让每个人都有机会过上健康而富有成效的生活——访比尔及梅琳达·盖茨基金会北京代表处首席代表郑志杰

为贯彻落实中央人才工作会议精神，科技部副部长、国家外国专家局局长李萌于2022年2月25日上午主持召开外国专家座谈会。来自美国、俄罗斯、英国、法国、瑞典、印度、埃及、日本、韩国等国11位在京工作的外国专家围绕我国国际人才交流、科技管理、科研作风学风建设和科研伦理、科技成果评估、人才评价，以及开放合作创新等方面作了专题发言。就是在这次座谈会上，我见到比尔及梅琳达·盖茨基金会北京代表处首席代表郑志杰先生。会上，郑志杰作了精彩发言。会后，我跟他约了这次采访。

一次生死别离：从要救一个人到救数万万人

其实，我们的职业选择背后都有必然，尽管看起来是偶然。

“我学医的决心来自童年经历，我的小妹妹在她三岁的时候因为肠道疾病离开了人世，那是我生命中最早经历的一次离别。明明早上走的时候还是三个人，回来的时候就只剩下爸爸妈妈两个人。那种刺痛和无能为力，让我坚定了学医的想法。”在郑志杰的办公室，我们一落座，他就讲起了个人经历。郑志杰出生于浙江省临海市的一个乡村，兄弟三人，只有一个妹妹却被今天看起来很“简单”的疾病夺去了生命。这样的经历，我也有。母亲怀过9个孩子，有3个都因为那个年代的医疗匮乏而夭折。

然而，梦想就是一粒种子，只要被用心浇灌、滋养就会发芽、长大，开花、结果。带着学医的信念，郑志杰先后在上海医科大学、复旦大学、美国北卡罗来纳大学读书。但是在接触医学的过程中，他逐步了解到预防医学、公共卫生的重要作用。

In the spirit of the Chinese Central Government Conference on Talent-Related Work, Li Meng, Vice Minister of Science and Technology and Director of the State Administration of Foreign Experts, hosted a forum for foreign experts in the morning of February 25, 2022. Eleven foreign experts from the United States, Russia, the United Kingdom, France,Sweden, India, Egypt, Japan, South Korea and other countries working professionally in Beijing made presentations on international talent exchange, science and technology management, research style and ethics, assessment of scientific and technological achievements, talent evaluation, and open cooperation and innovation in China. It was at this forum that I met Dr. Zheng Zhijie, Director of China Country Office at the Bill &Melinda Gates Foundation. After I heard his fascinating presentation I realized that I had to make an appointment to speak with him.

A separation of life and death: from saving one person to saving tens of millions of people

Even though career choice may seem accidental, I suppose that there is a sort of inevitability behind all of our career choices.

For Dr. Zheng Zhijie, it would seem almost fated…

“My determination to study medicine came from my childhood experience when my younger sister passed away when she was three years old because of an intestinal disease. That was one of the first times in my life that I experienced a parting of ways, the first time I experienced death. When I left the house in the early morning, there were three of us, but when I returned, there were only two of us left with mom and dad. That stabbing pain and powerlessness made me absolutely determined to study medicine.”

From the moment we were seated in Dr. Zheng Zhijie’s office, we began to trace his life path. Zheng Zhijie was born in a rural village in Linhai City, Zhejiang Province, to a family with three brothers and one sister, an only sister who nevertheless were taken away by what today seems to be a “run of the mill” easily treatable disease. Like Dr.Zheng, my mother had nine children, three of whom also died be-cause of the poor medical care. After hearing his story I instantly felt connected to Dr. Zheng, and his aspiration.

“我经常引用美国约翰霍普金斯大学公共卫生学院的院训，院训是这样说的：临床医生一次只能救一个人，但公共卫生配合上好的政策措施，能够挽救成千上万的生命。防患于未然，这对我来说是一种天然的吸引。就好像针对腹泻，不仅需要药物，还需要干净的水源、安全的卫生设施、良好的公共环境乃至落实到人的宣传倡导，这些缺一不可。”为此，郑志杰毕业后选择从事公共卫生相关的工作。在美国疾控中心和美国国立卫生研究院工作期间，他的工作领域一直是重大疾病预防与控制体系的监测、评估和应急机制。2010年，郑志杰离开学习工作生活了21年的美国回到祖国，担任上海交通大学公共卫生学院院长。这个决定是神圣而艰难的，因为当时他的儿子才10岁，夫人因为工作、儿子因为上学不能和他回中国，从此，一家人就分隔两地。在随后的十多年里，从上海交大到北京大学，他一直在高校任职，致力于传道授业解惑。“为公共卫生领域培养更多的专业人才，这为我带来了巨大的成就感。”郑志杰儒雅的气质、从容的话语，让人感受到一种信念的力量和笃定的魅力。

作为特聘教授回国后，郑志杰一方面培养人才，一方面推动中国在全球健康、全球发展领域发挥更重要作用。比如，协助北京大学成立了北京大学全球健康与发展研究院。2021年10月25日，郑志杰接任盖茨基金会北京代表处首席代表，走上了以减少健康和发展领域不平等现象为己任、更大更新更专业的事业舞台。

“加入盖茨基金会对我而言是一个自然而然的决定。近年来，全球健康和发展与当下、与我们每个人的关系越来越紧密。在全球化时代，如何团结各方力量解决全球性问题，创建一个更加公平和健康的世界，是这个时代的重要命题。作为全球最有影响力的基金会之一，盖茨基金会扮演着十分重要而独特的角色，一方面支持创新产品和技术的开发，另一方面通过建立广泛的合作伙伴关系让这些创新能够为更多人所用，以此来推动解决最复杂和最紧迫的全球性挑战。我非常认同基金会的理念，也看到中国在这一领域的巨大潜力。这份工作让我能在一个更加广阔的全球性平台上撬动资源、激发合作，帮助更多人改善健康、过上富有成效的生活。”从一名临床医生到预防医学和公共卫生领域的专家，从一名高校教授到全球最大私人慈善基金会的重要人物，他用实际行动践行着自己最初的梦想，让更多人拥有健康、过上幸福生活。

A dream of aspiration, however, is like a seed that will sprout and grow. If it is to blossom and bear fruit, it must be watered and nourished with conviction. Determined to study medicine, Dr. Zheng studied at Shanghai Medical University, Fudan University, and the University of North Carolina in the United States. During his career and long exposure to the field of medicine, he gradually came to appreciate the important role of preventive medicine and public health.

“I often quote the vision of the Johns Hopkins School of Public Health, which says that Protecting Health, Saving Lives-Millions at a Time. Prevention is better than the cure, and that idea has always held natural attraction for me. Similar to targeting a disease like diarrhea, not only drugs are needed, but also clean water, safe sanitation facilities, a sound public environment and even human advocacy initiatives are indispensable.” For these reasons, Zheng chose to pursue a public health-related career after graduation. In 2010, Zheng left the U.S., where he had lived and studied for 21 years, to return to his homeland taking up a post as Dean of the School of Public Health at Shanghai Jiao Tong University. This was a noble and difficult decision to make because his son was only 10 years old at the time and his wife and son could accompany him in his return to China because of work and school, and since then, the family has been separated from each other. For the next 10-plus years, Zheng has served in colleges and universities, from Shanghai Jiaotong University to Peking University,where he dedicated himself to education and teaching. Zheng Zhijie’s courteous temperament and calm manner of speaking gave me a sense of how powerful his conviction is for his work that leaves one invigorated by his determination. He says that “training more professionals for careers in public health has brought me an enormous sense of accomplishment.”

Since his return to China as a National Distinguished Professor, Dr.Zheng has cultivated talent while promoting a more important role for China in the field of global health and global development. Examples include his assistance of, Peking University in establishing the Peking University Institute for Global Health and Development, and on October 25, 2021, he took over as Director of China Country Office at the Bill &Melinda Gates Foundation, thus embarking on a larger,newer, and more specialized career taking on the mission of reducing inequality in health and development.

“Joining the Gates Foundation was a natural decision for me. In recent years, global health and development have become increasingly relevant to the here and now for each of us. In the age of globalization, it is an important time to unite the forces of all to solve global problems and create a more equitable and healthy world. The Gates Foundation, as one of the world’s most influential foundations, plays a very important and unique role in supporting the development of innovative products and technologies, and in making these innovations available to more people through a wide range of partnerships,thereby contributing to solving the most complex and pressing global challenges. I strongly identify with the Foundation’s vision and see great potential for China in this area. This work allows me to leverage our resources and inspire collaboration on a broader global platform to help more people improve their health and lead productive lives.”From serving as a clinician to acting as an authority in the field of preventive medicine and public health, as well as from being a university professor to a key figure in the world’s largest private philanthropic foundation, Dr. Zheng has fulfilled his original dream to enable more people to lead happy healthy lives.

盖茨基金会与中国：促进中国和全球健康公平

比尔·盖茨在他的新书《如何预防下一次大流行》中讲了他关注传染病、关注贫困人群健康的原因，以及成立比尔及梅琳达·盖茨基金会的初衷。“我对传染病这一主题的热情可以追溯到25年前，1997年1月，当时我和梅琳达在《纽约时报》上读到尼古拉斯·克里斯托夫（Nicholas Kristof）写的一篇文章。文中提到：每年有310万人死于腹泻，而且几乎都是儿童。我们感到很震惊。每年300万儿童！怎么会有这么多孩子死于据我们所知只是导致不太舒服的疾病呢？”他带着这份“不可思议”，查阅相关资料，了解到治疗腹泻的方法非常简单，只需一种可以补充腹泻期间流失的营养的廉价液体，但是这没有惠及数百万儿童，于是他们就开始提供资助，不仅大规模地推广这种治疗方法，还率先支持研发预防腹泻的疫苗。“我们相信，在一个人人平等的世界中，所有人都应从创新中受益，没有任何一个孩子会死于可预防的疾病。但我们看到的是，不平等依然大量存在。这个发现是我们慈善之路上的重要一步。震惊之余，我们心生愤慨，并决心为此采取行动。”

2000年1月，比尔及梅琳达·盖茨基金会成立，总部设在美国西雅图。基金会于2007年成立北京代表处，2008年启动首个在华项目。此后十余年间，基金会不断扩大对华合作，项目涵盖扶贫、结核病和艾滋病防治、烟草控制、助力非洲农业发展和消除疟疾等。截至2021年年底，基金会在全球144个国家开展项目，赠款总额超过650亿美元，而妇幼健康自始至终都是其中最重要的工作领域之一。

在2月25日的外国专家座谈会上，郑志杰侃侃而谈，儒雅、持重、睿智是他给我的最深刻印象。他在发言中首先介绍了自己的经历，然后谈了盖茨基金会与中国合作的情况，以及未来合作的建议。

盖茨基金会目前在非洲有三个办公室，在欧洲和亚洲分别有两个办公室，亚洲办公室一个在中国一个在印度。郑志杰在与我的对话中再次强调：“十几年来，中国一直是基金会的重要合作伙伴。”他认为，中国在公共卫生领域取得的长足进展令人瞩目。

郑志杰说，我们一方面见证了中国在改善本国人民健康福祉方面的巨大成就，也很荣幸地参与到中国结核病、艾滋病防控，提升基础医疗水平，扩大国家免疫规划等重要领域；另一方面我们也看到中国不断加大科研投入，提升创新能力，并将新想法和新工具转化为有效的公共产品，帮助挽救了其他国家数以亿计的生命并改善了他们的生活。在这一过程中，基金会为中国合作伙伴提供资金和技术支持，并搭建国际合作的桥梁，帮助他们加速在卫生、农业和减贫领域的产品、技术和模式创新。我们也通过构建全球伙伴关系，让这些创新成果在中国和其他国家的脆弱人群中尽快得到普及。

The Gates Foundation and China: Promoting Health Equity in China and Around the World

“My passion for the subject goes back twenty-five years, to January 1997, when Melinda and I read an article inThe New York Timesby Nicholas Kristof. Nick reported that diarrhea was killing 3.1 million people every year, almost all of them children. We were shocked.Three million kids a year! How could that many children be dying from something that was, as far as we knew, little more than an uncomfortable inconvenience?" In his new book, “How to Prevent the Next Pandemic,” Bill Gates discusses his concern for infectious diseases and the health of the poor. With this seemingly inconceivable crisis in mind, he looked into the literature and learned that the cure for diarrhea was as simple as an inexpensive liquid that would replenish the nutrients lost during having diarrhea, but this treatment wasn’t reaching millions of children, so they began to provide funding, not only to promote this treatment on a large scale, but also to spearhead the development of a vaccine vaccinate against diarrhea.

The Bill & Melinda Gates Foundation was founded in January 2000 and is headquartered in Seattle, Washington, USA. In 2007, the Foundation opened its office in Beijing before launching its first program in China in 2008. Since then, the foundation as a whole has expanded its cooperation with China over the past decade, with projects covering poverty alleviation, tuberculosis, AIDS prevention,tobacco control, agricultural development in African countries, and malaria eradication.

At the Foreign Experts Symposium on February 25th, Zheng Zhijie spoke eloquently, and I was most struck by his refinement, composure,and wisdom. In his speech, he first described his experience, then discussed the Gates Foundation’s cooperation with China, and proposed suggestions for future cooperation.

The Gates Foundation currently has three offices in Africa, two in Europe and two in Asia, in China and in India. In his conversation with me, Dr. Zheng reemphasized that “China has been an important partner of the foundation for more than a decade.” He observed that China has made remarkable strides in the field of public health.

Dr. Zheng said that on the one hand, we have witnessed China’s tremendous achievements in improving the health and well-being of its people, and we are proud to be involved in such important areas as the prevention and control of tuberculosis and AIDS in China, as well as the upgrading of primary health care and the expansion of the national immunization program. On the other hand, we have watched China continue to increase its investment in scientific research,improve its capacity for innovation, and have seen new ideas and tools turn into effective public goods that have helped save and improve the lives of hundreds of millions of lives in countries around the world. In this effort, the Foundation provides financial and technical support to its Chinese partners and builds bridges for international collaboration,helping to accelerate innovation in products, technologies, models in health, agriculture and poverty reduction. Dr. Zheng also noted that the Foundation works to build global partnerships to bring these innovations to vulnerable populations in China and other countries as quickly as possible.

在中国15年，盖茨基金会主要秉持了两个策略。一个“在中国为中国”，比如关于结核病、艾滋病防控和扶贫减贫问题等。另一个是“在中国为世界”，这包括两个方面：一是支持中国为全球提供公共产品，疫苗、药物、诊断工具等。二是为了配合公共产品，支持中国成为全球健康与全球发展创新以及研发中心，成为更强、更有力的全球健康合作伙伴。“多年来，基金会与中国一起推动在非洲消除疟疾，中国在防治疟疾方面有许多的经验值得学习并推广。”郑志杰还举例说，基金会和中国在公共卫生设施改革主要是改厕、改水方面也做了大量工作。他说，单单关于厕所背后的科学和技术问题非常多，比如在缺水、缺电的情况下，在非洲和中国西部地区乡村或者家庭，如何解决厕所问题包括杀菌、水处理等。

在促进中国加速创新、促进中国以及全球健康公平方面，郑志杰特别介绍了几个项目。比如，2016年盖茨基金会与北京市政府、清华大学共同成立了全球健康药物研发中心（GHDDI），如今它已成为以推动健康公平为目标的全球包容性创新生态系统的主要参与者。凭借中国的创新人才和研发资源，GHDDI与全球的研究机构展开合作，致力于建设新药研发和转化的平台，旨在解决发展中国家面临的突出疾病，提高相关药物的可负担性和可及性，以确保贫困人口能够更快获得所需药物。GHDDI团队目前已经开展了十余个抗结核、新冠肺炎、疟疾及包虫病的新药项目管线并推进至重要研发里程碑，其中两个抗新冠肺炎小分子药物计划今年进入临床。

盖茨基金会与国家自然基金委的长期合作是另外一个调动研发资源，为解决全球健康和发展问题贡献中国力量的例子。2015年起双方共同设立了“中国大挑战”系列项目，针对全球面临的重大健康和发展挑战，资助研究那些安全、有效、可负担、易推广的解决方案。2016年的首次“大挑战”针对传染病疫苗和治疗方案，国内四个项目获得批准，研究团队获得双方总计约400万美元的联合资助。2020年新冠肺炎疫情之下，双方迅速开展新冠病毒研究应急专项合作，共同投入200万美元，联合资助5家中国研究团队开展新冠病毒研究。2021年，双方开展“大挑战：户外疟疾媒介控制项目”合作，共同投入300万美元，联合遴选和资助6个国内研究团队。今年，双方发起农业领域联合资助项目，共同投入200万美元支持科研人员开发创新解决方案，帮助低收入国家应对威胁农业生产的气候相关挑战。该项目将重点资助两个领域的研究，应对气候变化和极端天气的作物育种技术和策略，以及农业综合天气指数保险研究和实施。未来双方将继续合作支持全球健康和农业领域内的创新研究，继续推进联合国可持续发展目标的实现，促进各国科研人员的交流与合作。与此同时，基金会还与科技部、国家自然科学基金委及相关部门合作，通过举办论坛等方式推动国内国际对全球健康和发展重要议题的探讨，呼吁广泛的国际合作。比如，2021年基金会与科技部相关部门共同举办了中关村论坛平行论坛“传染病防治生物医药国际科技合作论坛”。从2020年开始，基金会与科技部、上海市科委合作举办浦江创新论坛平行论坛“全球健康与发展论坛”；从2019年至今，基金会与国家自然科学基金委合作举办的“全球健康学术研讨会”已成为年度重要国际学术交流会议。2022浦江创新论坛以“生物医药科技前沿与生命健康产业创新”为主题，郑志杰线上出席并发表主旨演讲，他表示盖茨基金会坚持“所有生命价值平等”的信念，在全球健康领域的全价值链上为伙伴提供资金和技术支持，基金会希望未来在发挥中国创新优势解决全球挑战上取得更多的成效和进展。

In its 15 years in China, the Gates Foundation has pursued two primary strategies. First among them is “In China, For China”, that targets issues such as tuberculosis, AIDS and poverty alleviation. The second strategy that the Foundation pursues is named “In China, For the World,” includes support for China's to provide global public products,such as vaccines, drugs, diagnostic tools, and so on. The second is to complement public products and support China’s efforts to become a stronger and more powerful global health partner by establishing itself as a center for global health and global development innovation and R&D. According to Zheng, “Over the years, the Foundation has worked with China to promote the elimination of malaria in Africa. Because China has significant experience with the disease, there is much to learn from and replicate elsewhere.” For example, the foundation and China have also advanced a lot in terms of public sanitation reform,mainly in the areas of public toilets and water treatment. Zheng added that there are many scientific and technical issues concerning the science of just toilets alone, such as how to solve toilet problems including sterilization and water treatment in villages, be they households in Africa, or western China, where there isn’t access to enough water and electricity.

In terms of fostering accelerated innovation in China and promoting health equity, in China as well as globally, Zheng highlighted several projects. In 2016, the Gates Foundation, together with the Beijing Municipal Government and Tsinghua University, established the Global Health Drug Discovery Institute(GHDDI), which is now a major player in the global ecosystem of inclusive innovation aimed at advancing health equity. With China's innovative talent and R&D resources, the GHDDI works with research institutions around the world to build a platform for new drug development and scale-up,addressing prominent diseases in developing countries and improving the affordability and accessibility of relevant medicines to ensure that poor populations have more rapid access to the medicines they need. The GHDDI team is currently working on a portfolio of more than a dozen anti-tuberculosis, novel coronavirus, malaria, and worm diseases. To date the Institute has hit key development milestones including two small molecule treatments for coronavirus that are expected to be brought into clinics this year.

也许源于小时候的悲痛经历，郑志杰十分关注生命健康主题。据相关数据显示，新中国成立前我国的婴儿死亡率高达200‰，也就是说1/5的宝宝在襁褓中就夭折了。令人欣慰的是，目前我国居民人均预期寿命已提高至78.2岁；孕产妇死亡率从16.9/10万降至16.1/10万，婴儿死亡率从5.4‰降至5.0‰，均为历史最低水平。“我相信，中国在过去几十年所做的贡献及取得的经验，可以作为公共产品供中低收入国家借鉴。”郑志杰说。

在推动中国创新成为全球公共产品，惠及广大发展中国家，提升全球健康水平方面，基金会也开展了很多工作。郑志杰举了两个例子，一是消除疟疾二是疫苗公平。关于消除疟疾，他介绍说，2021年中国得到了世界卫生组织消除疟疾的认证，对中国致力于在全球范围内抗击疟疾的行动，基金会正在支持中国的多个合作伙伴开展相关工作。一方面，基金会支持中国企业生产的青蒿素类药物进一步提升质量，作为高质量的全球公共产品服务全球抗疟事业。另一方面，基金会也在支持中国科研机构开展青蒿素生物合成优化项目。如果这一构想得以实现，将进一步降低以青蒿素为基础的联合疗法的成本并增加其供应。基金会也与中国和非洲的伙伴一起合作，创新疟疾防控模式。例如，基金会于2018年开始支持中国和坦桑尼亚合作开展创新试点，将中国消除疟疾的经验因地制宜地在非洲加以应用，设计出适用于当地防控现状的“以社区为基础的1，7疟疾检测响应模式”（1，7-mRCT），取得了显著成果。目前，世界卫生组织正在牵头扩大该模式在坦桑尼亚的覆盖范围，并推广到赞比亚、塞内加尔和布基纳法索等其他疟疾高发国家。

The Gates Foundation’s long-standing collaboration with the Natural Science Foundation of China (NSFC) is another excellent example of how R&D resources have been mobilized to contribute to global health and development issues in China. In 2015, the two Foundations jointly initiated the “Grand Challenges China” program to deal with major health and development challenges around the world and fund safe,effective, affordable and accessible solutions. In 2016 the first “Grand Challenges China” targeted vaccines and therapies for infectious diseases, yielded four project approvals in which research teams were awarded a total of approximately $4 million in co-funding. In 2021,the two partners launched another “Grand Challenges China” which zeroed in on outdoor vector control of malaria with a joint investment of $3 million to select and fund six Chinese teams. This year, the two organizations launched jointly funded programs in agriculture,that invested $2 million in research support to develop innovative solutions to help low-income countries address climate change related challenges that threaten agricultural production. The program will focus on funding research in two areas: crop breeding technologies and strategies to address climate change and extreme weather; and will research and implement comprehensive weather index policies that protect agriculture. In the future, the two organizations will continue to collaborate to support innovative research within the fields of global health and agriculture, and continue to promote the pursuit of the United Nations Sustainable Development Goals, and further exchange and collaboration among researchers globally. In parallel with these initiatives, the Foundation cooperates with the Ministry of Science and Technology (MOST), the NSFC, and other relevant departments to promote domestic and international discussions on important issues of global health and development, and to call for extensive international cooperation by holding forums. Among these,in 2021, the Foundation co-organized with the Ministry of Science and Technology the Zhongguancun Forum and the parallel related forum “International Scientific and Technological Cooperation Forum on Biomedicine for Prevention and Control of Infectious Diseases”.“Since 2020, the Foundation is cooperating with the National Ministry of Science and Technology and the Shanghai Municipal Science and Technology Commission to hold two parallel forums: the Pujiang Innovation Forum on “Global Health and Development”. The Foundation also continued its cooperation with the NSFC to organize the “Global Health Forum”, which has become an important annual international academic conference since 2019.

The Gates Foundation has also undertaken a number of efforts to promote Chinese innovation as a global public good, benefiting the developing world and improving global health at large. Zheng cited two examples of this: the eradication of malaria and the vaccine equity.With respect to malaria elimination, he explained that in 2021, China was recognized by the World Health Organization for the eradication of malaria domestically, and its continued commitment combat malaria globally with the support of the Foundation, and multiple other partners in China to carry out similar work. In one respect,the Foundation supports Chinese companies to further improve the quality of artemisinin-based drugs to better serve the global antimalaria cause by providing high-quality public products to the world.On another front, the Foundation also supports Chinese research institutions in their artemisinin biosynthesis optimization projects. If this concept comes to fruition, it will further reduce costs, and increase the availability of artemisinin-based combination therapies. From a systemic perspective, the Foundation with its partners in China and Africa, is also working to formulate models for malaria control. In 2018,the Foundation began supporting an innovative pilot collaboration between China and Tanzania to adapt China's experience in malaria elimination to Africa, designing a community-based 1,7-mRCT approach is applicable to the local control, has achieved outstanding results. The WHO is currently leading the scale-up of the approach in Tanzania and to other countries heavily burdened by malaria such as Zambia, Senegal and Burkina Faso.

关于疫苗公平，郑志杰介绍说，基金会一直与中国疫苗行业开展广泛合作，让更多的中国疫苗成为全球公共品，缩小全球健康水平的差距。中国目前已经有三个新冠疫苗进入世卫组织紧急使用清单，截至2021年年底，已通过双边和多边渠道向全球提供了超过20亿剂，其中多数供应了发展中国家，为促进疫苗公平贡献了力量。除了新冠疫苗，多年来，中国疫苗企业还向发展中国家提供了通过世卫组织预认证的疫苗。以流行性乙型脑炎疫苗为例。15年前，基金会与几家合作伙伴探索如何减轻全球流行性乙型脑炎造成的疾病负担。乙脑经由蚊子传播，是亚洲病毒性脑炎的一个主要病种，每年有成千上万的儿童因此死亡或致残。在了解到有一家中国企业发明了一种安全、有效、可负担的单剂乙脑疫苗后，基金会资助合作伙伴PATH为这家中国企业提供全程技术支持。8年后，也就是2013年10月，这支乙脑疫苗通过了世界卫生组织预认证，为其在全球的推广使用铺平了道路。通过与Gavi等国际组织的合作，中国生产的乙脑疫苗为境外超过4亿名儿童提供了保护。乙脑疫苗的成功获批，也为更多中国疫苗获得世卫组织预认证开启了良好势头。迄今，中国已有包括流感、脊髓灰质炎和甲型肝炎在内的多个疫苗获得世卫组织预认证，可以供应给有需要的国家。未来，基金会将持续在这一方面为中国企业提供支持、开展合作。

预防下一次大流行：有赖于全球的团结合作

“在我看来，发明创造的力量是世界发展的核心，但是在现实中，不可否认，我们可能永远无法设计出一种比一块廉价的材料上缝上两条弹性带子更便宜、更有效的方法来阻止呼吸道病毒的传播。”比尔·盖茨对口罩的赞美令我惊叹。他在新书《如何预防下一次大流行》中还讲了使用口罩控制疾病的历史。他说，通过推广口罩的使用来控制疾病的理念朴实而悠久，可以追溯到1910年。当时，医学领域先驱伍连德医生应中国政府要求，领导应对满洲里地区暴发的鼠疫，鼠疫的致死率为100%，有的甚至在24小时内就会死亡。当时，鼠疫被认为是通过生活在老鼠身上受感染的跳蚤传播。伍连德认为，病原体不是通过啮齿类动物传播的，而是通过空气传播。他坚持要求医务人员、病人甚至普通民众都佩戴口罩。当然实际上你可能被老鼠携带的跳蚤传染，但更危险的情况是，当病原体感染了患者的肺部，进而会通过空气传播给其他人。伍连德的策略阻止了疫情的进一步恶化，在很大程度上，由于他的领导，在中国口罩用于预防疾病、空气重污染或两者兼具，人们对此习以为常。即使新冠肺炎没有发生，佩戴口罩也仍是当今中国社会习惯的一部分。2020年3月，中国疾控中心主任高福院士表示，美国和欧洲最大的错误是人们没有佩戴口罩。

On the subject of global vaccine equity, Zheng explains that the Foundation has been collaborating extensively with the Chinese vaccine industry to make more Chinese vaccines global public goods and make them widely available to close worldwide health disparities.China now has three COVID-19 vaccines on the WHO list of vaccines for emergency use, and as of the end of 2021, China has made more than two billion vaccine shots globally available through bilateral and multilateral channels, most of which have been supplied to developing countries and thereby contributing to the promotion of vaccine equity. In addition to COVID-19 vaccines, for many years,China has both made and supplied WHO prequalified vaccines to developing countries. Fifteen years ago, the Foundation and several partners explored ways to reduce the global burden of diseases by targeting epidemic encephalitis B. Spread by mosquitoes, this form of encephalitis is a leading cause of viral encephalitis in Asia that kills or disables thousands each year. After learning that a Chinese company had invented a safe, effective and affordable single-dose encephalitis B vaccine, the Foundation funded its partner Program for Appropriate Technology in Health (PATH) that provides technical support to the Chinese vaccine producer throughout the duration of the project.

Eight years later, in October 2013, this encephalitis B vaccine was prequalified by the World Health Organization thus paving the way for its widespread use worldwide. Collaboration with international organizations such as Global Alliance for Vaccine Immunization (Gavi),helped the China-made encephalitis B vaccine protect more than 400 million children beyond its manufacturers borders. The WHO approval of the China-made encephalitis vaccine also kick-started forward momentum for more Chinese vaccines to be pre-qualified for use. To date, several vaccines that are made in China, including influenza, polio and hepatitis A, have been pre-qualified by the WHO for use in countries in need. In the future, the Foundation will continue to support and collaborate with Chinese companies in this area.

Preventing the next pandemic requires global solidarity and cooperation

比尔及梅琳达·盖茨基金会北京代表处首席代表郑志杰先生

I applaud Bill Gates for his praise of masks. In his new book, “How to Prevent the Next Pandemic,” Gates describes the long history of simple masks to control the spread of disease and amusingly comments: “ This is a little hard to admit, because the power of inventing things is so central to my worldview, but it’s true: We may never devise a cheaper,more effective way to block the transmission of certain respiratory viruses than a piece of inexpensive material with a couple of elastic straps sewn onto it.” In 1910, when masks were first being introduced,Dr. Wu Lien-teh, a Chinese pioneer in the field of medicine, was asked by the Chinese government to lead the response to an outbreak of plague in the Manchuria region, which had a 100% lethality rate, with some dying within 24 hours. At the time, the plague was thought to be spread by infected fleas living on rats. Dr. Wu Lien-teh believed that the pathogen was not spread by rodents, but rather, was by airborne transmission. He insisted that medical personnel, patients, and even the general public wear masks. Of course you can actually be infected with the plague by fleas carried by rats, but the more dangerous scenario is when the pathogen is spread to others through the air and in turn infects the lungs. Dr. Wu Lien-teh’s mask wearing strategy fortunately prevented the epidemic from worsening, and thanks in large part to his leadership, masks for preventing disease, heavy air pollution, or both,later became commonplace in China. Even if COVID-19 did not occur,mask wearing would still be part of the social habits commonly found in China. In March 2020, academician Gao Fu, director of the Chinese CDC, said that the biggest mistake in the United States and Europe was that people did not wear masks.

“人们一直在生病，但不是每种疾病都会暴发。”比尔·盖茨接着说，“疫情暴发无法避免，大流行却可以防范。”除了佩戴口罩，还有保持社交距离、良好的通风等这些非药物干预措施，这些措施与疫苗搭配使用，就“可以帮助我们最终消灭所有流感病毒株”。

Bill Gates notes that “People get sick all the time, but not every illness leads to an out break..” In his book, Gates observed “Outbreaks are inevitable, but pandemics are optional.” In addition to wearing masks,there are non-pharmaceutical interventions such as maintaining social distance and good ventilation that, when paired with vaccines, “could help us eventually eradicate every strain of flu”.

关于新冠疫苗的研制、上市和接种的速度是令人难以置信的——2020年新冠肺炎疫情暴发，2021年疫苗上市并实现了全球50%的人口接种。然而，在新冠肺炎大流行前，疫苗研发速度的极限纪录是4年。但是“生产疫苗并获得批准只是一个方面，如何避免形成一个疫苗获取存在差异的世界完全是另一个挑战”。盖茨基金会在这一领域的第一个主要项目是帮助创建和组织——全球疫苗免疫联盟（Gavi），这是一个筹集资金以帮助贫穷国家购买疫苗的组织。

我们知道，这次新冠肺炎疫情的波及范围之大、持续时间之长都是前所未见的，也因此对全球最脆弱群体造成了尤为严重的影响——全球极端贫困人口增加了7%，疫苗接种率降至20世纪90年代的水平，结核病和疟疾的发病和死亡人数都出现了十多年来的首次上升。抗击疫情，除了非药物措施和接种疫苗，还有其他办法吗？或者说如何让比尔·盖茨说的两种办法真正发挥作用呢？

郑志杰认为，这要有赖于全球的团结合作。“尽管依靠各地科学家的通力协作，全球仅用18个月就史无前例地制造出了安全、有效的疫苗，但我更想说的是，只有科技还远远不够。最终抗疫成败的关键，有赖于团结合作的范围和程度。有人说，新冠肺炎大流行是全球化的产物。但实际上，造成疫情不断传播的原因恰恰是人类无法互通有无、有效协作。不论是早期对抗疫物资的争抢，还是仍在持续的疫苗不公平分配，这些都没有能减缓疫情在全球的蔓延趋势，反而让病毒持续变异，让人们处于更危险的境地。”他介绍说，由世卫组织、欧盟委员会、法国和盖茨基金会发起成立的“全球合作加速开发、生产、公平获取新冠肺炎防控新工具”倡议（ACT-A）和“新冠疫苗实施计划”（COVAX）发挥了重要作用。截至2022年5月，COVAX已经向146个国家和地区提供了超过15亿剂新冠疫苗；截至4月，ACT-A向中低收入国家提供了超过1.56亿份新冠试剂。2月，中国与Gavi签订协议，决定向COVAX捐赠1亿美元，并已向COVAX供应超过2亿剂新冠疫苗，为提高疫苗在发展中国家的可及性和可负担性发挥了建设性作用。但是，至今非洲国家完成两针新冠疫苗接种率仅8%——这次疫情凸显了全球合作的重要性。人类只有通过全球合作实现抗疫工具的公平获取，才能取得更大的进展，才能尽早终结疫情。

The blistering pace of COVID-19 vaccine R&D to availability to the market has been mind boggling. Before the pandemic, the fastest that a vaccine had ever went from development to widespread use was just 4 years, yet from the outbreak of COVID-19 in 2020, new vaccines hit the market in record speed, and 50% of the global population was vaccinated by 2021. But “producing vaccines and getting them approved is only one piece of the puzzle; avoiding a world of disparities in access to vaccine is quite another challenge altogether.” The Gates Foundation’s first major undertaking was to address the disparity been to help create and organize the Gavi, an organization that raises funds to help poor countries buy vaccines.

We know that the COVID-19 pandemic has been unprecedented in its scope and duration, and as a result the world’s most vulnerable populations in poor countries have been disproportionally severely impacted by other crises. Due to the pandemic we have seen an increase of 7% in extreme global poverty, a drop in vaccination rates to 1990s levels, and have experienced the first increase in both incidence and deaths from tuberculosis and malaria in more than a decade. This begs the question:are there other ways to fight the epidemics than non-pharmaceutical measures and vaccination? Alternatively, how can we make the two approaches Bill Gates advocates for actually work?

According to Dr. Zheng, this depends on global support and cooperation. “Although by relying on the collaborative efforts of scientists from around the world led to the world production of safe and effective COVID-19 vaccines in an unprecedentedly speedy 18 months, I would go further and say that employing technology alone is not enough.Ultimately the key to success or failure in the fight against the pandemics depends on the scope and extent of our solidarity and cooperation.Some say that the COVID-19 pandemic is a product of globalization, in reality, the cause of the ongoing spread of the epidemic is precisely the inability of humanity to cooperate effectively. Neither the early scramble for anti-epidemic supplies nor the ongoing inequitable distribution of vaccines has slowed the global spread of the pandemic, but rather virus has been allowed to continue to mutate and put people at greater risk.” Dr. Zheng says that the Global Collaboration to Accelerate the Development, Production, and Access to COVID-19 Tools Accelerator(ACTA) initiative and the COVID-19 Vaccines Global Access (COVAX), which was established by the WHO, as well as the European Commission,France and the Gates Foundation, have all played important roles. As of May, 2022, COVAX delivered more than 1.5 billion doses of COVID-19 vaccines to 146 countries and territories of which ACT-A procured and delivered more than 156 million COVID-19 tests to low and middle income countries. Among collaborators, The People’s Republic of China donated $100 million and supplied more than 200 million doses of COVID-19 vaccine to the COVAX program. Despite this, the fact that only 8 percent of the population in African countries have received two doses of COVID-19 vaccine underscores the importance of global cooperation. Only with global cooperation to achieve equitable access to tools to fight the COVID-19 pandemic, can humanity make headway fighting the Pandemic and finally extinguish it sooner, rather than later.

在抗击新冠肺炎疫情中，中国取得重大成果，这得益于“非典”过后的近20年里，中国在国家、省、市、县各级建立了全国疾控中心网络，有80余万公共卫生专职人员通过实时报告系统和协调网络来应对公共卫生突发事件；还有2014年中国派出一支由 1200多名临床医生、公共卫生专家组成的医疗队，奔赴非洲助力控制埃博拉疫情，在100天内在塞拉利昂建立了一个生物安全防护三级实验室……中国的公共卫生体系在“非典”疫情之后得到了显著加强。

郑志杰说，中国不断完善其全球健康与发展创新体系，以及为全球健康与发展贡献自身力量，盖茨基金会期待中国继续增强研发能力，激发更多创新成果，并推动这些成果有效转化为市场解决方案，促进健康产品以国际质量标准实现规模化生产，参与应对全球健康与发展面临的共同挑战，为其他发展中国家的发展带来更大的积极影响。北京代表处将在促进中国强化国际科技交流、积极参与全球创新网络、推进基础研究和科技成果转化、帮助连接全球资源、建立创新合作模式等方面持续努力，与中国的公共与私营部门深化合作，探索更多合作模式在全球大流行、应对和防范重大传染病、疫苗与药物研发、健康产品创新、农业研发、公共卫生设施革新等领域，催化产生更多科技创新项目和产品，并培育更多研发创新人才。

从20世纪90年代末比尔和梅琳达为改变低收入国家每年有数百万儿童死于可预防疾病现状的初衷，到今天盖茨基金会已经为全球健康与发展作出了重要贡献，我们看到“让每个人都过上健康而富有成效的生活”的理念一路熠熠发光，并且越来越达成更多共识、得到更多支持。国内、国外，体制内、体制外，郑志杰的丰富经历使他深知，基金会相对于政府而言，可以更快地采取行动、承担更多风险，从而形成以循证为基础的、可规模化推广的方法。他说，无论是在全球抗击新冠肺炎疫情还是与中国一起促进疫苗公平，我们都深刻地体会到——政府在引领政策制定和资源调动上拥有绝对的主导权。但是应对卫生健康挑战所需的资源又是任何一个单独的部门或行业所无法承担的，政府、私营部门、民间和慈善组织在内的所有部门应该一起行动，发挥各自应有的作用。

China has made significant gains in the fight against the pandemic thanks to the establishment of a national network of centers for disease control at the national, provincial, municipal and county levels. In the nearly 20 years since SARS, the Chinese CDC has employed more than 800,000 public health professionals that respond to public health emergencies through a real-time reporting system and coordination network. The CDC network dispatched a medical brigade of more than 1,200 clinicians and public health experts to Africa in 2014 to help control the Ebola outbreak and established a biosafety level 3 laboratory in Sierra Leone within 100 days of the outbreak. From this it is obvious that China’s public health system gained significant momentum in the wake of the SARS epidemic.

Zheng Zhijie notes that as China continuously optimizes its global health and innovate systems for development, it additionally contributes its own strengths to global health and development, the Gates Foundation expects China to continue to enhance its R&D capabilities, stimulate more innovations, and commercialize the effective translation of these achievements into market solutions, promote the production of health products at scale with international quality standards, participate in solving common challenges facing global health and development, and bring a stronger positive impacts to the development of other developing countries.

The Beijing Gates Foundation office will continue its efforts to strengthen China’s participation in international science and technology exchanges by promoting active participation in global innovation networks, promoting of commercialization of basic research and scientific and technological achievements, helping to connect global resources, and establishing innovative cooperation models to deepen cooperation with China’s public and private sectors. The Foundation will also continue to explore additional models for cooperation. This will be focused in the realms of global pandemics, response and prevention of major infectious diseases, vaccine and drug development, promote innovations in health products, agricultural research and development, public health facility innovations, acting as a catalyst to generate more innovative projects in science and technology,products, and train more innovative R&D professionals.

Since Bill and Melinda Gates became first inspired in the late 1990s to change the status quo of preventable diseases that kill millions of children in low-income countries every year, the Gates Foundation has been able to significantly contribute to global health and development and thus materialize their vision for “a healthy and productive life for everyone” while fostering consensus and added support for the cause. Dr. Zheng’s extensive experience in China and abroad, both in public service and the private sector, led him to the deep realization that the Foundation could act more rapidly and take more risks than governments could and evidence-based approaches could be scaled up via its support. Whether we are fighting COVID-19 globally or working with China to promote vaccine equity, Dr.Zheng says that we have learned that governments have absolute dominance in leading policy development and resource mobilization. However,the resources needed to address health challenges are beyond the reach of any one sector or industry alone, and all sectors - government, private sector, civil society and philanthropic organizations - should act together to play their respective roles.

在郑志杰简单、整洁的办公室里，在北京代表处中西合璧的各个角落，我们都可以感受到一种文化。“无论人们身处何种环境，住在哪里、生活怎样，我们都抱有同样的梦想和希望。”梅琳达·弗兰奇·盖茨的话被印在一张海报上。海报前面放着被动式疫苗冷藏设备Arktek和Mazzi牛奶桶。郑老师详细地向我介绍这些设备的来源和用途。这些于我来说遥远的故事忽然那么亲切。是的，它们关乎每个人的健康，也关乎一种梦想和希望。而只要有梦想就有未来。

“未来依然值得期待。”郑志杰坚定地说，2050年时，在大规模接种的帮助下，脊灰很可能成为世界上第二种被根除的人类传染病；HPV疫苗的公平可及则有可能让宫颈癌成为人类根除的第一种癌症；在新冠肺炎疫情中发挥重要作用的mRNA技术平台，将很可能助力我们在艾滋病、结核病、疟疾预防方面取得突破性的进展；而环境卫生技术的变革，例如无下水道厕所的广泛使用也将保护更多人免受污染和潜在致命疾病暴发的危害；在农业领域，更高产、更能抵御气候变化的新作物将帮助小农户渡过气候危机……我们一起努力，大流行就可以避免，世界将变得更加公平和健康。

“他是一个极其敏锐、渊博，具有超强学习能力的人。”这是郑志杰对比尔·盖茨的评价。郑志杰印象最深的就是盖茨对他的面试，“当时还有点紧张，但是谈了几分钟后就不紧张了，我们交流了一个多小时”。我问郑志杰“盖茨是一位慈善家还是企业家”，他说，“盖茨先生是一位成功的企业家，也是一位成功的慈善家，他尤其强调慈善的影响力”，不仅这些，盖茨还有专家学者的博学、慎思和严谨。他接着说，盖茨是我们的榜样，特别是青少年的榜样。他希望青少年能充满好奇心和野心。这里的野心是指追求和梦想。教育不能让所有人成为“平均的人”。

我曾看到一个故事说，比尔·盖茨7岁时，幻想制造一个香烟盒那么大但能把一大本大百科全书都收进去的魔盒。当然，他的“幻想”已经实现。我想，盖茨和基金会、郑志杰和中国，还有我们所有人只要心中永远充满“幻想”并且付诸行动，“幻想”一定会照进现实。

对了，比如，科技创新就是来自幻想。

In Zheng’s simple, clean, office in Beijing at the Foundation, one gains a sense if it being a place where China, the East, meets the West. “Whatever the conditions of people’s lives, wherever they live, however they live, they share the same hopes.” are the words of Melinda French Gates printed on a poster in the office. In front of the poster sat on display an Arktek, a passive vaccine refrigeration device, and the Mazzi milk bucket. Zheng explained to me in detail where these devices came from and what they were used for. These stories, which were really abstract to me, suddenly hit home. Yes,they are about everyone’s health, but they were really about a dream of hope. And as long as there is a dream, there is a future.

“The future is still worth looking forward to,” Zheng says firmly. Much can improve. By 2050, with the help of mass vaccination, polio will likely be the world’s second human infectious disease to be eradicated. Equitable access to HPV vaccines in the future also has the potential to make cervical cancer the first cancer to be eradicated. Still also, the COVID-19 pandemic has played an important role in the future scale up of mRNA technology platforms which will likely help us make breakthroughs in AIDS, tuberculosis, and malaria prevention. Changes in sanitation technologies, such as the widespread use of sewer-less toilets, will protect more people from pollution and potentially deadly disease outbreaks. In agriculture, new crops that are more productive and more resistant to climate change will help small scale farmers survive the looming climate crisis. Finally, we can avoid pandemics if we work together and the world can become a fairer and healthier place.

“He is an extremely sharp, knowledgeable person with a superb ability to learn,” so says Zheng Zhijie says about Bill Gates. Zheng recalls being interviewed by Gates as being particularly memorable. Zheng says “I was still a little nervous, but after talking for a few minutes I was not nervous anymore,and we ended up talking for more than an hour”. I asked Dr. Zheng “is Bill Gates a philanthropist or an entrepreneur”? Zheng responded that “Mr.Gates is indeed not only a successful entrepreneur; he is also a successful philanthropist that especially emphasizes the impact of charity”. Furthermore,Gates also has the erudition of a scholar and he is deliberate and rigorous in the way he thinks. Dr. Zheng went on to opine that Mr. Gates is a role model for us, especially for young people. He [Gates] wants young people to be curious and ambitious in terms of their curiosity and advises them to dream big.Education cannot merely be for the “average person” he says.

I once read that when Bill Gates was 7 years old, he imagined that he could create a magic box that was as big as a cigarette box that could fit a large encyclopedia in it. Of course, in the end, he made this a reality. I think that if we are like Gates and the Foundation, Zheng Zhijie and China, if we forever imagine, if we continue to dream, we will surely see our dreams become reality.

I suppose that innovation in science and technology really is just imagination and conviction materialized.