're not trying to get it down to just a few cases,
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我們不希望還有少數地區會出現病例
05:01
because this disease is like a root fire;
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因為這種疾病像是星星之火
05:03
it can explode again if you don't snuff it out completely.
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如果不把它完全根除的話，它可能會再次爆發
05:06
So what we're looking for
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所以我們希望找到
05:08
is a permanent solution.
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永久的解決辦法
05:10
We want a world in which every child, just like you guys,
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我們希望世界上所有的孩童，如同在座各位
05:13
can take for granted
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能理所當然的
05:15
a polio-free world.
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生活在沒有小兒麻痺症的世界
05:17
So we're looking for a permanent solution,
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我們想找到永久的解決之道
05:19
and this is where we get lucky.
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我們很幸運的是
05:21
This is one of the very few viruses in the world
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小兒麻痺病毒是世界上
05:24
where there are big enough cracks in its armor
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少見能被治癒的病毒
05:26
that we can try to do something truly extraordinary.
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我們能試著做些真正特別的事
05:29
This virus can only survive in people.
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這種病毒只會靠人類傳染
05:32
It can't live for a very long time in people.
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在人體也無法存活很久
05:34
It doesn't survive in the environment hardly at all.
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也不能在嚴厲的環境中存活
05:37
And we've got pretty good vaccines, as I've just showed you.
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如同我剛展示的，我們有相當好的疫苗
05:40
So we are trying
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所以我們嘗試
05:42
to wipe out this virus completely.
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要完全根除這種病毒
05:45
What the polio eradication program is trying to do
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小兒麻痺症根絕計畫要做的事
05:48
is to kill the virus itself
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是消滅世界各地
05:50
that causes polio
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會引發
05:52
everywhere on Earth.
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小兒麻痺症的病毒
05:54
Now we don't have a great track record
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當我們開始做這樣的事時
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when it comes to doing something like this,
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我們不曾有過根絕疾病的
05:58
to eradicating diseases.
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良好紀錄
06:00
It's been tried six times in the last century,
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在上一個世紀中，已經嘗試過六次
06:03
and it's been successful exactly once.
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僅僅只有一次成功過
06:07
And this is because disease eradication,
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是因為根除疾病
06:10
it's still the venture capital of public health.
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是大眾健康的一種風險投資
06:13
The risks are massive,
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雖然風險甚大
06:15
but the pay-off --
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但是各方面的回報
06:18
economic, humanitarian, motivational --
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像是經濟，人道主義，激勵作用
06:20
it's absolutely huge.
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也絕對是龐大的
06:22
One congressman here in the United States
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一位美國的國會議員
06:25
thinks that the entire investment
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認為美國投注在
06:28
that the U.S. put into smallpox eradication
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根除天花的全部資源中
06:30
pays itself off every 26 days --
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每二十六天就能在放棄治療的費用
06:33
in foregone treatment costs
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和接種疫苗的費用上
06:35
and vaccination costs.
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得到回饋
06:37
And if we can finish polio eradication,
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如果我們能完成小兒麻痺症的防治
06:40
the poorest countries in the world
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世界上最窮困的國家
06:42
are going to save over 50 billion dollars
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將可以在未來的二十五年
06:46
in the next 25 years alone.
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省下500億美金
06:49
So those are the kind of stakes that we're after.
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這才是我們在追求的利益
06:52
But smallpox eradication was hard;
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根除天花是件困難的事
06:54
it was very, very hard.
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是非常困難的
06:56
And polio eradication, in many ways, is even tougher,
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而根除小兒麻痺症，在很多方面又更加困難
06:59
and there's a few reasons for that.
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有幾個原因
07:02
The first is that,
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第一
07:04
when we started trying to eradicate polio
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當我們在二十多年前
07:06
about 20 years ago,
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開始嘗試要根除小兒麻痺症時
07:08
more than twice as many countries were infected
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有疫情的國家總數
07:10
than had been when we started off with smallpox.
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是我們開始根除天花時的兩倍
07:13
And there were more than 10 times as many people
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這些國家的人口數
07:15
living in these countries.
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則是十倍以上
07:17
So it was a massive effort.
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這需要龐大的資源
07:19
The second challenge we had was --
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第二個難處是
07:21
in contrast to the smallpox vaccine,
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比較起來
07:23
which was very stable, and a single dose protected you for life --
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天花疫苗非常穩定，單劑就有終生保護作用
07:26
the polio vaccine is incredibly fragile.
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而小兒麻痺症疫苗相較脆弱
07:29
It deteriorates so quickly in the tropics
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在熱帶地區會快速的敗壞
07:32
that we've had to put this special vaccine monitor
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我們必須在每一瓶疫苗
07:34
on every single vial
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都設置特殊的疫苗監控
07:36
so that it will change very quickly
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因為疫苗暴露在高溫時
07:38
when it's exposed to too much heat,
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變化會相當快速
07:40
and we can tell that it's not a good vaccine to use on a child --
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變成不能在兒童身上使用的疫苗
07:43
it's not potent; it's not going to protect them.
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沒有保護作用，不能讓他們免於病毒
07:45
Even then, kids need many doses of the vaccine.
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此外，孩童需要很多的疫苗
07:48
But the third challenge we have --
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第三個難處是
07:50
and probably even bigger one, the biggest challenge --
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或許這是最困難的部分
07:53
is that, in contrast to smallpox where you could always see your enemy --
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相較天花，你能輕易看出症狀
07:56
every single person almost who was infected with smallpox
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每個感染到天花的人
07:59
had this telltale rash.
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身上都有清楚的皮疹
08:01
So you could get around the disease;
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所以能夠找到疾病
08:03
you could vaccinate around the disease and cut it off.
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可以及時注射疫苗，讓疾病治癒
08:06
With polio it's almost completely different.
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但小兒麻痺症是完全不同的情況
08:09
The vast majority of people who are infected with the polio virus
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絕大多數感染小兒麻痺病毒的人
08:12
show absolutely no sign of the disease.
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幾乎看不出任何該疾病的病症
08:15
So you can't see the enemy most of the time,
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大部分時間，你不清楚敵人位在何方
08:18
and as a result,
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因此
08:20
we've needed a very different approach to eradicate polio
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我們需要一種相當不同於天花的方法
08:23
than what was done with smallpox.
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來根除小兒麻痺症
08:25
We've had to create
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我們發動了
08:27
one of the largest social movements in history.
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有史以來最大規模的社會運動
08:30
There's over 10 million people,
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有超過一千萬人
08:32
probably 20 million people,
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也許是兩千萬人
08:34
largely volunteers,
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眾多的志工
08:36
who have been working over the last 20 years
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在過去二十年來
08:38
in what has now been called
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在現在和平時期所說的
08:40
the largest internationally-coordinated operation in peacetime.
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參與這最大的國際合作行動
08:44
These people, these 20 million people,
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這些人，這兩千萬人
08:47
vaccinate over 500 million children
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在我們的任務最高峰的時期
08:50
every single year,
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一年替五億名孩童
08:52
multiple times
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注射疫苗
08:54
at the peak of our operation.
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而且不只一次
08:57
Now giving the polio vaccine is simple.
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現在注射小兒麻痺症疫苗很簡單
08:59
It's just two drops, like that.
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只要像這樣滴兩滴
09:01
But reaching 500 million people
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但替五億人注射疫苗
09:03
is much, much tougher.
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這是更困難的
09:05
And these vaccinators, these volunteers,
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這些注射疫苗的人，也就是這些志工
09:08
they have got to dive headlong
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他們必須深入到世界上
09:10
into some of the toughest, densest
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一些最艱困，人口最密集的
09:12
urban slums in the world.
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貧民窟城市
09:14
They've got to trek under sweltering suns
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他們得在炎熱的太陽下跋涉到
09:17
to some of the most remote, difficult to reach places in the world.
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一些最偏遠且難以到達的地方
09:21
And they also have to dodge bullets,
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而且他們還必須躲避子彈
09:23
because we have got to operate
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因為我們必須要在
09:25
during shaky cease-fires and truces
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混亂的停火和停戰的情況下
09:27
to try and vaccinate children,
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嘗試為兒童接種疫苗
09:29
even in areas affected by conflict.
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即便是有衝突影響的地區也一樣
09:32
One reporter
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一位記者
09:34
who was watching our program in Somalia about five years ago --
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觀看我們五年前在索馬利亞的任務
09:37
a place which has eradicated polio,
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該地區已經根絕小兒麻痺症
09:39
not once, but twice, because they got reinfected.
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不只一次，是兩次，因為他們遭受二次感染
09:41
He was sitting outside of the road,
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他就坐在馬路旁
09:43
watching one of these polio campaigns unfold,
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觀看這些宣傳小兒麻痺症的資訊
09:45
and a few months later he wrote:
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幾個月後他寫道：
09:47
"This is foreign aid at its most heroic."
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「這是最英雄式的外援‧」
09:51
And these heroes, they come from every walk of life,
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這些英雄來自來自各行各業
09:53
all sorts of backgrounds.
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有著不同的生活背景
09:55
But one of the most extraordinary is Rotary International.
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其中最特別的是國際扶輪社
09:58
This is a group
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這個團體
10:00
whose million-strong army of volunteers
237
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上百萬的志工們
10:02
have been working to eradicate polio
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已經有超過20年
10:04
for over 20 years.
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致力於根除小兒麻痺症的工作
10:06
They're right at the center of the whole thing.
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他們就在這整件事情的核心
10:09
Now it took years to build up the infrastructure
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現在花了相當多年的時間建立了
10:11
for polio eradication --
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根除小兒麻痺症的基礎建設
10:13
more than 15 years, much longer than it should have --
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花了十五年的時間，遠多於預期
10:16
but once it was built, the results were striking.
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但一旦建立完成，將會有驚人的結果
10:19
Within a couple of years,
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幾年之內
10:21
every country that started polio eradication
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每一個實行根除小兒麻痺症計畫的國家
10:23
rapidly eradicated all three of their polio viruses,
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都迅速根除了三種小兒麻痺症的病毒
10:27
with the exception of four countries that you see here.
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除了你在這裡看到的這四個國家
10:30
And in each of those, it was only part of the country.
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在這四個國家裡，只有一部分的地區還有此問題
10:34
And then, by 1999,
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在1999年當時
10:36
one of the three polio viruses
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其中一種我們試圖要根除的
10:38
that we were trying to eradicate
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小兒麻痺病毒
10:40
had been completely eradicated worldwide --
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已經完全從世界上根除了
10:43
proof of concept.
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這已經證實了
10:45
And then today,
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到今天
10:48
there's been a 99 percent reduction --
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受到小兒麻痺症
10:50
greater than 99 percent reduction --
257
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此種可怕病毒
10:52
in the number of children
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感染的兒童人數
10:54
who are being paralyzed by this awful disease.
259
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已減少了99%--甚至是99%以上--
10:57
When we started, over 20 years ago,
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從二十年前，我們開始執行
10:59
1,000 children were being paralyzed
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每一天就有1,000名兒童
11:01
every single day by this virus.
262
646000
3000
受到病毒感染而癱瘓
11:04
Last year, it was 1,000.
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去年，感染人數是1,000人
11:07
And at the same time,
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同時
11:09
the polio eradication program
265
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小兒麻痺症根除計畫
11:11
has been working to help with a lot of other areas.
266
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已經幫助了很多地區
11:13
It's been working to help control pandemic flu,
267
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也同時幫助控制了流感大流行
11:16
SARS for example.
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例如SARS(傳染性非典型肺炎)
11:18
It's also tried to save children by doing other things --
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他們也試圖給予孩童其他幫助 --
11:21
giving vitamin A drops, giving measles shots,
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給予維他命A滴劑，注射麻疹疫苗
11:24
giving bed nets against malaria even
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甚至在其中一些活動中
11:26
during some of these campaigns.
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提供蚊帳防治瘧疾
11:28
But the most exciting thing
273
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但最令人振奮的事
11:30
that the polio eradication program has been doing
274
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是小兒麻痺症根除計畫
11:32
has been to force us,
275
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迫使我們
11:34
the international community,
276
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國際間的社會團體
11:36
to reach every single child, every single community,
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去到每一個社區，聯繫上每一名孩童
11:39
the most vulnerable people in the world,
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他們是世界上最脆弱的族群
11:42
with the most basic of health services,
279
687000
2000
提供他們最基本的保健服務
11:44
irrespective of geography, poverty,
280
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4000
不論地理位置，貧困
11:48
culture and even conflict.
281
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文化，甚至衝突
11:50
So things were looking very exciting,
282
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2000
原先這一切令人振奮
11:52
and then about five years ago,
283
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但在五年前
11:54
this virus, this ancient virus, started to fight back.
284
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這種古老的病毒又捲土重來
11:57
The first problem we ran into
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我們碰到的第一個問題是
12:00
was that, in these last four countries, the strongholds of this virus,
286
705000
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在這最後的四個國家，病毒的大本營
12:03
we just couldn't seem to get the virus rooted out.
287
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4000
我們似乎就是沒辦法讓病毒完全根除
12:07
And then to make the matters even worse,
288
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更糟糕的情況是
12:09
the virus started to spread out of these four places,
289
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病毒開始蔓延到這四個國家以外的地區
12:12
especially northern India and northern Nigeria,
290
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3000
自印度北部和奈及利亞北部
12:15
into much of Africa, Asia, and even into Europe,
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進入非洲許多地區，亞洲，甚至到歐洲
12:18
causing horrific outbreaks
292
723000
2000
造成可怕的疫情
12:20
in places that had not seen this disease for decades.
293
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4000
這些地方已經幾十年沒有出現過病例
12:24
And then,
294
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然後
12:26
in one of the most important, tenacious
295
731000
3000
在一個最重要，最頑強的
12:29
and toughest reservoirs of the polio virus in the world,
296
734000
3000
小兒麻痺病毒的傳染窩
12:32
we found that our vaccine was working
297
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3000
我們發現我們的疫苗
12:35
half as well as it should have.
298
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功效只有原先的一半
12:37
In conditions like this,
299
742000
2000
在這樣的條件下
12:39
the vaccine just couldn't get the grip it needed to
300
744000
2000
疫苗無法有效作用
12:41
in the guts of these children
301
746000
2000
給予這些孩子
12:43
and protect them the way that it needed to.
302
748000
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他們所需要的保護
12:45
Now at that time,
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在當時
12:47
there was a great, as you can imagine,
304
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各位可以想像的到，一股非常大的
12:49
frustration -- let's call it frustration --
305
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2000
挫敗 --我們認為是挫敗--
12:51
it started to grow very, very quickly.
306
756000
2000
這種氣氛擴散的非常快
12:53
And all of a sudden, some very important voices
307
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2000
突然，非常多來自
12:55
in the world of public health
308
760000
2000
世界公衛組織的聲音
12:57
started to say, "Hang on.
309
762000
2000
開始說「等等。」
12:59
We should abandon this idea of eradication.
310
764000
3000
「我們該放棄根除病毒的想法了。」
13:02
Let's settle for control -- that's good enough."
311
767000
3000
「我們就試圖控制住疫情--這樣就很好了。」
13:05
Now as seductive as the idea of control sounds,
312
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4000
現在，控制疫情的想法的確吸引人
13:09
it's a false premise.
313
774000
2000
但這是個錯誤的想法
13:11
The brutal truth is,
314
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2000
殘酷的事實是
13:13
if we don't have the will or the skill,
315
778000
2000
如果我們沒有意願或技能
13:15
or even the money that we need
316
780000
3000
甚至所需要的經費
13:18
to reach children, the most vulnerable children in the world,
317
783000
3000
運用簡單的
13:21
with something as simple
318
786000
2000
口服小兒麻痺症疫苗
13:23
as an oral polio vaccine,
319
788000
3000
去保護這些世界上最脆弱的孩童們
13:26
then pretty soon,
320
791000
2000
那麼很快
13:28
more than 200,000 children
321
793000
2000
未來每年將會有
13:30
are again going to be paralyzed by this disease
322
795000
2000
超過二十萬的兒童
13:32
every single year.
323
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2000
會因此疾病變成癱瘓
13:34
There's absolutely no question.
324
799000
2000
這是毫無疑問的
13:36
These are children like Umar.
325
801000
3000
這些孩童就像Umar一樣
13:39
Umar is seven years old,
326
804000
3000
Umar現年七歲
13:42
and he's from northern Nigeria.
327
807000
2000
他住在奈及利亞北部
13:44
He lives in a family home there
328
809000
2000
他和八個兄弟姊妹
13:46
with his eight brothers and sisters.
329
811000
2000
同住在一起
13:48
Umar also has polio.
330
813000
3000
Umar罹患小兒麻痺症
13:51
Umar was paralyzed for life.
331
816000
2000
Umar後半生都會是癱瘓
13:53
His right leg was paralyzed
332
818000
2000
他的右腿
13:55
in 2004.
333
820000
2000
在2004年時癱瘓了
13:57
This leg, his right leg,
334
822000
3000
他的右腿
14:00
now takes an awful beating
335
825000
2000
現在有嚴重的挫傷
14:02
because he has to half-crawl,
336
827000
2000
因為他必須半爬
14:04
because it's faster to move that way
337
829000
2000
這樣移動的速度會快些
14:06
to keep up with his friends, keep up with his brothers and sisters,
338
831000
2000
好跟上他的朋友，他的兄弟姊妹
14:08
than to get up on his crutches and walk.
339
833000
3000
這比起拿拐杖行走的速度要快
14:11
But Umar is a fantastic student. He's an incredible kid.
340
836000
3000
但Umar是位了不起的學生，他令人讚嘆
14:14
As you probably can't see the detail here,
341
839000
2000
各位可能沒辦法看清楚這上頭的字
14:16
but this is his report card,
342
841000
2000
但這是他的成績單
14:18
and you'll see, he's got perfect scores.
343
843000
2000
可以看出來，他的成績相當好
14:20
He got 100 percent in all the important things,
344
845000
2000
他在所有重要的項目都拿滿分
14:22
like nursery rhymes, for example there.
345
847000
3000
例如這邊寫的，像是童謠
14:25
But you know I'd love to be able to tell you
346
850000
3000
各位也許認為我會說
14:28
that Umar is a typical kid with polio these days,
347
853000
2000
Umar是這些年來典型罹患小兒麻痺症的孩子
14:30
but it's not true.
348
855000
2000
但不是
14:32
Umar is an exceptional kid
349
857000
2000
Umar是例外
14:34
in exceptional circumstances.
350
859000
2000
他是在特殊情況下感染的
14:36
The reality of polio today
351
861000
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事實上今天的小兒麻痺症
14:38
is something very different.
352
863000
3000
是非常不一樣的
14:41
Polio strikes the poorest communities in the world.
353
866000
4000
小兒麻痺症擊垮世界上最窮困的地區
14:45
It leaves their children paralyzed,
354
870000
2000
它讓該地區的孩童癱瘓
14:47
and it drags their families
355
872000
2000
拖垮他們的家庭
14:49
deeper into poverty,
356
874000
2000
讓全家陷入更貧困的境地
14:51
because they're desperately searching
357
876000
2000
因為他們的家庭拼命地尋找
14:53
and they're desperately spending the little bit of savings that they have,
358
878000
2000
不顧一切地支出他們僅存的積蓄
14:55
trying in vain
359
880000
2000
妄圖尋找
14:57
to find a cure for their children.
360
882000
3000
治癒他們的孩子的解藥
15:01
We think children deserve better.
361
886000
3000
我們認為兒童該過更好的生活
15:04
And so when the going got really tough
362
889000
3000
所以在兩年前
15:07
in the polio eradication program
363
892000
2000
根除小兒麻痺症計畫
15:09
about two years ago,
364
894000
2000
最瓶頸的時候
15:11
when people were saying, "We should call it off,"
365
896000
2000
當人們都在說「我們應該停止」
15:13
the Polio Partnership
366
898000
2000
小兒麻痺症夥伴關係
15:15
decided to buckle down once again
367
900000
2000
決定再一次傾全力
15:17
and try and find innovative new solutions,
368
902000
3000
嘗試找尋新的解決方法
15:20
new ways to get to the children
369
905000
2000
以新的方式去聯繫上
15:22
that we were missing again and again.
370
907000
2000
我們一次又一次錯過的孩童們
15:24
In northern India, we started mapping the cases
371
909000
2000
在印度的北部，我們運用衛星圖
15:26
using satellite imaging like this,
372
911000
2000
定位出每一個病例
15:28
so that we could guide our investments and vaccinator shelters,
373
913000
3000
我們就能通知資方，還有疫苗接種站
15:31
so we could get to the millions of children
374
916000
2000
然後就能聯繫上位在
15:33
on the Koshi River basin
375
918000
2000
戈西河流域的數百萬名兒童
15:35
where there are no other health services.
376
920000
2000
那裏沒有其他的醫療服務
15:37
In northern Nigeria,
377
922000
2000
在奈及利亞北部
15:39
the political leaders and the traditional Muslim leaders,
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政治領導人和傳統的穆斯林領袖
15:41
they got directly involved in the program
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他們直接參與了該計劃
15:43
to help solve the problems of logistics
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928000
2000
幫助解決後勤的問題
15:45
and community confidence.
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和建立社會信心
15:47
And now they've even started using these devices --
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現在他們甚至已經開始使用這些設備
15:50
speaking of cool technology --
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談一點新的科技
15:52
these little devices, little GIS trackers like this,
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3000
這些小型全球地理資訊系統的裝置
15:55
which they put into the vaccine carriers of their vaccinators.
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940000
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讓疫苗接種人員放在疫苗載具上
15:58
And then they can track them,
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然後就能追蹤他們
16:00
and at the end of the day, they look and see,
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並在結束日查看
16:02
did these guys get every single street, every single house.
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看他們是否有走完每一條街道，去過每一棟房子
16:04
This is the kind of commitment now we're seeing
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這是我們想做到的承諾
16:07
to try and reach all of the children we've been missing.
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952000
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試圖幫助所有我們錯過的每一名孩子
16:10
And in Afghanistan, we're trying new approaches --
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955000
3000
而在阿富汗，我們正嘗試新的方法
16:13
access negotiators.
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2000
進入談判
16:15
We're working closely with the International Committee of the Red Cross
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3000
我們密切與國際紅十字會合作
16:18
to ensure that we can reach every child.
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以確保我們能聯繫上每一名孩童
16:21
But as we tried these extraordinary things,
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966000
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當我們嘗試做這些特別的事
16:24
as people went to this trouble
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當其他人重新檢視問題
16:26
to try and rework their tactics,
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2000
重新修正戰術
16:28
we went back to the vaccine -- it's a 50-year-old vaccine --
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973000
3000
我們也檢討了這支50歲的疫苗
16:31
and we thought, surely we can make a better vaccine,
399
976000
3000
然後我們想，我們當然可以研發一支很好的疫苗
16:34
so that when they finally get to these kids,
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979000
2000
讓志工們聯繫上這些孩童們時
16:36
we can have a better bang for our buck.
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981000
2000
能提供更好的防疫效果
16:38
And this started an incredible collaboration with industry,
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3000
因此就展開一場與產業的驚奇合作
16:41
and within six months,
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986000
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六個月內
16:43
we were testing a new polio vaccine
404
988000
2000
我們測試了新的小兒麻痺症疫苗
16:45
that targeted, just two years ago,
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990000
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就在兩年前，針對的是
16:47
the last two types of polio in the world.
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3000
世界上最後兩種小兒麻痺病毒
16:50
Now June the ninth, 2009,
407
995000
3000
2009年六月九日
16:53
we got the first results from the first trial with this vaccine,
408
998000
3000
我們得到了疫苗第一次測試的結果
16:56
and it turned out to be a game-changer.
409
1001000
2000
局面馬上改觀
16:58
The new vaccine
410
1003000
2000
新的疫苗
17:00
had twice the impact on these last couple of viruses
411
1005000
3000
在對付這兩種病毒的功效
17:03
as the old vaccine had,
412
1008000
2000
是舊疫苗的兩倍
17:05
and we immediately started using this.
413
1010000
2000
我們立即開始使用新的疫苗
17:07
Well, in a couple of months we had to get it out of production.
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1012000
3000
幾個月內，我們必須開始生產
17:10
And it started rolling off the production lines
415
1015000
2000
讓疫苗進入生產線然後完成
17:12
and into the mouths of children around the world.
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2000
進到世界各地每一位孩子的口中
17:14
And we didn't start with the easy places.
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2000
我們沒有從疫情輕微的地方開始
17:16
The first place this vaccine was used
418
1021000
2000
新的疫苗首次使用
17:18
was in southern Afghanistan,
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2000
是在阿富汗南部
17:20
because it's in places like that
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1025000
2000
因為目的本該是
17:22
where kids are going to benefit the most
421
1027000
2000
運用科技讓孩童們
17:24
from technologies like this.
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1029000
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獲益更多
17:26
Now here at TED, over the last couple of days,
423
1031000
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在TED這裡，過去幾天
17:29
I've seen people challenging the audience again and again
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許多人一次又一次不斷地宣揚
17:33
to believe in the impossible.
425
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3000
企圖讓人相信不可能的發生
17:36
So this morning at about seven o'clock,
426
1041000
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今天早上大約七點左右
17:39
I decided that we'd try to drive Chris
427
1044000
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我決定我們要讓Chris
17:41
and the production crew here berserk
428
1046000
2000
還有製作團隊再麻煩一次
17:43
by downloading all of our data from India again,
429
1048000
4000
把我們在印度的數據重新下載
17:47
so that you could see something
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1052000
2000
所以你可以看到
17:49
that's just unfolding today,
431
1054000
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這些數據是今天才發表
17:51
which proves that the impossible is possible.
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1056000
4000
這證明了不可能是能達成的
17:55
And only two years ago, people were saying that this is impossible.
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1060000
3000
就在兩年前，大家都在說這是不可能的
17:58
Now remember, northern India is the perfect storm
434
1063000
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還記得每當提及小兒麻痺症
18:01
when it comes to polio.
435
1066000
2000
印度北部總是令人頭痛
18:03
Over 500,000 children
436
1068000
2000
有超過五十萬名兒童
18:05
are born in the two states that have never stopped polio --
437
1070000
3000
出生在這小兒麻痺症肆虐的
18:08
Uttar Pradesh and Bihar --
438
1073000
3000
北方邦和比哈爾邦
18:11
500,000 children every single month.
439
1076000
2000
每個月有五十萬名兒童感染
18:13
Sanitation is terrible,
440
1078000
2000
衛生條件相當糟糕
18:15
and our old vaccine, you remember,
441
1080000
2000
你們應該有印象
18:17
worked half as well as it should have.
442
1082000
3000
我們的舊疫苗功效只有一半
18:20
And yet, the impossible is happening.
443
1085000
3000
然而不可能的事發生了
18:23
Today marks exactly six months --
444
1088000
4000
今天剛好滿六個月
18:27
and for the first time in history,
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1092000
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史上第一次
18:29
not a single child has been paralyzed
446
1094000
2000
在北方邦和比哈爾邦
18:31
in Uttar Pradesh or Bihar.
447
1096000
2000
沒有任何一位孩童感染
18:33
(Applause)
448
1098000
11000
(掌聲)
18:44
India's not unique.
449
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印度並不是唯一
18:47
In Umar's home country of Nigeria,
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在Umar的家鄉，奈及利亞
18:49
a 95 percent reduction
451
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2000
去年兒童因感染
18:51
in the number of children paralyzed by polio last year.
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3000
小兒麻痺而癱瘓的比率下降了95%
18:54
And in the last six months,
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在過去半年
18:56
we've had less places reinfected by polio
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2000
二次感染小兒麻痺的地區
18:58
than at any other time in history.
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3000
也比過去來的更少
19:02
Ladies and gentlemen, with a combination
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各位女士們，先生們
19:04
of smart people, smart technology
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2000
在結合優秀人力，優良科技
19:06
and smart investments,
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2000
以及優質發明
19:08
polio can now be eradicated anywhere.
459
1133000
4000
任何地區都能根除小兒麻痺症
19:12
We have major challenges, you can imagine,
460
1137000
2000
你們可以想像，要完成這項任務
19:14
to finish this job,
461
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2000
是種巨大的挑戰
19:16
but as you've also seen,
462
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2000
但各位也看到了
19:18
it's doable,
463
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2000
這是可行的
19:20
it has great secondary benefits,
464
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2000
它的次要效益是很大的
19:22
and polio eradication is a great buy.
465
1147000
3000
根絕小兒麻痺症是值得投資的
19:25
And as long as any child anywhere
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1150000
3000
只要任何地方
19:28
is paralyzed by this virus,
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1153000
2000
有兒童受到病毒侵襲而癱瘓
19:30
it's a stark reminder
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這是清楚的告訴我們
19:32
that we are failing, as a society, to reach children
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1157000
3000
我們的社會沒辦法
19:35
with the most basic of services.
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2000
提供每一位孩童最基本的保障
19:37
And for that reason, polio eradication:
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2000
因此，根絕小兒麻痺症
19:39
it's the ultimate in equity
472
1164000
3000
是最終的公平
19:42
and it's the ultimate in social justice.
473
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3000
也是最終的社會正義
19:45
The huge social movement
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2000
這場根除小兒麻痺症的
19:47
that's been involved in polio eradication
475
1172000
2000
大型社會運動
19:49
is ready to do way more for these children.
476
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2000
已經準備好為這些孩童們做更多的事
19:51
It's ready to reach them with bed nets, with other things.
477
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3000
提供他們蚊帳和其他事物
19:54
But capitalizing on their enthusiasm,
478
1179000
3000
運用他們的熱情
19:57
capitalizing on their energy
479
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2000
善用他們的精力
19:59
means finishing the job
480
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2000
要完成這項
20:01
that they started 20 years ago.
481
1186000
3000
他們二十年前就開始的工作
20:04
Finishing polio is a smart thing to do,
482
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3000
根除小兒麻痺症是明智的
20:07
and it's the right thing to do.
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2000
更是正確的
20:09
Now we're in tough times economically.
484
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3000
我們現在處在財政困難的時期
20:12
But as David Cameron of the United Kingdom
485
1197000
3000
但如同一個月前英國首相David Cameron
20:15
said about a month ago when he was talking about polio,
486
1200000
3000
在他談到小兒麻痺症時所說的
20:18
"There's never a wrong time
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「只要是做對的事
20:20
to do the right thing."
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2000
時間永遠不會是錯的。」
20:22
Finishing polio eradication
489
1207000
2000
根除小兒麻痺症
20:24
is the right thing to do.
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1209000
2000
就是對的事
20:26
And we are at a crossroads right now
491
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2000
我們正處在關鍵時刻
20:28
in this great effort over the last 20 years.
492
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2000
經過二十年來的眾多努力
20:30
We have a new vaccine,
493
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2000
我們有了新的疫苗
20:32
we have new resolve,
494
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2000
我們有新的解決方法
20:34
and we have new tactics.
495
1219000
2000
我們也有新的策略
20:36
We have the chance
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2000
我們有機會
20:38
to write an entirely new polio-free chapter
497
1223000
3000
在人類歷史上
20:41
in human history.
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1226000
3000
寫下無小兒麻痺症的新頁
20:44
But if we blink now,
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3000
但如果我們現在疏忽
20:47
we will lose forever
500
1232000
2000
我們將永遠失去
20:49
the chance to eradicate an ancient disease.
501
1234000
4000
可以根除這個古老疾病的機會
20:54
Here's a great idea to spread:
502
1239000
3000
這個偉大的想法要傳遞出去
20:57
End polio now.
503
1242000
2000
現在就終結小兒麻痺症
20:59
Help us tell the story.
504
1244000
2000
幫助我們傳遞這故事
21:01
Help us build the momentum
505
1246000
2000
幫助我們宣揚這股動力
21:03
so that very soon
506
1248000
2000
然後很快的
21:05
every child, every parent
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1250000
2000
每一個孩子，每一對父母
21:07
everywhere
508
1252000
2000
每一個地方
21:09
can also take for granted
509
1254000
2000
都能理所當然永遠地
21:11
a polio-free life forever.
510
1256000
3000
過著沒有小兒麻痺症的生活
21:14
Thank you.
511
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2000
謝謝各位
21:16
(Applause)
512
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22000
(掌聲)
21:38
Bill Gates: Well Bruce, where do you think the toughest places are going to be?
513
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Bill Gates：Bruce，你覺得未來最困難的事情會是什麼？
21:41
Where would you say we need to be the smartest?
514
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你覺得我們最該注意的什麼地方？
21:44
BA: The four places where you saw, that we've never stopped --
515
1289000
3000
BA：剛看過的四個地區是我們一直沒辦法終止疫情
21:47
northern Nigeria, northern India,
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2000
奈及利亞北部，印度北部
21:49
the southern corner of Afghanistan
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1294000
2000
阿富汗南方一角
21:51
and bordering areas of Pakistan --
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1296000
2000
以及巴基斯坦邊界地區
21:53
they're going to be the toughest.
519
1298000
2000
這四個區域會是最困難的
21:55
But the interesting thing is, of those three,
520
1300000
2000
但有趣的是，其中三個地區
21:57
India's looking real good, as you just saw in the data.
521
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印度目前情況很好，像各位剛在數據上看到的
21:59
And Afghanistan, Afghanistan, we think
522
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至於阿富汗，我們認為
22:01
has probably stopped polio repeatedly.
523
1306000
2000
可能已經終止小兒麻痺再現
22:03
It keeps getting reinfected.
524
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2000
但仍然有病例傳出
22:05
So the tough ones: going to get the top of Nigeria finished
525
1310000
2000
因此困難的地方是：首要終止奈及利亞的疫情
22:07
and getting Pakistan finished.
526
1312000
2000
接著是巴基斯坦
22:09
They're going to be the tough ones.
527
1314000
2000
這些區域是困難的
22:11
BG: Now what about the money?
528
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2000
BG：那有關經費呢？
22:13
Give us a sense of how much the campaign costs a year.
529
1318000
3000
跟我們談談一年需要的宣傳經費是多少？
22:16
And is it easy to raise that money?
530
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3000
是否容易獲取更多的經費？
22:19
And what's it going to be like the next couple of years?
531
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2000
在未來幾年，經費的運用會是如何？
22:21
BA: It's interesting.
532
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2000
BA：這很有趣
22:23
We spend right now about 750 million
533
1328000
2000
我們目前每年約花費
22:25
to 800 million dollars a year.
534
1330000
3000
7.5億到8億美金
22:28
That's what it costs to reach 500 million children.
535
1333000
2000
這是要幫5億名孩童注射疫苗的花費
22:30
It sounds like a lot of money; it is a lot of money.
536
1335000
3000
這聽起來很多錢；不過這的確是非常多錢
22:33
But when you're reaching 500 million children multiple times --
537
1338000
3000
但你想想，要幫5億名孩童多次注射疫苗
22:36
20, 30 cents to reach a child --
538
1341000
2000
每個孩子花20，30分錢
22:38
that's not very much money.
539
1343000
2000
這樣其實不多
22:40
But right now we don't have enough of that.
540
1345000
2000
但現在我們的經費不太夠
22:42
We have a big gap in that money. We're cutting corners,
541
1347000
2000
我們需要很多經費，有時我們減少疫苗注射的次數
22:44
and every time we cut corners,
542
1349000
2000
但每當我們減少疫苗注射的次數
22:46
more places get infected that shouldn't have, and it just slows us down.
543
1351000
3000
有更多地區又出現新的病例，這讓我們的工作延宕
22:49
And that great buy costs us a little bit more.
544
1354000
3000
因此又得花費更多經費
22:52
BG: Well, hopefully we'll get the word out,
545
1357000
3000
BG：希望這消息能傳遞出去
22:55
and the governments will keep their generosity up.
546
1360000
3000
然後政府能再補助更多的經費
22:58
So good luck. We're all in this with you.
547
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祝福你，我們都支持這項計畫
23:00
Thank you. (BA: Thank you.)
548
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謝謝你 (BA：謝謝你)
23:02
(Applause)
549
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(掌聲)
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