专访比尔·盖茨：人类下一次将面临什么样的危机？

Derek: So how did it feel to make this prediction and then have the world essentially not listen and not prepare?
看到自己当年的预测被所有人毫不在意地当作耳旁风，心里是个什么滋味？

Bill Gates: Well there's no good feeling that comes on something like this saying I told you so.
我看到危机如我预言的那样爆发时，心里当然是非常难过的。

If anything kills over 10 million people in the next few decades,
假设在未来几十年里有什么能消灭超过一千万人口的灾难，
it's most likely to be a highly infectious virus rather than a war.
那有高度传染性的病毒比起战争来说更有可能。

You know I just think back and could I have been more persuasive.
我现在回想起来，只恨自己的演讲不够有说服力。

We've actually invested very little in a system to stop an epidemic.
我们对于防疫系统的投入真的太少了。

We're not ready for the next epidemic.
我们根本没有准备好应对下次流行性疾病。

Derek: How did you make such a prescient prediction?
你是怎么做出这么有先见之明的预测的？

How did you know this was going to happen?
你怎么知道这种事情会发生呢？

BG（Bill Gates）: Well there's a number of respiratory viruses and from time to time one will come along that's very transmissive and causes some level of fatalities.
通过呼吸道传染的病毒数不胜数，时不时就会出现一种传染性很强、造成不少人丧生的呼吸道病毒。

Respiratory diseases are very scary because you're still walking around on a plane,
呼吸道病毒非常可怕，因为患者往往在患病时还在搭乘飞机、
a bus when you're infectious unlike some other diseases like ebola where you're mostly in a hospital bed by the time the viral load infects other people.
巴士这类公共交通，而反观其它类型的疾病，比如埃博拉病毒，等病人能够传播病毒的时候，一般就已经躺医院病床上了。

Derek: Hey,so recently I got the chance to interview Bill Gates when his foundation's annual letter came out.
最近，借盖茨基金会年度公开信发布的机会，我有幸采访了比尔·盖茨。

I'll link to it in the description and we talked about lots of things including conspiracy theories and misinformation but about the pandemic.
我会把公开信链接放在简介里面，我们讨论了不少东西，包括阴谋论和误导。

I wanted to know if so many people could see this coming and the costs of prevention were relatively small,then why wasn't more done about it?
不过关于这次疫情，我想知道一点，如果有许多人能可以预知到这次的展开，并且防疫的花费相对比较小，为什么我们当时不多做防备呢？

BG: Well there's some risks like earthquakes where we see small earthquakes all the time.
有些危机，比如说地震，几乎随时都会发生。

Or you know the history of war or fire or hurricanes so you don't forget.
又比如战争、火灾、飓风这样的历史性灾难，因此我们不会忘记它们的可怕。

These pandemics only come along so irregularly that being lulled into a sense of security where it probably won't be a problem in the next few years,why should we put money into that?
但传染病的发生毫无规律， 以至于人们产生了虚假的安全感，我们原本假想近几年“大概”不会爆发传染病，那还投钱干什么呢？

You don't buy the insurance policy,basically.
于是大家都不怎么买预防政策的账了。

This one will help us understand it needs to be a priority.
这次疫情让人们明白，预防胜于治疗。

Derek: I feel like humans have an issue though with fighting the last battle potentially,
我感觉，当今的人们讨论起来会认为这是最后一战，
so if we focus on pandemics now and there isn't one say for another hundred years 
我想说，如果我们能关注疫情，这可能是以后几世纪都不会发生的了。

What is the next disaster?
下一个灾难是什么？

What is the one that we're not prepared for?
下一个我们不足以应对的灾难是什么？

BG: Well,I'd point out two: One is climate change.
我想说两点，其一是气候变化。

Every year that would be a death toll even greater than we've had in this pandemic.
每年死于气候变化的人数其实都多于这次疫情的死亡人数。

Also,related to pandemics is something people don't like to talk about much which is bioterrorism,
其二跟传染病有关，很多人如今不愿谈及这个，生物恐怖主义，
that somebody who wants to cause damage could engineer a virus and so that means the cost the chance of running into this is more than just the naturally cost epidemics like the current one.
想破坏社会秩序的人可能有能力制造病毒，这意味着人造病毒爆发的可能性和危害要更甚于这次的流行病毒。

Derek: It feels to me like there's something similar about pandemics and you know climate change or like asteroid impact,
我感觉传染病跟气候变化、小行星撞击有点共同之处，
which is that you know they're not very tangible but you could do a little bit.
它们都是那种我们没有什么办法，但是又能做出一些改变的类型。

I don't know it seems like humans are not very good at those sorts of problems.
我不知道，但是感觉人类不擅长处理这类问题。

BG: Well，my favorite writer,Vaclav Smil,you know wrote about all the potential kinds of disasters like you know the risk of an asteroid,
唔，我喜欢的作家Václav Smil写过各种潜在的灾难，比如小行星撞击，
the risk of a you know yellowstone-like eruption and in fact he showed that pandemics were significantly the biggest thing other than a human-caused nuclear war that we needed to be more prepared for.
黄石公园的火山大爆发，而他展示给我们的是，传染病很明显是除了核战争以外最严重，我们最应该做足准备的灾难。

Derek: So what changes do we put in place to be readier for the next one and is it possible that covid-19 could be the last global pandemic?
那我们应该改变哪些东西，才能让我们更好地应对下一次疫情？有没有可能让“新冠”成为最后一次全球性的传染病？

BG: Well certainly there will be more pandemics.
好吧，以后一定会有更多的流行性疾病。

The ways that humans interact with other species,
人类与其他物种的互动，
these viruses are coming across a species barrier whether it's from bats or monkeys or.
会让病毒的传播跨越物种间的藩篱，病毒可能会在蝙蝠、猴子等动物身上传播。

Derek: But you don't think we could increase our preparedness to such a level that it never sort of becomes this global issue?
但你不觉得只要我们的准备工作足够完备，就能阻止新生的传染病在全球范围爆发吗？

BG: We could increase our preparedness so we never have a death toll uh anywhere near what we have today.
我们可以做更充分的准备，来避免再次出现这次这么高的死亡数。

You know pandemics can be worse in terms of the fatalities.
毕竟还可能出现致命性更高的疾病。

Smallpox was a over 30 per cent fatality.
比如天花的死亡率超过30%。

You know so a little bit we were lucky that the fatality here is not not super high,
所以不幸中的万幸，新冠病毒的死亡率并不非常高，
but we can nip it in the bud 
但我们可以将其扼杀在萌芽状态。

It'll still get to a lot of countries,
病毒还是会传播到许多国家，
but the number of deaths you know uh with the right system should be a tenth of what we we've seen here.
但在合理的医疗系统下，死亡人数应该只有目前的1/10。

Derek: And the systems that you want to put in place so this sort of so you can nip it in the bud or so what are the key elements that we didn't have that we should have going forward?
你理想的医疗系统是那种能把病毒扼杀在萌芽状态的吗？那么我们目前还有哪些不足的地方，是未来应该进一步加强的？

BG: I would divide it into two sections: there's the field based activity and the R&D activity.
我认为应该分成临床和研发这两个部分。

In R&D we need to mature mRNA so we can make it even faster and have factories all over the world,have it be cheap and thermal stable.
对于研发方面，我们需要尽快让mRNA疫苗技术成熟，才能更快地制造疫苗，并在世界范围开设医药工厂，让疫苗更便宜、更耐热。

There's a lot that can go into therapeutics including antibodies.
还有很多可以使用的疗法，包括抗体。

On diagnostics having the ability to give 10 million PCR tests a day.
在诊断时，我们得拥有每天进行一千万次核酸检测的能力。

Then in terms of the field we need a lot of diagnostic machines all over the world.
至于临床方面，我们需要在世界各地准备大量的诊疗仪器。

We need a team of epidemiologists.
我们需要一支由流行病学家组成的团队。

So the investments are about equal between R&D and the the field-based group and information that should beconstantly flowing.
因此，研究、临床两个领域的投资同等重要，并且研究部门与临床部门之间要不停地交流数据。

Derek: You know I feel like there's a meta-issue that is kind of above all of these issues which is you know the way that people connect with reality and figure out what's true and what's not and you know what information to believe.
我感觉有个“元问题”凌驾于这所有问题之上，也就是人们如何将信息和现实生活联系起来，分辨信息的真假，找出可信的信息。

I've got to say that you know as I was growing up and coming into this information age,
我要说的是，在我小时候，信息时代刚刚开始，
it seemed like the Internet and all these tools were going to make the correct information so much more easy to access and bring us into a more fact-based world.
那时看起来互联网之类的工具将会让获取真实的信息更加容易，会带来一个建立在事实真相上的世界。

Instead it doesn't look as though it's bringing us there.
但现在看起来并不是那样的。

I wonder if you shared a similar vision for you know what the Internet might do for all of us and I don't know if you have any thoughts about the current state of it you know how do we deal with this?
不知道你是否有类似的看法，比如互联网能为我们做什么，以及我也想知道你对互联网的现状有什么想法，以及我们应该怎么做来应对这种情况？

BG: Well the internet has done something fantastic which is if you want to learn,
互联网起到的伟大作用在于，如果你想学习的话，
you know the people who watch you are you know getting an opportunity to understand science and what's going on and that just wasn't there and so for a lot of people they're so much more informed.
比如那些看你节目的朋友——能够有机会去理解科学和了解时事，这在以往是做不到的，因此很多人都获得了远超以往的信息。

I mean I have friends who ask me about these variants where I'm just stunned at how up to date they are with the latest information so for people who want to learn facts this is a golden age.
比如我的一些朋友问起我最近的病毒变种时，我会被他们了解最新资讯的速度所震惊，当今时代对想要了解事实的人来说是个黄金时代。

You know we focus on the negative part with some of these conspiracy theories and anti-factual things and so because social media is so new figuring out how you curb that,
但是我们往往关注的是负面的部分，比如阴谋论，假新闻等等。又因为社交媒体是很新兴的事物，又因为社交媒体是很新兴的事物，
you know labeling it restrict the speed of spread of things that are titillating but false.
给它们打上标签，限制它们的传播速度。

We are missing some good ideas to,you know not have this kind of scary phenomena that in the case of anti-vaccine things may slow down how quickly we get lots of people to take the vaccine,
我们不知道如何阻止这种可怕的现象：反疫苗运动会阻碍大众接种疫苗的进程，
and therefore extend the epidemic and and cost us in in tens of thousands of lives.
使得疫情的传播无法停止，让成千上万人付出生命的代价。

Derek: It feels like you're running up against you know kind of that great American principle of free speech,right?
这感觉像是你试图与美国伟大的言论自由背道而驰，是吗？

I think it's a great point that you bring up that you know in the past the problem was kind of scarcity getting access to this sort of information,
我觉得你提出的有个观点很好，过去的问题是信息太匮乏，我们难以接触到，
and now it's sort of a problem of too much and figuring out which is the good stuff and which is not.
而当今的问题则是信息太多太杂，我们必须得辨别真伪。

BG: Well there are certainly clear things like you know saying completely false things about you know vaccines,
有些消息不言自明，比如关于疫苗的完全虚假的信息，
but there is kind of a gray area in the middle that figuring out what the rules are and who should be the one looking and interpreting those rules.
但是（在完全正确/完全错误之间）还存在着一个灰色地带：辨明规则，并划定解释规则的人。

Wow,we are missing that today.
我们当今尤为缺乏这一点。

You know can you get a group of experts that are weighing in on these things you don't really want the profit motive involved.
你希望能有个专家组来权衡这些问题，
But you want you know expertise and capacity and so you know a few years from now I hope we're more sophisticated on what or how that line should be drawn.
你期盼专家们能投入其专业知识与能力，而非从中渔翁得利。我希望过几年，我们能以更加成熟的态度来讨论这条线应该怎么划定。

Derek: You know a while back on my second channel I made a video called Be Hated,
很久以前，我在我的第二频道2veritasium上发了个视频《坚持原则》，
which was kind of about my thoughts about pushing back against misinformation,
这个视频是关于我当年关于回击谣言的想法，
that we should see anything that is wrong in the world and we should do our best to fight it so you should not be liked by everyone,
我觉得我们绝不能对社会上的谣言视而不见，我们还应该竭尽所能地打击谣言，所以你不应该讨好所有人，
because there are some people out there with bad ideas and you should be pushing back against them.
因为总有些人一肚子坏水。你应该坚决抵制这些人。

That was essentially my thought but since then I feel like my views have softened a little and now I think of our pushing back against misinformation a little bit like an immune system.
这曾经是我的想法，但自那个视频发布后我的观点似乎软化了一些。现如今，我觉得社会回击谣言的机制有点像免疫系统。

Obviously it's a problem if your immune system is weak if it doesn't respond to anything but it's also a problem if your immune system is too strong.
免疫系统太弱，完全不产生回应的话，当然会出现问题，但免疫系统太强也会成为问题。

You know during the 1918 flu pandemic there's a really interesting distribution of deaths where the young and old were more likely to die obviously,
在1918年大流感的死亡人群的年龄分布中，有项数据值得注意。小孩、老人的死亡率更高，明显是因为免疫系统弱，
because they have weak immune systems but also people in the sort of 25 to 35 year-old range,
但25-35岁人群的死亡率也出现了峰值，
because their immune systems were just so strong they were overactive and that ended up resulting in mortality so I feel like there's a sweet spot in terms of how much we push back against misinformation.
因为这部分人群的免疫系统太强了，免疫系统过度活跃导致这部分人的死亡率增加，所以我感觉我们回击谣言的力度也应该有个平衡点。

You know you'll never see me make a video about flat earthers because i just don't see the point.
你从来没见我视频谈及“地平说”的信众，因为我认为这是没意义的。

You know making that video only kind of reconfirms their world view and there's not really any minds to move there so that's kind of how I'm conceptualizing misinformation these days,
做个讲“地平说”的视频只会巩固他们的世界观，他们根本不会开窍，这类似我这几天将“谣言”这个概念给具象化了，
a bit like we have to be a targeted immune system.
也有点像我们的“免疫系统”必须有针对性。

So I wanted to push Bill a bit further on this idea and I brought up a tweet that I had seen doing the rounds on twitter that basically said that the Oxford vaccine development,
因此我想和比尔更深入地探讨这一想法，我展示了我在推特上看到的一条推文，推文大体上说的是牛津疫苗的研发，
they were going to open source that vaccine until the Bill and Melinda Gates Foundation got involved and said no,you must partner exclusively with a big pharma company AstraZeneca,
牛津大学本来想开源疫苗的版权，但是“比尔及梅琳达·盖茨基金会”中途掺了一脚，说道“不行，你们必须跟大型药企阿斯利康合作”，
and so obviously it seems to the people on Twitter that something nefarious was going on there,
所以推特上的风向看起来明显是觉得你们背地里有不法交易，
but I wanted to know from Bill what was the real story.
但我想听听从比尔嘴里吐露出来的真实情况。

BG: Well the making a safe vaccine is more complicated than say making a jet engine and people are very picky about vaccines.
造一支安全的疫苗比造喷气发动机要复杂得多，人们对疫苗又非常挑剔。

In fact you could ruin the reputation of vaccines if you're making them in factories where the quality control at every stage is not exquisite.
其实，如果生产疫苗的工厂进行的质量控制不够严格，疫苗的声誉就会被毁灭殆尽。

And you know any mistake you know you can have that factory shut down literally for months at a time when its output is needed to save millions of lives.
生产过程中的任何差错都可能使生产线停产数月，而其产品是需要用来拯救数百万人的生命的。

So vaccine factories are not something that you just you know you know like open source code that you can take and you know mess around with and so the the limitations on how many vaccines are being made,
所以疫苗工厂的建立不能搞成开源代码那样随便分发，这就是为什么我们会对疫苗的产量有所限制，
that's based on how many great capable vaccine manufacturers there are in the world and we've made sure that the AstraZeneca's being made in these big indian factories and there's no royalty for that,no charge at all.
这基于全世界有足够实力的疫苗制造厂数目，另外我们保证阿斯利康的这些疫苗都是在印度大厂生产的，并且我们不收使用费，事实上完全免费。

Now we've had to fund that,the Gates Foundation.
现在得靠盖茨基金会注资。

These are companies we've been working on their factory quality for over a decade so that there was spare capacity to make inexpensive vaccines so Oxford University is is wonderful,
这些公司是我们长期合作以提高工厂生产质量的，因此让它们来生产廉价疫苗绰绰有余，牛津大学固然非常优秀，
but they're not capable of doing a phase three trial and they they don't have factories.
但他们没有能力开展三期临床实验，也没有工厂。

We did tell Oxford that they needed to seek somebody with expertise and AstraZeneca came in and we didn't control that agreement,
我们已经跟牛津讲过，他们应该找专业药企合作，然后阿斯利康参与了进来，我们盖茨基金会并没有控制他们的商谈，
but they came in and said hey they want to do it on a non-profit basis and I'm impressed with how they put their best people on it and helped out.
总之阿斯利康说，他们打算以非盈利的形式来合作，阿斯利康打动我的地方在于他们投入了最顶尖的人才。

You know the pharma companies who didn't get involved nobody's criticizing them.
其它没参与研发的药企，可没有人去批评它们。

So you know you feel sorry for the ones that are really miraculously helping make these vaccines.
阿斯利康真正干了实事，奇迹般地研发出这些疫苗，（却遭受无端指责）我对此表示歉意。

These are the very good reasons that I suspect exist but that that's where I feel like social media just doesn't get the nuance and you know it pains me to see the world like that.
这些理由固然存在，但是我总感觉社交媒体没有搞清楚个中的细微差别，这样的世界让我感觉很受伤。

And you know even to see you,Bill,you know be the target of some of these conspiracy theories It seems to not bother you,
甚至连看到你——阴谋论者的众矢之的，尽管你气定神闲，
but you know it kind of bothers me as a guy who wants you know everyone to live in the same kind of reality,
但你知道这些阴谋论有点让我困扰，毕竟我希望大家能处在一个说真话的环境中。
and you know I see you out there doing great things and I think that you know that should be commended as opposed to what you get.
你在做着伟大的事情，你应该得到赞扬，而不是像如今这样遭受指责。

I'm not in a position to complain much you know I have a lot of things that you know make me extremely lucky and you know I hope these conspiracy theories go away and I don't know what what it'll mean for the future.
我坐的位子可不能老是抱怨，我有今天的成就是一路上的好运气使然，我当然想让阴谋论统统滚蛋。不知道阴谋论以后对我还会有哪些影响。

Derek: How do you feel about the vaccine roll-out so far?
你如何看待当下疫苗的推行情况？

BG: Well we you know we need the supply,we need the logistics and we need the demand and there are huge challenges in each of those.
我们需要供应，需要物流，还需要需求，每个环节都面临着巨大的挑战。

I'm hopeful that Johnson and Johnson in the next month will get approved because that's a single dose vaccine,
希望三月份强生公司的疫苗能获批，因为他们的疫苗是一种单剂疫苗，
very cheap highly scalable so AstraZenica,Johnson and Johnson and a few months later Novovax.
廉价且便于扩大生产，所以（准备推出新冠疫苗的公司有）阿斯利康、强生，过几个月还有Novobax。

Most of the developing world,those are the vaccines that will be going to them and so we put billions into trying to make that happen and you know in a few months hopefully it'll come together.
大部分发展中国家都会得到这些疫苗，所以我们投入数十亿资金向发展中国家供应新冠疫苗，乐观预计将在几个月内铺开。