The Philippines: an idyllic country with some of the clearest water and bluest skies on the planet. It is also the epicenter of one of the fastest-growing HIV epidemics in the world. On the surface, it seems as if we are just a late bloomer. However, the reasons for our current epidemic are much more complicated and may foreshadow a global resurgence of HIV.
菲律賓係一個田園國家 擁有地球上最乾淨嘅水和最藍嘅天空 同時都係世界上 HIV 傳染病例增長最快嘅重災區之一 表面上睇,菲律賓 似乎只係一個遲爆發 HIV 嘅國家 但係,事實上造成我哋疫情嘅原因 要複雜得多 而且疫情可能預示著 HIV 會再次喺全球爆發
While overall new cases of HIV continue to drop in the world, this trend may be short-lived when the next wave of more aggressive and resistant viruses arrive. HIV has a potential to transform itself into a new and different virus every time it infects a cell. Despite the remarkable progress we've made in reversing the epidemic, the truth is that we are just a few viral mutations away from disaster.
但全球 HIV 總體新病例數 正持續下降 呢個趨勢可能唔會持續 但係,下一輪嘅病毒 將會更強烈、抗藥性更强 每當 HIV 侵染一個細胞 佢都可能將自己變異成一種新病毒 雖然我哋同 HIV 傳染病嘅仗 已經取得顯著進展 事實上,只要病毒再變異幾次 災難就可能會再次來襲
To appreciate the profound way in which HIV transforms itself every time it reproduces, let's make a genetic comparison. If we look at the DNA variation among humans of different races from different continents, the actual DNA difference is only 0.1 percent. If we look at the genetic difference between humans, great apes, and rhesus macaques, that number is seven percent. In contrast, the genetic difference between HIV subtypes from different patients may be as much as 35 percent. Within a person infected with HIV, the genetic difference between an infecting mother virus and subsequent daughter viruses has been shown to be as much as five percent. This is the equivalent of a gorilla giving birth to a chimpanzee, then to an orangutan, then to a baboon, then to any random great ape within its lifetime.
為咗更加清楚咁瞭解 HIV 每次增殖后顯著嘅基因變異 我哋嚟做一個基因對比 如果我哋去睇各個大洲 唔同人種之間嘅 DNA 多樣性 事實上只有百分之零點一嘅差別 如果係人類、人科猿、 普通獼猴三者 基因差別係百分之七 相比之下,喺唔同病人身上嘅 HIV 亞種 基因差別會高達百分之三十五 同一個 HIV 患者身上 親代同子代病毒之間嘅基因差異 有百分之五噉多 親子代之間噉大嘅基因變異 就相當於大猩猩生黑猩猩 再生紅猩猩 然後生狒狒 又再喺生命之中生任何一種人猿
There are nearly 100 subtypes of HIV, with new subtypes being discovered regularly. HIV in the developed world is almost all of one subtype: subtype B. Mostly everything we know and do to treat HIV is based on studies on subtype B, even though it only accounts for 12 percent of the total number of cases of HIV in the world. But because of the profound genetic difference among different subtypes, some subtypes are more likely to become drug-resistant or progress to AIDS faster.
HIV 病毒有將近一百個亞種 仲有新亞種被持續發現 發達國家嘅 HIV 幾乎 都係同一個亞種︰ B 亞種 我哋對 HIV 一切嘅瞭解同治療 幾乎都係基於對 B 亞種嘅研究 雖然佢只占全世界 HIV 病例 嘅百分之十二 但由於唔同亞種之間 顯著嘅基因差異 一啲亞種產生抗藥性嘅可能性會更高 甚至會更快發展成愛滋病
We discovered that the explosion of HIV cases in the Philippines is due to a shift from the Western subtype B to a more aggressive Southeast Asian subtype AE. We are seeing younger and sicker patients with high rates of drug resistance. Initial encroachment of this subtype is already occurring in developed countries, including Australia, Canada and the United States. We may soon see a similar explosion of cases in these countries.
我哋發現菲律賓嘅 HIV 病例嘅爆發 係由於西部 B 亞種 變異成一種更強勁嘅 東南亞 AE 亞種 我哋發現更後生、病情更嚴重嘅病人 有更高嘅抗藥性比率 呢個亞種已經入侵發達國家 包括澳洲、加拿大同美國 可能好快,類似菲律賓嘅 HIV 疫情 就會喺呢啲國家發生
And while we think that HIV is done and that the tide has turned for it, just like with real tides, it can come right back. In the early 1960s, malaria was on the ropes. As the number of cases dropped, people and governments stopped paying attention. The result was a deadly resurgence of drug-resistant malaria.
如果我哋以為 HIV 大潮已經退去 就錯啦 事實上佢會返嚟 就好似真正嘅潮水會回潮 十八世紀六十年代早期 瘧疾大潮消退 病例數下降 人們同政府轉移咗注意力 結果抗藥性瘧疾又捲土重來
We need to think of HIV not as a single virus that we think we've figured out, but as a collection of rapidly evolving and highly unique viruses, each of which can set off the next deadly epidemic. We are incorporating more powerful and new tools to help us detect the next deadly HIV strain, and this needs to go hand in hand with urgent research on the behavior and proper treatment of non-B subtypes. We need to convince our governments and our funding agencies that HIV is not yet done.
我哋唔可以將 HIV 睇成 一種已經瞭解透徹嘅單一病毒 而係一系列進化快速、高度獨特嘅病毒 其中任何一種都有可能 引發下一次致命嘅疫情 依家我哋藉助更強大、更新嘅工具 去檢測下一個致命 HIV 噉又需要同時進行 對非 B 亞種嘅緊急研究同適當治療 我哋需要令我哋嘅政府、基金會相信 人類同 HIV 嘅惡戰仍未結束
Over 35 million people have died of HIV. We are on the verge of an AIDS-free generation. We need to pay attention. We need to remain vigilant and follow through. Otherwise, millions more will die.
超過三千五百萬人死於 HIV 我哋將邁入「零愛滋」嘅年代 我哋需要時刻關注 我哋需要保持警惕,及時跟進 唔係嘅話,仲會有千千萬萬個人喪生
Thank you.
多謝
(Applause)
(掌聲)