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盖茨要在中国的领导下消灭全球疟疾,恭维还是抱大腿?

2017-03-30 15:46:52

【文/ 观察者网专栏作者 林书友】

3月24日,美国慈善家、微软公司创始人比尔·盖茨访问北京大学,发表了以“中国的未来:创新、慈善与全球领导力”为主题的演讲。

他在演讲中提到,“继天花和即将被消灭的脊髓灰质炎之后,我们有望在中国的领导下,让疟疾成为第三种从地球上消失的人类疾病。”

3月24日,比尔·盖茨到北大演讲,并与林毅夫教授(右)对话

不愧是盖茨,他提到的这个目标,其实是相当宏大的。

西方主导世界几百年以来,人类在治疗疟疾上取得了较大的进步,但距离“消灭疟疾”的目标,其实还差得远。

一个多世纪前,疟疾几乎是所有国家致死率最高的疾病。虽然人类已在减少疟疾致死人数方面取得了巨大的进步。但目前世界上仍然有32亿人面临罹患疟疾的风险。疟疾的分布范围,也要比我们想象中的广得多,而且依然是一种发病率非常高的疾病。全球每年有2亿人染上疟疾,病人涵盖非洲、印度、东南亚、中美洲等热带区域。

世界疟疾分布图(2004年):

用不同颜色表示每10万人中的疟疾病例数

同时,疟疾与盖茨提到的已基本被消灭的天花和脊髓灰质炎的情况完全不同。

首先,上述两种疾病目前都有了有效而相对廉价的疫苗(意味着有打断传播的手段)。

其次,人类是上述两种疾病唯一可再次传播的寄主(意味着只需要把人类的事情处理好就行了,若动物可以与人交叉感染,控制起来相当困难)。

不幸的是,对于疟疾来说,目前世界上既没有有效的疟疾疫苗,主要通过蚊子传播的疟原虫也不是只在人体寄生。虽然百年来的现代医学努力使疟疾的死亡率大幅降低,但目前对于疟疾仍只能做到发病后的治疗。

另外,奎宁作为抗疟疾的一线药物已经很长时间,有相当一部分的疟原虫对奎宁类的药物产生了比较强的耐药性,而目前国外的抗疟药物基本都是奎宁的衍生物,耐药性产生的很快。使疟疾在许多地方有变本加厉卷土重来的趋势。

奎宁原料,金鸡纳树

从这个意义上来说,屠呦呦合成青蒿素的意义确实重大。青蒿素作用的原理和奎宁完全不同,抗疟效果好,相对较难产生抗药性。另外,青蒿素成本低,原料来源广,在疟疾泛滥的贫穷地区,价格的因素对普及率非常重要。因此,青蒿素是中国人为世界抗疟做出的卓越贡献。

但是考虑到上面所说的,数以亿计的病患数量,以及尚无疫苗等实际情况,似乎只靠青蒿素药物,距离盖茨提出的“消灭疟疾”的目标还差得远

那么,盖茨难道是在北大向东道主做一番东方式的“客套和恭维”吗?又或者,他所说的“在中国领导下消灭疟疾”,甚至是一口传说中的“毒奶”吗?

那也未必。

比尔·盖茨在演讲中说,需要在屠教授发现的青蒿素的基础上,开发单剂药物等其他更强有力的工具,并寻求更好的方法,以阻止疟疾通过蚊虫在人群中传播。

对于这个“更好的方法”,盖茨补充说,中国很有潜力开发一些既高效、又让发展中国家可负担的解决方案。在非洲和湄公河流域等疟疾最为肆虐的地区,我们现在就可以采取更多行动来控制乃至消灭这一疾病——通过分享自己的经验,中国能够帮助这些地区的家庭获得蚊帐,防止被感染。中国还能够帮助这些国家加强本国的卫生和疾病监控体系,更好地预防、诊断和治疗疟疾。

盖茨所说的,其实是公共卫生的范畴。

公共卫生工作宣传海报

单纯依赖疫苗、药物控制传染病是不经济的。特别是一旦疾病在一定区域流行起来,这样的“点杀”往往无济于事。但是,通过做好公共卫生,改变传播传染病的外部环境和人的生活方式,切断传染病的传播途径,却往往能够收到“面防控”的效果。

在这里要提到一个巧合,屠呦呦提炼青蒿素,是受到古代中医方剂著作《肘后备急方》的启发。在该书中,疟疾,和许多南方烈性传染病一起,被泛称为“瘴疠”,“瘴”指的就是古书中经常提到的“瘴气”,“疠”指的是烈性传染病。

而在英语中,疟疾被称为“malaria”,即意大利语“坏空气”的意思,古罗马人认为疟疾是沼泽地散发出的浊气引发的,概念和中国所谓的瘴气差不多。英语中的另一种说法是来自古法语的“ague”(急性),用来表示来得快、让人捉摸不透的热病,与“疠”又有些相同。

可见,无论是东方人还是西方人,对于疟疾的认识,可以说都与类似“瘴气”的环境有关。

笔者最初是从这里听说“瘴气”


那么,“瘴气”究竟是什么呢?

古人说瘴气,一般存在于南方未开化地区,在原始植被茂密的山区,容易留存不流动的积水。南方常见降雨多,气温高,没有活水带来氧气和冲走虫卵的洼地积水,就会变成了富含有机质的“细菌汤”和蚊虫“育婴室”,而这样的洼地在大多数地方常见。就算地表是斜面,倒下的树木,塌落的石头也经常会造成小型洼地。平时这些洼地蒸腾出水蒸气,在树林顶上重新凝结为细小的水滴,形成雾团。

这些雾团因此成为蚊虫病菌滋生的标志,被认为是“瘴”。再加上许多大群蚊虫远看就像云雾,古人因此认为南方的空气有问题。

非洲马拉维湖上的蠓虫群,远看就像云雾

在西方,1717年,意大利医生乔瓦尼·冯里亚·兰锡西首先明确指出,疟疾总是流行在蚊子繁多的潮湿沼泽地区,而在排水之后就会一度绝迹

既然西方人已经明确认识到,改善公共卫生可以有效防控疟疾,为何在非洲、印度、南美洲等大部分西方已经殖民数百年的地方,仍然有疟疾肆虐呢?

曾经的欧洲人从15世纪发现新大陆起就开始了殖民时代,然而他们一直到19世纪才开始对近在咫尺的非洲殖民,而且他们去的只是少数几个地方,比如南非和纳米比亚。没错,就是因为疟疾。非洲大陆又是疟疾的发源地,直到1870年,安全奎宁药物的出现(奎宁素1820年才被提炼成功,在此之前,奎宁树皮是一种副作用极大的危险药物。另外,奎宁能治疗疟疾也不是西方人的原创,而是印第安人的贡献。)才使欧洲人控制了非洲大陆的10%,而且殖民地局限于沿海地区,至于非洲内陆地区,还是靠着疟疾的“保护”尚未被欧洲人染指。

我们知道,曾经的欧洲人,在非洲的最古老事业是贩卖人口,后来驱动他们在非洲和美洲不断前进的最大动力是黄金,然后才有了一些农场主跟进,发展一些甘蔗种植等粗放农业。在这一过程中,数量稀少、人力有限的欧洲人并没有能力,也没有动力去大范围改善当地环境,因为这对他们来说是没有经济效益的。只要有有效的药物和治疗保证自己的健康,对于大面积瘟疫流行的地方,与其费心劳力去抵抗,不如离开。

情况在东方人这里就不大一样。

据史料记载,中国的“瘴气”并不是自古以来就不存在,而是经历了一个自北向南慢慢退却乃至消失的过程。从江南退到华南,再从华南退到西南,最后连西南的山间盆地(坝子)里也找不到瘴气,最终只是在农业区周围坡度更大,理论上更难存积水的山区还有“烟瘴之地”的存在。

没错,原因就是——农业发展

在2013年《春城晚报》一篇谈瘴气的文章“旧时蛮烟瘴雨地 谈虎色变是瘴气”中,作者写道:

“瘴气我曾见过,下过雨后,能闻见火药的臭味,是毒气,红红绿绿的,从山脚边、山洼里的坝塘也就是臭水塘上出来,但现在这些烂坝塘已经变成水田了,1960年都还能见到。这种红红绿绿的瘴气能持续一个多小时,人一碰到就会得病,有毒的,闻到就会打摆子。”

盈江一位姓邵的当地人也确定缅甸现在还有瘴气。小邵说:“我有两个哥1998年底的时候去缅甸原始森林砍柚木,之后中了瘴气打摆子,病了一年半多,吃不得冷的,头上冒白气,汗珠大滴大滴往下淌。这种病不容易根治,经常复发。”

随着人口增加,山区尤其是瘴气区开发速度加快,云南生态及社会环境发生了根本变化,瘴气逐渐消失。原本一直认为现在中国境内应当没有瘴气,但从考察的情况看,周琼教授相信,在部分湿热封闭、生态原始、人烟稀少的地方,可能还存在部分微弱的瘴气,或是瘴气的部分特征,如个别在调查中未深入的瘴气塘。此外,与云南相邻近的缅甸等地,气候湿热,生态原始,这些地区应当极有可能存在瘴气,即便这些瘴气的成分与当地未经开发前的瘴气应有不同,但主要成分应当是相同的。

这个调查说明,瘴气在开发程度高的地方就少,在1960年代后基本消失。换句话说,农业发达的地区,瘴气就会消失。为什么呢?

因为农业需要排水。

最早的农业是烧荒轮作,靠天吃饭,不会浇灌。慢慢地,农业技术进步,农民也希望定居下来过好日子,就必须对土地做深度开发了。深度开发的第一步就是搞水利,修堤坝,建渠道,用引来的活水灌溉土地,让庄稼生长不受气候波动的影响。但灌溉不是水利的全部,排水和浇灌一样重要。因为庄稼不仅会旱死,还会淹死。另外,长期用含有矿物质的井水或地下水浇灌,如果不做好排水,还会带来更可怕的后果——土地盐碱化。

所以,修水利不仅仅是修堤坝,修渠道,更要修整地面坡度,建梯田,给洼地开排水口,最终保证整个农业地区不存在完全低于周围地区的封闭洼地(水库的水是可以通过水闸放出的)。这样才能长期耕作。

这说明,农业开发意味着消灭“瘴气”的源头。

在农民和蛮荒山区的对抗中,每一代农民都有大量的伤亡,但最终农民填平了洼地,排干了沼泽,开垦了“坝子”,把烟瘴之地变成了肥沃的农业区。所以农业发达地区很少有“瘴气”。不过小农改造土地的能力毕竟有限,许多连片的洼地沼泽没法开垦,稍微偏一点的丘陵包围的洼地也不会去处理。直到人民公社时代,集体的力量和逐渐加强的县级水利技术部门配合,又给中国多垦出了几亿亩耕地,顺便消灭了大多数南方农业区的“瘴气”死角。这就是为什么前面的调查显示1960年前后是转折点的原因。

可见在中国,“消除瘴气”是农业发展的副产品。

都江堰示意图(说到农业水利设施,我们不膜拜谁,也不针对谁

另外,新中国成立后,政府有计划地开展“爱国卫生运动”,加速了这一过程。60年代的《赤脚医生手册》提到:

可见当时乡村防病,很重要的一点就是消灭村落周围的积水,让沟渠水流动起来,养鱼吃掉水田里的蚊虫卵。在70年代的老宣传画中,还号召孩子们把村落周围的破缸,破瓦罐都敲成小碎片,免得雨天过后滋生蚊虫。

爱国卫生运动宣传海报

据《光明日报》2014年4月报道,“爱国卫生运动”使中国的疟疾病患减少了近6000万人。

世界卫生组织驻华代表施贺德当时指出,“中国自1949年以来通过爱国卫生运动改善了卫生条件,大大减少了病媒传播疾病,如疟疾患病人数由1955年的6000万人降低到2013年的3000人,由寄生虫传播的血吸虫病患者也急剧减少。”

施贺德说,中国要彻底消灭疟疾和血吸虫病的决心和壮举证明了中国将引领世界的这一进程,世界卫生组织乐于支持中国同行们把好的经验和做法介绍到其他国家和地区。

可见,比尔·盖茨所说的,“在中国领导下消灭疟疾”,在某种程度上并非虚言。

事实上,“瘴气”的存在,在某种程度上说明当地植被丰富,降水充足,土地一般不差,对农业生产来说,是条件相当好的“处女地”。非洲除撒哈拉沙漠和南非以外的大部分地方也正是如此,土地相当肥沃。而湄公河一带,则正好处在江南-华南-西南这一“瘴气”退却路线的延伸带上。如果东方式农业和基础设施建设能到达这些地方,不但对当地人会是福音,对目前陷于低谷的全球经济来说,也将是一片新的广阔天地。

许多中国企业在林毅夫的牵头下,到埃塞俄比亚投资设厂

盖茨在演讲中引用了汪洋副总理几年前的一句话,“非洲的今天就是我们的昨天。”盖茨说,这句话令他记忆犹新。现在,来自中国的经验正在帮助非洲迈向一个崭新的明天。

在这个意义上,当晚与他站在一起的林毅夫可能也深有感触。这位为中国企业走进非洲埃塞俄比亚等国牵线的著名经济学家曾说,“1979年我来到中国大陆,当时,中国大陆人均收入只有撒哈拉以南非洲的不到三分之一。如今,中国已成为中高收入国家,并且极有可能在2020年步入高收入行列。我希望能在我的有生之年看到第三次经济转型——在埃塞俄比亚和其他非洲国家。如果它们能够坚持其他国家已经尝试并考验过的道路,我的这一愿望实现的可能性相当大。”

林毅夫当晚代无法到场的北大校友屠呦呦,宣读了她致比尔·盖茨的一封信,信中就提到了消灭疟疾与贫困的前景。

或许,这几位经济和科学上的巨人,正是从“战胜疟疾”这个切入点上,一起看到了“人类命运共同体”的明天。

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附:屠呦呦的信和比尔盖茨演讲中英全文

比尔·盖茨演讲中英文全文:

《中国的未来:创新、慈善与全球领导力》

很高兴来到北大,特别是在北大即将迎来120周年校庆之际。过去一个多世纪以来,北大在高等教育领域取得了卓越的成就。

自上世纪九十年代以来,我曾多次访问中国。最初,我来中国主要是因为微软的工作。十年前,我有幸成为北大荣誉校董;2008年奥运会期间,我在北大现场观看了中国队与韩国队的乒乓球半决赛,这给我留下了难忘的回忆。

大家可能还记得,当年中国队包揽了乒乓球男单、女单、男团、女团等各项金牌——还有两块银牌和两块铜牌。对于我这样的超级乒乓球迷来说,亲历赛场的感觉真是太棒了。

这从某种程度上展示了中国拥有的超凡潜力。无论是从自身的发展还是对世界的贡献来看,中国都是一个不断追求卓越的国度。

随着中国经济走向成熟,在应对能源和环境治理等自身挑战时,中国正在做出大胆的抉择,尽管这确实艰难。在气候变化和发展等全球重大议题上,中国也发挥着日益重要的作用。在这样一个快速变化的时代,世界面临着诸多不确定因素,中国的作用比以往任何时候都更重要。

全球化究竟能给普通民众带来多少好处?富裕国家的人们对此存在质疑。美国总统大选和英国脱欧公投结果印证了这些国家在移民、安全和全球发展等议题上出现了国内利益优先的倾向。

我们高兴地看到,中国正逐步展现其全球领导力,填补这一缺失。中国足以胜任这一角色。在过去的几十年里,中国取得了任何国家都无法企及的成就:帮助数亿人民摆脱了贫困和疾病,还以人类历史上前所未有的规模和速度实现了经济现代化。

我们虽然不能期望中国去填补富裕国家在发展援助领域留下的缺口,但中国承诺将对非洲的发展援助扩大三倍,真可谓明智之举。中国在很久以前就认识到,帮助其他国家消除贫困相当于给各国人民创造一个更加稳定和安全的世界。

中国通过中非发展基金等融资机制创新,鼓励对非投资,这不仅发展了非洲经济,也为中国产品走向世界开拓了新市场。

中国让数亿人口脱贫是一个不可思议的成就,不过中国的发展并不均衡,迄今仍有4300万人口生活在极端贫困之中。但令人振奋的是,习近平主席承诺中国将在2020年前消除极端贫困。

我们的基金会正在与中国开展新的合作项目,从改善加强农村基本医疗服务、提高儿童营养水平和扩大普惠金融等领域入手探索扶贫创新模式。

中国不仅在解决国内问题方面努力取得新突破,也在利用其对抗贫困和疾病方面的经验帮助其他国家应对类似挑战。几年前我访问北京的时候,汪洋副总理曾说:“非洲的今天就是我们的昨天。”这句话让我记忆犹新。现在,来自中国的经验正在帮助非洲迈向一个崭新的明天。

这对中国的年轻人来说是一个绝佳的时代。当你们步入社会时,恰逢中国崛起,成为全球发展和创新的中心。全世界的目光都在关注中国,关注你们这些即将走出校门的天之骄子。

接下来,我想和大家在四个方面进行探讨。我相信这些领域能够给你们提供大好机会,充分运用你们的知识,发挥你们的热情和抱负,推动中国和世界取得更加令人瞩目的进步。这四个领域分别是健康、农业、能源和技术。

首先是健康领域。17年前,当梅琳达和我决定成立基金会时,我们不断问自己:怎么才能使我们的资源产生最大的影响?很快,我们就意识到健康领域的改善是重中之重。

如果没有健康的身体,一个人就无法高效地学习或工作,更不用说摆脱贫困和赚钱养家了。

梅琳达和我亲眼目睹了中国为自己的人民创造了更加美好的生活,这也促使我们思考如何更好地支持中国的发展。过去的十年里,我们在中国的工作重心一直放在那些中国尚未完全解决的健康挑战上,如减少结核病和烟草相关疾病、预防艾滋病病毒传播以及改善艾滋病患者的治疗和关怀等等。

在持续支持这些领域的同时,我们在中国的工作也随着中国不断变化的需求和重心而改变。比如,我们看到中国在引领全球健康创新方面潜力巨大。

没有人能比屠呦呦教授更好地证明中国在这一领域的能力。屠教授是北大校友,也是首位获得诺贝尔奖的中国女性。

屠教授发现的青蒿素可以有效地治疗疟疾,已经挽救了数百万的生命,堪称20世纪热带病药物最重要的突破之一。她的贡献得到了世界的认可。

中国拥有大批才华横溢的科学家和强大的药物及疫苗研发能力。因此,当我们为一个新的“全球健康药物研发中心”项目选址时,中国的胜出毫无悬念。这个中心由盖茨基金会与北京市政府、清华大学携手共建,将通过加速药物研发应对全球卫生和人类健康的挑战。

今天早些时候,我有机会和几位正在从事前沿科学研究的中国科学家进行了近距离交流,其中有国家食品药品监督管理总局国家药品评审中心的首席科学家何如意博士。他本人的工作,以及食药监总局正在推行的改革,将为创新打造更为有利的环境。我们正在和食药监总局合作,吸引更多像何如意博士这样的专家,帮助提升中国的监管能力,以推动更多中国的医药健康产品进入全球市场,包括发展中国家市场。

在对抗疟疾挑战方面,中国有着巨大的潜力引领世界。继天花和即将被消灭的脊髓灰质炎之后,我们有望在中国的领导下,让疟疾成为第三种从地球上消失的人类疾病。

一个多世纪前,疟疾几乎是所有国家致死率最高的疾病。一百多年来,人类在减少疟疾致死人数方面取得了巨大的进步。中国正在为消除国内疟疾有序推进各项工作,很有可能在几年内实现这一目标。但是,目前世界上仍然有32亿人面临罹患疟疾的风险。

为在全球范围内消除疟疾,我们需要在屠教授发现的青蒿素的基础上,开发单剂药物等其他更强有力的工具,并寻求更好的方法,以阻止疟疾通过蚊虫在人群中传播。

中国很有潜力开发一些既高效、又让发展中国家可负担的解决方案。在非洲和湄公河流域等疟疾最为肆虐的地区,我们现在就可以采取更多行动来控制乃至消灭这一疾病——通过分享自己的经验,中国能够帮助这些地区的家庭获得蚊帐,防止被感染。中国还能够帮助这些国家加强本国的卫生和疾病监控体系,更好地预防、诊断和治疗疟疾。

除了健康领域之外,我认为中国能够推动全球进步的第二大领域是农业。1975年以来,中国的农业生产率以每年12%的速度增长,是非洲农业年增长率的四倍。农业发展不仅解决了基数巨大且不断增长的中国人口的温饱问题,还促进了国民营养和健康水平的改善、农村收入的增加和贫困人口的下降,并向其他产业提供劳动力,从而在整体上推动了中国经济发展。

引发中国当代绿色革命的因素有很多,其中最重要的一点是中国在农业创新领域的投入以及像袁隆平教授等杰出专家们的努力。袁教授是湖南农业大学的农作物专家,他研究的杂交水稻将水稻亩产量平均提高了20%。

中国在杂交水稻领域取得的持续进步能够为撒哈拉以南非洲地区数百万的小农户带来巨大的好处,他们中有很多人无法生产足够的粮食养活家人,并将在未来几十年面临更加严峻的气候状况。

自2008年起,我们支持中国农业科学院和其他科研机构开发水稻新品种。通过将这些品种与塞内加尔、坦桑尼亚和卢旺达等国的本地品种进行杂交,我们将得到高产量的耐逆境作物,增加农民的收成和收入。

但是,随着全球人口压力不断增长,我们还需付出更多努力。

中国科学家最令人瞩目的研究成果之一是作物的超级光合作用,这不仅能大幅提升粮食产量,还能减少对灌溉和化肥的需求。

我们还支持中国科学家开展提高家畜健康水平的研究工作,这对发展中国家的食品安全和农村经济具有至关重要的作用。我们正与中国商务部和农业部合作,共同推进非洲农业的可持续发展。

中国的第三大全球机遇是能源创新。中国目前已经成为可再生能源领域的全球领导者之一,而且最近还宣布将在2020年前,对可再生能源领域投资3600亿美元。无论从中国国内还是全球商业长远机遇的角度而言,这一举措都将产生丰厚的回报。

知易行难。中国现在需要找到常规能源和新能源技术的平衡点,这是一个不小的挑战。我们也需要更多类型的能源,在满足能源需求的同时实现温室气体减排。

中国在这方面能开展的另一项工作就是引领下一代核能技术的发展。下一代核技术将更加安全、廉价,并能克服目前核技术面临的许多困难。我投资的泰拉能源公司正与中国核工业集团公司以及其他中国企业合作,将这一设想变为现实。

我曾有机会与习近平主席多次会面,他在巴黎气候大会上作出的承诺和领袖风范令我深受鼓舞。中国连同其他21个国家承诺在今后五年内对清洁能源创新领域的投入增加一倍。

我和马云先生,还有一些其他投资者共同成立了一支10亿美元的突破能源基金,用于支持早期能源技术开发,将实验室里最好的想法转化为市场产品。

中国拥有巨大潜力的第四个领域是软件开发。我还在微软的时候,从中国各大高校走出的计算机科学家和研发人员给我们留下了深刻的印象,直接促使我们在北京成立微软亚洲研究院,到现在一晃已近二十年。

目前,微软亚洲研究院仍然是微软在美国本土以外最大的基础研究机构,聚集了200多名全球顶尖的研究和开发人员以及300多名访问学者和实习生。

研究院最大的优点是研究人员可以自由地探索自己最感兴趣的领域,只有这样才有可能实现像微软小冰这样的突破。小冰是一款人工智能聊天机器人,在座有人可能已经在微博上和她聊过天,在电视上看她播报过天气预报,或者在《钱江晚报》上读过她的专栏。

小冰目前已经吸引了4500万名粉丝。她非常善于同时处理多项工作。而且我听说小冰现在已经能够感知用户情绪,甚至在别人失恋时给予安慰。

除了为微软开发新技术外,亚洲研究院还帮助已经有好产品的软件创业人员扩大业务规模。在过去两年时间里,从“微软加速器”项目毕业的125家公司中的大部分都获得了追加的投资,而且其中有三家创业型企业已经成功上市。

亚洲研究院还支持奔跑在通向成功道路上的软件开发人员。我们在中国已经招募了5000多名实习生。有一个消息一定会让你们感到开心——过去三年里从北大招募的实习生数量比清华多。但是差距并不大。所以,在座计算机专业的各位同学们,你们要加把劲!

技术也在推动中国公益慈善事业的发展。这是一个日益增长并有巨大潜力的领域。2015年,公众通过中国四大在线捐助平台所捐赠的善款高达9.66亿人民币。

腾讯公益基金会几年前发起的“9·9公益日”取得了巨大的成功。这证明当人们拥有便捷的途径参与公益、回馈社会时,他们往往都会付诸行动。去年,在三天时间里,600万公众——这里面也许包括你们当中的一些人——募集了高达3.05亿元人民币的善款,为3600余个项目提供了支持。这只是公益慈善事业在中国蓬勃发展的一个例子。

马云、马化腾、陈一丹、牛根生等一大批成功的企业家已经令中国个人财富总值跃居世界第二,他们正积极采取各种行动参与公益、回馈社会。

中国去年9月生效的《慈善法》为个人参与公益慈善活动开辟了更多途径。人们积极参加各类重大公益慈善活动,比如去年秋季在北大校园举办的第6届全球社会化媒体与公益峰会,就吸引了众多年轻人的参与。

你们中的有些人可能会决定加入公益慈善组织,帮助弱势群体改善生活。不过即使不全职从事这样的工作,或者没有很多钱可以捐赠,你们依然可以通过其他方式贡献自己的力量。你们可以花时间去了解一个新的议题、为某个问题奔走呼吁,或者参与志愿服务,这些都很有意义。

大家想想,如果你坚信自己能让世界变得更美好,这该是多么令人心潮澎湃、备受鼓舞的事情。而眼下正是大家施展才华的最好时机。

当今,随着地缘政治风向的变化,中国有机会推动世界在最为紧迫的挑战上实现突破。中国的领导人正在抓住这一机遇,而传承这一事业则需要依靠中国的年轻人。

在过去的几十年间,成千上万的中国人获得了事业和财务上的成功。我相信今天在座的各位也会取得同样的成功。这是一件很棒的事。对我来说,在微软工作的每一刻都弥足珍贵,如果让我重新选择,我一定会选择再来一次。

现在,在从事慈善工作的过程中,我又遇到许多以其他方式挥洒激情、奉献才华的人。他们中的许多人都是乐天行动派——一群坚信现实能够改变并愿意为此付诸行动的人。

他们是大无畏的医生们,不顾自己的生命危险奋力拯救埃博拉患者的生命;他们是富有创造力的企业家们,通过无人机向偏远村庄运送救命药品;他们是来自社会各界的志愿者们,心甘情愿地帮助那些无家可归的穷人或面临生存风险的儿童。

你或许希望每一个在贫穷环境下成长的孩子都能获得足够的营养,以便在学校取得最好的成绩;你或许希望研发一种能够保护人们免受疟疾威胁的疫苗;你或许希望设计一款电池,在夜晚照亮人们的书桌,或者研发一项移动技术,有朝一日能帮助人们开办自己的公司。

无论你有什么样的雄心壮志要去改变世界,就放手去做吧。没有比现在更好的时机,也没有比现在更好的环境了。你们每个人都拥有很棒的机会,我对你们未来所能取得的成就充满期待。谢谢! 

LOOKING TO THE FUTURE: INNOVATION, PHILANTHROPY, AND GLOBAL LEADERSHIP

BILL GATES:

Thank you, Professor Lin. It’s great to be here today. Beida (Peking University) has a long history and I’m sure that, next year, as you celebrate its 120th anniversary, you will look back on the incredible contributions it has made to this country.

I’ve been coming to China since the early 1990s, initially for my work at Microsoft. Ten years ago, I was privileged to be named an honorary trustee here at Beida. I remember what a great time I had here in 2008 watching the Olympic table tennis semi-finals between China and South Korea.

As I’m sure you remember, China took the gold medal in every category—the men’s singles, the women’s singles, the men’s and women’s team events. That was on top of two silver and two bronze medals. For someone who’s as big of a fan of table tennis as I am, it was an incredible moment to witness.

And it highlights in one way, the incredible potential China has. This is a country on a quest for excellence, not only to improve itself but to contribute to the whole world.

As China’s economy matures, it is making bold and difficult choices on challenges like energy and pollution. And China is assuming a greater role on critical global issues like climate and development. This matters now more than ever as the world navigates a time of change and uncertainty.

In some rich countries, there is skepticism about how well globalization works for ordinary people. The results of the U.S. presidential election and the Brexit vote in the UK underscore the temptation to turn inward on issues like migration, security, and global development.

It’s great to see China stepping up to fill the leadership vacuum. It is uniquely well-equipped to do so. No other country has accomplished what China has achieved in the last few decades—breaking the relentless cycle of poverty and disease for hundreds of millions of people while modernizing its economy at a scale and speed unprecedented in human history.

Although China can’t be expected to fill a gap in development aid from wealthy countries, it has made a smart choice in tripling its commitment to African development. China has long understood that helping other countries lift themselves out of poverty creates a more stable and secure world for people everywhere.

And by encouraging investment through innovative financing mechanisms like the China-Africa Development Fund, China is strengthening not only Africa’s economic capacity, but also, over time, markets for Chinese goods.

It’s also great to see President Xi’s commitment to eliminate extreme poverty in China by 2020. China did a great job lifting millions out of poverty. But progress has been uneven. Forty-three million people are still living in extreme poverty.

Our foundation looks forward to a new partnership with China that will focus on innovative ways to reduce poverty—through better nutrition and healthcare in rural areas, and by increasing access to financial services for the poor.

China isn’t just striving to reach new heights at home. It is using its own experience fighting poverty and disease to help other countries tackle similar challenges. When I was in Beijing a few years ago, Vice Premier Wang Yang said something that stayed with me. He said: “Africa today is our yesterday.” Now, China is using the lessons it has learned to usher in a new tomorrow for Africa, too.

This is a pretty incredible time to be a young person in China. Your generation’s entrance into the workforce will coincide with your country’s rise as a center of global progress and innovation. The world’s eyes are on China . . . and as the generation now coming of age, the world’s eyes are specifically on all of you.

So, I’d like to spend the rest of my time with you today talking about four areas where I think there are exciting opportunities to use your education, your passion, and your opportunities to unlock more amazing progress—for both China and for the world.  Specifically, health, agriculture, energy, and technology.

First, health. When Melinda and I started our foundation 17 years ago, we asked ourselves: how can we use our financial resources to make the greatest impact? It didn’t take long to realize that improving health was at the top of the list.

When people aren’t healthy, they can’t learn in school or be productive at work. They’re unable to seize economic opportunities or do any of the things they need to do to lift themselves out of poverty.

Melinda and I saw the example of China creating a better life for its people, and it inspired us to see if there was a way to support China’s progress. Over the last decade, our work in China has focused on several of the most persistent domestic health challenges — specifically reducing the incidence of tuberculosis and tobacco-related diseases, preventing HIV transmission, and improving treatment and care for people living with AIDS.

While we are continuing to support progress in these areas, our work in China is evolving along with China’s new priorities. For example, China has a great opportunity to be a global leader in health innovation.

No one exemplifies this better than Professor Tu Youyou. As I’m sure most of you know, Professor Tu is a Beida graduate and the first woman in China to win a Nobel Prize.

Professor Tu was recognized for her discovery of artemisinin, a powerful medicine used to treat malaria. This was one of the most significant breakthroughs in tropical medicine in the 20th century and it has saved millions of lives.  

With its rich pool of talented scientists and its capacity to develop new drugs and vaccines, China was a clear choice for us to locate a new Global Health Drug Discovery Institute. This institute—a collaboration between our foundation, the Beijing Municipal Government, and Tsinghua University—will help speed the discovery and development of new lifesaving medicines.

I had a chance earlier today to meet with some of the Chinese scientists who are driving cutting edge research. For instance, Dr. He Ruyi is the Chief Scientist at the Center for Drug Evaluation of the Chinese Food and Drug Administration (CFDA). His work—and the reforms being carried out by his agency—will create an environment where innovation can thrive. We are working with the CFDA to bring in more experts like Dr. Ruyi to help improve its regulatory capacity so more Chinese health products can be made accessible to the entire world, including developing countries.

One area that China has an incredible chance to lead in is in reducing and eventually eradicating malaria. With China’s leadership, we stand a chance to make malaria the third human disease—after smallpox and, soon, polio—to be wiped off the face of the earth.

A little more than a century ago, malaria was a leading cause of death in nearly every country on earth. There has been great progress since then, and China is on track to eliminate malaria completely in the next few years. But more than 3.2 billion people around the world still live in areas where there’s a risk of malaria infection.

To achieve the goal of global eradication, we need to build on Professor Tu’s discovery of artemisinin and develop more powerful tools—like a single-dose cure and better ways to block transmission of malaria from mosquitos to humans.

China has the potential to develop these new high-impact solutions at a cost that developing countries can afford. We can start today by controlling and eliminating malaria in places like the Mekong River basin and in Africa.

Drawing on lessons learned from its own experience, China can help ensure that every family has bed nets to protect them from infection. And it can help countries strengthen their health and disease surveillance systems to better diagnose, treat, and prevent future cases of malaria.

That’s health. The second area where I believe China can drive global progress is agriculture.  Since 1975, Chinese agricultural productivity has grown at a rate of 12 percent per year—four times the annual rate of growth in Africa.

That hasn’t just fed a large and growing population. It has led to better nutrition and health, higher rural incomes, falling poverty rates, and more labor available to other sectors to drive China’s economic development.

There are many factors that accounted for China’s recent green revolution. One of the most significant is its commitment to agricultural innovation and the work of people like Professor Yuan Longping. A crop scientist at Hunan Agricultural University, Professor Yuan developed hybrid rice varieties that increased crop yields by 20 percent.

China’s continuing advances in rice could be of enormous benefit to millions of smallholder farmers in Sub-Saharan Africa, many of whom today are barely growing enough to feed their families and who will face more difficult weather conditions in the decades ahead.

Since 2008, we have been supporting work by the Chinese Academy of Agricultural Sciences and others to develop new varieties of rice that—when crossed with domestic varieties in countries like Senegal, Tanzania, and Rwanda—will result in high-yielding, stress-tolerant crops that will boost farmer yields and income. But to feed a growing planet, we need to do more.

One of the most exciting efforts is research by Chinese scientists to supercharge the process of photosynthesis in grains. This would significantly increase crop yields while reducing the demand for irrigation and fertilizer.

We also are supporting research by Chinese scientists to improve the health of livestock, which plays a vital role in food security and the rural economy of developing countries. And we are working with the Ministry of Commerce (MOFCOM) and the Ministry of Agriculture to promote sustainable agricultural development throughout Africa.

This brings me to what I think of as China’s third global opportunity: energy innovation. China already is one of the world leaders in renewable energy. And it recently announced that it will spend $360 billion on renewable power sources by 2020. This will pay off handsomely for China domestically, and as a long-term global business opportunity.

It won’t be easy. China faces a big challenge domestically sorting out the right mix of existing and new energy technologies. Many forms of energy will be needed to reduce greenhouse gases and meet energy needs.

One of the things China could do is pioneer next-generation nuclear technology. It will be dramatically safer and substantially cheaper and solve a lot of the challenges with today's nuclear energy. I have a company, TerraPower, that is partnering with China National Nuclear Corporation and other Chinese companies to make this a reality.

I’ve had the opportunity to meet several times with President Xi and am encouraged by his commitment— and by his leadership at the Paris Climate talks. China was one of the 22 countries that committed to doubling their investments in clean energy innovation over the next five years.

I’m also working with Jack Ma and other investors who have pledged to invest $1 billion in the development of early stage energy technology so we can move the best ideas from the research lab to the marketplace.

A fourth area where I see great potential for China is software. When I was at Microsoft, we were so impressed by the quality of computer scientists and developers coming out of universities in China that we established one of our first research labs in Beijing. That was almost 20 years ago.

Today, it is Microsoft’s largest research center outside the U.S.. It’s a phenomenal place, with 200 of the world’s top researchers and developers and more than 300 visiting scientists and fellows.

The best thing about it is that researchers are free to explore what they’re most passionate about, which leads to breakthroughs like Xiaoice, a natural-language chat bot that simulates human conversation.

Some of you may have had conversations with Xiaoice on Weibo, or seen her weather forecasts on TV, or read her column in the Qianjiang Evening News.

Xiaoice has attracted 45 million followers and is quite skilled at multitasking. And I’ve heard she’s gotten good enough at sensing a user’s emotional state that she can even help with relationship breakups.

Besides developing new technologies for Microsoft, the Beijing lab also helps software entrepreneurs who have a great product ideas and need help scaling their business. In the last two years, most of the 125 companies that graduated from the Microsoft Accelerator program were able to secure additional funding. And three of the startups have gone public.

The Beijing lab also supports up-and-coming software developers. We’ve hired more than 5,000 interns in China. And you’ll be happy to know that we’ve recruited more students in the last three years from Beida than from Tsinghua University. But it’s a slim lead, so those of you here in computer science, will have to keep up your good work!

Technology is also helping to power the philanthropic sector in China. It’s a growing sector and one with tremendous potential. In 2015, people contributed 966 million RMB to causes they care about using the four largest online donation platforms.

And the success of 9/9 Charity Day, started a few years ago by the Tencent Foundation, shows what is possible when people have an easy way to get involved and give back. In just three days last year, 6 million people—people like you—raised 305 million RMB in support of more than 3,600 projects. This is just one example of how philanthropy is beginning to blossom here in China.

A lot of the most successful entrepreneurs, like Jack Ma, Pony Ma, Charles Chen Yidan and Niu Gensheng, have helped create the world’s second largest pool of individual wealth. And now they’re taking steps to get involved and give back.

The new charity law that took effect last September opens up more opportunities for people to get engaged. People are coming together at events like the sixth China Social Good Summit held at Beida last fall.

Some of you may decide to work for NGOs that are making life better for the most vulnerable in society. But even if you don’t end up doing that, or to make big financial donations, there are other ways of getting involved. Just the fact that you’re learning about a topic, lending your voice to an issue, or volunteering your time, is important.

What an incredible, motivating thing that is—the belief that you can make the world a better place. There has never been a better moment.

As the geopolitical currents shifts, China has an opportunity to advance progress on the most urgent challenges the world faces. China's leaders are embracing this opportunity, but it will be up to China’s youth to carry this forward.

In the last few decades, millions of people in China have achieved professional and financial success. I’m sure all of you will too, and that's a great thing. I certainly enjoyed every moment at Microsoft and wouldn’t trade it for anything.

But now I’ve also had the opportunity in my philanthropic work to meet people who apply their talents and passion in other ways. Many of these people are impatient optimists. People who believe in the possibility of change and are eager to do something about it.

Doctors courageous enough to risk their own lives to save the lives of others suffering from Ebola. Entrepreneurs using their ingenuity to deliver life-saving drugs to remote villages by drone. And people of all walks of life who volunteer their time to help the homeless or mentor a child at risk.

Maybe you are the person who wants to ensure that every child growing up in poverty has the nutrition they need to do their best in school. Maybe you want to develop the next vaccine that protects everyone from malaria. Maybe you want to design the battery that lights people’s desks at night, or the mobile technology that will allow people to start new businesses.

No matter what your ambition is to improve the world, this is the best time and the best place to do it, and all of you have a great opportunity. I look forward to seeing what you’ll achieve. Thank you!

屠呦呦信件中英文全文:

尊敬的盖茨先生,

您好!高兴地得知您访问北京并在北京大学做公开演讲,对于您的光临,在此表示衷心的欢迎。非常感谢您和您的基金会邀请我参加这次活动,但由于我的身体状况所限,我非常抱歉无法回到母校聆听您的精彩讲演。科技创新正在改变世界,然而全球社会的发展并不平衡。您一向倡导创新,并号召有创新能力的机构和个人关注贫困人群的需求,以服务于贫困人群为己任。对此,我十分钦佩与赞赏。我相信,今天在座的听众也一定会有同感。人类始终面临疾病的威胁与健康的挑战。我和我的研究团队继续研究青蒿素的作用机理及其新适应症,致力于中医药的发展和应用。我们也相信,中国在疟疾防控方面的创新成果和成功经验可以为其他发展中国家所用,挽救更多生命。您和您的基金会一直关注全球危害穷人生命健康的重大传染性疾病,包括疟疾、结核病等疾病的防控。我非常赞赏您的不懈努力,并相信您在2017年度公开信中所说:"未来的美好将远超悲观主义者的想象"。您和您的基金会正在为人类健康的美好未来做出非凡的贡献。尊敬的盖茨先生,我们有共同的愿望,希望人类的明天更美好,并认为这是可以做到的。我期望年青一代能够心怀世界,以天下为己任,成长为德才兼备的栋梁,以创新迎战各种挑战,为人类的福祉做出更多的奉献。

致以最良好的祝愿!

屠呦呦教授,

主任中国中医科学院青蒿素研究中心

March 16, 2017

Dear Mr. Gates,

Please accept my warmest welcome ahead of your visit to Beijing. I am very grateful for your and the Gates Foundation's invitation to attend the speech you will be giving at my alma mater. However, I am reluctant to say that I will not be able to attend due to health reasons.In spite of the positive impact of science and technology, global development today is unequal. You have been a strong advocate for the importance of innovation and have called upon pioneering institutions and individuals to use innovative solutions to address the needs of the poor. I greatly admire your devotion to helping the disadvantaged, and I am sure the audience will share my sentiments.Human beings are constantly faced with the threat of disease and other health challenges. My team and I are continuing our research into artemisinin's mechanism of actions and its new indications, as well as promoting the development and application of traditional Chinese medicine. We believe that China's innovation and successful experience in malaria control can be applied to other developing countries to save more lives. You personally, and the Gates Foundation, have been focused on the prevention and control of critical infectious diseases, such as malaria and tuberculosis, that pose huge challenges to the lives and health of the poor. I greatly admire your constant efforts and share the belief you expressed in your 2017 annual letter: the future will surprise the pessimists. You and the Gates Foundation are indeed making an extraordinary contribution to the bright future of human health.Mr. Gates, we share the same hope for a better tomorrow and are convinced that it is within reach. I hope that the younger generation will take up the mantle of caring for the world with ability and integrity, look to the power of innovation when faced with challenges, and contribute to the wellbeing of all humankind.

Yours sincerely,

TU Youyou

Professor and DirectorArtemisinin Research CenterChinese Academy of Chinese Medical Sciences

林书友

林书友

媒体人

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