over the next 18 minutes

在接下來的18分鐘裡

a pretty incredible idea.

我想和大家說

Actually, it's a really big idea.

一個不可思議的想法

But to get us started,

事實上，這是一個很大的想法

I want to ask if everyone

但在我們開始之前

could just close your eyes for two seconds

我想請在座各位

and try and think of a technology or a bit of science

閉上眼睛，花兩秒的時間

that you think has changed the world.

試著去思考一項你認為

Now I bet, in this audience,

是改變世界的科技或科學

you're thinking of some really incredible technology,

我敢說，在座各位

some stuff that I haven't even heard of,

你們想到的確實是些很驚人的科技

I'm absolutely sure.

有些我甚至從未聽聞

But I'm also sure, pretty sure,

我非常確信是如此

that absolutely nobody is thinking of this.

但我也相當確定

This is a polio vaccine.

在座沒有任何人有想過這樣東西

And it's a great thing actually

這是小兒麻痺症疫苗

that nobody's had to think about it here today

這是一項偉大的發明

because it means that we can take this for granted.

但今天在這個場合不會有人想到

This is a great technology.

因為我們認為這件事是理所當然的

We can take it completely for granted.

這是一項偉大的科技

But it wasn't always that way.

我們當然會這樣想

Even here in California,

但事情不是總是這樣的

if we were to go back just a few years,

即便在加州

it was a very different story.

如果我們回到過去幾年前

People were terrified of this disease.

事情的發展是完全不同的

They were terrified of polio, and it would cause public panic.

人們非常害怕這種疾病

And it was because of scenes like this.

小兒麻痺症讓大眾感到恐懼，造成社會恐慌

In this scene,

也因為這樣的景象

people are living in an iron lung.

這張照片裡

These are people who were perfectly healthy two or three days before,

人要依賴鐵肺才能存活

and then two days later,

這些人兩三天前都還是相當健康的

they can no longer breathe,

但兩天後

and this polio virus has paralyzed

他們無法呼吸

not only their arms and their legs,

小兒麻痺病毒

but also their breathing muscles.

不僅是讓他們四肢癱瘓

And they were going to spend the rest of their lives, usually,

更讓他們的呼吸肌無法作用

in this iron lung to breathe for them.

通常他們的後半生

This disease was terrifying.

必須仰賴鐵肺，幫助他們呼吸

There was no cure,

這種疾病令人聞之喪膽

and there was no vaccine.

當時沒有治癒的方法

The disease was so terrifying

也沒有疫苗

that the president of the United States

這種疾病令人惶恐不安

launched an extraordinary national effort

當時的美國總統

to find a way to stop it.

發了特令動用國家資源

Twenty years later, they succeeded

企圖找到治療方法

and developed the polio vaccine.

二十年後，他們成功了

It was hailed as a scientific miracle

研發出小兒麻痺症疫苗

in the late 1950s.

這在50年代後期

Finally, a vaccine that could stop this awful disease,

被譽為是科學奇蹟

and here in the United States

終於有疫苗可以終止這種可怕的疾病

it had an incredible impact.

在美國

As you can see, the virus stopped,

疫苗有驚人的效應

and it stopped very, very fast.

大家可以看到，疫情止住了

But this wasn't the case

而且是迅速地終止

everywhere in the world.

但在世界上的其他地方

And it happened so fast in the United States, however,

就並非如此了

that even just last month Jon Stewart said this:

這在美國發生的太快了

(Video) Jon Stewart: Where is polio still active?

而就在上個月，Jon Stewart這樣說

Because I thought that had been eradicated

Jon Stewart：哪些地區仍然有小兒麻痺症？

in the way that smallpox had been eradicated.

我以為小兒麻痺症已經被根絕

Bruce Aylward: Oops. Jon, polio's almost been eradicated.

就像天花那樣已經完全根絕了

But the reality is

Bruce Aylward：喔，Jon，小兒麻痺是幾乎要被根絕

that polio still exists today.

事實上

We made this map for Jon to try to show him exactly where polio still exists.

小兒麻痺症到今天仍然存在

This is the picture.

我們製作了地圖讓Jon了解至今哪些地區仍存在有小兒麻痺症

There's not very much left in the world.

就是這張圖

But the reason there's not very much left

雖然世界上只有少數地區仍有此問題

is because there's been an extraordinary public/private partnership

至於大部分地區沒有這項問題

working behind the scenes, almost unknown,

是因為背後有傑出的公共/私人的組織機構

I'm sure to most of you here today.

持續為這項問題在努力

It's been working for 20 years

我想今天在座各位是不知道的

to try and eradicate this disease,

他們已經努力了二十年

and it's got it down to these few cases

嘗試要根絕這種疾病

that you can see here on this graphic.

從這張圖表上可以看到

But just last year,

這種疾病依然存在這少數幾個區域

we had an incredible shock

但就在去年

and realized that almost just isn't good enough

我們發現一樁令人驚駭的事

with a virus like polio.

然後我們意識到就小兒麻痺病毒而言

And this is the reason:

"幾乎"根絕是還不夠的

in two countries

原因是：

that hadn't had this disease for more than probably a decade,

在地球另一端有兩個國家

on opposite sides of the globe,

已經有超過將近十年的時間

there was suddenly terrible polio outbreaks.

沒有再出現過小兒麻痺症病例

Hundreds of people were paralyzed.

卻突然爆發嚴重的小兒麻痺症疫情

Hundreds of people died --

數百人癱瘓

children as well as adults.

數百人死亡

And in both cases,

有兒童，也有成人

we were able to use genetic sequencing to look at the polio viruses,

在這兩個國家

and we could tell these viruses were not from these countries.

我們利用基因測序檢查小兒麻痺病毒

They had come from thousands of miles away.

發現這些病毒並非原先就存在該地區

And in one case, it originated on another continent.

病毒是由千里之外的地區傳過來的

And not only that, but when they came into these countries,

其中一個病例，病毒是從另一個大陸傳來的

then they got on commercial jetliners probably

不僅如此，病毒到這些國家

and they traveled even farther

可能是藉由商業客機所傳遞

to other places like Russia,

也可能傳遞的更遠

where, for the first time in over a decade last year,

到其他地區去，例如俄羅斯

children were crippled and paralyzed

在超過十年的時間，就在去年

by a disease that they had not seen for years.

又有兒童受到這已長時間未出現的病毒

Now all of these outbreaks that I just showed you,

感染而變成殘廢和癱瘓

these are under control now,

我剛提到所有爆發的疫情

and it looks like they'll probably stop very, very quickly.

目前都在控制中

But the message was very clear.

而且應該會迅速地終止

Polio is still

但這件事很清楚地告訴我們

a devastating, explosive disease.

小兒麻痺症

It's just happening in another part of the world.

依然是一種駭人且會爆發傳染的疾病

And our big idea

這就發生在世界的另一個區域

is that the scientific miracle of this decade

而我們的想法是

should be the complete eradication

在眼前這十年的科學奇蹟

of poliomyelitis.

應該是要徹底根除

So I want to tell you a little bit

小兒麻痺症

about what this partnership, the Polio Partnership,

我想多跟你們說

is trying to do.

有關小兒麻痺症夥伴關係

We're not trying to control polio.

正嘗試在做的事

We're not trying to get it down to just a few cases,

我們不想只控制住疫情

because this disease is like a root fire;

我們不希望還有少數地區會出現病例

it can explode again if you don't snuff it out completely.

因為這種疾病像是星星之火

So what we're looking for

如果不把它完全根除的話，它可能會再次爆發

is a permanent solution.

所以我們希望找到

We want a world in which every child, just like you guys,

永久的解決辦法

can take for granted

我們希望世界上所有的孩童，如同在座各位

a polio-free world.

能理所當然的

So we're looking for a permanent solution,

生活在沒有小兒麻痺症的世界

and this is where we get lucky.

我們想找到永久的解決之道

This is one of the very few viruses in the world

我們很幸運的是

where there are big enough cracks in its armor

小兒麻痺病毒是世界上

that we can try to do something truly extraordinary.

少見能被治癒的病毒

This virus can only survive in people.

我們能試著做些真正特別的事

It can't live for a very long time in people.

這種病毒只會靠人類傳染

It doesn't survive in the environment hardly at all.

在人體也無法存活很久

And we've got pretty good vaccines, as I've just showed you.

也不能在嚴厲的環境中存活

So we are trying

如同我剛展示的，我們有相當好的疫苗

to wipe out this virus completely.

所以我們嘗試

What the polio eradication program is trying to do

要完全根除這種病毒

is to kill the virus itself

小兒麻痺症根絕計畫要做的事

that causes polio

是消滅世界各地

everywhere on Earth.

會引發

Now we don't have a great track record

小兒麻痺症的病毒

when it comes to doing something like this,

當我們開始做這樣的事時

to eradicating diseases.

我們不曾有過根絕疾病的

It's been tried six times in the last century,

良好紀錄

and it's been successful exactly once.

在上一個世紀中，已經嘗試過六次

And this is because disease eradication,

僅僅只有一次成功過

it's still the venture capital of public health.

是因為根除疾病

The risks are massive,

是大眾健康的一種風險投資

but the pay-off --

雖然風險甚大

economic, humanitarian, motivational --

但是各方面的回報

it's absolutely huge.

像是經濟，人道主義，激勵作用

One congressman here in the United States

也絕對是龐大的

thinks that the entire investment

一位美國的國會議員

that the U.S. put into smallpox eradication

認為美國投注在

pays itself off every 26 days --

根除天花的全部資源中

in foregone treatment costs

每二十六天就能在放棄治療的費用

and vaccination costs.

和接種疫苗的費用上

And if we can finish polio eradication,

得到回饋

the poorest countries in the world

如果我們能完成小兒麻痺症的防治

are going to save over 50 billion dollars

世界上最窮困的國家

in the next 25 years alone.

將可以在未來的二十五年

So those are the kind of stakes that we're after.

省下500億美金

But smallpox eradication was hard;

這才是我們在追求的利益

it was very, very hard.

根除天花是件困難的事

And polio eradication, in many ways, is even tougher,

是非常困難的

and there's a few reasons for that.

而根除小兒麻痺症，在很多方面又更加困難

The first is that,

有幾個原因

when we started trying to eradicate polio

第一

about 20 years ago,

當我們在二十多年前

more than twice as many countries were infected

開始嘗試要根除小兒麻痺症時

than had been when we started off with smallpox.

有疫情的國家總數

And there were more than 10 times as many people

是我們開始根除天花時的兩倍

living in these countries.

這些國家的人口數

So it was a massive effort.

則是十倍以上

The second challenge we had was --

這需要龐大的資源

in contrast to the smallpox vaccine,

第二個難處是

which was very stable, and a single dose protected you for life --

比較起來

the polio vaccine is incredibly fragile.

天花疫苗非常穩定，單劑就有終生保護作用

It deteriorates so quickly in the tropics

而小兒麻痺症疫苗相較脆弱

that we've had to put this special vaccine monitor

在熱帶地區會快速的敗壞

on every single vial

我們必須在每一瓶疫苗

so that it will change very quickly

都設置特殊的疫苗監控

when it's exposed to too much heat,

因為疫苗暴露在高溫時

and we can tell that it's not a good vaccine to use on a child --

變化會相當快速

it's not potent; it's not going to protect them.

變成不能在兒童身上使用的疫苗

Even then, kids need many doses of the vaccine.

沒有保護作用，不能讓他們免於病毒

But the third challenge we have --

此外，孩童需要很多的疫苗

and probably even bigger one, the biggest challenge --

第三個難處是

is that, in contrast to smallpox where you could always see your enemy --

或許這是最困難的部分

every single person almost who was infected with smallpox

相較天花，你能輕易看出症狀

had this telltale rash.

每個感染到天花的人

So you could get around the disease;

身上都有清楚的皮疹

you could vaccinate around the disease and cut it off.

所以能夠找到疾病

With polio it's almost completely different.

可以及時注射疫苗，讓疾病治癒

The vast majority of people who are infected with the polio virus

但小兒麻痺症是完全不同的情況

show absolutely no sign of the disease.

絕大多數感染小兒麻痺病毒的人

So you can't see the enemy most of the time,

幾乎看不出任何該疾病的病症

and as a result,

大部分時間，你不清楚敵人位在何方

we've needed a very different approach to eradicate polio

因此

than what was done with smallpox.

我們需要一種相當不同於天花的方法

We've had to create

來根除小兒麻痺症

one of the largest social movements in history.

我們發動了

There's over 10 million people,

有史以來最大規模的社會運動

probably 20 million people,

有超過一千萬人

largely volunteers,

也許是兩千萬人

who have been working over the last 20 years

眾多的志工

in what has now been called

在過去二十年來

the largest internationally-coordinated operation in peacetime.

在現在和平時期所說的

These people, these 20 million people,

參與這最大的國際合作行動

vaccinate over 500 million children

這些人，這兩千萬人

every single year,

在我們的任務最高峰的時期

multiple times

一年替五億名孩童

at the peak of our operation.

注射疫苗

Now giving the polio vaccine is simple.

而且不只一次

It's just two drops, like that.

現在注射小兒麻痺症疫苗很簡單

But reaching 500 million people

只要像這樣滴兩滴

is much, much tougher.

但替五億人注射疫苗

And these vaccinators, these volunteers,

這是更困難的

they have got to dive headlong

這些注射疫苗的人，也就是這些志工

into some of the toughest, densest

他們必須深入到世界上

urban slums in the world.

一些最艱困，人口最密集的

They've got to trek under sweltering suns

貧民窟城市

to some of the most remote, difficult to reach places in the world.

他們得在炎熱的太陽下跋涉到

And they also have to dodge bullets,

一些最偏遠且難以到達的地方

because we have got to operate

而且他們還必須躲避子彈

during shaky cease-fires and truces

因為我們必須要在

to try and vaccinate children,

混亂的停火和停戰的情況下

even in areas affected by conflict.

嘗試為兒童接種疫苗

One reporter

即便是有衝突影響的地區也一樣

who was watching our program in Somalia about five years ago --

一位記者

a place which has eradicated polio,

觀看我們五年前在索馬利亞的任務

not once, but twice, because they got reinfected.

該地區已經根絕小兒麻痺症

He was sitting outside of the road,

不只一次，是兩次，因為他們遭受二次感染

watching one of these polio campaigns unfold,

他就坐在馬路旁

and a few months later he wrote:

觀看這些宣傳小兒麻痺症的資訊

"This is foreign aid at its most heroic."

幾個月後他寫道：

And these heroes, they come from every walk of life,

「這是最英雄式的外援‧」

all sorts of backgrounds.

這些英雄來自來自各行各業

But one of the most extraordinary is Rotary International.

有著不同的生活背景

This is a group

其中最特別的是國際扶輪社

whose million-strong army of volunteers

這個團體

have been working to eradicate polio

上百萬的志工們

for over 20 years.

已經有超過20年

They're right at the center of the whole thing.

致力於根除小兒麻痺症的工作

Now it took years to build up the infrastructure

他們就在這整件事情的核心

for polio eradication --

現在花了相當多年的時間建立了

more than 15 years, much longer than it should have --

根除小兒麻痺症的基礎建設

but once it was built, the results were striking.

花了十五年的時間，遠多於預期

Within a couple of years,

但一旦建立完成，將會有驚人的結果

every country that started polio eradication

幾年之內

rapidly eradicated all three of their polio viruses,

每一個實行根除小兒麻痺症計畫的國家

with the exception of four countries that you see here.

都迅速根除了三種小兒麻痺症的病毒

And in each of those, it was only part of the country.