英国卫报:一万亿美元能治愈所有疾病吗?(4)（在线收听）

The team hammers out four key messages. First, the economic argument that is most likely to be repeated in the corridors of power: the returns from investment in healthcare are big.

该团队敲定了四条关键信息。首先，最有可能在权力走廊里重复的经济论点是：医疗投资的回报很高。

By avoiding long periods of poor health, we increase the value of additional life years (VALYs, in healthcare acronym jargon),

通过避免长期不佳的健康状况，我们增加了额外寿命年的价值(医疗保健术语缩写为VALYs)，

which generates an economic return that outweighs the healthcare investment we've put in by a factor of between nine and 20.

从而产生的经济回报比我们投入的医疗保健投资多出9到20倍。

It's striking that spending what seems like a huge sum of money will often deliver big economic returns.

花一大笔钱通常会带来巨大的经济回报，这一点令人吃惊。

The second point is that the convergence is achievable in less than a generation.

第二点是，这种趋同在不到一代人的时间内就可以实现。

Presumably this means that investors can look to make money relatively quickly, too.

这大概意味着投资者也可以相对快速地赚钱。

Governments can be confident of balancing their books fairly soon after a large initial outlay.

政府有信心在一大笔初始支出之后很快就能平衡收支。

To be able to see an effect in a matter of years helps turn the convergence from a vision document to actionable policy.

能够在几年时间内看到效果有助于将这种趋同从一纸愿景文件转变为可行动的政策。

The third point is that governments are underusing fiscal policies in healthcare.

第三点是，政府在医疗保健方面没有充分利用财政政策。

In other words, by increasing the tax on tobacco and alcohol, deaths from noncommunicable diseases and from injuries can be sharply reduced in low- and middle-income countries.

换句话说，通过提高对烟草和酒精的征税，中低收入国家可大幅减少非传染性疾病和伤害造成的死亡。

For example, a 50% price increase in cigarettes in China would prevent 20 million deaths and produce tax revenue of $20bn annually in the next 50 years.

例如，中国香烟价格上涨50%，将在未来50年防止2000万人死亡，并每年产生200亿美元的税收。

The same price increase over the same time period in India would save 4 million lives and bring in an extra $2bn a year in tax.

在同一时期内，印度同样的价格上涨将挽救400万人的生命，并带来每年20亿美元的额外税收。

Reducing the subsidies paid to fossil fuel companies also has the effect of improving general health, mostly through the reduction in respiratory diseases.

减少对化石燃料公司的补贴也有改善总体健康的效果，主要是通过减少呼吸道疾病。

But it's the fourth point that is most important for us: that universal healthcare is the most efficient way to achieve a convergence in global health.

但第四点对我们来说是最重要的：全民医疗是实现全球卫生一体化最有效的方式。

The Lancet's framework was written before Covid-19, but the response of various countries to the crisis shows that universal healthcare is a good protector for pandemics, too.

《柳叶刀》的框架是在新冠爆发之前编写的，但各国对危机的反应表明全民医疗也是预防大流行的良好屏障。

Jeremy Farrar is director of the Wellcome Trust, one of the world's largest medical research charities, with an endowment of about ￡30bn.

维康信托基金会世界上最大的医学研究慈善机构之一，捐款达300亿英镑，杰里米·法勒是维康信托基金会的负责人。

As someone with experience of problem-solving in global health, he is well placed to advise us on how to spend the trillion dollars.

作为一个在解决全球卫生问题方面经验丰富的人，他完全有资格就如何花费这万亿美元提出建议。

"The bedrock of your spending must be on universal healthcare," he told me.

“你的支出必须以全民医保为基础，”他告诉我。

An equitable system of healthcare is necessary to improve maternal health, child health, to improve end of life care and to fight epidemics.

一个公平的医疗保健系统对于改善孕产妇健康、儿童健康、改善临终护理和抗击流行病是必要的。

"Almost anything else is not equitable, not efficient and will not deliver what you need sustainably."

“其他几乎所有东西都是不公平的、低效的，也无法提供你可持续需要的东西。”