引言：
世界卫生组织2023年的监测发现，全球女性贫血率反而从2012年的基线上升到了30.7%，而原本的目标是将这个数字减少一半。
Christopher Elias的发言发生在联合国制定这个目标的2周之前，他在发言中提到了中国古老的智慧和现代的创新，并鼓励大家（政府、企业、公益组织）联合行动，创建一个不再需要问“为什么儿童会死亡”的世界。
他的发言非常清晰、精炼地说明了为什么我们需要食物强化，以及如何推动食物强化。
“为未来而强化”全球食品强化高峰论坛
Arusha, Tanzania
阿鲁沙，坦桑尼亚
September 10, 2015
2015年9月10日
I’d like to start by asking a very old and difficult question: Why do children die?
我想从一个非常古老且困难的问题开始：为什么儿童会死亡？
This line of inquiry has helped us make big strides to improve global health. One powerful indicator of that progress is the reduction in child mortality. Since 1990, the child mortality rate has been cut in half – the result of ambitious goals, innovation, and commitment.
对这一问题的探索，帮助我们取得了全球健康的巨大进步。儿童死亡率的降低是这一进展的有力佐证。自1990年以来，儿童死亡率已经减半——这是雄心勃勃的目标、创新和履行承诺的成果。
Yet, despite this progress, the world is not improving fast enough. More than 6 million children died in 2013. Appallingly, over half of those deaths were from preventable causes.
然而，尽管取得了这样的进步，世界进步的速度还不够快。 2013年有超过600万儿童死亡。令人震惊的是，超过一半的死亡是由可预防的原因引起的。
If a four-year-old girl in Tanzania or Malawi or India dies of tuberculosis or pneumonia, is that disease truly what claimed her life?
如果一个四岁的女孩在坦桑尼亚、马拉维或印度死于结核病或肺炎，那真的是疾病夺走了她的生命吗？
We have discovered that poor nutrition is often the handmaiden of child mortality. We know that undernutrition is a primary factor in 45% of the deaths of children under age five.
我们发现，营养不良往往是儿童死亡的帮凶。我们知道，营养不良是45%的五岁以下儿童死亡的主要原因。
We also now understand the particular importance that micronutrients play in the diets of children and women of reproductive age. Children who don’t get enough of the right micronutrients can suffer from impaired mental development, blindness, stunting, and diminished resistance to disease. Micronutrient deficiencies endanger expectant mothers during pregnancy and during childbirth.
我们还了解到，微量营养素在儿童和育龄妇女饮食中的特殊重要性。没有获得足够适当微量营养素的儿童，可能会遭受智力发展受损、失明、发育迟缓和对疾病的抵抗力降低。微量营养素缺乏危及孕妇在怀孕和分娩期间的健康。
An estimated 450,000 children die each year due to causes associated with zinc deficiency alone. Iron deficiency undermines the health of 40% of women in developing countries. Iron-deficiency anemia has also been linked to premature births and low birth-weight babies.
据估计，每年有45万名儿童死于与锌缺乏相关的原因。缺铁降低了发展中国家 40%妇女的健康。缺铁性贫血也与早产和低出生体重婴儿有关。
Worldwide, more than 2 billion people are deficient in essential vitamins and minerals—accounting for nearly 10% of the global health burden.
全球超过 20亿人缺乏必需的维生素和矿物质——占全球健康负担的近10%。
This burden is especially acute in many parts of Africa and South Asia. Nearly half a million children die in Sub-Saharan Africa each year from common diseases because they aren’t protected by sufficient vitamin A. In Southeast Asia, 600 million people suffer from iron deficiency anemia—those most affected are adolescent girls, women of reproductive age, and young children.
这一负担在非洲和南亚的许多地区尤为严重。在撒哈拉以南非洲，每年有近50万儿童因常见疾病死亡，因为他们没有足够的维生素A保护。在东南亚，有6亿人患有缺铁性贫血，受影响最大的是少女、育龄妇女和幼儿。
The economic toll of micronutrient deficiency also undermines the potential for prosperity in developing nations.
微量营养素缺乏的经济代价也破坏了发展中国家繁荣的潜力。
Countries may lose between 2-3% of their Gross Domestic Product as a result of iron, iodine, and zinc deficiencies.
国家可能因铁、碘和锌缺乏而损失 2-3%的国内生产总值。
In Uganda, for example, micronutrient deficiency contributes to an estimated $310 million in lost productivity.
例如，在乌干达，微量营养素缺乏导致约3.1亿美元的生产力损失。
Clearly, millions of women and children are not getting the nutrition they need, and the consequences for families, communities, and entire nations is devastating – but we have a powerful solution at our disposal: food fortification.
显然，数百万妇女和儿童没有获得他们所需的营养，这对家庭、社区乃至整个国家的后果是毁灭性的，但我们手中有一个强大的解决方案：食品强化。
The methods we use today to fortify food are made possible through advances in science, technology, and industry. But the idea that a good diet is often the best medicine goes back a long way.
我们今天用来强化食品的方法，是通过科学、技术和工业的进步实现的。但良好的饮食往往是最好的药物这一理念，可以追溯到很久以前。
As far back as 2700 BCE, Chinese medical texts reported that burnt seaweed was an effective treatment for goiter, a condition that results in swelling of the neck. And according to the Egyptian Ebers papyrus, which dates back to 1500 BCE, onions cure scurvy.
早在公元前 2700年，中国的医学文献就报告说，烧焦的海藻是治疗甲状腺肿的有效方法，甲状腺肿是一种导致颈部肿胀的疾病。根据可以追溯到公元前1500年的埃及埃伯斯纸草书，洋葱可以治愈坏血病。
Of course, what these ancient healers didn’t know was that it’s actually the vitamin C in the onions – and the iodine in seaweed – that produces the health benefits.
当然，这些古代治疗者不知道的是，实际上是洋葱中的维生素C，以及海藻中的碘，产生了健康益处。
Today, food fortification comes in many forms: soy sauce with added iron; Vitamin A-fortified cooking oil and sugar; and flour enriched with iron, zinc, folate, and B vitamins.
今天，食品强化以多种形式出现：添加铁的酱油；富含维生素 A的烹饪油和糖；以及富含铁、锌、叶酸和B族维生素的面粉。
Without a doubt, it is one of the most cost-effective weapons we have for fighting malnutrition.
毫无疑问，这是我们对抗营养不良的最经济有效的武器之一。
The Copenhagen Consensus Center concluded that the annual cost of increasing iodized salt access to reach 80% of the population of South Asia and Sub-Saharan Africa would cost just 5 cents per person treated, or $19 million in total. But the benefits from that investment would be worth as much as $570 million in health-care savings and increased productivity.
哥本哈根共识中心得出结论，通过增加碘化盐的可及性，以覆盖南亚和撒哈拉以南非洲80%人口的年成本，仅为每人5美分，或总共190万美元。但这项投资的好处，将节省未来医疗保健的投入，以及促进生产力提高，总回报高达5.7亿美元。
（注：哥本哈根共识中心是一个世界级智库，由包括诺贝尔经济学奖得主在内的经济学家，通过分析全球各类公共政策、项目的干预效果和成本效益，进而得出推荐结论。该中心多年推荐加大对微量营养元素干预的资金投入，并认为该问题受到的重视不足。）
The health imperative and the economic benefits are clear, which is why some of the Gates Foundation’s earliest nutrition investments were in food fortification. But even our resources can deliver only a small fraction of what’s needed.
这对公共健康的重要性，以及对经济效益的贡献是十分清晰的，这就是为什么盖茨基金会在营养领域最早的投资就是食品强化。但即便我们的资源，也只能提供所需的一小部分。
Through President Kikwete’s commitment and leadership, Tanzania launched its national food fortification program in 2011. Today, it is reaching millions of Tanzanians with fortified wheat flour and edible cooking oil.
通过 Kikwete总统的承诺和领导，坦桑尼亚在2011年启动了国家食品强化计划。今天，它通过强化小麦面粉和食用油为数百万坦桑尼亚人提供服务。
Tanzania was able to scale its efforts quickly, in significant part because of a strong partnership between domestic private-sector cooking oil producers, wheat-flour millers, and the National Food Fortification Alliance. While it is too early to know the long-term health outcomes of this program, it already provides a partnership model that other nations can learn from and build on.
坦桑尼亚能够迅速扩大其努力，在很大程度上是因为国内民营企业食用油生产商、小麦粉磨坊主和国家食品强化联盟之间的强大伙伴关系。虽然现在还不知道这个计划的长期健康结果，但它已经提供了一个其他国家可以学习和借鉴的伙伴关系模型。
Given all we have learned from more than a decade of work in the field, we believe there are three keys to expand and sustain food-fortification efforts to reach the most vulnerable populations.
鉴于我们在该领域十多年的工作中学到的所有知识，我们相信有三个关键点可以扩大和维持食品强化工作，以覆盖最脆弱的人口。
The first key is that governments in high-burden countries must establish an effective regulatory framework. This includes deciding what foods and condiments to fortify, setting fortification standards to achieve public-health outcomes, and ensuring quality control and compliance.
第一个关键是，对于高负担的国家，政府必须建立一个有效的监督框架。这包括决定强化哪些食品和调味品，设定强化标准以实现公共卫生成果，并确保质量控制和合规性。
The second key is that private food producers have to be part of the conversation about standards, and they must take the lead on quality assurance. After all, they are the ones producing fortified food. This includes first and foremost national producers of salt, flours and cooking oil, as well as producers of fortificants and premix.
第二个关键是，民营食品生产商必须要参与对标准的制定，他们必须在质量保证方面发挥领导作用。毕竟，他们是强化食品的生产者。这首先包括的是食盐、面粉和食用油的全国性生产商，以及强化剂和预混料生产商。
In 2004, a regional association of cooking oil producers made the bold decision to adopt vitamin A fortification as a standard practice.
2004年，一个区域食用油生产商协会做出了大胆的决定，将维生素A强化作为实践标准。
By last year, more than 80 million people across these eight countries were consuming fortified cooking oil.
到去年，这八个国家的超过 8000万人正在消费强化食用油。
These efforts have also sparked action across the Economic Community of West African States. In all, 14 countries in West Africa now have legislation on the books for mandatory food fortification.
这些努力也在西非国家经济共同体中引发了行动。西非现在共有14个国家，有强制性的食品强化立法。
Even when a company desires to contribute to an altruistic goal like public health, it is unlikely they will do so without a genuine market incentive. Without the private sector’s involvement, we will not achieve the kind of magnitude or quality assurance needed for sustainable fortification programs.
即使商业公司希望为公共卫生等利他目标做出贡献，但如果没有真正的市场激励，他们也不太可能这样做。没有民营企业的参与，我们将无法实现可持续强化计划所需的规模或质量保证。
The third key is the involvement of development partners – international agencies, NGOs, and the philanthropic sector.
第三个关键是发展伙伴的参与 ——国际机构、非政府组织和慈善部门。
If we are to unleash the full potential of food fortification, we must ensure access to everyone, most especially the poorest of the poor who often don’t get their food from the industrial food system. This is a fundamental challenge in food-fortification programs. If the poorest people can’t afford these products, or don’t have access, we risk falling short of global goals.
如果我们要释放食品强化的全部潜力，我们必须确保所有人都能获取，特别是最贫穷的人，他们往往不从工业食品系统中获取食物。这是食品强化计划的一个基本挑战。如果最贫穷的人买不起这些产品，或者无法获取，我们就有可能达不到全球目标（注：指联合国千年发展目标）。
China’s effort in the early 2000s to launch iron-fortified soy sauce as a method to combat anemia showed promise when it reached nearly 60 million people within two years. However, the program struggled to gain traction among poor and rural farmers, the very population most at risk of iron deficiency. In the time since, through partnership with GAIN, China has expanded the reach of the iron-fortified soy sauce to lower-income populations, bringing this product into seven new provinces.
中国在 2000年代初期努力推出铁强化酱油作为对抗贫血的方法，在两年内达覆盖了近6000万人，展现了政府的承诺。然而，该计划难以使贫困人口和农村农民获得支持，这些人口最有可能缺铁。从那时起，通过与GAIN的合作，中国扩大了铁强化酱油在低收入人群中的覆盖范围，将这种产品带入了七个新省份。
With a growing array of proven, cost-effective food fortification solutions available today, it would be a gross injustice to let a hundred years – or even 10 years – pass, without taking action.
在今天，有了越来越多的经过验证、成本效益高的食品强化解决方案，如果我们让一百年，甚至 10年过去，而不采取行动，那将是一个严重的不公。
Quite literally, the coins you have in your pocket right now can make the difference between a child’s life never realized and a productive life well-lived.
所见即所得，你现在口袋里的硬币，就可以决定一个孩子，是活在一种失去发展机会的生活之中，还是活在一个充满希望的生活之中。
We are here today because of the urgency of the problem and the feasibility of the solution. To achieve that solution, we need every proven nutrition strategy we’ve got – of which fortification is one.
我们今天在这里，是因为问题的紧迫性和解决方案的可行性。要实现这个解决方案，我们需要每一种经过验证的营养策略，而食品强化就是其中之一。
In two weeks, the United Nations will meet in New York City to adopt the Sustainable Development Goals.
两周后，联合国将在纽约市开会，通过可持续发展目标。
Yet, we will only succeed in achieving the SDG targets on poverty, hunger, and malnutrition – and feeding a future world population of 9 billion – if we work together to incorporate mandatory large-scale food fortification into national nutrition programs.
然而，我们只有通过共同的努力，将强制性大规模食品强化纳入国家营养计划，才能成功实现关于贫困、饥饿和营养不良的可持续发展目标 ——并养活未来90亿的世界人口。
It is up to us to build these partnerships. If we do, I believe we can accomplish more in the next 15 years of food fortification than we did in the previous 100 years, bringing us much closer to a world in which we no longer have to ask why children die.
构建这些伙伴关系是我们的责任。如果我们这样做，我相信我们可以在接下来的15年里，在食品强化方面取得比过去100年更多的成就，使我们更接近一个，不再需要问为什么儿童会死亡的世界。
注：本文是盖茨基金会全球发展部门主管Christopher Elias博士2015年在首届世界食品强化大会上的发言，此处为对精选部分的翻译。
原文链接：
https://www.gatesfoundation.org/ideas/speeches/2015/09/chris-elias-futurefortified-global-summit-on-food-fortification
