历经艰难一年后依然乐观的理由 | 盖茨笔记

When Paul and I were starting Microsoft, we had a vision that personal computers would one day play a significant role in people’s lives. But I don’t think either of us ever foresaw a future where they would be your only connection to the world. Like many people, there were entire days this year when the only human interaction I had was through a screen.

我和保罗创办微软时，有一个共同的愿景：个人电脑有一天会在人们的生活中扮演重要角色。但我们当年都没有预料到，未来某一天电脑会成为你与世界唯一的联系。像很多人一样，今年我时常一整天下来都只能通过屏幕与人交流。

The result has been the most unusual and difficult year of my life. (I suspect a lot of the people reading this might say the same.) 2020 had a brief period of relative normalcy before COVID-19 upended everything. In 2021, the pandemic has dominated our lives since day one. We’ve all had to adapt to a “new normal,” although what that looks like is different for every person. For me, the result has been a year spent mostly online.

2021年因此成为了我一生中最不寻常也最为艰难的一年（我猜很多人可能会有同样的感受）。2020年，在经历了一段相对正常的短暂时间后，新冠疫情颠覆了一切。而进入2021年，疫情从第一天起就主宰了我们的生活。尽管每个人的情况都有所不同，但我们都在适应这一“新常态”。对我来说，这一年的大部分时间都是在网上度过的。

I had stretches of time without any face-to-face social interaction. If I had a break between meetings, I’d walk around my yard just to see something different. After work, I’d play bridge with friends online or hang out with them over video chat. Once I got vaccinated, I started having some small in-person get-togethers, but my social life is still a lot more digital than it used to be.

我经常连续很长时间都没有面对面的社交活动。在会议间隙，我会在院子里走一走，看看不一样的东西。工作之余，我会和朋友们在网上打桥牌，或者跟他们视频聊聊天。接种疫苗后，我开始参加一些小型的聚会，但我的社交生活仍比以前更加“数字化”。

It’s been a strange and disorienting experience. My personal world has never felt smaller than it did over the last twelve months.

这是一段奇特又令人困惑的经历，我的世界从来没像过去12个月这样狭小过。

At the same time, this year was a reminder that our world is more connected than ever. 2021 was full of monumental events with global repercussions, including extreme weather events, the ongoing effects of the pandemic, and America’s withdrawal from Afghanistan. Every time you looked at the news, you were reminded of just how significantly something happening on the other side of the world could affect you at home. (Just look at how one container ship stuck in the Suez Canal for a week caused shipping delays around the world.) It’s never been clearer that tackling big problems requires people working together across borders and sectors.

与此同时，2021年也在提醒我们，世界比以往任何时候都更加紧密的联系在一起。2021年发生了很多具有全球影响的大事件，包括极端天气和新冠大流行的持续影响等等。每次看新闻，你都会感受到地球另一端发生的事正在对你的家庭产生多么重大的影响（比如一艘集装箱货轮在苏伊士运河滞留一周导致了全球航运延误）。解决重大问题需要跨国界和跨部门的努力，这一点毋庸置疑。

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图左：6月热浪来袭，人们在俄勒冈州波特兰市的避暑中心休息 / 法新社（Kathryn Elsesser）

图右：3月，一艘大型货船搁浅在苏伊士运河，导致全球贸易中断6天 / 盖蒂图片社（Songphol Thesakit）

Collaboration has been a constant theme with my work this year. The foundation continues to take up the bulk of my time, and I’m blown away by the amazing progress made by our team and our partners in 2021. Most weeks, we have a virtual get-together with everyone who’s working on our COVID response. Each meeting focuses on a different topic, like disease modelling or vaccine distribution. It’s inspiring to hear how groups are working together to find solutions.

合作一直是我今年工作的主题。基金会的工作依然占据了我大量的时间，我惊叹于我们的团队和合作伙伴在2021年取得的了不起的进展。在大部分时候，我们会与所有致力于抗击新冠疫情的人举行在线会议。每次会议都聚焦于一个不同的主题，比如疾病建模或疫苗分配。听到不同的团队共同努力寻找解决方案非常鼓舞人心。

Although COVID-19 has been a huge focus, the foundation continues to make progress in other areas. Our U.S. Program is working with partners to help students and teachers navigate the strange new world of pandemic-era education, and my colleagues working on gender equality are fighting for a more equitable global recovery. The global health and development teams have found creative ways to protect advancements on diseases like polio, TB, and HIV and continue progress in reducing childhood mortality. (This year’s Goalkeepers Report outlines how the pandemic hasn’t set us back as badly as feared.)

虽然新冠疫情是绝对的焦点，但基金会仍然在其他领域持续取得进展。我们的美国项目正与合作伙伴一道，帮助教师和学生们探索疫情时代的教育新世界；致力于性别平等领域工作的同事们正为更平等的全球复苏而努力；全球健康和发展团队找到了创新的方法来保护在脊髓灰质炎、结核病和艾滋病等领域取得的进展，并继续在降低儿童死亡率方面取得进步（今年的目标守卫者报告指出了疫情并没有像我们之前担忧的那样让世界倒退太多）。

One of the most exciting things that happened was WHO approval of the first malaria vaccine. Malaria kills nearly 650,000 people every year-more than half of them children under five-and remains one of the leading causes of death in low-income countries. We funded late-stage clinical development of the vaccine between 2001 and 2015 and continue to support research into how to optimize its effectiveness. This new vaccine is giving us insights into how to develop second-generation vaccines and preventative tools that can be used on all ages, are even more effective, and can help us reach the goal of eradication.

最激动人心的事情之一就是世界卫生组织批准了第一款疟疾疫苗。疟疾每年造成近65万人死亡，其中一半以上是五岁以下的儿童，它仍然是低收入国家的主要死亡原因之一。2001年至2015年期间，我们资助了该疫苗的后期临床研发，并持续支持优化其有效性的研究。这款新疫苗让我们深入了解如何开发可用于所有年龄段的第二代疫苗和预防工具，并使之更有效，从而帮助我们实现根除疟疾的目标。

This year also saw the start of a new chapter in my climate work. I released my book How to Avoid a Climate Disaster and launched the Breakthrough Energy Catalyst and Fellows programs to support financing, producing, and buying new clean-energy technologies. The reason I felt confident enough to expand our efforts so significantly was the incredible progress I’ve seen from Breakthrough Energy Ventures, where we are now supporting over 70 amazing companies.

这一年，我在气候领域的工作也开启了新篇章。我出版了《如何避免一场气候灾难》一书，并启动了“突破能源催化剂”（Breakthrough Energy Catalyst）和“创新伙伴”（Fellows）项目，以支持对新清洁能源技术的融资、生产和购买。我之所以对拓展这个领域的工作有足够的信心，是因为我看到了“突破能源基金”（Breakthrough Energy Ventures）所取得的非凡进展，他们正在支持70多家优秀的公司。

I’ve been working on climate and energy issues for a long time, but the area has become a bigger part of my focus over the last twelve months. I also found time to work on some non-foundation and non-climate related areas, like Alzheimer’s research and expanding free educational resources for teachers.

我研究气候和能源问题已有很长一段时间，但在过去的12个月里，我对这一领域的关注有所增加。我还抽出时间做了一些基金会和气候问题之外的事，比如对于阿尔茨海默症的研究，以及为教师扩大免费的教育资源。

Even though I think the things I’ve been working on are by far the most interesting part of my year, I know a lot of people are curious about a subject closer to home: my divorce. Melinda and I continue to run our foundation together and have found a good new working rhythm, but I can’t deny that it’s been a year of great personal sadness for me. Adapting to change is never easy, no matter what it is. I’ve been impressed by how resilient my loved ones-especially my kids-have been in this challenging time.

尽管我认为我正在做的这些工作是这一年中发生的最有趣的事，但我知道很多人都关注那个与家庭更相关的话题：我的离婚。虽然梅琳达和我仍在共同管理我们的基金会，并且找到了一个新的、良好的工作节奏。但我无法否认，这一年对我个人来说是悲伤的一年。适应变化从来都不是件容易的事，无论这种变化是什么。我深爱的那些人，尤其是我的孩子们，在这段充满挑战的日子里表现得非常坚强，这让我深受触动。

My family also experienced a lot of changes beyond what you probably saw in the news. My oldest daughter, Jenn, got married this fall, and her wedding was the highlight of my year. Our youngest, Phoebe, graduated from high school and went off to college. Since my son Rory is also away at school, that means I’m officially an empty nester. The house is a lot quieter without a bunch of teenagers hanging around all the time. I miss having them at home, even if it is easier to focus on reading a book or getting work done these days.

除了你可能在新闻里看到的，我的家庭还经历了很多其他变化。我的大女儿珍今年秋天结婚了，她的婚礼是我今年生活中的高光时刻。我们最小的女儿菲比也从高中毕业上了大学，儿子罗里也远在学校，这意味着我正式成为了一个空巢族。少了这些孩子们，家里安静了许多。尽管现在我更容易专注于读书或完成工作，但我更想念他们都在家的日子。

2021 has been a year of big transitions for me, but it hasn’t changed why I love the work I do. As it comes to a close, I wanted to sit down and write about four things that are top of mind heading into 2022: the latest progress toward ending the COVID-19 pandemic, why decreased trust in institutions might be the biggest obstacle standing in our way, what the climate conversation can teach us about making progress, and how the rapid digitization brought on by the pandemic will shape our future.

对我而言，2021年是重大转折的一年，但这并没有改变我对我所从事的工作的热爱。年终之际，我想坐下来写写2022年最重要的四件事：终结新冠大流行的最新进展；为什么对机构的信任度下降可能是我们前进道路上的最大阻力；气候变化相关的讨论教给我们如何取得进步；新冠大流行带来的快速数字化将如何塑造我们的未来。

01

Why I’m hopeful the end of the COVID-19 pandemic is finally in sight

为什么我对新冠大流行即将终结充满希望

In my previous end-of-year post, I wrote that I thought we’d be able to look back and say that 2021 was an improvement on 2020. While I do think that’s true in some ways-billions of people have been vaccinated against COVID-19, and the world is somewhat closer to normalthe improvement hasn’t been as dramatic as I hoped. More people died from COVID in 2021 than in 2020. If you’re one of the millions of people who lost a loved one to the virus over the last twelve months, you certainly don’t think this year was any better than last.

我在去年的年终回顾中写道，当我们回首过去，会发现2021年比2020年有所进步。虽然我确实认为这个预测在很多方面都得到了印证：数十亿人已接种了新冠疫苗，世界在某种程度上恢复了正常 —— 但进步并不像我所希望的那样显著，2021年死于新冠的人数超过了2020年。如果你是过去12个月里因新冠失去亲人的数百万人中的一个，你肯定不会认为今年比去年有任何好转。

Because of the Delta variant and challenges with vaccine uptake, we’re not as close to the end of the pandemic as I hoped by now. I didn’t foresee that such a highly transmissible variant would come along, and I underestimated how tough it would be to convince people to take the vaccine and continue to use masks.

到目前为止，由于德尔塔变异病毒和疫苗接种方面的挑战，我们还没有像我所希望的那样接近疫情的终点。我没有预见到如此高传染性的变异毒株会出现，而且我低估了说服人们接种疫苗并继续使用口罩的难度。

I am hopeful, though, that the end is finally in sight. It might be foolish to make another prediction, but I think the acute phase of the pandemic will come to a close some time in 2022.

尽管如此，我还是满怀希望地认为，终点在望。再做一个预测可能有些愚蠢，但我认为疫情的急性暴发期将在2022年的某个时间点结束。

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图左：泰国素万那普国际机场，工作人员正在执行安全检测程序 / 盖蒂图片社（Lillian Suwanrumpha）

图右：咖啡师宣布她的咖啡厅重新开张 / 盖蒂图片社

There’s no question that the Omicron variant is concerning. Researchers-including a network called GIISER that is supported by our foundation-are working urgently to learn more about it, and we’ll have a lot more information (like how well vaccines or previous infection protect you against it) soon. But here’s what we do know: The world is better prepared to tackle potentially bad variants than at any other point in the pandemic so far. We caught this variant earlier than we discovered Delta because South Africa has invested heavily in genomic sequencing capabilities, and we’re in a much better position to create updated vaccines if they’re needed.

毫无疑问，新毒株奥密克戎值得关注。包括我们基金会支持的一个名为GIISER的网络在内的研究人员们都在抓紧研究以深入了解奥密克戎，我们很快就会拿到更多信息（比如疫苗或之前的感染能多大程度保护你免受它的侵害)。但我们可以确定的是：与新冠疫情暴发以来的任一时期相比，世界在应对危险的变异毒株方面都更有所准备。比起德尔塔，我们更快发现了奥密克戎，因为南非在基因组测序能力上投入了大量资金；如果有必要，我们也更有能力制造升级的疫苗。

It’s troubling any time a new variant of concern emerges, but I’m still hopeful that, at some point next year, COVID-19 will become an endemic disease in most places. Although it is currently about 10 times more lethal than flu, vaccines and antivirals could cut that number by half or more. Communities will still see occasional outbreaks, but new drugs will be available that could take care of most cases and hospitals will be able to handle the rest. Your individual risk level will be low enough that you won’t need to factor it into your decision-making as much. It won’t be primary when deciding whether to work from the office or let your kids go to their soccer game or watch a movie in a theater. In a couple years, my hope is that the only time you will really have to think about the virus is when you get your joint COVID and flu vaccine every fall.

任何时候出现新的变异毒株都令人不安，但我仍然抱有希望，在明年的某个时候，新冠将在大多数地方成为像流感一样的地方流行病。虽然目前它的致死率比流感大概高10倍，但疫苗和抗病毒药物可能将这一数字降低一半或更多。社区仍将偶见暴发，但新的药物能够治疗大多数病例，而医院将有能力照顾重症病例。个人的感染风险将足够低，因此你在决策中不用再顾虑太多。当你决定是否去办公室上班、是否让孩子参加足球赛或去影院看电影的时候，新冠都不再是首要的考虑因素。几年后，我希望每年秋天接种新冠和流感联合疫苗是你们唯一需要想到新冠病毒的时候。

Now that we’re starting to move towards the end of this pandemic, I’ve been spending a lot of time thinking about what went right and what went wrong over the last two years. We can learn important lessons from the world’s COVID-19 response that will make us better prepared next time.

现在我们正开始接近这场大流行病的尾声，我花了很多时间思考过去两年里什么是对的，什么是错的。我们能够从全球应对新冠的经历中吸取重要教训，为应对下一次大流行病做好更充分的准备。

Even though the pandemic has dragged on longer than anticipated, a lot has gone well. To start, the progress we’ve made on vaccines is remarkable. The world has never made and distributed a vaccine for a disease faster than it did for COVID-19. The fact that we had one-let alone multiple!-vaccines during the first year of the pandemic is miraculous. That success is a tribute to how many candidates the world had in the pipeline. Vaccine development relies on a little bit of luck, and we hedged our bets by trying so many different approaches.

尽管疫情的持续时间超过预期，但很多方面进展顺利。首先，我们在疫苗方面取得了了不起的进步。世界从未像应对新冠这样，以史无前例的速度研发和交付了疫苗。事实上，在疫情大流行的第一年就能接种上疫苗（而且是多款疫苗），这堪称奇迹。这一成就归功于全球贡献的多款候选疫苗。疫苗的研发有运气的成分，我们通过尝试多种研发路径来对冲风险。

I think mRNA vaccines will ultimately be seen as the most consequential breakthrough of the pandemic. Proving that mRNA works as a vaccine platform has been a massive gamechanger-not just for this pandemic, but for the next one too. Now that mRNA is well-established, we’ll be able to develop safe and effective vaccines super-fast in the future.

我认为mRNA疫苗最终将被视为应对新冠大流行带来的最重要的技术突破。mRNA作为疫苗开发平台被证实有效是一个巨大的变革 —— 不仅对于此次疫情，对于应对下一次大流行病也同样意义重大。现在mRNA平台已足够完善，我们将能在未来快速开发出安全有效的疫苗。

We also learned a lot about non-pharmaceutical interventions (or NPIs) that will inform disease response moving forward. NPIs include things like mask mandates, quarantine procedures, and travel restrictions. The last two years have given us the opportunity to see how effective different strategies are against a respiratory disease like COVID. Next time, the world will be ready to deploy cheap and easy tools like masks much quicker, and governments will have a greater understanding of when and how to deploy more burdensome strategies like lockdowns.

我们还了解到许多非药物干预措施的效力，这些信息将为今后的疾病应对工作提供借鉴。非药物干预措施包括口罩、隔离措施和旅行限制等等。过去两年让我们有机会看到对防御新冠等呼吸道疾病采取不同措施的有效性。下一次，世界将能更快地部署像口罩等价格低廉且简单实用的工具，各国政府也将对在什么时间以及如何部署封锁等重大防疫策略有更深的理解。

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图左：阿富汗的一名社区卫生工作者正在分享新冠的预防知识

图右：印度的学生们在上户外课 / 盖蒂图片社（Majority World）

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图左：提醒司机们在疫情暴发初期待在家中的提示 / 盖蒂图片社（Asurobson）

图右：在赞比亚的卢萨卡，天主教修女在准备社区分发的口罩

Although stopping a pandemic is something that ultimately falls on systems and governments, the last two years have shown us that individuals can make a real impact. We’ve seen incredible people from around the world step up to do heroic work protecting their communities-from teachers who took time to drop off class materials on their students’ doorsteps to health workers who went house to house making sure everyone had the opportunity to get vaccinated. I wrote a separate post profiling several of those heroes from the African continent. You can read about them here.

尽管阻止疫情最终还是要靠系统和政府的力量，但过去两年的经验告诉我们，个人的影响力也不容小觑。我们已经看到来自世界各地的人挺身而出为保护他们的社区做出英勇的努力 —— 从花时间在学生家门口发放教材的老师，到挨家挨户确保每个人都有机会接种疫苗的卫生工作者。我写过一篇文章，讲述了非洲大陆几位英雄的故事。

One area that’s been a mixed bag is therapeutics. Up until the last couple of months, I was disappointed by the lack of progress we’d made on the treatment front. Remdesivir is expensive, and it just didn’t have that big an effect. Dexamethasone is cheaper and helped a bit, but not enough to make a huge dent in stopping disease early. Monoclonal antibodies-which I was quite optimistic about at one point-were too complicated logistically to get out and save that many people earlier in the pandemic, and they weren’t very effective against variants.

治疗的问题一直很棘手。直到最近几个月，我还对在治疗方面缺乏进展感到失望。瑞德西韦很贵，而且并没有那么有效。地塞米松更便宜，也有一定效力，但还不足以对早期阻止疾病进程产生重大影响。我曾一度对单克隆抗体持乐观态度，但受限于复杂的物流要求，单克隆抗体在疫情初期无法挽救那么多生命，而且它们对变异毒株也不是很有效。

The reason I’m now feeling much better about therapeutics is the recent news about two new antiviral drugs. These are the therapeutics we needed in 2020. One of them-a drug called molnupiravir from Merck-just got the seal of approval from the FDA for people at high-risk last week. It significantly reduces your chances of being hospitalized or dying from COVID-19 (although not as much as we’d initially hoped), it’s relatively cheap to make, and it’s an oral medication that’s easy to distribute.

最近传来了两种新型抗病毒药物的消息，让我看到了一些希望。这些是我们在2020年就希望得到的治疗方案。其中一种药物，默克公司的莫努匹韦，上周刚获得了美国食品药品监督管理局对高危人群使用的批准。它能显著降低因新冠住院或死亡的几率（尽管没达到我们最初的预期），它的制造成本相对较低，而且是一种容易分发的口服药物。

Earlier this year, before we knew the drug worked, the foundation supported an effort to streamline the process of producing molnupiravir in order to bring costs down. Merck is letting generic manufacturers make this simplified formulation, which will make the drug accessible to a lot more people. We also recently committed $120 million to making sure the drug is available in lower-income countries where it will save a lot of lives. I just wish it had come along sooner.

今年在我们知道这种药物有效之前，基金会就支持了一项通过简化莫努匹韦生产流程来降低成本的工作。默克公司允许仿制药生产商生产这种简化配方，以便让更多人获得这款药物。我们最近还承诺提供1.2亿美元来确保较低收入国家也能获益，从而挽救更多生命。我只是希望，这个药如能更早出现就更好了。

The area I see as the biggest disappointment is the inequity of vaccine allocation. This is something I’ve written about at length and something I’m going to keep talking about any chance I get, because it didn’t have to be this way. The world has done an outstanding job manufacturing and distributing billions of doses of vaccine, but the fact that so few people at high risk in low-income countries have received them is unacceptable. It just doesn’t make sense that so many low-risk people got vaccinated before we reached everyone who’s older or had an underlying medical condition. Moving forward, we need to change how the world allocates doses and find ways to ramp up manufacturing even faster, including by expanding global vaccine-making capacity and helping more countries develop, manufacture, and approve vaccines themselves.

而最令人失望的就是疫苗分配的不公平。就这个话题我已经写了很多，而且只要有机会，我就会继续谈论这个话题，因为事情本不该如此。全世界在制造和分发数十亿剂疫苗方面做了如此出色的工作，但低收入国家的高风险人群获得疫苗的数量却如此之少，这让人无法接受。那么多低风险人群先于年长或有潜在疾病的人接种了疫苗，这不合理。未来，我们需要改变世界分配疫苗的方式，并找到加快生产的方法，包括扩大全球疫苗生产能力，并帮助更多国家自行研发、生产和批准疫苗。

The other area where there is huge room for improvement is in finding ways to combat disinformation. As I mentioned, I thought demand for vaccines would be way higher than it has been in places like the United States. It’s clear that disinformation (including conspiracy theories that unfortunately involve me) is having a substantial impact on people’s willingness to get vaccinated. This is part of a larger trend toward distrust in institutions, and it’s one of the issues I’m most worried about heading into 2022.

另一个有巨大进步空间的领域是寻找对抗虚假信息的方法。正如前面提到的，我认为在包括美国的很多地方对疫苗的需求原本应该高得多，而虚假信息（包括涉及我本人的阴谋论）正在对人们接种疫苗的意愿产生重大影响。这是对机构不信任的表现，而这一趋势是我对2022年最担心的问题之一。

02

Declining trust makes it harder to tackle big challenges

信任度下降，让挑战难上加难

I’ve had a lot of people ask me recently if I’m still optimistic about the future. While the answer is yes, being an optimist doesn’t mean ignoring problems. I am deeply troubled by one challenge in particular.

最近很多人问我对未来是否仍然保持乐观。答案当然是肯定的，但做一个乐观主义者并不意味着忽视问题的存在，其中一个挑战让我倍感忧虑。

The pandemic has been a massive test of governance. When the pandemic finally comes to an end, it will be a tribute to the power of global cooperation and innovation. At the same time, this era has shown us how declining trust in public institutions is creating tangible problems and complicating our efforts to respond to challenges. Based on what I’ve seen over the last couple of years, I’m more worried than I’ve ever been about the ability of governments to get big things done.

新冠大流行是对治理工作的大规模考验。当疫情最终被终结时，这一切将归功于全球合作和创新的力量。与此同时，这个时代也向我们表明，对公共机构信任度的下降正在造成切实的问题，也正在让我们的应对工作变得更加复杂。根据过去几年看到的情况，我比以往任何时候都更担心公共机构在推动重大事件方面的能力。

We need governments to take action if we’re going to make progress on challenges like avoiding a climate disaster or preventing the next pandemic. But declining trust makes it harder for them to be effective. If your people don’t trust you, they’re not going to support major new initiatives. And when a major crisis emerges, they’re less likely to follow guidance necessary to weather the storm.

如果我们想在避免气候灾难或防止下一次疫情等重大挑战上取得进展，就需要各国政府采取行动，但信任度的下降使他们更难开展工作。如果你的人民不信任你，他们就不会支持新的重大举措。当一场大的危机出现时，他们也不太可能遵循指导来度过难关。

This decline in trust is happening all over the world. The 2021 Edelman Trust Index shows worrying drops across the globe. Part of it is understandable: Any time you have a really big crisis like a pandemic, people look for someone to blame. Governments are an obvious target.

信任度下降正在世界各地普遍发生。2021年爱德曼信任度指数（Edelman Trust Index）显示，全球范围内的信任度下降令人担忧。这在一定程度上可以理解：每当出现大流行病这样的危机时，人们总倾向于找人来推卸责任，而政府是个显而易见的目标。

But this trend toward less trust in government didn’t start in 2020. The pandemic only made clearer what had already been happening.

但这种对政府信任的降低趋势并不是从2020年才开始的，疫情只是让这些已经发生的问题变得更加突出。

网友总是盯着别人的对错 / xkcd.com

So, who or what is to blame? It’s clear that increased polarization is a significant driver. This is especially evident here in the United States, although we’re far from alone. Americans are becoming more divided and more deeply entrenched in their political beliefs. The gap between the left and the right is becoming a gulf that’s harder and harder to bridge.

那么，这种趋势到底是谁或什么原因造成的呢？显然日益加剧的两极分化是个重要的驱动因素。这在美国尤其明显，尽管我们并不是唯一一个深受其害的国家。美国人的政治信仰正越来越对立，也越来越根深蒂固，左派和右派之间正分裂出一个越来越难以弥合的鸿沟。

There are many reasons for this growing divide, including a 24-hour news cycle, a political climate that rewards headline generation over substantive debate, and the rise of social media. I’m especially interested in understanding the latter, since it’s the most technologically driven.

造成分歧日益加剧的原因有很多，包括24小时不间断的新闻播报，追求标题党而非展开实质性讨论的舆论氛围，以及社交媒体的崛起。我对深入了解后者尤为感兴趣，因为它是最受技术影响的因素。

Digital communication has profound benefits in terms of helping people collaborate, stay in touch, and share things with each other. But social media has played a huge role in spreading misinformation that makes people suspicious of their governments. Social media feeds have become so personalized that you don't see factual information if it doesn't align with your profile.

数字通信在帮助人们开展协作、保持联系和促进分享方面具有深远的益处。但社交媒体在传播错误信息方面同样发挥了巨大作用，这正让人们对他们的政府产生怀疑。社交媒体的内容推送已经非常个性化，以至于你根本看不到和你偏好不一致的真实信息。

I believe that governments need to regulate what you can and can’t use social media for. In the United States, this topic has raised a lot of free speech questions. But the reality is that our government already has all sorts of norms around communication.

我认为政府需要规范人们使用社交媒体的用途。在美国，这个话题引发了很多关于言论自由的讨论。但事实上，我们的政府已经建立了各种各样的传播规范。

You can’t slander someone or trick them out of their money by promising something you don’t deliver on. Network TV shows can’t show explicit sex scenes or use certain profane language before 10 p.m. in case children are watching. These rules exist to protect people. So why couldn’t our government create new rules to protect them from the most tangible harms created by social media? They wouldn’t be easy to enforce, and we’d need public debate about exactly where the lines should be, but this is doable and really important to get done. A video falsely claiming that the COVID-19 vaccine makes you infertile should not be allowed to spread widely under the guise of being news.

比如，你不能诽谤他人，也不能通过承诺一些你无法履行的事来骗取钱财，网络电视节目在晚上10点之前不能播放暴露的成人画面或使用亵渎性语言，以防被孩子们看到或听到。这些规则存在的目的就是为了保护公众。那么为什么政府不能制定新的规则来保护人们免受社交媒体带来的切实伤害呢？这确实不易执行，我们也需要公开讨论其边界，但这仍是可行且必要的。一段谎称新冠疫苗会导致不孕的视频借新闻之名大肆传播，这是不应该被允许的。

As people become more polarized on both sides of the aisle, politicians are incentivized to take increasingly extreme positions. In the past, if you didn’t like the way a government agency was operating, you’d run on a platform of fixing it. Today, we’re seeing more people get elected on the promise of abandoning institutions and norms outright.

随着人们在对立中变得越来越两极化，政客们也更有动力采取越来越极端的立场。过去，如果你不喜欢某个政府部门的运作方式，你会承诺寻找办法来解决问题。而如今，我们正看到越来越多的人因为承诺彻底抛弃制度和规则而当选。

When your government leaders are the ones telling you not to trust government, who are you supposed to believe? This creates a compounding effect where people lose confidence in government, elect politicians who share their distrust, and then become even more disillusioned as their leaders tell them how bad the institutions they now run are.

当政府领导人告诉你不要相信政府时，你还能相信谁？这造成了一种叠加效应：人们对政府失去信心，选出了与他们一样不信任政府的政客。然后，当领导人告诉他们，他们正在管理的政府机构有多糟时，幻想就会更加破灭。

This is usually where I’d lay out my ideas for how we fix the problem. The truth is, I don’t have the answers. I plan to keep seeking out and reading others’ ideas, especially from young people. I’m hopeful that the generations who grew up online will have fresh ideas about how to tackle a problem that is so deeply rooted in the Internet.

写到这儿，通常是我要提出解决方案的时候了。但事实是我对此也没有答案。我计划继续寻找和了解其他人 —— 尤其是年轻人 —— 的想法。我希望在互联网长大的一代能够对于如何解决这个根植于网络的问题提出新的想法。

This problem requires more than just innovation to solve, although there are some steps we can take (especially around e-governance and making data more available to the public) to make modest improvements. There are all sorts of ways that great scientific ideas get published and tested. For great political ideas, the pathways are not as clear. Thinktanks and academics can point in the right direction, but at the end of the day-in a democracy at least-it seems to me like you need to pick the right leaders and give them the space to try new ideas.

解决这个问题需要的不仅仅是创新，尽管我们可以通过采取一些措施（特别是电子政务和让数据更公开化）做出小的改善。对于伟大的科学想法，人们往往可以通过各种方式发表并进行检验，但对于重要的治理理念来说，路径就不那么清晰了。智囊团和专业学者当然可以指出正确的方向，但最终，我们还是需要选择对的领导人，并给他们尝试新想法的空间。

03

What we can learn about progress from the climate conversation

关于进步，我们能从气候对话中学到的

There’s a phrase we like to use at the foundation: Progress is possible, but not inevitable. Change happens because groups of people get together and decide to make things better. It might not happen as quickly as you want or need it. But if you have enough smart, thoughtful, and passionate people pushing for it, progress will eventually come.

在基金会，我们特别喜欢说的一句话是：进步是可能的，但不是必然的。改变之所以发生是因为有一群志同道合的人在一起决心让事情变得更好。它可能不会像你想象的或需要的那样迅速发生，但如果有足够多的既聪明又有思想，同时还富有激情的人一起推动进展，进步就终将到来。

I was reminded of this at the recent COP26 climate conference in Glasgow, Scotland. The climate conversation is often singled out as an area stymied by disagreement. In the past, there was a lot of debate about whether we had all the tools we needed to solve this problem. Now, there's a lot more agreement that we have some of what we need, but not all of it-and that we need to prioritize closing that gap if we’re going to avoid a climate disaster.

最近在苏格兰的格拉斯哥举行的全球气候峰会（COP26）是对这句话的又一次印证。气候对话往往被认为是一个因分歧而阻碍重重的领域。过去有很多争议都是关于我们是否拥有解决气候问题所需的全部手段。现在我们达成了进一步共识，即我们拥有了一些所需的手段，但不是全部，如果我们要避免气候灾难发生，就要优先考虑缩小这个差距。

I was blown away by the enthusiasm and intense engagement in Glasgow, especially compared to the last major COP conference in 2015. Everywhere you looked, you saw leaders from around the world-including lots of government officials and CEOs-eager to make real commitments.

在这次气候峰会上，我被大家的积极和热情所感染，尤其是与2015年的大会相比。放眼望去，你会发现世界各地的领导人，包括许多政府官员和公司的首席执行官，都渴望做出切实的承诺。

The biggest change I saw compared to 2015 was the focus on innovation. There is now a broad understanding that innovation needs to be at the forefront of any plan to get to zero emissions by 2050. The private sector is playing a central and necessary role alongside governments and nonprofits. It was encouraging to hear leaders from various industries that need to be part of the transition-including shipping, mining, and financial services-talk about their practical plans to decarbonize and to support innovation.

与2015年相比，我看到的最大变化是对创新的关注。现在有一个广泛的共识，任何到2050年实现零排放的计划都要把创新放在首位。私营部门正与政府和非营利组织一起发挥着核心和必要作用。需要参与转型的各行各业（包括航运业、采矿业和金融服务业）的领导人都在谈论他们关于减少碳排放和支持创新的切实计划，这一切非常振奋人心。

I spent a lot of time at the conference talking to people about how new green technologies need to be affordable enough for the whole world to use them. If we’re going to scale the innovations that get us to zero, we need to reduce the cost difference between things that emit greenhouse gases and things that don’t. I call this difference the Green Premium, and addressing it needs to be an essential part of any climate plan.

我在这次会议上花了很多时间和人们讨论如何让全世界都能负担得起新的绿色能源技术。如果我们要扩大创新的规模、实现零排放，就要缩小零排放燃料（或技术）和传统化石能源（或技术）之间的成本差异，我把这个差异称为“绿色溢价”（Green Premium），解决这个问题需要成为任何气候计划的重要组成部分。

I was also excited to see so much attention paid to adaptation. We will lose the global fight against poverty if we don’t help the world’s poorest adapt to climate change, especially subsistence farmers who rely on the food they grow to feed their families and are the most at risk. Even if the world hits its goal of net-zero by 2050, we’ll still experience significant warming. That will create huge problems for people in low- and middle-income countries unless we take steps now to help them, such as developing new crops that are more productive and can withstand weather changes.

我也很高兴看到人们对气候适应的广泛关注。如果我们不帮助世界上最贫困的群体适应气候变化 —— 尤其是那些依靠自己种植的粮食养家糊口、并承担了最大气候风险的的农民 —— 全球消除贫困的斗争就会失败。即使世界在2050年达成净零排放的目标，我们仍然会经历全球变暖带来的显著变化。而这将给中低收入国家的人民带来巨大挑战 —— 除非我们现在就采取措施帮助他们，比如开发更高产、更能抵御气候变化的新作物。

In short, this conference made it clear that the world is engaged and making progress. The result was a number of important concrete steps, like new commitments to investing in clean technologies, pledges to cut methane emissions and end deforestation by the end of the decade, and the creation of a coalition that will help farmers adapt.

简而言之，这次大会清楚地表明，世界正在积极关注气候问题并取得了进展。会议的成果包括一系列积极的执行方案，如投资清洁技术的新承诺，在10年内减少甲烷排放和停止森林砍伐，以及建立一个帮助农民适应气候变化的联盟。

None of this happened by accident. The improvements made over recent years are a testament to the activists, elected officials, business leaders, philanthropists, and engaged citizens fighting to move climate change up the global agenda. We still have a lot more work to do-even if every commitment made at the COP is fulfilled, we still won’t hit our target of limiting global warming to less than 2 degrees-and I hope the world builds on the progress made in Glasgow. But I’m optimistic that we have the momentum necessary to avoid a climate disaster.

这一切都不是偶然，近年来取得的进步是活动家、官员、商业领袖、慈善家和参与其中的世界公民们合力将气候变化提上全球议程的证明。我们还有很多工作要做，即使在格拉斯哥所做的每一项承诺都得到履行，仍很难实现将全球变暖控制在2摄氏度以内的目标，我希望世界能在格拉斯哥气候峰会取得的进展基础上继续前进。但我乐观地认为，我们拥有避免气候灾难所需要的动力。

04

2021 gave us a preview of our more digitized future

2021让我们看到了一个更加数字化的未来

Even after this pandemic ends, it’s clear that much of the digitization it brought on is here to stay. The last two years have led to monumental leaps forward in how we use technology, accelerating changes that would’ve taken years-if not a decade or longer-otherwise. We’ve seen rapid, widespread adoption of services that already existed, like ordering groceries online or having meetings over video chat. And we’ve seen the creation of new innovations that I think only represent the tip of the iceberg of what’s to come in the years ahead.

即使在新冠疫情结束后，它带来的许多数字化趋势仍会持续下去。在过去的两年里，我们在技术运用方面有了巨大的飞跃，加速了本来需要多年（10年或更长时间）才能实现的变革。我们看到已有的服务被迅速而广泛地采用，比如在线购物或视频会议等等。我们也见证了更多创新的诞生，而这些仅仅是未来发展的冰山一角。

Digitization is here to stay, but the technologies we’re using will continue to get better over time. We’re just at the start of how software will enable innovation. The more we use digital tools, the more feedback we get about how to make them better. It’ll take at least a decade to understand the full scope of the pandemic’s impact on digitization, but I predict we’ll see big changes in three areas.

数字化将会持续发展，我们使用的技术会随着时间的推移变得越来越好。我们正处于软件推动创新的起点，我们越多地使用数字工具，就会越多地获得如何优化它们的反馈。世界至少还要10年时间才能全面了解新冠疫情对数字化的影响，但我预测我们将在三个领域见证重大的变革。

The first and perhaps most significant is office work. The pandemic has revolutionized how companies think about productivity and presence in the workplace. The boundaries between once-discrete areas of work-brainstorming, team meetings, casual conversations in the hallway-are collapsing. We’re starting to see structures evolve that we thought were essential to office culture, and those changes will only intensify in the years to come as businesses and employees settle into new permanent ways of working.

首先，或许也是最重要的，就是办公模式。新冠大流行彻底改变了企业对工作效率和工作场所的认知。头脑风暴、团队会议或是走廊里的非正式谈话等等这些在传统办公环境中的不同场景之间的界限正在消失。我们开始意识到对办公文化至关重要的结构正在发生变化，随着企业和员工适应这种新的、甚至是永久性的工作方式，这些变化在未来几年只会逐渐加剧。

I’m really excited about the potential for experimentation. Expectations around what productivity looks like have been upended. I see lots of opportunity to rethink things and find out what is working and what isn’t.

“我对开展新尝试的可能性倍感兴奋。人们对工作效率的预期已被颠覆，我看到很多重新思考问题的机会，可以发现什么有效，什么无效。”

For example, there has been a lot of debate about whether companies should stay completely remote, plan a full return to the office, or find some compromise between the two. Although most companies will likely opt for the hybrid approach, there’s a good deal of flexibility around what exactly that approach might look like. What if your employees set their own schedule? Do you have people work from the office on Mondays and Fridays, or do you ask them to work remotely on those days knowing that traffic might be worse around the weekend?

例如，围绕着是否应该保持远程办公，还是完全回归办公室，或者在两者之间找一个折衷方案，人们都有很多讨论。虽然大多数公司可能会选择二者结合的方式，但具体形式上仍有很大的灵活性。比如是否让员工自己制定工作时间表？是否让员工在周一和周五来办公室工作，或者在这些日子里让他们在家远程办公以避免周末前后的交通拥堵？

I don’t see any reason why companies need to make firm decisions right away. As the pandemic ends and things start to become more normal, this is a great time to take an A/B testing approach to remote work. Maybe you have one team try one configuration while a different team tries another, so that you can compare the results and find the right balance for everyone.

公司不必马上做出决定。毕竟一旦新冠大流行结束，情况就会开始恢复常态，那将是对远程办公模式进行效率测试的最好时机。也许你可以让一个团队尝试A模式，另一个团队尝试B模式，这样就可以对结果进行比较并为每个人找到平衡点。

(It’s worth repeating that I’m talking about office jobs. The pandemic disrupted work in virtually every industry. There are huge sectors of the economy where things won’t change as much or will change in different ways from what I’m describing here.)

（值得重申的是，我现在讨论的是办公室性质的工作。新冠疫情几乎扰乱了所有行业的工作，在很多行业情况不会发生太大变化，或者会以不同于我在这里描述的方式改变。）

I’m also really interested in how technology can create more spontaneity with remote work moving forward.

此外，我还对技术如何在远程工作中创造出更多的“自发性互动”很感兴趣。

This is the biggest thing you lose when you’re not in the office. Let’s say you used to work in an open space with six other people. You could look up at any time and see what they were up to. You could tell whether they felt like talking, giving you advice, or just taking a break to chat about non-work stuff. That kind of spontaneous interaction stopped when many of us began working from home-you aren’t exactly going to have an unplanned conversation with a colleague about your last meeting in your living room. But there are a lot of innovations in the pipeline to replicate that experience at home.

“自发性互动”，恐怕是不在办公室工作的最大损失。假设你曾经和六个人在一个开放的空间里办公，可以随时抬头看到他们在做什么，你能知道他们是否想和你聊天、给你建议，或是想休息一下聊聊与工作无关的事情。当我们中的许多人开始在家工作时，这种自发的互动就停止了 —— 你不太可能和同事毫无计划地聊到你之前在客厅开的一次视频会议。但为了在家也能有这些互动的体验，有很多创新正在酝酿之中。

If you had a second screen that was very cheap and a physical place to put it, you could have a feed of all six of you sitting in your home offices working. You could look at the screen to see what everyone is doing (except when someone wants privacy and turns the camera off). When someone seems like they’re free to talk, you could just click on their video, zoom in, and start chatting. This isn’t radically different from how collaboration tools work today, and it’s something we have the bandwidth and software power to do now.

比如，如果你有一个很便宜的第二块屏幕和一个合适的摆放位置，就可以看到你们六个人坐在家中办公的画面。你可以通过屏幕看到每个人正在做什么（除非有人出于隐私考虑而关闭摄像头）。当某人看起来可以进行自由交谈时，你可以点击他们的视频放大，然后开始聊天。这与当今协同办公的工具并没有根本的不同，而且我们现在也有足够的带宽和软件来做这件事。

I think we’ll soon start to see an even bigger shift. People shouldn’t assume that the quality of the software that lets you have virtual experiences will stay the same. The acceleration of innovation is just starting.

我想我们很快就会见证更大的转变，让人拥有虚拟体验的软件质量会不断提升，创新的加速才刚刚开始。

Within the next two or three years, I predict most virtual meetings will move from 2D camera image grids-which I call the Hollywood Squares model, although I know that probably dates me-to the metaverse, a 3D space with digital avatars. Both Facebook and Microsoft recently unveiled their visions for this, which gave most people their first view of what it will look like.

在未来两三年，我预测大多数的虚拟会议将从二维图像（我称之为“好莱坞广场模型”，尽管我知道这么形容可能会让我显得有点过时）转向有“虚拟形象”的三维空间。“脸书”和微软最近都发布了他们对此的设计愿景，也让很多人第一次看到了这会是什么样子。

The idea is that you will eventually use your avatar to meet with people in a virtual space that replicates the feeling of being in an actual room with them. To do this, you’ll need something like VR goggles and motion capture gloves to accurately capture your expressions, body language, and the quality of your voice. Most people don’t own these tools yet, which will slow adoption somewhat. (One of the things that enabled the rapid change to video meetings was the fact that many people already had PCs or phones with cameras.) Microsoft plans to roll out an interim version next year, which uses your webcam to animate an avatar that’s used in the current 2D set-up.

这个概念的核心是，你最终将使用你的“虚拟形象”在一个虚拟的空间里与其他人会面，这个虚拟空间复刻了一个真实房间中的感觉。要做到这一点，你需要用VR眼镜和动作捕捉手套等设备来准确捕捉你的表情、肢体动作和音质。大多数人还没有这些设备，这将在一定程度上影响推广速度 (促使人们快速转向视频会议的原因之一是许多人早已拥有了带摄像头的个人电脑或手机)。微软计划在明年推出一个测试版，它会用网络摄像头创造一个在当前2D设置中可用的“虚拟形象”。

今年早些时候，我在尝试3D化身时获得了很多乐趣 / gatesnotes

There are a ton of companies working on 3D avatars, and I recently had the opportunity to test out some of their prototypes. I was super impressed by what I saw. One of the biggest improvements over what we use now is the use of spatial audio, where speech sounds like it’s actually coming from the direction of the person talking. You don’t realize how unusual it is to have meeting audio only coming from your computer’s speaker until you try something else. There’s still some work to do, but we’re approaching a threshold where the technology begins to truly replicate the experience of being together in the office.

很多公司都在开发3D“虚拟形象”，最近我有机会体验了他们的一些模型。我被眼前的景象深深打动了，与我们现在使用的方法相比，最大的改进之一就是“空间音频”的使用，声音听起来就像是从说话人的方向传来的，而这个充满立体感的声音仅仅来自于电脑的扬声器，这太不可思议了。尽管还有一些工作需要完善，但技术即将帮助我们真正复刻大家在一起办公的体验。

The second area where we’ll see the lasting effects of digitization is education. Unlike offices, schools will go back to only in-person instruction except maybe for some limited remote options for older high school students. What will change, though, is how we use digital tools to enhance the way kids learn.

第二个受数字化持久影响的领域是教育

。与办公室不同，除了为高年级的高中生提供一些有限的远程教学外，大多数学校将回归到面授课程的教学模式。然而面临改变的将是如何使用数字工具提高孩子们的学习效率。

The ability of new digital education tools to transform the classroom is, of course, dependent on kids having access to technology at home. The access gap has narrowed since the start of the pandemic and will continue to narrow, but a lot of kids still don’t have a decent computer or reliable, fast internet at home. Finding ways to expand access is just as important as the development of new innovations.

创新的数字化教学工具改变课堂的能力取决于孩子们在家里是否能拥有这些工具。疫情暴发以来，数字工具可及性的差距已在不断缩小，并将继续缩小，但许多孩子的家里仍然没有一台像样的电脑和高速可靠的网络，找到提升数字工具可及性的方法与开发创新同等重要。

The pandemic accelerated the development of dynamic curricula, as more teachers had to rely on digital tools to give students assignments during the periods when schools were closed. We’re starting to see that curriculum become more responsive as demand goes up, and it will only become more tailored to the individual needs of students and teachers in the years ahead. The intention is that these new tools will supplement classroom learning rather than replace it. (If there’s one thing the last two years made clear, it’s that many kids-especially younger ones-don’t do well sitting in front of a screen doing classwork all day.)

新冠疫情还加速了动态课程的发展，因为更多的教师不得不在停课期间依靠数字工具给学生布置作业。随着需求的增长，课程设计也变得越来越有针对性，并且在未来几年，会变得更加适应学生和教师的个性化需求。这些数字工具的目标是作为课堂学习的补充，而非取而代之（如果说过去两年证明了一件事，那就是很多孩子 —— 尤其是年幼的孩子，在屏幕前学了一天，效果却不甚理想）。

If you’re a student, you’ll be able to get feedback from the software while you do your homework online. The content will be more interactive and personalized to you, helping you focus on areas where you need a bit more help while boosting your confidence by giving you problems you’re more comfortable solving.

如果你是一个学生，在网上做作业的时候就能够从软件上即时获得反馈。学习内容也将更具互动性和个性化，能帮你专注于有待提高的部分，并通过给你更擅长解决的问题来增强信心。

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图左：一个大学生正在她的笔记本电脑上做作业 / 盖蒂图片社（Carol Yepes）

图右：中国吉林，老师用视频录下了给学生解释一道数学题的过程 / 盖蒂图片社（TPG）

If you’re a teacher, you’ll gain a deeper understanding of how your students are doing. A simple button click will show you that student X might need more help on a particular type of question while telling you that student Y is ready to take on a more advanced reading assignment.

如果你是一名老师，就能对学生的表现有更深的了解。点击一个按钮就能知道某个学生可能需要在特定类型的问题上获得帮助，而另一个学生已经准备好接受一个更高阶的阅读任务。

The foundation has been working on innovative new tools like this for years, and it’s been great to see so much progress made over the last two years in response to the pandemic.

盖茨基金会多年来一直致力于开发这样的创新工具，我很高兴看到过去两年，作为疫情响应的一部分，全球在这方面取得了如此大的进展。

Some of the biggest leaps forward have been in math curricula. A lot of kids develop a self-image of not being good at math. They struggle with problem sets that are perhaps too hard for their current skill level, and they never catch up as classes become more advanced. It’s a big problem that I’m optimistic we can solve with technology.

最大的进展是关于数学课程领域的，很多孩子觉得自己不擅长数学，挣扎于对他们目前水平来说颇具难度的数学题，随着课程升级他们会越来越跟不上进度。这是一个很大的问题，但我对于可以用技术解决这个难题充满乐观。

The final area where digitization is here to stay is in health care. Telehealth isn’t new, but its popularity during the pandemic was. Over the last two years, we’ve seen more people opting for virtual appointments instead of in-person care. The technologies that facilitate these appointments are already getting much better, and I expect huge improvements over time.

最后，我要讲的数字化领域是医疗服务。远程医疗并不是什么新事物，但它在疫情期间的普及却是个新趋势。过去两年中，我们看到越来越多的人选择在线问诊，而不是亲自就诊。在线医疗技术已经变得越来越好，而且我预计未来还会有更大的进步。

Although some medical fields have gone back to mostly in-person visits, one area that I predict is forever changed is behavioral health. Virtual appointments have so many upsides that I think the new model is here to stay.

虽然一些医疗领域逐步回归了线下模式，但我预测有一个领域将会永远改变，那就是“行为健康”（behavioral health）。在线预约有如此多的好处，我认为这一模式将继续存在下去。

Seeing your therapist is a lot less time-consuming and easier to fit in your day when you only have to turn your laptop on. Sessions can be as long or as short as needed-a 15-minute session might not feel worth it if you have to go to a doctor’s office, but it makes a lot more sense from home. Plus, many people feel more comfortable in their own spaces than in a clinical setting.

只需打开笔记本电脑就可以看病，花费的时间要少得多，而且更容易安排你的日程。就诊时间可以按需而定：如果你必须亲自去看医生，15分钟的会面可能会让你觉得很不值。但如果是在家里看病，15分钟就很有意义。此外，许多人觉得在自己熟悉的环境里看病比在医院舒服。

Other types of doctor’s visits might become more flexible as new tools emerge, too. Right now, when it’s time for your annual physical, you probably need to go into your doctor’s office to get your vitals taken and your blood drawn. But what if you had a device at home that your doctor could control remotely to test your blood pressure? What if he or she could look at data collected from your smart watch to see how you’re sleeping and what your active heart rate is? What if you could get your blood tested at a convenient place in your neighborhood-maybe at your local pharmacy-that sends the results directly to your doctor? What if you could keep seeing a primary care physician you like even if you moved to another state?

新工具的出现，让其他类型的医疗服务也可能变得更加灵活。比如，当你要做年度体检的时候，以前需要去医院抽血，检查各项指标。但如果在家就有设备可以让医生远程测量血压呢？如果医生通过你的智能手表所采集的数据，就可以了解你的睡眠状况和心率呢？如果可以在家附近一个更便捷的地方做血检，比如在社区的药剂师那里，然后把结果直接发给医生，又会怎么样呢？如果你搬到了另一个州，还可以继续选择看你喜欢的医生呢？

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图左：卫生工作者和“机器人医生”合影，这个机器人医生可以给新冠患者做咨询、治疗和心理健康评估 / 盖蒂图片社（Claudio Crus）

图右：一位父亲在测女儿的体温，医生正和他们视频通话 / 盖蒂图片社（Maskat）

These are all real possibilities in the future, and I’m curious to see how they transform health care. Beyond the technology and privacy limits, there are also regulatory hurdles we need to figure out before digital health care becomes truly mainstream. Some states still make it hard to see patients virtually in a different state because of how licensing currently works.

这些在未来都可能实现，我很好奇它们将如何改变医疗服务的方式。除了技术和隐私限制，在数字医疗成为真正的主流之前，我们还需要解决一些监管障碍。由于目前的许可制度，美国一些州的医生仍然很难为其他州的患者看病。

As unbelievable as it sounds, we’re only starting to see how digitization is going to change our lives. There is so much potential for technology to create more flexibility and options for people. I’m hesitant to suggest that anything about the COVID-19 pandemic has been positive. But when we look back at this period, I suspect history will view it as a time of terrible devastation and loss that also sparked lots of massive changes for the better.

虽然这听起来难以置信，但其实我们才刚刚开始见证数字化将如何改变我们的生活。技术有很大的潜力为人们创造更多的灵活性和选择。我不想说所有关于新冠疫情的变化都是积极的，但当我们回顾这段时期，历史既会把它视作一次可怕的灾难，同时也是一个激发了很多重大而积极改变的契机。

05

Reasons for optimism in 2022

我对2022感到乐观的理由

My work has always been driven by a simple idea: The world can get better. A big setback like the pandemic makes it harder to believe that progress is possible. I’m still optimistic, though, about our ability to build a world where everyone has the chance to live a healthy and productive life.

我的工作一直由一个简单的想法驱动：世界可以变得更好。像新冠疫情这样的重大挫折可能让人很难相信进步是可能的。不过，我仍然乐观地认为，我们有能力建设一个人人都有机会过上健康而富有成效的生活的世界。

But that ability is dependent on whether we can stop the next pandemic. We can’t afford to repeat the suffering of the last two years. The world had a chance to invest in the tools and systems that could’ve prevented the COVID-19 pandemic, and we didn’t take it. Now is the time to learn from our mistakes and take steps to prevent this terrible experience from ever happening again.

但这种能力取决于我们能否阻止下一场大流行病，我们不能让过去两年的痛苦重演。世界本有机会投资于预防新冠疫情的工具和系统，但我们没有抓住机会。现在是时候从过往吸取经验教训，并采取措施避免这种可怕的经历再次发生。

The good news is that the world no longer needs to be persuaded that stopping a pandemic is important. I’m hopeful that we’ll see broad support for pandemic preparedness efforts, and I plan on spending a lot of time advocating for them. This is the biggest and most important thing I’m going to work on in 2022. I’m currently writing a book that will come out some time next year, which lays out my plan for making sure that COVID-19 is the last pandemic.

好消息是，我们不再需要说服世界阻止大流行病的必要性。我们将看到对大流行病防范工作的广泛支持，我对此充满希望，并计划花大量时间推动这些工作。这也是2022年我要做的最大、最重要的事。我目前正在写一本书，将于明年出版，其中列出了我为确保新冠成为最后一次全球大流行病所做的计划。

I think we’ll see plenty of other reasons for optimism in 2022 as well, especially on the innovation front. I expect lots of progress as R&D that was put on hold by the pandemic picks up steam.

还有其他很多为2022年感到乐观的理由，尤其是在创新方面。我预计被疫情耽误的许多研发工作会加快步伐，取得更多进展。

One of the things I’m most excited to track is the clinical trials for a promising new HIV preventative called islatravir. Today, you can reduce your risk of getting infected by either taking a pill every day or what’s called “on-demand prophylaxis.” Although both current options provide terrific protection, the former relies on the ability to take it regularly, and the latter requires planning ahead.

最让我兴奋的是一种颇有潜力的新型艾滋病预防药物伊斯拉曲韦的临床试验。如今，你可以通过每天服用一片药或“按需预防”（on-demand prophylaxis）原则降低感染风险。尽管目前的两种选择都能提供极好的保护，但前者依赖于定期服药的能力，而后者需要提前计划。

Islatravir is a pill that you take just once a month. The first results from the Phase II trials were released this summer, and they’re terrific so far. I look forward to seeing more next year, as well as following progress on Phase III trials. Our foundation helped fund a Phase III trial of the drug in Africa, which started in early 2021 and will study how effective the drug is for young women for the next several years.

伊斯拉曲韦是一种每月只需服用一次的药物。二期临床试验的初期数据已于今年夏天发布，结果喜人。我期待明年收获更多的好消息，并会持续关注三期试验的进展。基金会资助了该药物在非洲的三期临床试验，该试验已于2021年初开始，将在未来几年研究该药物对年轻女性的有效性。

Another area to watch for in 2022 is Alzheimer’s diagnostics. Huge progress has been made on this front recently, and there’s a decent chance that the first affordable, accessible blood test for Alzheimer’s will get approved next year. Although this won’t be a gamechanger yet for people who have the disease-which currently has no cure or even a way to slow it down-this test will accelerate progress in the quest for a treatment breakthrough.

2022年另一个值得关注的领域是阿尔茨海默症的诊断。最近这方面已经取得了巨大的进展，第一个可负担且更易获得的阿尔茨海默症血检工具将在明年获批。虽然这对尚无治愈方案，甚至无法减缓病程进展的患者来说并非重大突破，但这个诊断办法将加速探索突破性治疗方案的进程。

I’m also looking forward to continuing the work of Breakthrough Energy Ventures, Catalyst, and Fellows to make clean-energy innovations more available and affordable for everyone. They’re enabling breakthroughs across a broad range of areas, many of which are still years away. One area where we might see some real progress soon is in making green hydrogen fuels more affordable. This would be a huge step forward, because hydrogen fuels would enable long-duration energy storage and could be used to run things like large planes and industrial processes.

我也期待突破能源基金、“突破能源催化剂”和“创新伙伴”项目的进展，从而让每个人都能更容易、更可负担地获得创新的清洁能源。这些项目正在广泛的领域实现突破，但其中的许多领域还需多年的努力才能带来改变。大家可能很快就能看到成果的一个领域是让绿色氢燃料变得更可负担，这将是一个巨大的进步，因为氢燃料可实现长期的能量存储，并可用于大型飞机和工业制造。

06

Settling into a new normal

进入一种“新常态”

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图左：泰国曼谷幼儿园里戴口罩的儿童 / 盖蒂图片社（Lauren DeCicca）

图右：在墨西哥，一名女性正在展示她的疫苗接种证明 / 盖蒂图片社（Paul Ratje）

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图左：又一天，又一次的在线会议

图右：肯尼亚内罗毕的一名教师在上课前检查学生的体温 / 盖蒂图片社（SOPA图片）

I’ve never been a big New Year’s resolution person. I don’t have any specific goal in mind for 2022 (although I guess I still have a couple more weeks to think of one). But what I do hope is that next year is a lot more settled than this one.

我从来都不热衷为新年下决心、定目标。对于2022年，我心中也没有任何具体的目标（尽管我还有几周的时间可以想出一个来)，但我希望明年能比今年更加安定。

Human beings are naturally resistant to change. Whether it’s the massive global upheaval of the last two years or transitions closer to home, it’s never easy to adjust to new ways of living.

人类天生抗拒改变，无论是过去两年的全球巨变，还是家庭生活的改变，适应新的生活方式从来都不是件容易的事。

I think 2022 will be a year when many of us finally settle into a post-pandemic new normal. For me, that will mean going into the office a bit more as COVID cases hopefully go down. I want to find a new rhythm at home now that all three of my kids have moved away and my day isn’t as structured around finding time to spend with them. I’m looking forward to spending more time engaging with people through my blog and other channels. I’d like to keep up my COVID-era habit of watching lots of educational videos on YouTube and subscription services like Wondrium, because they’re a really great way to learn about obscure topics. (I now know more about glassmaking, birdwatching, and the history of American Samoa than I ever expected.)

我想，2022年将是我们许多人最终适应疫情“新常态”的一年。对我来说，这意味着随着新冠病例持续减少，就能多去办公室。我还希望在家里找到一种新的节奏，因为三个孩子都搬走了，我不用再留出固定的时间陪伴他们。我期待花更多的时间通过博客和其他平台和人们多交流。我还想保留我的一些“新冠时期的习惯”，比如在YouTube和Wondrium订阅频道上观看大量的教育视频，因为这是学习晦涩话题的好方法（我现在对玻璃制作、观鸟和美属萨摩亚历史的了解比我想象的还要多）。

I hope you and your loved ones also find a way to create new routines. There’s no question that the pandemic will create huge, lasting changes that will take years to fully understand, which can feel scary. One of my favorite authors, Yuval Noah Harari, once wrote that, “people are usually afraid of change because they fear the unknown. But the single greatest constant of history is that everything changes.”

我希望你们和你们所爱的人也能找到创造新习惯的办法。毋庸置疑，新冠大流行将带来巨大、持久的变化，人们需要数年时间才能完全理解这些变化，这可能让人感到害怕。我最喜欢的一位作家尤瓦尔·诺亚·哈拉里（Yuval Noah Harari）曾写道：“人们通常害怕改变，因为他们害怕未知。但纵观历史，唯一确定不变的就是：一切都在变化之中。”

The world has adapted to big disruptions before, and we’ll do it again. In the meantime, I wish you a very happy holiday season.

世界曾经适应过破坏性的灾难，我们也会再次适应。与此同时，我祝你们度过一个愉快的新年。