Opening Remarks at a High-level Meeting on Building Resilient Health Systems in Ebola-affected Countries
在受埃博拉影响国家建设有恢复力的卫生系统高级别会议上的开幕词
Dr Margaret Chan, Director-General of the World Health Organization
世界卫生组织总干事陈冯富珍博士
Geneva, Switzerland, 10-11 December 2014
瑞士日内瓦，2014年12月10-11日
Excellences, honourable ministers, distinguished participants, ladies and gentlemen,
诸位阁下、各位尊敬的部长、尊敬的与会者、女士们、先生们：
Welcome to this high-level meeting on building resilient health systems. I thank you for your time and your expertise.
欢迎出席本次有关建设有恢复力的卫生系统的高级别会议。谢谢各位抽出时间出席并带来你们的专业意见。
Better health is a nation-building strategy. Without basic public health infrastructures and systems in place, no country is stable.
更好的卫生是建设国家战略的组成部分。没有基本的公共卫生基础设施和系统，没有哪个国家能够保持稳定。
No society is secure. No resilience exists to withstand shocks, whether coming from a changing climate, a natural disaster, or a killer virus like Ebola.
没有哪个社会是安全的。没有恢复力也就无法承受冲击，不管这种冲击是来自气候变化、自然灾害还是像埃博拉这样的致命病毒。
The 3 hardest-hit countries, Guinea, Liberia, and Sierra Leone, are among the poorest in the world. All 3 have only recently emerged from years of civil war and conflict that left health infrastructures badly damaged or destroyed.
几内亚、利比里亚和塞拉利昂这三个受影响最大的国家也属于世界上最贫穷的国家。三国都是近年来才结束多年内战和冲突，卫生基础设施遭到严重损失和破坏。
Prior to the outbreaks, these countries had only 1 to 2 doctors to treat a population of nearly 100 000 people. That number has been diminished as more than 600 health care staff have been infected.
疫情暴发前，三国都是每十万人口只有一到两名医生。现在连这个比例都达不到，因为有六百多位医务工作者感染埃博拉。
At the start of the outbreak, weaknesses existed throughout the health systems. Laboratories were few in number and concentrated in cities.
疫情开始时，整个卫生系统都存在薄弱环节。实验室数量少而且集中在城市里。
Many large referral hospitals had no electricity and running water or were made unsafe by electrical fires and floods. Isolation wards were rare, mostly dedicated to the care of Lassa fever patients.
许多大型转诊医院没有电和自来水或者由于电气火灾和洪水而变得不安全。隔离病房很罕见，而且大多用于护理拉沙热患者。
The numbers of ambulances and other vehicles, also for the transportation of diagnostic specimens, were inadequate.
救护车及其它车辆包括用来运送诊断样本的车辆不够用。
Supplies of essential medicines and personal protective equipment were unreliable, and systems for civil registration and vital statistics were nascent.
基本药物和个体防护装备的供应不可靠，民事登记和人口统计制度才刚刚起步。
Populations in all 3 countries remain deeply distrustful of health systems, especially Western medicine and foreign medical teams. Care from traditional healers is the preferred and, in rural areas, often the only option.
这三个国家的人民仍然很不信任卫生系统，特别是西药和外国医疗队。他们更倾向于传统治疗师，而在农村地区，往往也只有传统治疗师。
As we now know, the index case was a young boy who died of Ebola in Guinea on 28 December 2013.
正如我们现在所知，指示病例是2013年12月28日几内亚一位死于埃博拉的小男孩。
From that single case, the virus spread, undetected, for more than 3 months, in multiple chains of transmission involving urban as well as rural areas.
从该病例开始，病毒不为人知地传播了三个多月，在城市和农村地区形成多条传播链。
The virus entered the capital, Conakry, at the start of February. The disease was misdiagnosed twice as cholera and later thought to be Lassa fever.
二月初，病毒进入首都科纳克里。疾病被多次误诊为霍乱，后来又被认为是拉沙热。
As late as mid-March, when the government raised its first alert, cases of sudden death, reported around the country, were thought to be independent outbreaks caused by different diseases.
直到三月中政府首次提出预警，全国各地报告的突然死亡病例还被认为是不同疾病导致的孤立疫情。
By the time Ebola was identified as the causative agent, on 21 March, the virus was firmly entrenched in Guinea. This is what can happen in the absence of a well-functioning health system.
到3月21日确认埃博拉为致病原因时，病毒在几内亚已经根深蒂固。这就是卫生系统不能良好运转时会发生的情况。
As we have learned, Ebola is an unforgiving virus that can take advantage of any mistakes and exploit every opportunity to resist control.
正如我们大家所了解到的，埃博拉是一种无情的病毒，会利用任何错误和每一个机会来抵御人类控制它的努力。
Weak health systems created multiple opportunities. In some areas, all forms of essential care, whether for malaria treatment or safe childbirth, have ceased to function.
薄弱的卫生系统会提供很多这样的机会。在一些地区，所有形式的基本医疗保健服务，不论是治疗疟疾还是安全分娩，都已经无法继续。
The progress made in moving towards the health-related Millennium Development Goals has been reversed.
在实现卫生相关千年发展目标方面取得的进展被逆转了。
Ladies and gentlemen,
女士们、先生们，
We are here to find innovative solutions, to decide on what needs to be done, urgently and longer-term.
今天我们聚集一堂寻找创新解决方案，确定需要做些什么，包括现在就做的事和更长期的需要。
We need to focus on priorities, as advised by governments, and we need to know how essential measures will be accountably financed.
正如各国政府所指出的那样，我们需要关注重点。我们需要知道，如何以可问责的方式为基本措施提供资金。
I have a few suggestions for rebuilding resilient health systems.
对于重建有恢复力的卫生系统，我有几个建议。
First, follow a primary health care approach that brings services close to homes. One of the most important lessons we have learned concerns the critical role of community engagement.
首先要遵循初级卫生保健的方法，将服务带到人民身边。我们学到的最重要教训之一与社区参与的关键作用有关。
Communities know best what they need and are willing to accept. We cannot promote safe behaviour without community understanding and cooperation.
社区最了解自己需要什么、愿意接受什么。没有社区的理解和合作，我们就无法促进安全的行为。
A good referral system needs to be in place. Hospital facilities must be upgraded to provide safer and more effective care.
需要建立良好的转诊制度。必须升级医院设施，以提供更安全、更有效的护理。
Logistics need to improve to ensure an uninterrupted supply of electricity, running water, and essential medicines and supplies.
需要改进后勤保障工作，确保电力、自来水以及基本药物和其它物资的供应不被中断。
Much good work has been done to improve systems for civil registration and vital statistics. This work needs to increase.
在改进民事登记和人口统计制度方面已经做了不少很好的工作，需要继续努力。
Capacity to detect and respond to new or emerging infectious diseases needs to be an integral part of the health system.
需要使发现并应对新发和现有传染病的能力成为卫生系统的必要组成部分。
Finally, community confidence in traditional healers needs to be respected by giving these care-givers a place, with a clearly defined role, in the formal health system.
最后，需要尊重社区对传统治疗师的信任，在正式卫生系统中承认这些人员的地位并清晰界定其作用。
These are some thoughts as you begin your discussions.
这些想法供各位讨论参考。
I wish you a most productive meeting.
祝会议富有成果。
Thank you.
谢谢大家。
来源：WHO
心译翻工作室
