Last week, I traveled to Germany to attend the 58th Munich Security Conference, a gathering of leading experts on global security, health, development, and international relations. After learning from and working with so many of them virtually for two years, I was eager to hear from heads of state and global health leaders—in person at last!—about the ongoing impact of COVID-19 on their countries, the infectious disease and inequity challenges they’re still contending with, and what we need to be doing now to prevent future pandemics.上周，我前往德国参加了第58届慕尼黑安全会议，这是一次涉及全球安全、健康、发展和国际关系领域的顶尖专家的聚会。在和他们线上共事两年之后，我期待亲身听到各国元首和全球健康领导人的观点，关于新冠肺炎对他们国家的持续影响，仍在应对的来自传染病和不平等的挑战，以及我们现在需要做什么来预防未来的大流行。
Health security was already a big priority at the MSC in pre-COVID times, but this year’s conference underlined how much global health is now rightfully seen as a serious national and global security issue. It’s clearer than ever that investing in health R&D, disease surveillance, and strong health systems is critical to keeping people safe, wherever they live in the world.在新冠肺炎大流行之前，健康安全就已经是慕尼黑安全会议的重中之重，但今年的会议强调了将全球健康视为一个需认真对待的国家和全球安全问题有多么重要。无论人们生活在世界的哪个角落，投资于健康研发、疾病监测和建立强大的医疗卫生系统对于保证人们的安全至关重要，这一点毋庸置疑。
In Munich, I took part in a panel discussion that included the foreign ministers of Canada and Sweden, the CEO of the Crisis Group, and remarks from Tedros Adhanom Ghebreyesus, the director-general of World Health Organization. These leaders hit on the same themes I heard from many others I talked with on this trip—themes I’ve given a lot of thought to while writing a book about how to prevent the next pandemic. For one, when it comes to COVID, we’re not out of the woods yet, because the virus is still mutating. At the same time, the pandemic is evolving, with vaccines plus the rapid spread of Omicron appearing to offer many more people some protection against severe disease. Meanwhile, COVID continues to exacerbate existing inequities—something we’ll feel the effects of for years to come.在慕尼黑，我参加了一个小组讨论，参与讨论的人包括加拿大和瑞典的外交部长、国际危机组织的首席执行官，以及世界卫生组织总干事谭德塞。他们讨论的议题与我在这次旅行中与许多人谈过的主题相同——也是我在写一本关于如何预防下一次大流行的书时着重思考的角度和方向。一方面，对于新冠肺炎，由于病毒仍在变异，我们还没有走出困境。与此同时，大流行正在演变，疫苗和奥密克戎的迅速传播似乎带给更多人对重症的保护。但新冠肺炎继续加剧了现有的不平等现象——我们会在未来几年内切身感受这些负面影响。
In all countries, especially the poorest, the pandemic is still hindering the prevention and treatment of other diseases. The world’s response must continue prioritizing equity and protecting the most vulnerable. We need an integrated approach that manages COVID for the long haul alongside other infectious diseases such as HIV, TB, and malaria, which continue to kill millions. This will enable countries to take limited resources and apply them where they are needed most, whether by mitigating COVID risks, supplying insecticide-treated nets against rising malaria cases, or making up for lost ground with other life-saving vaccinations.所有国家中，尤其是最贫穷的国家，疫情仍在阻碍其他疾病的预防和治疗。全球的应对措施必须继续优先考虑公平和保护最弱势的群体。我们需要一种综合体系来长期管理新冠肺炎及其他传染病，如艾滋病、结核病和疟疾，这些疾病仍在危害着数百万人的生命。这将使各国能够将其有限的资源应用于最需要的地方，无论是通过降低新冠肺炎的风险、提供驱虫蚊帐以应对不断上升的疟疾病例，还是通过接种挽救生命的疫苗来弥补我们的损失。
Another theme that came up in Munich is the need for stronger health systems and tools to prevent, detect, and respond quickly to emerging and existing infectious diseases. We discussed how this can prevent future pandemics and what role multilateral cooperation must play. For example, the effects of COVID would have been much worse without investments made to fight other infectious diseases like HIV, TB, malaria, and polio. For decades, countries like Pakistan, Kenya, and South Africa have strengthened their health systems by training community health workers, building surveillance and lab capacity, creating efficient supply chains, and accelerating innovation.慕尼黑会议的另一个议题是我们需要更强大的医疗卫生系统和工具来预防、检测和快速应对新出现的和现有的传染病。我们讨论了这对预防未来的大流行所起的作用以及多边合作应发挥的作用。例如，如果不投入资金抗击艾滋病、结核病、疟疾和脊髓灰质炎等其他传染病，新冠肺炎的影响会严重得多。几十年来，巴基斯坦、肯尼亚和南非等国家通过培训社区卫生工作者、建设疾病监测和药物研发能力、创建高效供应链和加速创新来巩固和加强其医疗卫生系统。
The world’s response to COVID was far from perfect, but these advances helped put some countries in a better position to pivot and defend against the virus. And they helped mitigate the pandemic’s impact on these countries’ ability to fight other diseases.世界对新冠肺炎的应对远非完美，但公共卫生系统的进步帮助一些国家处于更有利的位置来应对和防御病毒。这些进步也减轻了大流行对这些国家抗击其他疾病能力的负面影响。
Take the Global Polio Eradication Initiative. Thanks to investments made by governments, the private sector, and philanthropy, wild polio cases are at a historic low, and the disease is endemic in just two countries: Pakistan and Afghanistan. Last week I also went to Pakistan, where I visited two of the country’s innovative command centers for fighting diseases, the National Emergency Operations Center for polio eradication and the National Command and Operation Centre for COVID. The NEOC uses state-of-the-art informational tools developed by GPEI to track polio so that no child is ever paralyzed by it again. The NCOC has applied resources and lessons learned from the polio program—including data analysis, vaccine campaign planning, and community engagement—to coordinate Pakistan’s response to COVID. Both centers blew me away.以全球根除脊髓灰质炎行动（GPEI）为例。藉由政府、私营企业和慈善机构的投资，野生脊髓灰质炎病例处于历史低位，该病目前仅在两个国家流行：巴基斯坦和阿富汗。上周我在巴基斯坦参观了该国两个抗击疾病的创新指挥中心，即国家根除脊髓灰质炎紧急行动中心（NEOC）和国家新冠肺炎指挥与行动中心（NCOC）。这两个中心的卓越表现，令我大为惊叹。NEOC使用GPEI开发的最先进的信息工具来追踪脊髓灰质炎，这样就不会再有孩子因其而瘫痪。NCOC已应用从脊髓灰质炎计划中汲取的资源和经验教训——包括数据分析、疫苗运动规划和社区参与——来协调该国应对新冠肺炎的措施。
At the NEOC, we pored over a wall of screens that displayed an up-to-the-minute summary of immunization rates and areas where children have not been reached with the vaccine. The health officials I talked to in Pakistan told me that the polio program’s infrastructure was invaluable once COVID hit. By setting its priorities based on the needs at the time, Pakistan was able to expand and redirect health infrastructure that had been supported by the global community—the national help line call center, communication systems, and networks of religious leaders and community influencers—to help protect people during the pandemic.在NEOC，我们仔细观察了一面屏幕，屏幕上显示了实时更新的免疫接种率和儿童尚未接种疫苗地区的情况。当地的卫生官员告诉我，一旦新冠肺炎来袭，脊髓灰质炎项目的基础设施就非常宝贵。因时制宜，巴基斯坦能够扩展和重新定位其得到国际社会支持的卫生基础设施——包括国家求助热线呼叫中心、通信系统以及宗教和社区领袖网络——在大流行期间保护其国民。
It’s easier to ramp up testing and deliver vaccines and protective gear during a pandemic when you already have a community health workforce, labs, surveillance capacity, and supply chains in place. Another organization that has proven invaluable over the last two years is the Global Fund, which funds more than half of all global programs working to end AIDS, tuberculosis, and malaria. The Global Fund’s partnerships with countries enabled community health workers who go door to door to detect, diagnose, and report fevers as malaria or COVID. Along the same lines, organizations like the Coalition for Epidemic Preparedness Innovations, which accelerates work on vaccines for infectious diseases, and Gavi, which has immunized nearly 1 billion children since 2000, have been key partners in developing and distributing COVID vaccines. 在大流行期间，拥有社区卫生工作人员、实验室、监测能力和供应链会让我们更容易加强检测并提供疫苗和防护装备。另一个在过去两年中被证明做出了突出贡献的组织是全球基金，该基金资助了一半以上致力于终结艾滋病、结核病和疟疾的全球项目。全球基金与各国的合作使社区卫生工作者能够深入各家各户就疟疾和新冠肺炎进行检测、诊断和报告。同样，流行病防范创新联盟（CEPI）和全球疫苗免疫联盟（Gavi）等组织在开发和分配新冠疫苗中发挥了重要作用。前者促进了传染病疫苗的研发工作，后者，自2000年以来为近10亿儿童接种疫苗。
Unfortunately, this isn’t a simple success story. We’ve also seen increases in cases and deaths from malaria, HIV, and tuberculosis for the first time in 20 years because of COVID. But the backsliding was not nearly as bad as it could have been.不幸的是，在可喜的成就背后，我们也看到了问题。由于新冠肺炎的不利影响，疟疾、艾滋病和结核病的病例和死亡人数20年来首次出现上升。好在这些倒退没有预想的那么严重。
I’m optimistic about the future. We have learned so much from COVID, and the innovations have been tremendous. Talking to public health leaders in Munich and Islamabad, it’s clear that long-term funding for global health—including investments in proven initiatives like GPEI, Global Fund, and CEPI —helped save millions of lives during this pandemic. Just think: It took less than a year after the virus emerged to develop a vaccine against it. I believe we’ll do even better next time and can deliver them to everyone within six months of an outbreak if we build enough global capacity.我对未来感到乐观。我们从新冠肺炎大流行中吸取了教训，拥有了大量的创新成果。通过在慕尼黑和伊斯兰堡与公共卫生领域的领导人交谈，我能明显看出，为全球健康提供长期的资金支持——包括对GPEI、全球基金和CEPI等已成功的机制的投资——帮助我们在这场大流行期间挽救了数百万人的生命。想想看：病毒出现后不到一年的时间，针对它的疫苗就已被开发出来。我相信下次我们会做得更好，如果我们建立起足够的全球应对能力，就可以在疫情暴发后的六个月内将疫苗送到每个人手上。
As the pandemic continues to evolve and the world adapts strategies and investments to match, we can apply these lessons and make choices that help prevent future pandemics. We need a full-time global team dedicated to responding to new disease outbreaks and working to end other infectious diseases. We should, above all, approach this work with a greater focus on improving inequities by understanding that investments in global health and pandemic prevention are critical security issues. And they’re mutually reinforcing.大流行继续演变，世界也随即调整战略和投资以应对其变化，我们可以应用这些经验教训并做出有助于预防未来大流行的选择。这需要国际合作，群策群力，致力于应对新的疾病暴发并努力结束其他传染病。我们应认识到投资全球健康和大流行预防是关乎安全的重要问题，进而加强改善不平等现象，以此实现对新的疾病暴发的有效控制和其他传染病的终结。双方是相辅相成的。
Now is the time to build on these lessons, increase our funding for the basic building blocks of public health, and support countries in meeting their needs. If we make the right choices and investments now, we can end other devastating diseases and make COVID-19 the last pandemic.前事不忘，后事之师。投入对公共卫生基础部分的资金，并支持各国满足他们的需求，尤为重要。如果我们现在做出正确的选择和投资，我们就可以结束其他破坏性的疾病并使新冠肺炎成为最后一次大流行。