陈冯富珍在世卫组织和世界银行全民健康覆盖部长级会议开幕式上的讲话（中英对照）

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在世卫组织和世界银行全民健康覆盖部长级会议开幕式上的讲话

Dr Margaret Chan, Director-General of the World Health Organization

世卫组织总干事陈冯富珍博士

Geneva, Switzerland

瑞士日内瓦

18 February 2013

2013年2月18日

Excellencies, honourable ministers, colleagues from the World Bank, ladies and gentlemen,

诸位阁下、各位部长、世界银行的同事们、女士们、先生们：

The goal of moving towards universal health coverage is gaining support, sometimes very enthusiastic support, often very high-level support.

实现全民健康覆盖的目标是赢得支持，有些时候我们需要非常热情的支持，而且往往需要非常高级别的支持。

Since publication of the 2010 World health report on health system financing, more than 70 developing countries have requested WHO technical support for their plans to move towards universal coverage. The online edition of that report has been downloaded, either in summary or full-text version, more than 640 000 times.

自从出版有关卫生系统筹资的2010年《世界卫生报告》以来，已经有70多个发展中国家请求世卫组织为其实现全民健康覆盖的计划提供技术支持。该报告在线版本的全文和摘要已经被下载64万余次。

Countries that have already reached the goal are sharing their experiences. They are singing some praises. But they are also making it clear: This is a struggle. It takes time. It takes unwavering political commitment at the highest level of government.

已经实现目标的国家正在分享其经验。他们在唱赞歌。但同时，他们也清楚地认识到：这是一场斗争；获胜需要时间，需要政府最高级别做出毫不动摇的政治承诺。

Last September, I participated in the launch of a Lancet series on universal health coverage. Papers in that series show the positive impact of universal coverage on health outcomes.

去年九月，我参加了《柳叶刀》杂志全民健康覆盖主题专刊的发布。该刊所发表的论文表明，全民覆盖对健康结果有积极影响。

They explore the transition to universal coverage in its political and economic dimensions, and offer lessons about how health financing reforms have been enacted in a number of lower income countries. Commentaries in the series offer a big-picture view of the historical significance of what is now perceived to be a movement.

论文探讨了向全民健康覆盖过渡的政治经济特征，总结了一些收入较低国家进行卫生筹资改革的经验教训。该专刊的论文点评则从整体上讨论了当前这项运动的历史重要性。

It is extremely helpful to have a respected economist, like Jeffrey Sachs, argue strongly against what he calls “lazy thinking”. This thinking assumes that user fees will reduce overconsumption of health services or increase their value in the user’s eyes. Not true. User fees punish the poor.

像杰弗里•萨克斯这样受人尊敬的经济学家强烈反对“懒人思维”，这一点对我们也很有帮助。按照懒人思维，向使用者收费可以减少过度消费卫生服务或增加卫生服务在使用者眼中的价值。这种想法不正确。向使用者收费会惩罚穷人。

Here is another warning. Health financing reforms are just one part of the picture. Health insurance raises public expectations. People expect ready access to medicines and services, and they want quality. They want care from people who care about them.

我这里还有另外一个警告。卫生筹资改革只是大局的一部分。医疗保险提升公众预期。人们期望随时获得药物和服务，还得是高质量的。他们希望从关心自己的人那里获得服务。

A commitment to universal coverage means meeting these expectations as well. Don’t punish the poor, but don’t disappoint them either.

全民覆盖承诺也就是要满足这些期望。不要惩罚穷人，也不要令其失望。

Also last year, the United Nations General Assembly adopted a resolution that endorsed the goal of universal health care and gave it a high place on the global health agenda.

去年，联合国大会通过决议，支持全民保健目标，并将其作为全球卫生议程的重点。

The resolution was sponsored by more than 90 countries, from every corner of the globe, and adopted by consensus. In a move described by some as “momentous”, the resolution urges member states to develop health systems that avoid significant direct payments at the point of care.

该决议由来自全世界各个角落的90多个国家联名提出，并以协商一致方式通过。该决议敦促会员国在发展卫生系统时避免在卫生保健点直接支付大笔资金的做法。

It further urges them to establish mechanisms for pooling risks to avoid catastrophic health expenditures that drive households into poverty. The resolution also affirms the strong links between universal coverage and the UN’s Political Declaration on the prevention and control of noncommunicable diseases.

决议呼吁各国建立风险分担机制，避免灾难性卫生支出使患者家庭陷入贫困。决议确认，全民覆盖和联合国有关预防和控制非传染性疾病的《政治宣言》之间存在强有力的联系。

And there are other links, of course. In fact, a health system designed to deliver universal care provides a solid platform for tackling all health problems, for reaching all health goals, in a fair, integrated, and efficient way.

当然还存在其它联系。事实上，旨在提供全民保健的卫生系统会成为一个坚实的平台，能够公平、综合、高效地跟踪所有卫生问题并实现所有卫生目标。

I have expressed my personal commitment to universal coverage on several occasions. I regard universal coverage as the single most powerful concept that public health has to offer.

我曾经在多个场合表示过，我个人致力于实现全民覆盖。我认为这是公共卫生领域唯一最有力的概念。

It is the best way to cement the health gains made during the previous decade. It operationalizes the highest ethical principles of public health. It is a powerful social equalizer and the ultimate expression of fairness.

它是巩固过去十年所取得的卫生成果的最佳方式。它使公共卫生的最高伦理原则得到落实。它是强大的社会均衡器，是公平的最终体现。

The recent enthusiasm for universal coverage occurs in a world in which social inequalities, in income levels, in opportunities, and in access to health care, are at the greatest levels seen in at least half a century.

当今世界，体现在收入水平、机会以及获得卫生保健服务情况等诸多方面的社会不公平已经达到了至少半个世纪以来的最高点。在这一背景下，近年来出现了对实现全民覆盖的热情。

At a time when policies in so many sectors are actually increasing social inequalities, I would be delighted to see health lead the world towards greater fairness in ways that matter to each and every person on this planet.

鉴于许多领域的政策事实上增加社会不公，我很高兴地看到，卫生部门在实现更大程度公平方面率先垂范，这与地球上每一个人都息息相关。