When 90-year-old Margaret Keenan received the world's first clinically authorized and tested Covid-19 vaccine, the end of the Covid-19 pandemic seemed finally in reach.
当90岁的玛格丽特·基南接种了世界上第一支通过临床认证和测试的疫苗时，新冠疫情的末日似乎总算来临了。
The rollout of the first vaccine in record time and the likely imminent approvals of others, is a turning point for wealthy countries that can afford vaccines.
But for public health officials in the developing world, it is a harsh reminder that the race to end this deadly pandemic will separate the world's haves and the have-nots.
对于买得起疫苗的发达国家来说，创下历史记录的首支新冠肺炎疫苗和未来即将获批的其它疫苗是一个转折点。但对于发展中国家的公共卫生官员来说，这却是一个残酷的提醒，提醒着他们以结束疫情为目的的疫苗竞赛将会在富人和穷人之间划清界限。
发达国家被控囤积疫苗、发展中国家回忆起痛苦的歧视历史，“全球团结一致”一词听上去充满讽刺。
Rich countries have been on a vaccine shopping spree for months. A continuously updated database compiled by the Duke Global Health Innovation Center shows bilateral deals worth billions of dollars by a handful of countries for emerging vaccines.
几个月来，发达国家一直在疯狂购入疫苗。杜克大学全球健康创新中心的实时数据显示，一些国家已经就新兴疫苗达成了数十亿美元的双边交易。
Several countries and regional blocks have preordered vaccines that could cover far more than their entire populations. The People's Vaccine Alliance, an international vaccine watchdog, said this past week that rich countries have bought enough Covid-19 vaccine doses to immunize their populations three times over.
部分国家和地区组织已经预购了数量远超其总人口的疫苗。国际疫苗监督组织，人类疫苗联盟表示，发达国家购买的疫苗数量足以让其所有人口接种三次。
The Canadian government alone has secured enough inoculations to vaccinate their citizens five or even six times over, though not all the vaccine candidates it preordered may be approved for usage.
加拿大政府预购的疫苗足够为其国民接种五到六次，虽然不是所有预购疫苗都保证能获得使用批准。
The Alliance's data shows that while the world's wealthiest nations are snapping up deals, nearly 70 poor countries will only be able to vaccinate one in 10 people at best during 2021.
人类疫苗联盟的数据显示，在世界上最富裕的国家疯抢疫苗的时候，将近70个贫困国家的人口中只有十分之一能在明年接种上疫苗。
"It is disappointing that despite the intent to get equity across the globe, that vaccine nationalism rules supreme," said the University of Cape Town's Professor Gregory Hussey, who is on the ministerial committee to advise the South African government on access to a Covid-19 vaccine.
开普敦大学教授Gregory Hussey是负责为南非政府提供新冠肺炎疫苗建议的委员会成员，他说：“令人失望的是，尽管各国都有在全球范围内保持公平的意向，但疫苗民族主义仍然声势浩大。”
Speaking to CNN on Thursday, the head of the Africa Centres for Disease Control and Prevention John Nkengasong said the inability for poorer countries to access vaccines would be "catastrophic."
非洲疾病控制与预防中心负责人John Nkengasong 接受CNN采访时表示，贫困国家得不到疫苗将会面临“长期停摆、经济滑坡”的严重威胁。
"The moment that we have all talked about, of global solidarity and global cooperation, is now. The litmus test is actually now. It makes absolutely no moral sense to have excess doses of vaccines in certain countries and absolutely no doses of vaccines in other areas of the world," he said.
他说：“现在，就是我们一直在讨论的全球团结与全球合作的时刻。现在就是测试真伪的时候。一些国家超量接种疫苗，而另一些国家却无疫苗可接种，这没有道义可言。”
As the novel coronavirus ripped through countries and filled up hospitals earlier this year, a global effort emerged to roll out eventual vaccines for everyone.
今年年初，新冠病毒在各国肆虐，医院里挤满了感染者。为了让所有人最终都能接种上疫苗，当时各国达成一项全球合作。
The compact is called COVAX and is led by Gavi, the Vaccine Alliance. It is a global initiative co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI), and WHO that brings together governments and manufacturers to ensure COVID-19 vaccines reach everyone, no matter how rich or poor, no matter where they live. It runs on two tracks. High and middle-income countries have committed substantial funding to ensure access to vaccines and vaccine manufacturing in an equitable fashion. Poorer countries, mostly on the African continent, have signed up to a separate COVAX facility to secure vaccines. These vaccines will be funded by development agencies and donations from groups like the Bill and Melinda Gates foundation.
疫苗联盟Gavi牵头达成了一项协议，被称为COVAX。
这是由免疫联盟（Gavi）、防疫创新联盟（CEPI）和世卫组织（WHO）共同领导的一项任务，将各国政府和制造商聚集在一起，以确保新冠疫苗普及到每个人身上，无论贫富与地域。该项协议双管齐下。高收入与中等收入国家承诺提供大量资金，以确保未来本国能公平地获得疫苗和生产技术。而以非洲国家为主的贫困国家则签署了一项独立的COVAX来保证本国能获得疫苗。发展机构和比尔与梅琳达·盖茨基金会等团体将捐款资助贫困国家的疫苗。
So far, 189 countries and territories have signed up to the two facilities. Notably absent are the United States and Russia.
目前，已有189个国家和组织签署了这两项协议。而值得注意的是，美国与俄罗斯没有加入。
This past week Dr. Anthony Fauci, the top US infectious diseases expert who said he was speaking in his personal capacity, stated that his country has a "moral responsibility" to ensure that Covid-19 vaccines are fairly distributed, contradicting the outgoing President Donald Trump's largely symbolic executive order calling for Americans to get vaccines first.
上周，美国首席传染病专家安东尼·福奇（Anthony Fauci）博士以个人名义表示，美国有确保新冠病毒疫苗得到公平分配的“道义责任”，这与特朗普的想法背道而驰。特朗普正试图通过行政命令让美国人获得接种疫苗优先权。
Equitable access to vaccines isn't necessarily just an issue of money. A spokesperson for Gavi said the alliance has raised more than $2 billion to purchase vaccines for the poorest countries and needs to raise more than $5 billion by the end of next year.
公平疫苗分发不一定只是钱的问题。免疫联盟表示该组织已经筹集了20多亿美元为最贫穷的国家购买疫苗，目标是在明年年底之前筹集到50亿美元以上的资金。
"Our priority remains to secure the financing needed to ensure these countries receive rapid access to Covid-19 vaccine candidates through the COVAX Facility," the spokesperson told CNN.
免疫联盟发言人在接受CNN采访时表示：“我们的首要任务是获得资金，以确保这些国家能够通过COVAX迅速获得候选疫苗。”
And key contributors to COVAX, like the EU, UK, and Canada, have done some of the largest bilateral deals with pharmaceutical companies. The People's Vaccine Alliance argues that these deals could undermine the COVAX pact they have been funding.
而COVAX的主要出资群体，如欧州、英国和加拿大，已经与制药公司达成了部分最大的双边协议。人民疫苗联盟认为，这些交易可能会破坏他们一直资助的COVAX项目。
In fact, Canada is one of the largest donors to the COVAX program to allow equitable access to poorer countries.
事实上，加拿大是COVAX计划的最大捐助国之一，该计划旨在让贫困国家公平地获得机会。
In an interview on Friday, Canada's Minister of International Development Karina Gould said her country needed to hedge its bets because most vaccines are still in development and thus only theoretical.
加拿大国际发展部部长古尔德（Karina Gould）周五在接受采访时表示，加拿大需要抓住更多的、不同的疫苗机会。
"We have entered into agreements with a number of different vaccine companies, just like the COVAX facility is doing, recognizing that not all of these vaccines might be successful," she said, adding that the government is committed to equitable and affordable access to the vaccine.
“我们已经和许多不同的疫苗公司签订了协议，就像COVAX一样，知道并非所有疫苗都可能成功，”她补充说，由于大多数疫苗仍在研发中，政府需要尽力找到对市民公平和负担得起的疫苗。
"We are not a country that is isolated from the world. We have friends and family and business partners in every region of the world. We could just vaccinate Canadians and make them safe, but we don't want to be disconnected from the world," Gould said.
“我们并非一个与世隔绝的国家。我们在世界各地都有朋友、家人和商业伙伴。我们可以优先给加拿大人疫苗，但我们不想与世界脱节，”古尔德说。
Dr. Richard Mihingo, the coordinator of Immunization and Vaccine Development at the World Health Organization (WHO) Africa region, said he understood that countries needed to ensure that their own citizens get vaccinated. He called the bilateral deals a "sad reality."
世界卫生组织（WHO）非洲地区免疫和疫苗开发协调员Richard Mihingo博士说，他理解各国需要确保本国公民接种疫苗。他称双边协议是“可悲的现实”。
"It is one thing to raise money, it is another to get access to the product. The funding is not enough if there is no supply. This complicates the situation," he said.
“筹集资金是一回事，获得疫苗是另一回事。如果没有供应资源，资金就不够。这使情况变得更复杂。”
The goal of WHO is to vaccinate 20% of the population in the Africa region by the end of 2021, but more meaningful coverage could take two to three years.
世卫组织的目标是2021年底为非洲地区20%的人口接种疫苗，但想要让更多人得到接种机会可能需要2至3年的时间。
这些钱都不能解决的问题，钱不能缩小特权阶层和穷人之间的差距。
African public health officials and scientists still remember the years-long tooth-and-nail fight to access life-saving drugs to combat HIV/Aids long after they were available in the West. More recently, despite similar talk of solidarity, the H1N1 flu vaccine arrived on the continent months after the peak of the epidemic in 2009.
非洲的公共卫生官员和科学家们至今还记得，在西方国家获得艾滋病毒疫苗后，非洲依然为了拿到疫苗苦苦挣扎了许多年。最近，尽管有类似的团结一致的言论，但H1N1流感疫苗在2009年疫情高峰几个月后才抵达非洲大陆。
Hussey believes that the Covid-19 vaccine debate will revive these painful memories. "This is not a new phenomenon. It has played itself out many times in the past," he said.
侯赛因认为，关于Covid-19疫苗的辩论将唤起这些痛苦的记忆。“历史重演，我一点都不惊讶。”
There are numerous other historical and contemporary examples of life-saving drugs made available to the wealthy but not to the poor.
无论是历史还是现在，许多其他的例子表明，重要的药物都是面向富人而不是贫困群体。
If the moral argument can't win over solidarity, officials on the continent hope the public health argument will do so. Stamping out Covid-19 everywhere is an epidemiological necessity. "Until everybody is protected, nobody can be safe. We are living in an interconnected world and even if those countries can protect themselves, they will be living on an island. We need a world where we can interact. Not just socially, but economically," Mihingo said.
如果光靠论述道德无法得到世界的团结一致，那么非洲的官员们便会寄希望于靠论述公众健康来达成。根据流行病学理论，在所有地方根除新冠病毒是必要的。“在所有人都能被保护到之前，没有人是安全的。我们生活在一个紧密联系的世界里。即使有些国家能自保，它们也将被迫与外界隔离。我们需要一个能相互沟通交流的世界，并且这一交流不光是社交上的，还应是经济上的。”米辛戈说到。
The long-term impact of any vaccination lag in poor countries will widen global inequalities, he believes. Mihingo said that as rich countries vaccinate their citizens, it is likely that vaccine passports will become necessary for travel, study and commerce. This has already been tested by the Australian airline Qantas.
米辛戈相信，贫穷国家疫苗短缺的问题如果持续下去将加剧贫富分化。富有的国家将给公民注射疫苗，而注射过新冠疫苗有可能成为前往当地进行旅行，学习和商贸的前提，这一规定已经在澳洲航空那开始试点了。
It would be just one way that developing countries could be locked out as the rest of the world opens up. "It reminds me of the old apartheid days where a black African needed a pass to get out of his ghetto and get into the city. The notion of no one left behind, it is a lot of balderdash at the end of the day," Hussey, the University of Cape Town's professor, said.
这一影响最后有可能使发展中国家被迫封锁全国而剩下的发达国家可以毫无顾虑地开放国门。开普敦大学的教授胡塞对此评论道：“这让我回想起了种族隔离时期，那时候黑人就像这样需要许可才能出贫民窟到市区去。‘一个人都不会掉队’的承诺到头来还是空头支票。”
这种关于不让任何人掉队的话都是说的好听，但在做决定时，富国总是拥有优先资格。
Despite the extreme squeeze on vaccine supply, the goal of COVAX is to deliver nearly 1 billion vaccine doses to lower-income countries by the end of 2021. Public health officials who spoke to CNN hope that wealthy countries will shift their unused orders into COVAX. Gould said it's too early to make those assurances, but that the Canadian government is in active discussions with COVAX on what a donation mechanism would look like.
尽管疫苗供应急剧缩减，COVAX的目标仍是在2021年前向低收入国家投放近10亿支疫苗。公共卫生健康官员希望富有的国家能将他们未使用的订单转交给COVAX。古尔德认为现在做出承诺还为时尚早，但是加拿大政府正在积极地与COVAX商讨捐赠机制。
Even if vaccines are shared, not all of them are suitable for low-income countries. The Pfizer/BioNTech and the Moderna vaccines are expensive and require extreme cold storage, a challenge for countries with limited health infrastructure. The Chinese Sinopharm vaccine efficacy data is yet to be shared publicly, but Chinese officials are pushing it hard as a possible solution for low-income countries. And while Johnson and Johnson has done a deal with South African pharmaceutical company Aspen Pharmacare to manufacture its vaccine, there is no guarantee those doses will go to the continent.
即使疫苗被分享了，也并不是所有的疫苗都适合低收入国家。辉瑞和摩德纳的疫苗很贵并且冷藏条件很苛刻，这不利于健康设施不完善的国家储存。中国政府正努力让国药集团的疫苗成为低收入国家的可选之一，但其还没有到能公开分享的阶段。除此之外，虽然强生已经与南非制药公司阿斯彭达成生产疫苗的协议，生产的疫苗会不会全部输入非洲还不得而知。
Perhaps the most promising early solution for low-income countries is the University of Oxford vaccine, the only one to date to have its efficacy and safety peer-reviewed. The vaccine can be transported using basic refrigeration and 1 billion doses of the vaccine will be manufactured by the Serum institute in India and should be provided at manufacturing cost to poorer countries through COVAX.
也许对于低收入国家来说，前期最好的选择是牛津大学研发的疫苗——迄今为止唯一一个疗效和安全性都得到评估的疫苗。该疫苗在基本冷藏条件下就能运输，并且印度的血清研究所将负责量产10亿支该疫苗，将它们通过COVAX以成本价卖给贫穷国家。
Despite those commitments, billions more doses of the Oxford vaccine have already been committed elsewhere through bilateral deals. Mihingo says the next few months will be critical to ensure that most of the world's population isn't left behind in the biggest vaccination drive of our time -- for everyone's sake. "We must provide the minimum supply to low-income countries to ensure they can not only protect the lives of the most vulnerable, but also open up to opportunities to commerce and help lift themselves out of poverty," he said.、
然而，尽管有这些承诺，还是有几十亿支牛津疫苗通过双边协议输送给了其他地方。米辛戈认为接下来几个月至关重要，它将决定在这场人类史上最大的，为了所有人的疫苗接种运动里，世界绝大部分人是否能被普惠到。“我们无论如何都要给低收入国家提供一定量的疫苗，只有这样这些国家的易感人群才能得到保护，也只有这样这些国家的对外贸易往来才能重启从而振兴当地经济。
编译 | 李家蕊 李翱 曹金杰
排版 | 曹金杰
