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

Translator: Alexandra Vázquez Reviewer: Serv. de Norm. Lingüística U. de Santiago de Compostela

Comezan os síntomas do neno

The child's symptoms begin

with mild fever, headache, muscle pains,

cunha suave febre, dor de cabeza, dores musculares

followed by vomiting and diarrhea,

seguidos por vómitos e diarrea,

logo sangrado de boca, nariz e enxivas.

then bleeding from the mouth, nose and gums.

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

Morte inminente por fallo multiorgánico debido a unha baixa presión arterial.

Sounds familiar?

Resúltavos familiar?

If you're thinking this is Ebola,

Se estades pensando en ébola,

actually, in this case, it's not.

o certo é, que neste caso non o é.

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

É unha forma extrema de dengue, enfermidade transmitida por mosquitos

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

que de feito non ten nin terapia nin vacina eficaz,

e mata 22 000 persoas cada ano.

and kills 22,000 people each year.

O que supón o dobre do número

That is actually twice the number of people

that have been killed by Ebola

de persoas falecidas a causa do ébola

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

nas case catro décadas desde o seu descubrimento.

As for measles, so much in the news recently,

En canto ao sarampelo, moi presente agora nas noticias,

the death toll is actually tenfold higher.

o custo en vidas é dez veces superior.

Yet for the last year,

No entanto, no último ano,

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

o ébola ocupou todos os titulares e propagou o medo.

É evidente que hai algo que nos afecta profundamente,

Clearly, there is something deeply rooted about it,

something which scares us and fascinates us

algo que nos dá medo e nos fascina

more than other diseases.

máis ca outras enfermidades.

But what is it, exactly?

Pero que é, exactamente?

Well, it's hard to acquire Ebola,

Ben, é difícil contraer ébola,

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

pero de facelo, o risco dunha morte horrible é alto

Why?

Por que?

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

Porque agora mesmo, non temos ningunha terapia nin vacina dispoñible.

Esa é a cuestión.

And so, that's the clue.

Pode que a teñamos algún día.

We may have it someday.

So we rightfully fear Ebola,

Polo que, con razón, tememos o ébola;

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

non porque mate tanta xente coma outras enfermidades.

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

De feito, é menos contaxioso ca outros virus como a gripe ou o sarampelo.

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

Tememos o ébola porque nos mata e non o podemos tratar.

Tememos o inevitable que vén co ébola.

We fear the certain inevitability that comes with Ebola.

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

O ébola ten ese lado inevitable que parece desafiar a medicina moderna.

But wait a second, why is that?

Pero, a que se debe?

We've known about Ebola since 1976.

Coñecemos o ébola desde 1976.

Sabemos de que é capaz.

We've known what it's capable of.

Tivemos moitas oportunidades de estudalo

We've had ample opportunity to study it

in the 24 outbreaks that have occurred.

nos 24 brotes que se produciron.

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

E de feito, temos posibles vacinas dispoñibles

for more than a decade.

desde hai máis dunha década.

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

Por que os ensaios clínicos se fan só agora?

This goes to the fundamental problem we have

Isto demostra o problema fundamental que temos

with vaccine development for infectious diseases.

co desenvolvemento de vacinas para enfermidades infecciosas.

It goes something like this:

O asunto é algo así:

The people most at risk for these diseases

As persoas máis en risco de contraer estas enfermidades

are also the ones least able to pay for vaccines.

son tamén as que menos capacidade teñen de mercar estas vacinas.

This leaves little in the way of market incentives

O que se traduce en pouco interese no mercado

for manufacturers to develop vaccines,

para os fabricantes de vacinas,

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

a menos que exista suficiente demanda en países ricos.

It's simply too commercially risky.

É un risco comercial demasiado alto.

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

No caso do ébola, non hai mercado en absoluto,

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

a única razón pola que temos dúas vacinas nas últimas fases de ensaio clínico,

ten que ver cun certo medo infundado.

is actually because of a somewhat misguided fear.

Ebola was relatively ignored

O ébola foi relativamente ignorado

until September 11 and the anthrax attacks,

ata o 11-S e os ataques con ántrax;

when all of a sudden, people perceived Ebola

de súpeto, o ébola foi percibido pola poboación

as, potentially, a bioterrorism weapon.

como unha potencial arma bioterrorista.

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

Por que non se deseñou a vacina do ébola nese momento?

Ben, porque era moi difícil

Well, partially, because it was really difficult --

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

--ou iso se pensaba -- converter un virus en arma,

but mainly because of the financial risk in developing it.

pero sobre todo, polo risco financeiro que suporía.

E é esta a cuestión.

And this is really the point.

The sad reality is, we develop vaccines

A triste realidade é que desenvolvemos vacinas

not based upon the risk the pathogen poses to people,

non tendo en conta o risco que o patóxeno supón,

senón tendo en conta o risco económico asociado ao seu deseño.

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

Vaccine development is expensive and complicated.

O desenvolvemento de vacinas é custoso e complexo.

It can cost hundreds of millions of dollars

Pode custar centos de millóns de dólares

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

só coller un antíxeno coñecido e convertelo nunha vacina viable.

Por fortuna, para enfermidades como o ébola,

Fortunately for diseases like Ebola,

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

podemos facer cousas para botar abaixo algunhas destas barreiras,

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

A primeira é recoñecer cando hai unha falla total no mercado.

In that case, if we want vaccines,

Neste caso, se queremos vacinas,

we have to provide incentives or some type of subsidy.

temos que ofrecer incentivos ou algún tipo de subvención.

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

Tamén temos que mellorar a forma de identificar de maneira máis eficaz

which are the diseases that most threaten us.

cales son as enfermidades máis perigosas.

By creating capabilities within countries, we then create the ability

Proporcionando recursos aos países afectados, ofréceselles a posibilidade

for those countries to create epidemiological and laboratory networks

de crear as súas propias redes epidemiolóxicas e de laboratorios

which are capable of collecting and categorizing these pathogens.

capaces de recompilar e categorizar estes patóxenos.

Estes datos podes ser usados despois

The data from that then can be used

to understand the geographic and genetic diversity,

para entender a diversidade xeográfica e xenética,

which then can be used to help us understand

que pode axudarnos a coñecer

how these are being changed immunologically,

qué cambios inmunolóxicos implican

e qué tipo de reaccións promoven.

and what type of reactions they promote.

So these are the things that can be done,

Pódense tomar algunhas destas medidas,

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

pero para facelo, se queremos abordar a total falla do mercado,

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

temos que cambiar o xeito de ver e prever as enfermidades infecciosas.

We have to stop waiting until we see evidence

Temos que deixar de esperar ata vermos probas

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

dunha enfermidade que vai supoñer unha ameaza global, para actuar.

So, for Ebola,

Entón, no caso do ébola,

the paranoid fear of an infectious disease,

o medo paranoico a unha enfermidade infecciosa,

followed by a few cases transported to wealthy countries,

seguido por uns poucos casos de infectados nos países ricos,

led the global community to come together,

fixo posible unha colaboración global,

e grazas ao traballo de empresas produtoras de vacinas,

and with the work of dedicated vaccine companies,

we now have these:

agora temos isto:

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

dúas vacinas contra o ébola probadas en ensaios clínicos en países con ébola --

(Applause)

(Aplausos)

e seguidas doutras en camiño.

and a pipeline of vaccines that are following behind.

Every year, we spend billions of dollars,

Cada ano gastamos miles de millóns de dólares,

keeping a fleet of nuclear submarines permanently patrolling the oceans

en manter unha frota de submarinos nucleares vixiando os océanos

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

para protexernos de ameazas que case con certeza non acontecerán.

And yet, we spend virtually nothing

E no entanto, non gastamos case nada

to prevent something as tangible and evolutionarily certain

en previr algo tan palpable e evolutivamente inevitable

as epidemic infectious diseases.

como as enfermidades infecciosas epidémicas.

E non nos equivoquemos --non é cuestión de "se ocorrerá", senón de "cando".

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

These bugs are going to continue to evolve

Estes bechos van seguir evolucionando

and they're going to threaten the world.

e van pór en perigo o mundo.

And vaccines are our best defense.

E as vacinas son a nosa mellor defensa.

Así que se queremos ser quen de previr epidemias como o ébola,

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

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

temos que arriscarnos a investir en desenvolver vacinas

and in stockpile creation.

e en acumular reservas.

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

E necesitamos ver isto, entón, como a medida disuasoria definitiva,

something we make sure is available,

algo que sabemos que está dispoñible,

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

pero ao mesmo tempo, rezamos para nunca ter que usar.

Thank you.

Grazas.

(Applause)

(Aplausos)