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RamananLaxminarayan_2014P-_迫在眉睫的抗生素危机_
The first patient to ever be treated with an antibiotic was a policeman in Oxford. 第一位接受抗生素治疗的患者 是一位来自牛津的警察。
patient:adj.有耐心的,能容忍的;n.病人;患者; treated:v.以…态度对待;把…看作;(treat的过去分词和过去式) antibiotic:adj.抗生的;抗菌的;n.抗生素,抗菌素;
On his day off from work, he was scratched by a rose thorn while working in the garden. 有一天他下班后, 在花园劳作时被一朵玫瑰上的刺划伤了。
scratched:adj.受抓损的;有刮痕;v.抓;搔;(scratch的过去式及过去分词) thorn:n.刺;[植]荆棘;
That small scratch became infected . 这个小伤口被感染了。
infected:adj.带菌的; v.传染; (infect的过去分词和过去式)
Over the next few days, his head was swollen with abscesses , and in fact his eye was so infected that they had to take it out, and by February of 1941, this poor man was on the verge of dying. 在接下来的几天里,他的脸开始浮胀 并出现了脓肿, 事实上他的眼球也被感染了, 不得不摘除。 到了1941年的2月, 这个可怜的人已经奄奄一息了。
swollen:adj.肿胀的,浮肿的;浮夸的;激动兴奋的; abscesses:n.[外科]脓肿(abscess的复数);v.形成脓肿(abscess的三单形式); on the verge of:濒临于;接近于;
He was at Radcliffe Infirmary in Oxford, and fortunately for him, a small team of doctors led by a Dr. Howard Florey had managed to synthesize a very small amount of penicillin , a drug that had been discovered 12 years before by Alexander Fleming 他在牛津市的Radcliffe Infirmary医院接受治疗, 幸运的是, 由霍华德·弗洛里医生（译注:澳洲药理学家） 带头的一个医疗小组 成功的合成了 少量的盘尼西林, 一种被亚历山大·弗莱明（译注:苏格兰药学家） 在12年前发现的药物,
Infirmary:n.医务室;医院;养老院; fortunately:adv.幸运地; synthesize:vt.合成;综合;vi.合成;综合; penicillin:n.盘尼西林(青霉素);
but had never actually been used to treat a human, and indeed no one even knew if the drug would work, if it was full of impurities that would kill the patient, but Florey and his team figured if they had to use it, they might as well use it on someone who was going to die anyway. 但它从来没有被用来给人治病, 事实上甚至没有人知道这种药是否有效, 如果这种药不纯净是否会致死, 但是弗洛里和他的团队觉得 如果他们需要使用这种药,不妨干脆在 已无药可救的患者身上试试看。
impurities:n.杂质(impurity的复数); might as well:不妨,何妨;还是…的好;
So they gave Albert Alexander, this Oxford policeman, the drug, and within 24 hours, he started getting better. 于是他们把这种药用在了 Albert Alexander这名牛津警察的身上, 还不到24小时, 他的病情就开始逐渐好转。
His fever went down, his appetite came back. 他的烧退了,食欲也恢复了。
appetite:n.食欲;嗜好;
Second day, he was doing much better. 第二天,他恢复的更快了。
They were starting to run out of penicillin, so what they would do was run with his urine across the road to re-synthesize the penicillin from his urine and give it back to him, and that worked. 不过盘尼西林快用完了, 于是医生们提取了他的尿液 来重新合成盘尼西林, 再回过头来治疗他, 这种做法见效了。
run out of:用完; urine:n.尿;
Day four, well on the way to recovery . 第四天,他仍在慢慢好转。
recovery:n.恢复,复原;痊愈;重获;
This was a miracle . 这是个奇迹。
miracle:n.奇迹,奇迹般的人或物;惊人的事例;
Day five, they ran out of penicillin, and the poor man died. 第五天,盘尼西林又用完了, 这个可怜的人就死了。
So that story didn't end that well, but fortunately for millions of other people, like this child who was treated again in the early 1940s, who was again dying of a sepsis , and within just six days, you can see, recovered thanks to this wonder drug, penicillin. 所以这个故事的结局不太好, 但是对其他几百万人来说却是个福音, 比如这个在40年代同样接受盘尼西林治疗的孩子, 她差点死于败血症, 但经过了仅仅6天的治疗,你们可以看到, 在神奇的盘尼西林的治疗下她已经康复。
sepsis:n.败血症,[医]脓毒病;腐败作用;
Millions have lived, and global health has been transformed . 几百万人因此活了下来, 全球的健康状况也发生了转变。
global:adj.全球的;总体的;球形的; transformed:v.使改变形态;使改变外观(或性质);(transform的过去分词和过去式)
Now, antibiotics have been used for patients like this, but they've also been used rather frivolously in some instances , for treating someone with just a cold or the flu, 现在,抗生素已经被用在 这样的病人身上, 但同时也应用于其他 非常不合适的情况, 比如仅仅用来治疗感冒或者流感,
antibiotics:n.抗菌素;抗生素(如青霉素);(antibiotic的复数) patients:n.接受治疗者,病人;(patient的复数) frivolously:adv.轻浮地;愚昧地; instances:n.相依物体,例子; v.举例说明(instance的第三人称单数形式); treating:v.以…态度对待;把…看作;处理;讨论;(treat的现在分词)
which they might not have responded to an antibiotic, and they've also been used in large quantities sub-therapeutically, which means in small concentrations , to make chicken and hogs grow faster. 而这很可能没什么效果, 抗生素也以非治疗的目的被大量使用, 也就是说用很低的浓度, 让鸡和猪长得更快。
responded:v.回答,回应;作出反应;响应;反应灵敏;(respond的过去式和过去分词) in large quantities:大量地; concentrations:n.关注点;[土壤]浓聚物(concentration的复数); hogs:[畜牧]猪;自私贪婪的人(hog的复数);
Just to save a few pennies on the price of meat, we've spent a lot of antibiotics on animals, not for treatment , not for sick animals, but primarily for growth promotion. 只为了买肉的时候省几分钱, 我们把大量的抗生素用在了动物身上, 但不是为了治疗,并没有用在生病的动物身上, 而主要是促进生长。
treatment:n.治疗;疗法;对待;处理;讨论; primarily:adv.首先;主要地,根本上;
Now, what did that lead us to? 那么,长此以往会怎么样呢？
Basically , the massive use of antibiotics around the world has imposed such large selection pressure on bacteria that resistance is now a problem, because we've now selected for just the resistant bacteria. 简单的说,世界范围内的 抗生素滥用 已经导致其对很多细菌不起作用了, 抗药性已经成为了一个问题, 因为我们如今所针对的细菌 恰恰都具备了抗药性。
Basically:adv.主要地,基本上; massive:adj.大量的;巨大的,厚重的;魁伟的; imposed:adj.强加的;施加的;应用的;v.欺骗(impose的过去分词);把…强加于; bacteria:n.[微]细菌; resistance:n.电阻;抵抗;阻力;抗力; resistant:adj.抵抗的,反抗的;顽固的;n.抵抗者;
And I'm sure you've all read about this in the newspapers, you've seen this in every magazine that you come across , but I really want you to appreciate the significance of this problem. 我很确定你们都在报纸上看到过这个信息, 你们浏览的每本杂志 也都提到了, 不过我真的希望你们能够认识到 这个问题的重要性。
come across:偶然遇见;给人以…的印象; appreciate:v.欣赏;感激;感谢;理解; significance:n.意义;重要性;意思;
This is serious. 情况已经很严重了。
The next slide I'm about to show you is of carbapenem resistance in acinetobacter. 在下一张幻灯片我要提到不动杆菌对碳青霉烯的抗药性。
Acinetobacter is a nasty hospital bug , and carbapenem is pretty much the strongest class of antibiotics that we can throw at this bug. 不动杆菌是一种极易附着在医疗材料上的细菌, 而碳青霉烯几乎是一种 我们可用来对付这种细菌的 最强的抗生素。
nasty:adj.极差的:令人厌恶的:不友好的:n.令人不愉快的事物: bug:n.臭虫,小虫;故障;窃听器;v.烦扰,打扰;装窃听器;
And you can see in 1999 this is the pattern of resistance, mostly under about 10 percent across the United States. 你们可以看到在1999年, 这种细菌抗药性在全美国的分布, 细菌抗药性只低于10%。
United:adj.联合的; v.联合,团结; (unite的过去分词和过去式)
Now watch what happens when we play the video. 现在我们看看视频里发生了哪些变化。
So I don't know where you live, but wherever it is, it certainly is a lot worse now than it was in 1999, and that is the problem of antibiotic resistance. 我不知道你们都住在哪里, 不过无论在哪,情况都比1999年 糟糕得多, 这就是抗生素耐菌性问题。
It's a global issue affecting both rich and poor countries, and at the heart of it, you might say, well, isn't this really just a medical issue? 这是个全球性的问题, 很多国家,不论穷富都受到了影响, 究其本质,你们可能会想, 这应该只是个医疗问题吧？
issue:n.重要议题;争论的问题;v.宣布;公布;发出;发行;
If we taught doctors how not to use antibiotics as much, if we taught patients how not to demand antibiotics, perhaps this really wouldn't be an issue, and maybe the pharmaceutical companies should be working harder to develop more antibiotics. 如果我们告诉医生们如何尽量少用抗生素, 如果我们告诉患者如何降低对抗生素的依赖, 这很有可能就不是个问题了, 可能制药公司 需要加大力度生产 更多的抗生素。
pharmaceutical:adj.制药(学)的;n.药物;
Now, it turns out that there's something fundamental about antibiotics which makes it different from other drugs, which is that if I misuse antibiotics or I use antibiotics, 现在事实已经证明了抗生素具备一些基本性质 让它不同于其他药物, 也就是说如果我误用了抗生素, 或者我仅仅是使用了抗生素,
fundamental:n.基础; adj.十分重大的; misuse:vt.滥用;误用;虐待;n.滥用;误用;虐待;
not only am I affected but others are affected as well, in the same way as if I choose to drive to work or take a plane to go somewhere, that the costs I impose on others through global climate change go everywhere, and I don't necessarily take these costs into consideration . 不光是我自己,其他人也会受到影响, 就好比我决定开车去上班, 或者飞去什么地方, 我的出行造成的气候变化 对其他人的影响无处不在, 我并不会意识到由此产生的代价。
necessarily:adv.必要地;必定地,必然地; consideration:n.顾及;报酬;斟酌;仔细考虑;
This is what economists might call a problem of the commons, and the problem of the commons is exactly what we face in the case of antibiotics as well: that we don't consider — and we, including individuals , patients, hospitals, entire health systems — 这就是经济学家们所谓的公地问题, 这种公地问题恰恰就是 我们在抗生素使用上需要面对的: 我们并没有考虑到—— 这里的我们包括个人,患者, 医院,整个卫生系统——
individuals:n.[经]个人;[生物]个体(individual的复数);
do not consider the costs that they impose on others by the way antibiotics are actually used. 没有认识到抗生素的实际使用方式 对其他人造成的影响。
by the way:顺便说一下;
Now, that's a problem that's similar to another area that we all know about, which is of fuel use and energy, and of course energy use both depletes energy as well as leads to local pollution and climate change. 这个问题同另一个众所周知的 领域非常相似, 也就是燃料的使用以及能源, 当然,能源的使用 不单大量的消耗了能源,同时也 导致了地域性的空气污染和气候变化。
depletes:vt.耗尽,用尽;使衰竭,使空虚; as well as:也;和…一样;不但…而且;
And typically , in the case of energy, there are two ways in which you can deal with the problem. 具体点说,在能源这个问题上, 有两种方法可以解决。
typically:adv.代表性地;作为特色地;
One is, we can make better use of the oil that we have, and that's analogous to making better use of existing antibiotics, and we can do this in a number of ways that we'll talk about in a second , 一个就是我们可以更好的利用现有的原油, 也就是说我们同样可以更好的利用 现有的抗生素, 可以通过很多种方法, 不胜枚举,
make better use of:更好地利用;更好利用; analogous:adj.类似的;[昆]同功的;可比拟的; in a second:立刻,很快;
but the other option is the "drill, baby, drill" option, which in the case of antibiotics is to go find new antibiotics. 不过另一个选择就是所谓的“不断开采”方式, 在抗生素的问题上就是找到新的抗生素。
option:n.选择;可选择的东西;
Now, these are not separate. 如今这两个问题已经不能区别对待了。
They're related, because if we invest heavily in new oil wells, we reduce the incentives for conservation of oil in the same way that's going to happen for antibiotics. 它们是相互关联的,因为如果我们大量的 开采新的油田, 我们就削弱了保护原油资源的动力, 对待抗生素也是如此。
invest:v.投资;(把资金)投入;投入(时间、精力等);授予; incentives:n.激励;奖励;诱因(incentive的复数形式);奖励措施; conservation:n.保存,保持;保护;
The reverse is also going to happen, which is that if we use our antibiotics appropriately , we don't necessarily have to make the investments in new drug development. 相反的情况也同样会发生,也就是 如果我们适当的使用抗生素, 在新药研发领域 也就不需要什么投资了。
reverse:n.反面; v.颠倒; adj.相反的; appropriately:adj.适当地;合适地;相称地; investments:n.[经]投资,投资的财产;投资学;(investment的复数)
And if you thought that these two were entirely, fully balanced between these two options , you might consider the fact that this is really a game that we're playing. 如果你觉得这两点在这两个选择中 可以完全平衡, 你们可能会想到事实上 我们在玩一个游戏。
options:n.选择; v.得到或获准进行选择; (option的三单形式)
The game is really one of coevolution , and coevolution is, in this particular picture, between cheetahs and gazelles. 这个游戏类似于共同进化, 而共同进化在这幅图片中就是 非洲猎豹和瞪羚的关系。
coevolution:n.共同进化(指两个以上相互依存的物种共同进化);
Cheetahs have evolved to run faster, because if they didn't run faster, they wouldn't get any lunch. 非洲猎豹已经进化到能够跑得更快, 因为如果它们不跑的再快一些, 它们就吃不到午餐。
evolved:v.(使)逐渐形成;进化;进化形成;(evolve的过去分词和过去式)
Gazelles have evolved to run faster because if they don't run faster, they would be lunch. 瞪羚也进化的跑得更快了, 因为如果它们不跑快点,就会被吃掉。
Now, this is the game we're playing against the bacteria, except we're not the cheetahs, we're the gazelles, and the bacteria would, just in the course of this little talk, would have had kids and grandkids and figured out how to be resistant just by selection and trial and error, trying it over and over again . 这就是我们要跟抗生素做的斗争, 只不过我们不是非洲猎豹, 我们是瞪羚, 而细菌们在 演讲的这段时间里 就已经繁殖了一代又一代, 弄清了如何通过筛选,尝试和误差 来变得更顽强, 不断的进行尝试,变化。
in the course of:在…过程中;在…期间; grandkids:n.(外)孙;(外)孙女;(grandkid的复数) over and over again:adv.一再地;反复不断地;
Whereas how do we stay ahead of the bacteria? 那么我们要如何抢在细菌前面呢？
Whereas:conj.然而;鉴于;反之;
We have drug discovery processes , screening molecules , we have clinical trials, and then, when we think we have a drug, then we have the FDA regulatory process. 我们有药物研究过程, 筛选分子, 我们有临床试验, 当我们认为研制出了一种新药, 还要通过食品药物管理局的监管流程。
processes:n.过程; v.处理(process的第三人称单数形式); molecules:n.[化学]分子,微粒;[化学]摩尔(molecule的复数); clinical:adj.临床的;诊所的; regulatory:adj.管理的;控制的;调整的;
And once we go through all of that, then we try to stay one step ahead of the bacteria. 一旦我们经历了这些过程, 我们就会尝试更进一步 对付细菌。
Now, this is clearly not a game that can be sustained , or one that we can win by simply innovating to stay ahead. 显然这并不是一个能够长期进行的游戏, 或者仅仅通过革新 就能保持领先优势。
sustained:adj.持续的; v.维持; (sustain的过去分词和过去式) innovating:n.创新;v.革新(innovate的现在分词);创立;
We've got to slow the pace of coevolution down, and there are ideas that we can borrow from energy that are helpful in thinking about how we might want to do this in the case of antibiotics as well. 我们需要减慢共同进化的脚步, 我们可以从能源领域借鉴一些想法, 能够帮助我们思考 我们应该如何 应对抗生素。
Now, if you think about how we deal with energy pricing, for instance, we consider emissions taxes, which means we're imposing the costs of pollution on people who actually use that energy. 如果你们想想我们是如何应对 能源价格上涨,打个比方, 我们考虑一下排放税, 也就是说我们在向使用了那些能源的 人们征税。
emissions:n.(光、热、气等的)发出,排放;排放物;散发物;(emission的复数) imposing:adj.壮观的; v.推行,采用; (impose的现在分词)
We might consider doing that for antibiotics as well, and perhaps that would make sure that antibiotics actually get used appropriately. 我们会想要用同样的方式对待抗生素, 这样可能会保证 抗生素能得到合理的使用。
There are clean energy subsidies , which are to switch to fuels which don't pollute as much or perhaps don't need fossil fuels. 洁净能源补贴 用在不会产生太多污染的燃料上, 或者可能完全不需要化石燃料。
subsidies:n.补贴;补助金;津贴;(subsidy的复数) fossil:n.化石;老人;老古董;adj.从地下发掘出来的;化石的;属于旧时代的;陈腐的;
Now, the analogy here is, perhaps we need to move away from using antibiotics, and if you think about it, what are good substitutes for antibiotics? 现在,相似的地方就是,可能我们需要 避免使用抗生素, 你们想一下,抗生素有哪些好的替代品？
analogy:n.类比;类推;类似; substitutes:n.替代品; v.用…代替;
Well, turns out that anything that reduces the need for the antibiotic would really work, so that could include improving hospital infection control or vaccinating people, particularly against the seasonal influenza . 任何可以减少对抗生素需求 的东西可能都行得通, 也就是说可能包括提高医院的感染控制能力, 或者给人们注射疫苗, 尤其是针对季节性流感。
improving:v.改进;改善;(improve的现在分词) infection:n.感染;传染;(身体某部位的)感染;传染病; vaccinating:vi.接种疫苗;vt.给…注射疫苗;n.被接种牛痘者; particularly:adv.特别地,独特地;详细地,具体地;明确地,细致地; seasonal:adj.季节的;周期性的;依照季节的; influenza:n.[内科]流行性感冒(简写flu);家畜流行性感冒;
And the seasonal flu is probably the biggest driver of antibiotic use, both in this country as well as in many other countries, and that could really help. 季节性流感可能 是抗生素使用的最大诱因, 不单是在我们国家,在其他国家也一样, 这很有帮助。
A third option might include something like tradeable permits. 第三种选择可能包括可交易许可之类的东西。
tradeable:adj.可做交易的;有销路的;
And these seem like faraway scenarios , but if you consider the fact that we might not have antibiotics for many people who have infections , we might consider the fact that we might want to allocate who actually gets to use some of these antibiotics over others, 这些看起来像遥不可及的计划, 但是如果你们思考一下这个事实,我们可能 没有足够的抗生素让所有受到感染的人都用上, 我们可能考虑到一个事实, 可能想要把这些抗生素分配给 那些更需要的人,
faraway:adj.遥远的;恍惚的; scenarios:n.情节;脚本;情景介绍(scenario的复数); infections:n.传染病;口腔病害(infection复数形式); allocate:vt.分配;拨出;使坐落于;vi.分配;指定;
and some of these might have to be on the basis of clinical need, but also on the basis of pricing. 而其中一些人需要考虑临床需要 以及价格。
on the basis of:根据;基于…;
And certainly consumer education works. 当然消费者教育起了作用。
consumer:n.[经]消费者;[生,生态]消费者;
Very often, people overuse antibiotics or prescribe too much without necessarily knowing that they do so, and feedback mechanisms have been found to be useful, 多数时候,人们用了过量的抗生素, 或者开了太多处方,而并没有意识到 他们确实做的过头了, 而反馈机制 也被证明很有用,
overuse:n.过度使用;vt.把…使用过度; prescribe:v.给…开(药);让…采用(疗法);开(处方);命令; feedback:n.反馈;反馈意见;回授;[电子]反馈; mechanisms:n.机制;[机]机构(mechanism的复数);机械;[机]机构学;
When you tell someone that they're using a lot of energy during peak hour, they tend to cut back, and the same sort of example has been performed even in the case of antibiotics. 当你跟别人说他们在高峰时间段 耗费了太多能源, 他们会开始节约, 同样的例子在抗生素上 也有所体现。
peak:n.高峰; v.达到高峰; adj.最高度的; performed:v.表演;执行;履行;演出;工作,运转(好/不好)(perform的过去分词和过去式)
A hospital in St. Louis basically would put up on a chart the names of surgeons in the ordering of how much antibiotics they'd used in the previous month, and this was purely an informational feedback, there was no shaming, 圣路易斯的一家医院简单的 把外科医生的名字依据 上个月用了多少抗生素 列了个表, 这就是个直接的信息反馈, 没什么可丢人的,
surgeons:n.外科医生;(surgeon的复数) previous:adj.以前的;早先的;过早的;adv.在先;在…以前; purely:adv.完全;仅仅; informational:adj.情报的;报告的;新闻的;
but essentially that provided some information back to surgeons that maybe they could rethink how they were using antibiotics. 不过重要的是这样做反馈给了 外科大夫一些信息,可能他们能够重新考虑 如何使用抗生素。
essentially:adv.本质上;本来; provided:conj.假如; v.提供; (provide的过去分词和过去式) rethink:v.重新考虑;再想;n.重新考虑;反思;新想法;
Now, there's a lot that can be done on the supply side as well. 如今,在供给这方面 也有不少可以采取的行动。
If you look at the price of penicillin, the cost per day is about 10 cents. 如果你们看看盘尼西林的价格, 每一天的花费是10美分。
It's a fairly cheap drug. 这已经很便宜了。
fairly:adv.相当地;公平地;简直;
If you take drugs that have been introduced since then — linezolid or daptomycin — those are significantly more expensive, so to a world that has been used to paying 10 cents a day for antibiotics, the idea of paying 180 dollars per day seems like a lot. 如果你们吃同一时期上市的药—— 利奈唑胺或者达托霉素—— 它们都要贵得多, 所以对于一个习惯了每天花费10美分在抗生素上的 市场来说,每天花180美元 看起来太多了。
linezolid:利奈唑胺;利奈唑酮; significantly:adv.意味深长地;值得注目地;
But what is that really telling us? 那么这究竟告诉了我们什么呢？
That price is telling us that we should no longer take cheap, effective antibiotics as a given into the foreseeable future, and that price is a signal to us that perhaps we need to be paying much more attention to conservation. 这个价格告诉了我们 我们在可预见的未来 不应该继续使用 廉价有效的抗生素了, 这个价格对我们来说也是个信号, 可能我们需要对节俭保护 给予重视。
effective:adj.有效的,起作用的;实际的,实在的;给人深刻印象; foreseeable:adj.可预知的;能预测的;
That price is also a signal that maybe we need to start looking at other technologies , in the same way that gasoline prices are a signal and an impetus , to, say, the development of electric cars. 这个价格也给出了另外一个信号, 可能我们需要开始转向其他技术, 就好像汽油价格是一种信号, 可以说其 刺激了电动车的发展。
technologies:n.技术;科技(technology的复数); gasoline:n.汽油; impetus:n.动力;促进;冲力; electric:n.供电;adj.电的;用电的;电动的;发电的;
Prices are important signals and we need to pay attention, but we also need to consider the fact that although these high prices seem unusual for antibiotics, they're nothing compared to the price per day of some cancer drugs, 价格是很重要的信号, 我们要重视起来, 但我们也要考虑到一个事实, 虽然这些高价对抗生素来说看起来不太寻常, 跟一些抗癌药的日常价格 相比抗生素的花销算不了什么,
compared:adj.比较的,对照的; v.相比; (compare的过去式和过去分词) cancer:n.癌症;恶性肿瘤;
which might save a patient's life only for a few months or perhaps a year, whereas antibiotics would potentially save a patient's life forever. 抗癌药可以让患者的生命多维持几个月或者一年, 而抗生素很可能 彻底挽救一个患者的生命。
potentially:adv.可能地,潜在地;
So this is going to involve a whole new paradigm shift , and it's also a scary shift because in many parts of this country, in many parts of the world, the idea of paying 200 dollars for a day of antibiotic treatment is simply unimaginable . 所以这将会包括 一个全新的模式变革 这种变化也很可怕,因为 在这个国家的很多地方, 在世界的各个角落, 每天花上200美元 来进行抗生素治疗 简直是不可想象。
involve:v.包含;需要;牵涉;牵连;影响;(使)参加; paradigm shift:n.范式转移(指行事或思维方式的重大变化); unimaginable:adj.不可思议的;难以想像的;
So we need to think about that. 所以我们需要好好想一想。
Now, there are backstop options, which is other alternative technologies that people are working on. 还有一些强化方案, 也就是人们正在努力研究的 很多其他技术。
backstop:n.挡球网;捕手;支撑物; alternative:adj.供选择的;选择性的;交替的;n.二中择一;供替代的选择;
It includes bacteriophages, probiotics , quorum sensing, synbiotics. 包括噬菌体,益生菌, 细菌群体行为调控机制,合生剂。
probiotics:n.益生菌,原生菌;促生素或益菌; quorum:n.法定人数;
Now, all of these are useful avenues to pursue , and they will become even more lucrative when the price of new antibiotics starts going higher, and we've seen that the market does actually respond, and the government is now considering ways of subsidizing new antibiotics and development. 现如今这些都是可以探寻的有效途径, 当新的抗生素的价格不断上涨时, 它们就会变得越来越盈利, 事实上市场已经开始有所回应了, 政府现在正在考虑 为新的抗生素及其研发提供补助。
avenues:n.[建]林荫道,[公路]大街; pursue:v.继续;从事;追赶;纠缠; lucrative:adj.有利可图的,赚钱的;合算的; subsidizing:vt.资助;给与奖助金;向…行贿;
But there are challenges here. 不过还有些挑战。
We don't want to just throw money at a problem. 我们可不想把钱都花在麻烦上面。
What we want to be able to do is invest in new antibiotics in ways that actually encourage appropriate use and sales of those antibiotics, and that really is the challenge here. 我们想要做的是 投资新的抗生素, 能够实际上鼓励 这些抗生素的适度使用和销售, 这就是真正的挑战。
Now, going back to these technologies, you all remember the line from that famous dinosaur film, "Nature will find a way." 那么现在回到这些技术上, 你们肯定都记得《侏罗纪公园》里的 台词,“大自然会自寻出路。”
So it's not as if these are permanent solutions. 所以这看起来并不像个一劳永逸的解决方案。
permanent:adj.永久的,永恒的;n.烫发;
We really have to remember that, whatever the technology might be, that nature will find some way to work around it. 我们需要谨记,无论采用什么样的技术, 大自然都会找到方法解决问题。
technology:n.技术;工艺;术语;
You might think, well, this is just a problem just with antibiotics and with bacteria, but it turns out that we have the exact same identical problem in many other fields as well, with multidrug-resistant tuberculosis , which is a serious problem in India and South Africa. 你们可能会想,这只是个有关 抗生素和细菌的问题, 不过事实证明我们在很多其他领域 都有相同的问题, 比如对很多药物都有耐药性的肺结核, 这种病在印度和南非的状况不容乐观。
identical:adj.同一的;完全相同的;n.完全相同的事物; multidrug-resistant:多药耐药; tuberculosis:n.肺结核;结核病;
Thousands of patients are dying because the second-line drugs are so expensive, and in some instances, even those don't work and you have XDR TB. 数以千计的患者都在面临死亡的威胁, 因为二线药物都很贵, 有的情况下,当你患有这种病时 它们甚至完全不起作用。
second-line:adj.第二线的;
Viruses are becoming resistant. 病毒也在变得更耐药。
Agricultural pests. Malaria parasites . 农业害虫。疟原虫。
Agricultural:adj.农业的;农艺的; Malaria:n.[内科]疟疾;瘴气; parasites:n.[基医]寄生虫;[生物]寄生生物(parasite的复数);
Right now, much of the world depends on one drug, artemisinin drugs, essentially to treat malaria. 现在,世界上很多地方都依赖一种药, 青蒿素药物, 尤其是用它来治疗疟疾。
artemisinin:n.青蒿素(抗疟药);青蒿提取物;
Resistance to artemisinin has already emerged , and if this were to become widespread , that puts at risk the single drug that we have to treat malaria around the world in a way that's currently safe and efficacious . 青蒿素耐菌性已经开始减弱了, 如果这种情况愈演愈烈, 单一药物的风险 就会在全世界出现出现,我们就需要采取目前看来安全有效的方式 来治疗疟疾。
emerged:v.(从隐蔽处或暗处)出现;暴露;露出真相;显现;(emerge的过去分词和过去式) widespread:adj.普遍的,广泛的;分布广的; currently:adv.当前;一般地; efficacious:adj.有效的;灵验的;
Mosquitos develop resistance. 蚊子也变得耐药了。
Mosquitos:n.蚊子(mosquito的变形);
If you have kids, you probably know about head lice , and if you're from New York City, 如果你有孩子,你可能知道头虱, 如果你从纽约市来,
lice:n.虱子(louse的复数);
I understand that the specialty there is bedbugs . 我知道那里的臭虫问题很严重。
specialty:n.专业,专长;特产;特性;招牌菜;adj.特色的;专门的;独立的; bedbugs:n.臭虫;
So those are also resistant. 这些东西都有耐药性。
And we have to bring an example from across the pond. 我们需要借鉴一洋之隔的例子。
Turns out that rats are also resistant to poisons. 事实证明老鼠对毒药也产生了耐性。
Now, what's common to all of these things is the idea that we've had these technologies to control nature only for the last 70, 80 or 100 years and essentially in a blink , we have squandered our ability to control, because we have not recognized 那么所有这些事的共同点就是 我们用现有的技术 控制大自然的力量仅仅有七八十,或者一百年左右, 而重点在于短时间内, 我们就浪费了真正能掌控大自然的能力 因为我们还没有认识到
blink:vt.眨眼;使…闪烁;vi.眨眼;闪烁;n.眨眼;瞬间;闪光; squandered:vt.浪费;vi.浪费;漂泊;n.浪费; recognized:v.认识;认出;辨别出;承认;意识到;(recognize的过去分词和过去式)
that natural selection and evolution was going to find a way to get back, and we need to completely rethink how we're going to use measures to control biological organisms , and rethink how we incentivize the development, introduction, in the case of antibiotics prescription , and use of these valuable resources . 自然选择和进化会找到 恢复原状的途径, 我们需要彻底重新考虑 应该如何 采取行动来控制生物体, 重新考虑我们要如何实质性的促进 发展和新型药物的引入, 比如抗生素药物处方, 以及如何使用这些珍贵的资源。
natural selection:n.自然选择;物竞天择; biological:adj.生物学的;生物的;与生命过程有关的;加酶的;n.[药]生物制品; organisms:n.[生物]生物体(organism的复数);[生物]有机体; incentivize:以物质刺激鼓励; prescription:n.处方;药方;医生开的药;开处方; valuable:adj.有价值的;贵重的;可估价的;n.贵重物品; resources:n.[计][环境]资源; v.向…提供资金(resource的第三人称单数);
And we really now need to start thinking about them as natural resources. 我们现在真的需要把它们 当成自然资源。
And so we stand at a crossroads . 我们正站在一个岔路口。
crossroads:n.十字路口;交叉路口;聚会的中心地点(crossroad的复数形式);
An option is to go through that rethinking and carefully consider incentives to change how we do business. 一种选择就是重新思考, 谨慎的考虑相关的动机 来改变我们的行事方式。
rethinking:n.反思;v.重新考虑(rethink的现在分词);
The alternative is a world in which even a blade of grass is a potentially lethal weapon. 另一种情况就是 即便只是一片草叶子 都可能成为一个世界的致命武器。
blade:n.叶片;刀片,刀锋;剑; lethal:adj.致命的,致死的;n.致死因子;
Thank you. 谢谢大家。
(Applause) （掌声）