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今天推出的内容是比尔•盖茨在36届J.P.摩根健康大会上的演讲“有生之年实现医疗健康公平”（节选），请看详细报道↓↓
我在旧金山参加第 36届 JP 摩根健康大会（ J.P. Morgan’s 36th Annual Healthcare Conference ）时，谈到在全球健康领域和企业的合作存在诸多可能，以下就是我演讲的全文。
I spoke about the possibilities that exist at the intersection of global health and the private sector earlier today at J.P. Morgan’s 36th Annual Healthcare Conference in San Francisco. Here is the full text of my prepared remarks:
十年来，不管走到哪里，也不管跟谁聊天，我自始至终都想说清一点：
No matter where I go, no matter who I talk to, there’s one point I always try to get across. It’s been my key message for more than a decade.
全球健康状况正在变好，而且正在以前所未有的速度变好。
It’s that health is getting better, and it’s getting better faster than ever before.
自1990年以来，全世界的儿童死亡率已经降低了一半；艾滋病不再是一种绝症；
Since 1990, the world has cut child mortality in half. HIV is no longer a certain death sentence.
每年影响 10 亿人的诸多“被忽视的疾病”不再被人忽视。
Many of the so-called neglected diseases that affect a billion people every year aren’t neglected anymore.
我之所以讲述我们过去的成就，是因为它让我对未来能够取得的成就感到乐观。
I talk about what we’ve accomplished in the past because it makes me optimistic about what we can accomplish in the future.
不过我们还有很大的进步空间。今年，5 岁以下儿童的死亡人数预计将达到 500 万，大部分来自贫穷国家。
But there’s still a lot of room for improvement. This year, 5 million children under the age of five will die, mostly in poor countries.
而疾病和营养不良的问题将困扰其他数亿人，消耗着他们及其国家的力量和未来发展的潜能。
And hundreds of millions of others will suffer from diseases and malnutrition that sap them, and their countries, of their strength and their potential.
我们可以通过向有需要的人群更好地提供救命药品和疫苗，来解决其中的一些问题。
Some of this can be addressed by doing a better job of getting lifesaving drugs and vaccines to the people who need them.
不过在目前的技术和消灭极端贫困导致的疾病的需求之间，仍然存在较大差距。
But there is still a substantial gap between the tools we have and the tools we need to eliminate the most persistent diseases of poverty.
弥补差距的办法就是创新，这也是我今天为来到这里感到无比激动的原因。
The way to fill that gap is to innovate, and that’s why I’m excited to be here today.
因为你们的创新和办法，或许能为挽救世界最贫困国家中的数百万生命，带来突破性的进展。
Because the tools and discoveries your companies are working on can also lead to breakthrough solutions that save millions of lives in the world’s poorest countries.
政府资助的基础科学研究确实为我们指出了通往医疗进步的希望之路。
It’s true that government-funded basic science research shines a light on promising pathways to health advances.
而慈善机构能够探索出最优秀的方案，促使其发展壮大，同时帮助企业合作伙伴达到风险和回报之间的平衡。
Philanthropy can help nurture the best ideas through discovery and development, and balance the risk-reward equation for private-sector partners.
不过要想将研究发明，转化为商业上可行的产品，就要借助企业的技术、经验和能力。
But industry has the skills, experience, and capacity necessary to turn discoveries into commercially viable products.
事实上，全球健康事业确实需要企业的参与。而且坦白地讲，从推动全球健康领域取得的突破中，企业自身也可获益良多。
The fact is that global health needs the private sector. And, frankly, the private sector has much to gain from pursuing breakthroughs in global health.
未来几十年，发展中国家的人口将继续增长。到 2050 年，非洲的人口将增长一倍多，达到约 25 亿人。这将是美国和欧洲预计总人口数的两倍多。
Over the next few decades, developing economies will continue to expand. By 2050, the population of Africa will more than double to almost 2.5 billion. That’s more than twice the forecasted population of the U.S. and Europe combined.
不过我们不用等20、30 年。即使从短期来看，对企业来说，造福他人的影响力和获得盈利之间也并不矛盾。
But we don’t have to wait 20 or 30 years. Even in the shorter term, impact and earnings are not mutually exclusive for the private-sector.
想必你们也知道，虽然我们的工作涉及其他多个具有重大影响力的项目，比如农业发展和美国本土的公共教育，但全球健康项目才是我们的重点所在。过去5年间，我们在全球健康领域的投资达到了近 120 亿美元。
As you probably know, global health is our primary focus at the Gates Foundation—although we also work in a few other areas that are big levers for impact like agricultural development and public education here in the U.S. Over the last five years, we have invested nearly $12 billion in global health.
这其中便包括对技术公司的资助和股权投资，这些公司掌握的技术极具发展前景，未来有可能在全球健康领域大有作为。
This includes grants and equity investments in companies with promising technologies that have potential application in global health.
我们还通过创造性的量价保障措施，降低企业在开发市场需求未经证实的新产品时所面临的风险。
We also use creative price and volume guarantees that help the private sector mitigate the risk in developing a new product for which demand is unproven.
我们的投资促进了抗击疟疾的新药和新型病媒控制工具的诞生，加快了向贫困国家引入新型疫苗的速度。
Our investments have led to new drugs and vector control tools for malaria,accelerated the introduction of new vaccines in poor countries.
确保了发展中国家的数百万人能够获得长效避孕用品，为这些国家的HIV感染者提供现有最好的抗逆转录病毒治疗。
And ensured that millions of people in the developing world have access to long-lasting contraceptives and the best-available antiretroviral treatment for HIV.
我们同时也在和世界卫生组织（WHO）以及中国和非洲国家的监管机构合作，旨在消除某些阻碍新药开发和进入其他市场的制度性障碍。
We are also working with the WHO and regulatory entities in China and Africa to eliminate systemic barriers that slow development of new products and access to new markets.
几年前，我们看过相关数据，在高收入国家，一款医药产品获得认证需要6到12个月的时间，而在低收入国家，这个过程要花4到7年。
A few years ago, we looked at the data, which showed that in high-income countries it took 6-12 months to get a product registered—compared to 4-7 years in low-income countries.
我们意识到，和其他问题一样，为有需要的群体提供新的健康解决方案也是一个非常大的挑战。
We realized this was as big a challenge as anything else in getting new health solutions to the people who need them.
尤其让我感到兴奋的是，我们正与中国国家食品药品监督管理总局 （CFDA ）合作，按照国际标准，共同建立一个更加高效和统一的药品和疫苗试验、审核和批准流程。这将改变游戏规则，有助于更多高质量的医药产品进出中国。
I’m particularly excited about our work with the Chinese FDA to provide a more efficient and consistent mechanism for testing, review, and approval of medicines and vaccines—using international standards. This would be a game changer in getting quality products into and out of China.
你们所做的工作和我们的工作之间还有一个重要的交叉点 ——这也是我今天想要讨论的内容。
There is another critical intersection emerging between what you do and what we do—and that’s what I’d like to talk about today.
在座生物科技公司和制药企业纳入研究议程的课题，和我们在全球健康领域想要解决的问题，正在以振奋人心的方式汇集到一起。
The questions driving your research agendas today in biotech and pharma—and the problems we’re trying to solve in global health—are starting to converge in exciting ways.
很多你们正在研究的解决办法，比如通过免疫疗法治疗癌症，破解人脑的奥秘以治疗阿兹海默症，了解人体的营养吸收机制从而解决肥胖和其他疾病等，在全球健康领域也有明确的用途。
Many of the solutions you’re working on—harnessing the immune system to tackle cancer, unraveling the mysteries of the brain to treat Alzheimer’s, and learning how bodies absorb nutrition to address the obesity epidemic and other diseases—also have clear applications in global health.
虽然全球健康工作者不像你们一样关注癌症疗法，不过我们确实需要理解免疫系统，以抗击艾滋病、疟疾和结核病等致命性疾病。
The global health community may not be thinking as much about treatments for cancer, but we need to understand the immune system to tackle deadly diseases like HIV, malaria, and TB.
虽然我们并不关注与老化相关的神经退行性疾病，不过我们关心贫穷国家数亿儿童的认知发展。
We aren’t focused on the neurodegenerative diseases commonly associated with aging, but we are concerned about the cognitive development of hundreds of millions of young children in poor countries.
虽然我们并不致力于解决非洲和南亚的肥胖危机，不过我们正设法应对与肥胖相反的发育迟缓和营养不良等问题。
We aren’t dealing with a crisis of obesity in Africa and South Asia, but we are trying to address its inverse, a crisis of stunting, wasting, and undernutrition.
虽然你们的兴趣可能在于，开发适用于富裕国家的医药产品，不过你们实验室的突破进展，也能挽救世界上最贫困国家的数百万生命。
You may be interested in developing products for rich-world markets, but the breakthroughs happening in your labs can also save millions of lives in the world’s poorest countries.
健康和医药领域的学习之道，在于“类比”，我们也会借鉴其他领域的洞见。
In health and medicine, we learn by analogy. We borrow insights from other fields.
当我们就免疫系统、大脑和人体微生物组等核心系统提出一类问题时，得出的答案或许也适用于其他领域。
And when we ask one kind of question about key systems like the immune system, the brain, or our human microbiota, the answers may also apply to a totally different line of questioning.
几个月前，《华尔街日报》的一则报道吸引了我的注意。这篇文章是很多同类文章之一，重点介绍了如何利用HIV病毒的遗传机制修改T细胞，从而使其具备攻击特定癌细胞的能力。
A few months ago, a headline caught my eye in The Wall Street Journal. The story was one of many that have highlighted how the HIV virus’s genetic machinery can be used as a tool to modify T-cells so they are capable of attacking specific cancers.
我相信再过10年，我们将会看到这样一则新闻 —— “癌症疗法如何帮助治愈 HIV ”。
I’m confident that a decade from now, we’ll see a headline that says: “How Cancer Tools are Helping Cure HIV.”
当然，事情并没有这么简单。当前免疫疗法仅对特定类型的癌症有效，且仅适用于特定的病人。
Of course, it’s not quite that simple. Immunotherapy today works only against certain types of cancers and only in certain patients.
另外，艾滋病、结核病和疟疾等传染性疾病和癌症一样，会与感染者的免疫系统发生复杂的交互作用。
And, like cancer, infectious diseases such as HIV, TB, and malaria have complex interactions with the immune system of infected individuals.
不过我们有理由相信，从癌症免疫疗法的持续研究中获得的洞见，终将帮助我们实现对所有传染性疾病的控制。
But there is reason to hope that the insights uncovered in ongoing immunotherapy research for cancer will eventually help us control all infectious diseases.
这将是人类的巨大胜利 —— 也有可能为生命科学带来巨大的市场机遇。
This would be a huge victory for humanity—and potentially a significant market for the life sciences.
其他人似乎也这样认为。Bob Nelsen和Bob More 等风险投资人已经帮助 VIR 生物技术公司融资5亿美元 —— 其中也有我们的一份 —— 以支持它找到严重传染性疾病的治疗办法。
Others seem to think so too. Venture capitalists like Bob Nelsen and Bob More have helped raise over $500 million for VIR Biotechnology—including funding from us—to discover and develop treatments for serious infectious diseases.
我们还投资了Immunocore，利用T细胞技术刺激人体的免疫系统。
We are also investors in Immunocore, which is using T-cell technology to help stimulate the body’s immune system.
虽然 Immunocore 的“T 细胞受体”技术在初始阶段以治疗癌症为目标，不过它也可以应用于对传染性疾病的治疗上。
Initially, Immunocore’s “T-cell receptor” technology targeted cancers, but it could also be applied against infectious diseases.
我们还支持 CureVac、Moderna 等公司通过 mRNA 技术研发疫苗和药物，这也许能帮助我们攻克癌症难题。
We are backing companies like CureVac and Moderna on mRNA approaches for vaccine and drug development, which have the potential to help us tackle cancer.
另外，这种有趣的技术还可用作HIV 、疟疾、流感和寨卡病毒的免疫干预手段。
This approach is also intriguing as a potential immunological intervention for HIV, malaria, flu and the Zika virus.
而且相较于传统疫苗，mRNA 疫苗的生产有可能更为便宜、简单、快速。
And mRNA vaccines are likely to be cheaper, easier, and faster to make than traditional vaccines.
这对流行病的控制极其有利 —— 不管它们是因自然因素爆发，抑或由人为生物袭击引起。
This would be particularly helpful in containing epidemics—whether they occur through nature or are the result of an intentional biological attack.
今天，一款新疫苗从研发到上市一般要花 10 年的时间。
Today, it typically takes up to 10 years to develop and license a new vaccine.
要想显著削减因病原体在空气中快速传播而造成的死亡人数，我们就必须大幅缩短从研发到上市的时间，将其减少到 90 天或更短。
To significantly curb deaths from a fast-moving airborne pathogen, we would have to get that down considerably—to 90 days or less.
当然，对抗传染性疾病只是我们需要关注的全球健康挑战之一，我们所面临的另一项挑战，就是新生儿健康问题。
Of course, fighting infectious disease is only one of the global health challenges that demand our attention. Another is newborn health.
尽管儿童死亡率已大幅降低，但预计今年，仍有将近 500 万五岁以下儿童死亡，其中出生 28 天内死亡的新生儿人数几乎占到了一半。
Despite the great progress in reducing child mortality, nearly 5 million children under the age of five will die this year—close to half in the first 28 days of life.
为了降低新生儿死亡率，我们首先需要了解并解决新生儿的患病风险问题，这一问题在贫困国家尤为突出。
To make inroads against neonatal mortality, we first have to understand and address the underlying vulnerabilities of newborns, especially in poor countries.
为何贫困国家的新生儿死亡人数如此之高？救治困难的原因何在？目前尚无法完全确定。
Right now, we don’t know exactly why many newborns in poor countries die, which makes it very difficult to save them.
但我们正积极地运用遗传学和其他企业的研究成果，帮助儿童平安出生、抵御致命感染，使他们能够身心健康地成长。
But we’re enthusiastic about leveraging the tools of genetics and other research the private sector is working on to help children survive birth, fend off deadly infections, and thrive both physically and cognitively.
提升全人类的健康和福祉是我们的共同目标。试想如果我们齐心协力，将实现多少看上去“不可能完成的任务”。
We all share the goal of improving the health and well-being of people globally. Imagine what’s possible if we work together.
我认为未来将是这样的一个世界：人类终于彻底根除了古老的顽疾 —— 疟疾，数以亿计的人口得以免遭结核病之苦，我们还找到了治愈艾滋病的方法……
Consider a world where the age-old scourge of malaria is finally eradicated . . . where hundreds of millions of people no longer suffer from tuberculosis . . . and where we have a cure for HIV.
我们用了 25 年的时间成功将儿童死亡率降低了 50%。凭借在座各位的满腔热情、专业知识和丰富的资源，到 2030 年，我们希望能够将儿童死亡率再降一半。
In a quarter century, we cut childhood mortality in half. With the passion, expertise, and resources of the people in this room, we can cut child mortality in half again by 2030.
我们还需要克服很多技术难题。然而一想到近一二十年来，科技创新的迅猛发展，我相信在我们的有生之年，人类将会实现更多卓越成就。
There are many technical challenges to overcome. But when I think about the breathtaking pace of innovation in just the last 10 or 20 years, I believe that even more extraordinary things are possible in our lifetime.
地球上有人正遭受着疾病和贫穷的无情折磨，而我们却享受着健康富足的生活，消除这二者之间的鸿沟在我看来是最为崇高的目标。
I can think of no more noble purpose than erasing the divide between those who suffer the relentlessness of disease and poverty—and those of us who enjoy good health and prosperity.
在我们的有生之年实现医疗健康公平，不仅仅是可能的，而且是必要的。无论生活在哪里，每个人都应该有机会过上健康而富有成效的生活。
Achieving health equity in our lifetime is not only a possibility. It is an imperative, because everyone—no matter where they live—deserves the chance to live a healthy and productive life.
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编辑 / 李静
来源 / 经济日报记者陈颐、朱琳
