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The World Has a Plan to Fight Coronavirus. Most Countries Are Not Using it.

来源:纽约时报    2020-03-13 12:27

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        For weeks, the World Health Organization resisted declaring the coronavirus outbreak a pandemic, fearing that doing so would incite panic across the globe.        几周以来,世卫组织一直拒绝宣布新冠病毒疫情为大流行,担心这样做会在全球引起恐慌。
        But facing the cameras on Wednesday, the agency’s director general, Dr. Tedros Adhanom Ghebreyesus, did just that, asking for global unity to “change the course of this pandemic.”        但是在周三,面对镜头的世卫组织总干事谭德塞(Tedros Adhanom Ghebreyesus)博士将其定性为大流行,要求全世界团结起来“改变这场流行病的进程”。
        It was a symbolic moment that underscored the standing of the W.H.O. as the world’s leading public health agency. But it also reflected the W.H.O.’s underlying weakness as an organization that by international treaty is supposed to lead and coordinate the global fight against coronavirus — yet that has, in many ways, been marginalized.        这是一个象征性的时刻,突显了世卫组织作为引领世界的公共卫生机构的地位,但也反映出世卫组织的根本弱点。根据国际条约,它本应领导和协调全球抗击冠状病毒,却在许多方面被边缘化了。
        Global solidarity has been noticeably absent in the fight to stop an outbreak that has already killed more than 4,300 people and spread to more than 110 countries. No one seems to be in charge. There doesn’t seem to be a plan.        该病毒已扩散至110余个国家,导致超过4300人死亡,在抗击疫情的过程中,却看不到全球的团结一致。似乎没有人担起责任。似乎没有什么计划。
        Except there is one. The problem is that relatively few countries are paying much attention to it.
        Fifteen years ago, the World Health Organization undertook a major revision of the International Health Regulations, the global framework for responding to outbreaks. The revision was intended to correct flaws in the global response to the 2003 SARS outbreak, which killed hundreds of people and pushed advanced health care systems to the breaking point.        15年前,世卫组织对疫情的全球应对行动框架《国际卫生条例》(International Health Regulations)进行了重大修订,旨在纠正全球在2003年SARS疫情中的反应缺陷,那次疫情造成了数百人死亡,并将多个先进的卫生保健系统推向了崩溃的边缘。
        The basic idea was that the W.H.O. would serve as a central coordinating body. Countries would notify the agency about outbreaks and share information to help scientists address an epidemic at the global level. The W.H.O. would coordinate efforts on containment, declare emergencies and make recommendations. The revised regulation is legally binding and has been signed by 196 countries, including the United States.        当时的基本想法是,世卫组织将作为一个中央协调机构。各国将向该机构通报疫情并分享信息,以帮助科学家在全球范围应对流行病。世卫组织将协调遏制工作,宣布紧急事件并给出建议。修订后的条例具有法律约束力,并且已由196个国家签署,包括美国。
        But dozens of countries are flouting the international regulations and snubbing their obligations. Some have failed to report outbreaks to the organization, as required. Others have instituted international travel restrictions, against the advice of the W.H.O., and without notifying global health officials.        但是,有数十个国家公然藐视该条例并且无视义务。有些国家未能按要求向世卫组织报告疫情。还有国家不顾世卫组织的建议,颁布国际旅行限制,并未通知全球卫生官员。
        “One of the biggest challenges we face is that too many affected countries are still not sharing data with W.H.O.,” Dr. Tedros said last month. He has also blamed some countries — he has refused to specify which ones — for failing to take the outbreak seriously enough.        谭德塞上个月表示:“我们面临的最大的挑战之一,就是太多受疫情影响的国家仍未与世卫组织共享数据。”他还批评一些国家未能足够认真地对待疫情,但拒绝点出是哪些国家。
        As part of the United Nations, the W.H.O. is broadly influential yet hampered by budget and political pressures. It lacks meaningful enforcement authority, creating a telling power imbalance. It is often accused of kowtowing to its donors — from powerful players like the United States and China to private funders like the Gates Foundation.        作为联合国的一部分,世卫组织具有广泛的影响力,但受到预算和政治压力的阻碍。它缺乏有意义的执法权,造成了明显的权力不平衡。人们经常指责它屈从于捐助者——从美国和中国这样的大国到盖茨基金会(Gates Foundation)这样的私人出资者。
        These contradictions contributed to the agency’s much-criticized response to the Ebola outbreak in West Africa and led some scholars to question the need for such a weak institution. But Rebecca Katz, a scholar at Georgetown University, said such criticism misses a fundamental point.        这些矛盾导致该机构在西非埃博拉病毒疫情的应对上遭致广泛批评,一些学者甚至质疑如此软弱的机构是否有必要存在。但是乔治城大学(Georgetown University)的学者丽贝卡·卡兹(Rebecca Katz)表示,这种批评忽略了一个基本点。
        “If there wasn’t a W.H.O., you’d have to invent it,” said Dr. Katz, who has studied health regulations for more than a decade. “They are in a bit of a tough spot because you know you have international law but then you also know that every nation is sovereign,” she said.        “如果没有世卫组织,你还是得创造一个出来,”从事卫生法规研究十多年的卡兹说。她说:“他们现在处境艰难,因为你知道你有国际法,但同时你也知道每个国家都是主权国家。”
        This time, some former critics credit the W.H.O. for doing a better job, declaring a global emergency much quicker than it did during the SARS and Ebola outbreaks, consistently sharing information with the public and convening more than 300 scientists and research funders to help develop tests, vaccines and medicines.        一些曾经持批评态度的人,这一次称赞世卫组织的工作有进步,与SARS和埃博拉疫情相比,它更加快速地宣布全球进入紧急情况,不断与公众分享信息,并召集300多名科学家和研究资助者来帮忙开发检测手段、疫苗和药物。
        Even so, the agency is also marginalized in many ways.        即便如此,世卫组织在许多方面仍被边缘化。
        The most obvious examples are the global flouting of international travel restrictions. More than 70 countries have instituted the restrictions, according to the W.H.O., including the United States, where President Trump announced on Wednesday night restrictions to travel from the European continent.        最明显的例子就是全球肆意发布国际旅行限制。世卫组织表示,超过70个国家实施了限制,其中包括美国——特朗普总统周三晚间宣布限制来自欧洲大陆的旅行。
        Yet in four advisories it has issued since early January, the W.H.O. has consistently advised against them, cautioning that limits on international movement during public health emergencies are unlikely to stop the pathogen’s spread.        然而,自1月初以来,世卫组织已经发布了四份警告,一直反对这种做法,并警告,在出现突发公共卫生事件时限制国际流动不太可能阻止病原体的传播。
        The rules do not apply to domestic travel restrictions or to decisions made by private airlines, but the W.H.O. has repeatedly warned that international bans can block needed resources, or delay aid and technical support. Such restrictions are justified only at the beginning of an outbreak to buy nations time to prepare, the agency said. Beyond that, they are more likely to cause significant economic and social harm.        这些规定并不适用于国内旅行限制或私人航空公司的决定,但世卫组织一再警告,国际禁令可能会阻碍所需资源的运输,或延误援助和技术支持。世卫组织说,这种限制只有在疫情开始时才合理,以便为各国争取时间做准备。除此之外,它们更有可能造成重大的经济和社会危害。
        Meanwhile, only 45 of the more than 70 countries that have adopted international travel restrictions have fulfilled the requirement to report their actions to the agency, a spokesman said.        一名发言人说,与此同时,在实行国际旅行限制的70多个国家中,只有45个国家做到了向该机构报告其行动的要求。
        Then there is the unwillingness of some countries to lift a ban on the export of protective equipment, complicating the broader fight against the disease. France and Germany have put limits on exports of such gear.
        “We can understand that governments have a primary responsibility to their own health workers,” said Michael Ryan, who heads the W.H.O.’s health emergencies program.        “我们可以理解,政府对本国的卫生工作者负有首要责任,”领导世卫组织卫生应急计划的迈克尔·瑞安(Michael Ryan)说。
        He urged nations to stop hoarding gear and called for solidarity across the globe.        他敦促各国停止囤积物资,并呼吁全球团结一致。
        “The life of a health worker in one country is certainly as valued as the life of a health worker in another,” Dr. Ryan said on Monday.        “一个国家卫生工作者的生命与另一个国家卫生工作者的生命同样受到重视,”瑞安博士于周一说。
        The national governments that signed onto the international regulation also left themselves a loophole, which they are exploiting now.        签署国际规则的国家政府给自己留了一个漏洞,他们现在正在利用它。
        The loophole was the product of hours of negotiations in Geneva, where the revisions were finalized in 2005, according to Gian Luca Burci, who served as the agency’s legal counsel for 11 years. Mr. Burci said negotiators stayed up until 5 a.m. before agreeing on a trade-off that balanced “public health considerations and the retention of the ultimate political power.”        曾任世卫组织法律顾问11年的吉恩·卢卡·伯奇(Gian Luca Burci)表示,这个漏洞是2005年该协议修订工作在日内瓦敲定期间经数小时谈判的结果。伯奇说,谈判代表们一直呆到凌晨5点,然后才达成一项折衷协议,在“公共卫生考虑和保留最终政治权力”之间取得平衡。
        Countries were reluctant to cede total control to an international agency. They drafted a provision that gave them the right to take health measures that they believed would have similar or better results than W.H.O. recommendations — on the premise that these measures were scientifically grounded and for the common good.        各国不愿将全部控制权交给一个国际机构。他们起草了一项条款,赋予各国权利,可以采取他们认为效果会与世卫组织的建议相似或更好的健康措施——前提是这些措施是基于科学的基础上,而且是为了共同的利益。
        “States gave themselves a ‘get-out-of-jail-free’ card,” Mr. Burci said.        “各国给了自己一张‘出狱卡’,”伯奇说。
        Under the rules, countries are obligated to report to the health agency within 48 hours any measures that they take beyond the collective guidelines, as well as report the rationale behind their actions. Many countries have failed to do so during the coronavirus outbreak, and the W.H.O. can do little about it.        根据这些规则,各国有义务在48小时内向世卫组织报告它们在集体准则之外采取的任何措施,并报告相关理由。在冠状病毒爆发期间,许多国家未能做到这一点,世卫组织对此也无能为力。
        In some cases, W.H.O. officials learned of travel shutdowns only after they happened, from reports in the media.        在某些情况下,世卫组织官员是在旅行关闭发生后才从媒体报道中得知这一消息的。
        “What do we really mean if nobody is following W.H.O.’s recommendation with impunity,” Mr. Burci asked.        “如果没有人听从世界卫生组织,那我们有什么意义呢?”伯奇问。
        Because they have no power to enforce international regulations, W.H.O. officials have to walk a diplomatic tightrope. In a statement, a W.H.O. spokesman said that the agency “cannot compel countries to change measures they have implemented.”        由于世卫组织官员没有权力执行国际规定,他们不得不在外交上走钢丝。世卫组织的一名发言人在一份声明中表示,该机构“不能强迫各国改变他们已经实施的措施”。
        Last month, Dr. Tedros sent two letters, which have not been made public, reminding nations about their obligations. His staff has collated media reports on the flurry of travel restrictions and is chasing after countries to obtain their rationale.        上个月,谭德塞博士发出了两封目前尚未公开的信件,提醒各国注意自己的义务。他的工作人员整理了媒体对一系列旅行限制的报道,并在追踪各国,听取它们的理由。
        Agency officials have resisted naming and shaming countries that breach the rules and have largely dodged media questions on the subject.        该机构的官员拒绝点名批评违反规定的国家,并在很大程度上回避了媒体在这个问题上的提问。

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