Ladies and gentlemen,
女士們、先生們,
At the very least, the Ebola outbreak in West Africa provides dramatic proof of the importance of having minimum capacities and infrastructures in place before a severe disease becomes established in a population.
至少這次西非埃博拉疫情給人們帶來了大量證據,以此證明當某種嚴重疾病在人群中扎下根之前具備最低限度的能力和基礎設施十分重要。
Ebola in Guinea, Liberia, and Sierra Leone was an extreme stress test that saw the virtual collapse of health services.
在幾內亞、利比里亞和塞拉利昂發生的埃博拉是一次極端強度測試,這使人看到了衛生服務幾近崩潰的一面。
The national responses in Nigeria, Senegal, and Mali show the good results possible when health officials are on high alert and the health system is well-prepared. But overall, national and international responses show how far the world is from achieving global health security. Overall, these experiences provide a stunning example of all that was missing, all that can go wrong.
尼日利亞、塞內加爾和馬里作出的國家性反應表明,當衛生官員處于高度戒備,衛生系統作出良好準備時就可能取得良好結果。但總體而言,國家和國際應對情況表明,這個世界離實現全球健康保障的距離有多遠??傊?,這些經驗用例證很好地說明了所缺失的一切,可能會出錯的一切。
The IHR call for national capacity "to detect events involving disease or death above expected levels for the particular time and place in all areas within the territory".
《國際衛生條例》要求具備"發現領土內所有地區與特定時間和地點發生的超過預期水平的涉及疾病或死亡的事件"的國家能力。
But how can countries that routinely experience deaths from diseases like malaria, Lassa fever, yellow fever, typhoid fever, dengue, and cholera recognize an unusual event in the midst of all this background noise from difficult and demanding diseases?
而面臨困難和棘手疾病這類背景噪音時,平常遇有因瘧疾、拉沙熱、黃熱病、傷寒、登革熱和霍亂等疾病造成的死亡的國家如何才能看到不尋常事件?
Maybe this is another truly fundamental problem that keeps the IHR from working as intended.
也許這是另一個真正使《國際衛生條例》無法按照預想情況正常運轉的根本性問題。
The Ebola virus circulated in Guinea for three months, undetected, off every radar screen, with no alarms sounding, misdiagnosed as cholera, then thought to be Lassa fever.
埃博拉病毒在沒有被發現的情況下在幾內亞流行了三個月,它沒有出現在雷達防線上,沒有發出警報,被誤診為霍亂,又想到了拉沙熱。
Even in Sierra Leone, where health officials were on high alert, the virus spread undetected for at least a month, sparking numerous chains of transmission that rapidly multiplied.
塞拉利昂的衛生官員保持著高度警惕,即便如此該病毒在沒有被發現的情況下至少傳播了一個月,觸發了多個很快成倍數增長的傳播鏈。
The earliest cases to reach the health system were managed as gastroenteritis, again with a diagnosis of cholera presumed.
最早抵達衛生系統的病例按照胃腸炎做了處置,又一次被假定診斷為霍亂。
Within six weeks, three hotspots of intense virus transmission were firmly established.
病毒嚴重傳播的三個熱點在六個星期之內就穩穩的扎下根來。
As we learned, cases at the start of an outbreak, when containment has the best chance of success, will be missed in the absence of sensitive surveillance, rapid laboratory support, and good information systems shared by the public health and clinical sectors. If the two arms of the health system are not talking or sharing information to raise awareness and take rapid action, we have seen what can happen
正如我們所學到的,在疫情之初對病例實施控制就有很大的可能取得成功,在缺少敏感性監測系統,沒有快速實驗室支持和由公共衛生和臨床部門共享的良好信息系統的情況下就會錯失這些病例。當衛生系統的這兩個部門不能夠以提高認識和采取快速行動為目的而相互交流并分享信息,我們已經看到了可能會出現什么情況。
As I always say, what gets measured gets done. What can't be seen can't be measured or managed.
我總在說,能衡量,始能執行。無法看到的東西就不能得到衡量或者處理。
As we learned, when new cases occur that cannot be linked to a known chain of transmission, an outbreak is out of control.
正如我們所學到的,當病例的發生不能與已知傳播鏈建立聯系時,疫情就會失控。
Ladies and gentlemen,
女士們、先生們,
As a second weakness, many countries imposed measures, such as restrictions on travel or trade, that went well beyond the temporary recommendations issued by the Emergency Committee last August.
第二個弱點就是許多國家采取了旅行或者貿易限制等措施,這大大超出了去年八月突發事件委員會發布的臨時建議。
These measures isolated the three countries and vastly increased economic hardship for some of the world's poorest people. All three ran short of food and fuel.
這些措施使這三個國家與外界隔絕,大大增加了世界上最為貧窮的一部分人的經濟困難。三個國家都缺少食物和燃料。
Just as important, travel restrictions, including the many airlines that suspended flights to West Africa, impeded the arrival of desperately needed response teams and equipment.
同樣重要的是,這些旅行限制,包括許多航空公司暫停了前往西非的航班,使前往災區的急需應對團隊和設備遭受了困難。
If countries are punished in this way, where is the incentive for rapid and transparent reporting?
如果國家受到這等懲罰,哪有動力作出快速且透明的疫情報告?
Whether and under what circumstances countries should be permitted to implement health measures beyond those recommended by WHO was a politically charged issue when the IHR were negotiated.
各國是否并且在何種情況下應當被準予在世衛組織提出的建議之外采取衛生措施,這是在《國際衛生條例》談判過程中一個帶有政治敏感性的問題。
At present, WHO does not have a mechanism for enforcing compliance with its recommended measures. This has to change.
目前,世衛組織并沒有一種強行遵守其所提建議措施的機制。這必須做出改變。
A third weakness is the absence of a formal alert level of health risk other than the declaration of a public health emergency of international concern, or PHEIC. This is a recommendation from the Stocking report for you to consider.
第三個弱點就是除了宣布為國際關注的突發公共衛生事件之外,尚缺少一種針對衛生危險的正式警報等級。這是Stocking報告中提出的供你們審議的一項建議。
Establishing a formal intermediate level of alert of health risk would require an amendment to the IHR.
對衛生危險設立一個正式的過渡性警報等級就需要對《國際衛生條例》做出修訂。
Another option is illustrated by the Emergency Committee convened to assess the MERS situation.
另一個選擇方案由評估中東呼吸綜合征疫情的突發事件委員會作了闡述。
Although many meetings under this Committee were held, none declared a PHEIC, yet their reports consistently set out advice aimed at reducing the number of cases and preventing further international spread.
盡管已經以該委員會名義召開了多次會議,但沒有一次將其宣布為國際關注的突發公共衛生事件。而會議發表的報告一直在提出建議,目的是減少病例數并防止進一步出現國際傳播。