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

Prevoditelj: Matko Bošnjak Recezent: Ivan Stamenković

The child's symptoms begin

Dječji simptomi počinju

with mild fever, headache, muscle pains,

s blagom groznicom, glavoboljom, bolovima u mišićima,

followed by vomiting and diarrhea,

nakon čega slijede povraćanje i proljev,

then bleeding from the mouth, nose and gums.

zatim krvarenje iz usta, nosa i desni.

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

Slijedi smrt u obliku zatajenja organa zbog niskog krvnog tlaka.

Sounds familiar?

Zvuči poznato?

If you're thinking this is Ebola,

Ako mislite da je to ebola,

actually, in this case, it's not.

zapravo, u ovom slučaju, nije.

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

To je ekstremni oblik dengi groznice, bolesti koju uzrokuju komarci

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

i za koju također ne postoji učinkovita terapija ili cjepivo

and kills 22,000 people each year.

i koja ubija 22,000 ljudi godišnje.

That is actually twice the number of people

To je zapravo dvostruko više ljudi

that have been killed by Ebola

od onih ubijenih ebolom

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

u gotovo četiri desetljeća koliko znamo za nju.

As for measles, so much in the news recently,

Što se tiče ospica, koje su često na vijestima u posljednje vrijeme,

the death toll is actually tenfold higher.

smrtnost je zapravo deset puta veća.

Yet for the last year,

Ipak, protekle godine

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

ebola je zauzela sve naslove i strah.

Clearly, there is something deeply rooted about it,

Očito postoji neki razlog,

something which scares us and fascinates us

nešto što nas plaši i fascinira

more than other diseases.

više nego druge bolesti.

But what is it, exactly?

Ali što je to točno?

Well, it's hard to acquire Ebola,

Pa, teško je zaraziti se ebolom,

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

ali ako se to dogodi, rizik užasne smrti je visok.

Why?

Zašto?

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

Zato što trenutno nemamo nikakvu učinkovitu terapiju ili dostupno cjepivo.

And so, that's the clue.

Dakle, to je ključ.

We may have it someday.

Jednog dana možda ćemo imati.

So we rightfully fear Ebola,

Dakle, s pravom se bojimo ebole

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

zato što ne ubija toliko ljudi poput drugih bolesti.

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

Zapravo, puno se teže prenosi od drugih virusa, kao na primjer gripe ili ospica.

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

Bojimo se ebole zbog činjenice da nas ubija i da ju ne možemo izliječiti.

We fear the certain inevitability that comes with Ebola.

Bojimo se određene neizbježnosti koja dolazi s ebolom.

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

Ebola posjeduje neizbježnost koja kao da prkosi današnjoj modernoj medicini.

But wait a second, why is that?

Ali čekajte malo, zašto je tome tako?

We've known about Ebola since 1976.

Znamo za ebolu od 1976.

We've known what it's capable of.

Znamo za što je sposobna.

We've had ample opportunity to study it

Imali smo dovoljno prilika da ju proučimo

in the 24 outbreaks that have occurred.

u 24 epidemije koje su se zbile.

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

I zapravo imamo moguća cjepiva koja su dostupna

for more than a decade.

već preko deset godina.

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

Zašto da cjepiva tek sada prolaze klinička testiranja?

This goes to the fundamental problem we have

Ovome je razlog osnovni problem koji imamo

with vaccine development for infectious diseases.

s razvojem cjepiva za zarazne bolesti.

Glasi ovako nekako:

It goes something like this:

The people most at risk for these diseases

Ljudi koji su najrizičnija skupina za te bolesti

are also the ones least able to pay for vaccines.

su ujedno i ljudi koji su najmanje u mogućnosti platiti cjepiva.

This leaves little in the way of market incentives

Zbog toga tržište nema inicijativu

for manufacturers to develop vaccines,

za proizvodnju i razvoj cjepiva

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

osim ako velik broj ljudi koji riskiraju oboljenje nije u bogatim zemljama.

It's simply too commercially risky.

Jednostavno je tržišno preriskantno.

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

Što se ebole tiče, ne postoji nikakvo tržište,

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

tako da je jedini razlog što imamo dva cjepiva u stadiju kliničkih istraživanja

is actually because of a somewhat misguided fear.

zapravo strah u nekoj zabludi.

Ebola was relatively ignored

Ebolu se relativno ignoriralo

until September 11 and the anthrax attacks,

do 11. rujna i napada bedrenicom,

when all of a sudden, people perceived Ebola

kada su ljudi odjednom počeli doživljavati ebolu

as, potentially, a bioterrorism weapon.

kao potencijalno oružje bioterorizma.

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

Zbog čega onda cjepivo protiv ebole još nije potpuno razvijeno?

Well, partially, because it was really difficult --

Pa ,djelomično zato što je stvarno teško --

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

ili se smatra teškim -- naoružati virus,

but mainly because of the financial risk in developing it.

ali uglavnom zbog financijskog rizika razvijanja tog cjepiva.

And this is really the point.

I tu je zapravo poanta.

The sad reality is, we develop vaccines

Tužna stvarnost je da razvijemo cjepiva,

not based upon the risk the pathogen poses to people,

ne prema riziku koji patogen predstavlja za ljude,

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

nego prema ekonomskom riziku razvoja cjepiva.

Vaccine development is expensive and complicated.

Razvoj cjepiva je skup i kompliciran.

It can cost hundreds of millions of dollars

Može koštati stotine milijuna dolara

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

da se čak vrlo dobro poznat antigen pretvori u učinkovito cjepivo.

Fortunately for diseases like Ebola,

Srećom, za bolesti kao što je ebola

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

postoje načini kojima možemo ukloniti neke od prepreka.

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

Prvi način je prepoznati potpuni neuspjeh tržišta.

In that case, if we want vaccines,

U tom slučaju, ako želimo cjepiva,

we have to provide incentives or some type of subsidy.

moramo dati poticaj ili neku vrstu novčane subvencije.

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

Također moramo biti bolji u dokučivanju

which are the diseases that most threaten us.

koje nas bolesti najviše ugrožavaju.

By creating capabilities within countries, we then create the ability

Stvaranjem mogućnosti u državama, stvaramo mogućnost

for those countries to create epidemiological and laboratory networks

za te države da stvore epidemiološke i laboratorijske veze

which are capable of collecting and categorizing these pathogens.

koje su u mogućnosti prikupiti i kategorizirati te patogene.

The data from that then can be used

Podaci iz toga se tada mogu iskoristiti

to understand the geographic and genetic diversity,

za razumijevanje zamljopisne i genetske raznolikosti,

which then can be used to help us understand

koji se zatim mogu iskoristiti za razumijevanje

how these are being changed immunologically,

kako se mijenjaju imunološki

and what type of reactions they promote.

i koji tip reakcija uzrokuju.

So these are the things that can be done,

To možemo napraviti,

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

ali da bismo to učinili, ako se želimo suočiti s potpunim neuspjehom tržišta,

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

moramo promijeniti način kako gledamo na zarazne bolesti i njihovu prevenciju.

We have to stop waiting until we see evidence

Moramo prestati čekati dokaze

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

da je bolest postala globalna prijetnja prije no što ju smatramo prijetnjom.

So, for Ebola,

Dakle, što se ebole tiče,

the paranoid fear of an infectious disease,

paranoični strah od zarazne bolesti,

followed by a few cases transported to wealthy countries,

kojeg prati par slučajeva prijenosa u bogate zemlje,

led the global community to come together,

poveo je globalno društvo u jedinstvo

and with the work of dedicated vaccine companies,

i radom posvećenih kompanija za razvoj cjepiva

we now have these:

sada imamo ovo:

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

Dva cjepiva protiv ebole na testiranju učinkovitosti u zemljama pogođenim ebolom

(Applause)

(Pljesak)

and a pipeline of vaccines that are following behind.

i niz cjepiva koja slijede.

Every year, we spend billions of dollars,

Svake godine, trošimo milijarde dolara

keeping a fleet of nuclear submarines permanently patrolling the oceans

održavajući flotu nuklearnih podmornica u stalnoj ophodnji oceana

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

da nas zaštite od prijetnje koja se gotovo sigurno nikada neće obistiniti.

And yet, we spend virtually nothing

Istovremeno, gotovo ništa ne trošimo

to prevent something as tangible and evolutionarily certain

da se zaštitimo od nečeg toliko bliskog i evolucijski sigurnog

as epidemic infectious diseases.

kao epidemijske zarazne bolesti.

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

I nemojte pogrešno misliti -- ovo nije pitanje "ako", nego pitanje "kada".

These bugs are going to continue to evolve

Ovi će virusi nastaviti evoluirati

and they're going to threaten the world.

i prijetit će svijetu.

And vaccines are our best defense.

A cjepiva su naša najbolja obrana.

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

Dakle, ako želimo spriječiti epidemije kao što je ebola,

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

moramo riskirati ulaganjem u razvoj

and in stockpile creation.

i masovnu proizvodnju cjepiva.

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

I moramo na ovo gledati kao na posljednju opomenu --

something we make sure is available,

nešto za što se trebamo pobrinuti da bude dostupno,

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

ali istovremeno se moleći da to nikada nećemo morati iskoristiti.

Thank you.

Hvala vam.

(Applause)

(Pljesak)