to Swedish undergraduate students.

給瑞典大學生講授全球發展

That was after having spent about 20 years

之前的20年我一直在非洲研究飢餓問題

together with African institutions studying hunger in Africa,

所以大家以為我對世界有些了解

so I was sort of expected to know a little about the world.

在我們的Karolinska醫學院

And I started in our medical university, Karolinska Institute,

我開設了一門本科生課程“全球健康”

an undergraduate course called Global Health.

剛開課的時候我還有些緊張

But when you get that opportunity, you get a little nervous.

因為來聽課的都是瑞典大學的優等生

I thought, these students coming to us

他們或許早已了解我準備教的內容

actually have the highest grade you can get in Swedish college systems --

於是在第一堂課裡，我作了一個小測試

so I thought, maybe they know everything I'm going to teach them about.

其中有一道題讓我受益匪淺

So I did a pre-test when they came.

下列5對國家中，哪一個的兒童死亡率高於另一個？

And one of the questions from which I learned a lot was this one:

我所選擇的配對國家都是

"Which country has the highest child mortality of these five pairs?"

一個的兒童死亡率是另一個的兩倍

I put them together, so that in each pair of country,

數據本身的不確定性可以忽略不計

one has twice the child mortality of the other.

今天我不會拿這來考大家

And this means that it's much bigger a difference

土耳其，波蘭，俄羅斯，巴基斯坦和南非

than the uncertainty of the data.

這是瑞典學生的測驗結果

I won't put you at a test here, but it's Turkey,

讓我高興的是

which is highest there, Poland, Russia, Pakistan and South Africa.

5道題平均答對的只有1.8題

And these were the results of the Swedish students.

我這個教授還有這門課

I did it so I got the confidence interval, which is pretty narrow, and I got happy,

因此都有了存在的必要

of course: a 1.8 right answer out of five possible.

但後來有天深夜，當我寫總結報告的時候

That means that there was a place for a professor of international health

我突然有了新的發現

and for my course.

瑞典大學的優等生們對世界的了解

(Laughter)

竟然還不如黑猩猩

But one late night, when I was compiling the report,

（笑聲）

I really realized my discovery.

因為黑猩猩們至少能蒙對一半

I have shown that Swedish top students

在兩個選項旁邊各放一根香蕉，就有一半的機率答對。

know statistically significantly less about the world than the chimpanzees.

這些優等生們卻做不到。這不是由於知識缺乏

(Laughter)

而是他們先入為主的錯誤理念

Because the chimpanzee would score half right

我還把這個測試拿去給卡羅林斯卡學院的教授們做

if I gave them two bananas with Sri Lanka and Turkey.

（笑聲）

They would be right half of the cases. But the students are not there.

他們每年負責頒發諾貝爾醫學獎

The problem for me was not ignorance; it was preconceived ideas.

結果教授們和黑猩猩半斤八兩

I did also an unethical study

（笑聲）

of the professors of the Karolinska Institute,

我意識到很有必要交流一下這個問題

that hands out the Nobel Prize in Medicine,

因為多數人並不知道

and they are on par with the chimpanzee there.

世界各國的兒童健康的改善

(Laughter)

我們作了一個軟件，每一個小球代表一個國家

This is where I realized that there was really a need to communicate,

這個是中國，這個是印度

because the data of what's happening in the world

小球的尺寸代表該國的人口，X軸是生育率

and the child health of every country is very well aware.

我曾問過學生們

We did this software which displays it like this:

如果讓你們來審視這個世界

every bubble here is a country.

你們的真實想法是什麼

This country over here is China.

其實這些教科書上都是丁丁歷險記（帶有殖民主義思想的漫畫）的人物

This is India.

（笑聲）

The size of the bubble is the population,

學生們回答 世界是由“我們和他們”組成的

and on this axis here, I put fertility rate.

“我們”指西方世界 “他們”指第三世界

Because my students, what they said

我又問“什麼是西方世界？”

when they looked upon the world, and I asked them,

“西方世界壽命長且家庭小；第三世界壽命短而家庭大。”

"What do you really think about the world?"

那麼一起來看。X軸是生育率，每個婦女的育兒數

Well, I first discovered that the textbook was Tintin, mainly.

從每人1，2，3，4胎，到8胎

(Laughter)

我們有1962年之後的各國家庭大小的可靠數據

And they said, "The world is still 'we' and 'them.'

數據誤差相當小。 Y軸是平均壽命

And 'we' is Western world and 'them' is Third World."

從30歲到70歲不等

"And what do you mean with Western world?" I said.

1962年的時候的確有一群國家在上面

"Well, that's long life and small family,

這些是發達國家，他們家庭小，壽命長

and Third World is short life and large family."

而這些則是發展中國家

So this is what I could display here.

他們家庭大，壽命也相對短些

I put fertility rate here: number of children per woman:

從1962年到今天 世界有什麼變化嗎？

one, two, three, four, up to about eight children per woman.

學生們正確嗎？國家還是分為2類嗎?

We have very good data since 1962 -- 1960 about --

或者發展中國家的家庭變小 （這些小球）移動到了左邊?

on the size of families in all countries.

或者發展中國家人們的壽命變長 （這些小球）移動到了上面?

The error margin is narrow.

我們一起看看，這些數據都來自於聯合國

Here, I put life expectancy at birth,

大家看到沒有？

from 30 years in some countries up to about 70 years.

這個是中國，他們在往上移動，健康狀況不斷改善

And 1962, there was really a group of countries here

這些綠色的拉丁美洲國家 正朝向小家庭的方向移動

that was industrialized countries,

這些黃色的小球是阿拉伯國家

and they had small families and long lives.

壽命在變長但家庭規模不變

And these were the developing countries:

非洲國家是下面的綠球，他們一直在下面

they had large families and they had relatively short lives.

這個是印度，印度尼西亞的移動速度非常快

Now, what has happened since 1962? We want to see the change.

（笑聲）

Are the students right? Is it still two types of countries?

80年代的時候，孟加拉國仍然和非洲國家在一起

Or have these developing countries got smaller families and they live here?

但是80年代的奇蹟發生在孟加拉國

Or have they got longer lives and live up there?

媽媽們開始宣傳和普及計劃生育

Let's see. We stopped the world then.

他們向左上角移動。90年代恐怖的艾滋病流行

This is all U.N. statistics that have been available.

導致非洲國家的平均壽命縮短

Here we go. Can you see there?

而其他國家都向左上角移動

It's China there, moving against better health there, improving there.

大家都有了長壽命和小家庭，而世界也煥然一新了

All the green Latin American countries are moving towards smaller families.

（掌聲）

Your yellow ones here are the Arabic countries,

現在我們對比一下美國和越南

and they get longer life, but not larger families.

1964年的美國家庭小壽命長

The Africans are the green here. They still remain here.

越南的家庭大而壽命短。這是後來的變化

This is India; Indonesia is moving on pretty fast.

越戰時期的數據顯示，儘管戰爭造成傷亡

(Laughter)

越南人的平均壽命仍有提高

In the '80s here, you have Bangladesh still among the African countries.

70年代末期，越南的計劃生育減小了家庭規模

But now, Bangladesh -- it's a miracle that happens in the '80s:

美國人的平均壽命也在延長

the imams start to promote family planning.

而家庭規模不變

They move up into that corner.

到了90年代，越南由計劃經濟轉為市場經濟

And in the '90s, we have the terrible HIV epidemic

其經濟發展的速度超過了社會的發展

that takes down the life expectancy of the African countries

今天（2003）越南人的平均壽命和家庭規模

and all the rest of them move up into the corner,

已經和越戰結束時（1974）的美國一樣

where we have long lives and small family, and we have a completely new world.

如果沒有看到這些數據的話

(Applause)

我們會低估了亞洲的巨大變化

(Applause ends)

這些超前於經濟發展的社會變革

Let me make a comparison directly

下面我們換個視角

between the United States of America and Vietnam.

X軸顯示了全世界的收入分佈

1964.

每天收入1美元，10美元和100美元

America had small families and long life;

富與窮之間的鴻溝幾乎消失了，簡直是個奇蹟

Vietnam had large families and short lives.

這裡還有一個很小的峰，但總體上是均數分佈的

And this is what happens:

我們看看收入的分配情況

the data during the war indicate that even with all the death,

這代表全世界人民每年的全部收入

there was an improvement of life expectancy.

最富有的20%那部分人得到了全部收入的74%

By the end of the year, the family planning started in Vietnam;

最貧窮的20%那部分人只得到2%

they went for smaller families.

可見發展中國家的理念極其的不確切

And the United States up there is getting for longer life,

我們總以為最富的人應該給最窮的人提供援助

keeping family size.

其實中間這部分才是世界人口的主體，而他們僅得到全部收入的24%

And in the '80s now, they give up Communist planning

這是個老問題了，中間這些人是誰？

and they go for market economy,

他們在哪些國家？先看非洲

and it moves faster even than social life.

非洲佔世界人口的十分之一，多數是窮人

And today, we have in Vietnam

這個代表富裕的經合組織成員國，聯合國俱樂部的會員

the same life expectancy and the same family size

他們在這邊，很小一部分與非洲重疊

here in Vietnam, 2003,

這是拉丁美洲，他們可以代表全世界

as in United States, 1974, by the end of the war.

從最貧窮到最富有的人都在那裡

If we don't look in the data,

再往上是東歐，東亞還有南亞

I think we all underestimate the tremendous change in Asia,

過去是什麼樣子的呢？

which was in social change before we saw the economical change.

如果我們回到1970年，這裡有一個明顯的峰

Let's move over to another way here in which we could display

這些絕對貧困的人大多數在亞洲

the distribution in the world of the income.

那時世界的問題就在於亞洲的貧窮

This is the world distribution of income of people.

後來隨著人口的增長

One dollar, 10 dollars or 100 dollars per day.

數以億計的亞洲人擺脫了貧困

There's no gap between rich and poor any longer. This is a myth.

另外一些人卻陷入貧窮，這就是今天的世界

There's a little hump here.

而這是世界銀行對未來最樂觀的預測

But there are people all the way.

世界再也不是貧富懸殊的，大多數人擁有中等的收入

And if we look where the income ends up,

當然這是指數冪分佈的圖

this is 100 percent the world's annual income.

因為經濟的增長是用百分比來衡量的

And the richest 20 percent,

我們用百分比的變化來評估經濟增長

they take out of that about 74 percent.

下面把X軸改為人均國內生產總值

And the poorest 20 percent, they take about two percent.

個人的數據轉為各大洲的數據

And this shows that the concept of developing countries

球的大小代表人口的多少

is extremely doubtful.

這個是經合組織國家，這是撒哈拉以南非洲

We think about aid,

我們把阿拉伯國家

like these people here giving aid to these people here.

從非洲和亞洲單獨分出來

But in the middle, we have most of the world population,

然後把X軸延伸一下，再加上一個新的維度

and they have now 24 percent of the income.

一個有社會價值的參數：兒童生存率

We heard it in other forms. And who are these?

X軸代表經濟，Y軸顯示兒童存活的比率

Where are the different countries? I can show you Africa.

一些國家的99.7%的小孩可以活到5歲以上

This is Africa.

另一些國家只有70%。很明顯可以看到

10% the world population, most in poverty.

經合組織成員國和拉丁美洲，東歐，東亞

This is OECD.

阿拉伯國家，南亞和非洲撒哈拉以南地區

The rich country. The country club of the U.N.

兒童生存率和經濟之間聯繫非常緊密

And they are over here on this side. Quite an overlap between Africa and OECD.

下面把撒哈拉以南非洲地區分解成各個國家

And this is Latin America.

分佈靠上邊的國家擁有更高的健康水平

It has everything on this Earth, from the poorest to the richest

撒哈拉以南的非洲各國是如此分佈的，球的尺寸代表該國人口

in Latin America.

塞拉里昂在下邊，毛里求斯在上邊

And on top of that, we can put East Europe,

毛里求斯是第一個消除了貿易壁壘的國家

we can put East Asia, and we put South Asia.

他們的蔗糖和紡織品的貿易協定與歐洲和北美一樣

And how did it look like if we go back in time,

但是非洲內部的差異非常巨大。加納在中部

to about 1970?

塞拉里昂需要人道主義援助

Then there was more of a hump.

烏干達則需要發展援助，在加納可以進行投資了

And we have most who lived in absolute poverty were Asians.

毛里求斯則可以去度假。非洲內部的差異之大確實很驚人

The problem in the world was the poverty in Asia.

而我們卻總以為非洲國家都差不多

And if I now let the world move forward,

下面分解南亞各國，印度是中間的藍色大球

you will see that while population increases,

而斯里蘭卡和阿富汗有著巨大差異

there are hundreds of millions in Asia getting out of poverty

把阿拉伯世界分解來看，儘管是相同的氣候，相同的文化

and some others getting into poverty,

相同的宗教，卻有巨大的差異

and this is the pattern we have today.

也門在打內戰，鄰國阿聯酋卻躺在錢堆裡

And the best projection from the World Bank

而且（阿聯酋的）兒童健康數據包含了所有的外籍勞工

is that this will happen,

大家總說數據不准確數據，其實比我們想像的好很多

and we will not have a divided world.

數據是有誤差

We'll have most people in the middle.

但柬埔寨和新加坡的差距肯定遠大於數據的誤差

Of course it's a logarithmic scale here,

再看東歐

but our concept of economy is growth with percent.

在蘇聯經濟模式下發展了多年，但在過去10年

We look upon it as a possibility of percentile increase.

卻經歷了巨大的變化

If I change this, and take GDP per capita instead of family income,

當今的拉丁美洲，古巴再也不是唯一的健康國家了

and I turn these individual data

幾年後，智利的兒童死亡率將低於古巴

into regional data of gross domestic product,

這些是經合組織成員國

and I take the regions down here,

這裡顯示的就是我們的世界

the size of the bubble is still the population.

大概就是這樣的情形。如果我們回到過去

And you have the OECD there, and you have sub-Saharan Africa there,

看看世界是怎樣的。從1960年開始

and we take off the Arab states there,

1960年（中國有）毛澤東，他給中國帶來了健康

coming both from Africa and from Asia, and we put them separately,

他去世後鄧小平給中國帶來了金錢，同時把中國帶回到世界的主流當中

and we can expand this axis, and I can give it a new dimension here,

其他國家的移動方向也不盡相同

by adding the social values there, child survival.

很難找出哪個國家

Now I have money on that axis,

能代表全世界的發展模式

and I have the possibility of children to survive there.

我們回到1960年做個比較

In some countries, 99.7% of children survive to five years of age;

先選中韓國（左邊的小黃球）；巴西（右邊的黃綠色大球）

others, only 70.

烏干達（Y軸上面的小紅球）

And here, it seems, there is a gap between OECD,

隨著時間的推移，我們看到

Latin America, East Europe, East Asia,

韓國的發展速度非常非常快

Arab states, South Asia and sub-Saharan Africa.

巴西就慢得多

The linearity is very strong between child survival and money.

我們再回到過去，給每個球畫出運動的軌跡

But let me split sub-Saharan Africa.

可以看到，發展速度的差距非常大

Health is there and better health is up there.

雖然各國的經濟和健康發展的軌跡大同小異

I can go here and I can split sub-Saharan Africa into its countries.

但是健康水平起點較高的國家

And when it burst,

發展速度遠超過經濟水平起點高的

the size of its country bubble is the size of the population.

為了說明這一點，我們看看阿聯酋

Sierra Leone down there. Mauritius is up there.

他們從這裡出發，一個資源型國家

Mauritius was the first country

他們靠石油大把賺錢，但健康絕不是超市裡的貨物

to get away with trade barriers, and they could sell their sugar --

需要衛生方面的投資，需要提高兒童的教育水平

they could sell their textiles --

需要培訓衛生工作者，還要教育民眾

on equal terms as the people in Europe and North America.

Sheikh Sayed 幹的非常漂亮

There's a huge difference between Africa. And Ghana is here in the middle.

儘管油價下跌了，他仍改善了阿聯酋的健康

In Sierra Leone, humanitarian aid.

這裡我們可以看到世界發展的主流

Here in Uganda, development aid.

各國對資金的分配和使用

Here, time to invest; there, you can go for a holiday.

都比過去合理的多

It's a tremendous variation within Africa

這里大家看到各國的數據基本上都是平均數

which we rarely often make -- that it's equal everything.

但是用平均數可能會很危險 因為國家內部也存在很大的差異

I can split South Asia here. India's the big bubble in the middle.

我們看這裡

But a huge difference between Afghanistan and Sri Lanka.

今天的烏干達和1960年的韓國差不多

I can split Arab states. How are they?

如果把烏干達分解開，可以看到內部的明顯差異

Same climate, same culture, same religion -- huge difference.

烏干達最富有的20%在右邊

Even between neighbors.

最貧窮的在左下邊。如果把南非分解開

Yemen, civil war.

尼日在下邊，他們剛遭受一場恐怖的飢荒

United Arab Emirates, money, which was quite equally and well used.

最貧窮的20%的尼日人在最左邊

Not as the myth is.

而最富有的20%的南非人在最右邊

And that includes all the children of the foreign workers

今天我們仍然在討論什麼方案能解決非洲的問題

who are in the country.

世界上所有的問題非洲都有

Data is often better than you think. Many people say data is bad.

我們不可能討論出一套通用方案，既能解決這些地方的艾滋病問題

There is an uncertainty margin, but we can see the difference here:

同時也適用於這些地方

Cambodia, Singapore.

世界的發展一定要因地制宜來分析

The differences are much bigger than the weakness of the data.

僅從各大洲的水平上來分析是不夠的

East Europe: Soviet economy for a long time,

當學生們接觸到這個軟件的時候他們都非常興奮

but they come out after 10 years very, very differently.

此外，政策制定者，各企業部門都會想知道世界的變化

And there is Latin America.

但為什麼大家仍然不知道（世界的變化）

Today, we don't have to go to Cuba

為什麼我們無法使用已知的數據呢

to find a healthy country in Latin America.

我們的聯合國，國家統計部門

Chile will have a lower child mortality than Cuba within some few years from now.

學院還有非政府組織都擁有數據

Here, we have high-income countries in the OECD.

但數據被隱藏在底層的數據庫裡

And we get the whole pattern here of the world,

而公眾在上面（太陽），互聯網（地平線）並未得到有效的使用

which is more or less like this.

之前我們看到的關於世界變化的信息

And if we look at it, how the world looks,

並不包括公眾資助的統計數據

in 1960, it starts to move.

的確有一些網站依靠數據庫的營養而存在著

This is Mao Tse-tung. He brought health to China.

但這是要收費的，還有愚蠢的密碼和討厭的統計表格

And then he died.

（笑聲，掌聲）

And then Deng Xiaoping came and brought money to China,

這個是行不通的。我們需要什麼？