医学考博英语阅读 | 流行病,预防不足

小白老师2017/11/06英语学习

摘要: 流行病的频繁爆发与全球化、人畜接触增加密切相关,而全球在预防和应对机制上的投入严重不足。加强公共卫生体系、疫苗研发及国际合作,是降低未来大流行风险的关键。预防性投资虽需成本,但相比疫情造成的经济与生命损失,具有更高的回报率。

  • 新型传染病因人口增长、交通互联和人畜接触增多而日益频繁,已成‘新常态’。
  • 埃博拉、SARS等疫情造成数百亿美元经济损失,凸显全球防备不足的代价。
  • 每年投入约45亿美元用于 pandemic preparedness(大流行准备)可显著提升全球安全水平。
  • 加强公共卫生系统不仅能防控大流行,还能有效应对结核病、疟疾等现有疾病负担。
  • 药企缺乏研发罕见病疫苗的动力,需政府通过责任分担和资金支持激励其参与应急响应。

小白老师说:一个人在自己的人生中是主角,应该努力演好自己的角色;一个人在别人的人生中只是配角,别要求别人理解你做不好事情的苦衷。学习是为自己而学,要付出全部,绝不留力,因为,别人不会安慰你因为没有时间才做得不够好。共勉。

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Pandemics:An ounce of prevention

流行病:预防不足

Crises of infectious diseases are becoming more common. The world should be better prepared.

传染病导致的危机已经越来越常见,世界应该做好更周全的准备

ONE of the sobering lessons of the Ebola crisis was how ill-prepared the world was for such a deadly disease. It is terrifying to reflect on how the virus’s advance was halted in the teeming city of Lagos thanks only to the heroism of a single doctor and because the place just happened to have the expertise needed to trace all of the first victim’s contacts. Today the world is facing a worrying outbreak of Zika virus, adding to a growing list of diseases that includes SARS, MERS and bird flu.

埃博拉危机让世界清醒地认识到,我们对于如此致命的疾病有多么的束手无策。细思恐极的是,当病毒在人声鼎沸的拉各斯肆虐时,多亏了一名医生的大无畏精神,疫情蔓延才得以中止,与此同时,拉各斯恰巧有技术能够追溯到所有与第一例病毒感染者接触的所有人。当今世界正面对着令人惊恐的寨卡病毒的爆发,这让已经包括 SARS、中东呼吸综合症以及禽流感的流行病队伍更加壮大。

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This is the new normal. New infectious diseases are becoming more common. With more people on the planet, more roads and flights connecting everyone, and greater contact between humans and animals, this is only to be expected. Over half of the 1,400 known human pathogens have their origins in animals such as pigs, bats, chickens and other birds.

这是一个新常态。新型传染病变得越来越普遍。随着地球上人口日益增加,大量的公路和航班提升了各个地区的通达性,再加上人与动物的接触越来越多,这样的情形不可避免。人类已知的 1400 个病原体中,有一半以上都源自动物宿主,包括猪、蝙蝠、鸡和其他禽类。

When a new outbreak occurs, fear spreads even more rapidly than the virus. Politicians respond, rationally or not, with travel bans, quarantines or trade blocks. Airlines ground flights. Travellers cancel trips. Ebola has infected almost 30,000 people, killed more than 11,000 and cost more than $2 billion in lost outputs in the three hardest-hit countries. SARS infected 8,000 and killed 800; because it hit richer places, it cost more than $40 billion. Predicting these losses is hard, but a recent report on global health risks puts the expected economic losses from potential pandemics at around $60 billion a year.

当新的疫情爆发时,恐惧情绪传播的比病毒更快。政治家们做出各种合理或不合理的反映:禁止出行、检疫隔离和贸易封锁。航线暂停,旅行者们取消出游。埃博拉感染了超过3万人,致死1.1万人,疫情最严重的三个国家因此损失产值超20亿。SARS感染了8千人,致死800人,由于爆发在较发达地区,其造成的产值损失超过400亿。预测这些疾病导致的损失不容易,但最近一份关于全球健康危机的报告预计,潜在的流行病将导致每年约600亿的经济损失。

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As the threat grows, so does the case for beefing up defences against disease. America’s National Academy of Medicine suggests that just $4.5 billion a year (equivalent to about 3% of what rich countries spend on development aid) devoted to preparing for pandemics would make the world a lot safer. The money would strengthen public-health systems, improve co-ordination in an emergency and fund neglected areas of R&D.

随着危机不断升级,对疾病的防御也应同样加强。美国国家医学研究院表示每年仅需投入 45 亿美金(相当于富有国家花在发展援助上的 3%)在流行疾病防控上,世界便会变得安全许多。资金的投入将会用于加强公共卫生体系,提高研发部门在应对突发情况以及资金短缺的协调性。

Many of the investments to prepare for pandemics would bring broader benefits, too. Stronger public-health systems would help fight such diseases as tuberculosis, which reduces global GDP by $12 billion a year, and malaria, which takes an even bigger toll. But the priority should be to advance vaccines for diseases that are rare today, but which scientists know could easily become pandemics in the future: Lassa fever, say, Crimean Congo haemorrhagic fever or Marburg.

在流行疾病的防控上注入更多的投资会带来更多的好处。每年仅在防治肺结核病上,全球 GDP 减少了 120 亿美金,而疟疾则耗费更多。若公共健康体系建立完善,将有利于防治肺结核等疾病,但首要的是去研制疫苗去防治现今极其罕见,但又被科学家们声称今后极易大流行的疾病,比如拉沙热,克里米亚刚果出血热,或者马尔堡出血热。

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Better sharing of data would help. More important is funding and a review of who has liability if firms rush vaccines or drugs to market. The initial development and early-stage testing of vaccines for the most likely future pandemics would cost roughly $150 million each. Drug firms have little incentive to invest in a vaccine that may never be used. For these firms even later-stage testing when a pandemic breaks out is tricky. The drug industry spent $1 billion on Ebola and took on liability risk, yet never made a profit. The same companies may not be so willing next time. To encourage drug firms to play their full part during an emergency, governments need to set out how they will share the burden.

若能更好地共享数据,那将会大有裨益。更为重要的是提供资金,还有当公司把疫苗或者药品推向市场时需审查责任人。即便是未来爆发可能性最高的流行病的防控疫苗,在处于初步发展与早期检测阶段时,也要耗费大约 1.5 亿美金。因此医药公司没有动力去投资开发未来可能都不会被使用的疫苗。对于这些公司,一旦疫情爆发,后期的疫苗测试也很难对付。医药行业花费了 10 亿美金在埃博拉上,同时承担了责任风险,然而从未获利。没有公司会愿意亏本第二次。为了鼓励医药公司在疫情时期充分发挥自己的作用,政府需要明确自己将会如何替他们分担责任。

Since the financial crisis, banks have been required to hold more capital in order to lower the risk of economic contagion. The world spends about $2 trillion annually on defence. Investing in health security is a similar form of insurance, but one with better returns.

自金融危机后,为了降低经济危机蔓延的风险,银行已被要求持有更多资本。全球每年共花去大约 2 万亿美金在防治疾病上面。在卫生安全上投资类似于购买保险,但是会取得更好的收益。

常见问题

为什么新型传染病越来越常见?

由于全球人口增长、交通网络密集以及人类与动物接触增加,超过一半的人类病原体源自动物,导致新发传染病频率上升。

预防大流行需要多少投入?效果如何?

美国国家医学研究院建议每年投入45亿美元用于大流行准备,仅占富裕国家发展援助支出的3%,却能大幅提升全球卫生安全。

为什么制药公司不愿研发潜在大流行病的疫苗?

因为这些疫苗可能长期不用,企业难以收回成本;即使疫情爆发,后期测试复杂且承担法律责任,如埃博拉项目投入10亿美元却未盈利。

加强大流行预防有哪些额外好处?

强化的公共卫生系统可同时改善结核病、疟疾等疾病的防控,每年分别减少120亿美元和更高额的GDP损失。

参考资料

Pandemics: An ounce of prevention

原文引自《经济学人》风格评论文章,讨论全球大流行防范不足问题。

美国国家医学研究院关于大流行准备的建议

文中提及该机构估算每年45亿美元投入可显著提升全球防疫能力。

全球健康风险与经济损失报告

文中引用该报告估计潜在大流行每年造成约600亿美元经济损失。