TEDTalks, Bill Clinton – TED Prize wish: Let's build a health care system in Rwanda (2007)

Bill Clinton – TED Prize wish: Let's build a health care system in Rwanda (2007)

I thought in getting up to my TED wish I would try to begin by putting in perspective what I try to do and how it fits with what they try to do.

We live in a world that everyone knows is interdependent, but insufficient in three major ways. It is first of all, profoundly unequal. Half the world's people still living on less than two dollars a day, a billion people with no access to clean water, two and a half billion no access to sanitation, a billion going to bed hungry every night. One in four deaths every year from AIDS, TB, malaria and the variety of infections associated with dirty water -- 80 percent of them under five years of age.

Even in wealthy countries it is common now to see inequality growing. In the United States, since 2001 we've had five years of economic growth, five years of productivity growth in the workplace, but median wages are stagnant and the percentage of working families dropping below the poverty line is up by four percent. The percentage of working families without health care up by four percent. So this interdependent world which has been pretty good to most of us -- which is why we're all here in Northern California doing what we do for a living, enjoying this evening -- is profoundly unequal. It is also unstable. Unstable because of the threats of terror, weapons of mass destruction, the spread of global disease and a sense that we are vulnerable to it in a way that we weren't not so many years ago. And perhaps most important of all, it is unsustainable because of climate change, resource depletion and species destruction.

Into this mix, people like us who are not in public office, have more power to do good than at any time in history, because more than half the world's people live under governments they voted in and can vote out. And even non-democratic governments are more sensitive to public opinion. Because primarily of the power of the Internet, people of modest means can band together and amass vast sums of money that can change the world for some public good if they all agree. When the tsunami hit South Asia, the United States contributed 1.2 billion dollars. 30 percent of our households gave. Half of them gave over the Internet. The median contribution was somewhere around 57 dollars. And thirdly, because of the rise of non-governmental organizations. They, businesses, other citizens' groups, have enormous power to affect the lives of our fellow human beings. When I became president in 1993, there were none of these organizations in Russia. There are now a couple of hundred thousand. None in India. There are now at least a half a million active. None in China. There are now 250,000 registered with the government, probably twice again that many who are not registered for political reasons.

When I organized my foundation, and I thought about the world as it is and the world that I hope to leave to the next generation, and I tried to be realistic about what I had cared about all my life that I could still have an impact on. I wanted to focus on activities that would help to alleviate poverty, fight disease, combat climate change, bridge the religious, racial and other divides that torment the world, but to do it in a way that would either use whatever particular skills we could put together in our group to change the way some public good function was performed so that it would sweep across the world more.

You saw one reference to that in what we were able to do with AIDS drugs. And I want to say that the head of our AIDS effort, and the person who also is primarily active in the wish I'll make tonight, Ira Magaziner, is here with me and I want to thank him for everything he's done. He's over there. (Applause) When I got out of office and was asked to work, first in the Caribbean, to try to help deal with the AIDS crisis, generic drugs were available for about 500 dollars a person a year. If you bought them in vast bulks, you could get them at a little under 400 dollars. The first country we went to work in, the Bahamas, was paying 3,500 dollars for these drugs. The market was so terribly disorganized that they were buying this medicine through two agents who were gigging them sevenfold. So the very first week we were working, we got the price down to 500 dollars. And all of a sudden, they could save seven times as many lives for the same amount of money.

Then we went to work with the manufacturers of AIDS medicines, one of whom was cited in the film, and negotiated a whole different change in business strategy. Because even at 500 dollars, these drugs were being sold on a high-margin, low-volume, uncertain-payment basis. So we worked on improving the productivity of the operations and the supply chain, and went to a low-margin, high-volume, absolutely certain-payment business. I joked that the main contribution we made to the battle against AIDS was to get the manufacturers to change from a jewelry store to a grocery store strategy. But the price went to 140 dollars from 500. And pretty soon, the average price was 192 dollars. Now we can get it for about 100 dollars. Children's medicine was 600 dollars, because nobody could afford to buy any of it. We negotiated it down to 190. Then, the French imposed their brilliantly conceived airline tax to create a something called UNITAID, got a bunch of other countries to help. Children's medicine is now 60 dollars a person a year.

The only thing that is keeping us from basically saving the lives of everybody who needs the medicine to stay alive are the absence of systems necessary to diagnose, treat and care for people and deliver this medicine. We started a childhood obesity initiative with the Heart Association in America. We tried to do the same thing by negotiating industry-right deals with the soft drink and the snack food industry to cut the caloric and other dangerous content of food going to our children in the schools. We just reorganized the markets. And it occurred to me that in this whole non-governmental world, somebody needs to be thinking about organizing public goods markets. And that is now what we're trying to do, and working with this large cities group to fight climate change to negotiate huge, big, volume deals that will enable cities which generate 75 percent of the world's greenhouse gases to drastically and quickly reduce greenhouse gas emissions in a way that is good economics. And this whole discussion as if it's some sort of economic burden, is a mystery to me. I think it's a bird's nest on the ground.

When Al Gore won his well-deserved Oscar for the "Inconvenient Truth" movie, I was thrilled, but I had urged him to make a second movie quickly. For those of you who saw "An Inconvenient Truth," the most important slide in the Gore lecture is the last one, which shows here's where greenhouse gases are going if we don't do anything, here's where they could go. And then there are six different categories of things we can do to change the trajectory. We need a movie on those six categories. And all of you need to have it embedded in your brains and to organize yourselves around it. So we're trying to do that.

So organizing these markets is one thing we try to do. Now we have taken on a second thing, and this gets to my wish. It has been my experience in working in developing countries that while the headlines may all be -- the pessimistic headlines may say, well, we can't do this or the other thing because of corruption, I think incapacity is a far bigger problem in poor countries than corruption, and feeds corruption. We now have the money, given these low prices, to distribute AIDS drugs all over the world to people we cannot presently reach. Today these low prices are available in the 25 countries where we work, and in a total of 62 countries. And about 550,000 people are getting the benefits of them. But the money is there to reach others. The systems are not there to reach the people.

And the test is: one, will it do the job, will it develop -- provide high quality care? And two, will it do it at a price that will enable the country to sustain a health care system without foreign donors after five to 10 years? Because the longer I deal with these problems, the more convinced I am that we have to -- whether it's economics, health, education, whatever -- we have to build systems. And the absence of systems that function break the connection which got you all in this seat tonight. You think about whatever your life has been, however many obstacles you have faced in your life, at critical junctures you always knew there was a predictable connection between the effort you exerted and the result you achieved. In a world with no systems, with chaos, everything becomes a guerilla struggle, and this predictability is not there. And it becomes almost impossible to save lives, educate kids, develop economies, whatever.

The person, in my view, who has done the best job of this in the health care area, of building a system in a very poor area is Dr. Paul Farmer, who many of you know, has worked for now 20 years with his group, Partners in Health, primarily in Haiti where he started. But they've also worked in Russia, in Peru and other places around the world. As poor as Haiti is, in the area where Farmer's clinic is active -- and they serve a catchment area far greater than the medical professionals they have would indicate they could serve -- since 1988, they have not lost one person to tuberculosis, not one. And they've achieved a lot of other amazing health results. So when we decided to work in Rwanda on trying to dramatically increase the income of the country and fight the AIDS problem, we wanted to build a healthcare network, because it had been totally destroyed during the genocide in 1994, and the per capita income was still under a dollar a day. So I rang up, asked Paul Farmer if he would help. Because it seemed to me if we could prove there was a model in Haiti and a model in Rwanda that we could then take all over the country, number one, it would be a wonderful thing for a country that has suffered as much as any on Earth in the last 15 years, and number two, we would have something that could then be adapted to any other poor country anywhere in the world. And so we have set about doing that.

Now, we started working together 18 months ago. And we're working in an area called Southern Kayonza, which is one of the poorest areas in Rwanda, with a group that originally includes about 400,000 people. We're essentially implementing what Paul Farmer did in Haiti, where he develops and trains paid community health workers who are able to identify health problems, ensure that people who have AIDS or TB are properly diagnosed and take their medicine regularly, who work on bringing about health education, clean water and sanitation, providing nutritional supplements and moving people up the chain of health care if they have problems of the severity that require it. The procedures that make this work have been perfected, as I said, by Paul Farmer and his team in their work in rural Haiti over the last 20 years. Recently we did an evaluation of the first 18 months of our efforts in Rwanda. And the results were so good that the Rwandan government has now agreed to adopt the model for the entire country, and has strongly supported and put the full resources of the government behind it.

I'll tell you a little bit about our team because it's indicative of what we do. We have about 500 people around the world working in our AIDS program, some of them for nothing -- just for transportation, room and board. And then we have others working in these other related programs. Our business plan in Rwanda was put together under the leadership of Diana Noble, who is an unusually gifted woman, but not unusual in the type of people who have been willing to do this kind of work. She was the youngest partner at Schroder Ventures in London in her 20s. She was CEO of a successful e-venture -- she started and built Reed Elsevier Ventures -- and at 45 she decided she wanted to do something different with her life. So she now works full-time on this for very little pay. She and her team of former business people have created a business plan that will enable us to scale this health system up for the whole country. And it would be worthy of the kind of private equity work she used to do when she was making a lot more money for it.

When we came to this rural area, 45 percent of the children under the age of five had stunted growth due to malnutrition. 23 percent of them died before they reached the age of five. Mortality at birth was over two and a half percent. Over 15 percent of the deaths among adults and children occurred because of intestinal parasites and diarrhea from dirty water and inadequate sanitation, all entirely preventable and treatable. Over 13 percent of the deaths were from respiratory illnesses -- again, all preventable and treatable. And not a single soul in this area was being treated for AIDS or tuberculosis.

Within the first 18 months, the following things happened: we went from zero to about 2,000 people being treated for AIDS. That's 80 percent of the people who need treatment in this area. Listen to this: less than four-tenths of one percent of those being treated stopped taking their medicine or otherwise defaulted on treatment. That's lower than the figure in the United States. Less than three-tenths of one percent had to transfer to the more expensive second-line drugs. 400,000 pregnant women were brought into counseling and will give birth for the first time within an organized health care system. That's about 43 percent of all the pregnancies. About 40 percent of all the people -- I said 400,000. I meant 40,000. About 40 percent of all the people who need TB treatment are now getting it -- in just 18 months, up from zero when we started. 43 percent of the children in need of an infant feeding program to prevent malnutrition and early death are now getting the food supplements they need to stay alive and to grow.

We've started the first malaria treatment programs they've ever had there. Patients admitted to a hospital that was destroyed during the genocide that we have renovated along with four other clinics, complete with solar power generators, good lab technology. We now are treating 325 people a month, despite the fact that almost 100 percent of the AIDS patients are now treated at home. And the most important thing is because we've implemented Paul Farmer's model, using community health workers, we estimate that this system could be put into place for all of Rwanda for between five and six percent of GDP, and that the government could sustain that without depending on foreign aid after five or six years. And for those of you who understand healthcare economics you know that all wealthy countries spend between nine and 11 percent of GDP on health care, except for the United States, we spend 16 -- but that's a story for another day. (Laughter)

We're now working with Partners in Health and the Ministry of Health in Rwanda and our Foundation folks to scale this system up. We're also beginning to do this in Malawi and Lesotho. And we have similar projects in Tanzania, Mozambique, Kenya and Ethiopia with other partners trying to achieve the same thing, to save as many lives as quickly as we can, but to do it in a systematic way that can be implemented nationwide and then with a model that can be implemented in any country in the world. We need initial upfront investment to train doctors, nurses, health administration and community health workers throughout the country, to set up the information technology, the solar energy, the water and sanitation, the transportation infrastructure. But over a five to 10-year period, we will take down the need for outside assistance and eventually it will be phased out.

My wish is that TED assist us in our work and help us to build a high-quality rural health system in a poor country, Rwanda, that can be a model for Africa, and indeed, for any poor country anywhere in the world. My belief is that this will help us to build a more integrated world with more partners and fewer terrorists, with more productive citizens and fewer haters, a place we'd all want our kids and our grandchildren to grow up in. It has been an honor for me, particularly to work in Rwanda where we also have a major economic development project in partnership with Sir Tom Hunter, the Scottish philanthropist, where last year we, using the same thing with AIDS drugs, cut the cost of fertilizer and the interest rates on microcredit loans by 30 percent and achieved three to four hundred percent increases in crop yields with the farmers.

These people have been through a lot and none of us, most of all me, helped them when they were on the verge of destroying each other. We're undoing that now, and they are so over it and so into their future. We're doing this in an environmentally responsible way. I'm doing my best to convince them not to run the electric grid to the 35 percent of the people that have no access, but to do it with clean energy, to have responsible reforestation projects. The Rwandans, interestingly enough have been quite good, Mr. Wilson in preserving their topsoil. There's a couple of guys from southern farming families -- the first thing I did when I went out to this place was to get down on my hands and knees and dig in the dirt and see what they'd done with it.

We have a chance here to prove that a country that almost slaughtered itself out of existence can practice reconciliation, reorganize itself, focus on tomorrow and provide comprehensive, quality health care with minimal outside help. I am grateful for this prize, and I will use it to that end. We could use some more help to do this, but think of what it would mean if we could have a world-class health system in Rwanda -- in a country with less than one dollar a day per capita income, one that could save hundreds of millions of lives over the next decade if applied to every similarly situated country on Earth. It's worth a try and I believe it would succeed. Thank you and God bless you. (Applause)

http://www.ted.com/talks/bill_clinton_on_rebuilding_rwanda.html

Bill Clinton – TED Prize wish: Let's build a health care system in Rwanda (2007) ||TED Talks|||||||||| Bill Clinton - TED-Preis-Wunsch: Lasst uns ein Gesundheitssystem in Ruanda aufbauen (2007) Bill Clinton - Deseo del premio TED: construyamos un sistema de atención médica en Ruanda (2007) Bill Clinton - vœu pour le prix TED : Construisons un système de santé au Rwanda (2007) ビル・クリントン - TED賞の願い：ルワンダに医療システムを構築しよう (2007) Bill Clinton - TED Prize-wens: Laten we een gezondheidszorgsysteem opbouwen in Rwanda (2007) Bill Clinton - Desejo do Prémio TED: Vamos construir um sistema de saúde no Ruanda (2007) Билл Клинтон - Пожелание премии TED: Давайте построим систему здравоохранения в Руанде (2007) Bill Clinton - TED Ödülü dileği: Ruanda'da bir sağlık sistemi kuralım (2007) 比尔·克林顿 – TED 奖愿望：让我们在卢旺达建立医疗保健系统 (2007) 比爾柯林頓 – TED 獎願望：讓我們在盧安達建立醫療保健系統 (2007)

I thought in getting up to my TED wish I would try to begin by putting in perspective what I try to do and how it fits with what they try to do. ||||||||||||||||||||||||||||||cố gắng|| Pensé que al cumplir mi deseo de TED intentaría comenzar poniendo en perspectiva lo que trato de hacer y cómo encaja con lo que ellos intentan hacer. Я подумал, что, говоря о своем желании TED, я попытаюсь начать с рассмотрения того, что я пытаюсь сделать, и того, как это согласуется с тем, что они пытаются делать.

We live in a world that everyone knows is interdependent, but insufficient in three major ways. |sống||||||||||không đủ|||| |||||||||interdependent||unzureichend|||| It is first of all, profoundly unequal. |||||tiefgreifend|ungleich Прежде всего, это глубокое неравенство. Half the world’s people still living on less than two dollars a day, a billion people with no access to clean water, two and a half billion no access to sanitation, a billion going to bed hungry every night. |||||||||||||||||||||water||||||||||||||||| One in four deaths every year from AIDS, TB, malaria and the variety of infections associated with dirty water -- 80 percent of them under five years of age. |||||||||sốt rét||||||||||||||||| ||||||||TBC|||||||||||||||||| |||deaths|every|||||||||||||||||||||| Каждый четвертый год умирает от СПИДа, туберкулеза, малярии и различных инфекций, связанных с грязной водой — 80 процентов из них в возрасте до пяти лет.

Even in wealthy countries it is common now to see inequality growing. ||||||||||Ungleichheit| |||||||now|||| In the United States, since 2001 we’ve had five years of economic growth, five years of productivity growth in the workplace, but median wages are stagnant and the percentage of working families dropping below the poverty line is up by four percent. |||||||||||||||||||||Median|||stagnierend|||||||||||||||| |||||||||||||||||||||medianas||||||||||||||||||| The percentage of working families without health care up by four percent. So this interdependent world which has been pretty good to most of us -- which is why we’re all here in Northern California doing what we do for a living, enjoying this evening -- is profoundly unequal. Entonces, este mundo interdependiente que ha sido bastante bueno para la mayoría de nosotros, razón por la cual todos estamos aquí en el norte de California haciendo lo que hacemos para ganarnos la vida, disfrutando esta noche, es profundamente desigual. It is also unstable. |||instabil También es inestable. Unstable because of the threats of terror, weapons of mass destruction, the spread of global disease and a sense that we are vulnerable to it in a way that we weren’t not so many years ago. ||||||khủng bố||||||||||||||||||||||||||||| ||||Bedrohungen||||||||||||||||||verwundbar||||||||||||| And perhaps most important of all, it is unsustainable because of climate change, resource depletion and species destruction. ||||||||nachhaltig||||||erschöpfung||| ||||||||||||||depleción||| И, пожалуй, самое главное - она неустойчива из-за изменения климата, истощения ресурсов и уничтожения видов.

When I think about the world I would like to leave to my daughter and the grandchildren I hope to have, it is a world that moves away from unequal, unstable, unsustainable interdependence to integrated communities -- locally, nationally and globally -- that share the characteristics of all successful communities. ||||||||||||||||||||||||||||||||Interdependenz||||lokal|national|||||||||| ||||||||||||||||||||||||||||||||interdependencia||||||||||||||| Cuando pienso en el mundo que me gustaría dejar a mi hija y a los nietos que espero tener, es un mundo que se aleja de la interdependencia desigual, inestable e insostenible hacia comunidades integradas, local, nacional y globalmente, que comparten las características de todas las comunidades exitosas. Когда я думаю о мире, который я хотел бы оставить своей дочери и внукам, которых я надеюсь иметь, это мир, который уходит от неравной, нестабильной, неустойчивой взаимозависимости к интегрированным сообществам — на местном, национальном и глобальном уровнях — которые разделяют характеристики всех успешных сообществ. A broadly shared, accessible set of opportunities, a shared sense of responsibility for the success of the common enterprise and a genuine sense of belonging. |breit||||||||||||||||||||||| Ein breit geteiltes, zugängliches Set von Möglichkeiten, ein gemeinsames Verantwortungsbewusstsein für den Erfolg des gemeinsamen Unternehmens und ein echtes Zugehörigkeitsgefühl. Un conjunto accesible y ampliamente compartido de oportunidades, un sentido compartido de responsabilidad por el éxito de la empresa común y un genuino sentido de pertenencia. Широкий доступный набор возможностей, общее чувство ответственности за успех общего предприятия и подлинное чувство сопричастности. All easier said than done. Alles leichter gesagt als getan. Todo es más fácil decirlo que hacerlo. Все проще сказать, чем сделать. When the terrorist incidents occurred in the United Kingdom a couple of years ago, I think even though they didn’t claim as many lives as we lost in the United States on 9/11, I think the thing that troubled the British most was that the perpetrators were not invaders, but homegrown citizens whose religious and political identities were more important to them than the people they grew up with, went to school with, worked with, shared weekends with, shared meals with. ||||||||||||||||||||||||||||||||||||||||||||thủ phạm||||||||||||||||||||||||||||||||||| ||Terrorist|Vorfälle|geschah|||||||||||||||||||||||||||||||||||||||||||||||||||Identitäten|||||||||||||||||||||||| |||||||||||||||||||||||||||||||||||||||||||||||||nacional|||||||||||||||||||||||||||||| Als vor ein paar Jahren die terroristischen Vorfälle im Vereinigten Königreich stattfanden, denke ich, dass, obwohl sie nicht so viele Leben gefordert haben wie wir in den Vereinigten Staaten am 11. September verloren haben, das, was die Briten am meisten beunruhigte, war, dass die Täter keine Eindringlinge waren, sondern einheimische Bürger, deren religiöse und politische Identitäten wichtiger für sie waren als die Menschen, mit denen sie aufgewachsen sind, zur Schule gegangen sind, gearbeitet haben, Wochenenden geteilt haben und Mahlzeiten geteilt haben. Cuando ocurrieron los incidentes terroristas en el Reino Unido hace un par de años, creo que aunque no cobraron tantas vidas como las que perdimos en los Estados Unidos el 11 de septiembre, creo que lo que más preocupó a los británicos fue que los perpetradores no eran invasores, sino ciudadanos locales cuyas identidades religiosas y políticas eran más importantes para ellos que las personas con las que crecieron, fueron a la escuela, trabajaron, compartieron fines de semana y comidas. Когда пару лет назад в Соединенном Королевстве произошли террористические акты, я думаю, что хотя они и не унесли столько жизней, сколько мы потеряли в Соединенных Штатах 11 сентября, больше всего британцев беспокоило то, что преступники были не захватчиками, а доморощенными гражданами, чья религиозная и политическая идентичность была для них важнее, чем люди, с которыми они выросли, с которыми ходили в школу, работали, делили выходные, делили трапезу. In other words, they thought their differences were more important than their common humanity. Другими словами, они думали, что их различия важнее, чем их общая человечность. It is the central psychological plague of humankind in the 21st century. |||||||nhân loại|||| |||||Plage|||||| Es ist die zentrale psychologische Plage der Menschheit im 21. Jahrhundert. Это главная психологическая чума человечества в 21 веке.

Into this mix, people like us who are not in public office, have more power to do good than at any time in history, because more than half the world’s people live under governments they voted in and can vote out. In diese Mischung haben Menschen wie wir, die nicht im öffentlichen Amt stehen, mehr Macht, Gutes zu tun als zu jeder anderen Zeit in der Geschichte, denn mehr als die Hälfte der Menschen auf der Welt lebt unter Regierungen, die sie gewählt haben und abwählen können. В этой смеси такие люди, как мы, которые не занимают государственные должности, имеют больше возможностей творить добро, чем когда-либо в истории, потому что более половины людей в мире живут при правительствах, за которые они проголосовали, и могут проголосовать против. And even non-democratic governments are more sensitive to public opinion. Und sogar nicht-demokratische Regierungen sind empfindlicher gegenüber der öffentlichen Meinung. E incluso los gobiernos no democráticos son más sensibles a la opinión pública. И даже недемократические правительства более чувствительны к общественному мнению. Because primarily of the power of the Internet, people of modest means can band together and amass vast sums of money that can change the world for some public good if they all agree. |hauptsächlich|||||||||||||||ansammeln||Summen||||||||||||||| Primär aufgrund der Macht des Internets können Menschen mit bescheidenen Mitteln sich zusammenschließen und immense Geldsummen anhäufen, die die Welt zum Wohle der Allgemeinheit verändern können, wenn sie alle einverstanden sind. В первую очередь из-за возможностей Интернета люди со скромным достатком могут объединиться и накопить огромные суммы денег, которые могут изменить мир на какое-то общественное благо, если они все согласятся. When the tsunami hit South Asia, the United States contributed 1.2 billion dollars. ||tsunami||||||||| Als der Tsunami Südostasien traf, trugen die Vereinigten Staaten 1,2 Milliarden Dollar bei. 30 percent of our households gave. 30 Prozent unserer Haushalte haben gespendet. 30 процентов наших домохозяйств давали. Half of them gave over the Internet. Die Hälfte von ihnen gab über das Internet. The median contribution was somewhere around 57 dollars. |mediana||||| Der mediane Beitrag lag bei etwa 57 Dollar. And thirdly, because of the rise of non-governmental organizations. Und drittens, wegen des Ansturms von Nichtregierungsorganisationen. И в-третьих, из-за подъема неправительственных организаций. They, businesses, other citizens' groups, have enormous power to affect the lives of our fellow human beings. Они, предприятия, другие группы граждан, обладают огромной властью влиять на жизнь наших собратьев. When I became president in 1993, there were none of these organizations in Russia. Когда я стал президентом в 1993 году, в России не было ни одной из этих организаций. There are now a couple of hundred thousand. Сейчас их несколько сотен тысяч. None in India. There are now at least a half a million active. None in China. There are now 250,000 registered with the government, probably twice again that many who are not registered for political reasons. В настоящее время в правительстве зарегистрировано 250 000 человек, вероятно, вдвое больше, чем тех, кто не зарегистрирован по политическим причинам.

When I organized my foundation, and I thought about the world as it is and the world that I hope to leave to the next generation, and I tried to be realistic about what I had cared about all my life that I could still have an impact on. Когда я организовывал свой фонд и думал о мире таким, какой он есть, и о мире, который я надеюсь оставить следующему поколению, я пытался быть реалистом в отношении того, о чем я заботился всю свою жизнь, что я все еще могу оказывать влияние на. I wanted to focus on activities that would help to alleviate poverty, fight disease, combat climate change, bridge the religious, racial and other divides that torment the world, but to do it in a way that would either use whatever particular skills we could put together in our group to change the way some public good function was performed so that it would sweep across the world more. ||||||||||||||||||các|||||||hành hạ|||||||||||||||||||||||||||||||||||||||||| ||||||||||lindern||||||||||rassischen|||Gräben||quälen|||||||||||||||||||||||||||||||||||||||||| Я хотел сосредоточиться на деятельности, которая помогла бы бороться с нищетой, бороться с болезнями, бороться с изменением климата, преодолевать религиозные, расовые и другие разногласия, терзающие мир, но делать это таким образом, чтобы либо использовать любые конкретные навыки, которые мы могли бы применить. вместе в нашей группе, чтобы изменить способ выполнения какой-либо общественной функции, чтобы она распространилась по миру больше.

You saw one reference to that in what we were able to do with AIDS drugs. Вы видели одно упоминание об этом в том, что мы смогли сделать с лекарствами от СПИДа. And I want to say that the head of our AIDS effort, and the person who also is primarily active in the wish I’ll make tonight, Ira Magaziner, is here with me and I want to thank him for everything he’s done. ||||||||||||||||||primär|||||||||Magaziner|||||||||||||| |||||||||||||||||||||||||||Magaziner|||||||||||||| И я хочу сказать, что глава нашего движения по борьбе со СПИДом и человек, который также в первую очередь активно участвует в желании, которое я загадаю сегодня вечером, Айра Магазинер, здесь со мной, и я хочу поблагодарить его за все, что он сделал. He’s over there. (Applause) When I got out of office and was asked to work, first in the Caribbean, to try to help deal with the AIDS crisis, generic drugs were available for about 500 dollars a person a year. |||||||||||||||||||||||||Generika|||||||||| (Аплодисменты) Когда я вышел из офиса и меня попросили работать, сначала на Карибах, чтобы попытаться помочь справиться с кризисом СПИДа, непатентованные лекарства были доступны примерно по 500 долларов на человека в год. If you bought them in vast bulks, you could get them at a little under 400 dollars. ||||||khối lượng||||||||| ||||||Mengen||||||||| ||||||grandes cantidades||||||||| Если вы покупаете их большими партиями, вы можете получить их чуть меньше 400 долларов. The first country we went to work in, the Bahamas, was paying 3,500 dollars for these drugs. |||||||||Bahamas|||||| Первая страна, в которой мы поехали работать, Багамы, платила за эти лекарства 3500 долларов. The market was so terribly disorganized that they were buying this medicine through two agents who were gigging them sevenfold. ||||schrecklich|unorganisiert||||||||||||übervorteilen||siebenfach |||||||||||||||||cobrando||siete veces Рынок был настолько ужасно дезорганизован, что они покупали это лекарство через двух агентов, которые накручивали их в семь раз больше. So the very first week we were working, we got the price down to 500 dollars. Так что в первую же неделю работы мы снизили цену до 500 долларов. And all of a sudden, they could save seven times as many lives for the same amount of money. И вдруг они могут спасти в семь раз больше жизней за те же деньги.

Then we went to work with the manufacturers of AIDS medicines, one of whom was cited in the film, and negotiated a whole different change in business strategy. ||||||||||medikamenten||||||||||verhandelten||||||| Затем мы начали работать с производителями лекарств от СПИДа, одного из которых цитировали в фильме, и договорились о совершенно другом изменении бизнес-стратегии. Because even at 500 dollars, these drugs were being sold on a high-margin, low-volume, uncertain-payment basis. ||||||||||||Marge||||| Потому что даже по 500 долларов эти лекарства продавались с высокой маржой, небольшими объемами и неопределенной оплатой. So we worked on improving the productivity of the operations and the supply chain, and went to a low-margin, high-volume, absolutely certain-payment business. |||||||||Betrieb|||||||||||||||Zahlung| Поэтому мы работали над повышением производительности операций и цепочки поставок и перешли к низкодоходному, крупномасштабному бизнесу с абсолютно гарантированной оплатой. I joked that the main contribution we made to the battle against AIDS was to get the manufacturers to change from a jewelry store to a grocery store strategy. Я пошутил, что основной вклад, который мы внесли в борьбу со СПИДом, заключался в том, чтобы убедить производителей перейти от стратегии ювелирного магазина к стратегии продуктового магазина. But the price went to 140 dollars from 500. Но цена ушла в 140 долларов с 500. And pretty soon, the average price was 192 dollars. И довольно скоро средняя цена составила 192 доллара. Now we can get it for about 100 dollars. Теперь мы можем получить его примерно за 100 долларов. Children’s medicine was 600 dollars, because nobody could afford to buy any of it. Детские лекарства стоили 600 долларов, потому что никто не мог позволить себе их купить. We negotiated it down to 190. Мы договорились о снижении до 190. Then, the French imposed their brilliantly conceived airline tax to create a something called UNITAID, got a bunch of other countries to help. |||verhängten|||konzipierte||Steuer||||||UNITAID|||Haufen||||| ||||||||||||||UNITAID|||||||| Затем французы ввели свой блестяще задуманный налог на авиаперевозки, чтобы создать что-то под названием UNITAID, получив помощь от других стран. Children’s medicine is now 60 dollars a person a year. ||||Dollar||||

The only thing that is keeping us from basically saving the lives of everybody who needs the medicine to stay alive are the absence of systems necessary to diagnose, treat and care for people and deliver this medicine. |||||||||retten||||||||||||||||||||behandeln|||||||| Единственное, что удерживает нас от спасения жизней всех, кто нуждается в лекарстве, чтобы остаться в живых, — это отсутствие систем, необходимых для диагностики, лечения и ухода за людьми и доставки этого лекарства. We started a childhood obesity initiative with the Heart Association in America. ||||Fettleibigkeit|Initiative|||||| Мы начали инициативу по борьбе с детским ожирением совместно с Ассоциацией кардиологов в Америке. We tried to do the same thing by negotiating industry-right deals with the soft drink and the snack food industry to cut the caloric and other dangerous content of food going to our children in the schools. ||||||||verhanden||||||||||||||||kalorische||||||||||||| Мы пытались сделать то же самое, заключая отраслевые соглашения с производителями безалкогольных напитков и закусок, чтобы сократить калорийность и другое опасное содержание пищи, поступающей к нашим детям в школах. We just reorganized the markets. ||reorganisierten|| ||reorganizamos|| Мы просто реорганизовали рынки. And it occurred to me that in this whole non-governmental world, somebody needs to be thinking about organizing public goods markets. ||kam||||||||staatlich||||||||||| И мне пришло в голову, что во всем этом неправительственном мире кто-то должен подумать об организации рынков общественных благ. And that is now what we’re trying to do, and working with this large cities group to fight climate change to negotiate huge, big, volume deals that will enable cities which generate 75 percent of the world’s greenhouse gases to drastically and quickly reduce greenhouse gas emissions in a way that is good economics. |||||||||||||||||||||verhanden||||||||||||||||||drastisch||||||||||||| И это то, что мы сейчас пытаемся сделать, работая с этой группой крупных городов над борьбой с изменением климата, чтобы заключить огромные, большие, объемные сделки, которые позволят городам, которые производят 75 процентов парниковых газов в мире, резко и быстро сократить выбросы парниковых газов. выбросы газа таким образом, что это хорошая экономика. And this whole discussion as if it’s some sort of economic burden, is a mystery to me. |||||||||||Lasten||||| И вся эта дискуссия, как будто это какое-то экономическое бремя, для меня загадка. I think it’s a bird’s nest on the ground. ||||Vogel|||| Я думаю, это птичье гнездо на земле.

When Al Gore won his well-deserved Oscar for the "Inconvenient Truth" movie, I was thrilled, but I had urged him to make a second movie quickly. ||Gore|||||Oscar|||unbequeme|||||begeistert|||||ihn|||||| ||||||merecido|||||||||||||||||||| Когда Эл Гор получил свой заслуженный «Оскар» за фильм «Неудобная правда», я был в восторге, но убедил его поскорее снять второй фильм. For those of you who saw "An Inconvenient Truth," the most important slide in the Gore lecture is the last one, which shows here’s where greenhouse gases are going if we don’t do anything, here’s where they could go. |||||||unbequeme|||||||||Vorlesung|||||||||||||||||||||| Для тех из вас, кто видел «Неудобную правду», самым важным слайдом в лекции Гора является последний, который показывает, куда уходят парниковые газы, если мы ничего не делаем, и вот куда они могут уйти. And then there are six different categories of things we can do to change the trajectory. |||||||||||||||quỹ đạo |||||||||||||||Verlauf Кроме того, есть шесть различных категорий вещей, которые мы можем сделать, чтобы изменить траекторию. We need a movie on those six categories. Нам нужен фильм по этим шести категориям. And all of you need to have it embedded in your brains and to organize yourselves around it. И всем вам нужно, чтобы это было встроено в ваши мозги, и вы организовались вокруг этого. So we’re trying to do that.

So organizing these markets is one thing we try to do. Die Organisation dieser Märkte ist eine Sache, die wir zu tun versuchen. Now we have taken on a second thing, and this gets to my wish. Jetzt haben wir eine zweite Sache übernommen, und das kommt meinem Wunsch zugute. Теперь мы взялись за вторую вещь, и это соответствует моему желанию. It has been my experience in working in developing countries that while the headlines may all be -- the pessimistic headlines may say, well, we can’t do this or the other thing because of corruption, I think incapacity is a far bigger problem in poor countries than corruption, and feeds corruption. ||||||||||||||||||bi quan||||||||||||||||||||||||||||tham nhũng||| |||||||||||||Überschriften|||||||||||||||||||||||Unfähigkeit||||||||||||| ||||||||||||||||||||||||||||||||||||incapacidad||||||||||||| Es ist meine Erfahrung in der Arbeit in Entwicklungsländern, dass während die Schlagzeilen vielleicht alle pessimistisch sein mögen und sagen, nun, wir können dies oder das aufgrund von Korruption nicht tun, denke ich, dass Unfähigkeit ein viel größeres Problem in armen Ländern ist als Korruption und Korruption nährt. По моему опыту работы в развивающихся странах, хотя все заголовки могут быть... пессимистичные заголовки могут говорить, ну, мы не можем делать то или иное из-за коррупции, я думаю, что нетрудоспособность является гораздо более серьезной проблемой в бедных странах, чем коррупция, и подпитывает коррупцию. We now have the money, given these low prices, to distribute AIDS drugs all over the world to people we cannot presently reach. ||||||||||verteilen|||||||||||| Wir haben jetzt das Geld, angesichts dieser niedrigen Preise, um AIDS-Medikamente weltweit an Menschen zu verteilen, die wir derzeit nicht erreichen können. Теперь у нас есть деньги, учитывая эти низкие цены, чтобы распространять лекарства от СПИДа по всему миру среди людей, которых мы в настоящее время не можем охватить. Today these low prices are available in the 25 countries where we work, and in a total of 62 countries. Heute sind diese niedrigen Preise in den 25 Ländern, in denen wir arbeiten, und insgesamt in 62 Ländern verfügbar. Сегодня эти низкие цены доступны в 25 странах, где мы работаем, а всего в 62 странах. And about 550,000 people are getting the benefits of them. Und etwa 550.000 Menschen profitieren davon. But the money is there to reach others. Но деньги есть, чтобы достучаться до других. The systems are not there to reach the people. Системы существуют не для того, чтобы достучаться до людей.

So what we have been trying to do, working first in Rwanda and then in Malawi and other places -- but I want to talk about Rwanda tonight -- is to develop a model for rural health care in a very poor area that can be used to deal with AIDS, TB, malaria, other infectious diseases, maternal and child health, and a whole range of health issues poor people are grappling with in the developing world, that can first be scaled for the whole nation of Rwanda, and then will be a model that could literally be implemented in any other poor country in the world. |||||||||||||||Malawi|||||||||||||||||||||||||||||||||||||infektiöse||mütterliche||||||||||||||grappling||||||||||||||||||||||||||||||||||| Итак, что мы пытались сделать, работая сначала в Руанде, а затем в Малави и других местах — но я хочу поговорить о Руанде сегодня вечером — это разработать модель сельского здравоохранения в очень бедном районе, которую можно было бы использовать. для борьбы со СПИДом, туберкулезом, малярией, другими инфекционными заболеваниями, здоровьем матери и ребенка и целым рядом проблем со здоровьем, с которыми борются бедные люди в развивающихся странах, которые сначала могут быть масштабированы для всей нации Руанды, а затем быть моделью, которую можно было бы буквально реализовать в любой другой бедной стране мира.

And the test is: one, will it do the job, will it develop -- provide high quality care? И тест таков: во-первых, будет ли он выполнять свою работу, будет ли он развиваться, обеспечивать высококачественный уход? And two, will it do it at a price that will enable the country to sustain a health care system without foreign donors after five to 10 years? ||||||||||||||||||||||nhà tài trợ|||| Во-вторых, будет ли это сделано ценой, которая позволит стране поддерживать систему здравоохранения без иностранных доноров через 5-10 лет? Because the longer I deal with these problems, the more convinced I am that we have to -- whether it’s economics, health, education, whatever -- we have to build systems. Потому что чем дольше я занимаюсь этими проблемами, тем больше убеждаюсь в том, что мы должны — будь то экономика, здравоохранение, образование, что угодно — мы должны создавать системы. And the absence of systems that function break the connection which got you all in this seat tonight. И отсутствие функционирующих систем разрывает связь, из-за которой вы все сегодня сидите в этом кресле. You think about whatever your life has been, however many obstacles you have faced in your life, at critical junctures you always knew there was a predictable connection between the effort you exerted and the result you achieved. |||||||||||||||||||giai đoạn|||||||có thể dự đoán||||||đã bỏ ra||||| |||||||||||||||||||Momenten|||||||vorhersehbare||||||||||| ||||||||||||||||||||||||||||||||ejerciste||||| Вы думаете о том, какой бы ни была ваша жизнь, сколько бы препятствий вы ни встретили в своей жизни, в критические моменты вы всегда знали, что существует предсказуемая связь между приложенными вами усилиями и результатом, которого вы достигли. In a world with no systems, with chaos, everything becomes a guerilla struggle, and this predictability is not there. |||||||||||Guerillakampf||||Vorhersehbarkeit||| |||||||||||guerilla||||||| And it becomes almost impossible to save lives, educate kids, develop economies, whatever.

The person, in my view, who has done the best job of this in the health care area, of building a system in a very poor area is Dr. Paul Farmer, who many of you know, has worked for now 20 years with his group, Partners in Health, primarily in Haiti where he started. But they’ve also worked in Russia, in Peru and other places around the world. As poor as Haiti is, in the area where Farmer’s clinic is active -- and they serve a catchment area far greater than the medical professionals they have would indicate they could serve -- since 1988, they have not lost one person to tuberculosis, not one. ||||||||||||||||||||||||||||||||||||||||lao|| |||||||||||||||||Einzugsgebiet||||||||||||||||||||||||| |||||||||||||||||área de influencia||||||||||||||||||||||||| And they’ve achieved a lot of other amazing health results. So when we decided to work in Rwanda on trying to dramatically increase the income of the country and fight the AIDS problem, we wanted to build a healthcare network, because it had been totally destroyed during the genocide in 1994, and the per capita income was still under a dollar a day. ||||||||||||||||||||||||||||||||||||||diệt chủng||||||||||||| So I rang up, asked Paul Farmer if he would help. Because it seemed to me if we could prove there was a model in Haiti and a model in Rwanda that we could then take all over the country, number one, it would be a wonderful thing for a country that has suffered as much as any on Earth in the last 15 years, and number two, we would have something that could then be adapted to any other poor country anywhere in the world. And so we have set about doing that.

Now, we started working together 18 months ago. And we’re working in an area called Southern Kayonza, which is one of the poorest areas in Rwanda, with a group that originally includes about 400,000 people. ||||||||Kayonza||||||||||||||||| ||||||||Kayonza||||||||||||||||| We’re essentially implementing what Paul Farmer did in Haiti, where he develops and trains paid community health workers who are able to identify health problems, ensure that people who have AIDS or TB are properly diagnosed and take their medicine regularly, who work on bringing about health education, clean water and sanitation, providing nutritional supplements and moving people up the chain of health care if they have problems of the severity that require it. |về cơ bản|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||Schwere||| The procedures that make this work have been perfected, as I said, by Paul Farmer and his team in their work in rural Haiti over the last 20 years. ||||||||||||||||||||||nông thôn||||| Recently we did an evaluation of the first 18 months of our efforts in Rwanda. And the results were so good that the Rwandan government has now agreed to adopt the model for the entire country, and has strongly supported and put the full resources of the government behind it.

I’ll tell you a little bit about our team because it’s indicative of what we do. |||||||||||đặc trưng|||| |||||||||||indicativ|||| |||||||||||indicativo|||| We have about 500 people around the world working in our AIDS program, some of them for nothing -- just for transportation, room and board. And then we have others working in these other related programs. Our business plan in Rwanda was put together under the leadership of Diana Noble, who is an unusually gifted woman, but not unusual in the type of people who have been willing to do this kind of work. She was the youngest partner at Schroder Ventures in London in her 20s. ||||||Schroder|||||| ||||||Schroder|||||| She was CEO of a successful e-venture -- she started and built Reed Elsevier Ventures -- and at 45 she decided she wanted to do something different with her life. ||||||||||||Reed|Elsevier|||||||||||||| ||||||||||||Reed|Elsevier|||||||||||||| So she now works full-time on this for very little pay. She and her team of former business people have created a business plan that will enable us to scale this health system up for the whole country. And it would be worthy of the kind of private equity work she used to do when she was making a lot more money for it.

When we came to this rural area, 45 percent of the children under the age of five had stunted growth due to malnutrition. |||||||||||||||||||||suy dinh dưỡng |||||||||||||||||||||Unterernährung 23 percent of them died before they reached the age of five. Mortality at birth was over two and a half percent. Over 15 percent of the deaths among adults and children occurred because of intestinal parasites and diarrhea from dirty water and inadequate sanitation, all entirely preventable and treatable. ||||||||||||intestinaler||||||||||||||behandelbar |||||||||||||parásitos||||||||||||| Over 13 percent of the deaths were from respiratory illnesses -- again, all preventable and treatable. |||||||hô hấp|||||| And not a single soul in this area was being treated for AIDS or tuberculosis.

Within the first 18 months, the following things happened: we went from zero to about 2,000 people being treated for AIDS. That’s 80 percent of the people who need treatment in this area. Listen to this: less than four-tenths of one percent of those being treated stopped taking their medicine or otherwise defaulted on treatment. ||||||||||||||||||||versäumten|| ||||||décimas||||||||||||||no cumplieron|| Послушайте: менее четырех десятых процента тех, кто лечился, прекратили прием лекарств или иным образом не выполнили лечение. That’s lower than the figure in the United States. Less than three-tenths of one percent had to transfer to the more expensive second-line drugs. 400,000 pregnant women were brought into counseling and will give birth for the first time within an organized health care system. That’s about 43 percent of all the pregnancies. ||||||Schwangerschaften ||||||embarazos About 40 percent of all the people -- I said 400,000. I meant 40,000. About 40 percent of all the people who need TB treatment are now getting it -- in just 18 months, up from zero when we started. 43 percent of the children in need of an infant feeding program to prevent malnutrition and early death are now getting the food supplements they need to stay alive and to grow.

We’ve started the first malaria treatment programs they’ve ever had there. Patients admitted to a hospital that was destroyed during the genocide that we have renovated along with four other clinics, complete with solar power generators, good lab technology. |||||||bị phá hủy|||||||||||||||||||| |||||||||||||||||||Kliniken|||||||| We now are treating 325 people a month, despite the fact that almost 100 percent of the AIDS patients are now treated at home. And the most important thing is because we’ve implemented Paul Farmer’s model, using community health workers, we estimate that this system could be put into place for all of Rwanda for between five and six percent of GDP, and that the government could sustain that without depending on foreign aid after five or six years. |||||||||||||||||||||||||||||||||||||||||||duy trì||||||||||| And for those of you who understand healthcare economics you know that all wealthy countries spend between nine and 11 percent of GDP on health care, except for the United States, we spend 16 -- but that’s a story for another day. (Laughter)

We’re now working with Partners in Health and the Ministry of Health in Rwanda and our Foundation folks to scale this system up. We’re also beginning to do this in Malawi and Lesotho. |||||||||Lesotho |||||||||Lesotho And we have similar projects in Tanzania, Mozambique, Kenya and Ethiopia with other partners trying to achieve the same thing, to save as many lives as quickly as we can, but to do it in a systematic way that can be implemented nationwide and then with a model that can be implemented in any country in the world. We need initial upfront investment to train doctors, nurses, health administration and community health workers throughout the country, to set up the information technology, the solar energy, the water and sanitation, the transportation infrastructure. ||||||||||||||||||||||||||||||vệ sinh||| |||vorausgehende|||||||||||||||||||||||||||||| But over a five to 10-year period, we will take down the need for outside assistance and eventually it will be phased out. |||||||||||||||||||||loại bỏ| |||||||||||||||||||||auslaufen|

My wish is that TED assist us in our work and help us to build a high-quality rural health system in a poor country, Rwanda, that can be a model for Africa, and indeed, for any poor country anywhere in the world. |||||unterstützt||||||||||||||||||||||||||||||||||||| My belief is that this will help us to build a more integrated world with more partners and fewer terrorists, with more productive citizens and fewer haters, a place we’d all want our kids and our grandchildren to grow up in. ||||||||||||tích hợp|||||||khủng bố|||||||kẻ thù|||||||||||||| ||||||||||||||||||||||||||Hasser|||||||||||||| It has been an honor for me, particularly to work in Rwanda where we also have a major economic development project in partnership with Sir Tom Hunter, the Scottish philanthropist, where last year we, using the same thing with AIDS drugs, cut the cost of fertilizer and the interest rates on microcredit loans by 30 percent and achieved three to four hundred percent increases in crop yields with the farmers. |||||||||||||||||||||||||||||||||||||||||||||phân bón||||||||||||||||||||||| ||||||||||||||||||||||||||||schottische|Philanthropist||||||||||||||||Dünger||||||Mikrokredit|Darlehen||||||||||||Anbau|erwirtschaftet||| |||||||||||||||||||||||||||||||||||||||||||||||||||microcrédito|||||||||||||||||

These people have been through a lot and none of us, most of all me, helped them when they were on the verge of destroying each other. Эти люди прошли через многое, и никто из нас, особенно я, не помог им, когда они были на грани уничтожения друг друга. We’re undoing that now, and they are so over it and so into their future. |machen rückgängig||||||||||||| |deshaciendo||||||||||||| Мы уничтожаем это сейчас, а они уже пережили это и ушли в свое будущее. We’re doing this in an environmentally responsible way. I’m doing my best to convince them not to run the electric grid to the 35 percent of the people that have no access, but to do it with clean energy, to have responsible reforestation projects. |||||||||||||||||||||||||||||||||trồng rừng phục hồi| |||||überzeugen||||||||||||||||||||||||||||Aufforstung| Я делаю все, что в моих силах, чтобы убедить их не подключать к электросети 35 процентов людей, не имеющих доступа, а делать это с использованием чистой энергии, иметь ответственные проекты по лесовосстановлению. The Rwandans, interestingly enough have been quite good, Mr. Wilson in preserving their topsoil. |Rwander||||||||||erhalten||Oberboden |||||||||||||camada superficial do solo |ruandeses||||||||||||suelo superficial There’s a couple of guys from southern farming families -- the first thing I did when I went out to this place was to get down on my hands and knees and dig in the dirt and see what they’d done with it. Es gibt ein paar Jungs aus südlichen Landwirtfamilien -- das erste, was ich tat, als ich an diesen Ort kam, war, mich auf Hände und Knie zu begeben, in den Boden zu graben und zu sehen, was sie daraus gemacht hatten.

We have a chance here to prove that a country that almost slaughtered itself out of existence can practice reconciliation, reorganize itself, focus on tomorrow and provide comprehensive, quality health care with minimal outside help. ||||||||||||giết|||||||||||||||||||||| |||||||||||||||||||Versöhnung|sich neu organisieren||||||||||||minimal|| ||||||||||||||||||||reorganizarse|||||||||||||| ||||||||||||se matou||||||||reorganizar-se|||||||||||||| Wir haben hier die Chance zu beweisen, dass ein Land, das sich fast selbst ausgerottet hat, Versöhnung üben, sich neu organisieren, sich auf morgen konzentrieren und umfassende, qualitativ hochwertige Gesundheitsversorgung mit minimaler externer Hilfe bieten kann. I am grateful for this prize, and I will use it to that end. Ich bin dankbar für diesen Preis und ich werde ihn dafür nutzen. We could use some more help to do this, but think of what it would mean if we could have a world-class health system in Rwanda -- in a country with less than one dollar a day per capita income, one that could save hundreds of millions of lives over the next decade if applied to every similarly situated country on Earth. ||||||||||||||||||||||||||||||||||||||bình quân||||||||||||||||||||||| ||||||||||||||||||||||||||||||||||||||pro Kopf||||||||||||||||||||liegt||| It’s worth a try and I believe it would succeed. Thank you and God bless you. (Applause)

http://www.ted.com/talks/bill_clinton_on_rebuilding_rwanda.html