Polio

　　小兒麻痹癥

　　A Rotary engine

　　扶輪社計劃

　　Can a businessmen s club eradicate polio from the world?

　　商人組織能否根除世界各地的小兒麻痹癥?

　　IT IS a year since the last case of polio was diagnosed in India. That is not enough topronounce the country polio-free-three clear years are the conventional period required forthat to happen. But it is a good start. And if India really is clear, then what was once a globalscourge will now be endemic to a mere three countries: Afghanistan, Nigeria and Pakistan.The number of people infected, meanwhile, has dropped from 350,000 in 1988 to 650 lastyear.

　　距印度最后一例小兒麻痹癥患者被確診到現在已經1年。那不足以宣布這個國家脫離了小兒麻痹癥人們習慣上將三年不出現小兒麻痹癥病例作為一個國家宣布脫離小兒麻痹癥的周期。但這已經是一個好的開始。如果印度擺脫了小兒麻痹癥，那么曾經風靡全球的災難在現在將僅存于三個國家：阿富汗、尼日利亞和巴基斯坦。于此同時，感染小兒麻痹癥的人的數量已經從1988年的 350,000降低到了去年的650.

　　All this is in large part thanks to the efforts of Rotary International. In 1985, after a successfulpilot study in the Philippines, this businessmen s club cum global charity announced a planto eradicate polio by vaccinating every child under five at risk of catching it. The estimatethen was that it would cost $120m. Some $800m of Rotary money later , the virus is still out there, but its remaining hidey-holes tell their own story: wherecivil disorder is rife, medicine is hard.

　　所有這一切很大程度上得益于扶輪國際。1985年，一個在菲律賓進行的初步研究成功之后，商人組織和全球慈善團體宣布了一項計劃，這項計劃通過給有患小兒麻痹癥風險的五歲以下兒童接種疫苗來根除小兒麻痹癥。預計這個計劃將耗資一億兩千萬美元。其后要花費扶輪社八億美元，病毒仍然還會存在，但是那些剩余的隱藏的地點發出自己的心聲：越是內亂盛行的地方，醫療就越發的困難。

　　On January 17th Rotary announced it had raised yet another $200m. The Bill MelindaGates Foundation will contribute a further $405m, and the pressure will thus be kept up.John Germ, one of Rotary s trustees, thinks that if all goes well 2023 might be the first yearwhen no new cases are reported. That would, though, mean spending more than $1 billion ayear between now and then.

　　1月17日，扶輪社宣布已經另外募集了兩億美元的資金。比爾及梅林達?蓋茨基金會將另外捐獻四億零五百萬美元，即便如此還是會有壓力。扶輪社的理事之一約翰澤恩認為如果一切進行順利，那么2023年可能是第一年沒有新的病例被報道的一年。盡管那將意味著從此時到彼時每年要花費至少10億美元。

　　The inspiration for Rotary s campaign against polio came from the eradication ofsmallpox. Like polio, smallpox was a viral disease for which effective, easily administeredvaccines existed. And crucially, like polio, smallpox had only one animal host: Homo sapiens.In principle, then, extermination should be possible. The practice, however, has turned outrather different.

　　扶輪社遏制小兒麻痹癥的啟發來自天花的根除。和小兒麻痹癥一樣，天花是一種可以被存活的疫苗簡單有效的治理的病毒性疾病。關鍵是天花像小兒麻痹癥一樣僅有一個動物寄主：人類。一般而言根除應該是可能的。然而時間證明卻是恰恰相反的。

　　First, unlike smallpox, polio viruses can survive for long periods outside a host-for instance insewage. Second, when the campaign began in earnest there were three main varieties ofpolio, each of which required a specially tailored vaccine. Focusing effort on one of thesestrains often led to the resurgence of another. Third, besides the inevitable difficulties ofworking in places that have poor medical infrastructure, the campaign ran into somespecific human problems. The most notorious of these was the rumour, spread in 2003 bycertain religious leaders in Nigeria, that the vaccine would sterilise girls and was part of anAmerican plot to rid the world of Muslims. This helps explain why polio persists in Nigeria.

　　第一，與天花不同的是，小兒麻痹癥病毒在寄主之外可以長時間的存活例如在下水道。第二，當此項活動開始正兒八經的進展的時候已經存在三類主要的小兒麻痹癥，每一類都需要一種特別定做的疫苗。集中對其中一類小兒麻痹癥下功夫經常會導致另一類病毒的死灰復燃。第三，除了這些不可避免的醫療設備落后的工作困難之外，此項活動偶爾還會遇到人類問題。其中最臭名昭著的就是在2003年尼日利亞的某一宗教領導人散布的謠言，謠言稱疫苗將會使女孩絕育并且是一個消滅世界上伊斯蘭教徒的美國陰謀的一部分。這幫助解釋了尼日利亞的小兒麻痹癥得不到遏制的原因。

　　That polio can actually be eradicated is suggested by the elimination, in 1999, of one of thethree strains. Whether the resources needed to do so might be better spent elsewhere,though, is a matter of debate. Some would prefer to see a shift to policies that improveoverall health, including investing in decent sanitation and clean water.

　　1999年，三類小兒麻痹癥之一的消除證明了小兒麻痹癥實際上可以根除。但是根治小兒麻痹所需要的資源財力是否可以在別處更好的支配是一個值得討論的問題。一些人更希望看到一個改善全民健康的政策的轉變，包括像樣的環境衛生和干凈的水。

　　The response to that is that if you remove the specific pressure on polio it will simplybounce back. Moreover, in practice, a synthesis between the two positions is emerging.According to Mr Germ there is already a debate within Rotary about what to do next.Providing clean water and improving maternal and child health are popular options.

　　對于此觀點的回應是如果你對小兒麻痹癥疏忽大意它將會輕易的恢復活力。此外，實際上兩種立場已經顯現出達成一致的勢頭。據澤恩先生說，早就已經在扶輪社內部召開了關于接下來該怎么做的討論會。提供干凈的水和改善母嬰健康是符合大眾的選擇。

　　One thing everyone wants to avoid, though, is what happened after smallpox waseliminated. Then, the infrastructure of health workers and clinics that had been created todetect and fight the disease was allowed to evaporate. Had it been used instead to focus onpolio, that illness, too, might have been vanquished by now.

　　不過，每個人都想避免的一件事是天花被消除以后發生的事。此外，已經制造的用于檢測和治療疾病的保健人員和診所的醫療設施是可以消除疾病的。至于這些設備是否也已經用于治療小兒麻痹癥這樣的疾病到目前為止可能已經可行了。

　　Polio

　　小兒麻痹癥

　　A Rotary engine

　　扶輪社計劃

　　Can a businessmen s club eradicate polio from the world?

　　商人組織能否根除世界各地的小兒麻痹癥?

　　IT IS a year since the last case of polio was diagnosed in India. That is not enough topronounce the country polio-free-three clear years are the conventional period required forthat to happen. But it is a good start. And if India really is clear, then what was once a globalscourge will now be endemic to a mere three countries: Afghanistan, Nigeria and Pakistan.The number of people infected, meanwhile, has dropped from 350,000 in 1988 to 650 lastyear.

　　距印度最后一例小兒麻痹癥患者被確診到現在已經1年。那不足以宣布這個國家脫離了小兒麻痹癥人們習慣上將三年不出現小兒麻痹癥病例作為一個國家宣布脫離小兒麻痹癥的周期。但這已經是一個好的開始。如果印度擺脫了小兒麻痹癥，那么曾經風靡全球的災難在現在將僅存于三個國家：阿富汗、尼日利亞和巴基斯坦。于此同時，感染小兒麻痹癥的人的數量已經從1988年的 350,000降低到了去年的650.

　　All this is in large part thanks to the efforts of Rotary International. In 1985, after a successfulpilot study in the Philippines, this businessmen s club cum global charity announced a planto eradicate polio by vaccinating every child under five at risk of catching it. The estimatethen was that it would cost $120m. Some $800m of Rotary money later , the virus is still out there, but its remaining hidey-holes tell their own story: wherecivil disorder is rife, medicine is hard.

　　所有這一切很大程度上得益于扶輪國際。1985年，一個在菲律賓進行的初步研究成功之后，商人組織和全球慈善團體宣布了一項計劃，這項計劃通過給有患小兒麻痹癥風險的五歲以下兒童接種疫苗來根除小兒麻痹癥。預計這個計劃將耗資一億兩千萬美元。其后要花費扶輪社八億美元，病毒仍然還會存在，但是那些剩余的隱藏的地點發出自己的心聲：越是內亂盛行的地方，醫療就越發的困難。

　　On January 17th Rotary announced it had raised yet another $200m. The Bill MelindaGates Foundation will contribute a further $405m, and the pressure will thus be kept up.John Germ, one of Rotary s trustees, thinks that if all goes well 2023 might be the first yearwhen no new cases are reported. That would, though, mean spending more than $1 billion ayear between now and then.

　　1月17日，扶輪社宣布已經另外募集了兩億美元的資金。比爾及梅林達?蓋茨基金會將另外捐獻四億零五百萬美元，即便如此還是會有壓力。扶輪社的理事之一約翰澤恩認為如果一切進行順利，那么2023年可能是第一年沒有新的病例被報道的一年。盡管那將意味著從此時到彼時每年要花費至少10億美元。

　　The inspiration for Rotary s campaign against polio came from the eradication ofsmallpox. Like polio, smallpox was a viral disease for which effective, easily administeredvaccines existed. And crucially, like polio, smallpox had only one animal host: Homo sapiens.In principle, then, extermination should be possible. The practice, however, has turned outrather different.

　　扶輪社遏制小兒麻痹癥的啟發來自天花的根除。和小兒麻痹癥一樣，天花是一種可以被存活的疫苗簡單有效的治理的病毒性疾病。關鍵是天花像小兒麻痹癥一樣僅有一個動物寄主：人類。一般而言根除應該是可能的。然而時間證明卻是恰恰相反的。

　　First, unlike smallpox, polio viruses can survive for long periods outside a host-for instance insewage. Second, when the campaign began in earnest there were three main varieties ofpolio, each of which required a specially tailored vaccine. Focusing effort on one of thesestrains often led to the resurgence of another. Third, besides the inevitable difficulties ofworking in places that have poor medical infrastructure, the campaign ran into somespecific human problems. The most notorious of these was the rumour, spread in 2003 bycertain religious leaders in Nigeria, that the vaccine would sterilise girls and was part of anAmerican plot to rid the world of Muslims. This helps explain why polio persists in Nigeria.

　　第一，與天花不同的是，小兒麻痹癥病毒在寄主之外可以長時間的存活例如在下水道。第二，當此項活動開始正兒八經的進展的時候已經存在三類主要的小兒麻痹癥，每一類都需要一種特別定做的疫苗。集中對其中一類小兒麻痹癥下功夫經常會導致另一類病毒的死灰復燃。第三，除了這些不可避免的醫療設備落后的工作困難之外，此項活動偶爾還會遇到人類問題。其中最臭名昭著的就是在2003年尼日利亞的某一宗教領導人散布的謠言，謠言稱疫苗將會使女孩絕育并且是一個消滅世界上伊斯蘭教徒的美國陰謀的一部分。這幫助解釋了尼日利亞的小兒麻痹癥得不到遏制的原因。

　　That polio can actually be eradicated is suggested by the elimination, in 1999, of one of thethree strains. Whether the resources needed to do so might be better spent elsewhere,though, is a matter of debate. Some would prefer to see a shift to policies that improveoverall health, including investing in decent sanitation and clean water.

　　1999年，三類小兒麻痹癥之一的消除證明了小兒麻痹癥實際上可以根除。但是根治小兒麻痹所需要的資源財力是否可以在別處更好的支配是一個值得討論的問題。一些人更希望看到一個改善全民健康的政策的轉變，包括像樣的環境衛生和干凈的水。

　　The response to that is that if you remove the specific pressure on polio it will simplybounce back. Moreover, in practice, a synthesis between the two positions is emerging.According to Mr Germ there is already a debate within Rotary about what to do next.Providing clean water and improving maternal and child health are popular options.

　　對于此觀點的回應是如果你對小兒麻痹癥疏忽大意它將會輕易的恢復活力。此外，實際上兩種立場已經顯現出達成一致的勢頭。據澤恩先生說，早就已經在扶輪社內部召開了關于接下來該怎么做的討論會。提供干凈的水和改善母嬰健康是符合大眾的選擇。

　　One thing everyone wants to avoid, though, is what happened after smallpox waseliminated. Then, the infrastructure of health workers and clinics that had been created todetect and fight the disease was allowed to evaporate. Had it been used instead to focus onpolio, that illness, too, might have been vanquished by now.

　　不過，每個人都想避免的一件事是天花被消除以后發生的事。此外，已經制造的用于檢測和治療疾病的保健人員和診所的醫療設施是可以消除疾病的。至于這些設備是否也已經用于治療小兒麻痹癥這樣的疾病到目前為止可能已經可行了。