陳馮富珍博士在英國藥品監管局的演講

Address at UK Medicines Regulatory Authority
在英國藥品監管局的演講
Annual lecture of the Medicines and Healthcare Products Regulatory Agency
藥品和保健產品監管局年度講座
From health care products to trust and reliance: the expanded role of regulatory authorities in an era of global health perils
從健康保健產品到信任和信賴：全球健康危害時代監管機構的新增作用
Dr. Margaret Chan, Director-General of the World Health Organization
世界衛生組織總幹事 陳馮富珍博士
London, United Kingdom
英國，倫敦
1 March 2016
2016年3月1日
Distinguished staff at the Medicines and Healthcare Products Regulatory Agency, distinguished guests, ladies and gentlemen,
尊敬的藥品和保健產品監管局的職員們，尊敬的來賓、女士們、先生們：
Thank you very much for the invitation. It is an honour and a pleasure to deliver the 2016 MHRA annual lecture.
非常感謝你們的邀請。在2016年的藥品和保健產品監管局的年度講座上發表演講，我感到榮幸，也很高興。
The infrastructures, mechanisms, and agencies that protect public health on a daily basis often go unnoticed until something terrible goes wrong, like drinking water contaminated with lead, melamine in infant formula, counterfeit cough syrups and fever medications that kill hundreds of children, or falsified yellow fever and meningitis vaccines.
基礎設施、機制和機構如此年復一日地保護着公共衛生，但常常不被人們所重視，直到發生了惡性事件，例如飲水鉛污染、嬰兒配方食品中含有三氯氰胺，假造的咳嗽糖漿和發燒藥品，造成數以百計的兒童死亡，或還有假造的黃熱病和腦膜炎疫苗。
The reasons for these breakdowns are multiple: human error, a slip-up in good manufacturing practice, the greed that motivates criminal behaviour, or the sheer lack of regulatory capacity that dominates much of the developing world.
發生這些事件的原因是多方面的：人爲的過失、在良好的生產製造過程中的疏忽、貪婪誘發的犯罪行爲，或是大多數發展中國家完全不具備的監管能力。
The recent catastrophe with the water supply in Flint, Michigan is a tragic reminder of what can happen when the need to cut costs takes precedence over the duty to keep the public safe. It also shows how quickly a mishap can topple politicians and health officials and destroy public confidence in government.
最近發生在密歇根州弗林特市的供水災難是一次慘痛的記憶，說明了只考慮降低成本，之後才履行保護公共安全職責，任何事情都有可能發生。它還表明，一場災禍要使政客和衛生官員一敗塗地以及毀掉公衆對政府的信任會如此之快。
Work done by the UK’s Medicines and Healthcare Products Regulatory Agency, or MHRA, quietly and effectively protects public health on a daily basis. More specifically, it protects millions of people every day, in multiple ways.
英國藥品和保健產品監管局，或簡稱MHRA，所做的工作就是天天都在默默無聞和有效地保護着公衆健康。更具體地講，這項工作每一天都以多種方式在保護着數百萬人。
Public confidence in the quality and safety of medical products translates into confidence in national health services and confidence in the government’s commitment to protect its people.
對醫療產品的質量和安全性的公衆信任轉換爲對國家衛生服務的信任和對政府承諾保護人民的信任。
I wonder how many members of the general public know all the things you do to gather product-related intelligence and build systematic and broad-based barriers to harm.
我不知道公衆當中有多少人知道你們做的所有事情是在蒐集與產品相關的信息和建立系統的和有廣泛基礎的屏障去阻止危害。
Your drug and device alerts and your marketing authorization and licensing work are well-known components of the regulatory framework.
你們的藥物和器械報警信號和你們的銷售部門以及發放許可證的工作都是監管框架中衆所周知的組成部分。
I am thinking of other functions that give the public such a wide and sturdy safety net, while also creating space for innovation.
我正在思考其它的功能，給公衆一個廣泛和健全的安全網，同時也爲創新打造空間。
I am thinking about the new toolkit for pregnant women that will make them better informed about the risk of developmental disorders and birth defects associated with certain prescription drugs. About promising innovative medicines that may be eligible, based on early clinical data, for inclusion in your scheme for early access to medicines.
我正在考慮爲孕婦提供一個新的工具包，使她們對發育障礙和出生缺陷與某種處方藥之間的關聯的風險有更好的瞭解。根據早期臨牀數據，考慮關於將有前途的或許是合格的創新藥列入你們的早日獲得藥品的方案中。
About the way you keep watch over the content of websites, addressed to consumers that promote prescription-only medicines.
關於你們留意保護網站內容的方式，對消費者的內容，推廣只開處方藥。
The support you provide to WHO and world health is immense. The reporting forms used in our 50-year-old programme for international drug monitoring are adapted versions of the UK Yellow Card Scheme.
你們向世衛組織和全球衛生提供的支持是巨大的。在我們長達50年之久的藥物監測國際規劃中使用的報告表格是英國黃卡方案的改編版。
Your labs have helped us unravel some deadly cases of contaminated medicines in several countries.
你們的實驗室幫助我們解開了在幾個國家發生的一些污染藥品的致命案例。
With your support, we will soon issue an international good practice for regulatory authorities and inspectors that can help reduce incidents of incomplete presentation of data by manufacturers or deliberate data falsification.
在你們的支持下，我們很快將爲監管部門和檢察員推出國際最佳實踐手冊，旨在可以減少發生製造商提供的數據不完整或是蓄意的虛假數據的情況。
Our joint work on international noNPRoprietary names for pharmaceutical products benefits patients everywhere in the world.
我們在醫藥產品國際非專利商標名開展的共同工作惠及世界各地的患者。
Within the Agency, the National Institute for Biological Standards and Control, or NIBSC, is a global leader in assuring the quality of vaccines and other biological medicines, in developing standards and reference materials for worldwide use, and in carrying out applied research.
在監管局旗下，設立的國家生物標準和控制研究所，或縮寫NIBSC，是確保疫苗和其它生物藥品質量，制定供全世界使用的標準和參考資料以及進行應用研究的領跑者。
You are the leading WHO International Laboratory for Biological Standards and a designated WHO collaborating centre for polio and influenza.
你們是世衛組織生物標準國際實驗室和指定的世衛組織脊髓灰質炎和流感的主要合作中心。
For the R&D community, having biological standards is equivalent to what postal codes do to speed up the mail and how country codes standardize international telecommunications.
對於研發界而言，制定生物標準與郵政編碼如何加快郵遞和國家編碼如何使國際通訊標準化如出一轍。
As another added value for world health, your work on biological standardization makes it possible for new high-quality competitor products to enter the market on an equal footing with those from established manufacturers.
世界衛生的另一個附加值是，你們在生物標準方面開展的工作使新的高質量競爭者的產品與那些老製造商的產品公平進入市場成爲可能。
Doing so has changed the market for public health vaccines, increasing predictable supplies and getting prices down.
這樣的做法改變了公共衛生疫苗市場，增加可預見性供給和降低價格。
Working with your European Union and global partners, including WHO, MHRA responds to the challenges created by an increasingly globalized world. Biological and pharmaceutical products and medical devices keep growing in number and complexity.
藥品和健康保健產品監管局與你們的歐盟和全球夥伴共事，包括與世衛組織共事，應對一個日益全球化世界帶來的挑戰。生物和醫藥產品以及醫療器械的數量和複雜性不斷增加。
Supply chains are becoming ever more complex. Products are often produced by several companies. They may move through multiple countries and distributors before finally reaching the patient.
供應鏈變得更加複雜。產品常常由幾家公司生產。產品或許要經過多個國家和批發商之後，患者才能最後拿到。
WHO welcomes the meeting you will hold in May to look at the future of biological medicines, including ways to keep the vaccine pipeline flowing.
世衛組織歡迎你們在五月召開會議，研究生物藥品的未來，包括保持疫苗渠道暢通的方法。
New vaccines can be breakthroughs for global health, but they can also help address the problem of antimicrobial resistance, which is moving the world ever closer to a post-antibiotic era in which common infections will once again kill.
新疫苗對全球衛生而言是個重要的新發現，但它們也有助於處理抗微生物藥物的耐藥性問題，這使世界進入一個後抗生素時代向前邁進了一步，新的傳染病將再次肆虐。
While all of these functions of the Agency and Institute may be out of the spotlight on a daily basis, they certainly become highly visible, and vitally important, during public health emergencies of international concern, like the recent outbreaks of Ebola and Zika virus disease.
雖然每日都關注的焦點或許並不是監管局和研究所的所有這些功能，但在國際關注的突發公共衛生事件期間，例如近期暴發的埃博拉和寨卡病毒疫情，他們的可視度自然很高並且舉足輕重。
To support the WHO response to Ebola, MHRA fast tracked the review of clinical trial applications for Ebola vaccines. NIBSC fast tracked the development and production of five reference reagents for use in the calibration of PCR tests and serological assays.
藥品和健康保健產品監管局快速追蹤了對使用埃博拉疫苗的臨牀試驗進行了評審的情況，旨在支持世衛組織應對埃博拉。國家生物標準和控制研究所也快速追蹤了在校準聚合酶鏈反應試劑和血清測定中使用的五種基準試劑的研發和生產情況。
The reference reagent for serology assays helps standardize methods used to measure antibodies in epidemiological studies and in clinical trials of candidate vaccines and immune therapies.
血清測定的基準試劑有助於將流行病學研究和在候選疫苗臨牀試驗以及免疫療法使用的測定抗體的方法標準化。
Endorsed by WHO last year, these five reagents are the global gold standards used by anyone undertaking Ebola R&D. All of this work leaves the world better prepared for the next Ebola outbreak.
去年經世衛組織批准的這五項試劑是供任何人從事埃博拉研發使用的全球金標準。所有這項工作的目的，是使世界在下一次暴發埃博拉疫情時做好更充分的準備。
The new collaborative mechanisms that brought scientists, national health officials, pharmaceutical companies, and regulatory authorities together during the Ebola response establish pathways that can expedite product development during other health emergencies.
在應對埃博拉疫情期間，新的協調機制聚集了科學家、各國的衛生官員、醫藥公司和監管部門，建立了在其它突發的衛生事件期間加速推進產品研發通道。
This is happening right now with Zika.
這正是應對寨卡形成的局面。MHRA have offered to support WHO, as needed, in the evaluation of candidate Zika products. NIBSC responded immediately to the WHO request to develop and evaluate reference preparations for anti-Zika antibodies.
藥品和健康保健產品監管局向世衛組織提供了在評估候選寨卡產品所需要的支持。國家生物標準和控制研究所立即迴應了世衛組織開發和評估抗寨卡抗體參考製品的要求。
These reference preparations will provide researchers, product developers, and regulatory authorities with a single standard that can be used to benchmark the multiple diagnostic tests for Zika that are currently under development.
這些參考製品爲研究人員、產品開發商和監管部門提供了一個統一的標準，可以用來測試當前正在研發的寨卡多項診斷檢測。

Better diagnostic tools are urgently and desperately needed. The current PCR test can detect the virus only during the brief window of viraemia. This weakness is further compounded by the fact that the illness is so mild. Many people infected with Zika will not be prompted to seek a test during this brief window of just a few days.
迫切急需的，是更好的診斷工具。當前的聚合酶鏈反應試劑只有在病毒血症特定的時間內纔可檢測出病毒。這一弱點又加上病症很輕微。許多人感染了寨卡後，沒有在僅有幾天的短暫時間內及時去進行檢查。

Moreover, the Zika virus frequently co-circulates with dengue and chikungunya viruses. These viruses cross-react in tests for IgM antibodies against Zika virus, making them imprecise.
此外，寨卡病毒經常是與登革熱和基孔肯雅病毒共同傳播的。這些病毒在對寨卡病毒進行的免疫球蛋白M抗體的測試中有交叉反應，使得檢測不夠精確。

Imagine the anguish of a pregnant woman living in or returning from an affected country, with no way of knowing whether she and her fetus have been affected. Ultrasound detection of microcephaly is possible only late in pregnancy.
可以想象得出，一名生活在或從一個受到疫情影響的國家歸來的孕婦，在對她和其胎兒是否受到影響一無所知的情況下是何等悲痛。只有在懷孕晚期使用超聲波纔有可能檢測出小頭症。

As with Ebola, Zika has caught the medical and scientific communities largely empty-handed, with WHO left to promote mosquito control as the most immediate line of defence.
如同埃博拉一樣，醫療和科學界對付寨卡總體上是一無所獲，而世衛組織可以做的只能是推廣控制蚊子作爲最緊急的防線。

For both of these diseases, we are in the 21st century and yet cannot immediately tap the power of modern medical tools.
對待這兩種疾病，雖然我們身處21世紀，但還是不能立刻發掘現代醫療工具的力量。

For Ebola, it was early detection, contact tracing, quarantine, and infection control. For Zika, right now, it is mosquito control at a time when more and more insecticides have been rendered ineffective by the development of resistance.
對於埃博拉，要做到早期檢查、追蹤接觸者、檢疫和控制感染。對於寨卡，當越來越多的殺蟲劑由於抗藥性使之無效而放棄的時候，當前更應控制蚊子。

Zika is a tricky virus that continues to astonish scientists. Who could have imagined that a mosquito bite would be linked to severe birth defects and other serious neurological complications?
寨卡是一種詭異的病毒，不斷使科學家感到吃驚不已。有誰能想象得到，一次蚊子叮咬會與嚴重的出生缺陷和其它嚴重的神經併發症有關聯呢？

More than half of the world’s population lives in an area where Aedes aegypti mosquitoes are present. Who knows what the next nasty surprise will be?
世界上有一半以上的人口生活在有埃及伊蚊的地方。誰知道下一次嚴重的意外事件會是什麼樣的情景？

We know there will be more nasty surprises, if not from the volatile microbial world, then from some of the other complex threats in this era of global perils.
我們知道會有更多的嚴重意外事件發生，如果不是發生在一個反覆無常充滿微生物的世界，那麼也會在這個充滿全球風險時代的某些其它複雜的威脅中發生。

Ladies and gentlemen,
女士們，先生們：

The world has changed dramatically since the start of this century, when the Millennium Development Goals became the focus of international efforts to reduce human misery.
自本世紀伊始以來，世界發生了戲劇性的變化，千年發展目標成爲進行國際努力減少人類痛苦的重點。

At that time, human misery was thought to have a discrete set of principal causes, like poverty, hunger, poor water and sanitation, several infectious diseases, and lack of essential care during pregnancy, childbirth, and childhood.
當時，人類的苦難被認爲是由一組抽象的主要原因造成的，例如貧困、飢餓、不良水源和衛生、多種傳染性疾病以及在懷孕、分娩和童年期間缺少基本的護理。

The results of that focus, and all the energy, resources, and innovations it unleashed, exceeded the wildest dreams of many. It demonstrated the power of solidarity and brought out the best in human nature.
那個重點的結果，以及釋放的能量、資源和創造力，超越了許多人最強烈的夢想。它展示出團結的力量，揭示出人性中的真諦。

Last year, the United Nations General Assembly finalized the new 2030 Agenda for Sustainable Development. The factors that now govern the well-being of the human condition, and of the planet that sustains it, are no longer so discrete. The new agenda, with its 17 goals and 169 targets, will try to shape a very different world.
去年，聯合國大會出臺了新的2030年可持續發展議程。人類福祉條件的治理的種種因素，以及支撐人類福祉條件的星球，再也不是抽象的。這項包含17個目標和169個具體目標的新議程將努力打造出一個嶄新的世界。

More and more we are seeing the worst in human nature: international terrorism, senseless mass shootings, bombings in markets and places of worship, ancient and priceless archaeological sites reduced to rubble, and seemingly endless armed conflicts that have contributed to the worst refugee crisis since the end of the second World War.
我們越來越能看清人性中最醜陋的一面：國際恐怖主義、市場和祈禱地點無情的大規模的槍擊和爆炸、古老和價值連城的遺蹟變成了廢墟、看來無休止的武裝衝突造成了自第二次世界大戰以來最爲嚴重的難民危機。

Our world is profoundly interconnected and this, too, has consequences. The refugee crisis in Europe shattered the notion that wars in faraway lands will stay remote.
我們的世界是相互緊密相聯的，而且這也產生了後果。難民危機打破了那種遠方發生的戰爭且可隔岸觀火的概念。

The Ebola outbreak shattered the notion that a disease of small African nations will have no consequences elsewhere.
埃博拉疫情打破了那種非洲小國的疾病不會殃及其他的概念。

The explosive spread of Zika virus disease throughout Latin America and the Caribbean shattered the notion that a disease long considered a medical curiosity will stay that way.
暴發寨卡病毒疫情蔓延了整個拉丁美洲和加勒比，打破了那種早有定論的罕見病例的疾病不可逆轉的概念。

And there are other perils. Inequalities, in income levels, opportunities, life expectancy, and access to health care have reached their highest levels seen in more than half a century. Some wealthy nations are losing their middle classes, the backbone of stability for democratic societies.
並且還有其它危害，在半個多世紀，收入水平、機會、預期壽命和獲得健康保健方面存在的不平等，達到了最爲嚴重的程度。一些富裕國家正在失去民主社會穩定的支柱——中產階級。

The climate is changing, with numerous consequences for health. These consequences are also profoundly unfair. The countries that contributed least to greenhouse gas emissions will be the hardest hit.
氣候正在發生變化，對健康造成了衆多後果。這些後果也是非常不公平的。對溫室氣體排放貢獻最小的國家受到的衝擊最大。

Chronic noncommunicable diseases have overtaken infectious diseases as the number one killers worldwide. Treatment for chronic conditions vastly increases the need for medical products and raises questions about their constantly rising prices.
慢性非傳染性疾病取代了傳染病，成爲世界範圍的頭號殺手。慢性病人口的治療對醫藥產品的需求量大幅度增加，因而出現了藥品價格不斷攀升的問題。

With most newly approved cancer treatments costing more than $120,000 per patient per year, treatment is becoming unaffordable even for the wealthiest countries in the world. In some developing countries, the management of diabetes alone absorbs more than a third of the entire health budget.
隨着最新的癌症治療方法的認可，每個患者每年需花費超過12萬美元，這種治療即便是世界上最富有的國家也難以承受。在一些發展中國家，僅糖尿病管理一項就佔全部衛生預算的三分之一以上。

We are losing our vital but fragile antimicrobials. The detection last year by Chinese scientists of a new resistance mechanism, the MCR-1 gene, sent shockwaves through the medical and scientific communities.
我們正在失去極其重要的但卻是脆弱的抗微生物藥物。去年中國科學家進行的新的耐藥性檢查機制轟動了整個醫療和科學界。

The gene is located on a mobile plasmid that transfers easily from one bacterial strain to others. This is a horizontal transfer of resistance, and it is frightening.
基因位於流動的質粒中，很容易從一個菌株轉移到另一個菌株。這是一次橫向的耐藥性轉移，是令人恐懼的。

In the Chinese study, the MCR-1 gene conferred resistance to colistin, the last-resort antibiotic used to treat several life-threatening infections caused by Gram-negative bacteria.
在中國的研究中，MCR-1基因賦予粘菌素耐藥性，是治療由革蘭氏陰性菌引起危及生命感染時使用抗生素的最後手段。

Colistin is a 50-year-old antibiotic that was shelved in the 1970s because of its toxic effects on the kidneys. It was brought back into clinical use when all newer antibiotics began to fail.
粘菌素是一個有50年之久的抗生素，在1970年代被停用，因爲它對腎有毒性作用。在所有更新的抗生素開始失敗時，粘菌素重新在臨牀中使用。
As colistin had not been widely used, it was still effective. It was also cheap, which encouraged its massive use as a growth promoter in food production in several countries, including China.
由於粘菌素一直未被廣泛使用，所以它仍然有效。粘菌素還很便宜，在包括中國在內的一些國家的糧食生產中，鼓勵將其作爲一種促生長劑加以大規模使用。
The Chinese findings, which have been replicated in several other countries, solidify the links between the agricultural use of antibiotics, resistance in slaughtered animals, resistance in food, and resistance in humans. All of the dots are connected.
已由一些其它國家仿效中國的研究成果，將農用抗生素、被屠宰牲畜的耐藥性，糧食中的耐藥性和人類耐藥性之間的聯繫具體化了。
If we lose colistin, as several experts are predicting, we lose our last medicine for fighting a number of serious infections.
正如一些專家預測的那樣，如果我們失去了粘菌素，我們就失去了抵抗一些嚴重感染的最後藥品。
Last month, British treasury minister Lord Jim O’Neill, who heads the UK panel reviewing antimicrobial resistance, likened current trends to a “slow-motion car crash” and singled out vaccines as a crucial part of the solution.
上個月，英國財政部國務大臣吉姆•尼爾勳爵帶領了一個專家小組審查了抗微生物藥物的耐藥性，把當前的趨勢比作一次“慢鏡頭的撞車動作”並挑選出疫苗作爲解決方案中一個重要的組成部分。
As noted, widespread vaccination against bacterial infections would reduce the need for antibiotics, thus reducing a key driver of resistance at source.
正如前面所說的，廣泛採用疫苗接種防止細菌感染，將減少對抗生素的需求，因此從源頭上減少了耐藥性的一個主要動因。
The panel will publish its final report in May. I am very pleased to know that your Prime Minister, David Cameron, is committed to pushing its recommendations through the UN General Assembly and the G7 group of countries.
專家小組將在五月發佈它的最後報告。我非常高興地得知，你們的首相戴維·卡梅倫承諾通過聯合國大會和七國集團採納專家組的建議。

Ladies and gentlemen,
女士們，先生們：
The health targets in the new 2030 Sustainable Development Agenda are supremely ambitious.
在新的2030年可持續發展議程中的衛生目標是極爲宏偉的目標。
They aim at nothing less than the elimination of AIDS, tuberculosis, and malaria and an end to preventable maternal and childhood deaths. They also explicitly call on governments to support R&D for new vaccines and medicines.
這些目標並不亞於消除艾滋病毒、結核病和瘧疾的目標，以及防止孕產婦和兒童死亡的目標。這些目標明確呼籲各國政府支持研發新的疫苗和藥品。

Yes, we can aim for the moon and, yes, we will have to have new tools to get there. All global strategies, approved by our Member States, for reaching the 2030 health targets stress that success depends on specific R&D breakthroughs.
是的，我們可以制定登月計劃，當然我們必須擁有踏上月球的工具。我們的會員國批准的所有實現2030年衛生目標的全球戰略都強調，成功取決於具體研發的重大突破。

Many of these breakthroughs are broadly beneficial. For example, having reliable and affordable point-of-care diagnostics is another way to make prescribing more precise and thus reduce the overuse of antimicrobials.
這些重要的新發現中許多是受益面很廣泛的。例如，提供可靠的和可承受的現場即時診斷是另外一種使開具處方更加準確、減少過量使用抗微生物藥物的方法。
The MenAfriVac vaccine, developed and priced specifically for use in Africa, provides a good example of the impact a new vaccine can have.
A羣腦膜炎球菌結合疫苗，專門爲在非洲使用而開發和定價的疫苗，是一個展示了一種新的疫苗可以產生影響的良好典範。
Since 2010, more than 230 million people in 16 countries in Africa’s meningitis belt have been vaccinated against meningococcal meningitis serogroup A, with support from GAVI and the Bill and Melinda Gates Foundation.
自2010年以來，在全球疫苗和免疫聯盟以及比爾和梅林達·蓋茨基金會的支持下，在非洲腦膜炎發病地帶的16個國家逾2.3億人爲防止患上A羣腦膜炎球菌性腦膜炎接種了疫苗。
Given the added impact of herd immunity, the recurring outbreaks of meningitis A that have devastated 26 African countries for decades have been virtually eliminated.
鑑於人羣免疫屏障的附加影響，在過去幾十年裏毀掉了26個非洲國家的頻繁暴發的甲型腦膜炎實際上已經滅絕了。
Aiming for the moon at a time when most budgets for domestic and international health are shrinking also calls for approaches that use what already exists more wisely. Finding more creative uses for existing vaccines can change patterns of use, with multiple spillover benefits for health.
當用於本國和國際衛生方面的大部分預算正在縮減的那一刻，卻瞄準了月球，即使如此，也需要有一個合理利用現有資源的方法。探索更加有創造性地使用現有疫苗可以改變使用的格局，這對衛生具有多個溢出效應。
In July 2013, WHO created a stockpile of oral cholera vaccines in response to a critical situation. Cholera epidemics were raging, yet the demand for vaccines was low and manufacturers had little incentive to increase supplies.
2013年7月，爲了應對嚴峻的局勢，世衛組織建立了口服疫苗儲存。儘管霍亂流行肆虐，但是對疫苗的需求不高，製造商對增加供應量毫無積極性。
Establishing the stockpile, WHO made a commitment to buy and use 2 million doses a year in order to stimulate demand and convince industry that a stable market exists.
世衛組織建立了儲存，承諾每年購買和使用200萬劑疫苗，以刺激需求和說服企業，穩定的市場是視而可見的。
Although the cholera vaccine stockpile is essentially a vaccine procurement and distribution mechanism, it has generated multiple health benefits well beyond saving lives.
儘管有了霍亂疫苗儲存，基本上是一個疫苗採購和分配的機制，但它帶來的多方面的衛生益處遠遠超過了挽救生命的意義。
It improved reporting. In public health, the promise of assistance is one of the strongest incentives to report epidemic-prone diseases immediately and transparently.
它改進報告程序。在公共衛生方面，提供援助的許諾是對快速和公開報告有流行傾向疾病最強有力的激勵之一。

As long experience shows, the temptation to cover up a cholera outbreak is great, given the potential impact on trade and tourism.
正如長期經驗顯示的那樣，鑑於對貿易和旅遊帶來的潛在影響，那種掩蓋霍亂疫情的誘惑是巨大的。
It improved the speed needed for an emergency response, especially in the context of humanitarian crises. Following receipt of a request, vaccines arrive in the country within a maximum of 10 days.
它提高了緊急反應所需要的速度，特別是在人道主義危機的環境下亦是如此。在接到要求後，疫苗最多在10天之內運達該國。
It increased supplies. Three producers have now been prequalified by WHO, with vaccine supply set to double this year. These vastly increased supplies have opened the first opportunity for pre-emptive campaigns in “hot spots” with repeated outbreaks.
它增加了供應量。世衛組織已經確定了三個預審合格的生產商，疫苗供應量確定翻一番。大量增加供應量爲在疫情頻發的“熱點地區”開展先發制人的運動創造了先機。
It increased access in underserved populations. More cholera vaccines have been deployed to affected areas over the past two years than in the previous 15 years combined.
它爲缺醫少藥的人口增加了獲取服務的渠道。過去兩年調往受影響地區的霍亂疫苗數量超過了前15年的總和。
It decreased costs as more producers entered the market.
由於有更多的生產商進入了市場，成本降低了。
It generated data on vaccine safety, efficacy, and the duration of immunity, thus strengthening the case for further investment.
它建立了疫苗安全、功效數據，以及免疫期，因此增強了進一步投資的理由。
And it has stimulated the development of better vaccines offering greater protection, a longer shelf life, and fewer logistical challenges.
並且它刺激了開發具有更強的保護、更長的保質期和更少的後勤拖累的更好的疫苗。
In short, a seemingly simple thing, like creating a stockpile, has transformed a vicious cycle of low demand, low production, high price, and inequitable distribution to a virtuous cycle of increased demand, increased production, reduced price, and greater equity of access.
簡而言之，表面看起來是件簡單的事情，如建立儲存，但卻將低需求、低產量、高昂的價格和不公平分配的惡性循環轉變成需求增加、生產增加、調低價格和更公平合理的獲得疫苗的良性循環。
A stockpile of rabies vaccine is a logical next step to follow.
下一步是儲存狂犬病疫苗。Ladies and gentlemen,
女士們，先生們：
The tremendous contribution that this Agency and Institute make to the quality and safety of existing medical products and the development of new ones will make little difference in the absence of systems for delivering these products to those in greatest need.
這個監管局和研究所對現有的醫藥產品的質量和安全性方面以及開發新藥方面做出了巨大貢獻，但在缺少一種系統，將這些產品送達最需要的人的情況下，這種巨大的貢獻不會產生多大影響。
Let me conclude with a visionary example.
讓我舉一個有遠見的實例來結束我的演講。
The government of Rwanda is implementing a product delivery programme that will use drones to deliver medical supplies, such as blood bags, to remote rural areas that cannot be reached by roads.
盧旺達政府正在實施一項產品運送計劃，使用無人機運送醫療用品，例如血袋，送到無道路交通的偏遠地區。
Since post-partum haemorrhage is the leading cause of maternal mortality, the life-saving potential is vast.
由於產後出血是孕產婦死亡的主要原因，挽救生命的潛力是巨大的。
Drones can deliver many other health interventions. Post-exposure treatments for rabies and snakebites are especially important, as most deaths from these conditions occur in rural areas.
無人機可以運送許多其它的衛生干預手段。對狂犬病和被蛇咬傷進行接觸後治療尤爲重要，因爲大多數發生在農村地區的死亡者都是這種原因造成的。
Studies conducted by Ugandan and US researchers have shown that transportation by drone does not impair the quality of lab samples and medicines.
烏干達和美國研究人員進行的研究表明，無人機運輸並不會損壞實驗室標本和藥品的質量。
The first test flights in Rwanda, known as the “land of a thousand hills”, are scheduled to begin in August.
在以“千山之國”著稱的盧旺達進行第一次試飛計劃在8月開始。
Plans for the future include the building of three drone-ports that will be able to cover almost half of Rwanda’s countryside. You will be pleased to know that British architect Norman Foster is one of the partners supporting this project.
未來的計劃包括，建造三個無人機停機坪，這將覆蓋幾乎盧旺達一半以上的農村地區。當知道英國建築師諾曼•福斯特是支持這一項目的夥伴之一，你們一定會感到高興。
Just as mobile phones overcame the lack of landlines, the use of drones to deliver life-saving medical products can overcome the lack of road infrastructure seen in much of rural Africa.
就像移動電話解決了缺少固定電話的問題一樣，在缺少道路基礎設施的大部分非洲農村地區，使用無人機解決了運送搶救生命醫療用品的問題。
Though it is early days, experts have been quick to recognize the extraordinary potential of this delivery innovation.
就像移動電話解決了缺少固定電話的問題一樣，在缺少道路基礎設施的大部分非洲農村地區，使用無人機解決了運送搶救生命醫療用品的問題。
It could transform the capacity of rural health facilities to save lives.
它可以將農村衛生設施的能力轉化爲挽救生命。
It could revolutionize the ability to retain qualified staff by assuring them they will not have to stand by, helpless, and watch people die from treatable causes.
它可對保留合格人員的能力進行徹底改革，使他們相信，他們不需要袖手旁觀，感到無用武之地，看着人們死於可治療的病因。
In an era of global health perils, we need to let our imaginations soar when looking for ways to get quality medical products to those in greatest need.
在一個全球衛生岌岌可危的時代，當我們爲把高質量的醫療產品送達那些最需要的人的手中而探索方式方法時，我們必須讓想象力釋放出來。
That will, indeed, help us reach the moon.
在一個全球衛生岌岌可危的時代，當我們爲把高質量的醫療產品送達那些最需要的人的手中而探索方式方法時，我們必須讓想象力釋放出來。
Thank you.
謝謝大家。