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.
Dječji simptomi počinju s blagom groznicom, glavoboljom, bolovima u mišićima, nakon čega slijede povraćanje i proljev, zatim krvarenje iz usta, nosa i desni. Slijedi smrt u obliku zatajenja organa zbog niskog krvnog tlaka.
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.
Zvuči poznato? Ako mislite da je to ebola, zapravo, u ovom slučaju, nije. To je ekstremni oblik dengi groznice, bolesti koju uzrokuju komarci i za koju također ne postoji učinkovita terapija ili cjepivo i koja ubija 22,000 ljudi godišnje. To je zapravo dvostruko više ljudi od onih ubijenih ebolom u gotovo četiri desetljeća koliko znamo za nju. Što se tiče ospica, koje su često na vijestima u posljednje vrijeme, smrtnost je zapravo deset puta veća. Ipak, protekle godine ebola je zauzela sve naslove i strah.
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.
Očito postoji neki razlog, nešto što nas plaši i fascinira više nego druge bolesti. Ali što je to točno? Pa, teško je zaraziti se ebolom, ali ako se to dogodi, rizik užasne smrti je visok. Zašto? Zato što trenutno nemamo nikakvu učinkovitu terapiju ili dostupno cjepivo.
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.
Dakle, to je ključ. Jednog dana možda ćemo imati. Dakle, s pravom se bojimo ebole zato što ne ubija toliko ljudi poput drugih bolesti. Zapravo, puno se teže prenosi od drugih virusa, kao na primjer gripe ili ospica. Bojimo se ebole zbog činjenice da nas ubija i da ju ne možemo izliječiti. Bojimo se određene neizbježnosti koja dolazi s ebolom. Ebola posjeduje neizbježnost koja kao da prkosi današnjoj modernoj medicini.
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?
Ali čekajte malo, zašto je tome tako? Znamo za ebolu od 1976. Znamo za što je sposobna. Imali smo dovoljno prilika da ju proučimo u 24 epidemije koje su se zbile. I zapravo imamo moguća cjepiva koja su dostupna već preko deset godina. Zašto da cjepiva tek sada prolaze klinička testiranja?
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.
Ovome je razlog osnovni problem koji imamo s razvojem cjepiva za zarazne bolesti. Glasi ovako nekako: Ljudi koji su najrizičnija skupina za te bolesti su ujedno i ljudi koji su najmanje u mogućnosti platiti cjepiva. Zbog toga tržište nema inicijativu za proizvodnju i razvoj cjepiva osim ako velik broj ljudi koji riskiraju oboljenje nije u bogatim zemljama. Jednostavno je tržišno preriskantno.
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.
Što se ebole tiče, ne postoji nikakvo tržište, tako da je jedini razlog što imamo dva cjepiva u stadiju kliničkih istraživanja zapravo strah u nekoj zabludi. Ebolu se relativno ignoriralo do 11. rujna i napada bedrenicom, kada su ljudi odjednom počeli doživljavati ebolu kao potencijalno oružje bioterorizma.
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.
Zbog čega onda cjepivo protiv ebole još nije potpuno razvijeno? Pa ,djelomično zato što je stvarno teško -- ili se smatra teškim -- naoružati virus, ali uglavnom zbog financijskog rizika razvijanja tog cjepiva. I tu je zapravo poanta. Tužna stvarnost je da razvijemo cjepiva, ne prema riziku koji patogen predstavlja za ljude, nego prema ekonomskom riziku razvoja cjepiva. Razvoj cjepiva je skup i kompliciran. Može koštati stotine milijuna dolara da se čak vrlo dobro poznat antigen pretvori u učinkovito cjepivo.
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.
Srećom, za bolesti kao što je ebola postoje načini kojima možemo ukloniti neke od prepreka. Prvi način je prepoznati potpuni neuspjeh tržišta. U tom slučaju, ako želimo cjepiva, moramo dati poticaj ili neku vrstu novčane subvencije. Također moramo biti bolji u dokučivanju koje nas bolesti najviše ugrožavaju. Stvaranjem mogućnosti u državama, stvaramo mogućnost za te države da stvore epidemiološke i laboratorijske veze koje su u mogućnosti prikupiti i kategorizirati te patogene. Podaci iz toga se tada mogu iskoristiti za razumijevanje zamljopisne i genetske raznolikosti, koji se zatim mogu iskoristiti za razumijevanje kako se mijenjaju imunološki i koji tip reakcija uzrokuju.
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 --
To možemo napraviti, ali da bismo to učinili, ako se želimo suočiti s potpunim neuspjehom tržišta, moramo promijeniti način kako gledamo na zarazne bolesti i njihovu prevenciju. Moramo prestati čekati dokaze da je bolest postala globalna prijetnja prije no što ju smatramo prijetnjom. Dakle, što se ebole tiče, paranoični strah od zarazne bolesti, kojeg prati par slučajeva prijenosa u bogate zemlje, poveo je globalno društvo u jedinstvo i radom posvećenih kompanija za razvoj cjepiva sada imamo ovo: Dva cjepiva protiv ebole na testiranju učinkovitosti u zemljama pogođenim ebolom
(Applause)
(Pljesak)
and a pipeline of vaccines that are following behind.
i niz cjepiva koja slijede.
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.
Svake godine, trošimo milijarde dolara održavajući flotu nuklearnih podmornica u stalnoj ophodnji oceana da nas zaštite od prijetnje koja se gotovo sigurno nikada neće obistiniti. Istovremeno, gotovo ništa ne trošimo da se zaštitimo od nečeg toliko bliskog i evolucijski sigurnog kao epidemijske zarazne bolesti. I nemojte pogrešno misliti -- ovo nije pitanje "ako", nego pitanje "kada". Ovi će virusi nastaviti evoluirati i prijetit će svijetu. A cjepiva su naša najbolja obrana. Dakle, ako želimo spriječiti epidemije kao što je ebola, moramo riskirati ulaganjem u razvoj i masovnu proizvodnju cjepiva. I moramo na ovo gledati kao na posljednju opomenu -- nešto za što se trebamo pobrinuti da bude dostupno, ali istovremeno se moleći da to nikada nećemo morati iskoristiti.
Thank you.
Hvala vam.
(Applause)
(Pljesak)