盖茨笔记：为什么我认为我们可以预测未来

I’ve always admired Stephen Hawking. He was a brilliant physicist—and an equally brilliant science communicator. His ability to make the universe accessible inspired millions to get interested in the sciences.

我一直很欣赏史蒂芬·霍金。他是一位杰出的物理学家，也是一位同样杰出的科学传播者。他能够让整个宇宙变得简单易懂，激发数百万人对科学产生兴趣。

That’s why I was honored to be chosen to be this year’s recipient of the 2019 Professor Hawking Fellowship. As part of the fellowship, I got to deliver a lecture in the historic Cambridge Union debate hall at Cambridge University.

因此我十分荣幸被选为2019年霍金奖学金的获得者。作为该计划的一部分，我在剑桥大学历史悠久的联合辩论厅发表了演讲。

When I was deciding what to talk about, I knew I wanted to try and live up to Hawking’s legacy of making the sciences interesting. I picked a topic that’s close to my heart—global health—and opted to do something that I hope would’ve delighted Professor Hawking: predict the future.

当我在考虑讲什么时，我知道我想要尝试和践行霍金让科学变得有趣的精神。我挑了一个我非常关注的话题“全球健康”，并且选择做一件我希望能让霍金教授欣慰的事情：预测未来。

You can read my remarks below. I’m grateful to the Cambridge Union Society for inviting me to give this lecture.

下面是我的演讲稿。感谢剑桥联合会邀请我来进行这次演讲。

Remarks as prepared

2019 Professor Hawking Fellowship Lecture

Cambridge University, United Kingdom

October 7, 2019

2019年霍金奖学金演讲

剑桥大学，英国

2019年10月7日

Thank you, Lucy [Hawking]. I was lucky to have spent time with your father over the years, and it was wonderful to meet you this morning.

谢谢你，露西·霍金。这些年来，我有幸与你父亲为伴，今天早上能见到你真是太好了。

I am deeply honored to be selected as this year’s Hawking fellow. I want to thank the selection committee, the Cambridge Union, and the entire Hawking family for this tremendous distinction.

我很荣幸被选为今年的霍金奖学金获得者。我要感谢评选委员会、剑桥联合会和整个霍金家族给我带来的巨大荣誉。

I first met Professor Hawking in 1997, when I was here to announce a new research lab that Microsoft opened with Cambridge. We saw each other several times over the years—both here in Cambridge, and in Seattle for some particularly memorable dinners. I wish I could tell you something surprising about our conversations, but we mostly talked about physics.

我第一次见到霍金教授是在1997年，当时我就在这里，宣布微软与剑桥大学合作建立一个新的研究实验室。这些年来，我们见过好几次面，在剑桥和西雅图共进了几次特别难忘的晚餐。我很希望能告诉你们一些关于我们所谈令人惊讶的事情，但其实我们主要谈论的是物理。

Trust me: if you’re as interested in physics as I am and you have an OPPOrtunity to talk to Professor Hawking about his work, you take it. He was as exceptional in person as you imagined he was. He not only had a brilliant mind for physics, but he was also a remarkably gifted communicator.

相信我：如果你和我一样对物理学感兴趣，并且有机会和霍金教授聊聊他的研究，你一定要抓住这个机会。他的个性和你想象中的一样特别。他不仅在物理方面很有天赋，还是一个非常有天份的沟通者。

Hawking wanted the public to think about and engage with science. He devoted his career to making it accessible and interesting. He urged people to be curious—to learn the facts and ask questions.

霍金希望公众思考并参与科学。他的整个职业生涯都致力于使它变得通俗易懂且有趣。他鼓励人们保持好奇心**——**了解事实并提出问题。

In fact, Hawking’s last book was all about asking big questions. One of those questions was, can we predict the future?

事实上，霍金的最后一本书通篇都是关于提出大问题的。其中一个大问题就是，我们能预测未来吗?

Today, I want to use this platform created by Professor Hawking and his family to try and answer that question. Can we predict the future? When it comes to the future of health, I believe the answer is yes—we can.

霍金希望公众思考并参与科学。他的整个职业生涯都致力于使它变得通俗易懂且有趣。他鼓励人们保持好奇心**——**了解事实并提出问题。

Why do I think we can predict the future? Because of three facts that explain how we got to where we are today.

为什么我认为我们可以预测未来呢？因为有三个事实可以解释我们是如何达成今天的成就的。

Fact #1: Global health has seen dramatic improvements in recent decades.

事实一：近几十年来，全球健康状况得到了显著改善。

The country with the worst health outcomes today is better off than the best country a century ago. The world has seen remarkable drops in childhood mortality and amazing increases in life expectancy.

如今健康状况最差的国家比一个世纪前健康状况最好的国家都要好。世界儿童死亡率大幅下降，预期寿命涨幅惊人。

I love this chart, because it shows just how much progress we’ve made. Each line shows how many people died in each age group, with the youngest at the top and the oldest at the bottom. The left side is 1990, and the right side is 2017.

我喜欢这个图表，因为它展示了我们已取得了巨大的进步。每一行显示了各个年龄段的死亡人数，最年轻的人群在最上面，最年老的人群在最下面。左边是1990年，右边是2017年。

Look at that top line on the left. In 1990, the age group with the highest mortality rate was, by far, kids under five. 12 million children died that year. Now look at the same line on the right… 6 million. By 2017, under 5 deaths had been cut in half. The age group with the highest mortality rate was 80 to 84. That means that more people are the world are living to see old age.

看左边顶部的那一行。1990年，死亡率最高的年龄组是五岁以下的儿童。那一年有1200万儿童死亡。再看右边同一行：600万。到2017年，五岁以下儿童死亡人数减少了一半。死亡率最高的年龄组为80-84岁。这意味着世界上有更多的人活到了老年。

But despite these improvements, we’re still seeing huge inequities in health.

尽管我们已取得了这些进展，我们仍然可以看到健康方面存在巨大的不平等。

Let’s look at a map of under 5 mortality today:

让我们看一下如今5岁以下儿童死亡率的分布图：

Look at where the deaths are: They’re mostly in sub-Saharan Africa. And these kids are often dying from diseases that are preventable and treatable, like diarrhea. That’s because the breakthroughs that save lives in places like Cambridge and Seattle have been slow to reach them. Which brings me to fact number two…

看看死亡都发生在哪里：大多在撒哈拉以南的非洲。这些孩子通常死于可以预防和治疗的疾病，比如腹泻。这是因为在剑桥和西雅图等地挽救生命的突破进展缓慢。这让我想到了第二个事实……

Fact #2: Improvements are made possible by innovation.

事实二：进步是通过创新实现的。

When most people picture health innovation, they think of big medical breakthroughs—like when Salk developed the first polio vaccine. But innovation isn’t limited to new treatments. Sometimes the biggest impacts come from improved systems, which allow us to reach more people.

当大多数人设想健康领域的创新时，他们想到的是医学上的重大突破，比如索尔克研制出第一支脊髓灰质炎疫苗。但创新并不局限于新疗法，有时最大的影响来自于优化的系统，它使我们得以触达更多的人。

For example, the oral polio vaccine that’s pushed polio to the brink of extinction in recent years has been available since 1961. But for decades, it wasn’t accessible to all children everywhere. That changed in 1988, with the creation of a new partnership called the Global Polio Eradication Initiative.

例如，近年来将脊髓灰质炎推向灭绝边缘的口服脊髓灰质炎疫苗自1961年就已问世，但几十年来，并非世界各地所有的孩子都能获得该疫苗。1988年，随着一个名为“**全球根除脊髓灰质炎行动”（GPEI）**的新机构的建立，这种情况发生了转变。

GPEI developed innovative strategies to reach every last child with the vaccine and conducted disease surveillance to trace the virus anywhere in the world. Thanks to tireless efforts of partners and country governments, as well a massive volunteer effort from Rotary International, GPEI has driven down polio cases by over 99.9% globally.

GPEI制定了创新性战略，目标是触达并为每一个儿童接种疫苗。它还开展了疾病监测，以便在全球各地追踪病毒。由于合作伙伴和各国政府的不懈努力，以及扶轮国际的大规模志愿工作，GPEI已在全球范围内将脊髓灰质炎病例减少了99.9%以上。

The innovations that enable progress also include new methods of understanding.

推动进步的创新还包括新的认知方法。

When Melinda and I first started this work, we were stunned by how little the world knew about how human health works—and especially about what health looked like in the poorest places. Today, our understanding is a lot deeper and more precise.

When I first got interested in global health, this is all we knew about who suffered from one of the world’s biggest killers: diarrhea.

当我和梅琳达第一次开始这项工作时，我们震惊地发现世界对卫生工作知之甚少，特别是对最贫困地区的健康状况知之甚少。而我们今天的认识要深刻和准确得多。

当我一开始对全球健康感兴趣时，面对世界上最大的健康杀手之一——腹泻，我们对遭受这种疾病的患者所了解的全部内容都包含在这张表里。

What does this tell us? Aside from the fact that a lot of people had diarrhea in 1990, not a lot. It tells you what big categories are killing kids in various regions, but not even which country they’re in or what’s causing their diarrhea. It gives you a sense of the scope of the problem, but it’s not particularly useful for coming up with a plan.

它告诉我们什么？除了在1990年有很多人得了腹泻这一事实之外，这张表显示的内容并不是很多。它告诉你在不同的地区有哪些疾病大类造成了儿童死亡，但甚至并没有告诉你他们在哪个国家或什么使他们患上了腹泻。它能让你体会到问题的严重程度，但对于提出计划来说并不是特别有用。

This is what the data we have on diarrhea looks like today:

这是今天我们有的关于腹泻的数据：

We can break down diarrhea deaths by country and more than a dozen causes.

Better data helps us use our resources better. For example, by looking at this chart, we know it makes sense to invest more money in rotavirus vaccines for Chad—with its high percentage of deaths—than for Ethiopia, which has a relatively low percentage of rotavirus deaths.

我们可以按国家和十几种原因来细分腹泻死亡人数。

更好的数据帮助我们更好地利用资源。例如，通过观察这张图表，我们知道，将更多的资金投入到乍得的轮状病毒疫苗比投入到埃塞俄比亚更有意义，因为乍得的轮状病毒死亡率相对高于埃塞俄比亚。

This chart is from an incredible tool called the Global Burden of Disease. If you work in global health, it’s invaluable. It can tell you almost anything you want to know about who gets what diseases where. If you don’t work in global health, it’s a great way to track the amazing progress we’ve made—and the progress still to come. And there’s a lot still to come, because…

这张图表来自一个非常棒的工具，叫做“全球疾病负担”（**Global Burden of Disease**）。如果你在全球健康领域工作，这个工具是极有价值的。关于哪些人在哪里患上哪种疾病的相关信息，它可以告诉你几乎所有你想知道的内容。如果你不在全球健康领域工作，它也是跟踪我们已取得的惊人进展的好方法——而且进展还将继续。我们还有很多事情要做，因为……

Fact #3: Innovation is a long game.

事实三：创新是一场持久战。

There’s a reason we talk about the R