Hans Rosling on HIV: New facts and stunning data visuals

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2009-05-13・ 1997    87


http://www.ted.com Hans Rosling unveils new data visuals that untangle the complex risk factors of one of the world's deadliest (and most misunderstood) diseases: HIV. He argues that preventing transmissions -- not drug treatments -- is the key to ending the epidemic. TEDTalks is a daily video podcast of the best talks and performances from the TED Conference, where the world's leading thinkers and doers give the talk of their lives in 18 minutes. Featured speakers have included Al Gore on climate change, Philippe Starck on design, Jill Bolte Taylor on observing her own stroke, Nicholas Negroponte on One Laptop per Child, Jane Goodall on chimpanzees, Bill Gates on malaria and mosquitoes, Pattie Maes on the "Sixth Sense" wearable tech, and "Lost" producer JJ Abrams on the allure of mystery. TED stands for Technology, Entertainment, Design, and TEDTalks cover these topics as well as science, business, development and the arts. Closed captions and translated subtitles in a variety of languages are now available on TED.com, at http://www.ted.com/translate. Watch a highlight reel of the Top 10 TEDTalks at http://www.ted.com/index.php/talks/top10

Instruction

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Translator: Ingrid Lezar Reviewer: Christo Crafford
00:12
(Applause)
(Applous)
00:18
AIDS was discovered 1981; the virus, 1983.
Vigs is in 1981 ontdek; die virus -- 1983.
00:23
These Gapminder bubbles show you
Hierdie Gapminder borrels wys
00:25
how the spread of the virus was in 1983 in the world,
hoe die virus in 1983 wêreldwyd versprei was,
00:29
or how we estimate that it was.
of hoe ons benader dit was.
00:31
What we are showing here is --
Wat ons hier wys is --
00:33
on this axis here, I'm showing percent of infected adults.
op dié as dui ek die persentasie besmette volwassenes aan.
00:40
And on this axis, I'm showing dollars per person in income.
En hier, inkomste in dollar per persoon.
00:45
And the size of these bubbles, the size of the bubbles here,
En die grootte van die borrels hier
00:49
that shows how many are infected in each country,
wys hoeveel besmet is in elke land,
00:52
and the color is the continent.
en die kleur is die vasteland.
00:54
Now, you can see United States, in 1983,
Julle kan sien die VSA het, in 1983,
00:56
had a very low percentage infected,
’n baie lae persentasie infeksies gehad,
00:59
but due to the big population, still a sizable bubble.
maar a.g.v. die groot bevolking, is dit steeds ’n wesenlike borrel.
01:03
There were quite many people infected in the United States.
Nogal heelwat mense was besmet in die VSA.
01:06
And, up there, you see Uganda.
En, hier bo, sien julle Uganda.
01:08
They had almost five percent infected,
Hulle't amper vyf persent gehad,
01:11
and quite a big bubble in spite of being a small country, then.
en nogal ’n groot borrel, al was dit toe nog ’n klein land.
01:14
And they were probably the most infected country in the world.
En hulle was waarskynlik die mees besmette land ter wêreld.
01:19
Now, what has happened?
Nou, wat het gebeur?
01:21
Now you have understood the graph
Nou dat julle die grafiek verstaan,
01:23
and now, in the next 60 seconds,
en nou, in die volgende 60 sekondes,
01:26
we will play the HIV epidemic in the world.
sal ons die MIV-epidemie oor die wêreld afspeel.
01:29
But first, I have a new invention here.
Maar eers, het ek ’n nuwe uitvinding hier.
01:34
(Laughter)
(Gelag)
01:39
I have solidified the beam of the laser pointer.
Ek het die straal van die laserwyser gesoliedifiseer.
01:43
(Laughter)
(Gelag)
01:46
(Applause)
(Applous)
01:52
So, ready, steady, go!
So, op julle merke, gereed, weg!
01:56
First, we have the fast rise in Uganda and Zimbabwe.
Eerste, het ons die vinnige styging in Uganda en Zimbabwe.
02:00
They went upwards like this.
Hulle't opgegaan soos dit.
02:02
In Asia, the first country to be heavily infected was Thailand --
In Asië, was Thailand die eerste erg besmette land.
02:06
they reached one to two percent.
Hulle't een tot twee persent bereik.
02:08
Then, Uganda started to turn back,
Toe het Uganda begin terugdraai,
02:10
whereas Zimbabwe skyrocketed,
terwyl Zimbabwe uitgeskiet het,
02:12
and some years later South Africa had a terrible rise of HIV frequency.
en so paar jaar later het Suid-Afrika ’n vreeslike styging in MIV-frekwensie.
02:16
Look, India got many infected,
Kyk, Indië het baie besmet gehad,
02:18
but had a low level.
maar met ’n lae vlak.
02:20
And almost the same happens here.
En omtrent dieselfde gebeur hier.
02:22
See, Uganda coming down, Zimbabwe coming down,
Sien, Uganda kom af, Zimbabwe kom af,
02:25
Russia went to one percent.
Rusland gaan tot by een persent.
02:27
In the last two to three years,
In die laaste twee tot drie jaar,
02:30
we have reached a steady state of HIV epidemic in the world.
het ons ’n bestendige toestand in die wêreld se MIV-epidemie bereik.
02:34
25 years it took.
Dit het 25 jaar geneem.
02:37
But, steady state doesn't mean that things are getting better,
Maar, bestendigheid beteken nie dat dinge beter word nie,
02:40
it's just that they have stopped getting worse.
dit het net ophou erger word.
02:43
And it has -- the steady state is, more or less,
Die bestendige toestand is, min of meer,
02:47
one percent of the adult world population is HIV-infected.
een persent van die volwasse wêreldbevolking wat MIV-besmet is.
02:51
It means 30 to 40 million people,
Dit beteken 30 tot 40 miljoen mense,
02:54
the whole of California -- every person,
die hele Kalifornië, elke persoon,
02:56
that's more or less what we have today in the world.
is min of meer wat ons het in die wêreld vandag.
02:58
Now, let me make a fast replay of Botswana.
Laat ek Botswana weer ’n keer vinnig deurspeel.
03:03
Botswana -- upper middle-income country in southern Africa,
Botswana -- hoër-middelinkomste land in suider-Afrika,
03:07
democratic government, good economy,
demokratiese regering, goeie ekonomie,
03:10
and this is what happened there.
en dis wat daar gebeur het.
03:12
They started low, they skyrocketed,
Hulle't laag begin, toe uitgeskiet,
03:14
they peaked up there in 2003,
hulle't daar bo gepiek in 2003,
03:17
and now they are down.
en nou is hulle af.
Maar hulle val net stadig-stadig,
03:19
But they are falling only slowly,
03:21
because in Botswana, with good economy and governance,
want in Botswana, met ’n goeie ekonomie en regering,
03:23
they can manage to treat people.
kan hulle dit bybring om mense te behandel.
03:26
And if people who are infected are treated, they don't die of AIDS.
En as besmette mense behandel word, sterf hulle nie aan vigs nie.
03:29
These percentages won't come down
Hierdie persentasies sal nie daal nie,
03:32
because people can survive 10 to 20 years.
want mense kan oorleef vir 10 tot 20 jaar.
03:34
So there's some problem with these metrics now.
So daar's nou ’n probleem met hierdie maatstawwe.
03:37
But the poorer countries in Africa, the low-income countries down here,
Maar die armer lande in Afrika, die lae-inkomste lande hier onder,
03:41
there the rates fall faster, of the percentage infected,
daar val die infeksiekoers vinniger,
03:47
because people still die.
want mense sterf steeds.
03:49
In spite of PEPFAR, the generous PEPFAR,
Ten spyte van die vrygewige PEPFAR,
03:52
all people are not reached by treatment,
word almal nie deur behandeling bereik nie,
03:55
and of those who are reached by treatment in the poor countries,
en van dié wat wel bereik word in die arm lande,
03:57
only 60 percent are left on treatment after two years.
ontvang slegs 60 persent ná twee jaar steeds behandeling.
04:00
It's not realistic with lifelong treatment
Lewenslange behandeling is nie realisties
04:04
for everyone in the poorest countries.
vir almal in die armste lande nie.
04:06
But it's very good that what is done is being done.
Maar dis baie goed dat wat gedoen word, wel gedoen word.
04:09
But focus now is back on prevention.
Maar die fokus is nou terug op voorkoming.
04:13
It is only by stopping the transmission
Slegs deur oordrag stop te sit
04:16
that the world will be able to deal with it.
sal die wêreld dit kan baasraak.
Medisyne is te duur -- met die entstof,
04:19
Drugs is too costly -- had we had the vaccine,
04:21
or when we will get the vaccine, that's something more effective --
of wanneer ons dit kry, dis iets meer effektief --
04:24
but the drugs are very costly for the poor.
maar die medisyne is baie duur vir armes.
04:26
Not the drug in itself, but the treatment
Nie die medisyne self nie, maar die behandeling
04:28
and the care which is needed around it.
en die sorg wat daar rondom nodig is.
So, as ons na die patroon kyk,
04:32
So, when we look at the pattern,
04:35
one thing comes out very clearly:
kom een ding duidelik na vore:
04:37
you see the blue bubbles
julle sien die blou borrels
04:39
and people say HIV is very high in Africa.
en mense sê MIV is baie hoog in Afrika.
04:41
I would say, HIV is very different in Africa.
Ek sou sê, MIV is baie ánders in Afrika.
04:44
You'll find the highest HIV rate in the world
’n Mens sal die hoogste MIV-koers ter wêreld
04:48
in African countries,
in Afrikalande kry,
04:50
and yet you'll find Senegal, down here --
en tog het Senegal, hier onder,
04:52
the same rate as United States.
dieselfde koers as die VSA.
04:54
And you'll find Madagascar,
En julle sal Madagaskar kry,
04:56
and you'll find a lot of African countries
en baie Afrikalande kry
04:58
about as low as the rest of the world.
wat omtrent so laag is soos die res van die wêreld.
05:01
It's this terrible simplification that there's one Africa
Dis hierdie vreeslike vereenvoudiging dat daar een Afrika is,
05:05
and things go on in one way in Africa.
en dat dinge op een manier werk in Afrika.
05:07
We have to stop that.
Ons moet ophou daarmee.
05:09
It's not respectful, and it's not very clever
Dis nie respekvol nie, en dis nie baie slim
05:12
to think that way.
om so te dink nie.
05:14
(Applause)
(Applous)
05:18
I had the fortune to live and work for a time in the United States.
Ek was bevooreg om vir ’n ruk in die VSA te woon en werk.
05:21
I found out that Salt Lake City and San Francisco were different.
Ek het agtergekom dat Salt Lake City en San Francisco baie verskillend is.
05:25
(Laughter)
(Gelag)
05:27
And so it is in Africa -- it's a lot of difference.
En so is dit in Afrika -- daar's baie verskille.
05:30
So, why is it so high? Is it war?
So, hoekom is dit so hoog? Is dit oorlog?
05:32
No, it's not. Look here.
Nee, dis nie. Kyk hier.
05:34
War-torn Congo is down there -- two, three, four percent.
Die oorloggeteisterde Kongo is hier onder -- twee, drie, vier persent.
05:37
And this is peaceful Zambia, neighboring country -- 15 percent.
En hierdie is vreedsame Zambië, naburige land -- 15 persent.
05:41
And there's good studies of the refugees coming out of Congo --
Daar's goeie studies van die vlugtelinge uit die Kongo --
05:44
they have two, three percent infected,
twee, drie persent is besmet,
05:46
and peaceful Zambia -- much higher.
en vreedsame Zambië -- baie hoër.
05:48
There are now studies clearly showing
Daar's nou studies wat duidelik aandui
05:50
that the wars are terrible, that rapes are terrible,
dat die oorloë aaklig is, dat verkragtings aaklig is,
05:53
but this is not the driving force for the high levels in Africa.
maar dis nie die dryfkrag vir die hoë vlakke in Afrika nie.
05:56
So, is it poverty?
So, is dit armoede?
05:58
Well if you look at the macro level,
Wel, as ’n mens kyk op die makrovlak,
06:00
it seems more money, more HIV.
blyk dit meer geld, meer MIV.
06:02
But that's very simplistic,
Maar dis baie simplisties,
06:05
so let's go down and look at Tanzania.
so kom ons gaan af en kyk na Tanzanië.
06:07
I will split Tanzania in five income groups,
Ek deel Tanzanië in vyf inkomstegroepe op,
06:11
from the highest income to the lowest income,
van die hoogste na die laagste inkomste,
06:13
and here we go.
en hier gaan ons.
06:15
The ones with the highest income, the better off -- I wouldn't say rich --
Dié met die hoogste inkomste, ek sou wel nie sê ryk nie,
06:18
they have higher HIV.
hulle't hoër MIV.
06:20
The difference goes from 11 percent down to four percent,
Die verskil gaan van 11 persent af tot by vier persent,
06:23
and it is even bigger among women.
en dis selfs groter onder vroue.
06:25
There's a lot of things that we thought, that now, good research,
Daar's baie dinge wat ons gedink het wat nou, deur navorsing,
06:29
done by African institutions and researchers
van Afrika-instansies en -navorsers
06:32
together with the international researchers, show that that's not the case.
saam met internasionale navorsers, wys dat dit nie die geval is nie.
06:35
So, this is the difference within Tanzania.
Dis die verskil binne Tanzanië.
06:37
And, I can't avoid showing Kenya.
En, ek moet Kenia wys.
06:39
Look here at Kenya.
Kyk hier.
06:41
I've split Kenya in its provinces.
Ek het Kenia in provinsies opgedeel.
06:43
Here it goes.
Hier gaan dit.
06:45
See the difference within one African country --
Kyk die verskil binne een Afrikaland --
06:48
it goes from very low level to very high level,
dit gaan van ’n baie lae tot by ’n baie hoë vlak,
06:51
and most of the provinces in Kenya is quite modest.
en die meeste van die provinsies in Kenia is betreklik beskeie.
06:54
So, what is it then?
So, wat is dit dan?
06:56
Why do we see this extremely high levels in some countries?
Hoekom sien ons sulke uiters hoë vlakke in sommige lande?
07:00
Well, it is more common with multiple partners,
Wel, dis meer algemeen met meer as een seksmaat,
07:03
there is less condom use,
kondoomgebruik is minder algemeen,
07:06
and there is age-disparate sex --
en daar is ouderdom-disparate seks --
07:09
that is, older men tend to have sex with younger women.
dit is, ouer mans is geneig om met jonger vroue seks te hê.
07:12
We see higher rates in younger women than younger men
Ons sien ’n hoër koers in jonger vroue as jonger mans
07:15
in many of these highly affected countries.
in baie van die erg geaffekteerde lande.
07:17
But where are they situated?
Maar waar is hulle geleë?
07:19
I will swap the bubbles to a map.
Ek sit die borrels op ’n kaart.
07:21
Look, the highly infected are four percent of all population
Kyk, die hoogs geïnfekteerdes is vier persent van die hele bevolking
07:25
and they hold 50 percent of the HIV-infected.
en hulle hou 50 persent van die MIV-geïnfekteerdes.
07:28
HIV exists all over the world.
MIV bestaan regoor die wêreld.
07:31
Look, you have bubbles all over the world here.
Daar's borrels regoor die wêreld hier.
07:33
Brazil has many HIV-infected.
Brasilië het baie MIV-geïnfekteerdes.
07:36
Arab countries not so much, but Iran is quite high.
Arabiese lande nie so veel nie, maar Iran is nogal hoog.
07:39
They have heroin addiction and also prostitution in Iran.
Hulle het heroïnverslawing en ook prostitusie in Iran.
07:43
India has many because they are many.
Indië het baie want daar is baie.
07:45
Southeast Asia, and so on.
Suid-oos Asië, en so aan.
Maar, daar is een deel van Afrika --
07:47
But, there is one part of Africa --
07:49
and the difficult thing is, at the same time,
en die moeilike ding is, terselftertyd,
07:51
not to make a uniform statement about Africa,
om nie ’n eenvormige uitspraak oor Afrika te maak nie,
07:55
not to come to simple ideas of why it is like this, on one hand.
om nie met simpel idees voorendag te kom oor hoekom dit so is, aan die een kant.
07:59
On the other hand, try to say that this is not the case,
Aan die ander kant, om te erken dat dit ’n ernstige geval is,
08:02
because there is a scientific consensus about this pattern now.
want daar is nou wetenskaplike konsensus oor hierdie patroon.
08:06
UNAIDS have done good data available, finally,
VNVIGS het, uiteindelik, goeie data beskikbaar gestel,
08:09
about the spread of HIV.
oor die verspreiding van MIV.
08:12
It could be concurrency.
Dit kan samelopendheid wees.
08:15
It could be some virus types.
Dit kan sekere virustipes wees.
08:18
It could be that there is other things
Dit kan wees dat daar ander dinge is
08:22
which makes transmission occur in a higher frequency.
wat oordrag teen ’n hoër frekwensie laat voorkom.
08:25
After all, if you are completely healthy and you have heterosexual sex,
As jy immers heeltemal gesond is en jy hê heteroseksuele seks,
08:28
the risk of infection in one intercourse is one in 1,000.
is die infeksierisiko tydens een omgang een in ’n 1000.
08:33
Don't jump to conclusions now on how to
Moenie oorhaastig raak met
08:35
behave tonight and so on.
julle gedrag vanaand nie.
08:37
(Laughter)
(Gelag)
08:39
But -- and if you are in an unfavorable situation,
Maar as jy in ’n ongunstige situasie is,
08:42
more sexually transmitted diseases, it can be one in 100.
meer seksueeloordraaglike siektes, kan dit een in ’n 100 wees.
08:45
But what we think is that it could be concurrency.
Maar wat ons dink dit kan wees, is samelopendheid.
08:48
And what is concurrency?
En wat is dit?
08:50
In Sweden, we have no concurrency.
In Swede het ons geen samelopendheid nie.
08:52
We have serial monogamy.
Ons het reeks-monogamie.
08:54
Vodka, New Year's Eve -- new partner for the spring.
Vodka, Oujaarsaand -- ’n nuwe maat vir die lente.
08:56
Vodka, Midsummer's Eve -- new partner for the fall.
Vodka, Midsomersaand -- ’n nuwe maat vir die herfs.
08:58
Vodka -- and it goes on like this, you know?
Vodka -- en so gaan dit aan, julle weet?
09:00
And you collect a big number of exes.
En jy versamel ’n groot aantal ekse.
09:03
And we have a terrible chlamydia epidemic --
En ons het ’n vreeslike chlamidia-epidemie --
09:05
terrible chlamydia epidemic which sticks around for many years.
’n vreeslike chlamidia-epidemie wat vir baie jare rondhang.
09:09
HIV has a peak three to six weeks after infection
MIV bereik drie tot ses weke na infeksie ’n piek
09:12
and therefore, having more than one partner in the same month
en dus, is om meer as een seksmaat in een maand te hê
09:15
is much more dangerous for HIV than others.
baie meer gevaarlik in MIV-oordrag as met ander infeksies.
09:18
Probably, it's a combination of this.
Waarskynlik, is dit ’n kombinasie hiervan.
09:20
And what makes me so happy is that we are moving now
En wat my so gelukkig maak is dat ons nou in die rigting van
09:23
towards fact when we look at this.
feite beweeg wanneer ons hierna kyk.
09:25
You can get this chart, free.
Julle kry dié grafiek, pasella.
09:27
We have uploaded UNAIDS data on the Gapminder site.
Ons't VNVIGS data op Gapminder.org opgelaai.
09:30
And we hope that when we act on global problems in the future
En ons hoop dat wanneer ons in die toekoms op globale probleme reageer
09:34
we will not only have the heart,
ons nie net die hart sal hê nie,
09:37
we will not only have the money,
nie net die geld sal hê nie,
09:39
but we will also use the brain.
maar dat ons ook die brein sal inspan.
09:42
Thank you very much.
Baie dankie.
09:44
(Applause)
(Applous)
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