When you think back on 2023, how will you remember it?

当你回顾2023年时，你将如何记起？

For me, this will always be the year I became a grandparent. It will be the year I spent a lot of precious time with loved ones—whether on the pickleball court or over a rousing game of Settlers of Catan. And 2023 marked the first time I used artificial intelligence for work and other serious reasons, not just to mess around and create parody song lyrics for my friends.

对我来说，这将永远是我成为祖父的一年。这将是我与所爱的人共度宝贵时光的一年——无论是在匹克球场上，还是在激动人心的《卡坦岛》游戏中。2023年标志着我第一次将人工智能用于工作和其他正经事，而不仅仅是为了胡闹和为我的朋友创作拙劣的歌词。

This year gave us a glimpse of how AI will shape the future, and as 2023 comes to a close, I’m thinking more than ever about the world today’s young people will inherit. In last year’s letter, I wrote about how the prospect of becoming a grandparent made me reflect on the world my granddaughter will be born into. Now I’m thinking more about the world she will inherit and what it will be like decades from now, when her generation is in charge.

今年让我们看到了人工智能将如何塑造未来，随着2023年即将结束，我比以往任何时候都更多地思考当今年轻人将继承的世界。在去年的年度展望中，我写道，即将成为祖父母的展望如何让我反思孙女即将出生的世界。现在，我更多地在考虑她将继承的世界，以及几十年后，当她这一代人有话语权时，世界会是什么样子。

I can begin to picture it: the tools she will use, the ways she will stay in touch with her loved ones, the problems these innovations will help solve. We now have a better sense of what types of jobs AI will be able to do by itself and which ones it will serve as a copilot for. And it’s clearer than ever how AI can be used to improve access to education, mental health, and more. It motivates me to make sure this technology helps reduce—and doesn’t contribute to—the awful inequities we see around the world. I've always been a firm believer in the power of innovation to offer every child an equal chance to survive and thrive. AI is no exception.

我可以开始想象：她将使用的工具，她与亲人保持联系的方式，以及这些创新将帮助解决的问题。现在，我们对人工智能能够独自完成哪些工作，以及充当哪些工作的人工智能助手有了更好的认识。而且，我们比以往任何时候都更清楚地知道，如何利用人工智能来改善教育、心理健康等方面的机会。这激励我去确保这项技术有助于减少——而不是助长——我们在世界各地看到的严重的不平等现象。我一直坚信创新的力量可以为每个孩子提供平等的生存和发展机会。人工智能也不例外。

The early years of a new age are often marked by lots of changes. If you are old enough to remember, think back to the beginning of the internet. At first, you probably didn’t know many people who were using it. But it became more common over time until, one day, you realized most people had email addresses, bought things online, and used search engines to answer their questions.

一个新时代的最初几年往往以许多变化为标志。如果你年纪够大，还记得互联网诞生之初的情景。起初，你可能不知道有多少人在使用它。但随着时间的推移，它变得越来越普遍，直到有一天，你意识到大多数人都有电子邮件地址，在网上购物，并使用搜索引擎来回答他们的问题。

We are just at the beginning of this transition right now. This is an exciting and confusing time, and if you haven’t figured out how to make the best use of AI yet, you are not alone. I thought I would use AI tools for the foundation’s strategy reviews this year, which require reading hundreds of pages of briefing materials that an AI could accurately summarize for me. But old habits are hard to break, and I ended up preparing for them the same way I always do.

我们现在正处于这一转变的开端。这是一个令人兴奋和困惑的时代，如果你还没有想好如何充分利用人工智能，那你并不孤单。我本以为今年会在基金会的战略评估中使用人工智能工具，这需要阅读数百页的简报材料，而人工智能可以准确地为我总结。但旧习难改，我最终还是按照往常的方式做了准备。

Of course, AI is far from the only defining feature of 2023. My heart is broken for the continued suffering of Israelis and Palestinians, as well as for the people of Sudan. At the same time, more people are being forced to endure hardship as a result of more frequent extreme weather events caused by climate change. And families around the world continue to be hit hard by rising inflation and slow economic growth.

当然，人工智能远不是2023年的唯一定义。我为以色列人和巴勒斯坦人以及苏丹人民继续遭受的苦难感到心碎。与此同时，由于气候变化导致极端天气事件更加频繁，更多的人被迫忍受苦难。世界各地的家庭继续受到通货膨胀加剧和经济增长缓慢的沉重打击。

There’s no question these are challenging times, but I remain optimistic about the future. The speed of innovation has never been faster. We’re making big strides on tough problems—like Alzheimer’s, obesity, and sickle cell disease—that will improve the lives of millions of people. My friend the late Hans Rosling used to say that “things can be badand getting better.” It’s a good reminder that progress is not only possible but happening every day.

毫无疑问，这是一个充满挑战的时代，但我对未来依然乐观。创新的速度前所未有。我们在阿尔茨海默病、肥胖症和镰状细胞病等棘手问题上取得了长足进步，这将改善数百万人的生活。我的朋友、已故的汉斯·罗斯林（Hans Rosling）曾经说过："事情可能会变得更糟，也可能会变得更好。这句话很好地提醒我们，进步不仅是可能的，而且每天都在发生。

That’s why I remain dedicated to making sure that, even in the face of setbacks, the world continues to do more to help the poorest people. I do the bulk of this work through the Gates Foundation, where my colleagues remain dedicated to improving global health, education, gender equality, and more. While I could write a thousand pages about the incredible work they’re doing with our partners, this letter focuses on just a few of the most exciting breakthroughs.

这就是为什么我仍然致力于确保即使面对挫折，世界继续为帮助最贫穷的人群做出更多的努力。我的大部分工作是通过盖茨基金会完成的，我的同事们继续致力于改善全球健康、教育、性别平等等方面的工作。虽然我可以写上几千页的篇幅来介绍他们与我们的合作伙伴一起所做的令人难以置信的工作，但这封信只集中介绍其中几项最令人兴奋的突破。

I also write about why I’m optimistic about the world’s climate progress. Most of my climate and energy work is done through Breakthrough Energy, although the Gates Foundation is helping people in low- and middle-income countries adapt to a warming world. I also continue to privately fund research into other areas like Alzheimer’s disease. And I still get to advise Microsoft, which gives me insight into what’s coming down the pipeline and how it can be used to make the world a more equitable place.

我还写了我对世界气候进展持乐观态度的原因。我的大部分气候和能源工作都是通过突破能源（Breakthrough Energy）完成的，尽管盖茨基金会正在帮助中低收入国家的人们适应气候变暖的世界。我还继续为阿尔茨海默病等其他领域的研究提供私人资助。我还在为微软公司提供建议，这让我能够深入了解即将推出的产品，以及如何利用这些产品让世界变得更加公平。

I’m lucky that my work gives me insight into all the ways the world is getting better. The challenges we face feel a lot less daunting when you understand what exactly it will take to tackle them. In this letter, I will share just a few reasons I am optimistic about the year ahead. I hope they make you as excited about all the progress to come as I am.

我很幸运，我的工作让我了解到这个世界正在变得越来越好。当你了解我们所面临的挑战时，你就会觉得这些挑战并不那么可怕。在这封信中，我将与大家分享我对未来一年感到乐观的几个原因。我希望它们能让你和我一样，对即将实现的所有进展感到期待。

AI is about to supercharge the innovation pipeline.

人工智能将为创新管线提供超动力。

My work has always been rooted in a core idea: Innovation is the key to progress. It’s why I started Microsoft, and it’s why Melinda and I started the Gates Foundation more than two decades ago.

我的工作始终植根于一个核心理念：创新是进步的关键。这是我创办微软的原因，也是二十多年前我和梅琳达创办盖茨基金会的原因。

Innovation is the reason our lives have improved so much over the last century. From electricity and cars to medicine and planes, innovation has made the world better. Today, we are far more productive because of the IT revolution. The most successful economies are driven by innovative industries that evolve to meet the needs of a changing world.

创新是我们的生活在上个世纪得到极大改善的原因。从电力和汽车到医药和飞机，创新让世界变得更加美好。今天，由于信息技术革命，我们的生产力大大提高。最成功的经济体都是由创新产业推动的，这些产业不断发展，以满足不断变化的世界的需求。

My favorite innovation story, though, starts with one of my favorite statistics: Since 2000, the world has cut in half the number of children who die before the age of five.

不过，我最喜欢的创新故事要从我最喜欢的一个统计数据说起：自2000年以来，世界上五岁以下儿童的死亡人数减少了一半。

How did we do it? One key reason was innovation. Scientists came up with new ways to make vaccines that were faster and cheaper but just as safe. They developed new delivery mechanisms that worked in the world’s most remote places, which made it possible to reach more kids. And they created new vaccines that protect children from deadly diseases like rotavirus.

我们是如何做到的？一个关键原因是创新。科学家们想出了更快、更便宜但同样安全的疫苗制造新方法。他们开发出了在世界最偏远地区也能使用的新接种机制，从而使更多的儿童能够接种疫苗。他们还创造了新疫苗，保护儿童免受轮状病毒等致命疾病的侵袭。

In a world with limited resources, you have to find ways to maximize impact. Innovation is the key to getting the most out of every dollar spent. And artificial intelligence is about to accelerate the rate of new discoveries at a pace we’ve never seen before.

在一个资源有限的世界里，你必须找到最大化影响的方法。创新是让每一分钱发挥最大效益的关键。而人工智能将以前所未有的速度加快新发现的速度。

One of the biggest impacts so far is on creating new medicines. Drug discovery requires combing through massive amounts of data, and AI tools can speed up that process significantly. Some companies are already working on cancer drugs developed this way. But a key priority of the Gates Foundation in AI is ensuring these tools also address health issues that disproportionately affect the world's poorest, like AIDS, TB, and malaria.

迄今为止，最大的影响之一是创造新药。药物发现需要梳理海量数据，人工智能工具可以大大加快这一过程。一些公司已经在用这种方法开发抗癌药物。但盖茨基金会在人工智能领域的一个关键优先事项是确保这些工具也能解决艾滋病、结核病和疟疾等严重影响世界上最贫困人口的健康问题。

We’re taking a hard look at the wide array of AI innovation in the pipeline right now and working with our partners to use these technologies to improve lives in low- and middle-income countries.

我们正在认真研究目前正在进行的大量人工智能创新，并与我们的合作伙伴合作，利用这些技术改善中低收入国家的生活。

In the fall, I traveled to Senegal to meet with some of the incredible researchers doing this work and to celebrate the 20th anniversary of the foundation’s Grand Challenges initiative. When we first launched Grand Challenges—the Gates Foundation’s flagship innovation program—it had a single goal: Identify the biggest problems in health and give grants to local researchers who might solve them. We asked innovators from developing countries how they would address health challenges in their communities, and then we gave them the support to make it happen.

今年秋天，我前往塞内加尔会见了一些从事这项工作的优秀研究人员，并庆祝盖茨基金会“大挑战”20周年。盖茨基金会的旗舰创新项目“大挑战”最初启动时只有一个目标：找出健康领域的最大问题，并向可能解决这些问题的当地研究人员提供资助。我们询问发展中国家的创新者将如何解决其社区面临的健康挑战，然后我们为他们提供支持，帮助他们实现目标。

Many of the people I met in Senegal were taking on the first-ever AI Grand Challenge. The foundation didn’t have AI projects in mind when we first set that goal back in 2003, but I’m always inspired by how brilliant scientists are able to take advantage of the latest technology to tackle big problems.

我在塞内加尔遇到的许多人都参加了有史以来的首次人工智能大挑战。当我们在2003年第一次设定目标时，基金会并没有考虑人工智能项目，但我总是被聪颖的科学家们如何能够利用最新技术来解决重大问题所鼓舞。

Much of their work is in the earliest stages of development—there’s a good chance we won’t see any of them used widely in 2024 or even 2025. Some might not even pan out at all. The work that will be done over the next year is setting the stage for a massive technology boom later this decade.

他们的许多工作都处于最早期的开发阶段——我们很有可能在2024年甚至2025年都无法看到其中任何一项技术得到广泛应用。有些甚至根本不会成功。明年的工作将为本十年晚些时候的大规模技术繁荣奠定基础。

Still, it’s impressive to see how much creativity is being brought to the table. Here is a small sample of some of the most ambitious questions currently being explored:

尽管如此，看到这么多的创意被提到台面上还是令人印象深刻。以下是目前正在探讨的一些最具雄心的问题的一小部分：

● Can AI combat antibiotic resistance? Antibiotics are magical in their ability to end infection, but if you use them too often, pathogens can learn how to ignore them. This is called antimicrobial resistance, or AMR, and it is a huge issue around the world—especially in Africa, which has the highest mortality rates from AMR. Nana Kofi Quakyi from the Aurum Institute in Ghana is working on an AI-powered tool that helps health workers prescribe antibiotics without contributing to AMR. The tool will comb through all the available information—including local clinical guidelines and health surveillance data about which pathogens are currently at risk of developing resistance in the area—and make suggestions for the best drug, dosage, and duration.

●人工智能能否对抗抗生素耐药性？抗生素具有终结感染的神奇功效，但如果使用过于频繁，病原体就会学会如何忽视它们。这就是所谓的抗菌药物耐药性（AMR）。这在全世界都是一个巨大的问题，尤其是在非洲，因为非洲的AMR死亡率最高。加纳Aurum研究所的Nana Kofi Quakyi正在开发一种人工智能驱动的工具，帮助卫生工作者在开具抗生素处方时避免造成AMR。该工具将梳理所有可用信息——包括当地临床指南和健康监测数据，了解哪些病原体目前在该地区有产生耐药性的风险——并就最佳药物、剂量和疗程提出建议。

●Can AI bring personalized tutors to every student? The AI education tools being piloted today are mind-blowing because they are tailored to each individual learner. Some of them—like Khanmigo and MATHia—are already remarkable, and they’ll only get better in the years ahead. One of the things that excites me the most about this type of technology is the possibility of localizing it to every student, no matter where they live. For example, a team in Nairobi is working on Somanasi, an AI-based tutor that aligns with the curriculum in Kenya. The name means “learn together” in Swahili, and the tutor has been designed with the cultural context in mind so it feels familiar to the students who use it.

●人工智能能否为每个学生提供个性化辅导？目前正在试点的人工智能教育工具令人耳目一新，因为它们是为每个学习者量身定制的。其中一些工具，如Khanmigo和MATHia，已经非常出色，而且在未来几年只会越来越好。这类技术最让我兴奋的一点是，无论学生住在哪里，都有可能将其本地化。例如，内罗毕的一个团队正在开发Somanasi，这是一种基于人工智能的导师，与肯尼亚的课程保持一致。这个名字在斯瓦希里语中的意思是“一起学习”，导师的设计考虑到了文化背景，因此使用它的学生感觉很熟悉。

● Can AI help treat high-risk pregnancies? A woman dies in childbirth every two minutes. That’s a horrifying statistic, but I’m hopeful that AI can help. Last year, I wrote about how AI-powered ultrasounds could help identify pregnancy risks. This year, I was excited to meet some of the researchers at ARMMAN, who hope to use artificial intelligence to improve the odds for new mothers in India. Their large language model will one day act as a copilot for health workers treating high-risk pregnancies. It can be used in both English and Telugu, and the coolest part is that it automatically adjusts to the experience level of the person using it—whether you’re a brand-new nurse or a midwife with decades of experience.

●人工智能能否帮助治疗高危妊娠？每两分钟就有一名妇女死于分娩。这是一个可怕的统计数字，但我希望人工智能能有所帮助。去年，我有写到人工智能驱动的超声波检查如何帮助识别妊娠风险。今年，我很高兴能见到ARMMAN公司的研究人员，他们希望利用人工智能来提高印度新妈妈的分娩成功率。他们的大型语言模型有朝一日将成为医护人员治疗高危妊娠的人工智能助手。它可以用英语和泰卢固语使用，最酷的是，它会根据使用它的人的经验水平自动调整——无论你是一位完全没有经验的护士，还是一位有几十年经验的助产士。

●Can AI help people assess their risk for HIV? For many people, talking to a doctor or nurse about their sexual history can be uncomfortable. But this information is super important for assessing risk for diseases like HIV and prescribing preventive treatments. A new South African chatbot aims to make HIV risk assessment a lot easier. It acts like an unbiased and nonjudgmental counselor who can provide around-the-clock advice. Sophie Pascoe and her team are developing it specifically with marginalized and vulnerable populations in mind—populations that often face stigma and discrimination when seeking preventive care. Their findings suggest that this innovative approach may help more women understand their own risk and take action to protect themselves.

●人工智能能否帮助人们评估感染艾滋病毒的风险？对很多人来说，向医生或护士谈论自己的性史可能会让人感到不舒服。但是，这些信息对于评估艾滋病等疾病的风险和开具预防性治疗处方却非常重要。南非的一款新聊天机器人旨在让艾滋病风险评估变得更容易。它就像一个不带偏见、不做评判的咨询师，可以提供全天候的建议。索菲·帕斯科（Sophie Pascoe）和她的团队在开发这款聊天机器人时，特别考虑到了边缘化人群和弱势群体——这些人群在寻求预防性治疗时往往遭遇污名化和歧视。他们的研究结果表明，这种创新方法可以帮助更多的妇女了解自身的风险，并采取行动保护自己。

●Could AI make medical information easier to access for every health worker? When you’re treating a critical patient, you need quick access to their medical records to know if they’re allergic to a certain drug or have a history of heart problems. In places like Pakistan, where many people don’t have any documented medical history, this is a huge problem. Maryam Mustafa’s team is working on a voice-enabled mobile app that would make it a lot easier for maternal health workers in Pakistan to create medical records. It asks a series of prompts about a patient and uses the responses to fill out a standard medical record. Arming health workers with more data will hopefully improve the country’s pregnancy outcomes, which are among the worst in the world.

●人工智能能否让每位医务工作者更容易获取医疗信息？在治疗危重病人时，你需要快速查阅他们的病历，了解他们是否对某种药物过敏或有心脏病史。在巴基斯坦这样的地方，很多人没有任何病史记录，这是一个大问题。玛丽亚姆·穆斯塔法（Maryam Mustafa）的团队正在开发一款支持语音的移动应用程序，它能让巴基斯坦的孕产妇保健工作者更轻松地创建医疗记录。该应用会询问一系列有关病人的信息，然后根据回答填写标准病历。为卫生工作者提供更多的数据，有望改善巴基斯坦的妊娠结局，该国的妊娠结局是世界上最糟糕的。

There is a long road ahead for projects like these. Significant hurdles remain, like how to scale up projects without sacrificing quality and how to provide adequate backend access to ensure they remain functional over time. But I’m optimistic that we will solve them. And I’m inspired to see so many researchers already thinking about how we deploy new technologies in low- and middle-income countries.

像这样的项目还有很长的路要走。仍然存在巨大的障碍，比如如何在不牺牲质量的情况下扩大项目规模，以及如何提供足够的后台访问权限以确保项目长期保持功能。但我乐观地认为，我们一定能解决这些问题。看到这么多研究人员已经在思考如何在中低收入国家部署新技术，我很受启发。