The child's symptoms begin with mild fever, headache, muscle pains, followed by vomiting and diarrhea, then bleeding from the mouth, nose and gums. Death follows in the form of organ failure from low blood pressure.
Comezan os síntomas do neno cunha suave febre, dor de cabeza, dores musculares seguidos por vómitos e diarrea, logo sangrado de boca, nariz e enxivas. Morte inminente por fallo multiorgánico debido a unha baixa presión arterial.
Sounds familiar? If you're thinking this is Ebola, actually, in this case, it's not. It's an extreme form of dengue fever, a mosquito-born disease which also does not have an effective therapy or a vaccine, and kills 22,000 people each year. That is actually twice the number of people that have been killed by Ebola in the nearly four decades that we've known about it. As for measles, so much in the news recently, the death toll is actually tenfold higher. Yet for the last year, it has been Ebola that has stolen all of the headlines and the fear.
Resúltavos familiar? Se estades pensando en ébola, o certo é, que neste caso non o é. É unha forma extrema de dengue, enfermidade transmitida por mosquitos que de feito non ten nin terapia nin vacina eficaz, e mata 22 000 persoas cada ano. O que supón o dobre do número de persoas falecidas a causa do ébola nas case catro décadas desde o seu descubrimento. En canto ao sarampelo, moi presente agora nas noticias, o custo en vidas é dez veces superior. No entanto, no último ano, o ébola ocupou todos os titulares e propagou o medo.
Clearly, there is something deeply rooted about it, something which scares us and fascinates us more than other diseases. But what is it, exactly? Well, it's hard to acquire Ebola, but if you do, the risk of a horrible death is high. Why? Because right now, we don't have any effective therapy or vaccine available.
É evidente que hai algo que nos afecta profundamente, algo que nos dá medo e nos fascina máis ca outras enfermidades. Pero que é, exactamente? Ben, é difícil contraer ébola, pero de facelo, o risco dunha morte horrible é alto Por que? Porque agora mesmo, non temos ningunha terapia nin vacina dispoñible.
And so, that's the clue. We may have it someday. So we rightfully fear Ebola, because it doesn't kill as many people as other diseases. In fact, it's much less transmissible than viruses such as flu or measles. We fear Ebola because of the fact that it kills us and we can't treat it. We fear the certain inevitability that comes with Ebola. Ebola has this inevitability that seems to defy modern medical science.
Esa é a cuestión. Pode que a teñamos algún día. Polo que, con razón, tememos o ébola; non porque mate tanta xente coma outras enfermidades. De feito, é menos contaxioso ca outros virus como a gripe ou o sarampelo. Tememos o ébola porque nos mata e non o podemos tratar. Tememos o inevitable que vén co ébola. O ébola ten ese lado inevitable que parece desafiar a medicina moderna.
But wait a second, why is that? We've known about Ebola since 1976. We've known what it's capable of. We've had ample opportunity to study it in the 24 outbreaks that have occurred. And in fact, we've actually had vaccine candidates available now for more than a decade. Why is that those vaccines are just going into clinical trials now?
Pero, a que se debe? Coñecemos o ébola desde 1976. Sabemos de que é capaz. Tivemos moitas oportunidades de estudalo nos 24 brotes que se produciron. E de feito, temos posibles vacinas dispoñibles desde hai máis dunha década. Por que os ensaios clínicos se fan só agora?
This goes to the fundamental problem we have with vaccine development for infectious diseases. It goes something like this: The people most at risk for these diseases are also the ones least able to pay for vaccines. This leaves little in the way of market incentives for manufacturers to develop vaccines, unless there are large numbers of people who are at risk in wealthy countries. It's simply too commercially risky.
Isto demostra o problema fundamental que temos co desenvolvemento de vacinas para enfermidades infecciosas. O asunto é algo así: As persoas máis en risco de contraer estas enfermidades son tamén as que menos capacidade teñen de mercar estas vacinas. O que se traduce en pouco interese no mercado para os fabricantes de vacinas, a menos que exista suficiente demanda en países ricos. É un risco comercial demasiado alto.
As for Ebola, there is absolutely no market at all, so the only reason we have two vaccines in late-stage clinical trials now, is actually because of a somewhat misguided fear. Ebola was relatively ignored until September 11 and the anthrax attacks, when all of a sudden, people perceived Ebola as, potentially, a bioterrorism weapon.
No caso do ébola, non hai mercado en absoluto, a única razón pola que temos dúas vacinas nas últimas fases de ensaio clínico, ten que ver cun certo medo infundado. O ébola foi relativamente ignorado ata o 11-S e os ataques con ántrax; de súpeto, o ébola foi percibido pola poboación como unha potencial arma bioterrorista.
Why is it that the Ebola vaccine wasn't fully developed at this point? Well, partially, because it was really difficult -- or thought to be difficult -- to weaponize the virus, but mainly because of the financial risk in developing it. And this is really the point. The sad reality is, we develop vaccines not based upon the risk the pathogen poses to people, but on how economically risky it is to develop these vaccines. Vaccine development is expensive and complicated. It can cost hundreds of millions of dollars to take even a well-known antigen and turn it into a viable vaccine.
Por que non se deseñou a vacina do ébola nese momento? Ben, porque era moi difícil --ou iso se pensaba -- converter un virus en arma, pero sobre todo, polo risco financeiro que suporía. E é esta a cuestión. A triste realidade é que desenvolvemos vacinas non tendo en conta o risco que o patóxeno supón, senón tendo en conta o risco económico asociado ao seu deseño. O desenvolvemento de vacinas é custoso e complexo. Pode custar centos de millóns de dólares só coller un antíxeno coñecido e convertelo nunha vacina viable.
Fortunately for diseases like Ebola, there are things we can do to remove some of these barriers. The first is to recognize when there's a complete market failure. In that case, if we want vaccines, we have to provide incentives or some type of subsidy. We also need to do a better job at being able to figure out which are the diseases that most threaten us. By creating capabilities within countries, we then create the ability for those countries to create epidemiological and laboratory networks which are capable of collecting and categorizing these pathogens. The data from that then can be used to understand the geographic and genetic diversity, which then can be used to help us understand how these are being changed immunologically, and what type of reactions they promote.
Por fortuna, para enfermidades como o ébola, podemos facer cousas para botar abaixo algunhas destas barreiras, A primeira é recoñecer cando hai unha falla total no mercado. Neste caso, se queremos vacinas, temos que ofrecer incentivos ou algún tipo de subvención. Tamén temos que mellorar a forma de identificar de maneira máis eficaz cales son as enfermidades máis perigosas. Proporcionando recursos aos países afectados, ofréceselles a posibilidade de crear as súas propias redes epidemiolóxicas e de laboratorios capaces de recompilar e categorizar estes patóxenos. Estes datos podes ser usados despois para entender a diversidade xeográfica e xenética, que pode axudarnos a coñecer qué cambios inmunolóxicos implican e qué tipo de reaccións promoven.
So these are the things that can be done, but to do this, if we want to deal with a complete market failure, we have to change the way we view and prevent infectious diseases. We have to stop waiting until we see evidence of a disease becoming a global threat before we consider it as one. So, for Ebola, the paranoid fear of an infectious disease, followed by a few cases transported to wealthy countries, led the global community to come together, and with the work of dedicated vaccine companies, we now have these: Two Ebola vaccines in efficacy trials in the Ebola countries --
Pódense tomar algunhas destas medidas, pero para facelo, se queremos abordar a total falla do mercado, temos que cambiar o xeito de ver e prever as enfermidades infecciosas. Temos que deixar de esperar ata vermos probas dunha enfermidade que vai supoñer unha ameaza global, para actuar. Entón, no caso do ébola, o medo paranoico a unha enfermidade infecciosa, seguido por uns poucos casos de infectados nos países ricos, fixo posible unha colaboración global, e grazas ao traballo de empresas produtoras de vacinas, agora temos isto: dúas vacinas contra o ébola probadas en ensaios clínicos en países con ébola --
(Applause)
(Aplausos)
and a pipeline of vaccines that are following behind.
e seguidas doutras en camiño.
Every year, we spend billions of dollars, keeping a fleet of nuclear submarines permanently patrolling the oceans to protect us from a threat that almost certainly will never happen. And yet, we spend virtually nothing to prevent something as tangible and evolutionarily certain as epidemic infectious diseases. And make no mistake about it -- it's not a question of "if," but "when." These bugs are going to continue to evolve and they're going to threaten the world. And vaccines are our best defense. So if we want to be able to prevent epidemics like Ebola, we need to take on the risk of investing in vaccine development and in stockpile creation. And we need to view this, then, as the ultimate deterrent -- something we make sure is available, but at the same time, praying we never have to use it.
Cada ano gastamos miles de millóns de dólares, en manter unha frota de submarinos nucleares vixiando os océanos para protexernos de ameazas que case con certeza non acontecerán. E no entanto, non gastamos case nada en previr algo tan palpable e evolutivamente inevitable como as enfermidades infecciosas epidémicas. E non nos equivoquemos --non é cuestión de "se ocorrerá", senón de "cando". Estes bechos van seguir evolucionando e van pór en perigo o mundo. E as vacinas son a nosa mellor defensa. Así que se queremos ser quen de previr epidemias como o ébola, temos que arriscarnos a investir en desenvolver vacinas e en acumular reservas. E necesitamos ver isto, entón, como a medida disuasoria definitiva, algo que sabemos que está dispoñible, pero ao mesmo tempo, rezamos para nunca ter que usar.
Thank you.
Grazas.
(Applause)
(Aplausos)