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　　Medicines can be expensive and often make up a large portion of any family's health care budget. And the burden can be even greater for people in poor countries, where the cost of vital medicines can push them into poverty.
药品有时很贵，通常会在家庭的保健预算中占很大比例。但是在贫穷国家，重要药品的开支能使人倾家荡产。
The problem is growing as more people around the world are diagnosed with chronic¹ diseases such as high blood pressure and diabetes². Being diagnosed with a chronic disease usually compells patients to seek treatment for a prolonged period of time. That increases the eventual³ price tag for health, says health economist⁴ Laurens Ni?ns at Erasmus University in the Netherlands.
荷兰艾拉斯穆斯大学卫生经济学家劳伦斯·尼恩斯说，高血压和糖尿病等慢性病，在世界各地越来越普遍。这就意味着，病人不得不接受长期治疗。
Ni?ns examined medication pricing data from the World Health Organization and also looked at data from the World Bank on household income in many countries. Using the data, he calculated how much people need to spend on necessities such as food, housing, education and medicines.
尼恩斯从世界卫生组织的资料中查阅药品价格，同时研究世界银行的资料有关许多国家的家庭收入情况。然后，他计算出人们在食物、住房、教育和医药等必须项目上的开支是多少。
"The medicines we looked at are medicines for patients who suffer from asthma⁵, diabetes, hypertension and we looked at an adult respiratory infection," Ni?ns says. "Three conditions are for chronic diseases, which basically means that people need to procure⁶ those medicines each and every day."
他说：“我们主要是看治疗哮喘、糖尿病、高血压的药物，以及成年人呼吸道感染。这三种都是慢性病，基本上，病人需要每天服药。”
Ni?ns focused on the cost of medicine for those conditions. He found the essential drugs could be considered unaffordable for many people in poor countries - so much so that their cost often pushes people into abject⁸ poverty.
尼恩斯把重点放在这几种病的医药支出。他发现，这些最基本的药，对许多贫困国家的人来说，都是负担不起的，以至能使人落到一贫如洗的地步。
"The proportion of the population that is living below the poverty line, plus the people that are being pushed below the poverty line, can reach up to 80 percent in some countries for some medicines," Ni?ns says.
“在某些国家，生活在困线以下的人，加上因为吃药而降至贫困线以下的人，可能高达总人口的百分之80。”
He points out that generic⁹ medicines - which are more affordable⁷ than brand-name medications - are often not available in the marketplace. And, according to Ni?ns, poor government policies can drive up the cost of medications.
尼恩斯说，非专利(通用)药品比品牌药品便宜得多。但是往往在药店里买不到。尼恩斯并且指出，政府政策的不完善，也会使药品价格上涨。
"For instance, a lot of governments actually tax medicines when they come into the country," he says. "[They] have no standard for the markups on medicines through the distribution chain. So often, governments think they pay a good price for the medicines when they procure them from the producer. However, before such a medicine reaches a patient, markups are sometimes up to 1,000 percent."
“例如，许多政府对进口药品征税。在药品营销过程中，没有设定附加利润的限制。因此，政府常常觉得从制药厂买药时价格不错，而且对发展中国家还有折扣。其实，病人拿到药时，各种附加费用和利润，已经使药价比原来高了10倍了。”
Ni?ns believes governments and NGOs must work together to increase the affordability¹⁰ of medicines. And that pharmaceutical¹¹ companies should create high-quality generic drugs that won't break a family's budget. He also says that establishing national health insurance systems can help keep families from falling into poverty as they buy the medications they need to stay alive.
劳伦斯·尼恩斯说，政府和非政府组织必须共同努力，使药品价格更能为人所接受。制药公司应该生产高品质的无专利通用药品，以减轻病人家庭的经济负担。他还指出，应建立国家健保系统，帮助那些必须购买救命药物的家庭免于陷入贫困。