比尔盖茨谈论对抗疟疾武器：让蚊帐覆盖整个国家

8月18日消息 比尔盖茨官方微信号发布了新的盖茨笔记，获悉，在文章中，比尔盖茨表示，蚊帐是一种非常简单的工具，但事实证明它是我们对抗疟疾最有效的武器之一。增长的蚊帐使用率，很大程度上帮助将全球疟疾死亡自2000年以来降低了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.

如果你曾经去过疟疾或其他蚊媒传染病肆虐的地区，你当时很可能睡在蚊帐里面。

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.

这种薄纱织物可以形成一道物理屏障，保护人们免受蚊虫的叮咬。与此同时，你也充当了一个致命陷阱的诱饵。经过强力杀虫剂处理的蚊帐，可以在蚊子落在上面想要叮咬你时置其于死地。

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.

这是一种非常简单的工具，但事实证明它是我们对抗疟疾最有效的武器之一。增长的蚊帐使用率，很大程度上帮助将全球疟疾死亡自 2000 年以来降低了 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，我们仍然需要做更多工作，以确保生活在疟疾高风险地区的人们能够获得蚊帐。因此，我激动地得知贝宁政府今年推出了一种新的、独创的蚊帐分发方式。

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.

利用智能手机、实时数据采集、卫星测绘和其他监测技术，贝宁的蚊帐分发项目将向卫生官员提供其所需要的数据，确保提供覆盖全国的蚊帐分配网络。

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.

贝宁是世界上受疟疾影响最严重的国家之一。这个拥有近 1200 万人口的西非国家每年有大约 200 万例疟疾病例。一旦成功，这一新的蚊帐分发项目将挽救数千条生命，并为其他疟疾高负担国家提供了一个效仿的蓝图。

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，向每一户居民分发蚊帐是一项浩大的后勤工程，涉及到数千参与者——从卡车司机到卫生工作者。在确切人口数都不确定的贝宁，实施这一工程甚至更加艰辛。

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.

多年来，贝宁的蚊帐分发工作都基于用铅笔在纸上写字的系统。卫生官员使用厚厚的账本来记录居民的姓名和地址，以及他们需要多少蚊帐。这项工作不仅耗时，而且常常不准确。没人确切知道到底需要多少顶蚊帐，抑或这些蚊帐是否到达了预定的目的地。其结果是，许多家庭在分发过程中被遗漏了，使得他们由于缺乏蚊帐的保护而面临更高的疟疾风险。

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.

但是今年的分发工作有所不同。在同天主教救济会及我们基金会的合作中，贝宁的全国疟疾防治项目创建了一个全新的数字化分发系统，从而更准确、更有效地将蚊帐送到全国所有居民的家中。

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.

从许多方面来看，这项工作都是基于全球健康界在同脊髓灰质炎的斗争中得到的经验。当疫苗接种员想要在印度和尼日利亚为每一个孩子接种脊灰疫苗时，他们有时会遗漏一些居民，尤其是那些偏远地区的家庭。但通过卫星测绘和更好的数据采集，卫生工作者能够迅速地发现免疫覆盖缺口，并使接种服务触达每一户居民。

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.

贝宁新型蚊帐分发系统的运转方式大体相同。卫生工作者在全国挨家挨户走访，通过一个简短的调查来记录每户的人口数（包括儿童和孕妇的人数），以及所需要的蚊帐数量等等。他们使用手机将这些信息录入数据库。他们还会给每户居民一张具有唯一编码的代金券，用来在附近的分发中心领取他们的蚊帐。

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.

在分发当天，人们前来领取他们的蚊帐，并接受正确使用和维护蚊帐的培训。当人们到达分发中心用代金券兑换蚊帐时，疟疾小组就能获得关于哪些家庭领取了蚊帐而哪些没领的实时数据。这些可以在一张数字地图上查阅的数据，使疟疾小组得以快速发现配送系统的任何问题。这些数据还为卫生工作者提供了详细的信息，关于哪些家庭需要针对性的跟进，以确保他们都有蚊帐可用。

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.

我承认我刚才描述的这些方法听起来都不那么具有革命性。但在全球健康领域，我一次又一次地认识到，挽救生命正是把最小的细节做对之后取得的结果——这些细节从疫苗的温度到受益人的地址。而贝宁的新型数字化蚊帐分发项目恰好做到了这一点，实现途径是为政府提供了一个强大的工具来管理一项复杂的工作。

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.

有了这个新型数字化分发系统，贝宁可以用其作为一个平台来管理其他大型卫生项目，例如脑膜炎疫苗接种和挨家挨户消灭被忽视的热带病的工作。

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.

我期待听到更多关于贝宁得益于这个新系统而在抗击疟疾及其他疾病中取得的进展，我也希望其他国家能从贝宁的成功中得到启发。