I'm the luckiest guy in the world. I got to see the last case of killer smallpox in the world. I was in India this past year, and I may have seen the last cases of polio in the world. There's nothing that makes you feel more -- the blessing and the honor of working in a program like that -- than to know that something that horrible no longer exists. So I'm going to tell you -- (Applause) so I'm going to show you some dirty pictures. They are difficult to watch, but you should look at them with optimism, because the horror of these pictures will be matched by the uplifting quality of knowing that they no longer exist.
Ja sam najsretniji čovjek na svijetu. Uspio sam vidjeti posljednji slučaj boginja u svijetu. Bio sam u Indiji protekle godine i moguće da sam vidio posljednje slučajeve polija na svijetu. Nema ničeg što vas može učiniti više – blagoslov i čast rada u takvom programu i spoznaja da nešto tako užasno više ne postoji. Pa, ispričat ću vam – (Pljesak) -- pokazat ću vam neke slike groznih stvari. Teške su za gledati, ali trebate ih gledati s optimizmom jer će užas ovih fotografija biti izjednačen s kvalitetom spoznaje da više ne postoje.
But first, I'm going to tell you a little bit about my own journey. My background is not exactly the conventional medical education that you might expect. When I was an intern in San Francisco, I heard about a group of Native Americans who had taken over Alcatraz Island, and a Native American who wanted to give birth on that island, and no other doctor wanted to go and help her give birth. I went out to Alcatraz, and I lived on the island for several weeks. She gave birth; I caught the baby; I got off the island; I landed in San Francisco; and all the press wanted to talk to me, because my three weeks on the island made me an expert in Indian affairs. (Laughter)
Ali, prvo ću vam ispričati nešto o svom vlastitom putovanju. Moja pozadina i nije baš konvencionalno medicinsko školovanje koje biste mogli očekivati. Kada sam bio stažist u San Franciscu, čuo sam za grupu Indijanaca, koji su preuzeli otok Alcatraz, i domorotkinji koja je željela roditi na otoku, ali nije bilo liječnika koji je želio otići i pomoći joj pri porodu. Otišao sam na Alcatraz, i živio na otoku nekoliko tjedana. Ona je rodila, ulovio sam bebu, otišao s otoka, iskrcao se u San Francisco, i svi su mediji željeli pričati sa mnom jer su me moja tri tjedna učinila stručnjakom za poslove Indijanaca. Pojavio sam se na svakom televizijskom showu.
I wound up on every television show. Someone saw me on television; they called me up; and they asked me if I'd like to be in a movie and to play a young doctor for a bunch of rock and roll stars who were traveling in a bus ride from San Francisco to England. And I said, yes, I would do that, so I became the doctor in an absolutely awful movie called "Medicine Ball Caravan." (Laughter) Now, you know from the '60s, you're either on the bus or you're off the bus; I was on the bus. My wife of 37 years and I joined the bus. Our bus ride took us from San Francisco to London, then we switched buses at the big pond. We then got on two more buses and we drove through Turkey and Iran, Afghanistan, over the Khyber Pass into Pakistan, like every other young doctor. This is us at the Khyber Pass, and that's our bus. We had some difficulty getting over the Khyber Pass. But we wound up in India. And then, like everyone else in our generation, we went to live in a Himalayan monastery.
Netko me vidio na televiziji, nazvali su me i pitali me želim li biti u filmu i igrati mladog liječnika za hrpetinu zvijezda rock'n'rolla koji su putovali autobusom od San Francisca do Engleske. I rekao sam – da, učinio bih to, te sam postao liječnik u apsolutno groznom filmu nazvanom „Medicine Ball Caravan.“ Dakle, znate da u '60.-ima, ili ste u autobusu ili niste. Moja supruga i ja, prije 37 godina, pridružili smo se autobusu. Naš autobus vozio nas je od San Francisca do Londona. Presjeli smo na Atlantiku. Tada smo sjeli na dva autobusa i vozili se kroz Tursku i Iran, Afganistan, preko prijevoja Khyber, u Pakistan, kao i svaki drugi mladi liječnik. Ovo smo mi na prijevoju Khyber, a ovo je naš autobus. Imali smo nekih poteškoća s prelaskom preko prijevoja, ali smo završili u Indiji. I onda, kao i svi drugi u našoj generaciji, otišli smo živjeti u himalajanski samostan.
(Laughter)
(Smijeh)
This is just like a residency program, for those of you that are in medical school. (Laughter) And we studied with a wise man, a guru named Karoli Baba, who then told me to get rid of the dress, put on a three-piece suit, go join the United Nations as a diplomat and work for the World Health Organization. And he made an outrageous prediction that smallpox would be eradicated, and that this was God's gift to humanity, because of the hard work of dedicated scientists. And that prediction came true. This little girl is Rahima Banu, and she was the last case of killer smallpox in the world. And this document is the certificate that the global commission signed, certifying the world to have eradicated the first disease in history.
Ovo je kao specijalistički staž, za one od vas koji su na studiju medicine. I učili smo s mudrim čovjekom, guruom zvanim Karoli Baba koji mi je tada rekao da se riješim haljine, nabacim trodjelno odijelo, pridružim se Ujedinjenim narodima kao diplomat i radim za Svjetsku zdravstvenu organizaciju. Izrekao je silovito proročanstvo da će boginje biti iskorijenjene i da je to bio Božji dar čovječanstvu zbog teškog rada posvećenih znanstvenika. I to se proročanstvo ispunilo, i ova mala djevojčica je Rahima Banu, i ona je bila zadnji slučaj ubojitih boginja u svijetu. I ovaj dokument je certifikat da je globalno povjerenstvo potvrdilo svijetu da je iskorijenjena prva bolest u povijesti.
The key to eradicating smallpox was early detection, early response. I'm going to ask you to repeat that: early detection, early response. Can you say that?
Ključ iskorijenjenja boginja je bilo rano otkriće, rani odgovor. Zamolit ću vas da ponovite to, rano otkrivanje, rani odgovor. Možete li to reći?
Audience: Early detection, early response.
Publika: Rano otkrivanje, rani odgovor.
Larry Brilliant: Smallpox was the worst disease in history. It killed more people than all the wars in history. In the last century, it killed 500 million people. You're reading about Larry Page already. Somebody reads very fast. (Laughter) In the year that Larry Page and Sergey Brin -- with whom I have a certain affection and a new affiliation -- in the year in which they were born, two million people died of smallpox. We declared smallpox eradicated in 1980. This is the most important slide that I've ever seen in public health, [Sovereigns killed by smallpox] because it shows you to be the richest and the strongest, and to be kings and queens of the world, did not protect you from dying of smallpox. Never can you doubt that we are all in this together.
Larry Brilliant: Boginje su bile najgora bolest u povijesti. Ubile su više ljudi nego ratovi u povijesti. U posljednjem stoljeću, ubile su 500 milijuna ljudi. Više od dva-- već čitate o Larryju Pageu, netko čita jako brzo. (Smijeh) U godini kada su Larry Page i Sergey Brin – prema kojem osjećam određenu naklonost i novo povezivanje – u godini kada su oni rođeni, dva milijuna ljudi umrlo je od boginja. Objavili smo da su boginje iskorijenjene 1980. Ovo je najvažniji slajd koji sam vidio u javnom zdravstvu jer vam pokazuje da biti najbogatiji i najsnažniji, i biti kraljevi i kraljice svijeta, nije štitilo od umiranja od boginja. Nikad se ne može sumnjati da smo u ovome svi zajedno.
But to see smallpox from the perspective of a sovereign is the wrong perspective. You should see it from the perspective of a mother, watching her child develop this disease and standing by helplessly. Day one, day two, day three, day four, day five, day six. You're a mother and you're watching your child, and on day six, you see pustules that become hard. Day seven, they show the classic scars of smallpox umbilication. Day eight.
Ali, vidjeti boginje iz perspektive vladara je kriva perspektiva. Trebali biste ih vidjeti iz perspektive majke koja gleda svoje dijete kako razvija ovu bolest i stoji ondje bespomoćno. Dan jedan, dan dva, dan tri, dan četiri, dan pet, dan šest. Vi ste majka i gledate svoje dijete, i šesti dan, vidite čiriće koji otvrdnjavaju. Dan sedam, pokazuju svoje tipične ožiljke udubljivanja boginja. Dan osam. I Al Gore je rekao ranije da je najfotografiranija slika na svijetu,
And Al Gore said earlier that the most photographed image in the world, the most printed image in the world, was that of the Earth. But this was in 1974, and as of that moment, this photograph was the photograph that was the most widely printed, because we printed two billion copies of this photograph, and we took them hand to hand, door to door, to show people and ask them if there was smallpox in their house, because that was our surveillance system. We didn't have Google, we didn't have web crawlers, we didn't have computers.
najprintanija slika u svijetu, bila ta slika Zemlje. Ali, to je bilo 1974., i od tog trenutka ova fotografija je bila fotografija koja je najviše puta isprintana jer smo isprintali dvije milijarde primjeraka ove fotografije, i nosili smo je od ruke do ruke, od vrata do vrata, kako bismo je pokazali ljudima i pitali ih je li bilo boginja u njihovoj kući jer to je bio naš nadzorni sustav. Nismo imali Google, nismo imali web pretraživače, nismo imali računala.
By day nine -- you look at this picture and you're horrified; I look at this picture and I say, "Thank God," because it's clear that this is only an ordinary case of smallpox, and I know this child will live. And by day 13, the lesions are scabbing, his eyelids are swollen, but you know this child has no other secondary infection. And by day 20, while he will be scarred for life, he will live.
Do devetog dana, pogledate ovu fotografiju i zgroženi ste. Ja pogledam ovu fotografiju i kažem, „Hvala Bogu“ jer je jasno da je ovo samo uobičajen slučaj boginja i ja znam da će ovo dijete živjeti. 13-tog dana, lezije se krastaju, očni kapci su natečeni, ali vi znate da ovo dijete nema sekundarnu infekciju. I 20-tog dana, iako će biti unakažen, živjet će.
There are other kinds of smallpox that are not like that. This is confluent smallpox, in which there isn't a single place on the body where you could put a finger and not be covered by lesions. Flat smallpox, which killed 100 percent of people who got it. And hemorrhagic smallpox, the most cruel of all, which had a predilection for pregnant women. I've probably had 50 women die. They all had hemorrhagic smallpox. I've never seen anybody die from it who wasn't a pregnant woman.
Ima drugih vrsta boginja koje nisu takve. Ovo su rasprostranjene boginje i ne postoji dio tijela na koji možete staviti prst, a da nije prekriven oštećenjima. Ravne boginje, koje su ubile 100 posto ljudi koji su ih imali. I hemoragične boginje, najopakije od svih, koje su imale sklonost trudnicama. Ja sam vjerojatno bio prisutan smrti 50 žena. Sve su imale hemoragične boginje. Nikad nisam vidio nikoga da je umro od toga, a da nije bio trudna žena.
In 1967, the WHO embarked on what was an outrageous program to eradicate a disease. In that year, there were 34 countries affected with smallpox. By 1970, we were down to 18 countries. 1974, we were down to five countries. But in that year, smallpox exploded throughout India. And India was the place where smallpox made its last stand. In 1974, India had a population of 600 million. There are 21 linguistic states in India, which is like saying 21 different countries. There are 20 million people on the road at any time, in buses and trains, walking; 500,000 villages, 120 million households, and none of them wanted to report if they had a case of smallpox in their house, because they thought that smallpox was the visitation of a deity, Shitala Mata, the cooling mother, and it was wrong to bring strangers into your house when the deity was in the house. No incentive to report smallpox.
1967. WHO se upleo u nešto što je bio nečuven program iskorjenjivanja bolesti. Te godine, 34 države su bile pogođene boginjama. Do 1970, smanjili smo taj broj na 18 država. 1974, bili smo na pet država. Ali u toj godini, boginje su buknule Indijom. I Indija je mjesto koje je boginjama bilo posljednja postaja. 1974.godine, Indija je imala populaciju od 600 milijuna ljudi. U Indiji postoji 21 govorno područje, što je kao 21 različita zemlja. Bilo je u svakom trenu 20 milijuna ljudi na putu – u autobusima, vlakovima, hodajućih; 500.000 sela, 120 milijuna kućanstava i nijedno od njih nije željelo prijaviti jesu li imali slučaj boginja u svojoj kući jer su mislili da su boginje posjet božanstva, Shitale Mata, majke hlađenja, i bilo je neispravno dovesti strance u svoju kuću ako je božanstvo u kući. Nije bilo motivacije za prijavu boginja. Nije samo Indija imala božanstva boginja,
It wasn't just India that had smallpox deities; smallpox deities were prevalent all over the world. So, how we eradicated smallpox was -- mass vaccination wouldn't work. You could vaccinate everybody in India, but one year later there'd be 21 million new babies, which was then the population of Canada. It wouldn't do just to vaccinate everyone. You had to find every single case of smallpox in the world at the same time, and draw a circle of immunity around it. And that's what we did. In India alone, my 150,000 best friends and I went door to door, with that same picture, to every single house in India. We made over one billion house calls.
božanstva boginja bila su rasprostranjena po cijelom svijetu. Dakle, kako smo iskorijenili boginje – maksimalno cijepljenje ne bi uspjelo. Mogli ste cijepiti sve u Indiji, ali u sljedećoj godini bio bi 21 milijun novih beba, što je tada bila populacija Kanade. Ne bi bilo dovoljno samo sve cijepiti. Morali ste naći svaki slučaj boginja u svijetu istovremeno i napraviti krug imunosti oko njih. I to je ono što smo učinili. Samo u Indiji, mojih 150.000 najboljih prijatelja i ja išli smo od vrata do vrata s istom onom fotografijom do svake kuće u Indiji. Napravili smo više od milijarde kućnih posjeta.
And in the process, I learned something very important. Every time we did a house-to-house search, we had a spike in the number of reports of smallpox. When we didn't search, we had the illusion that there was no disease. When we did search, we had the illusion that there was more disease. A surveillance system was necessary, because what we needed was early detection, early response. So we searched and we searched, and we found every case of smallpox in India. We had a reward. We raised the reward. We continued to increase the reward. We had a scorecard that we wrote on every house. And as we did that, the number of reported cases in the world dropped to zero. And in 1980, we declared the globe free of smallpox.
I usput, naučio sam nešto vrlo važno. Svaki put kad smo napravili od-kuće-do-kuće potragu, imali smo porast broja prijava boginja. Kada nismo tražili, imali smo dojam da nije bilo bolesti. Kada smo tražili, imali smo dojam da ima više bolesti. Nadzorni sustav je bio nužan jer smo trebali rano otkrivanje, rani odgovor. Tražili smo i tražili i pronašli svaki slučaj boginja u Indiji. Imali smo naknadu. Podigli smo naknadu. Nastavili smo povećavati naknadu. Imali smo kartu koju smo stavljali na svaku kuću. I kako smo to radili, broj prijavljenih slučajeva u svijetu pao je na nulu, te smo 1980. objavili da je svijet slobodan od boginja. Bila je to najveća kampanja u povijesti Ujedinjenih naroda do rata u Iraku.
It was the largest campaign in United Nations history, until the Iraq war. 150,000 people from all over the world -- doctors of every race, religion, culture and nation, who fought side by side, brothers and sisters, with each other, not against each other, in a common cause to make the world better. But smallpox was the fourth disease that was intended for eradication. We failed three other times. We failed against malaria, yellow fever and yaws. But soon we may see polio eradicated. But the key to eradicating polio is early detection, early response. This may be the year we eradicate polio. That will make it the second disease in history. And David Heymann, who's watching this on the webcast -- David, keep on going. We're close! We're down to four countries.
150.000 ljudi iz cijelog svijeta, liječnici svih rasa, religija, kultura i nacija, borili su se na istoj strani, braće i sestre, jedni s drugima, ne jedni protiv drugih, sa zajedničkim ciljem učiniti svijet boljim. Ali, boginje su bile četvrta bolest koja je trebala biti iskorijenjena. Nismo uspjeli ostala tri puta. Nismo uspjeli protiv malarije, žute groznice i tropske frambezije. Ali, uskoro možemo vidjeti iskorijenjen polio. Ključ za iskorjenjivanje polija je rano otkrivanje, rani odgovor. Ovo bi mogla biti godina iskorjenjenja polija – i to bi bila druga bolest u povijesti. I David Heymann, koji gleda ovo putem Interneta – Davide, samo nastavi. Blizu smo. Ostalo su nam četiri zemlje.
(Applause)
(Pljesak)
I feel like Hank Aaron. Barry Bonds can replace me any time.
Osjećam se kao Hank Aaron. Barry Bonds može me zamijeniti svakog trena.
Let's get another disease off the list of terrible things to worry about. I was just in India working on the polio program. The polio surveillance program is four million people going door to door. That is the surveillance system. But we need to have early detection, early response. Blindness, the same thing. The key to discovering blindness is doing epidemiological surveys and finding out the causes of blindness, so you can mount the correct response.
Skinimo još jednu bolest s liste užasnih stvari zbog kojih se brinemo. Baš sam bio u Indiji radeći na polio programu. Polio nadzorni sustav čini četiri milijuna ljudi koji idu od vrata do vrata. To je nadzorni sustav. Ali trebali smo rano otkrivanje, rani odgovor. Sljepoća, ista stvar. Ključ za otkrivanje sljepoće je epidemiološko istraživanje i otkrivanje uzroka sljepoće tako da možete postaviti točan odgovor.
The Seva Foundation was started by a group of alumni of the Smallpox Eradication Programme, who, having climbed the highest mountain, tasted the elixir of the success of eradicating a disease, wanted to do it again. And over the last 27 years, Seva's programs in 15 countries have given back sight to more than two million blind people. Seva got started because we wanted to apply these lessons of surveillance and epidemiology to something which nobody else was looking at as a public health issue: blindness, which heretofore had been thought of only as a clinical disease.
Seva zaklada započeta je od strane grupe ljudi koji su sudjelovali u programu iskorjenjivanja boginja i koji su, popevši se na najvišu planinu, okusili eliksir uspjeha istrebljenja bolesti te su to željeli ponoviti. I proteklih 27 godina, Seva programi u 15 država vratili su vid više od dva milijuna slijepih ljudi. Seva je započeta jer smo željeli primijeniti spoznaje o nadgledanju i epidemiologiji na nešto što nitko drugi nije gledao kao problem javnog zdravstva: sljepoća, koja je do tada bila smatrana samo kliničkim poremećajem.
In 1980, Steve Jobs gave me that computer, which is Apple number 12, and it's still in Kathmandu, and it's still working, and we ought to go get it and auction it off and make more money for Seva. And we conducted the first Nepal survey ever done for health, and the first nationwide blindness survey ever done, and we had astonishing results. Instead of finding out what we thought was the case -- that blindness was caused mostly by glaucoma and trachoma -- we were astounded to find out that blindness was caused instead by cataract. You can't cure or prevent what you don't know is there.
1980., Steve Jobs dao mi je to računalo, koje je Apple broj 12, i još uvijek je u Kathmanduu te još uvijek radi. Trebali bi ga dati na aukciju i zaraditi više novaca za Sevu. Potpomagali smo prvo nepalsko istraživanje ikad napravljeno za zdravlje i prvo nacionalno istraživanje sljepoće ikad učinjeno i dobili smo začuđujuće rezultate. Umjesto da smo saznali ono što smo očekivali da je slučaj – da je sljepoća većinom uzrokovana glaukomom i trahomom – bili smo iznenađeni saznanjem da je nasuprot tome sljepoća bila uzrokovana kataraktom. Ne možeš liječiti ili spriječiti nešto što ne znaš da je tu.
In your TED packages there's a DVD, "Infinite Vision," about Dr. V and the Aravind Eye Hospital. I hope that you will take a look at it. Aravind, which started as a Seva project, is now the world's largest and best eye hospital. This year, that one hospital will give back sight to more than 300,000 people in Tamil Nadu, India. (Applause) Bird flu. I stand here as a representative of all terrible things -- this might be the worst. The key to preventing or mitigating pandemic bird flu is early detection and rapid response. We will not have a vaccine or adequate supplies of an antiviral to combat bird flu if it occurs in the next three years. WHO stages the progress of a pandemic. We are now at stage three on the pandemic alert stage, with just a little bit of human-to-human transmission, but no human-to-human-to-human sustained transmission.
U svojim TED paketima možete naći DVD ˝Neograničeni vid,˝ o dr. V i očnoj klinici Aravind. Nadam se da ćete ga pogledati. Aravind, koji je započeo kao Seva projekt, je danas najveća i najbolja očna klinika u svijetu. Ove godine ta će klinika vratiti vid više od 300.000 ljudi u Tamil Nadu, Indija. (Pljesak) Ptičja gripa. Ovdje sam kao reprezentativac svih loših stvari – ova bi mogla biti najgora. Ključ u prevenciji ili ublaživanju pandemske ptičje gripe je u ranom otkrivanju i brzom reagiranju. Ako dođe do ptičje gripe u sljedeće tri godine, nećemo imati cjepivo ili adekvatne zalihe antivirusa za borbu protiv nje. WHO navodi stupnjeve pandemije. Sada smo na trećoj fazi opreznosti od pandemije, s malim prijenosom s čovjeka na čovjeka, ali bez prijenosa s čovjeka na čovjeka na čovjeka.
The moment WHO says we've moved to category four -- this will not be like Katrina. The world as we know it will stop. There'll be no airplanes flying. Would you get in an airplane with 250 people you didn't know, coughing and sneezing, when you knew that some of them might carry a disease that could kill you, for which you had no antivirals or vaccine? I did a study of the top epidemiologists in the world in October. I asked them -- these are all fluologists and specialists in influenza -- and I asked them the questions you'd like to ask them: What do you think the likelihood is that there'll be a pandemic? If it happens, how bad do you think it will be?
Kada prijeđemo u četvrtu fazu, kaže WHO, neće biti kao Katrina. Svijet kakav znamo će prestati. Zrakoplovi više neće letjeti. Biste li ušli u zrakoplov s 250 nepoznatih ljudi, koji kašlju i kišu, kada biste znali da samo neki od njih mogu biti zaraženi bolešću koja bi Vas mogla ubiti, za koju ne bi imali ni antivirus ni cjepivo? U listopadu sam istražio najbolje epidemiologe u svijetu. Pitao sam ih – svi su oni fluolozi i specijalisti za gripu – pitao sam ih pitanja koja biste ih Vi pitali. Što mislite kolika je vjerojatnost za pandemiju? Ako se pojavi, koliko će grozna biti?
Fifteen percent said they thought there'd be a pandemic within three years. But much worse than that, 90 percent said they thought there'd be a pandemic within your children or your grandchildren's lifetime. And they thought that if there was a pandemic, a billion people would get sick. As many as 165 million people would die. There would be a global recession and depression as our just-in-time inventory system and the tight rubber band of globalization broke, and the cost to our economy of one to three trillion dollars would be far worse for everyone than merely 100 million people dying, because so many more people would lose their job and their healthcare benefits, that the consequences are almost unthinkable. And it's getting worse, because travel is getting so much better.
15 posto ih je reklo kako bi moglo biti pandemije u naredne tri godine. Još gore od toga, njih 90 posto je reklo kako misle da će biti pandemije za vrijeme života Vaše djece ili unuka. Također su mislili kako će, ako dođe do pandemije, milijarda ljudi oboliti. Čak 165 milijuna ljudi će umrijeti. Došlo bi do globalne recesije i depresije dok bi se naš pravovremeni popisivački sustav i uska gumica globalizacije uništili, i trošak našem gospodarstvu od jednog do tri bilijuna dolara bio bi mnogo gori nego jedva 100 milijuna umirućih ljudi zbog toga što će toliko mnogo više ljudi ostati bez posla i zdravstvenog osiguranja da su posljedice skoro nezamislive. I pogoršava se jer putovanje postaje sve bolje.
Let me show you a simulation of what a pandemic looks like. So we know what we're talking about. Let's assume, for example, that the first case occurs in South Asia. It initially goes quite slowly. You get two or three discrete locations. Then there'll be secondary outbreaks, and the disease will spread from country to country so fast that you won't know what hit you. Within three weeks it will be everywhere in the world. Now, if we had an "undo" button, and we could go back and isolate it and grab it when it first started -- if we could find it early, and we had early detection and early response, and we could put each one of those viruses in jail -- that's the only way to deal with something like a pandemic. And let me show you why that is.
Dopustite mi da Vam pokažem simulaciju pandemije kako bi znali o čemu govorimo. Pretpostavimo da se prvi slučaj pojavio u Južnoj Aziji. U početku se razvija prilično sporo. Bolest izbije na dvije ili tri diskretne lokacije. Potom izbiju sekundarni napadi i bolest se proširi sa zemlje na zemlju tako brzo da ne znaš ni što se dogodilo. U roku tri tjedna bit će svugdje u svijetu. Kada bismo mogli poništiti situaciju i kada bismo se mogli vratiti natrag i izolirati je kada je počela. Kada bi je mogli rano naći i kada bi je rano primijetili i rano reagirali i kada bi mogli staviti svaki od tih virusa u ćeliju – to je jedini način za nošenje s nečim kao pandemija. I dopustite mi da Vam pokažem zašto je to tako.
We have a joke. This is an epidemic curve, and everyone in medicine, I think, ultimately gets to know what it is. But the joke is, an epidemiologist likes to arrive at an epidemic right here and ride to glory on the downhill curve. (Laughter) But you don't get to do that usually. You usually arrive right about here. What we really want is to arrive right here, so we can stop the epidemic. But you can't always do that. But there's an organization that has been able to find a way to learn when the first cases occur, and that is called GPHIN; it's the Global Public Health Information Network. And that simulation that I showed you that you thought was bird flu -- that was SARS. And SARS is the pandemic that did not occur. And it didn't occur because GPHIN found the pandemic-to-be of SARS three months before WHO actually announced it, and because of that, we were able to stop the SARS pandemic. And I think we owe a great debt of gratitude to GPHIN and to Ron St. John, who I hope is in the audience some place -- over there -- who's the founder of GPHIN.
Postoji šala. Ovo je epidemična krivulja i svi u medicini, ja mislim, na kraju je i upoznaju. Šala je da epidemiolog voli stići točno ovdje i proslaviti se na padajućoj krivulji. Inače se ne događaju takve stvari. Obično kreneš odavde. Što mi zapravo želimo je krenuti ovdje kako bi mogli zaustaviti epidemiju. Ali ne možemo uvijek to napraviti. Postoji organizacija koja je uspjela naći način kako saznati kada su se pojavili prvi slučajevi, i zove se GPHIN. To je Globalna javna zdravstvena mreža informacija. A ona simulacija koju sam vam pokazao, za koju ste mislili da je ptičja gripa, bio je SARS. SARS je pandemija do koje nije došlo. Do nje nije došlo jer je GPHIN pronašao buduću pandemiju SARS-a tri mjeseca prije nego ju je WHO objavio, i zbog toga smo uspjeli zaustaviti pandemiju SARS-a. Mislim da dugujemo veliku zahvalnost GPHIN-u i Ron St. Johnu, za kojeg se nadam da sjedi u publici – ondje – koji je osnivač GPHIN-a.
(Applause)
(Pljesak)
Hello, Ron!
Bok, Ron.
(Applause)
(Pljesak)
And TED has flown Ron here from Ottawa, where GPHIN is located, because not only did GPHIN find SARS early, but you may have seen last week that Iran announced that they had bird flu in Iran, but GPHIN found the bird flu in Iran not February 14 -- but last September. We need an early-warning system to protect us against the things that are humanity's worst nightmare. And so my TED wish is based on the common denominator of these experiences. Smallpox -- early detection, early response. Blindness, polio -- early detection, early response. Pandemic bird flu -- early detection, early response. It is a litany. It is so obvious that our only way of dealing with these new diseases is to find them early and to kill them before they spread.
TED je doveo Rona ovdje iz Ottawe, gdje je sjedište GPHIN-a, ne samo zbog toga što je GPHIN otkrio SARS, nego i zbog, mogli ste prošli tjedan vidjeti da je Iran objavio da su otkrili ptičju gripu, ali je GPHIN otkrio pričju gripu u Iranu, ne 14. veljače nego prošlog rujna. Trebamo sustav ranog upozorenja da nas zaštiti od najgore noćne more čovječanstva. Tako je moja TED želja bazirana na zajedničkom nazivniku ovih eksperimenata. Boginje – rano otkrivanje, rani odgovor. Sljepoća, polio – rano otkrivanje, rani odgovor. Pandemija ptičje gripe – rano otkrivanje, rani odgovor. To je litanija. Toliko je očito da je naš jedini način nošenja s novim bolestima da ih rano nađemo i zaustavimo prije nego se prošire. I tako, moja TED želja je da pomognemo sagraditi globalni sustav,
So, my TED wish is for you to help build a global system -- an early-warning system -- to protect us against humanity's worst nightmares. And what I thought I would call it is "Early Detection," But it should really be called ... "Total Early Detection." [TED]
sustav ranog upozorenja, da bi se zaštitili od naših najgorih noćnih mora. Mislio sam ga nazvati Rano otkrivanje, ali u stvari bi se zapravo trebao zvati Potpuno rano otkrivanje. (Smijeh)
(Laughter) What?
(Pljesak)
(Applause) What? (Applause)
But in all seriousness, because this idea is birthed in TED, I would like it to be a legacy of TED, and I'd like to call it the "International System for Total Early Disease Detection." [INSTEDD] And INSTEDD then becomes our mantra. So instead of a hidden pandemic of bird flu, we find it and immediately contain it. Instead of a novel virus caused by bio-terror or bio-error, or shift or drift, we find it and we contain it. Instead of industrial accidents like oil spills or the catastrophe in Bhopal, we find them, and we respond to them. Instead of famine, hidden until it is too late, we detect it, and we respond. And instead of a system which is owned by a government, and hidden in the bowels of government, let's build an early detection system that's freely available to anyone in the world in their own language.
Budimo ozbiljni – zato što se ideja razvila u TED-u, htio bih da to bude nasljedstvo TED-a, i htio bi ga nazvati Međunarodni sustav za potpuno rano otkrivanje bolesti (International System for Total Early Disease Detection). INSTEDD onda postaje naša mantra. Umjesto skrivene pandemije pričje gripe, otkrijemo je i odmah je spriječimo. Umjesto novog virusa uzrokovanog biološkim terorom ili biološkom greškom, ili promjenom ili zanošenjem, mi je otkrijemo i spriječimo. Umjesto industrijskih nesreća kao izlijevanja nafte ili katastrofe u Bhopalu, nađemo ih i reagiramo na njih. Umjesto da je skriveno dok nije prekasno, otkrijemo to i odgovorimo. I umjesto sustava kojeg posjeduje vlada i koji je skriven u vladinim prolazima, napravimo sustav ranog otkrivanja, koji je dostupan svima u svijetu na njihovom materinjem jeziku.
Let's make it transparent, non-governmental, not owned by any single country or company, housed in a neutral country, with redundant backup in a different time zone and a different continent. And let's build it on GPHIN. Let's start with GPHIN. Let's increase the websites that they crawl from 20,000 to 20 million. Let's increase the languages they crawl from seven to 70, or more. Let's build in outbound confirmation messages, using text messages or SMS or instant messaging to find out from people who are within 100 meters of the rumor that you hear, if it is, in fact, valid. And let's add satellite confirmation. And we'll add Gapminder's amazing graphics to the front end.
Napravimo ga vidljivim, nevladinim, koji ne pripada nijednoj državi ili tvrtki, sa sjedištem u neutralnoj državi, s prekomjernom rezervom u različitoj vremenskoj zoni i različitom kontinentu, i nadogradimo ga na GPHIN. Počnimo s GPHIN-om. Povećajmo broj web stranica koje pretražuju s 20.000 na 20 milijuna. Povećajmo broj jezika koje koriste sa sedam na 70 ili više. Ugradimo bezgraničnu potvrdu poruka koristeći tekstualne poruke ili SMS ili instantne poruke kako bi saznali od ljudi koji su u području od 100 metara od glasine koju si čuo, je li ona važeća činjenica. Dodajmo potvrdu satelita. Dodajmo Gapminderove odlične grafike.
And we'll grow it as a moral force in the world, finding out those terrible things before anybody else knows about them, and sending our response to them, so that next year, instead of us meeting here, lamenting how many terrible things there are in the world, we will have pulled together, used the unique skills and the magic of this community, and be proud that we have done everything we can to stop pandemics, other catastrophes, and change the world, beginning right now.
Razvit ćemo ga kao moralnu snagu u svijetu nalazeći grozne stvari prije svih i šaljući naš odgovor na njih. Kako bi sljedeće godine, umjesto sastanka ovdje, raspravljajući o mnogim groznim stvarima u svijetu, pribrali se, koristili naše jedinstvene sposobnosti i čaroliju zajednice, i bit ćemo ponosni što smo napravili sve kako bi zaustavili pandemije, ostale katastrofe i promijenili svijet - počinjući sada.
(Applause)
(Pljesak)
Chris Anderson: An amazing presentation. First of all, just so everyone understands: you're saying that by creating web crawlers, looking on the Internet for patterns, they can detect something suspicious before WHO, before anyone else can see it? Give an example of how that could possibly be true.
Chris Anderson: Izuzetna prezentacija. Kao prvo, samo da svi razumiju, vi kažete da gradeći – kreirajući, web pretraživače, gledajući internet za uzorke, oni mogu otkriti nešto sumnjivo prije WHO, prije nego što itko drugi vidi? Samo objasnite. Dajte mi primjer kako tako nešto može biti istinito.
Larry Brilliant: You're not mad about the copyright violation?
Larry Brilliant: Kao prvo, niste ljuti zbog kršenja autorskih prava?
CA: No. I love it.
CA: Ne, obožavam to.
(Laughter)
LB: Eto, vidite, kao Ron St. John – ja se nadam da ćete otići i upoznati ga
LB: Well, as Ron St. John -- I hope you'll go and meet him in the dinner afterwards and talk to him. When he started GPHIN -- In 1997, there was an outbreak of bird flu -- H5N1. It was in Hong Kong. And a remarkable doctor in Hong Kong responded immediately, by slaughtering 1.5 million chickens and birds, and they stopped that outbreak in its tracks. Immediate detection, immediate response. Then a number of years went by, and there were a lot of rumors about bird flu. Ron and his team in Ottawa began to crawl the web -- only crawling 20,000 different websites, mostly periodicals -- and they read about and heard about a concern, of a lot of children who had high fever and symptoms of bird flu.
za večerom poslije i popričati s njim – Kad smo osnovali GPHIN 1997., bilo je izbijanje ptičje gripe. H5N1. To je bilo u Hong Kongu. I izuzetan liječnik iz Hong Konga je odmah reagirao ubivši 1.5 milijuna pilića i ptica, i sasjekao izbijanje u korijenu. Neposredno otkrivanje, neposredno reagiranje. Zatim je određeni broj godina prošao i bilo je dosta glasina o ptičjoj gripi. Ron i njegov tim iz Ottawe započeli su pretraživati internet, pretražujući samo 20.000 različitih web stranica, većinom periodički, i pročitali su i čuli o zabrinutosti mnogih za djecu koja su imala visoku temperaturu i simptome ptičje gripe.
They reported this to WHO.
Prijavili su to WHO-u. WHO-u je trebalo neko vrijeme kako bi stupio u akciju,
WHO took a little while taking action, because WHO will only receive a report from a government, because it's the United Nations. But they were able to point to WHO and let them know that there was this surprising and unexplained cluster of illnesses that looked like bird flu. That turned out to be SARS. That's how the world found out about SARS. And because of that, we were able to stop SARS. Now, what's really important is that, before there was GPHIN, 100 percent of all the world's reports of bad things -- whether you're talking about famine or you're talking about bird flu or you're talking about Ebola -- 100 percent of all those reports came from nations.
jer WHO prima izvješća od vlade, jer su to Ujedinjeni Narodi. Ali, bili su u mogućnosti pokazati WHO-u i javiti im da se događa velik broj iznenađujućih i neobjašnjivih bolesti koje su izgledale kao ptičja gripa. Ispalo je da je to bio SARS. Tako je svijet saznao za SARS. I zbog toga smo uspjeli zaustaviti SARS. Sada, što je vrlo važno je da, prije nego što je bio GPHIN, 100 posto svih ljudskih izvješća o lošim stvarima – bilo da se radi o gladi ili o ptičjoj gripi ili o Eboli – 100 posto tih izvješća došlo je iz naroda.
The moment these guys in Ottawa -- on a budget of 800,000 dollars a year -- got cracking, 75 percent of all the reports in the world came from GPHIN, 25 percent of all the reports in the world came from all the other 180 nations. Now, here's what's really interesting: after they'd been working for a couple years, what do you think happened to those nations? They felt pretty stupid. So they started sending in their reports early. And now, their reporting percentage is down to 50 percent, because other nations have started to report. So, can you find diseases early by crawling the web? Of course you can. Can you find it even earlier than GPHIN does now? Of course you can. You saw that they found SARS using their Chinese web crawler a full six weeks before they found it using their English web crawler. Well, they're only crawling in seven languages. These bad viruses really don't have any intention of showing up first in English or Spanish or French.
Trenutak kada su ti dečki iz Ottawe, s budžetom od 800.000 dolara na godinu, počeli raditi, 75 posto svih izvješća u svijetu dolazilo je od GPHIN-a, 25 posto svih izvješća u svijetu dolazilo je od ostalih 180 naroda. Sada, evo što je stvarno zanimljivo, kada su već radili nekoliko godina, što mislite što se dogodilo s tim narodima? Osjećali su se prilično glupo pa su počeli slati izvješća ranije. Sada je postotak njihovih izvješća pao za 50 posto jer su ostali narodi počeli slati svoja izvješća ranije. Znači, možete li pronaći izvješća ranije pretražujući internet? Naravno da možete. Možete li ih naći prije nego to učini GPHIN? Naravno da možete. Vidjeli ste da su pronašli SARS koristeći kineski internet pretraživać punih šest tjedana ranije prije nego što su ga našli koristeći njihov engleski internet pretraživač. Zapravo, oni pretražuju u samo sedam jezika. Ti grozni virusi stvarno nemaju nikakvu namjeru pojaviti se prvo na engleskom ili španjolskom ili francuskom.
(Laughter)
(Smijeh)
So yes, I want to take GPHIN, I want to build on it. I want to add all the languages of the world that we possibly can. I want to make this open to everybody, so that the health officer in Nairobi or in Patna, Bihar will have as much access to it as the folks in Ottawa or in CDC. And I want to make it part of our culture that there is a community of people who are watching out for the worst nightmares of humanity, and that it's accessible to everyone.
Da, hoću uzeti GPHIN, hoću raditi na njemu, hoću dodati sve jezike na svijetu koje mogu, hoću otvoriti oči svima kako bi zdravstveni radnici u Nairobiju ili Patni, Bihar imali istu dostupnost kao i ljudi iz Ottawe ili iz CDC-a. Želim napraviti dijelom naše kulture postojanje zajednice ljudi koji paze na najgore noćne more čovječanstva, i da je to dostupno svima.