2022年上海高级口译复习:陈冯富珍在世卫组织
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Opening Remarks at a WHO/World Bank Ministerial-level Meeting on Universal Health Coverage
在世卫组织和世界银行全民健康覆盖部长级会议开幕式上的讲话
Dr Margaret Chan, Director-General of the World Health Organization
世卫组织总干事陈冯富珍博士
Geneva, Switzerland
瑞士日内瓦
18 February 2013
2013年2月18日
Excellencies, honourable ministers, colleagues from the World Bank, ladies and gentlemen,
诸位阁下、各位部长、世界银行的同事们、女士们、先生们:
The goal of moving towards universal health coverage is gaining support, sometimes very enthusiastic support, often very high-level support.
实现全民健康覆盖的目标是赢得支持,有些时候我们需要非常热情的支持,而且往往需要非常高级别的支持。
Since publication of the 2010 World health report on health system financing, more than 70 developing countries have requested WHO technical support for their plans to move towards universal coverage. The online edition of that report has been downloaded, either in summary or full-text version, more than 640 000 times.
自从出版有关卫生系统筹资的2010年《世界卫生报告》以来,已经有70多个发展中国家请求世卫组织为其实现全民健康覆盖的计划提供技术支持。该报告在线版本的全文和摘要已经被下载64万余次。
Countries that have already reached the goal are sharing their experiences. They are singing some praises. But they are also making it clear: This is a struggle. It takes time. It takes unwavering political commitment at the highest level of government.
已经实现目标的国家正在分享其经验。他们在唱赞歌。但同时,他们也清楚地认识到:这是一场斗争;获胜需要时间,需要政府最高级别做出毫不动摇的政治承诺。
Last September, I participated in the launch of a Lancet series on universal health coverage. Papers in that series show the positive impact of universal coverage on health outcomes.
去年九月,我参加了《柳叶刀》杂志全民健康覆盖主题专刊的发布。该刊所发表的论文表明,全民覆盖对健康结果有积极影响。
They explore the transition to universal coverage in its political and economic dimensions, and offer lessons about how health financing reforms have been enacted in a number of lower income countries. Commentaries in the series offer a big-picture view of the historical significance of what is now perceived to be a movement.
论文探讨了向全民健康覆盖过渡的政治经济特征,总结了一些收入较低国家进行卫生筹资改革的经验教训。该专刊的论文点评则从整体上讨论了当前这项运动的历史重要性。
It is extremely helpful to have a respected economist, like Jeffrey Sachs, argue strongly against what he calls “lazy thinking”. This thinking assumes that user fees will reduce overconsumption of health services or increase their value in the user’s eyes. Not true. User fees punish the poor.
像杰弗里?萨克斯这样受人尊敬的经济学家强烈反对“懒人思维”,这一点对我们也很有帮助。按照懒人思维,向使用者收费可以减少过度消费卫生服务或增加卫生服务在使用者眼中的价值。这种想法不正确。向使用者收费会惩罚穷人。
Here is another warning. Health financing reforms are just one part of the picture. Health insurance raises public expectations. People expect ready access to medicines and services, and they want quality. They want care from people who care about them.
我这里还有另外一个警告。卫生筹资改革只是大局的一部分。医疗保险提升公众预期。人们期望随时获得药物和服务,还得是高质量的。他们希望从关心自己的人那里获得服务。
A commitment to universal coverage means meeting these expectations as well. Don’t punish the poor, but don’t disappoint them either.
全民覆盖承诺也就是要满足这些期望。不要惩罚穷人,也不要令其失望。
Also last year, the United Nations General Assembly adopted a resolution that endorsed the goal of universal health care and gave it a high place on the global health agenda.
去年,联合国大会通过决议,支持全民保健目标,并将其作为全球卫生议程的重点。
The resolution was sponsored by more than 90 countries, from every corner of the globe, and adopted by consensus. In a move described by some as “momentous”, the resolution urges member states to develop health systems that avoid significant direct payments at the point of care.
该决议由来自全世界各个角落的90多个国家联名提出,并以协商一致方式通过。该决议敦促会员国在发展卫生系统时避免在卫生保健点直接支付大笔资金的做法。
It further urges them to establish mechanisms for pooling risks to avoid catastrophic health expenditures that drive households into poverty. The resolution also affirms the strong links between universal coverage and the UN’s Political Declaration on the prevention and control of noncommunicable diseases.
决议呼吁各国建立风险分担机制,避免灾难性卫生支出使患者家庭陷入贫困。决议确认,全民覆盖和联合国有关预防和控制非传染性疾病的《政治宣言》之间存在强有力的联系。
And there are other links, of course. In fact, a health system designed to deliver universal care provides a solid platform for tackling all health problems, for reaching all health goals, in a fair, integrated, and efficient way.
当然还存在其它联系。事实上,旨在提供全民保健的卫生系统会成为一个坚实的平台,能够公平、综合、高效地跟踪所有卫生问题并实现所有卫生目标。
I have expressed my personal commitment to universal coverage on several occasions. I regard universal coverage as the single most powerful concept that public health has to offer.
我曾经在多个场合表示过,我个人致力于实现全民覆盖。我认为这是公共卫生领域唯一最有力的概念。
It is the best way to cement the health gains made during the previous decade. It operationalizes the highest ethical principles of public health. It is a powerful social equalizer and the ultimate expression of fairness.
它是巩固过去十年所取得的卫生成果的最佳方式。它使公共卫生的最高伦理原则得到落实。它是强大的社会均衡器,是公平的最终体现。
The recent enthusiasm for universal coverage occurs in a world in which social inequalities, in income levels, in opportunities, and in access to health care, are at the greatest levels seen in at least half a century.
当今世界,体现在收入水平、机会以及获得卫生保健服务情况等诸多方面的社会不公平已经达到了至少半个世纪以来的最高点。在这一背景下,近年来出现了对实现全民覆盖的热情。
At a time when policies in so many sectors are actually increasing social inequalities, I would be delighted to see health lead the world towards greater fairness in ways that matter to each and every person on this planet.
鉴于许多领域的政策事实上增加社会不公,我很高兴地看到,卫生部门在实现更大程度公平方面率先垂范,这与地球上每一个人都息息相关。
Ladies and gentlemen,
女士们、先生们,
There is no universal formula for reaching universal coverage. Each country must carve its own way forward.
实现全民覆盖并无统一公式。每个国家都必须找到适合自己的前进道路。
Any move towards universal coverage is an inherently country-owned initiative. It must be home-grown, strongly rooted in the country’s culture, its domestic political institutions, the legacy of the existing health system, and the expectations of its people.
为实现全民覆盖而采取的任何举措从本质上都应当是本国自主行动。它应该是土生土长的,植根于本国的文化、政治制度和现有卫生系统以及本国民众的期望。
This is a key purpose of this meeting: to give countries a platform for exchanging experiences in specific areas. The meeting places particular emphasis on health financing reforms, including the management of fiscal and macroeconomic policy concerns, and the use of financial incentives to promote efficiency, high-quality care, and results.
本次会议的关键宗旨就是给各国搭建一个平台,让它们交流具体领域的经验。会议特别强调卫生筹资改革,包括管理财政和宏观经济政策关切,以及利用经济激励措施促进提高效率、推动高质量保健服务和获得预期结果。
To be most effective, mechanisms for pooled financing should go hand-in-hand with a primary health care approach. This is the most cost-effective way. Use of health services will increase. Health spending will increase. We know this.
要实现最佳效果,集中财力的机制应与初级卫生保健思路相结合。这是最具成本效益的办法。对卫生服务的使用将会增加。卫生支出将会增加。我们知道会出现这种情况。
But these increases can be counterbalanced through cost-effective prevention, early detection, and management of many conditions in the community or in homes. Such an approach becomes all the more important as the world braces for the coming onslaught of noncommunicable diseases.
但是,可以通过性价比高的干预措施、早期发现以及在社区和家里管理多种疾病抵消相应增加。随着全世界对非传染性疾病发起进攻,这种做法显得尤为重要。
A commitment to efficient and fair health services asks health officials to make some key policy decisions, and enforces their authority to do so.
要实现高效、公平的卫生服务,卫生官员需要做出一些关键政策决定,并推动其执行。
Officials can fix prices and fees, adjust provider incentives, introduce policies that promote generic medicines, and rationalize the use of expensive technologies. In some cases, policy-makers will also need to find ways to protect against the overuse of health services.
官员可以固定价格和收费,调整针对服务提供者的激励措施,推出有利于仿制药的政策,使昂贵技术的使用合理化。在一些情况下,决策者还需找到防止过度使用卫生服务的办法。
We also need to think about the overutilization of health technologies. Unlike many other areas of technological innovation, like mobile phones, where devices get cheaper and easier to use, advances in medical interventions are usually additive, not replacement technologies.
我们也需要思考卫生技术的过度使用问题。在许多其它技术创新领域,如手机,相关设备会越来越便宜、越来越容易使用。但是,在医疗领域,干预手段的进步往往是在现有技术上添加,而不是取代现有技术。
These are just some of the issues you will be discussing.
这些都是你们即将讨论到的问题。
I thank the World Bank for its support and look forward to our continuing collaboration.
感谢世行的支持,我期待着双方继续合作。
Progress towards universal coverage cannot be achieved by health ministers acting alone, even in the presence of political commitment at the highest level of government. It requires a concerted national effort, with an especially close engagement of minsters of health and finance.
仅靠卫生部长单打独斗不可能实现全民健康覆盖,即使存在政府高层的政治承诺也不行。要取得进展,就需要协调一致的国家努力,特别是卫生部长和财政部长之间的密切合作。
I hope you will also share experiences about how best to create a dialogue between these two branches of government.
我希望,各位能够就卫生部和财政部开展对话的最佳方式交流经验。
As I conclude, let me refer to a commentary published in the Lancet series.
最后,请允许我引用前述《柳叶刀》专刊论文点评的内容。
It describes the movement to achieve universal health coverage as a “great transition” that is “sweeping the globe, changing how health care is financed and how health systems are organized.”
该点评认为,实现全民健康覆盖的运动是一个“伟大的过渡”,将会“席卷全球,改变卫生保健获得资金的方式和卫生系统得以组织的方式。”
Let us think about that perspective as this meeting gets under way.
会议进行期间,让我们从这个角度展开思考。
Thank you.
谢谢大家。
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