評論
打印
Ambassadors, invited speakers, experts in public health, representatives of sister UN agencies, professional associations, civil society, and philanthropies, ladies and gentlemen,
各位大使、特邀發(fā)言者、公共衛(wèi)生專家,以及姊妹聯(lián)合國機(jī)構(gòu)、專業(yè)協(xié)會(huì)、民間社會(huì)和慈善機(jī)構(gòu)的代表們、女士們、先生們，
Welcome to this high-level dialogue where you will be discussing the response to noncommunicable diseases as an issue for development cooperation and a route to poverty reduction.
歡迎參加本次高級別對話，大家將在這里討論作為一個(gè)發(fā)展合作問題以及減貧路徑對非傳染性疾病的應(yīng)對。
The challenges facing public health have changed dramatically in character and complexity since the start of this century, when NCDs were not included among the Millennium Development Goals.
本世紀(jì)開端時(shí)，非傳染性疾病并沒有納入千年發(fā)展目標(biāo)，但此后，公共衛(wèi)生所面臨挑戰(zhàn)的特點(diǎn)和復(fù)雜性發(fā)生了極大變化。
Since then, a number of events and reports, and a host of research studies and economic estimates have increased the visibility of NCDs as a development issue and caused several long-standing assumptions to crumble.
自那以來，一系列的事件和報(bào)告，以及許多研究報(bào)告和經(jīng)濟(jì)統(tǒng)計(jì)數(shù)字彰顯了非傳染性疾病作為一個(gè)發(fā)展問題的存在，導(dǎo)致若干長期存在的假設(shè)崩潰。
Fifteen years into the 21st century, the health community is grappling with some game-changing statistics.
進(jìn)入二十一世紀(jì)這15年，衛(wèi)生界一直在與一些改變游戲規(guī)則的統(tǒng)計(jì)數(shù)字相糾纏。
Worldwide, NCDs have overtaken infectious diseases as the leading cause of mortality. This shift challenges traditional development thinking, which has long focused primarily on infectious diseases and maternal and child mortality as priorities for international action. We continue to support this focus, but need to make space for additional challenges.
在世界范圍，非傳染性疾病超過傳染病，成為死亡率的主要原因。這一轉(zhuǎn)換改變了主要注重傳染病和母嬰死亡率，將之作為國際行動(dòng)優(yōu)先考慮的傳統(tǒng)發(fā)展思維。我們繼續(xù)支持這一側(cè)重點(diǎn)，但需要為種種新的挑戰(zhàn)留出空間。
Around 70% of the world’s poor now live in middle-income countries, where economic growth and modernization have opened wide the entry point for the spread of unhealthy lifestyles. This is likely the first time in history that economic growth threatens to damage health rather than improve it.
世界上有大約70%的窮人生活在中等收入國家，在這些國家，經(jīng)濟(jì)增長和現(xiàn)代化開啟了傳播不健康生活方式的大門。這很可能是歷史上的第一次，經(jīng)濟(jì)增長有可能損害健康，而不是增進(jìn)健康。
NCDs can no longer be conceptualized as a rich-country problem. WHO estimates that 80% of the burden from NCDs now falls on low- and middle-income countries, where people develop these diseases earlier, fall sicker, and unfortunately die sooner than their counterparts in wealthy nations.
非傳染性疾病不再被視為富國的麻煩。世衛(wèi)組織估計(jì)，非傳染性疾病負(fù)擔(dān)的80%落在低收入和中等收入國家的身上，人們早早患上此類疾病，病情漸趨加重，不幸的是，他們要比富裕國家的同類患者死得更快。
Nor can we continue to think of NCDs as the killers of the old and frail. WHO estimates that NCDs are responsible for 14 million premature deaths in the developing world each year.
我們也不能再認(rèn)為，非傳染性疾病是老年人和羸弱者的殺手。世衛(wèi)組織估計(jì)，非傳染性疾病每年在發(fā)展中世界造成1400萬例過早死亡。
In some developing countries in Asia, the number of deaths from cardiovascular disease before the age of 55 is twice that in wealthy countries. The reference to type 2 diabetes as “adult onset diabetes” is no longer apt, as so many children are now being diagnosed with this disease. Just two decades ago, type 2 diabetes was almost never seen in children.
在亞洲一些發(fā)展中國家，55歲之前心血管疾病的死亡數(shù)字兩倍于富裕國家。將II型糖尿病稱為“成人型糖尿病”已經(jīng)不再貼切，因?yàn)闉閿?shù)眾多的兒童現(xiàn)在被診斷患有這種疾病。僅僅20年前，II型糖尿病在兒童中間幾乎聞所未聞。
The responsibility for the rise in NCDs does not fall on individuals who choose to eat, smoke, and drink too much or opt for a sedentary lifestyle. The responsibility falls on the environments in which these choices are made.
非傳染性疾病的興起，不應(yīng)歸咎于個(gè)人貪食、酗酒或吸煙過多，或選擇了久坐不動(dòng)的生活方式，而應(yīng)歸咎于造成了這些選擇的環(huán)境。
Can children be blamed for an addiction to nicotine when single cigarettes are sold at the gates of their schoolhouse? Can parents be blamed for their overweight children when cities have no green spaces or the crime rate is so high that children are not safe playing outdoors? For the millions of people living in so-called “urban food deserts”, healthy eating is simply not an option.
難道可以責(zé)怪兒童尼古丁成癮，卻不問學(xué)校門口就有單支香煙在售賣？難道可以為兒童超重責(zé)怪其父母，卻不問城市中沒有綠地，或犯罪率過高，兒童不能在戶外安全玩耍？對生活在所謂的“城市食品荒漠”中的千百萬人來說，健康飲食根本就不是一個(gè)選項(xiàng)。
Ladies and gentlemen,
女士們，先生們，
This is the first big challenge. The evidence, statistics, and arguments you put forward for international cooperation must stress the need for policy solutions that shape social environments. These solutions must be supported at the highest level of government, and they need to be put in place through a whole-of-government approach.
這是第一個(gè)巨大挑戰(zhàn)。你們就國際合作提出的證據(jù)、統(tǒng)計(jì)數(shù)字和論據(jù)都應(yīng)強(qiáng)調(diào)需要制定塑造社會(huì)環(huán)境的政策解決辦法。這些解決辦法必須得到政府高層的支持，并通過整個(gè)政府的方針加以推行。
A second big challenge is competition. With 17 goals and 169 targets currently proposed for the post-2015 development agenda, this is competition for a sliver or some crumbs from the pie, not a piece.
第二個(gè)巨大挑戰(zhàn)是競爭。2015年后發(fā)展議程，目前有17個(gè)目標(biāo)和169個(gè)具體目標(biāo)，這中間的競爭，關(guān)乎能從蛋糕中分得一片還是只有幾粒殘?jiān)也灰f一大塊了。
You are being asked to sharpen the evidence showing the two-way links between NCDs and poverty. You are being asked to make a stronger case for viewing the prevention and control of NCDs as an explicit poverty-reduction strategy.
我們請大家拿出更確鑿的證據(jù)，顯示非傳染性疾病與貧窮之間的雙向聯(lián)系。我請大家更有力地論證為何要將預(yù)防和控制非傳染性疾病視為一項(xiàng)明確的的減貧戰(zhàn)略。
You are being asked to provide an inventory of international agencies that have integrated NCDs into their development policies and extract the lessons learned. We want to hear your proposals about how official development assistance can be used to strengthen prevention and control, yet without compromising funding for other health priorities.
我們請大家提供一份將非傳染性疾病納入其發(fā)展政策并從中汲取經(jīng)驗(yàn)教訓(xùn)的國際機(jī)構(gòu)名單。我們希望從你們那里聽到有關(guān)建議，說明國際發(fā)展援助如何可用于防控工作，同時(shí)不會(huì)影響其它衛(wèi)生重點(diǎn)的資金籌供。
We ask you to do all of these things because of your expertise, knowledge, and experience.
所以要請大家做所有這些事情，是因?yàn)槟銈兊膶ｉL、知識(shí)和經(jīng)驗(yàn)。
A third big challenge is the opposition. This is opposition from powerful economic operators who strongly oppose any regulatory control or restrictions on their marketing of health-harming products.
第三個(gè)巨大挑戰(zhàn)是反對力量。反對來自那些勢力強(qiáng)大的經(jīng)濟(jì)運(yùn)營者，他們強(qiáng)烈反對就他們銷售的有害健康的產(chǎn)品進(jìn)行任何管控或限制。
This is a formidable obstacle to prevention. Economic power readily translates into political power. We rely on civil society for support in many areas, but most especially in this one.
這是預(yù)防工作面對的一個(gè)可怕障礙。經(jīng)濟(jì)實(shí)力隨時(shí)可轉(zhuǎn)化為政治勢力。我們在許多領(lǐng)域依賴民間社會(huì)的支持，在這一領(lǐng)域，情況尤其如此。
The public health community has some tools in hand to respond to these challenges. The 2011 UN Political Declaration on NCDs sets out some compelling arguments.
公共衛(wèi)生界掌握一些應(yīng)對這些挑戰(zhàn)的手段。2011年的《聯(lián)合國非傳染性疾病政治宣言》載有一些令人信服的說法。
It positions these diseases as one of the major challenges for development in the 21st century. It points out their threat to economies and their contribution to inequalities.
該宣言將這些疾病列為二十一世紀(jì)的發(fā)展面臨的主要挑戰(zhàn)之一。它指出了其對經(jīng)濟(jì)的威脅，以及其對不平等的助長。
It gives the primary role and responsibility of responding to these challenges to governments. And it underscores how strongly prevention and control depend on the engagement of multiple non-health sectors.
它指出，政府負(fù)有應(yīng)對這些挑戰(zhàn)的基本作用和責(zé)任。它強(qiáng)調(diào)了強(qiáng)有力的預(yù)防和控制依賴多個(gè)非衛(wèi)生部門的參與。
To guide work, we have an action plan through 2020, a monitoring framework with 9 global targets, and a set of effective and affordable interventions, known as “best buys”, that can make a difference in any resource setting.
為指導(dǎo)工作，我們有一個(gè)直至2020年的行動(dòng)計(jì)劃，一個(gè)有9項(xiàng)全球目標(biāo)的監(jiān)測框架，以及一整套切實(shí)和可負(fù)擔(dān)的干預(yù)措施，稱為“最合算的”干預(yù)措施，可在任何資源背景下都產(chǎn)生影響。
As the root causes of NCDs lie beyond the direct purview and responsibility of the health sector, combatting these diseases is a complex task involving multiple sectors. Here, too, we have support from the Global Coordination Mechanism and a UN Interagency Task Force.
非傳染性疾病的根本原因超出了衛(wèi)生部門的職能和責(zé)任范圍，因此，與這些疾病的斗爭是一項(xiàng)涉及多個(gè)部門的復(fù)雜任務(wù)。這里，我們同樣有全球協(xié)調(diào)機(jī)制和聯(lián)合國機(jī)構(gòu)間工作隊(duì)的支持。
Ladies and gentlemen,
女士們，先生們，
Let me conclude by repeating two points made in the discussion paper prepared for this meeting.
最后，讓我重復(fù)為本次會(huì)議準(zhǔn)備的討論文件中的兩點(diǎn)。
First, the UN General Assembly’s 2014 progress review found no lack of high-level government commitment to NCDs. But it witnessed, in far too many countries, a lack of capacity to act, largely because of insufficient national expertise in low- and middle-income countries. International cooperation can provide this expertise.
第一，聯(lián)合國大會(huì)2014年的進(jìn)展審查認(rèn)為，對非傳染性疾病，不缺乏高級別的政府承諾。但它看到有太多國家缺乏行動(dòng)能力，這主要是由于在低收入和中等收入國家，國家專門知識(shí)不足。國際合作可提供這類知識(shí)。
Second, efforts to prevent and control NCDs depend on a well-functioning health system, ideally one that aims to reach universal health coverage. Any look at the interactions between NCDs and poverty must also look at ways to increase access to care and reduce the catastrophic medical bills that push so many millions of families below the poverty line each year.
其次，對非傳染性疾病的預(yù)防和控制取決于運(yùn)轉(zhuǎn)良好的衛(wèi)生系統(tǒng)，最好是意在實(shí)現(xiàn)全民健康覆蓋的衛(wèi)生系統(tǒng)。對非傳染性疾病與貧窮之間相互作用的任何檢視，都必須同時(shí)檢視如何增進(jìn)保健的獲取，減少災(zāi)難性的醫(yī)療費(fèi)用，正是此類費(fèi)用，每年將數(shù)百萬家庭推入貧困線以下。
Thank you.
謝謝大家。
