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.
我是這世界上最幸運的人。 我有機會看到世界上最後一宗致命天花的案例。 去年我在印度 可能也看到世上最後一宗小兒痲痹案例。 沒有什麼比這感覺更好的:有這樣的福氣及榮耀 可以在這樣一個團隊中工作 知道這麼恐怖的東西不復存在。 所以,我要說 (掌聲) 所以,我要給你們看一些可怕的圖片。 看這些圖片很難熬,但你們應該抱以樂觀的態度 因為圖片恐怖的程度 與知道它們不復存在所帶來的振奮感相當。
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)
但我要先告訴你們一些我經歷的事。 我的背景不完全像你們預期的 傳統醫學教育。 我在舊金山實習的時候, 我聽說有一群美國原住民(美洲印第安人) 居住在惡魔島(Alcatraz Island), 有一個印地安人在島上要生小孩, 但沒有醫生想去那裡幫她接生。 我去了惡魔島,在那住了幾個禮拜。 她生了小孩,我接生了嬰兒,然後我離開那個島。 我回到舊金山,所有媒體都想要訪問我, 因為在那兒的三個禮拜,讓我成為印地安問題的專家。 我上了每個電視節目。
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.
有人看到我在節目上,打電話問我 願不願意在一部電影中演個 一群搭車由舊金山前往英國的搖滾樂星們 的隨隊年輕醫生。我說:「好,我可以。」 所以我成為一部大爛片中的醫生, 這部片叫「Medicine Ball Caravan」。 好,你知道在六零年代, 你要不是在車上旅行; 就是根本不在車上。(摘錄Ken Kesey 的名言,指跟 Kesey 同陣線或不同) 我在車上。我太太和我,共37年,加入了車隊(指這事業)。 我們的車帶我們從舊金山到倫敦。 我們在大西洋換了車。然後又換了兩次車 我們開過土耳其、伊朗、阿富汗、 穿過開伯爾山口進入巴基斯坦,就跟其他年輕醫生一樣。 這是我們在開伯爾山口,那是我們的車。 我們在穿越開伯爾山口時遇到些困難, 但我們最後到了印度。 然後,跟所有我們這輩的人一樣, 我們住在喜馬拉雅山脈的修道院內。
(Laughter)
(笑聲)
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.
這是我們的駐院醫師實習訓練, 跟醫學院的學生所應受的駐院實習訓練一樣. 我們跟一個很有智慧的人學習,叫Karoli Baba的古魯(印度教的導師), 他告訴我們脫下袍子 穿上西裝 去加入聯合國當個外交官 為世界衛生組織工作。 他還不可思議的預測天花可以被消滅, 而這是上帝給人類的禮物, 因為在這些科學家的努力下 這個預測成真了。這個小女孩是Rahima Banu, 她是最後一宗致命天花的患者。 這是一張世界委員會開的證明文件 證明史上第一次消滅一種疾病。
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?
消滅天花最重要的是早發現、早行動。 我要你們重複這個「早發現、早行動」 你們可以說嗎?
Audience: Early detection, early response.
觀眾:早發現、早行動。
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:天花是史上最嚴重的疾病。 它殺死的人比任何戰爭都多。 在上個世紀,有五億人死於天花。 超過兩個--你已經在看Larry Page了, 有些人看得很快。(笑聲) 在Larry Page和Sergey Brinn-- 我和他們有些關係和最近的新組織-- 在他們出生那年, 兩百萬人死於天花。 我們在1980年宣布天花被消滅了。 這是我在公衛上看過最重要的投影片, 因為它告訴你:就算你是最富有,最有強壯的人、 是世界上最有權的國王皇后(埃及法老照片:死於天花) 也沒辦法讓你不受害於天花。 無法否認, 我們大家在同一條船上.
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.
以一個最高統治者的角度來看天花 是錯誤的。 你應該以一個母親的角色 看他的孩子染病卻束手無策。 第一天、第二天、第三天、第四天、第五天、第六天。 你是個母親而你正在看你的小孩, 在第六天,你看到膿包變硬。 第七天,你看到天花經典的臍狀疤。 第八天。 高爾之前說世界上最常被拍照的、
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.
最常被印出來的圖片 是地球。但在1974年, 這張照片才是 曝光率最高的. 因為我們為這張照片印了二十億張 我們拿著它們挨家挨戶 給人們看並問他們家中有沒有天花病患. 因為那是我們的監控系統。我們沒有Google、 我們沒有網路爬蟲(自動化瀏覽網路)、我們沒有電腦。
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.
到了第九天,你看這張圖片,你會驚駭。 我看這張圖片而我會說:「感謝上帝」 因為這代表了這只是普通的天花病例, 而我知道這個小孩會活下來。 到了第十三天,傷口長滿疙瘩、他的眼皮還是腫脹, 但這個孩子沒有繼發性感染。 到第二十天,雖然他會一生帶疤,但他會活下來。
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.
還有其它種天花不是這樣的。 這是個融合性天花, 病人全身上下沒有任何一個地方有超過 手指頭大小的完好肌膚。 扁平天花,得病者百分之百死亡。 出血性天花,最殘忍的, 易感染於懷孕女性。 我看過大約五十個女人死亡,她們全都染了出血性天花。 我從來沒有看過一個出血性天花死亡者不是懷孕女性。
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.
在1967年,WHO開始了一個不可思議的計畫 要消滅一個疾病。 在那年,34個國家有天花病例。 到了1970年,只剩下18個國家。 1974年,只剩下五個國家。 但在那年,天花在印度爆發。 印度也成為天花最後病例的所在地。 1974年,印度有六億人口。 那時印度有21個語言區, 就像是說有21個不同國家一樣。 任何時間都有兩千萬人在路上, 在搭著車、火車、 走路,有五十萬村莊、一億兩千萬戶人家, 但沒有任何人願意告訴我們:他們家裡有天花病人 因為他們認為天花是女神Shitala Mata (降溫女神)的拜訪, 當女神來訪的時候不該讓陌生人進家門。 所以沒有任何匯報天花役疫情的意願。 不是只有印度有天花女神,
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.
這種"天花神"的迷信在全世界各地普遍存在的。 所以我們要如何消滅天花?大眾接種是沒有用的。 你可以讓印度每個人都接種, 但一年後又有兩千一百萬新生兒, 在當時等於加拿大的人口。 為每個人打疫苗是沒有用的。 你必須在同一時間找到全世界每一宗天花案例 且在每個案例周圍建立防疫圈。 我們就是這麼做的。 光在印度,我和我的十五萬好朋友們 拿著同樣的照片在印度 挨家挨戶拜訪。我們拜訪了超過一千萬家庭。
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.
在過程中,我學到一件重要的事情: 我們每做一次門戶搜索, 天花病例的數目就突然高起來一次。 當我們沒有搜索時,我們有了疾病被消除的假象。 當我們搜索時,我們有疾病病例增加的假象。 一個監控系統是必須的, 因為我們需要的是早發現,早行動。 所以我們一直找一直找,找到 印度的每一宗天花。我們提供獎勵。 然後我們提高獎勵。我們繼續提高獎勵。 我們在每一棟房子牆上記錄到訪的日期(像計分表一樣)。 當我們一直這麼做時,天花病例的數目最後也降到零。 在1980年,我們宣布天花不復存在。 這是聯合國在伊拉克戰爭前最大的活動,
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.
十五萬人來自世界各地 及不同種族、不同宗教、不同國家的醫生們, 肩並肩,互相幫助而無紛爭, 完成一個讓世界更美好的任務。 但天花是我們試著消滅的第四個疾病。 我們之前失敗了三次。 在瘧疾、黃熱病和雅司(熱帶莓疹)病上我們都失敗了。 不過很快的,小兒痲痹也會被消滅的。 消滅小兒痲痹的金鑰是:早發現,早行動。 今年有可能是我們消滅小兒痲痹的一年, 這就會是史上第二個被消滅的疾病。 David Heymann, 如果你透過網路轉播看這場演講。 David, 繼續努力。我們快要做到了,我們只剩下四個國家。
(Applause)
(掌聲)
I feel like Hank Aaron. Barry Bonds can replace me any time.
我覺得我跟Hank Aaron(美國棒球球員)一樣, 會很快的被Barry Bonds(棒球球員)追上取代。
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.
讓我們再把一個疾病從我們耽心的清單中移除。 我才在印度參與消滅小兒痲痹的工作。 小兒痲痹的監控系統是四百萬人挨家挨戶去尋找。 那是我們的監控系統。 我們需要早發現,早行動。 失明,一樣的。發現失明的鑰匙是 做流行病學問卷並找出失明的原因, 方能做出正確的反應。
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.
賽瓦基金會是由一群 曾參與消滅天花的人組成的。 這群人爬到了頂峰 嘗了消滅一種疾病的成功滋味, 且想要再做一次。 在過去的27年當中,賽瓦基金在十五個國家 已經幫兩百萬失明人士找回光明。 賽瓦的開始是因為我們想要將 監控系統和流行病學理論 用在其他人都不認為是 公衛的問題:失明。 在這之前只被認為是個臨床疾病。
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年賈伯斯給我一台電腦,蘋果第十二號, 它現在還在加德滿都(尼泊爾首都)運作著。 我們應該把它拿來拍賣,為賽瓦籌得到更多錢。 我們做了史上第一個尼泊爾的健康問卷, 也是第一個全國性的失明問卷, 而結果另我們吃驚。 我們以為會得到的結果是: 青光眼和沙眼是造成失明主要的原因. 但我們驚訝的發現失明竟多數是由白內障造成的。 你不可能醫治或預防你不知道的東西。
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.
在你們的TED包裹中有一片DVD「無限視覺」, 在講V醫生和Aravind眼科醫院。 我希望你們能看一看。 Aravind一開始是賽瓦的一個計畫, 現在是世界上最大最好的眼科醫院。 今年,這間醫院會在印度 塔米德邦為三十萬人恢復視力。 (掌聲) 禽流感。我在這裡為這些恐怖的事情發言-- 這有可能是最遭的。 防止或是減輕禽流感流行的鑰匙是 早發現、早行動。 在未來的三年中,我們不會有疫苗或是 足夠的抗病毒素來對抗禽流感。 這是世界衛生組織將大流行病分級表。 我們現在在警戒區第三級, 只有一些些的人傳人病例, 但沒有大量人傳人病例。
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?
當世界衛生組織宣布我們在第四級時, 這不會像科特莉娜颶風只局部在一區。我們知道的世界將會停擺。 不會有任何飛機飛行。 你會願意搭乘一架有250個陌生人的飛機 有人正在咳嗽和擤鼻涕,而你知道其中幾個 有可能帶有致人於死地的傳染病, 而你沒有機會得到抗病毒素或疫苗嗎? 我在十月的時候對世界頂尖的流行病學家做了問卷。 我問他們,這些人是流感病學家和流感病毒專家, 我問他們你們也想問他們的問題。 你覺得流感流行的可能性有多大? 如果發生了,你覺得會有多嚴重?
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.
百分之十五認為在三年內會發生流感。 但更遭的是, 百分之九十認為我們下一代 或下下一代也會有大流感流行。 而且他們認為如果流行了, 會有十億人生病。 大約一億六千五百萬人會死亡。 會發生全球蕭條及衰退, 當恰好足夠的存貨系統, 和全球緊密的架構崩潰, 將造成十到三十兆經濟損失, 會比一億人死亡更遭的是, 更多人會沒有工作, 他們的健保也沒了, 後果不堪設想。 而且情況這會越來越遭,因為旅遊越來越容易。(更易傳染)
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.
讓我模擬一個流感的模型給你們看, 所以大家知道我在講甚麼。 讓我們預設,舉例來說,第一宗病例發生在亞洲南方。 一開始非常緩慢。 然後傳到兩到三個不同的地方。 會有個二度爆發,然後疾病會在 國家跟國家之間傳播,快到你都不知道發生什麼事。 三週內,全球各處都染上了。 現在,如果我們有個還原鍵,我們可以回去並在疾病一開始時 便抓住隔離它。如果我們可以早發現, 且我們有早探測到,早行動, 這樣我們可以把每一個病毒關到牢裡, 那是唯一可以阻止大流行(瘟疫)的方法。 讓我給你們看為什麼。
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.
我們有個笑話。這是流行病曲線。每個在醫學的人, 我想都會知道這是什麼。 笑話是這樣的:一個流行病學家喜歡來到流行病曲線 的這裡, 然後享受隨曲線下滑的榮耀。 但大部份時候不是這樣的。 大部份時候你會來到這裡。 我們想要的是來到這裡,這樣我們可以阻止疾病流行。 但你不是永遠都做得到的。幸好有個組織 找到一個可以得知第一宗病例發生的方法, 這個組織叫做GPHIN。 Global Public Health Information Network (世界公衛資訊系統) 我剛剛給你們看的模擬,你們認為是禽流感的, 那是SARS。SARS 是一個沒有發生的大流感。 它沒有發生因為GPHIN在世界衛生組織 宣布前三個月就發現了這可能的未來大流感: SARS。 也因此我們能夠阻止SARS的蔓延。 我認為我們欠GPHIN和Ron St. John很多。 我希望他在觀眾席中--在那-- 他是GPHIN的創辦人。
(Applause)
(掌聲)
Hello, Ron!
哈囉Ron。
(Applause)
(掌聲)
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將Ron從渥太華也就是GPHIN的所在地接過來。 因為GPHIN不只提早發現SARS, 你可能有看到前幾個禮拜伊朗宣布境內有禽流感, 但GPHIN不是在二月十四,而是在去年九月就發現伊朗有禽流感。 我們需要一個早期警告系統 來保護我們免於被這種人類惡夢(大流行)的迫害。 所以我的TED願望就是根據這些經驗而來的 天花:早發現、早行動。 失明、小兒痲痹:早發現、早行動。 禽流感:早發現、早行動。這是祈禱文。 很明顯的我們唯一可行的方法是 早期發現且在流行起來前殺盡致病菌。 所以,我的TED願望是希望你們都能幫忙建造一個全球系統,
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]
一個早期警告系統, 來使我們免於人類最糟惡夢的迫害。 我想我可以叫它「Early Detection」(早期發現) 但它應該叫做「Total Early Detection」(完全早期發現)(TED) (笑聲)
(Laughter) What?
(掌聲)
(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.
真的! 認真來說-- 因為這個點子來自TED, 我希望它成為TED的傳說,所以我要叫他 「International System for Total Early Disease Detection」(完全早期發現國際組織) 然後INSTEDD成為我們的六字大明咒(觀世音咒)。(救苦救難真言) 與其隱匿不知禽流感流行, 我們應早期發現、馬上控制住疫情. 與其在小說中憶測由生物恐怖、生物失誤造成的新型病毒。 我們應早期發現、馬上控制住此新型病毒。 以早發現、早行動取代 像伯帕爾漏油事件的工業意外。 以早發現、早行動取代發現時已來不及的飢荒。 與其由政府組成的一個系統、 一個被埋在政府五臟六腑的系統內, 讓我們打造一個早期偵測系統, 一個世界上每一個人都可以自由地用自己的語言來使用。
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.
讓它透明化、非政府化、 不屬於任何一個國家或公司擁有、 建立在一個中立國家、且在每個不同時區、 每個大洲都有備份。 讓我們以GPHIN為基礎,從GPHIN出發。 讓我們將他們的網站數從兩千萬提高到兩百億。 讓我們將他們使用的語言從七種提高到七十種或更多。 讓我們建造向外的確認方法, 用簡訊或SMS或即時訊息, 從謠言所在地100公尺內的人身上得知 謠言是否是真的。 讓我們再加上衛星確認。 並在前端加上Gapminder引人入勝的圖表。
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.
我們要讓它成為一個道德力量且持續成長, 在任何人根本還未知前,提早找出這些可怕的事件, 且採取行動。所以明年, 在這裡再見面, 我們不會 哀悼曾有多少可怕的事情發生過, 我們會團結一起運用我們特有的能力、 和這個群體不可思議的力量 自豪的說:我們做了所有我們能做的來阻止大流行(大瘟疫). 及其它大災害。讓我們從現在開始改變世界。
(Applause)
(掌聲)
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:很精彩的演講。首先, 只是讓大家更瞭解。你說建造-- 設計網路爬蟲(自動化瀏覽網路的程式)、只是經由網路模式, 他們可以在世界衛生組織之前發現可疑的事件, 在任何人之前? 解釋一下。給一個例子解釋這怎麼可能。
Larry Brilliant: You're not mad about the copyright violation?
Larry Brilliant:首先,你沒有因為侵犯智慧財產權生氣吧?
CA: No. I love it.
CA:沒有。我很喜歡。
(Laughter)
LB:好的,嗯, 當Ron St. John--我希望你
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.
等會的晚餐上會去跟他碰面講講話-- 當他1997年成立GPHIN的時候,那時禽流感剛爆發時,是H5N1種。 發生在香港。而一個卓越的香港醫生 馬上匯報,經由殺了一百五十萬隻家禽和小鳥, 他們阻止了禽流感持續傳染爆發。 馬上發現、馬上行動。 然後幾年過去了, 有很多禽流感的謠言。 Ron和他的團隊開始在渥太華瀏覽監控網路, 只瀏覽監控兩萬個不同的網站,大部分是(醫學)期刊。 他們讀到聽到有關於很多小孩發燒 且有禽流感的症狀。
They reported this to WHO.
他們報告給WHO。WHO花了一些時間才行動,
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.
因為WHO只接受從政府來的報告, 因為WHO屬於聯合國。 但他們有能力能指出地區讓WHO知道 那兒有無法解釋的許多病例, 而症狀類似禽流感. 結果就是SARS。 那是這世界怎麼知道SARS的。 也因此我們可以阻止SARS。 現在,很重要的是,在GPHIN之前, 世上所有壞事的報導-- 不管是飢荒或是禽流感 或是伊波拉病毒-- 全部來自各國官方報導。
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.
當這些在渥太華預算只有每年八十萬元的人開始做事時, 百分之75的報導來自GPHIN, 剩下的25來自 世界各地180個國家。 現在,有趣的是, 他們開始工作幾年後, 你覺得那些國家怎麼了? 他們覺得自己很蠢,所以開始早點送出報告。 現在他們的報告佔了百分之五十, 因為這些國家開始報導了。 所以你可以藉由網路找到疾病嗎? 當然可以。你可以比GPHIN更早發現嗎? 當然可以。你知道嗎? 用中文找到SARS的資訊 比用英文找到的資訊 足足早了六個禮拜。 現在他們只用七種語言。 這些可惡的病毒並沒有意願 以英文或西班牙文或法文現身。
(Laughter)
(笑聲)
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.
所以,是的,我要以GPHIN為基礎,繼續建造, 我想要盡我們所能加進世界上所有語言。 我想要讓每個人都有使用它, 這樣奈洛比或巴特那或比哈爾省的健康官員 可以如渥太華或美國疾病防治中心的人一樣使用, 而且我希望讓它成為我們文化的一部份, 就是有一群人正在守護著、讓我們遠離人類最可怕的惡夢, 而且是每個人都能使用的。