唐義均　趙天銥

Passage

Both WHO’s constitution and the declaration assert that health is a human right， not a privilege for those who can afford it. Over time， that right has made its way into both national and international law. But importantly， the right to health is not simply a noble idea on a piece of paper.

It has been a platform for major improvements in global health. Since 1948， life expectancy has increased by 25 years. Maternal and childhood mortality have plummeted. Smallpox has been eradicated and polio is on the brink. We have turned the tide on the HIV/AIDS epidemic. Deaths from malaria have dropped dramatically. New vaccines have made once-feared diseases easily preventable. And there are many other causes for celebration. But even as we continue to struggle with old threats， new ones have arisen. Climate change will have profound effects on health. Antimicrobial resistance has the potential to undo the gains of modern medicine. Vaccine hesitancy is putting millions of young lives at risk. Noncommunicable diseases， including heart disease， stroke， cancer， diabetes， hypertension， lung diseases and mental illnesses have become the major killers of our time. And of course， we continue to face the ever-present threat of outbreaks and other health emergencies.

In the past 12 months， WHO has responded to 47 emergencies in 50 countries. We are currently responding to an outbreak of Ebola in the Democratic Republic of the Congo， very near the border with Uganda. As of today， there have been 373 cases and 216 deaths since the outbreak started in August. So far， we have managed to prevent Ebola from spreading across the border， partly （largely） because we have much better tools with which to fight Ebola than at any time in history. More than 32，000 people have been vaccinated， which is one of the reasons the outbreak has not spread further than it has. We also have ways to treat those infected. So far， 150 people have been treated with one of four drugs. 14 million travelers have been screened， there have been more than 190 safe and dignified burials， we have done door-to-door advocacy in almost 4000 households and we have trained more than 500 community leaders. But this outbreak has been much more difficult to control， largely because of the security situation in eastern DRC. Armed groups operating in the area conduct regular attacks on the city of Beni， the epicentre of the outbreak. And every time there is an attack， the virus gets an advantage. Vaccination and contact tracing are disrupted.

Health security and health systems are the two sides of the same coin. The best long-term investment in protecting and promoting the right to health is to invest in stronger health systems. Because there is simply no other way to achieve universal health coverage and the Sustainable Development Goals （SDGs） than primary health care， with a focus on health promotion and disease prevention. But it will also require WHO and the global health community to work in a much more integrated and coherent way. That’s why WHO and 10 other international health agencies have agreed to work together on a Global Action Plan for Healthy Lives and Well-Being. The plan has three strategic approaches： integrate， accelerate and account1. First， we have committed to integrate many of our processes to increase our collective efficiency. Second， we have committed to accelerate progress by identifying areas of work in which we can truly bend the curve and make more rapid progress towards the health-related SDGs—like research and development， data and sustainable financing.2 And third， we have committed to keep each other accountable， both to the people we serve， and to the donors and partners who expect results from the resources they give us.

【參考譯文】

世衛(wèi)組織的章程和宣言均宣稱，健康是一項人權，而不是那些有錢維持身體健康的人群的特權。久而久之，健康權已經(jīng)寫入國內(nèi)法和國際法。但重要的是，健康權不僅僅是高大上的紙上談兵。

健康權一直是全球重大衛(wèi)生改善的行動目標。自1948年以來，人類預期壽命延長了25歲。產(chǎn)婦死亡率和兒童死亡率大幅下降。天花已得到根除，脊髓灰質(zhì)炎也已基本解決。艾滋病蔓延的態(tài)勢得到扼制。死于瘧疾的人數(shù)大幅下降。新疫苗使曾經(jīng)令人談之色變的疾病變得易于預防。還有許多其他可喜可賀的事情。但正在我們不斷與舊威脅較量之時，新威脅已經(jīng)出現(xiàn)。氣候變化將對健康產(chǎn)生深遠影響。細菌耐藥性有可能使現(xiàn)代醫(yī)學的成果付諸東流。對接種疫苗的猶疑態(tài)度正將數(shù)百萬年輕生命置于危險之中。包括心臟病、中風、癌癥、糖尿病、高血壓、肺病和精神疾病在內(nèi)的非傳染性疾病已成為我們這個時代的主要殺手。當然，我們還要面對無時不在的疾病爆發(fā)和其他緊急衛(wèi)生事件的威脅。

過去12個月，世衛(wèi)組織應對了50個國家的47起緊急事件。目前，我們正在應對剛果民主共和國在靠近與烏干達邊界處爆發(fā)的埃博拉疫情。自8月疫情爆發(fā)以來，迄今已有373例病例和216例死亡。截至目前，我們成功阻斷了埃博拉病毒跨境傳播，部分原因（很大程度上）是我們有了有史以來最好的抗擊埃博拉的方法。超過3.2萬人接種過疫苗，這是疫情沒有像以往那樣向更大范圍蔓延的原因之一。對感染者，我們也治療有方。迄今為止，已有150人接受了四種藥物中的一種進行治療。1400萬旅客通過了篩查，190多人得到了安全、體面的安葬;我們對近4000個家庭挨家挨戶進行宣傳，培訓了500多名社區(qū)領袖。但此次疫情更加難以控制，主要原因是剛果民主共和國東部的安全形勢。在該地區(qū)活動的武裝組織定期對疫情中心班尼市發(fā)動襲擊。每次襲擊，病毒都會趁勢傳播，疫苗接種和接觸者追蹤都會受阻。

衛(wèi)生安全和衛(wèi)生體系是同一枚硬幣的正反兩面。保護和促進健康權的最佳長期投入就是投資建立更強大的衛(wèi)生體系。實現(xiàn)全民健康覆蓋和可持續(xù)發(fā)展目標的唯一途徑就是初級醫(yī)療保健，重點在于促進健康和預防疾病。但這也將要求世衛(wèi)組織和全球衛(wèi)生界以更加協(xié)調(diào)一致的方式開展工作。這就是世衛(wèi)組織和其他10個國際衛(wèi)生機構同意在“健康生活和福祉的全球行動計劃”上同心勠力的原因。該計劃有三大戰(zhàn)略舉措：整合、加速和擔當。第一，我們承諾整合諸多程序，以提高集體效率。第二，我們承諾加速前進，確定能夠真正扭轉(zhuǎn)局勢、朝著健康相關的可持續(xù)發(fā)展目標——如研發(fā)、數(shù)據(jù)和可持續(xù)融資等——快步邁進的工作領域。第三，我們承諾相互擔當，既對我們服務的對象有所擔當，也對那些希望自己提供給我們的資源發(fā)揮作用的捐助者和合作伙伴有所擔當。

【評注】

1. 本句中的account （vi.）是語境語義，必須根據(jù)下面的we have committed to keep each other accountable一句來決定意義。這一句子是對account的解釋，因此應譯為“擔當（責任）”。

2. 句子中的by identifying areas of work表示方式，“in which we can truly bend the curve and make more rapid progress…”是定語從句。其中，bend the curve的字面意思是“彎曲曲線”，但它隱喻“改變局面或發(fā)展方向”。因此，可處理成“確定能夠真正扭轉(zhuǎn)局勢、朝著健康相關的可持續(xù)發(fā)展目標——如研發(fā)、數(shù)據(jù)和可持續(xù)融資等——快步邁進的工作領域”。