The next outbreak? We’re not ready | Bill Gates | TED

Translator: Serv. de Norm. Lingüística U. de Santiago de Compostela Reviewer: Xusto Rodriguez

When I was a kid,

Cando eu era un rapaz,

the disaster we worried about most was a nuclear war.

o desastre que máis temiamos era unha guerra nuclear.

That's why we had a barrel like this down in our basement,

Por iso tiñamos no soto un barril coma este,

filled with cans of food and water.

cheo de conservas e de auga.

When the nuclear attack came,

Cando o ataque nuclear viñese,

we were supposed to go downstairs, hunker down, and eat out of that barrel.

teriamos que baixar ao soto, agocharnos nel e comer dese barril.

Today the greatest risk of global catastrophe

Na actualidade, o maior risco de catástrofe global

doesn't look like this.

non se parece a isto.

Instead, it looks like this.

Máis ben, parécese a isto.

If anything kills over 10 million people in the next few decades,

Se algo ha matar máis de 10 millóns de persoas nas vindeiras décadas,

it's most likely to be a highly infectious virus

é moito máis probábel que sexa un virus altamente contaxioso

rather than a war.

ca unha guerra.

Not missiles, but microbes.

Non mísiles, senón microbios.

Now, part of the reason for this is that

En parte, isto é así

we've invested a huge amount in nuclear deterrents.

porque fixemos grandes investimentos en disuasión nuclear.

But we've actually invested very little in a system to stop an epidemic.

Pero investimos moi pouco nun sistema que free unha epidemia.

We're not ready for the next epidemic.

Non estamos preparados para a próxima epidemia.

Let's look at Ebola.

Ollemos para o ébola.

I'm sure all of you read about it in the newspaper,

Seguro que todos lestes no xornal cousas sobre el,

lots of tough challenges.

sobre os seus grandes desafíos.

I followed it carefully through the case analysis tools

Eu seguino con detalle coas ferramentas de análise

we use to track polio eradication.

que usamos para seguir a erradicación da poliomielite.

And as you look at what went on,

Se se observa o que ocorreu,

the problem wasn't that there was a system that didn't work well enough,

o problema non foi ter un sistema que non funcionou abondo ben,

the problem was that we didn't have a system at all.

o problema foi que non existía ningún sistema.

In fact, there's some pretty obvious key missing pieces.

De feito, faltan pezas clave moi obvias.

We didn't have a group of epidemiologists ready to go, who would have gone,

Non había un grupo de epidemiólogos listo para ir, que iría,

seen what the disease was, seen how far it had spread.

para ver que enfermidade era e canto se espallara.

The case reports came in on paper.

Os informes chegaron en papel.

It was very delayed before they were put online

Tardouse moito tempo en publicalos en liña

and they were extremely inaccurate.

e eran terriblemente imprecisos.

We didn't have a medical team ready to go.

Non había un equipo médico listo para ir.

We didn't have a way of preparing people.

Non había xeito de preparar á xente.

Now, Médecins Sans Frontières did a great job orchestrating volunteers.

Médicos Sen Fronteiras fixo un gran labor organizando voluntarios.

But even so, we were far slower than we should have been

Pero aínda así, fomos máis lentos do que debiamos ser

getting the thousands of workers into these countries.

para enviar os miles de traballadores a eses países.

And a large epidemic would require us to have hundreds of thousands of workers.

E para unha grande epidemia precisariamos centos de miles de traballadores.

There was no one there to look at treatment approaches.

Non había ninguén alí para analizar abordaxes de tratamento.

Ninguén para analizar os diagnósticos.

No one to look at the diagnostics.

No one to figure out what tools should be used.

Ninguén para descubrir que ferramentas deberían usarse.

As an example, we could have taken the blood of survivors,

Por exemplo, podiamos coller sangue dos superviventes,

processed it, and put that plasma back in people to protect them.

procesalo, e volver colocar ese plasma nas persoas sas para as protexer.

But that was never tried.

Pero nunca tal se intentou.

So there was a lot that was missing.

Faltaron unha chea de cousas.

And these things are really a global failure.

E esas cousas foron un fallo global.

The WHO is funded to monitor epidemics, but not to do these things I talked about.

A OMS fundouse para controlar epidemias, non para facer isto que estamos falando.

Nos filmes é bastante diferente.

Now, in the movies it's quite different.

There's a group of handsome epidemiologists ready to go,

Hai un grupo de epidemiólogos guapos listos para partir,

they move in, they save the day, but that's just pure Hollywood.

que entran en escena e amañan o problema, pero iso só pasa en Hollywood.

The failure to prepare could allow the next epidemic

A incapacidade para prepararnos pode facer a próxima epidemia

to be dramatically more devastating than Ebola

moitísimo máis devastadora que o ébola.

Let's look at the progression of Ebola over this year.

Ollemos para a progresión do ébola durante este ano.

About 10,000 people died,

Morreron arredor de 10 000 persoas,

and nearly all were in the three West African countries.

case todas elas nos tres países da África Occidental.

There's three reasons why it didn't spread more.

Hai tres razóns para que a doenza non se espallase máis.

The first is that there was a lot of heroic work by the health workers.

A primeira: o traballo heroico que fixeron moitos traballadores sanitarios.

They found the people and they prevented more infections.

Atoparon as persoas e impediron máis infeccións.

The second is the nature of the virus.

A segunda: a natureza do virus.

Ebola does not spread through the air.

O ébola non se espalla polo ar.

And by the time you're contagious,

Cando unha persoa pode contaxiar

most people are so sick that they're bedridden.

adoita estar tan enferma que está encamada.

Third, it didn't get into many urban areas.

A terceira: non entrou en moitas áreas urbanas.

And that was just luck.

Iso foi pura sorte.

If it had gotten into a lot more urban areas,

Se chega a entrar nelas,

the case numbers would have been much larger.

o número de casos sería moito maior.

So next time, we might not be so lucky.

Pero a próxima, se cadra non temos tanta sorte.

You can have a virus where people feel well enough while they're infectious

Pode ser un virus que non faga sentirse enfermo a quen o transmite,

that they get on a plane or they go to a market.

polo que viaxan en avión ou van ao mercado.

The source of the virus could be a natural epidemic like Ebola,

A fonte do virus pode ser natural, coma no ébola,

or it could be bioterrorism.

ou pode vir do bioterrorismo.

So there are things that would literally make things a thousand times worse.

Hai variables que poderían empeoralo todo mil veces.

In fact, let's look at a model of a virus spread through the air,

De feito, ollemos para o modelo de expansión dun virus polo ar,

like the Spanish Flu back in 1918.

como a gripe española de 1918.

So here's what would happen:

Isto é o que pasaría:

It would spread throughout the world very, very quickly.

Espallaríase por todo o mundo moi, moi rápido.

And you can see over 30 million people died from that epidemic.

Fíxense en que 30 millóns de persoas morreron naquela epidemia.

So this is a serious problem.

Por iso, este é un problema grave.

We should be concerned.

Deberiamos preocuparnos.

But in fact, we can build a really good response system.

Pero podemos construír un sistema de resposta moi bo.

We have the benefits of all the science and technology that we talk about here.

Temos os beneficios de toda a ciencia e a tecnoloxía das que tanto falamos aquí.

We've got cell phones

Temos móbiles

to get information from the public and get information out to them.

para recibir e difundirlle información ao público.

We have satellite maps where we can see where people are and where they're moving.

Temos mapas de satélite en que podemos ver onde están e a onde van as persoas.

We have advances in biology

Temos avances en bioloxía

that should dramatically change the turnaround time to look at a pathogen

que debían mudar radicalmente o tempo preciso para estudar un patóxeno.

and be able to make drugs and vaccines that fit for that pathogen.

e ser capaces de producir medicamentos e vacinas adecuados contra el.

So we can have tools,

but those tools need to be put into an overall global health system.

Podemos ter ferramentas,

pero hai que poñelas no marco dun sistema de saúde global.

And we need preparedness.

E precisamos prepararnos.

The best lessons, I think, on how to get prepared

As mellores leccións, ao meu ver, sobre como facelo

are again, what we do for war.

son, unha vez máis, o que facemos para a guerra.

For soldiers, we have full-time, waiting to go.

Temos soldados a xornada completa, listo para partir.

We have reserves that can scale us up to large numbers.

Temos reservistas que poden incrementar o número de tropas.

NATO has a mobile unit that can deploy very rapidly.

A OTAN ten unha unidade móbil que pode despregarse moi rapidamente.

NATO does a lot of war games to check, are people well trained?

A OTAN fai manobras para comprobar se as tropas están ben adestradas,

Do they understand about fuel and logistics

se entenden de combustíbel e loxística

and the same radio frequencies?

e se usan as mesmas frecuencias de radio.

So they are absolutely ready to go.

Por iso, están totalmente preparadas para partir.

So those are the kinds of things we need to deal with an epidemic.

Este é o tipo de cousas que precisamos para lidar cunha epidemia.

What are the key pieces?

Cales son as claves?

First, we need strong health systems in poor countries.

Un: cómpren sistemas de saúde fortes nos países pobres.

That's where mothers can give birth safely,

Que as nais poidan dar a luz con seguranza,

kids can get all their vaccines.

que os nenos reciban todas as súas vacinas.

But, also where we'll see the outbreak very early on.

Pero tamén, onde poidamos detectar o brote moi axiña.

We need a medical reserve corps:

Precisamos corpos médicos de reserva:

lots of people who've got the training and background

xente que teña formación e experiencia,

who are ready to go, with the expertise.

que estea lista para ir, que teña coñecementos.

And then we need to pair those medical people with the military.

Precisamos integrar eses médicos cos militares,

taking advantage of the military's ability to move fast, do logistics

aproveitando a capacidade destes últimos para moverse rápido, organizar a loxística

and secure areas.

e protexer zonas.

We need to do simulations,

Precisamos de facer simulacros,

germ games, not war games, so that we see where the holes are.

manobras microbianas en vez de militares, para detectar os fallos.

The last time a germ game was done in the United States

A última vez que se fixeron manobras microbianas nos EE. UU.

was back in 2001, and it didn't go so well.

foi en 2001, e non saíron aí moi ben.

So far the score is germs: 1, people: 0.

De momento, o marcador vai: Xermes: 1 - Persoas: 0.

Finally, we need lots of advanced R&D in areas of vaccines and diagnostics.

Por último, precisamos moito I+D no terreo das vacinas e os diagnósticos.

There are some big breakthroughs, like the Adeno-associated virus,

Hai algúns grandes descubrimentos, coma os virus adenoasociados,

that could work very, very quickly.

que poderían funcionar moi, moi axiña.

Now I don't have an exact budget for what this would cost,

Non teño unha factura exacta do que isto podería custar,

but I'm quite sure it's very modest compared to the potential harm.

pero estou seguro de que moi pouco se o comparamos cos posibles danos.

The World Bank estimates that if we have a worldwide flu epidemic,

O Banco Mundial estima que, de termos unha epidemia global de gripe,

global wealth will go down by over three trillion dollars

a riqueza global diminuirá en máis de tres billóns de dólares

and we'd have millions and millions of deaths.

e teriamos millóns e millóns de mortes.

These investments offer significant benefits

Estes investimentos ofrecen importantes vantaxes

beyond just being ready for the epidemic.

á parte de preparármonos para a epidemia.

The primary healthcare, the R&D,

A atención primaria, o I+D

those things would reduce global health equity

poderían reducir a desigualdade global en saúde

and make the world more just as well as more safe.

e farían este mundo máis xusto e seguro.

So I think this should absolutely be a priority.

Por iso, penso que esta debería ser unha prioridade absoluta.

There's no need to panic.

Non é preciso caer no pánico.

We don't have to hoard cans of spaghetti or go down into the basement.

Non nos fai falta acumular latas de conservas nin baixar aos sotos.

But we need to get going, because time is not on our side.

Pero temos que comezar, porque o tempo corre en contra nosa.

In fact, if there's one positive thing that can come out of the Ebola epidemic,

De feito, se da epidemia do ébola pode quitarse algo positivo

it's that it can serve as an early warning, a wake-up call, to get ready.

é que pode servir de aviso previo, de alerta para acordar, para prepararnos.

If we start now, we can be ready for the next epidemic.

Se comezamos agora, podemos estar listos para a próxima epidemia.

Thank you.

Grazas.

(Applause)

(Aplausos)