比爾蓋茨談?wù)搶?duì)抗瘧疾武器：讓蚊帳覆蓋整個(gè)國(guó)家

8月18日消息 比爾蓋茨官方微信號(hào)發(fā)布了新的蓋茨筆記，獲悉，在文章中，比爾蓋茨表示，蚊帳是一種非常簡(jiǎn)單的工具，但事實(shí)證明它是我們對(duì)抗瘧疾最有效的武器之一。增長(zhǎng)的蚊帳使用率，很大程度上幫助將全球瘧疾死亡自2000年以來(lái)降低了50％以上。

If you’ve ever traveled to a part of the world where there’s a risk of malaria or other mosquito-borne disease, you probably slept under a mosquito net.

如果你曾經(jīng)去過(guò)瘧疾或其他蚊媒傳染病肆虐的地區(qū)，你當(dāng)時(shí)很可能睡在蚊帳里面。

The gauzy fabric creates a physical barrier that protects you from mosquitoes. At the same time, you serve as bait in a deadly trap. Treated with potent insecticides, the net kills mosquitoes that land on it during their futile efforts to bite you.

這種薄紗織物可以形成一道物理屏障，保護(hù)人們免受蚊蟲(chóng)的叮咬。與此同時(shí)，你也充當(dāng)了一個(gè)致命陷阱的誘餌。經(jīng)過(guò)強(qiáng)力殺蟲(chóng)劑處理的蚊帳，可以在蚊子落在上面想要叮咬你時(shí)置其于死地。

It’s a remarkably simple tool, but it’s proven to be one of the most effective weapons we have against malaria. Increased bed net use is largely responsible for the more than 50 percent drop in malaria deaths worldwide since 2000.

這是一種非常簡(jiǎn)單的工具，但事實(shí)證明它是我們對(duì)抗瘧疾最有效的武器之一。增長(zhǎng)的蚊帳使用率，很大程度上幫助將全球瘧疾死亡自 2000 年以來(lái)降低了 50% 以上。

Still, more needs to be done to ensure that communities at highest risk of malaria have access to them. That’s why I’m excited that the government of Benin this year launched a new, innovative approach to distributing bed nets to their population.

但是，我們?nèi)匀恍枰龈喙ぷ鳎源_保生活在瘧疾高風(fēng)險(xiǎn)地區(qū)的人們能夠獲得蚊帳。因此，我激動(dòng)地得知貝寧政府今年推出了一種新的、獨(dú)創(chuàng)的蚊帳分發(fā)方式。

Using smartphones, real time data collection, satellite mapping and other surveillance techniques, Benin’s distribution program will give health officials the data they need to provide full bed net coverage to the country.

利用智能手機(jī)、實(shí)時(shí)數(shù)據(jù)采集、衛(wèi)星測(cè)繪和其他監(jiān)測(cè)技術(shù)，貝寧的蚊帳分發(fā)項(xiàng)目將向衛(wèi)生官員提供其所需要的數(shù)據(jù)，確保提供覆蓋全國(guó)的蚊帳分配網(wǎng)絡(luò)。

Benin is faced with one of the highest burdens of malaria in the world. The West African country of nearly 12 million people has about 2 million cases each year. If successful, this new bed net distribution effort will save thousands of lives and serve as a blueprint for other high burden malaria countries to follow.

貝寧是世界上受瘧疾影響最嚴(yán)重的國(guó)家之一。這個(gè)擁有近 1200 萬(wàn)人口的西非國(guó)家每年有大約 200 萬(wàn)例瘧疾病例。一旦成功，這一新的蚊帳分發(fā)項(xiàng)目將挽救數(shù)千條生命，并為其他瘧疾高負(fù)擔(dān)國(guó)家提供了一個(gè)效仿的藍(lán)圖。

As you might imagine, distributing bed nets to every household is a massive logistical effort involving thousands of people—from truck drivers to health workers. And the job is made even harder in Benin where exact population numbers are uncertain.

你可以想象到，向每一戶居民分發(fā)蚊帳是一項(xiàng)浩大的后勤工程，涉及到數(shù)千參與者——從卡車司機(jī)到衛(wèi)生工作者。在確切人口數(shù)都不確定的貝寧，實(shí)施這一工程甚至更加艱辛。

For many years, Benin’s distribution campaigns were run with pencil and paper systems. Health officials used thick ledgers to keep track of the names and addresses of residents and how many beds nets they needed. It was time-consuming and often inaccurate. No one knew exactly how many nets would be needed or if they reached their intended destinations. As a result, many families were missed during the distribution, putting them at higher risk of malaria because they lacked the protection of a bed net.

多年來(lái)，貝寧的蚊帳分發(fā)工作都基于用鉛筆在紙上寫字的系統(tǒng)。衛(wèi)生官員使用厚厚的賬本來(lái)記錄居民的姓名和地址，以及他們需要多少蚊帳。這項(xiàng)工作不僅耗時(shí)，而且常常不準(zhǔn)確。沒(méi)人確切知道到底需要多少頂蚊帳，抑或這些蚊帳是否到達(dá)了預(yù)定的目的地。其結(jié)果是，許多家庭在分發(fā)過(guò)程中被遺漏了，使得他們由于缺乏蚊帳的保護(hù)而面臨更高的瘧疾風(fēng)險(xiǎn)。

But this year’s distribution is different. In partnership with Catholic Relief Services and our foundation, Benin’s national malaria program created a new, digitized distribution system that is more accurate and efficient in getting bed nets into the homes of all households in the country.

但是今年的分發(fā)工作有所不同。在同天主教救濟(jì)會(huì)及我們基金會(huì)的合作中，貝寧的全國(guó)瘧疾防治項(xiàng)目創(chuàng)建了一個(gè)全新的數(shù)字化分發(fā)系統(tǒng)，從而更準(zhǔn)確、更有效地將蚊帳送到全國(guó)所有居民的家中。

In many ways, this effort is based on the lessons the global health community has learned in the fight against polio. As vaccinators sought to immunize every child against polio in India and Nigeria, they would sometimes miss households, especially in remote areas. But with satellite mapping and better data collection, health workers were able to quickly identify gaps in vaccination coverage and reach every home.

從許多方面來(lái)看，這項(xiàng)工作都是基于全球健康界在同脊髓灰質(zhì)炎的斗爭(zhēng)中得到的經(jīng)驗(yàn)。當(dāng)疫苗接種員想要在印度和尼日利亞為每一個(gè)孩子接種脊灰疫苗時(shí)，他們有時(shí)會(huì)遺漏一些居民，尤其是那些偏遠(yuǎn)地區(qū)的家庭。但通過(guò)衛(wèi)星測(cè)繪和更好的數(shù)據(jù)采集，衛(wèi)生工作者能夠迅速地發(fā)現(xiàn)免疫覆蓋缺口，并使接種服務(wù)觸達(dá)每一戶居民。

Benin’s new bed net distribution operates in much the same way. Walking door to door, health workers make home visits throughout the country and perform a brief census: the number of people living there, including number of children and pregnant women, number of bed nets needed, etc. Using cell phones, they enter this information into a database. They also give each household a uniquely coded voucher to redeem at a nearby distribution center where they can collect their bed nets.

貝寧新型蚊帳分發(fā)系統(tǒng)的運(yùn)轉(zhuǎn)方式大體相同。衛(wèi)生工作者在全國(guó)挨家挨戶走訪，通過(guò)一個(gè)簡(jiǎn)短的調(diào)查來(lái)記錄每戶的人口數(shù)（包括兒童和孕婦的人數(shù)），以及所需要的蚊帳數(shù)量等等。他們使用手機(jī)將這些信息錄入數(shù)據(jù)庫(kù)。他們還會(huì)給每戶居民一張具有唯一編碼的代金券，用來(lái)在附近的分發(fā)中心領(lǐng)取他們的蚊帳。

On the distribution day, people come to collect their nets and get lessons on the proper way to set up and care for them. As people arrive to redeem their vouchers for the nets, the malaria team has real time data on which households have received their nets and which ones have not. This data—which can be reviewed on a digital map—allows the malaria team to quickly identify any problems with their delivery system. It also gives health workers with detailed information about which households need to be targeted for follow up to ensure they all have nets.

在分發(fā)當(dāng)天，人們前來(lái)領(lǐng)取他們的蚊帳，并接受正確使用和維護(hù)蚊帳的培訓(xùn)。當(dāng)人們到達(dá)分發(fā)中心用代金券兌換蚊帳時(shí)，瘧疾小組就能獲得關(guān)于哪些家庭領(lǐng)取了蚊帳而哪些沒(méi)領(lǐng)的實(shí)時(shí)數(shù)據(jù)。這些可以在一張數(shù)字地圖上查閱的數(shù)據(jù)，使瘧疾小組得以快速發(fā)現(xiàn)配送系統(tǒng)的任何問(wèn)題。這些數(shù)據(jù)還為衛(wèi)生工作者提供了詳細(xì)的信息，關(guān)于哪些家庭需要針對(duì)性的跟進(jìn)，以確保他們都有蚊帳可用。

I admit none of what I’ve just described may sound that revolutionary. But in global health, I’ve learned again and again that saving lives is the result of getting the smallest details—from the temperature of a vaccine to the address of a beneficiary—right. And Benin’s new digitized bed net distribution program does just that by giving the government a powerful tool to manage a complex job.

我承認(rèn)我剛才描述的這些方法聽(tīng)起來(lái)都不那么具有革命性。但在全球健康領(lǐng)域，我一次又一次地認(rèn)識(shí)到，挽救生命正是把最小的細(xì)節(jié)做對(duì)之后取得的結(jié)果——這些細(xì)節(jié)從疫苗的溫度到受益人的地址。而貝寧的新型數(shù)字化蚊帳分發(fā)項(xiàng)目恰好做到了這一點(diǎn)，實(shí)現(xiàn)途徑是為政府提供了一個(gè)強(qiáng)大的工具來(lái)管理一項(xiàng)復(fù)雜的工作。

And with this new digital distribution system is in place, Benin can use it as a platform to manage other big health campaigns—like vaccinating against meningitis and door-to-door efforts to eliminate neglected tropical diseases.

有了這個(gè)新型數(shù)字化分發(fā)系統(tǒng)，貝寧可以用其作為一個(gè)平臺(tái)來(lái)管理其他大型衛(wèi)生項(xiàng)目，例如腦膜炎疫苗接種和挨家挨戶消滅被忽視的熱帶病的工作。

I’m looking forward to hearing more about Benin’s progress in the fight against malaria and other diseases because of this new system—and I hope other countries will learn from their success.

我期待聽(tīng)到更多關(guān)于貝寧得益于這個(gè)新系統(tǒng)而在抗擊瘧疾及其他疾病中取得的進(jìn)展，我也希望其他國(guó)家能從貝寧的成功中得到啟發(fā)。