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

Prevoditelj: Ivan Balić Recezent: Ivan Stamenković

When I was a kid,

Kada sam bio dijete

the disaster we worried about most was a nuclear war.

katastrofa o kojoj smo najviše brinuli je bio nuklearni rat.

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

Zbog toga smo imali bačvu poput ove u našem podrumu

filled with cans of food and water.

napunjenu konzervama hrane i vode.

When the nuclear attack came,

Kada bi došlo do nuklearnog rata,

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

trebali smo sići u podrum, sakriti se i jesti iz te bačve.

Today the greatest risk of global catastrophe

Danas, najveći rizik od globalne katastrofe

doesn't look like this.

ne izgleda ovako.

Instead, it looks like this.

Zapravo, izgleda ovako.

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

Ako postoji išta što će ubiti 10 milijuna ljudi u idućih nekoliko desetljeća,

it's most likely to be a highly infectious virus

najvjerojatnije je da će to biti vrlo zarazni virus,

rather than a war.

a ne rat.

Not missiles, but microbes.

Ne rakete, nego mikrobi.

Now, part of the reason for this is that

Dio razloga za ovo je činjenica

we've invested a huge amount in nuclear deterrents.

da smo uložili puno novca u odvraćanje od nuklearnog oružja.

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

Ali zapravo smo uložili jako malo u sustav za zaustavljanje epidemije.

We're not ready for the next epidemic.

Nismo spremni za sljedeću epidemiju.

Let's look at Ebola.

Pogledajmo ebolu.

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

Siguran sam da ste svi vi pročitali o njoj u novinama;

lots of tough challenges.

puno teških izazova.

I followed it carefully through the case analysis tools

Ja sam je pažljivo pratio kroz sredstva za analizu slučaja

we use to track polio eradication.

koje koristimo kako bismo pratili istrebljenje dječje paralize.

And as you look at what went on,

I kako pratite događaje,

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

vidi se da problem nije u tome što nije bilo sustava koji nije radio dovoljno dobro,

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

nego je problem bio u tome što uopće nismo imali sustav.

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

Zapravo, postoje neki poprilično vidljivi nedostaci.

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

Nismo imali grupu epidemiologa spremnih da reagiraju

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

i vide o kojoj je bolesti riječ i koliko se raširila.

The case reports came in on paper.

Izvješća su došla.

It was very delayed before they were put online

Bila su odgađana dok nisu postavljena na internet

and they were extremely inaccurate.

i bila su strašno netočna.

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

Nismo imali medicinski tim spreman za reakciju.

We didn't have a way of preparing people.

Nismo znali kako pripremiti ljude.

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

Liječnici Bez Granica su radili odličan posao u orkestriranju volontera,

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

ali čak i tada smo bili puno sporiji nego što smo trebali

getting the thousands of workers into these countries.

u prebacivanju tisuća radnika u ove države.

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

A velika epidemija zahtijeva od nas da imamo stotine tisuća radnika.

There was no one there to look at treatment approaches.

Nismo imali nikoga da nadgleda terapije.

No one to look at the diagnostics.

Nikoga da pregleda dijagnostiku.

No one to figure out what tools should be used.

Nikoga tko bi shvatio kakvi bi alati trebali biti korišteni.

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

Na primjer, mogli smo uzeti krv preživjelih,

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

obraditi je te ubrizgati plazmu nazad u ljude kako bismo ih zaštitili.

But that was never tried.

Ali to nikada nije oprobano.

So there was a lot that was missing.

Tako da smo imali puno nedostataka.

And these things are really a global failure.

I ove stvari su zapravo globalni neuspjeh.

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

WHO je financirana da nadgleda epidemije, ali ne da radi stvari o kojima sam pričao.

Now, in the movies it's quite different.

Naravno, u filmovima je sve bitno drugačije.

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

U filmovima imate grupu zgodnih epidemiologa spremnih za akciju.

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

Oni krenu i spase dan; ali to je samo Hollywood.

The failure to prepare could allow the next epidemic

Neuspjeh u pripremanju bi mogao dozvoliti idućoj epidemiji

to be dramatically more devastating than Ebola

da bude dramatično više razarajuća od ebole.

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

Pogledajmo napredak ebole tijekom ove godine.

About 10,000 people died,

Oko 10,000 mrtvih

and nearly all were in the three West African countries.

od kojih su skoro svi bili u tri zapadnoafričke države.

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

Postoje tri razloga zašto se nije još proširila.

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

Prvi razlog je zato što smo imali puno heroizma među zdravstvenim radnicima.

They found the people and they prevented more infections.

Oni su našli ljude i spriječili su daljne infekcije.

The second is the nature of the virus.

Drugi razlog je sama priroda virusa.

Ebola does not spread through the air.

Ebola se ne širi zrakom.

And by the time you're contagious,

Tako da do vremena kada su zarazni,

most people are so sick that they're bedridden.

većina ljudi je toliko bolesna da su vezani za krevet.

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

Treći razlog je to što nije dospjela u urbana područja.

And that was just luck.

No, to je bila samo sreća.

If it had gotten into a lot more urban areas,

Da je penetrirala dublje u urbana područja,

the case numbers would have been much larger.

brojevi slučajeva zaraze bi bili mnogo veći.

So next time, we might not be so lucky.

Idući put možda nećemo biti ovako sretni.

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

Mogli bismo imati virus gdje će se ljudi osjećati dobro iako su zarazni

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

da će onda putovati zrakoplovima ili će ići na tržnice.

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

Izvor potencijalnog virusa bi mogla biti prirodna epidemija poput ebole,

or it could be bioterrorism.

ali bi mogao biti i bioterorizam.

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

Tako da postoji mogućnost da stvari budu tisuću puta gore.

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

Zapravo, pogledajmo model virusa koji se širi zrakom,

like the Spanish Flu back in 1918.

poput Španjolske gripe iz 1918.

So here's what would happen:

Ovo bi se dogodilo.

It would spread throughout the world very, very quickly.

Kroz svijet bi se proširio velikom brzinom.

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

Vidite da bi oko 30 milijuna ljudi umrlo od epidemije.

So this is a serious problem.

Ovo je ozbiljan problem.

We should be concerned.

I trebali bismo biti zabrinuti.

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

Ali zapravo, mi možemo napraviti jako dobar sustav za odgovor.

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

Imamo sve znanstvene i tehnološke beneficije o kojima možemo pričati ovdje.

We've got cell phones

Imamo mobilne telefone

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

kojima bismo mogli dobiti informacije od javnosti, ali i davati ih.

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

Imamo satelitske mape preko kojih možemo vidjeti gdje su ljudi i kuda se kreću.

We have advances in biology

Postoji napredak u biologiji

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

koji bi trebao dramatično promijeniti brzinu vremena potrebnog da pregledamo patogen

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

te bi bilo moguće napraviti lijekove i cjepiva koji odgovaraju tom patogenu.

So we can have tools,

Mi imamo sredstva,

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

ali ta sredstva trebaju biti stavljena u cjelokupni globalni zdravstveni sustav.

And we need preparedness.

I trebamo pripravnost.

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

Po mom mišljenju, najbolje lekcije kako da se pripremimo

are again, what we do for war.

dobijamo iz načina na koji ratujemo.

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

Za vojnike imamo puno vrijeme dok čekaju.

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

Imamo rezerve koje se mjere u ogromnim brojkama.

NATO has a mobile unit that can deploy very rapidly.

NATO ima mobilnu jedinicu koja može krenuti vrlo brzo.

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

NATO radi puno ratnih igrica kako bi testirali jesu li ljudi spremni.

Do they understand about fuel and logistics

Također, testira znaju li o gorivima i logistici

and the same radio frequencies?

i razumiju li iste radio frekvencije,

So they are absolutely ready to go.

Tako da su oni spremni za akciju.

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

To su stvari koje trebamo imati kako bismo bili spremni za sučeljavanje s epidemijom.

What are the key pieces?

Koji su ključni dijelovi?

First, we need strong health systems in poor countries.

Prvo, trebamo jake zdravstvene sustave u siromašnim državama.

That's where mothers can give birth safely,

Tako da bi majke mogle sigurno rađati

kids can get all their vaccines.

i djeca bi mogla dobiti sva cjepiva.

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

Ali također, mogli bismo predvidjeti izbijanje epidemije vrlo rano.

We need a medical reserve corps:

Trebamo rezervne medicinske korpuse;

lots of people who've got the training and background

mnogo ljudi koji bi stekli obuku i temelje

who are ready to go, with the expertise.

kako bi bili spremni i stručni.

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

I onda trebamo upariti to medicinsko osoblje s vojskom

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

kako bismo imali vojnu prednost i logistiku

and secure areas.

i kako bismo mogli osiguravati područja.

We need to do simulations,

Moramo raditi simulacije,

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

"igre mikroba", ne igre ratova, kako bismo vidjeli gdje su rupe u sustavu.

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

Zadnji put kada smo imali "igru mikroba" u Americi

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

bilo je to 2001. godine, i nije prošlo dobro.

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

Sadašnji rezultat je mikrobi: 1 - ljudi: 0.

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

Naposljetku, trebamo puno naprednog I&R-a u cijepljenju i dijagnostici.

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

Postoje veliki napretci poput onih koji su povezani s Adeno virusom,

that could work very, very quickly.

a koji bi mogli raditi vrlo, vrlo brzo.

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

Ja nemam točan proračun koji bi odredio koliko bi ovo koštalo,

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

ali sam vrlo siguran da je poprilično jeftin u usporedbi s potencijalnom štetom.

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

Svjetska banka procjenjuje da, kada bismo imali epidemiju gripe širom svijeta,

global wealth will go down by over three trillion dollars

vrijednost svjetskog bogatstva bi pala za više od tri trilijuna dolara

and we'd have millions and millions of deaths.

i imali bismo milijune i milijune mrtvih.

These investments offer significant benefits

Ovakve investicije nude značajne beneficije

beyond just being ready for the epidemic.

koje nadilaze spremnost za epidemiju.

The primary healthcare, the R&D,

Osnovno zdravstvo, istraživanje i razvoj (R&D),

those things would reduce global health equity

ovakve stvari bi umanjile trošak svjetskog zdravstva

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

i učinile bi svijet puno sigurnijim.

So I think this should absolutely be a priority.

Zbog ovoga mislim da bi spomenuto trebalo biti prioritet.

There's no need to panic.

Ne trebamo paničariti.

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

Ne trebamo skupljati konzerve špageta niti silaziti u podrume.

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

Ali moramo otpočeti s radom zato što vrijeme nije na našoj strani.

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

Zapravo, ako postoji jedna pozitivna stvar koja može proizaći iz epidemije ebole,

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

to je nekakva vrsta uranjenog upozorenja, poziva na buđenje i pripremu.

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

Ako počnemo sada, možemo biti spremni za sljedeću epidemiju.

Thank you.

Hvala Vam.

(Applause)

(Pljesak)