苍术,双语:陈冯富珍博士在世界护理会的宗旨说话,关于春节的诗

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Global Citizen, Global Nursing: Reshaping Nursing for the Future Needs of Citizens

全球公民,全球护理:为公民未来的需求重塑护理

– Keynote Address at the International Council of Nurses Conference

——在国际护理睬的主旨说话

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

国际卫生安排总干事陈冯富珍博士

Seoul, Republic of Korea

韩国首尔

20 June 2015

2015620

Excellencies, members and executives of the International Council of Nurses, ladies and gentlemen,

诸位尊下、国际护理睬成员和高管、女士们、先生们:

It is said that a person who saves a life is a hero. A person who saves hundreds of lives is obviously a nurse.

人们说,抢救一个人生命的人是英豪。抢救成百上千人生命的人显然是护理。

That person is likely to be overworked, underpaid, and vastly under-appreciated, especially at the policy-making level. Yet that person is saving lives, all the same.

这样一个人往往作业时刻过长、取得的酬劳过低,并且人们一般知道不到其作业的重要性,特别是决议计划层。但这样一个人依然是在抢救生命。

Through the auspices of a unifying federation like ICN, millions of nurses around the world speak with a single compelling voice. You are united by a shared vision, and guided by an international code of ethics that has been in place since 1953.

经过国际护理睬这一统一安排,全国际数以百万计的护理能够以同一个有说服力的声响说话。你们团结在一起愿景下,并一起遵从1953年确认的国际道德原则。

ICN has a much longer history than WHO, but has been in official relations with this Organization since 1948, when WHO was founded.

国际护理睬比世卫安排的前史要长得多,但自1948年本安排树立以来你们就与本安排树立了正式联系。

We have been close allies in the best of times, like during the health for all movement and the expansion of childhood immunization, but also in the worst of times, including the darkest years of the AIDS epidemic and during countless emergencies and humanitarian disasters.

在最好的年代,咱们黑猫男友的是亲近盟友,比如在人人享有卫生保健运动和扩展儿童免疫作业期间;在最坏的年代,咱们也是亲近盟友,包括在艾滋病盛行的最漆黑年代以及无数次突发事情和人道主义灾祸期间。

I thank ICN and its members for their pas苍术,双语:陈冯富珍博士在国际护理睬的主旨说话,关于新年的诗sionate commitment to the right to health, and to the provision of patient-centred, family-centred, and evidence-based primary health care. I appreciate the recent endorsement of universal health coverage as a route to achieving better奇人王恩庆 health outcomes for all people.

我感谢国际护理睬及其成员满怀热心地致力于健康权、致力于供给以患者为本、以家庭为中心的循证初级卫生保健。我欣赏你们最近支撑经过全民健康掩盖使一切人取得更好的健康成果。

The documentation prepared to commemorate this year’s International Nurses Day includes a number of insightful observations. Let me mention just one. “The international community has given too little attention to investments in health services in general and to the health workforce in particular.”

为留念本年的国际护理节预备的文件内容包括一些很有见地的观念。在此,我谨举一个比如。“关于在全体卫生服务方面进行出资以及更详细而言对卫生人力进行出资,国际社会重视得太少。”

I could not agree more.

对这种说法,我再赞同不过。

Prior to the outbreak of Ebola virus disease in West Africa, Guinea, Liberia, and Sierra Leone had only one to two physicians available per 100,000 population. WHO does not have estimates for the number of nurses working in any of these countries. Bu梁岩岩t we do know how many nurses were infected, and how many died.

西非埃博拉病毒病疫情爆发前,几内亚、利比里亚和塞拉利昂均匀每10万人只要一到两位医师。世卫安排没有这些国家有多少护理的估量数字。但咱们的确知道有多少护理被感染,又有多少逝世。

Last month, WHO issued its first report on Ebola infections in health care workers, including doctors and nurses, but also laboratory staff, ambulance drivers, burial teams, cleaners, and community-based workers. More than 800 healthcare workers have been infected and more than 500 of them died.

上个月,世卫安排宣布了有关医务作业者感染埃博拉病毒情况的陈述,其间包括医师和护理,也包括实验室作业人员、救护车司机、掩埋团队、清洁工和社区作业人员。总共有八百多名医务作业者感染,其间五百余人逝世。

The report co都市超级股神ntains a startling statistic. Well over half of all those infected with Ebola were employed as nurses. Two-thirds of them died.

陈述包括一个令人震惊的统计数据。半数以上被感染医务人员是护理,其间三分之二逝世。

We also know that many of these nurses were not paid their salaries or promised hazard pay, sometime for months. Early on in the outbreak, when not enough personal protective equipment was available, nurses used plastic trash bags to fashion aprons and protect their hands and feet.

咱们还知道,这些护理中的许多人没有拿到薪酬或是承诺的损害岗位津贴,有时拿不到酬劳的时刻长达数月。疫情初期,个别防护配备不够用,护理们就用塑料垃圾袋围熊猫哥哥和功夫美少女裹身体、维护四肢。

Yet despite no pay and no protection, they kept on working, kept on managing patients, putting their own lives at risk.

可是,尽管没有酬劳也没有维护,他们仍是冒着生命危险持续作业,持续办理患者。

We must praise their courage and dedication. I doubt that any other statistics portray so dramatically the role of the nursing profession in providing front-line care. I can think of no other recent outbreak that portrays so dramatically the consequences of failing to invest in health services and the health workforce for so many decades.

咱们有必要赞扬他们的勇气和奉献。我置疑,是否有任何其它统计数字能够如此有目共睹地展现一线护理所发挥的作用。我也想不出其它任何一次最近的疫情能够如此有目共睹地展现数十年来未能充沛出资于卫生服务和卫生人力所发生的成果。

Ladies and gentlemen,

女士们、先生们,

We are global citizens in a world that has changed dramatically since the start of this century, when the Millennium Development Goalswere put forward as an overarching framework for international cooperation.

本世纪初,千年展开方针成为国际协作的总结构。自那以来,全国际现已发生巨大改动。而咱们是这个国际上的全球公民。

These changes reveal the consequences of living in a world of radically increased interdependence. National affairs are intertwined as never before by the international systems that govern economies, financial markets, business relations, and trade.

这些改动提醒出世活在日益相互依存国际的成果。经济、金融商场、商业联系和交易方面的国际原则以史无前例的方法将国家业务交错在一起。

Given the phenomenal increases in the volume and speed of international travel, there is no such thing as a local outbreak anymore. The definition of sovereign national autonomy no longer holds true.

考虑到国际游览的数量和速度大大添加,这国际上再也不存在本地疫情。传统的主权国家自主权界说也不再适用。

Drug-resistant bacteria easily cross borders. Pollution is trans-national. Climate change is universal. The advertising of unhealthy products is beamed across borders by satellite. Social media propagate rumours like they were facts, clouding medical advice and sometimes undermining policies, like those for childhood immunization.

耐药细菌能够简略跨过边境。污染不分国界。气候改动遍及影响一切人。不健康产品的广告经过卫星广播到不同国家。交际媒体把流言作为现实传达,给医疗主张蒙上阴云,有时还会削弱方针,例如有关儿童期免疫的方针。

The distinctions between policy spheres have likewise become blurred. What looks like a good policy for one sector of government can be disastrous for another.

各个方针范畴之间的区别也变得含糊。某个政府部门的好方针可能给别的一个范畴形成灾祸性影响。

Biofuels can reduce the environmental damage caused by reliance on fossil fuels, but they can also endanger food security for millions. Trade agreements can open markets, but they can also shut down local livelihoods when heavily subsidized imports flood in.

生物燃料能够削减依靠化石燃料形成的环境损坏,但也会要挟到数百万人的粮食安全。交易协议能够翻开商场大门,但当取得很多补助的进口产品涌入,当地人也会发现自己生计维艰。

All around the world, health is being shaped by the same powerful forces, like population ageing, rapid urbanization, and the globalized marketing of unhealthy products.

在全国际,健康都被相同的巨大力气所刻画,例如人口老龄化、快速城市化以及不健康产品的全球化营销。

These universal trends have given the world a number of “firsts”.

这些遍及趋势给国际许多“第一次”。

For the first time in history, the population of people aged 60 years and older outnumbers the population of children under the age of five. In other words, being in the older age group has becom余爱绕梁e the “new normal” in the world’s demographic profile.

前史上第一次,60岁及以上人口数量超越了5岁以下儿童数量。换言之,全国际人口构成的“新常态”便是老龄人口增多。

The implications of this shift, in terms of the demands and costs of health care, are immense. The health workforce is also getting old.

这种改动关于卫生保健需求和费用的影响是巨大的。卫生人力部队也在变老。

For the first time in history, more than half of humanity lives in an urban setting. Living in a city brings many benefits, like more opportunities for employment, improved food 苍术,双语:陈冯富珍博士在国际护理睬的主旨说话,关于新年的诗security, educational and cultural advantages, and better access to be鲛人皇后tter health care.

前史上第一次,半数以上人类日子在城市。日子在城市有许多优点,例如更多就业时机、粮食安全更有保证、教育和文明优势以及更有时机取得更好的卫生保健服务。

But not for everyone. WHO estimates that nearly a billion people live in urban slums, shantytowns, on sidewalks, under bridges, or along the railroad tracks. As this year’s State of the World’s Mothers, issued by Save the Children, shows, one of the worst places in the world to be a mother is in an urban slum.

但并非对一切人都是如此。依据世卫安排估量,全国际近10亿人日子在城市贫民窟和棚户区或许是城市便道、桥下或铁道旁。依据救助儿童会本年发布的《国际母亲情况陈述》,全国际最糟糕的做母亲的地址便是城市贫民窟。

For the first time in history, chronic noncommunicable diseases have overtaken infectio娘道洪县长us diseases as the leading cause of mortality worldwide. The burden of these diseases, long associated with affluent societies, has changed places.

前史上第一次,缓慢非感染性疾病超越感染病成为全国际形成逝世的首要原因。这些疾病担负长时刻以来都和殷实社会亲近相关,现在则改动了发生地址。

Today, 80% of premature mortality caused by heart disease, cancer, diabetes, and chronic lung disease is concentrated in low- and middle-income countries, which have the least capacity to cope.

今日,80%的心脏病、癌症和缓慢肺病导致的过早逝世发生在应对才能最差的低收入和中等收入国家。

Most health systems in the developing world were built to manage brief episodes of acute infections, in which the patient either survives or dies. These systems are ill-prepared to manage diseases requiring long-term if not life-long care.

大部分展开我国家的卫生体系旨在办理急性感染的简略发生,患者要么活下来要么死去。这些体系没有做好办理需求长时刻乃至毕生护理的疾病的预备。

For NCDs, all agree that prevention must be the cornerstone of the global response. Yet prevention 小韩村djis problematic, as the root causes of these diseases lie in non-health sectors.

关于非感染性疾病,一切人都赞同,有必要以防备作为全球应对作业的柱石。可是,防备也面临许多问题,由于这些疾病的本源在卫生部门以外。

Many of the risk factors for NCDs are amplified by the products and practices of corporations that are powerful economic operators, namely the tobacco, food, beverage, and alcohol industries. Market power readily translates into political power.

非感染性疾病的许多危险要素被身为强壮经济运营者的烟草、食物、饮料和酒精业公司的产品和做法扩展了。商场力气垂手可得地变成了政治力气。

These corporations seldom interfered with efforts to reach the health-related Millennium Development Goals. No PR firms were hired to portray the delivery of medicines for HIV and TB as interference with personal liberties by the Nanny State, with WHO depicted as the Mother Superior of all Nannies.

这些公司很少为完成卫生相关千年展开方针做出干涉尽力。并没有公关公司受雇于人,说供给抗艾滋病毒和结核病药物是保姆式国家搅扰个人自在,或许世卫安排是一切嬷嬷背面的女修道院院长。

No lawsuits were filed to stop countries from reducing the risks for child mortality. No research was funded军中铁脊柱 by industry to cast doubt on the causes of maternal mortality. Mosquitoes do not have front groups, and mosquitoes do not have lobbies.

没有人提起诉讼阻挠各国削减儿童逝世危险。没有企业资助质疑孕产妇逝世原因的研讨。蚊子没有幌子公司,也不进行游说。

But the industries that contribute to the rise of NCDs do. When public health policies cross purposes with vested economic interests, we will face opposition, well-orchestrated opposition, and very well-funded opposition.

可是,滋长非感染性疾病添加的企业却这样做了。当公共卫生方针与既得经济利益相冲突,咱们将会遭到对立,并且是精心策划并且资金雄厚的对立。

Taken together, these trends give us yet another “first” that calls into question the very way the world defines human progress.

这些趋势也是“第一次”呈现,并使全国际对人类行进的界说成为问题。

Beginning in the 19th century, improvements in hygiene and living conditions were followed by vast improvements in health status and life-expectancy. These environmental improvements aided the control of infectious diseases, totally vanquishing many major killers from modern societies.苍术,双语:陈冯富珍博士在国际护理睬的主旨说话,关于新年的诗

19世纪开端,卫生和日子条件的改进使人类健康情况大为改进、预期寿数大为延伸。这些环境上的改进有助于操控感染病,使许多首要死因从现代社会消失。

Today, the tables are turned. Instead of diseases vanishing as living conditions improve, socioeconomic progress is actually creating the conditions that favour the rise of NCDs. Economic growth, modernization, and urbanization have opened wide the entry point for the spread of unhealthy lifestyles.

今日,局势发生了一百八十度大转弯。从日子条件改进使疾病消失变成社会经济行进发明了滋长非感染性疾病添加的条件。经济添加、现代化和城市化为不健康日子方法的延伸大开其门。

This is a unique time in history where economic progress is actually increasing threats to health instead of reducing them.

这是前史上的共同时刻:经济行进没有削减而是在添加对健康的要挟。

In recent decades, China and India have lifted millions of their people out of poverty. This is one of the great achievements of economic development. But it has a clear d苍术,双语:陈冯富珍博士在国际护理睬的主旨说话,关于新年的诗own-side as well.

最近几十年,我国和印度稀有千万人脱节赤贫。这是经济展开的伟大成就之一,但它也有显着的负面效应。

Two years ago, Chinese scientists published the results of a large national survey of diabetes prevalence. The authors estimated that China now has 114 million adults living with diabetes, representing a prevalence in the adult Chin流纹色母ese population of nearly 12%.

两年前,我国科学家宣布全国糖尿病盛行率大规模调查成果。据作者估量,我国现在有1.14亿成年人患糖尿病,占成人人口近12%

Less than a third of those surveyed were aware of their condition and only a quarter reported receiving treatment.

只要不到三分之一被调查者了解自己的情况,只要四分之一在承受医治。

Think about what this debilitating disease, with all its costly complications, means in the world’s second largest economy.

想想这种令人衰弱的疾病及其医治费用贵重的并发症对国际第二大经济体意味着什么。

Will the rising incidence and costs of NCDs devour the benefits of economic gain? The demography of poverty has also shifted. Today, more than 70% of the poor live in middle-income countries.

非感染性疾病患病率和费用上升是否会吞噬经济展开的优点?赤贫的人口构成也发生了改动。现在,70%以上贫贫民口日子在中等收入国家。

If the economy is going well, what pressure will be placed on governments to take care of the poor? The world does not need any more rich countries full of poor people.

假如经济展开杰出,政府在照料贫民方面会面临哪些压力?咱们不需求更多处处都是贫民的富国。

There is a final global trend that shapes the challenges ahead as health professionals, and most especially nurses, transition to the post-2015 development era.

跟着卫生作业者特别是护理步入2015年今后的展开年代,还有一个全球趋势影响着未相似91来的应战。

This is the world’s growing inequalities.

这便是全国际日益添加的不相等。

According to the Organization for Economic Cooperation and Development, or OECD, inequalities, in income levels and opportunities, have reached their most extreme levels seen in more than half a century.

依据经济协作与展开安排的研讨,收入水平缓时机方面的不相等现已到达半个多世纪以来最极点的程度。

Put another way, the Swiss bank, Credit Suisse, estimated last year that the combined wealth of the world’s richest 85 people equals the combined wealth of the world’s poorest 3.5 billion people.

此外,瑞士信贷集团上一年估量,全国际最富有85人的财富加起来相当于全国际最赤贫35亿人的财富之和。

A world that is so badly out of balance is neither stable nor secure.

如此失衡的国际既不安稳也不安全。

I recall the statement from your ethical code: “The nurse advocates for equity and social justice in resource allocation, access to health care and other social and economic services.”

我记住你们的《道德原则》中有这样一句话:“在资源分配、获取卫生保健及其它社会和经济服务方面,护理推进公平缓社会正义。”

Again, I thank ICN for its commitment to universal health coverage. UHC is one of the most powerful social equalizers among all policy options.

我要再次感谢国际护理睬致力于全民健康掩盖。这是一切方针计划中完成社会相等最有力的东西之一。

Ladies and gentlemen,

女士们、先生们,

The nursing profession is acutely aware of what these trends mean for health care, the costs, and the added demands on the daily practice of your work. The 公主驸马育儿记level of awareness is readily apparent in the agenda for this event.

护理职业现已敏锐地注意到这些趋势关于卫生保健、相关费用以及对你们日程作业的更多要求意味着什么。这种知道也显着反映在本次大会的议程上。

The nursing profession, that so-called “sleeping giant”, is actually wide awake and ready to race ahead in clearly defined strategic directions. You are waiting for the starting gun.

护理职业这个所谓的“熟睡的伟人”其实早已醒来,并预备好朝着清晰界定的战略方向全力奔驰。你们正在等候发令枪响。

Even more so, you are waiting for someone to let up on the reins that hold you back, the constraints that keep you from performing with the full set of competencies for which you were educated, trained, and licensed.

乃至,你们正在等候有人来放松捆绑着你们的缰绳,使你们脱节约束,然后发挥出你们经过教育、训练取得并因此具有从业资历的悉数才能。

Some constraints have historical roots, often in legislation. As far back as 1986, experts convened by WHO concluded that national and subnational regulations often prevent nurses from exercising their full knowledge and skills.

一些约束有其前史渊源,往往存在于立法中。早在1986年,世卫安排招集的专家就得出定论:国家和地方法规常使护理无法运用他们的悉数常识和技术。

The report set out a strategy for strengthening the contribution of nurses to primary health care based on a reorientation of legislation.

该陈述论述了经过调整立法加强护理对初级卫生保健的奉献的战略。

The impact of that strategy has been disappointing. Much more recently the US Institute of Medicine’s 2010 report on “The future of nursing: leading change, advancing health” reached much the same conclusion.

该战略的影响令人绝望。美国医学研讨所2010年陈述《护理的未来:引领革新、推进健康》得出了根本相同的定论。

Again, that report argued that nurses should be able to practice to the full extent of their education and training.

陈述再次指出,应该让护理充沛实践他们所遭到的教育苏益仕苏打水和训练。

The conclusion is similar to the one made 24 years ago: regulatory and institutional obstacles, including limits on nurses’ scope of practice, should be removed so that health systems can reap t苍术,双语:陈冯富珍博士在国际护理睬的主旨说话,关于新年的诗he full ben帝妻赋efit of their training, skills, and knowledge.

其定论与24年前的定论相似:应消除监管和体系妨碍,包括对护理执业规模的约束,使卫生体系能够充沛利用他们的训练、技术和常识。

Other constraints are attitudinal, often entrenched in the views and policies of national medical associations. As bluntly stated by the IOM report, physicians are unwilling to embrace policy that expands the supply and roles of nurses.

其它约束则是态度上的,根深柢固地存在于国家医学协会的观念和方针中。正如美国医学研讨所陈述所直爽指出的那样,医师不愿意承受扩展护理供给和功能的方针。

My own view is this. Given the enormous complexity of health challenges faced as the world transitions to the post-2015 era, no one, including WHO, dares to ignore the full contribution that the nursing profession can make.

我个人的观点是这样的:跟着全国际进入2015年今后阶段,鉴于卫生应战极为杂乱,没有人,包括世卫安排,敢忽视护理专业人员所能做出的悉数奉献。

If for no other reason, we cannot afford to ignore you.

即便没有其它原因,咱们也担负不起忽视你们的成果。

A recent study conducted in the US found that the majority of clinicians have no idea about the costs of the interventions they order or the procedures they perform. In contrast, nurses are trained to work in a context of cost constraints, especially when their job involves procurement of medicines and hospital supplies.

美国最近一项研讨发现,大部分临床医师关于自己所要求采纳的干涉方法或是展开的医学程序的费用一窍不通。与此相反,护理承受的训练就包括在费用受限情况下展开作业,特别是在其作业触及收购药品和医院物资的情况下。

Nurses need to have a much more a易贝闪贷ctive role in the policy process, especially in decisions that influence the financing of health services.

护理需求在决议计划进程中发挥更为活跃的作用,特别是对影响卫生服务供资的决议。

For NCDs, we cannot afford to miss opportunities for prevention, for early diagnosis, for counselling aimed at behavioural change, or for community-based approaches that improve health literacy.

面临非感染性疾病,咱们担负不起失掉防备、前期确诊、供给咨询以促进行为改动或是以社区为根底进步健康认识时机的成果。

As I speak, many health systems are at a critical juncture in planning their health workforces. For several reasons, the supply of primary health care physicians is dwindling, precisely at a time when the need for primary care has never been greater.

现在,许多卫生体系都处于规划卫生人力的关键时刻。由于种种原因,初级卫生保健医师的供给正在萎缩,而初级保健需求却比前史上任何时候都多。

In countries facing a shortage of primary care physicians, one way to fill the gap is to permi法力擦的原理t nurses with advanced degrees to practice without a doctor’s oversight, order and interpret diagnostic tests, prescribe medicines, and administer treatment. Yet this obvious solution still faces opposition from the medical profession.

在缺少初级保朱梓晓健医师的国家,填补空白的一个方法是答应具有高档学位的护理在没有医师监督的情况下执业,包括开化验单和解读化验成果、开药以及办理医治。可是,这一显着的解决计划仍面临来自医师的对立定见。

Physicians who continue to believe that expanding the scope of nursing practice will have an adverse effect on the quality of patient care have not looked at the evidence. Mounting evidence shows that this opposition is more about competition than competence.

依然以为扩展护理执业规模对患者护理质量有不良影响的医师是没有研讨依据。越来越多依据标明,这种对立定见更多是出于竞赛而不是才能考虑。

Nor can we afford to ignore other lines of evidence. Hospitals with a higher ratio of nurses to patient have lower mortality rates.

咱们也担负不起忽视其它依据的成果。护理与患者份额更高的医院逝世率更低。

Studies underscore the quality of care provided by nurses, including preventing medical errors and medication mistakes, reducing or eliminating infections, shortening hospital stays, and easing the transition of patients from hospital to home.

多项研讨显现,护理能够供给高质量护理,包括避免医疗和用药过错、削减或消除感染、缩短住院时刻、使患者从医院到家里的过渡更为简略。

Nurses using爱旺旺网站 new technologies to care for patients, including the elderly, in their homes have been shown to reduce the number of hospital readmissions and visits to emergency wards. All of this cuts costs, of course, but it also improves the quality of life for patients.

有依据显现,护理运用新技术在患者(包括老年人)家里供给护理有助于削减从头住院和进入急诊病房的次数。一切这些当然都会下降费用,但也会进步患者的日子质量。

What is needed is a less rigid dichotomy between the autonomy of nurses and doctors, and more collaborative teamwork.

需求削减护理和医师之间死板的二分法,并进行更多团队协作。

This emphasis is thought to be one reason for the effectiven苍术,双语:陈冯富珍博士在国际护理睬的主旨说话,关于新年的诗ess of the WHO Surgical Safety Checklist, which gives all members of the team, and most especially nurses, an equal voice in decisions about surgical care.

着重这一苍术,双语:陈冯富珍博士在国际护理睬的主旨说话,关于新年的诗点被以为是世卫安排手术安全检查表有实效的原因之一。该检查表使一切团队成员,特别是护理,在有关手术护理的决议中有相等发言权。

Studies conducted in eight countries showed that use of this simple 19-item checklist reduced the rate of deaths and surgical complications by more than one third.

在八个国家进行的研讨标明,这一简略的包括19项内容的检查表使逝世和手术并发症率下降了三分之一还多。

Other studies have noted an increased likelihood of staff speaking up when a problem is noticed. In fact, WHO recommends that a nurse be put in charge of running the checklist.

其它研讨还注意到,作业人员更愿意在注意到问题时把问题提出来。现实上,世卫安排主张由护理担任依据检查表核对各项内容。

Ladies and gentlemen,

女士们、先生们,

The nursing profession can transform the way health services are organized and how health care is delivered.

护理专业能够改动卫生服务的安排和供给方法。

The sleeping giant is wide awake. With health challenged by so many first-time events, the starting gun has sounded.

熟睡的伟人早已醒来。面临如此之多“第一次”事情带来的应战,发令枪现已打响。

You know where the health of this world needs you to run, and you are fully competent to move in those directions.

你们知道这个国际的卫生事业需求你们往哪个方向奔驰,并且你们也彻底有才能朝那个方向行进。

As I said, no one can afford to ignore your potential to change things for the better.

如我所言,没有人担负得起忽视你们改动局势使之朝好的方向展开的潜力所发生的成果。

More cost-effective and more care-effective services will be the result.

而你们的尽力将带来更有本钱效益、更见护理作用的服务。

Thank you.

谢谢我们。