By the middle of 2020, when there were more than 2.5 million coronavirus cases in the US, and when numbers were growing at an alarming rate, Cuba had reported just 2,448 cases in a population of 11.3 million. One reason for their success in controlling the outbreak is likely to be the country's strong healthcare system. Cuba has 8.19 doctors per 1,000 patients, which is the highest ratio in the world.
到2020年年中,當(dāng)美國(guó)的新冠病毒感染病例超過(guò)了250萬(wàn)例并以驚人的速度增長(zhǎng)時(shí),古巴1130萬(wàn)人口中僅報(bào)告了2448例病例。他們成功控制疫情的一個(gè)原因可能是該國(guó)強(qiáng)大的醫(yī)療體系。古巴每1000名病人中就有8.19名醫(yī)生,這一比例為世界最高。
A trillion dollars isn't enough to change the world's healthcare system, so here's an idea. We allocate some of our money to setting up a system of universal healthcare in one country. This country becomes a flagship, an advert to other countries of the benefits of universal healthcare.
一萬(wàn)億美元不足以改變整個(gè)世界的醫(yī)療體系,所以我有個(gè)想法。咱們撥出一部分錢在一個(gè)國(guó)家建立全民醫(yī)療保健系統(tǒng)。等這個(gè)國(guó)家變成精英后再向其他國(guó)家宣傳全民醫(yī)保的好處。
I want to choose a large country, so that the transformation is both a challenge and a beacon. Take Ethiopia, for example. With a population of 100 million, Ethiopia has a large economy but only about three doctors per 100,000 people. Maternal and child mortality is relatively high, mainly because most births take place in homes, without the presence of a trained modern midwife. Poor sanitation and inadequate nutrition exacerbate health problems.
我想選擇一個(gè)大國(guó),這樣的轉(zhuǎn)型既是挑戰(zhàn),也是燈塔(指路明燈)。以埃塞俄比亞為例。埃塞俄比亞有1億人口,經(jīng)濟(jì)規(guī)模很大,但每10萬(wàn)人中卻只有3名醫(yī)生。產(chǎn)婦和兒童的死亡率相對(duì)較高,主要是因?yàn)榇蠖鄶?shù)分娩都是在家里進(jìn)行的,沒有受過(guò)訓(xùn)練的現(xiàn)代助產(chǎn)士的幫助。衛(wèi)生條件差和營(yíng)養(yǎng)不足加劇了健康問(wèn)題。
If we helped transform Ethiopia's healthcare system, of the many benefits, one would be that trained professional medics would be more inclined to stay in the country rather than emigrate. We'll need to look at and learn from other places, including Indonesia, with its ambitious attempt to introduce a system of universal healthcare, Jaminan Kesehatan Nasional, which by 2019 covered 221 million people, or 83% of the population.
如果我們幫助改變埃塞俄比亞的醫(yī)療保健系統(tǒng),在眾多好處中,其中之一就是訓(xùn)練有素的專業(yè)醫(yī)療人員將更傾向于留在該國(guó)而不是移民他國(guó)。我們需要借鑒其他國(guó)家的經(jīng)驗(yàn),包括印度尼西亞,該國(guó)嘗試引入全民醫(yī)保體系——Jaminan Kesehatan Nasional,且雄心勃勃。該體系到2019年為止覆蓋了2.21億人,占其總?cè)丝诘?3%。
So there's some of our money to be spent on a demonstration of universal healthcare. Another good chunk should go to vaccines, both development and deployment. If this wasn't considered much of a priority before the coronavirus crisis, it is now. We all understand only too well now that the development, testing and equitable distribution of a vaccine is a huge and costly undertaking, with results that are far from guaranteed.
所以我們可以把一部分錢花在全民醫(yī)保的示范國(guó)上,另外一大部分應(yīng)該用于疫苗的開發(fā)和部署。如果說(shuō)在新冠病毒危機(jī)出現(xiàn)之前這還不是一個(gè)優(yōu)先事項(xiàng),那么現(xiàn)在已經(jīng)是了。我們大家現(xiàn)在都非常清楚,疫苗的開發(fā)、測(cè)試和公平分配是一項(xiàng)巨大且昂貴的工作,其結(jié)果遠(yuǎn)遠(yuǎn)不能得到保證。