返回首页

SueDesmondHellmann_2016-_用更聪明、更精准的方式思考公共健康问题_
OK, first, some introductions. OK,首先,先自我介绍一下。
My mom, Jennie, took this picture. 这张照片是我母亲珍妮拍的,
That's my dad, Frank , in the middle. 在中间的是我爸,法兰克。
Frank:adj.坦白的,直率的;老实的;n.免费邮寄特权;v.免费邮寄;
And on his left, my sisters: 在他左边的是我姊姊:
Mary Catherine, Judith Ann, Theresa Marie. 玛莉凯瑟琳、侨蒂丝安、泰瑞莎马瑞。
John Patrick's sitting on his lap and Kevin Michael's on his right. 约翰派崔克坐在他脚上,凯文麦克在他右边。
And in the pale-blue windbreaker , 穿着浅蓝色防风夹克的
windbreaker:n.防风牌夹克衫(商标名);
Susan Diane. Me. 就是在下我,苏珊黛安娜。
I loved growing up in a big family. 我很开心可以在大家庭长大。
And one of my favorite things was picking names. 而我最喜欢的事就是命名。
But by the time child number seven came along, we had nearly run out of middle names. 但到了第七个孩子出生时, 我们家几乎已经用光所有的名字,
run out of:用完;
It was a long deliberation before we finally settled on Jennifer Bridget. 我们考虑了很久, 最后才把珍妮佛布里兹的名字定下来。
deliberation:n.审议;考虑;从容;熟思; finally:adv.终于;最终;(用于列举)最后;彻底地; settled:adj.稳定的; v.结束; (settle的过去分词和过去式)
Every parent in this audience knows the joy and excitement of picking a new baby's name. 在场的每位爸爸妈妈 都很了解幫宝宝命名时的 幸福与兴奋。
excitement:n.兴奋;刺激;令人兴奋的事物;
And I was excited and thrilled to help my mom in that special ceremonial moment. 而我竟然可以在这种喜庆的时刻幫助我妈 自然是兴奋又激动的。
thrilled:adj.非常兴奋; v.使非常兴奋; (thrill的过去分词和过去式) ceremonial:adj.仪式的;正式的,礼仪的;n.仪式,礼节;
But it's not like that everywhere. 但世界上的其它地方就不一定是如此了。
I travel a lot and I see a lot. 我时常旅行,见闻丰富。
But it took me by surprise to learn in an area of Ethiopia , parents delay picking the names for their new babies by a month or more. 但令我吃惊的是, 在伊索比亚的地方, 父母不会马上为孩子命名, 有时会拖延到一个月或更久之后。
Ethiopia:n.埃塞俄比亚;
Why delay? 为什么要拖延？
Why not take advantage of this special ceremonial time? 为什么不把握特别的一刻？
take advantage of:利用;
Well, they delay because they're afraid. 其实,他们拖延的原因是害怕。
They're afraid their baby will die. 他们害怕宝宝会死亡。
And this loss might be a little more bearable without a name. 如果不幸过世,宝宝没有名字他们比较不会那么难过。
bearable:adj.可忍受的;支持得住的;
A face without a name might help them feel just a little less attached . 不取名字能幫助他们 减少一点对新生儿的不舍。
attached:adj.依恋;v.重视;把…固定;(attach的过去分词和过去式)
So here we are in one part of the world -- a time of joy, excitement, dreaming of the future of that child -- while in another world, parents are filled with dread , not daring to dream of a future for their child beyond a few precious weeks. 世上有一部分父母是 ——沉浸在幸福里,梦想着宝宝的未来—— 而另一个世界的父母...... 却是担心受怕, 不敢在那宝贵的几个星期里, 梦想着他们小孩的未来。
dread:n.恐惧;可怕的人(或物);vi.惧怕;担心;vt.惧怕;担心;adj.可怕的; precious:adj.宝贵的;珍贵的;矫揉造作的;
How can that be? 怎么会这样？
How can it be that 2.6 million babies die around the world before they're even one month old? 为什么世界上有260 万个小宝宝 会在出生头一个月去世？
2.6 million. 260万！
That's the population of Vancouver . 这可是温哥华的总人口啊！
Vancouver:n.温哥华(加拿大主要港市);
And the shocking thing is: 令人震惊的是:
Why? 为什么？
In too many cases, we simply don't know. 很多时候,我们真的束手无策。
Now, I remember recently seeing an updated pie chart . 我记得最近看到一张最新的圆形图表,
recently:adv.最近;新近; updated:adj.更新的;现代化的;v.使现代化;更新;(update的过去分词和过去式) pie chart:n.饼形图;饼分图;
And the pie chart was labeled , "Causes of death in children under five worldwide ." 图表的主题是, 《全世界低于五岁小孩的死亡原因》
labeled:adj.有标签的; v.示踪; (label的过去分词和过去式) worldwide:adj.全世界的;adv.在世界各地;
And there was a pretty big section of that pie chart, about 40 percent -- 40 percent was labeled " neonatal ." 图表上有很大部分,大约40%, 有 40% 的原因是「初生」,
neonatal:adj.新生的;初生的;
Now, "neonatal" is not a cause of death. 「初生」不是一种死因
Neonatal is simply an adjective , an adjective that means that the child is less than one month old. 「初生」只是一个形容词, 是用来形容刚出生不到一个月的新生儿。
adjective:adj.形容词的;从属的;n.形容词;
For me, "neonatal" said: "We have no idea." 对我而言,这像是对着新生儿们说:「我们无能为力」。
Now, I'm a scientist. I'm a doctor. 我是一位科学家,我是医生。
I want to fix things. 我想要做点事改善这个状况。
But you can't fix what you can't define . 但你无法改善你不理解的事。
define:v.定义;使明确;规定;
So our first step in restoring the dreams of those parents is to answer the question: 所以,要重建那些父母亲的梦想, 我们第一步就是要回答这个问题:
restoring:adj.恢复的;v.恢复,重建;正在恢复;(restore的现在分词);
Why are babies dying? 为什么宝宝会死亡？
So today, I want to talk about a new approach , an approach that I feel will not only help us know why babies are dying, but is beginning to completely transform the whole field of global health. 所以,今天,我想要来谈谈一个新的方法, 一个我觉得不只可以幫助我们了解 为什么宝宝会死亡, 也让我们可以开始动手 彻底改革全球医疗系统。
approach:n.方法;路径;v.接近;建议;着手处理; transform:v.使改变;使改观;使转换;n.[数]变换式;[化]反式;
It's called " Precision Public Health." 这个方法叫做「精准公共医疗」。
Precision:n.精度,[数]精密度;精确;adj.精密的,精确的;
For me, precision medicine comes from a very special place. 我对「精准医学」的知识来自一个特别的地方。
I trained as a cancer doctor, an oncologist . 我是一位癌症及肿瘤医师。
cancer:n.癌症;恶性肿瘤; oncologist:n.肿瘤学家;肿瘤医师;
I got into it because I wanted to help people feel better. 我会进入这一个领域的原因,是因为我想要让病人更舒服。
But too often my treatments made them feel worse. 但很多时候,我的治疗方式只会让他们更痛苦。
treatments:n.治疗;疗法;对待;处理;讨论;(treatment的复数)
I still remember young women being driven to my clinic by their moms -- adults, who had to be helped into my exam room by their mothers. 我仍记得那些年轻女孩们被她们的妈妈载来我诊所的那一幕, 这些成年人,被她们的妈妈们载来我的诊疗室寻求幫助。
clinic:n.诊所;临床实习;(医院的)门诊部;门诊时间;
They were so weak from the treatment I had given them. 我的治疗方式让她们变得很虚弱。
But at the time, in those front lines in the war on cancer, we had few tools. 但在当时对抗癌症这场战役的前线, 我们可用的工具极少。
And the tools we did have couldn't differentiate between the cancer cells that we wanted to hit hard and those healthy cells that we wanted to preserve . 而我们拥有的工具, 无法区别出需要消灭的癌症细胞 及想要保留的健康细胞。
differentiate:vi.区分,区别;vt.区分,区别; preserve:vt.保存;保护;维持;腌;禁猎;n.保护区;禁猎地;加工成的食品;
And so the side effects that you're all very familiar with -- hair loss, being sick to your stomach, having a suppressed immune system , so infection was a constant threat -- were always surrounding us. 大家都相当了解这些治疗方式产生的副作用—— 掉发、感到恶心、 免疫系统不良,于是常常别感染的威胁 无时无刻潜伏在我们的身边。
familiar:adj.熟悉的;常见的;亲近的;n.常客;密友; suppressed:adj.抑制的,发育不全的;v.镇压,禁止;(suppress的过去时和过去分词) immune system:n.免疫系统; infection:n.感染;传染;(身体某部位的)感染;传染病;
And then I moved to the biotechnology industry. 所以我转到生物科技领域找方法,
biotechnology:n.[生物]生物技术;[生物]生物工艺学;
And I got to work on a new approach for breast cancer patients that could do a better job of telling the healthy cells from the unhealthy or cancer cells. 我全心投入到一个治疗乳癌病患的新方法, 这个方法比较能有效地分辨出 不健康的细胞或癌细胞。
patients:n.接受治疗者,病人;(patient的复数) unhealthy:不健康的
It's a drug called Herceptin. 这是一种叫「贺癌平」的药。
And what Herceptin allowed us to do is to precisely target HER2-positive breast cancer, at the time, the scariest form of breast cancer. 贺癌平可以让我们精准地 标靶到当时最恐怖的HER2 乳癌细胞,
And that precision let us hit hard the cancer cells, while sparing and being more gentle on the normal cells. 它能精准地攻击癌症细胞, 且对正常细胞的伤害降到最低。
sparing:adj.节约的;贫乏的;保守的;n.抽出;宽恕;免去;给予(spare的现在分词);
A huge breakthrough . 相当重大的突破,
breakthrough:n.突破;开始取得成功之时;adj.突破性的;
It felt like a miracle , so much so that today, we're harnessing all those tools -- big data, consumer monitoring, gene sequencing and more -- to tackle a broad variety of diseases . 感觉相当神奇, 因此今日, 我们可以利用这些工具—— 大资料、消费监控、基因定序......等等 来对抗各类疾病。
miracle:n.奇迹,奇迹般的人或物;惊人的事例; harnessing:v.给(马等)装上挽具(harness的现在分词);治理,利用; consumer:n.[经]消费者;[生,生态]消费者; gene:n.基因;遗传基因;遗传因子; sequencing:n.[计]排序; v.[计]定序(sequence的ing形式); tackle:v.处理; n.用具; variety:n.多样;种类;杂耍;变化,多样化; diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类;
That's allowing us to target individuals with the right remedies at the right time . 它可以让我们用精准的疗程 及时对个人做治疗。
individuals:n.[经]个人;[生物]个体(individual的复数); remedies:n.处理方法; v.改正; (remedy的第三人称单数和复数) at the right time:在适当时候;
Precision medicine revolutionized cancer therapy . 「精准医学」变革了癌症治疗的方式。
revolutionized:adj.革命化的;被彻底改革的;v.彻底改革(revolutionize的过去式); therapy:n.治疗,疗法;
Everything changed. 每件事都改变了,
And I want everything to change again. 而我希望每件事能再次改变。
So I've been asking myself: 所以,我一直在问我自己:
Why should we limit this smarter, more precise , better way to tackle diseases to the rich world? 为什么我们把 这种较聪明的、较精准的对抗疾病的方式, 限制在富人阶层？
precise:adj.准确的;确切的;精确的;明确的;
Now, don't misunderstand me -- 千万别误会我的意思——
misunderstand:v.误解;误会;
I'm not talking about bringing expensive medicines like Herceptin to the developing world, although I'd actually kind of like that. 我不是在谈,把类似「贺癌平」这种贵重的药, 带到开发中国家去, 虽然我是这么希望。
What I am talking about is moving from this precise targeting for individuals to tackle public health problems in populations. 我说的是, 把这种精准的个人医疗方式, 转移去解决公共医疗问题。
Now, OK, I know probably you're thinking, "She's crazy. 我知道,你们可能在想,「这女的疯了,
You can't do that. That's too ambitious ." 不能这样搞,这样太大胆了！」
ambitious:adj.野心勃勃的;有雄心的;热望的;炫耀的;
But here's the thing: we're already doing this in a limited way, and it's already starting to make a big difference. 但事情是这样的: 在资源有限的情况下,我们已经开始在做这件事, 而且已经有很大的成效了。
limited:adj.有限的; n.高级快车; v.限制; (limit的过去分词和过去式)
So here's what's happening. 我接下来谈谈成效如何,
Now, I told you I trained as a cancer doctor. 我刚跟各位提到,我是一位癌症医师,
But like many, many doctors who trained in San Francisco in the '80s, 但就如同在 80 年代旧金山受训的医师们一样,
I also trained as an AIDS doctor. 我也是一位爱滋病治疗医师,
It was a terrible time. 那段时间,情况非常糟糕。
AIDS was a death sentence . 感染爱滋病等同宣判死亡,
death sentence:n.死刑;
All my patients died. 我所有的爱滋病人都死了。
Now, things are better, but HIV/AIDS remains a terrible global challenge. 现在,情况好转了, 但爱滋病仍然是全球艰苦的挑战。
Worldwide, about 17 million women are living with HIV . 全世界,目前约有1700万女人感染爱滋病。
HIV:n.艾滋病病毒;
We know that when these women become pregnant , they can transfer the virus to their baby. 我们都晓得,当这些女人怀孕时, 她们会把病毒传染给小孩。
pregnant:adj.怀孕的;富有意义的; transfer:n.转移;调任;调离;[体]转会球员;v.调任;调走;转学;转移;
We also know in the absence of therapy, half those babies will not survive until the age of two. 我们也清楚,因缺乏治疗的方式, 一半的爱滋宝宝活不到 2 岁。
in the absence of:缺乏,不存在;无…时,缺少…时;
But we know that antiretroviral therapy can virtually guarantee that she will not transmit the virus to the baby. 但我们知道抗逆转录病毒疗法可以保证 她们不会把病毒传染给孩子。
antiretroviral:adj.抗逆转录病毒的,抗后病毒的; virtually:adv.事实上,几乎;实质上; guarantee:n.保证;担保;保证人;保证书;抵押品;v.保证;担保; transmit:v.传送;发射;播送;传播;传染;
So what do we do? 所以,我们要怎么做？
Well, a one-size-fits-all approach, kind of like that blast of chemo , would mean we test and treat every pregnant woman in the world. 我们要找出一个一体适用的方法, 意思就是要找到一个可以檢测并治疗全世界女人的方法。
one-size-fits-all:一刀切;一体适用;万全之策; blast:n.爆炸; v.爆破; chemo:n.化疗(等于chemotherapy);化学疗法;
That would do the job. 这样才能达到目标,
But it's just not practical . 但有点不实际。
practical:adj.实际的;真实的;客观存在的;n.实习课;实践课;
So instead, we target those areas where HIV rates are the highest. 所以,我们把目标转到爱滋病率最高的区域。
We know in certain countries in sub-Saharan Africa we can test and treat pregnant women where rates are highest. 我们知道在撒哈拉南边的某些非洲国家有相当高的爱滋病感染率, 我们可以在这里檢测并治疗到最多的女人。
sub-Saharan:撒哈拉以南地区;
This precision approach to a public health problem has cut by nearly half 这个针对性的公共医疗方式, 在最近这五年,解决了将近一大半
HIV transmission from mothers to baby in the last five years. 从母亲身上传染爱滋病到孩童身上的公共医疗问题。
transmission:n.传输;传染;播送;发射;广播;传动装置;
(Applause) （掌声）
Screening pregnant women in certain areas in the developing world is a powerful example of how precision public health can change things on a big scale . 筛檢这些开发中国家怀孕的女人, 充分展示了精准公共医疗 可以如何大规模改善现状。
scale:n.规模;比例;鳞;刻度;天平;数值范围;v.衡量;攀登;剥落;生水垢;
So ... 所以,
How do we do that? 我们要怎么做？
We can do that because we know. 因为我们知道,我们做的到。
We know who to target, what to target, where to target and how to target. 我们知道要治疗谁、 要治疗甚么病、 去哪治疗、如何治疗。
And that, for me, are the important elements of precision public health: who, what, where and how. 对我而言,这些是精准公共医疗的重要元素: （治疗）谁、甚么、去哪、如何。
elements:n.要素;基本部分;少量;一群;(element的复数)
But let's go back to the 2.6 million babies who die before they're one month old. 但让我们回到 260 万个活不到一个月的宝宝身上。
Here's the problem: we just don't know. 问题是这样的:我们只是不了解。
It may seem unbelievable , but the way we figure out the causes of infant mortality in those countries with the highest infant mortality is a conversation with mom. 这听起来好像不可思议。 但我们想到一个方法, 就是直接找 有最高婴儿死亡率国家的母亲对话。
unbelievable:adj.(非正式)难以置信的;不可信的 infant:n.婴儿;幼儿;未成年人;adj.婴儿的;幼稚的;初期的;未成年的; mortality:n.死亡数,死亡率;必死性,必死的命运;
A health worker asks a mom who has just lost her child, "Was the baby vomiting ? Did they have a fever?" 医疗人员会问宝宝刚过世的母亲一个问题, 「宝宝有呕吐吗？有发高烧吗？」
vomiting:v.呕吐(vomit的现在分词);
And that conversation may take place as long as three months after the baby has died. 对话也许就在 宝宝去世后的三个月。
take place:发生;举行; as long as:conj.只要;长达;如果;既然;
Now, put yourself in the shoes of that mom. 现在,各位换位思考一下那位母亲的感受,
It's a heartbreaking , excruciating conversation. 那会是一场多么令人心碎与备受折磨的对话啊...
heartbreaking:adj.令人心碎的;使人悲痛的; excruciating:adj.折磨人的;极痛苦的;极坏的;v.折磨;使受酷刑;(excruciate的现在分词)
And even worse -- it's not that helpful, because we might know there was a fever or vomiting, but we don't know why. 更糟糕的是,这一点也没有幫助, 因为,我们只知道有发烧呕吐的情况发生, 但我们不知道为什么。
So in the absence of knowing that knowledge, we cannot prevent that mom, that family, or other families in that community from suffering the same tragedy . 因为缺乏这方面的知识, 我们就无法阻止那位母亲、家庭 或在那个社区的其他家庭 悲剧继续发生。
community:n.社区;[生态]群落;共同体;团体; tragedy:n.悲惨的事;不幸;灾难;悲剧作品;
But what if we applied a precision public health approach? 但如果我们应用精准公共医疗的治疗方式呢？
what if:如果…怎么办? applied:adj.应用的;实用的;v.应用;使用;申请,请求;(apply的过去分词和过去式)
Let's say, for example, we find out in certain areas of Africa that babies are dying because of a bacterial infection transferred from the mother to the baby, known as Group B streptococcus . 举个例子, 我们在非洲发现到某些特定区域, 有母亲传染细菌给宝宝而造成宝宝死亡的案例, 而这细菌也就是大家所孰悉的 B 型链球菌。
bacterial:adj.[微]细菌的; transferred:v.(使)转移,搬迁;(使)调动;(transfer的过去分词和过去式) streptococcus:n.链球菌;链球菌属;
In the absence of treatment, mom has a seven times higher chance that her next baby will die. 因缺乏治疗,这些母亲的下一个宝宝死亡率 会比正常高出七倍。
Once we define the problem, we can prevent that death with something as cheap and safe as penicillin . 一旦我们找出问题的核心,我们就可以利用便宜又安全 类似青霉素的药物来避免死亡。
penicillin:n.盘尼西林(青霉素);
We can do that because then we'll know. 我们这样做之后就能够了解致病的根本原因,
And that's the point: once we know, we can bring the right interventions to the right population in the right places to save lives. 这才是重点: 一旦我们了解了,我们就能用正确的治疗方式, 对特定区域的人做精准且即时的治疗,来完成救人的目的。
interventions:n.[法]干预,干涉;处置(intervention的复数);
With this approach, and with these interventions and others like them, 有了这个方法、这些介入的方式 及其它类似的方法,
I have no doubt that a precision public health approach can help our world achieve our 15-year goal. 我深信, 精准公共医疗方法 可以幫助我们完成 「15 年目标」。
And that would translate into a million babies' lives saved every single year. 我们也可以把它解读成
translate:v.翻译;被翻译;被译成;(使)转变;
One million babies every single year. 每年一百万个宝宝。
And why would we stop there? 为什么我们要停下来？
A much more powerful approach to public health -- imagine what might be possible. 一个对公众健康这么有幫助的方法—— 想像一下,还有甚么病也可以用这种方式来解决？
Why couldn't we more effectively tackle malnutrition ? 为什么我们不可以更有效地解决营养不良问题？
malnutrition:n.营养失调,营养不良;
Why wouldn't we prevent cervical cancer in women? 为什么我们不能防止女性的子宫颈癌？
cervical:adj.颈的;子宫颈的;
And why not eradicate malaria ? 为什么不能根除疟疾？
eradicate:vt.根除,根绝;消灭; malaria:n.[内科]疟疾;瘴气;
(Applause) （掌声）
Yes, clap for that! 是的,为这件事用力鼓掌吧！
clap:n.鼓掌;拍手;掌声;拍手声;v.拍手(表示赞许或欣赏);击掌;
(Applause)
So, you know, I live in two different worlds, one world populated by scientists, and another world populated by public health professionals . 各位知道吗,我们住在两个截然不同的世界里, 一个世界充满了科学家, 而另一个世界却到处是公共医疗专家。
populated:v.生活于; professionals:n.[管理]专业人员(professional的复数);
The promise of precision public health is to bring these two worlds together. 精准公共医疗的承诺, 就是把这两个世界结合在一起。
But you know, we all live in two worlds: the rich world and the poor world. 但各位要知道,我们都住在这两个世界里: 富人与穷人的世界。
And what I'm most excited about about precision public health is bridging these two worlds. 我对精准公共医疗最兴奋的地方, 就是将这两个世界连结一起。
Every day in the rich world, we're bringing incredible talent and tools -- everything at our disposal -- to precisely target diseases in ways I never imagined would be possible. 在富人世界的每一天, 这些完美的天分与工具, 在我们的掌控下, 用前所未有的精准方式治疗富人的疾病。
incredible:adj.难以置信的,惊人的; disposal:n.处理;清除;去掉;(企业、财产等的)变卖;
Surely, we can tap into that kind of talent and tools to stop babies dying in the poor world. 当然,我们也要运用这些天分与工具 来阻止穷人世界宝宝的死亡。
If we did, then every parent would have the confidence to name their child the moment that child is born, daring to dream that that child's life will be measured in decades, not days. 如果我们能做到, 如此,每个爸爸妈妈都可以在宝宝出生的那一刻, 大胆地梦想宝宝未来的十几年, 而不是只有几天而已。
confidence:n.信心;信任;秘密;adj.(美)诈骗的;骗得信任的; measured:adj.缓慢谨慎的; v.测量; (measure的过去分词和过去式)
Thank you. 谢谢各位！
(Applause) （掌声）