Why Vaccines are Made Too Late... If They’re Made At All | Seth Berkley | TED Talks

57,337 views ・ 2015-09-17

TED


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00:13
The child's symptoms begin
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with mild fever, headache, muscle pains,
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followed by vomiting and diarrhea,
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then bleeding from the mouth, nose and gums.
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Death follows in the form of organ failure from low blood pressure.
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Sounds familiar?
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If you're thinking this is Ebola,
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actually, in this case, it's not.
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It's an extreme form of dengue fever, a mosquito-born disease
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which also does not have an effective therapy or a vaccine,
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and kills 22,000 people each year.
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That is actually twice the number of people
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that have been killed by Ebola
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in the nearly four decades that we've known about it.
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As for measles, so much in the news recently,
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the death toll is actually tenfold higher.
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Yet for the last year,
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it has been Ebola that has stolen all of the headlines and the fear.
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Clearly, there is something deeply rooted about it,
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something which scares us and fascinates us
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more than other diseases.
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But what is it, exactly?
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Well, it's hard to acquire Ebola,
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but if you do, the risk of a horrible death is high.
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Why?
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Because right now, we don't have any effective therapy or vaccine available.
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And so, that's the clue.
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We may have it someday.
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So we rightfully fear Ebola,
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because it doesn't kill as many people as other diseases.
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In fact, it's much less transmissible than viruses such as flu or measles.
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We fear Ebola because of the fact that it kills us and we can't treat it.
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We fear the certain inevitability that comes with Ebola.
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Ebola has this inevitability that seems to defy modern medical science.
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But wait a second, why is that?
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We've known about Ebola since 1976.
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We've known what it's capable of.
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We've had ample opportunity to study it
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in the 24 outbreaks that have occurred.
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And in fact, we've actually had vaccine candidates available now
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for more than a decade.
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Why is that those vaccines are just going into clinical trials now?
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This goes to the fundamental problem we have
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with vaccine development for infectious diseases.
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It goes something like this:
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The people most at risk for these diseases
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are also the ones least able to pay for vaccines.
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This leaves little in the way of market incentives
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for manufacturers to develop vaccines,
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unless there are large numbers of people who are at risk in wealthy countries.
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It's simply too commercially risky.
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As for Ebola, there is absolutely no market at all,
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so the only reason we have two vaccines in late-stage clinical trials now,
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is actually because of a somewhat misguided fear.
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Ebola was relatively ignored
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until September 11 and the anthrax attacks,
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when all of a sudden, people perceived Ebola
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as, potentially, a bioterrorism weapon.
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Why is it that the Ebola vaccine wasn't fully developed at this point?
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Well, partially, because it was really difficult --
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or thought to be difficult -- to weaponize the virus,
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but mainly because of the financial risk in developing it.
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And this is really the point.
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The sad reality is, we develop vaccines
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not based upon the risk the pathogen poses to people,
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but on how economically risky it is to develop these vaccines.
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Vaccine development is expensive and complicated.
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It can cost hundreds of millions of dollars
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to take even a well-known antigen and turn it into a viable vaccine.
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Fortunately for diseases like Ebola,
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there are things we can do to remove some of these barriers.
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The first is to recognize when there's a complete market failure.
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In that case, if we want vaccines,
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we have to provide incentives or some type of subsidy.
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We also need to do a better job at being able to figure out
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which are the diseases that most threaten us.
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By creating capabilities within countries, we then create the ability
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for those countries to create epidemiological and laboratory networks
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which are capable of collecting and categorizing these pathogens.
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The data from that then can be used
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to understand the geographic and genetic diversity,
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which then can be used to help us understand
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how these are being changed immunologically,
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and what type of reactions they promote.
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So these are the things that can be done,
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but to do this, if we want to deal with a complete market failure,
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we have to change the way we view and prevent infectious diseases.
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We have to stop waiting until we see evidence
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of a disease becoming a global threat before we consider it as one.
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So, for Ebola,
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the paranoid fear of an infectious disease,
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followed by a few cases transported to wealthy countries,
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led the global community to come together,
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and with the work of dedicated vaccine companies,
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we now have these:
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Two Ebola vaccines in efficacy trials in the Ebola countries --
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(Applause)
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and a pipeline of vaccines that are following behind.
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Every year, we spend billions of dollars,
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keeping a fleet of nuclear submarines permanently patrolling the oceans
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to protect us from a threat that almost certainly will never happen.
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And yet, we spend virtually nothing
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to prevent something as tangible and evolutionarily certain
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as epidemic infectious diseases.
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And make no mistake about it -- it's not a question of "if," but "when."
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These bugs are going to continue to evolve
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and they're going to threaten the world.
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And vaccines are our best defense.
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So if we want to be able to prevent epidemics like Ebola,
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we need to take on the risk of investing in vaccine development
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and in stockpile creation.
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And we need to view this, then, as the ultimate deterrent --
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something we make sure is available,
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but at the same time, praying we never have to use it.
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Thank you.
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(Applause)
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