TED2011
Bruce Aylward: How we'll stop polio for good
布鲁斯·艾尔沃德：我们怎样才能根除脊髓灰质炎
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脊髓灰质炎几乎被完全灭绝。但正如布鲁斯·艾尔沃德说道：对于这样一种恐怖的疾病，我们做的似乎总是不够。艾尔沃德给我们介绍了一个持续创造科学奇迹的项目。这个项目已在世界绝大多数国家根除了脊髓灰质炎，并且将完全的，永久地，在全世界将其灭绝。
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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我要
00:17
over the next 18 minutes
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在接下来的18分钟内
00:19
a pretty incredible idea.
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与大家分享一个不可思议的愿景
00:21
Actually, it's a really big idea.
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一个非常雄伟的愿景
00:23
But to get us started,
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不过首先
00:25
I want to ask if everyone
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我想请在座各位
00:27
could just close your eyes for two seconds
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闭上双眼在几秒钟内想一想
00:29
and try and think of a technology or a bit of science
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某种技术或者科学
00:32
that you think has changed the world.
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在你看来，改变了世界
00:38
Now I bet, in this audience,
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我打赌，这里所有的观众
00:40
you're thinking of some really incredible technology,
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你一定想到了某种神奇的技术
00:42
some stuff that I haven't even heard of,
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某种我甚至没听说过的玩意儿
00:44
I'm absolutely sure.
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绝对是的
00:46
But I'm also sure, pretty sure,
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但我同时也确信，非常肯定
00:49
that absolutely nobody is thinking of this.
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绝对没有人想到它
00:53
This is a polio vaccine.
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这是一支脊髓灰质炎疫苗
00:56
And it's a great thing actually
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其实，这很好
00:58
that nobody's had to think about it here today
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今天在座没人想到它
01:00
because it means that we can take this for granted.
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是因为我们已将它视为理所当然
01:02
This is a great technology.
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这是一项伟大的技术
01:04
We can take it completely for granted.
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我们可以完全地应用它
01:06
But it wasn't always that way.
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但是过去并不是这样
01:09
Even here in California,
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甚至就在这里，加利福尼亚
01:12
if we were to go back just a few years,
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如果退后几十年
01:14
it was a very different story.
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情况可大不相同
01:16
People were terrified of this disease.
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当时，人们惧怕这种疾病
01:18
They were terrified of polio, and it would cause public panic.
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他们十分害怕脊髓灰质炎，它能引起公众惊恐
01:21
And it was because of scenes like this.
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原因就如图中所示
01:24
In this scene,
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在这张图片里
01:26
people are living in an iron lung.
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人们生活在铁制的肺中
01:28
These are people who were perfectly healthy two or three days before,
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这些人，两三天前还相当健康
01:31
and then two days later,
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可几天后
01:33
they can no longer breathe,
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便丧失呼吸功能
01:35
and this polio virus has paralyzed
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脊髓灰质炎病毒
01:37
not only their arms and their legs,
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不仅仅瘫痪了他们的四肢
01:39
but also their breathing muscles.
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就连控制呼吸的肌肉也不放过
01:41
And they were going to spend the rest of their lives, usually,
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通常，他们的余生都得在
01:44
in this iron lung to breathe for them.
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铁肺里度过
01:46
This disease was terrifying.
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这个疾病十分可怕
01:48
There was no cure,
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当时却没有疗法
01:50
and there was no vaccine.
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也没有疫苗
01:52
The disease was so terrifying
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这个疾病如此恐怖
01:54
that the president of the United States
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以至于当时的美国总统
01:56
launched an extraordinary national effort
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发动了一场声势浩大的全国运动
01:59
to find a way to stop it.
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来试图阻止它的传播
02:02
Twenty years later, they succeeded
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二十年后，他们成功地
02:05
and developed the polio vaccine.
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开发出脊髓灰质炎疫苗
02:07
It was hailed as a scientific miracle
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这被视为科学奇迹
02:09
in the late 1950s.
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当时是20世纪50年代末
02:11
Finally, a vaccine that could stop this awful disease,
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终于，有一种疫苗能够阻止这种可怕的疾病
02:14
and here in the United States
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在美国
02:16
it had an incredible impact.
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它有着惊人的影响力
02:18
As you can see, the virus stopped,
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正如我们所知，病毒被遏制
02:20
and it stopped very, very fast.
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并且很快被遏制
02:23
But this wasn't the case
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可并不是
02:26
everywhere in the world.
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全世界都如此
02:28
And it happened so fast in the United States, however,
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虽然在美国，情况迅速好转，但是
02:31
that even just last month Jon Stewart said this:
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甚至就在上个月，乔恩·斯图尔特问我
02:34
(Video) Jon Stewart: Where is polio still active?
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（录像）乔恩·斯图尔特：脊髓灰质炎还活跃在哪些地方呢？
02:36
Because I thought that had been eradicated
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我以为它已经被灭绝
02:39
in the way that smallpox had been eradicated.
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就如天花从地球上消失一样
02:41
Bruce Aylward: Oops. Jon, polio's almost been eradicated.
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布鲁斯·艾尔沃德：哎，乔恩，脊髓灰质炎是几乎被灭绝了
02:45
But the reality is
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但现实是
02:47
that polio still exists today.
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它仍然存在于世间
02:49
We made this map for Jon to try to show him exactly where polio still exists.
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我们绘制了疾病分布图，给乔恩展示了目前的状况
02:52
This is the picture.
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这就是那张图
02:54
There's not very much left in the world.
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存于世界的病源已经很好了
02:57
But the reason there's not very much left
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而这是因为
02:59
is because there's been an extraordinary public/private partnership
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有一个非常出色的公私合作组织
03:02
working behind the scenes, almost unknown,
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一直在幕后积极工作
03:05
I'm sure to most of you here today.
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我肯定今天在座几乎都没听说过这个组织
03:07
It's been working for 20 years
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在过去20年来
03:09
to try and eradicate this disease,
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这个组织一直试图根除这种疾病
03:11
and it's got it down to these few cases
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并终于将其影响区域下降到
03:13
that you can see here on this graphic.
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我们现在看到的状况
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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我们被强烈震动
03:20
and realized that almost just isn't good enough
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我们似乎总是做得不够
03:23
with a virus like polio.
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难以应对像脊髓灰质炎这样的病毒
03:26
And this is the reason:
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原因如下
03:28
in two countries
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有两个国家
03:30
that hadn't had this disease for more than probably a decade,
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十多年未出现脊髓灰质炎
03:33
on opposite sides of the globe,
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它们各位于地球两端
03:35
there was suddenly terrible polio outbreaks.
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却突然都爆发了严重的脊髓灰质炎
03:38
Hundreds of people were paralyzed.
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数百人瘫痪
03:40
Hundreds of people died --
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死亡人数上百--
03:43
children as well as adults.
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儿童和成年人都成了受害者
03:45
And in both cases,
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在这两个国家
03:47
we were able to use genetic sequencing to look at the polio viruses,
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我们都运用了基因排序的方法来观察查病毒
03:50
and we could tell these viruses were not from these countries.
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发现这些病毒并不是来自本土
03:53
They had come from thousands of miles away.
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他们从几千公里外的地方远道而来
03:56
And in one case, it originated on another continent.
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其中一个国家的病毒竟来自于另一个大陆
03:59
And not only that, but when they came into these countries,
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不仅如此，当他们进入这些国家后
04:02
then they got on commercial jetliners probably
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很可能又登上了商务航班
04:05
and they traveled even farther
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飞到了更远的地方
04:07
to other places like Russia,
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如俄罗斯
04:09
where, for the first time in over a decade last year,
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在那里，去年，十多年来第一次
04:12
children were crippled and paralyzed
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有儿童因脊髓灰质炎而瘫痪
04:15
by a disease that they had not seen for years.
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而当地已多年未见这种疾病
04:19
Now all of these outbreaks that I just showed you,
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刚才我展示给你的这些疾病突发区域
04:22
these are under control now,
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情况已经得到控制
04:24
and it looks like they'll probably stop very, very quickly.
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并且看起来它们很快将停止
04:27
But the message was very clear.
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但信息是清晰的
04:30
Polio is still
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脊髓灰质炎仍然是
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a devastating, explosive disease.
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毁灭性，爆炸性的疾病
04:35
It's just happening in another part of the world.
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它不过正在世界另外一个角落发生
04:39
And our big idea
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我们巨大的愿景是
04:42
is that the scientific miracle of this decade
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本时代的科学奇迹
04:46
should be the complete eradication
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将彻底根除
04:48
of poliomyelitis.
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脊髓灰质炎
04:50
So I want to tell you a little bit
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在这里，我想要介绍一下
04:52
about what this partnership, the Polio Partnership,
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之前提到的合作伙伴组织，脊髓灰质炎合作机构
04:54
is trying to do.
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当前的工作
04:56
We're not trying to control polio.
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我们不是单纯去控制脊髓灰质炎
04:58
We're not trying to get it down to just a few cases,
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将它的发病率降低到极低
05:01
because this disease is like a root fire;
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因为这种疾病就像是火种
05:03
it can explode again if you don't snuff it out completely.
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若不完全熄灭，它随时可能爆发
05:06
So what we're looking for
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因此我们寻求的
05:08
is a permanent solution.
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是一种永久的解决方案
05:10
We want a world in which every child, just like you guys,
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我们希望在这个世界，每个孩子，都能像在座各位一样
05:13
can take for granted
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不用再为
05:15
a polio-free world.
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脊髓灰质炎而担心
05:17
So we're looking for a permanent solution,
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是的，我们在寻找一种永久的解决方案
05:19
and this is where we get lucky.
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幸运的是
05:21
This is one of the very few viruses in the world
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脊髓灰质炎属于这样一种少见的病毒类
05:24
where there are big enough cracks in its armor
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其本身带有一定缺陷
05:26
that we can try to do something truly extraordinary.
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让人类可以攻克，并取得伟大成就
05:29
This virus can only survive in people.
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脊髓灰质炎病毒只能在人体中存活
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It can't live for a very long time in people.
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并且存活时间很短
05:34
It doesn't survive in the environment hardly at all.
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它在自然界中几乎无法生存
05:37
And we've got pretty good vaccines, as I've just showed you.
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我们有很有效的疫苗，我刚才已展示给各位
05:40
So we are trying
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此我们正努力
05:42
to wipe out this virus completely.
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彻底根除这种病毒
05:45
What the polio eradication program is trying to do
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脊髓灰质炎根除项目正试图
05:48
is to kill the virus itself
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根除这种病毒本身
05:50
that causes polio
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来防止导致脊髓灰质炎
05:52
everywhere on Earth.
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在地球上肆意蔓延
05:54
Now we don't have a great track record
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我们并不擅长
05:56
when it comes to doing something like this,
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根除疾病
05:58
to eradicating diseases.
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这样的任务
06:00
It's been tried six times in the last century,
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上个世纪我们尝试了六次
06:03
and it's been successful exactly once.
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但只有一次真正成功
06:07
And this is because disease eradication,
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因为疾病根除
06:10
it's still the venture capital of public health.
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仍是公众健康的风险资金
06:13
The risks are massive,
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风险是巨大的
06:15
but the pay-off --
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但回报
06:18
economic, humanitarian, motivational --
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无论从经济，全人类，还是推动力来看
06:20
it's absolutely huge.
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也都是巨大的
06:22
One congressman here in the United States
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美国一位国会议员认为
06:25
thinks that the entire investment
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美国投入的
06:28
that the U.S. put into smallpox eradication
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用以根除天花的全部投资
06:30
pays itself off every 26 days --
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每26天就能收回一次成本
06:33
in foregone treatment costs
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通过抵消治疗成本
06:35
and vaccination costs.
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和疫苗的成本
06:37
And if we can finish polio eradication,
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如果我们能够完全根除小儿麻痹症
06:40
the poorest countries in the world
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世界上最穷的那些国家
06:42
are going to save over 50 billion dollars
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则将节省500亿美元
06:46
in the next 25 years alone.
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时间是仅在未来的25年内
06:49
So those are the kind of stakes that we're after.
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这就是我们追求的利益
06:52
But smallpox eradication was hard;
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但是根除天花的过程是很困难的
06:54
it was very, very hard.
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相当，相当艰难
06:56
And polio eradication, in many ways, is even tougher,
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而要根除小儿麻痹症，从很多方面来讲，还要难
06:59
and there's a few reasons for that.
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这里有几个因素
07:02
The first is that,
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首先
07:04
when we started trying to eradicate polio
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我们开始尝试根除脊髓灰质炎时
07:06
about 20 years ago,
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时间大概是20年前
07:08
more than twice as many countries were infected
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当时，被其感染的国家数量
07:10
than had been when we started off with smallpox.
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是开始根除天花之际的两倍多
07:13
And there were more than 10 times as many people
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而感染脊髓灰质炎国家的人口数
07:15
living in these countries.
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超过感染天花的10倍
07:17
So it was a massive effort.
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因此当时的努力是艰巨的
07:19
The second challenge we had was --
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我们面临的第二个挑战是--
07:21
in contrast to the smallpox vaccine,
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脊髓灰质炎疫苗与天花疫苗性质不同
07:23
which was very stable, and a single dose protected you for life --
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天花疫苗性质稳定，打一次就终身免疫
07:26
the polio vaccine is incredibly fragile.
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而脊髓灰质炎疫苗是否脆弱
07:29
It deteriorates so quickly in the tropics
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在赤道地区，它很快变质
07:32
that we've had to put this special vaccine monitor
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我们必须将特殊的疫苗检测器
07:34
on every single vial
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安在每支疫苗上
07:36
so that it will change very quickly
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因此它能迅速做出反应
07:38
when it's exposed to too much heat,
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当疫苗因为受热过多而改变性质时
07:40
and we can tell that it's not a good vaccine to use on a child --
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我们便知道它不再适用于儿童
07:43
it's not potent; it's not going to protect them.
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因为效力不够，无法保护儿童
07:45
Even then, kids need many doses of the vaccine.
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即便这样，儿童仍然需要多次注射疫苗
07:48
But the third challenge we have --
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我们当时面临的第三个挑战
07:50
and probably even bigger one, the biggest challenge --
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很可能是最大的一个挑战
07:53
is that, in contrast to smallpox where you could always see your enemy --
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与天花作战时，我们总能看清敌人
07:56
every single person almost who was infected with smallpox
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几乎每个感染天花的人
07:59
had this telltale rash.
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都会长出明显的疹子
08:01
So you could get around the disease;
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因此我们可以从疾病周边入手
08:03
you could vaccinate around the disease and cut it off.
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给疾病存在的周边区域打疫苗,将其断绝
08:06
With polio it's almost completely different.
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而脊髓灰质炎则全然不同
08:09
The vast majority of people who are infected with the polio virus
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绝大多数被病毒感染的人
08:12
show absolutely no sign of the disease.
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不会表现出任何迹象
08:15
So you can't see the enemy most of the time,
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因此很多时候我们根本看不见敌人
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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我们需要一种与应对天花非常不同的方式
08:23
than what was done with smallpox.
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来根除脊髓灰质炎
08:25
We've had to create
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我们不得不创造出
08:27
one of the largest social movements in history.
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历史上最大的社会运动之一
08:30
There's over 10 million people,
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投入人数超过一千万
08:32
probably 20 million people,
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甚至接近两千万
08:34
largely volunteers,
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大多为志愿者
08:36
who have been working over the last 20 years
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他们过去二十年来一直努力
08:38
in what has now been called
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贡献于现在被称为
08:40
the largest internationally-coordinated operation in peacetime.
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和平年代最大的国际协同运作
08:44
These people, these 20 million people,
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这些人，这两千万人
08:47
vaccinate over 500 million children
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给五亿多的儿童注射疫苗
08:50
every single year,
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每年如此
08:52
multiple times
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在运作繁忙的时候
08:54
at the peak of our operation.
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注射数量增倍
08:57
Now giving the polio vaccine is simple.
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注射脊髓灰质炎疫苗很简单
08:59
It's just two drops, like that.
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就是这样简单的两针
09:01
But reaching 500 million people
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但要普及五亿多人
09:03
is much, much tougher.
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那可是难上加难
09:05
And these vaccinators, these volunteers,
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这些疫苗注射者，这些志愿者们
09:08
they have got to dive headlong
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必须投身到
09:10
into some of the toughest, densest
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一些环境最恶劣的
09:12
urban slums in the world.
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城市贫民窟中
09:14
They've got to trek under sweltering suns
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必须在炎阳下跋涉
09:17
to some of the most remote, difficult to reach places in the world.
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到一些最遥远，最难以到达的地方
09:21
And they also have to dodge bullets,
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有时他们也要躲避战火
09:23
because we have got to operate
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因为我们必须要运作
09:25
during shaky cease-fires and truces
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即使在不稳定的停火和休战条约下
09:27
to try and vaccinate children,
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也要给孩子注射疫苗
09:29
even in areas affected by conflict.
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在卷入冲突的地区也如此
09:32
One reporter
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一个记者
09:34
who was watching our program in Somalia about five years ago --
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五年前曾关注我们在索马里的项目
09:37
a place which has eradicated polio,
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在那里，脊髓灰质炎曾被根除
09:39
not once, but twice, because they got reinfected.
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然而，不是一次，而是两次，因其再度蔓延
09:41
He was sitting outside of the road,
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他坐在路边
09:43
watching one of these polio campaigns unfold,
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关注一项脊髓灰质炎运动是如何展开的
09:45
and a few months later he wrote:
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几个月后他写道
09:47
"This is foreign aid at its most heroic."
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这是最伟大的外来援助
09:51
And these heroes, they come from every walk of life,
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这些英雄，他们来自各行各业
09:53
all sorts of backgrounds.
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各种背景
09:55
But one of the most extraordinary is Rotary International.
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但其中最卓越的是国际扶轮社
09:58
This is a group
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这个组织中
10:00
whose million-strong army of volunteers
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有上百万的志愿者
10:02
have been working to eradicate polio
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为根除脊髓灰质炎
10:04
for over 20 years.
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努力了二十年
10:06
They're right at the center of the whole thing.
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他们是整个运动的正中心
10:09
Now it took years to build up the infrastructure
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我们花了很多时间来发展基础建设
10:11
for polio eradication --
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为的是根除脊髓灰质炎
10:13
more than 15 years, much longer than it should have --
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超过十五年，比我们预计要长
10:16
but once it was built, the results were striking.
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但一旦建成，效果是显著的
10:19
Within a couple of years,
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几年之类
10:21
every country that started polio eradication
246
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那些开始进行脊髓灰质炎根除的国家
10:23
rapidly eradicated all three of their polio viruses,
247
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迅速地消灭了现有的三种脊髓灰质炎病毒
10:27
with the exception of four countries that you see here.
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唯一例外是图表上的这四个国家
10:30
And in each of those, it was only part of the country.
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而在这几个国家中，疾病都只存在于一小部分区域
10:34
And then, by 1999,
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1999年
10:36
one of the three polio viruses
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我们试图根除的
10:38
that we were trying to eradicate
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三种脊髓灰质炎病毒其中之一
10:40
had been completely eradicated worldwide --
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被完全地在全世界消灭
10:43
proof of concept.
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证明了这是有效的方式
10:45
And then today,
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今天
10:48
there's been a 99 percent reduction --
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有百分之九十九
10:50
greater than 99 percent reduction --
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超过百分之九十九的
10:52
in the number of children
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儿童
10:54
who are being paralyzed by this awful disease.
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免于因这恐怖疾病而瘫痪
10:57
When we started, over 20 years ago,
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而在二十多年前我们开始之际
10:59
1,000 children were being paralyzed
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一千名儿童因它瘫痪
11:01
every single day by this virus.
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这是每一天的数据
11:04
Last year, it was 1,000.
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去年一年的总数仅为一千
11:07
And at the same time,
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同时
11:09
the polio eradication program
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脊髓灰质炎根除项目
11:11
has been working to help with a lot of other areas.
266
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也在帮助其他领域的工作
11:13
It's been working to help control pandemic flu,
267
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比如控制流行感冒
11:16
SARS for example.
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非典型肺炎
11:18
It's also tried to save children by doing other things --
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它也试图通过其他方式来拯救儿童
11:21
giving vitamin A drops, giving measles shots,
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例如注射维他命A，注射麻疹药物
11:24
giving bed nets against malaria even
271
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散发蚊帐来抵御疟疾
11:26
during some of these campaigns.
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在这些运动中
11:28
But the most exciting thing
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最振奋人心的是
11:30
that the polio eradication program has been doing
274
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脊髓灰质炎根除项目的行动
11:32
has been to force us,
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也促使我们
11:34
the international community,
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679000
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国际社区
11:36
to reach every single child, every single community,
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来采取行动，帮助每一个儿童，每一个社区--
11:39
the most vulnerable people in the world,
278
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3000
帮助那些最脆弱的人群
11:42
with the most basic of health services,
279
687000
2000
给予他们最基本的医疗服务
11:44
irrespective of geography, poverty,
280
689000
4000
无论地理，贫困
11:48
culture and even conflict.
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文化甚至武装冲突状况如何
11:50
So things were looking very exciting,
282
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进展本来激动人心
11:52
and then about five years ago,
283
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2000
可大概在五年前
11:54
this virus, this ancient virus, started to fight back.
284
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这种病毒，这种古老的病毒，重回战场
11:57
The first problem we ran into
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我们遇到的第一个问题是
12:00
was that, in these last four countries, the strongholds of this virus,
286
705000
3000
在最后的四个国家，这种病毒的根据地
12:03
we just couldn't seem to get the virus rooted out.
287
708000
4000
我们似乎无法将它根除
12:07
And then to make the matters even worse,
288
712000
2000
更糟糕的是
12:09
the virus started to spread out of these four places,
289
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病毒开始在这四个国家以外的地区传播
12:12
especially northern India and northern Nigeria,
290
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特别是在印度北部和尼日尼亚北部
12:15
into much of Africa, Asia, and even into Europe,
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它深入到非洲亚洲多数地区，甚至是欧洲
12:18
causing horrific outbreaks
292
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导致了极大的爆发
12:20
in places that had not seen this disease for decades.
293
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4000
而这些地方已经几十年没有出现过这种疾病
12:24
And then,
294
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然后
12:26
in one of the most important, tenacious
295
731000
3000
在最重要，最顽固的
12:29
and toughest reservoirs of the polio virus in the world,
296
734000
3000
脊髓灰质炎病毒感染区
12:32
we found that our vaccine was working
297
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我们发现我们的疫苗
12:35
half as well as it should have.
298
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效力减半
12:37
In conditions like this,
299
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2000
在这种情况下
12:39
the vaccine just couldn't get the grip it needed to
300
744000
2000
疫苗无法满足要求的时间
12:41
in the guts of these children
301
746000
2000
进入孩子的胃中
12:43
and protect them the way that it needed to.
302
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按他们需要的方式来保护他们
12:45
Now at that time,
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在那时
12:47
there was a great, as you can imagine,
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我们感到一种巨大的，你能够想象的
12:49
frustration -- let's call it frustration --
305
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沮丧，我们暂且称之为沮丧吧
12:51
it started to grow very, very quickly.
306
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2000
它开始迅速蔓延
12:53
And all of a sudden, some very important voices
307
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突然，一些世界公众医疗领域
12:55
in the world of public health
308
760000
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很重要的声音
12:57
started to say, "Hang on.
309
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开始说，等等
12:59
We should abandon this idea of eradication.
310
764000
3000
我们应该放弃根除的目标
13:02
Let's settle for control -- that's good enough."
311
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我们以控制为目标吧，这其实已足够
13:05
Now as seductive as the idea of control sounds,
312
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控制这一主意听起来是不错
13:09
it's a false premise.
313
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可它是一张空头支票
13:11
The brutal truth is,
314
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2000
残酷的现实是
13:13
if we don't have the will or the skill,
315
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2000
如果我们没有愿望或技能
13:15
or even the money that we need
316
780000
3000
或者所需的资金
13:18
to reach children, the most vulnerable children in the world,
317
783000
3000
来帮助儿童，那些世界上最脆弱的儿童
13:21
with something as simple
318
786000
2000
哪怕方法是通过简单的
13:23
as an oral polio vaccine,
319
788000
3000
口头脊髓灰质炎疫苗
13:26
then pretty soon,
320
791000
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那么很快
13:28
more than 200,000 children
321
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2000
超过二十万的儿童
13:30
are again going to be paralyzed by this disease
322
795000
2000
将再一次因脊髓灰质炎而瘫痪
13:32
every single year.
323
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2000
每年如此
13:34
There's absolutely no question.
324
799000
2000
毫无疑问
13:36
These are children like Umar.
325
801000
3000
乌玛就是其中之一
13:39
Umar is seven years old,
326
804000
3000
他七岁
13:42
and he's from northern Nigeria.
327
807000
2000
来自尼日尼亚北部
13:44
He lives in a family home there
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809000
2000
他住在一家中
13:46
with his eight brothers and sisters.
329
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2000
与他的八个兄弟姐妹在一起
13:48
Umar also has polio.
330
813000
3000
乌玛有脊髓灰质炎
13:51
Umar was paralyzed for life.
331
816000
2000
终身瘫痪
13:53
His right leg was paralyzed
332
818000
2000
他的右腿
13:55
in 2004.
333
820000
2000
在2004年瘫痪
13:57
This leg, his right leg,
334
822000
3000
这只腿，他的右腿
14:00
now takes an awful beating
335
825000
2000
现在受到严重的损害
14:02
because he has to half-crawl,
336
827000
2000
因为它必须半爬行
14:04
because it's faster to move that way
337
829000
2000
才能行动得更快
14:06
to keep up with his friends, keep up with his brothers and sisters,
338
831000
2000
才能跟上他的朋友，兄弟姐妹
14:08
than to get up on his crutches and walk.
339
833000
3000
这比靠拐杖行走要快
14:11
But Umar is a fantastic student. He's an incredible kid.
340
836000
3000
但乌玛也是一个非常优秀的学生，一个不可思议的孩子
14:14
As you probably can't see the detail here,
341
839000
2000
你可能难以看清细节
14:16
but this is his report card,
342
841000
2000
这是他的成绩卡
14:18
and you'll see, he's got perfect scores.
343
843000
2000
如你所见，他成绩完美
14:20
He got 100 percent in all the important things,
344
845000
2000
所有的重要科目他都拿了满分
14:22
like nursery rhymes, for example there.
345
847000
3000
比如这儿，儿歌
14:25
But you know I'd love to be able to tell you
346
850000
3000
我也希望能够告诉各位
14:28
that Umar is a typical kid with polio these days,
347
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2000
乌玛是目前典型的一个患脊髓灰质炎的儿童
14:30
but it's not true.
348
855000
2000
但事实不是这样
14:32
Umar is an exceptional kid
349
857000
2000
他是个例外的孩子
14:34
in exceptional circumstances.
350
859000
2000
处在例外的环境中
14:36
The reality of polio today
351
861000
2000
今天，脊髓灰质炎的现实
14:38
is something very different.
352
863000
3000
与以前大不相同
14:41
Polio strikes the poorest communities in the world.
353
866000
4000
它打击的是世界上最穷困的社会群体
14:45
It leaves their children paralyzed,
354
870000
2000
它让孩子们瘫痪
14:47
and it drags their families
355
872000
2000
让他们的家庭
14:49
deeper into poverty,
356
874000
2000
深陷贫困
14:51
because they're desperately searching
357
876000
2000
因为他们绝望地搜寻疗法
14:53
and they're desperately spending the little bit of savings that they have,
358
878000
2000
绝望地花费掉那少得可怜的积蓄
14:55
trying in vain
359
880000
2000
却徒劳无获
14:57
to find a cure for their children.
360
882000
3000
找不到拯救孩子的办法
15:01
We think children deserve better.
361
886000
3000
我们相信，孩子们应该过得更好
15:04
And so when the going got really tough
362
889000
3000
我们的脊髓灰质炎根除项目
15:07
in the polio eradication program
363
892000
2000
曾一度举步维艰
15:09
about two years ago,
364
894000
2000
那大概是两年前的时候
15:11
when people were saying, "We should call it off,"
365
896000
2000
人们都说，“我们应该停止了”
15:13
the Polio Partnership
366
898000
2000
而脊髓灰质炎伙伴机构
15:15
decided to buckle down once again
367
900000
2000
决定再次投身其中
15:17
and try and find innovative new solutions,
368
902000
3000
寻找创新的解决方案
15:20
new ways to get to the children
369
905000
2000
用新的方式来拯救那些
15:22
that we were missing again and again.
370
907000
2000
被我们一再遗落的孩子们
15:24
In northern India, we started mapping the cases
371
909000
2000
在印度北部，我们开始绘制疾病分布图
15:26
using satellite imaging like this,
372
911000
2000
应用这样的卫星成像
15:28
so that we could guide our investments and vaccinator shelters,
373
913000
3000
我们能够引导我们的投资和接种员队伍
15:31
so we could get to the millions of children
374
916000
2000
找到上百万儿童
15:33
on the Koshi River basin
375
918000
2000
他们居住在波曲河盆地
15:35
where there are no other health services.
376
920000
2000
那里没有其他任何医疗服务
15:37
In northern Nigeria,
377
922000
2000
在尼日尼亚北部
15:39
the political leaders and the traditional Muslim leaders,
378
924000
2000
政治领导和传统穆斯林领导
15:41
they got directly involved in the program
379
926000
2000
都直接参与到项目中
15:43
to help solve the problems of logistics
380
928000
2000
帮助解决物流问题
15:45
and community confidence.
381
930000
2000
建立社区信心
15:47
And now they've even started using these devices --
382
932000
3000
现在他们开始运用这些设备
15:50
speaking of cool technology --
383
935000
2000
这些高科技
15:52
these little devices, little GIS trackers like this,
384
937000
3000
这些小型的GIS跟踪器
15:55
which they put into the vaccine carriers of their vaccinators.
385
940000
3000
被放到接种员的疫苗携带器中
15:58
And then they can track them,
386
943000
2000
这样他们可以跟踪接种员
16:00
and at the end of the day, they look and see,
387
945000
2000
每天工作结束之际，他们会检查
16:02
did these guys get every single street, every single house.
388
947000
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看看这些人是否到访了每条街的每户人家
16:04
This is the kind of commitment now we're seeing
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我们需要的就是这样的承诺
16:07
to try and reach all of the children we've been missing.
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来找到所有那些被我们遗落的儿童
16:10
And in Afghanistan, we're trying new approaches --
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在阿富汗，我们尝试新的方法
16:13
access negotiators.
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通入谈判者
16:15
We're working closely with the International Committee of the Red Cross
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我们与国际红十字委员会紧密合作
16:18
to ensure that we can reach every child.
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保证我们能够触及每个孩子
16:21
But as we tried these extraordinary things,
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在我们尝试这些独特的方式
16:24
as people went to this trouble
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当人们费劲心思
16:26
to try and rework their tactics,
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重新制定战略的同时
16:28
we went back to the vaccine -- it's a 50-year-old vaccine --
398
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我们再度回到疫苗本身，这疫苗已有50年历史
16:31
and we thought, surely we can make a better vaccine,
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我们确信，我们能够研制出更好的疫苗
16:34
so that when they finally get to these kids,
400
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因此当儿童最终接收到疫苗时
16:36
we can have a better bang for our buck.
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我们会取得更好的预防效果
16:38
And this started an incredible collaboration with industry,
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我们在行业内进行了辉煌的合作
16:41
and within six months,
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六个月后
16:43
we were testing a new polio vaccine
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我们便开始测试一种新型疫苗
16:45
that targeted, just two years ago,
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针对的是，自前年以来
16:47
the last two types of polio in the world.
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世界上余下的两种脊髓灰质炎病毒
16:50
Now June the ninth, 2009,
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2009年6月9日
16:53
we got the first results from the first trial with this vaccine,
408
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我们得到了第一批疫苗的测试结果
16:56
and it turned out to be a game-changer.
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这是一个转折点
16:58
The new vaccine
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2000
新的疫苗的效应
17:00
had twice the impact on these last couple of viruses
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3000
针对这最后的两种病毒
17:03
as the old vaccine had,
412
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2000
比旧的强一倍
17:05
and we immediately started using this.
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我们立刻投入使用新疫苗
17:07
Well, in a couple of months we had to get it out of production.
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几个月后，我们便生产出成品
17:10
And it started rolling off the production lines
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疫苗源源不断地从生产线上
17:12
and into the mouths of children around the world.
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被送到世界各地儿童口中
17:14
And we didn't start with the easy places.
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我们并不是从容易的地方开始
17:16
The first place this vaccine was used
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第一个采用新疫苗的地方
17:18
was in southern Afghanistan,
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2000
是阿富汗南部
17:20
because it's in places like that
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因为正是在这些地方
17:22
where kids are going to benefit the most
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孩子们最能从
17:24
from technologies like this.
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这样的新科技中获益
17:26
Now here at TED, over the last couple of days,
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现在，在这里，最近几天
17:29
I've seen people challenging the audience again and again
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我看到各位发言人不断挑战观众
17:33
to believe in the impossible.
425
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去相信不可能的事物
17:36
So this morning at about seven o'clock,
426
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所以今天早上7点左右
17:39
I decided that we'd try to drive Chris
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我决定要把克里斯
17:41
and the production crew here berserk
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和出品团队弄得抓狂
17:43
by downloading all of our data from India again,
429
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我再次下载我们印度的所有数据
17:47
so that you could see something
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为了各位能看到
17:49
that's just unfolding today,
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我们今天刚刚发生的事情
17:51
which proves that the impossible is possible.
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它证明了不可能也能成为可能
17:55
And only two years ago, people were saying that this is impossible.
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而就在两年前，人们还说这是不可能发生的
17:58
Now remember, northern India is the perfect storm
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大家都还记得，印度北部
18:01
when it comes to polio.
435
1066000
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是脊髓灰质炎的风暴之地
18:03
Over 500,000 children
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1068000
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超过500，000名儿童
18:05
are born in the two states that have never stopped polio --
437
1070000
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出生于这两个从未中止脊髓灰质炎的地区--
18:08
Uttar Pradesh and Bihar --
438
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他们是Uttar Pradesh和Bihar省
18:11
500,000 children every single month.
439
1076000
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500,000名儿童，每个月出生
18:13
Sanitation is terrible,
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1078000
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卫生条件极其糟糕
18:15
and our old vaccine, you remember,
441
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2000
而我们的旧疫苗，你知道的
18:17
worked half as well as it should have.
442
1082000
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效力只有一半
18:20
And yet, the impossible is happening.
443
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但是不可能的事情正在发生
18:23
Today marks exactly six months --
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今天刚好满六个月
18:27
and for the first time in history,
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1092000
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这是历史上第一次
18:29
not a single child has been paralyzed
446
1094000
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没有一个孩子因脊髓灰质炎而瘫痪
18:31
in Uttar Pradesh or Bihar.
447
1096000
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这是Uttar Pradesh和Bihar省的情况
18:33
(Applause)
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11000
掌声
18:44
India's not unique.
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不仅在印度
18:47
In Umar's home country of Nigeria,
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在乌玛的家乡尼日尼亚
18:49
a 95 percent reduction
451
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有百分之九十五的减少
18:51
in the number of children paralyzed by polio last year.
452
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出现在去年因脊髓灰质炎瘫痪的儿童数量中
18:54
And in the last six months,
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在过去六个月
18:56
we've had less places reinfected by polio
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2000
脊髓灰质炎再感染地区的数量
18:58
than at any other time in history.
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3000
也下降到历史以来最低
19:02
Ladies and gentlemen, with a combination
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女士们先生们，我们结合了
19:04
of smart people, smart technology
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人类的智慧，先进的科技
19:06
and smart investments,
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2000
创新的发明
19:08
polio can now be eradicated anywhere.
459
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4000
使得脊髓灰质炎无处藏身
19:12
We have major challenges, you can imagine,
460
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2000
我们面临巨大的挑战，如你所知
19:14
to finish this job,
461
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来完成这项事业
19:16
but as you've also seen,
462
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但你也看到了
19:18
it's doable,
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2000
它可能的
19:20
it has great secondary benefits,
464
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2000
它能带来巨大的衍生利益
19:22
and polio eradication is a great buy.
465
1147000
3000
而根除脊髓灰质炎是一笔很棒的交易
19:25
And as long as any child anywhere
466
1150000
3000
只要世界上还有儿童
19:28
is paralyzed by this virus,
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2000
因其瘫痪
19:30
it's a stark reminder
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2000
就提醒着我们
19:32
that we are failing, as a society, to reach children
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整个社会就还未成功地给儿童
19:35
with the most basic of services.
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2000
提供最基本的服务
19:37
And for that reason, polio eradication:
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2000
因此，根除脊髓灰质炎
19:39
it's the ultimate in equity
472
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3000
意味着最终的平等
19:42
and it's the ultimate in social justice.
473
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3000
和社会公正
19:45
The huge social movement
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这个巨大的社会活动群体
19:47
that's been involved in polio eradication
475
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2000
一直以来参与到根除脊髓灰质炎事业中
19:49
is ready to do way more for these children.
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2000
正准备为这些儿童贡献更多
19:51
It's ready to reach them with bed nets, with other things.
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1176000
3000
给他们提供蚊帐，以及其他
19:54
But capitalizing on their enthusiasm,
478
1179000
3000
而利用他们的热情
19:57
capitalizing on their energy
479
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2000
他们的能量
19:59
means finishing the job
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2000
意味着完成
20:01
that they started 20 years ago.
481
1186000
3000
这项20年前开始的工作
20:04
Finishing polio is a smart thing to do,
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3000
根除脊髓灰质炎是一件明智的事
20:07
and it's the right thing to do.
483
1192000
2000
同时也是正确的
20:09
Now we're in tough times economically.
484
1194000
3000
现在我们处在金融困难时期
20:12
But as David Cameron of the United Kingdom
485
1197000
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但正如英国大卫·卡梅隆首相
20:15
said about a month ago when he was talking about polio,
486
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3000
一个月前谈到脊髓灰质炎时所说的
20:18
"There's never a wrong time
487
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“做合适的事情
20:20
to do the right thing."
488
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2000
从来没有错误的时间”
20:22
Finishing polio eradication
489
1207000
2000
而根除脊髓灰质炎
20:24
is the right thing to do.
490
1209000
2000
就是这样无比正确一件事
20:26
And we are at a crossroads right now
491
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2000
我们现在处在十字路口
20:28
in this great effort over the last 20 years.
492
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2000
经过20年来艰难的努力
20:30
We have a new vaccine,
493
1215000
2000
我们有了新的疫苗
20:32
we have new resolve,
494
1217000
2000
我们有了新的解决方式
20:34
and we have new tactics.
495
1219000
2000
有了新的战术
20:36
We have the chance
496
1221000
2000
我们有机会
20:38
to write an entirely new polio-free chapter
497
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3000
将告别脊髓灰质炎的新篇章
20:41
in human history.
498
1226000
3000
书写进人类历史
20:44
But if we blink now,
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但稍一恍惚
20:47
we will lose forever
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1232000
2000
我们便可能永远失去
20:49
the chance to eradicate an ancient disease.
501
1234000
4000
彻底根除这个古老疾病的机会
20:54
Here's a great idea to spread:
502
1239000
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这就是我今天要传播的愿景
20:57
End polio now.
503
1242000
2000
立即根除脊髓灰质炎
20:59
Help us tell the story.
504
1244000
2000
请帮我们传播这个故事吧
21:01
Help us build the momentum
505
1246000
2000
帮我们筑造声势
21:03
so that very soon
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那么很快
21:05
every child, every parent
507
1250000
2000
每一个孩子，每一个父母
21:07
everywhere
508
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2000
不论在哪里
21:09
can also take for granted
509
1254000
2000
都能理所应当地
21:11
a polio-free life forever.
510
1256000
3000
永远不再为脊髓灰质炎担忧
21:14
Thank you.
511
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谢谢大家
21:16
(Applause)
512
1261000
22000
掌声
21:38
Bill Gates: Well Bruce, where do you think the toughest places are going to be?
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比尔·盖茨：布鲁斯，你认为最困难的地方在哪里
21:41
Where would you say we need to be the smartest?
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我们需要在那些地方特别谨慎
21:44
BA: The four places where you saw, that we've never stopped --
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布鲁斯·艾尔沃德：就是你刚才看到的那四个地方，我们从未中止过疾病的区域
21:47
northern Nigeria, northern India,
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1292000
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尼日尼亚北部，印度北部
21:49
the southern corner of Afghanistan
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1294000
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阿富汗南角
21:51
and bordering areas of Pakistan --
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和巴基斯坦交界处
21:53
they're going to be the toughest.
519
1298000
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这些区域是最困难的
21:55
But the interesting thing is, of those three,
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关于其中三个国家，有一点很有趣
21:57
India's looking real good, as you just saw in the data.
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印度现在情况很好，正如刚才的数据显示
21:59
And Afghanistan, Afghanistan, we think
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在阿富汗，我们
22:01
has probably stopped polio repeatedly.
523
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2000
大概多次了中断了脊髓灰质炎感染
22:03
It keeps getting reinfected.
524
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2000
但它又不断复发
22:05
So the tough ones: going to get the top of Nigeria finished
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因此最困难的是尼日尼亚北部
22:07
and getting Pakistan finished.
526
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和巴基斯坦
22:09
They're going to be the tough ones.
527
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它们是我们最难根除脊髓灰质炎的地区
22:11
BG: Now what about the money?
528
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比尔·盖茨：资金方面呢？
22:13
Give us a sense of how much the campaign costs a year.
529
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3000
这场运动每年大概会耗费多少钱
22:16
And is it easy to raise that money?
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资金的筹集容易吗？
22:19
And what's it going to be like the next couple of years?
531
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接下来几年情况如何？
22:21
BA: It's interesting.
532
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布鲁斯·艾尔沃德：这一点比较有趣
22:23
We spend right now about 750 million
533
1328000
2000
我们现在每年花费7.5
22:25
to 800 million dollars a year.
534
1330000
3000
到8亿美元
22:28
That's what it costs to reach 500 million children.
535
1333000
2000
这是帮助5亿儿童的花费
22:30
It sounds like a lot of money; it is a lot of money.
536
1335000
3000
这数目听起来很大，的确，是花了很多钱
22:33
But when you're reaching 500 million children multiple times --
537
1338000
3000
但用这些钱，我们能给5亿儿童提供多次的帮助
22:36
20, 30 cents to reach a child --
538
1341000
2000
每个儿童仅花费了20到 30美分
22:38
that's not very much money.
539
1343000
2000
这其实是很少的数目
22:40
But right now we don't have enough of that.
540
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而现在我们资金不够
22:42
We have a big gap in that money. We're cutting corners,
541
1347000
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我们差的还很远。因此我们在减少开支
22:44
and every time we cut corners,
542
1349000
2000
但每减少一次
22:46
more places get infected that shouldn't have, and it just slows us down.
543
1351000
3000
就意味着更多本不该被感染的地区受到感染，同时减缓我们的进度
22:49
And that great buy costs us a little bit more.
544
1354000
3000
而这项伟大交易的成本又上涨了一些
22:52
BG: Well, hopefully we'll get the word out,
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3000
比尔·盖茨：希望我们可以
22:55
and the governments will keep their generosity up.
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让政府慷慨许诺，资助这项事业
22:58
So good luck. We're all in this with you.
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祝好运，我们都支持你们
23:00
Thank you. (BA: Thank you.)
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非常感谢（比尔·盖茨：谢谢你）
23:02
(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