評論
打印
Excellences, honourable ministers, distinguished participants, ladies and gentlemen,
諸位閣下、各位尊敬的部長、尊敬的與會者、女士們、先生們：
Welcome to this high-level meeting on building resilient health systems. I thank you for your time and your expertise.
歡迎出席本次有關建設有恢復力的衛生系統的高級別會議。謝謝各位抽出時間出席并帶來你們的專業意見。
Better health is a nation-building strategy. Without basic public health infrastructures and systems in place, no country is stable.
更好的衛生是建設國家戰略的組成部分。沒有基本的公共衛生基礎設施和系統，沒有哪個國家能夠保持穩定。
No society is secure. No resilience exists to withstand shocks, whether coming from a changing climate, a natural disaster, or a killer virus like Ebola.
沒有哪個社會是安全的。沒有恢復力也就無法承受沖擊，不管這種沖擊是來自氣候變化、自然災害還是像埃博拉這樣的致命病毒。
The 3 hardest-hit countries, Guinea, Liberia, and Sierra Leone, are among the poorest in the world. All 3 have only recently emerged from years of civil war and conflict that left health infrastructures badly damaged or destroyed.
幾內亞、利比里亞和塞拉利昂這三個受影響最大的國家也屬于世界上最貧窮的國家。三國都是近年來才結束多年內戰和沖突，衛生基礎設施遭到嚴重損失和破壞。
Prior to the outbreaks, these countries had only 1 to 2 doctors to treat a population of nearly 100 000 people. That number has been diminished as more than 600 health care staff have been infected.
疫情暴發前，三國都是每十萬人口只有一到兩名醫生。現在連這個比例都達不到，因為有六百多位醫務工作者感染埃博拉。
At the start of the outbreak, weaknesses existed throughout the health systems. Laboratories were few in number and concentrated in cities.
疫情開始時，整個衛生系統都存在薄弱環節。實驗室數量少而且集中在城市里。
Many large referral hospitals had no electricity and running water or were made unsafe by electrical fires and floods. Isolation wards were rare, mostly dedicated to the care of Lassa fever patients.
許多大型轉診醫院沒有電和自來水或者由于電氣火災和洪水而變得不安全。隔離病房很罕見，而且大多用于護理拉沙熱患者。
The numbers of ambulances and other vehicles, also for the transportation of diagnostic specimens, were inadequate.
救護車及其它車輛包括用來運送診斷樣本的車輛不夠用。
Supplies of essential medicines and personal protective equipment were unreliable, and systems for civil registration and vital statistics were nascent.
基本藥物和個體防護裝備的供應不可靠，民事登記和人口統計制度才剛剛起步。
Populations in all 3 countries remain deeply distrustful of health systems, especially Western medicine and foreign medical teams. Care from traditional healers is the preferred and, in rural areas, often the only option.
這三個國家的人民仍然很不信任衛生系統，特別是西藥和外國醫療隊。他們更傾向于傳統治療師，而在農村地區，往往也只有傳統治療師。
As we now know, the index case was a young boy who died of Ebola in Guinea on 28 December 2013.
正如我們現在所知，指示病例是2013年12月28日幾內亞一位死于埃博拉的小男孩。
From that single case, the virus spread, undetected, for more than 3 months, in multiple chains of transmission involving urban as well as rural areas.
從該病例開始，病毒不為人知地傳播了三個多月，在城市和農村地區形成多條傳播鏈。
The virus entered the capital, Conakry, at the start of February. The disease was misdiagnosed twice as cholera and later thought to be Lassa fever.
二月初，病毒進入首都科納克里。疾病被多次誤診為霍亂，后來又被認為是拉沙熱。
As late as mid-March, when the government raised its first alert, cases of sudden death, reported around the country, were thought to be independent outbreaks caused by different diseases.
直到三月中政府首次提出預警，全國各地報告的突然死亡病例還被認為是不同疾病導致的孤立疫情。
By the time Ebola was identified as the causative agent, on 21 March, the virus was firmly entrenched in Guinea. This is what can happen in the absence of a well-functioning health system.
到3月21日確認埃博拉為致病原因時，病毒在幾內亞已經根深蒂固。這就是衛生系統不能良好運轉時會發生的情況。
As we have learned, Ebola is an unforgiving virus that can take advantage of any mistakes and exploit every opportunity to resist control.
正如我們大家所了解到的，埃博拉是一種無情的病毒，會利用任何錯誤和每一個機會來抵御人類控制它的努力。
Weak health systems created multiple opportunities. In some areas, all forms of essential care, whether for malaria treatment or safe childbirth, have ceased to function.
薄弱的衛生系統會提供很多這樣的機會。在一些地區，所有形式的基本醫療保健服務，不論是治療瘧疾還是安全分娩，都已經無法繼續。
The progress made in moving towards the health-related Millennium Development Goals has been reversed.
在實現衛生相關千年發展目標方面取得的進展被逆轉了。
Ladies and gentlemen,
女士們、先生們，
We are here to find innovative solutions, to decide on what needs to be done, urgently and longer-term.
今天我們聚集一堂尋找創新解決方案，確定需要做些什么，包括現在就做的事和更長期的需要。
We need to focus on priorities, as advised by governments, and we need to know how essential measures will be accountably financed.
正如各國政府所指出的那樣，我們需要關注重點。我們需要知道，如何以可問責的方式為基本措施提供資金。
I have a few suggestions for rebuilding resilient health systems.
對于重建有恢復力的衛生系統，我有幾個建議。
First, follow a primary health care approach that brings services close to homes. One of the most important lessons we have learned concerns the critical role of community engagement.
首先要遵循初級衛生保健的方法，將服務帶到人民身邊。我們學到的最重要教訓之一與社區參與的關鍵作用有關。
Communities know best what they need and are willing to accept. We cannot promote safe behaviour without community understanding and cooperation.
社區最了解自己需要什么、愿意接受什么。沒有社區的理解和合作，我們就無法促進安全的行為。
A good referral system needs to be in place. Hospital facilities must be upgraded to provide safer and more effective care.
需要建立良好的轉診制度。必須升級醫院設施，以提供更安全、更有效的護理。
Logistics need to improve to ensure an uninterrupted supply of electricity, running water, and essential medicines and supplies.
需要改進后勤保障工作，確保電力、自來水以及基本藥物和其它物資的供應不被中斷。
Much good work has been done to improve systems for civil registration and vital statistics. This work needs to increase.
在改進民事登記和人口統計制度方面已經做了不少很好的工作，需要繼續努力。
Capacity to detect and respond to new or emerging infectious diseases needs to be an integral part of the health system.
需要使發現并應對新發和現有傳染病的能力成為衛生系統的必要組成部分。
Finally, community confidence in traditional healers needs to be respected by giving these care-givers a place, with a clearly defined role, in the formal health system.
最后，需要尊重社區對傳統治療師的信任，在正式衛生系統中承認這些人員的地位并清晰界定其作用。
These are some thoughts as you begin your discussions.
這些想法供各位討論參考。
I wish you a most productive meeting.
祝會議富有成果。
Thank you.
謝謝大家。
