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

Translator: Mailis Laos Reviewer: Aari Lemmik

The child's symptoms begin

Esimesed sümptomid on lapsel

with mild fever, headache, muscle pains,

kerge palavik, peavalu ja lihasevalu,

followed by vomiting and diarrhea,

millele järgneb oksendamine ja kõhulahtisus,

then bleeding from the mouth, nose and gums.

seejärel hakkavad veritsema tema suu, nina ja igemed.

Death follows in the form of organ failure from low blood pressure.

Surm saabub madalast vererõhust tingitud elundipuudulikkuse tagajärjel.

Sounds familiar?

Tuleb tuttav ette?

If you're thinking this is Ebola,

Kui arvad, et see on ebola,

actually, in this case, it's not.

siis antud juhul pole see nii.

It's an extreme form of dengue fever, a mosquito-born disease

See on raskekujuline dengue palavik, sääskedega leviv haigus,

which also does not have an effective therapy or a vaccine,

millele samuti pole tõhusat ravi ega vaktsiini

and kills 22,000 people each year.

ja millesse sureb 22 000 inimest aastas.

That is actually twice the number of people

Seda on tegelikult kaks korda rohkem kui neid,

that have been killed by Ebola

kes on surnud ebolasse

in the nearly four decades that we've known about it.

ligi nelja aastakümne jooksul, mil seda haigust on tuntud.

As for measles, so much in the news recently,

Leetrite puhul, millest on nüüd uudistes palju juttu,

the death toll is actually tenfold higher.

on suremus kümme korda suuremgi.

Yet for the last year,

Viimasel aastal

it has been Ebola that has stolen all of the headlines and the fear.

on aga ebola hõivanud kõik esiküljed ja külvanud hirmu.

Clearly, there is something deeply rooted about it,

On näha, et ebola puudutab meid väga sügaval tasandil,

something which scares us and fascinates us

ta on ühtaegu hirmutav ja paeluv

more than other diseases.

palju enam kui teised haigused.

But what is it, exactly?

Mis see siis täpselt on?

Well, it's hard to acquire Ebola,

Ebolasse pole lihtne haigestuda,

but if you do, the risk of a horrible death is high.

ent kui sa haigestud, siis on suur tõenäosus, et sured piinarikkalt.

Why?

Miks?

Because right now, we don't have any effective therapy or vaccine available.

Sest praegu pole olemas sellele mingit tõhusat ravi või vaktsiini.

And so, that's the clue.

See annabki vihje.

We may have it someday.

Me võime ühel päeval sellesse haigestuda.

So we rightfully fear Ebola,

Seepärast me kardame õigusega ebolat,

because it doesn't kill as many people as other diseases.

sest ... see küll ei tapa nii paljusid kui teised haigused.

In fact, it's much less transmissible than viruses such as flu or measles.

Tegelikult on see palju vähem nakkav kui gripp või leetrid.

We fear Ebola because of the fact that it kills us and we can't treat it.

Aga me kardame ebolat, sest see on surmav ja me ei oska seda ravida.

We fear the certain inevitability that comes with Ebola.

Me kardame seda paratamatust, mis ebolaga kaasneb.

Ebola has this inevitability that seems to defy modern medical science.

Ebolat saadab teatav paratamatus, mis esitab tänapäeva arstiteadusele väljakutse

But wait a second, why is that?

Miks on see aga nii?

We've known about Ebola since 1976.

Oleme olnud ebolast teadlikud 1976. aastast alates.

We've known what it's capable of.

Me teame, milleks ta on võimeline.

We've had ample opportunity to study it

Meil on olnud ohtralt võimalusi seda uurida

in the 24 outbreaks that have occurred.

seni aset leidnud 24 haiguspuhangu jooksul,

And in fact, we've actually had vaccine candidates available now

Ja tegelikult on meil olnud ka võimalikud vaktsiinid olemas

for more than a decade.

juba üle kümne aasta.

Why is that those vaccines are just going into clinical trials now?

Miks on need vaktsiinid alles kliiniliste katsete etapis?

This goes to the fundamental problem we have

Siit tulenebki aga meie põhiprobleem

with vaccine development for infectious diseases.

nakkushaiguste vaktsiinide väljatöötamises.

It goes something like this:

Ma sõnastaksin selle nii:

The people most at risk for these diseases

inimesed, kel on suurem oht neisse haigustesse haigestuda

are also the ones least able to pay for vaccines.

on need, kel on vähem võimalusi vaktsiinide eest maksta.

This leaves little in the way of market incentives

Tootajate meelest pole selliste vaktsiinide

for manufacturers to develop vaccines,

tootmine majanduslikult tulus enne,

unless there are large numbers of people who are at risk in wealthy countries.

kui haigus ei ohusta jõukamate riikide elanikke.

It's simply too commercially risky.

Majanduslikus mõttes liiga riskantne äri.

As for Ebola, there is absolutely no market at all,

Ebolast rääkides pole turgu ollagi.

so the only reason we have two vaccines in late-stage clinical trials now,

Ainus põhjus, miks kaks vaktsiini on kliiniliste katsete lõppfaasis,

is actually because of a somewhat misguided fear.

on tegelikult mõneti alusetu hirm.

Ebola was relatively ignored

Ebolat ignoreeriti

until September 11 and the anthrax attacks,

kuni 11. septembri ja antraksi rünnakuteni,

when all of a sudden, people perceived Ebola

mil ühtäkki inimesed adusid, et ebolat

as, potentially, a bioterrorism weapon.

võidakse kasutada biorelvana.

Why is it that the Ebola vaccine wasn't fully developed at this point?

Miks polnud ebola vaktsiini selleks ajaks välja töötatud?

Well, partially, because it was really difficult --

Osaliselt seepärast, et oli väga raske -

or thought to be difficult -- to weaponize the virus,

või peeti väga raskeks - viirust relvaks muuta,

but mainly because of the financial risk in developing it.

kuid põhiliselt, kuna arendusega kaasnes finantsrisk.

Ja selles asi ongi.

And this is really the point.

The sad reality is, we develop vaccines

On kurb tõsiasi, et vaktsiine arendatakse

not based upon the risk the pathogen poses to people,

mitte tulenevalt haigustekitaja ohtlikkusest,

but on how economically risky it is to develop these vaccines.

vaid hinnates riski, kuivõrd see äriliselt ära tasuks.

Vaccine development is expensive and complicated.

Vaktsiini väljatöötamine on kallis ja keeruline.

It can cost hundreds of millions of dollars

Võib kuluda sadu miljoneid dollareid,

to take even a well-known antigen and turn it into a viable vaccine.

et muuta ka mõni tuntud antigeen toimivaks vaktsiiniks.

Õnneks saame ebola sarnaste haiguste puhul

Fortunately for diseases like Ebola,

there are things we can do to remove some of these barriers.

midagi teha ära selleks, et neid takistusi kõrvaldada.

The first is to recognize when there's a complete market failure.

Esiteks tuleb ära tunda, millal eksisteerib turutõrge.

In that case, if we want vaccines,

Sel juhul, kui me soovime vaktsiine,

we have to provide incentives or some type of subsidy.

tuleb pakkuda stiimuleid või võimaldada toetust.

We also need to do a better job at being able to figure out

Samuti on vaja rohkem pingutada, et suudaksime kindlaks teha,

which are the diseases that most threaten us.

haigused, mis meid enim ohustavad.

By creating capabilities within countries, we then create the ability

Toetades riikide võimekust anname neile võimaluse

for those countries to create epidemiological and laboratory networks

ehitada üles epidemioloogiline ja laboratoorne võrgustik,

which are capable of collecting and categorizing these pathogens.

mis suudaks patogeene koguda ja tuvastada.

The data from that then can be used

Nende andmeid saab siis kasutada selleks,

to understand the geographic and genetic diversity,

et mõista geograafilisi ja geneetilisi erinevusi,

which then can be used to help us understand

mida omakorda saab kasutada selleks, et mõista,

how these are being changed immunologically,

kuidas need on muutunud immunoloogiliselt

and what type of reactions they promote.

ja milliseid reaktsioone need tekitavad.

So these are the things that can be done,

Seda kõike on võimalik teha,

but to do this, if we want to deal with a complete market failure,

kuid selleks, et tulla toime täieliku turutõrke olukorras,

we have to change the way we view and prevent infectious diseases.

tuleb muuta senist ennetustööd ja suhtumist nakkushaigustesse.

We have to stop waiting until we see evidence

Pole aega oodata, kuni on ilmselge,

of a disease becoming a global threat before we consider it as one.

et haigus on levinud globaalselt enne kui me sellest arugi saame.

So, for Ebola,

Ebola puhul sundis paranoiline hirm nakkuse ees,

the paranoid fear of an infectious disease,

followed by a few cases transported to wealthy countries,

mille järgnesid vaid üksikud haigusjuhud jõukamates riikides,

led the global community to come together,

globaalset üldsust tegema ühiseid jõupingutusi.

and with the work of dedicated vaccine companies,

Koostöös vaktsiinifirmadega

we now have these:

oleme saavutanud selle:

Two Ebola vaccines in efficacy trials in the Ebola countries --

kaks ebola vaktsiini, mida katsetatakse ebola kolletega riikides, ...

(Applause)

(Aplaus)

and a pipeline of vaccines that are following behind.

... ja tulemas on veel hulk vaktsiine.

Every year, we spend billions of dollars,

Igal aastal me kulutame miljardeid dollareid,

keeping a fleet of nuclear submarines permanently patrolling the oceans

et hoida tuumaallveelaevu ookeanides patrullimas

to protect us from a threat that almost certainly will never happen.

ja kaitsmas meid ohu eest, mida ilmselt mitte kunagi ei tekigi.

And yet, we spend virtually nothing

Samas ei kuluta me praktiliselt sentigi sellele,

to prevent something as tangible and evolutionarily certain

et hoida ära midagi meid otseselt puudutavat ja evolutsiooniliselt tõenäolist

as epidemic infectious diseases.

nagu seda on nakkushaiguste epideemiad.

And make no mistake about it -- it's not a question of "if," but "when."

Siin pole kahtlust, et küsimus on pigem millal see juhtub, mitte kas see juhtub.

These bugs are going to continue to evolve

Viirused arenevad pidevalt

and they're going to threaten the world.

ja ohustavad jätkuvalt kogu maailma.

And vaccines are our best defense.

Ja vaktsiinid on meie parim kaitse.

So if we want to be able to prevent epidemics like Ebola,

Kui me tahame vältida selliseid epideemiaid nagu ebola,

we need to take on the risk of investing in vaccine development

tuleb meil riskida investeerimisega vaktsiinide väljatöötamisse

and in stockpile creation.

ja nende varude soetamisse.

And we need to view this, then, as the ultimate deterrent --

Peaksime suhtuma vaktsiinidesse kui ülimasse heidutusvahendisse -

something we make sure is available,

midagi, mis peaks kindlasti olemas olema,

but at the same time, praying we never have to use it.

kuid mida poleks loodetavasti vaja kunagi kasutada.

Thank you.

Aitäh.

(Applause)

(Aplaus)