Seth Berkley: HIV and flu -- the vaccine strategy

Translator: Barbara Stojanov Reviewer: Snežana Stone

Do you worry about what is going to kill you?

Se kdaj sprašujete, zaradi česa boste umrli?

Heart disease, cancer,

Zaradi bolezni srca, raka,

a car accident?

prometne nesreče?

Most of us worry about things we can't control,

Večinoma nas skrbijo stvari, ki jih ne moremo nadzorovati,

like war, terrorism,

kot na primer vojna, terorizem,

the tragic earthquake that just occurred in Haiti.

tragični potres, ki je pred kratkim prizadel Haiti.

But what really threatens humanity?

A kaj resnično grozi človeštvu?

A few years ago, Professor Vaclav Smil

Pred nekaj leti je profesor Vaclav Smil

tried to calculate the probability

skušal izračunati verjetnost,

of sudden disasters

da se bo nenadoma zgodila dovolj velika katastrofa,

large enough to change history.

ki bo spremenila zgodovino.

He called these,

Te dogodke je poimenoval

"massively fatal discontinuities,"

"uničujoče motnje",

meaning that they could kill

s čimer je hotel povedati,

up to 100 million people

da lahko povzročijo smrt 100 milijonov ljudi

in the next 50 years.

v naslednjih 50 letih.

He looked at the odds of another world war,

Zanimala ga je verjetnost ponovne svetovne vojne,

of a massive volcanic eruption,

velikih vulkanskih izbruhov

even of an asteroid hitting the Earth.

in celo padca asteroida na Zemljo.

But he placed the likelihood of one such event

Verjetnost enega večjega dogodka

above all others

je presegala vse ostale.

at close to 100 percent,

S skoraj 100 % verjetnostjo

and that is a severe flu pandemic.

se bo zgodila huda epidemija gripe.

Now, you might think of flu

Verjetno se vam zdi, da je gripa pravzaprav

as just a really bad cold,

le malo hujši prehlad,

but it can be a death sentence.

a lahko pomeni tudi smrtno obsodbo.

Every year, 36,000 people in the United States

Vsako leto v ZDA za sezonsko gripo

die of seasonal flu.

umre 36.000 ljudi.

In the developing world, the data is much sketchier

Podatki za države v razvoju niso tako natančni,

but the death toll is almost

vendar je zagotovo tam

certainly higher.

smrtnost še večja.

You know, the problem is if

Težavo predstavljajo

this virus occasionally mutates

mutacije virusov gripe,

so dramatically,

ki so včasih tako obsežne,

it essentially is a new virus

da pravzaprav nastane nov virus.

and then we get a pandemic.

Takrat se pojavi pandemija.

In 1918, a new virus appeared

Leta 1918, ko se je pojavil nov virus,

that killed some 50 to 100 million people.

je umrlo od 50 do 100 milijonov ljudi.

It spread like wildfire

Širil se je z neverjetno hitrostjo.

and some died within hours of developing symptoms.

Marsikdo je umrl v nekaj urah po pojavu simptomov.

Are we safer today?

Ali smo dandanes kaj bolj varni?

Well, we seem to have dodged

Vse kaže, da smo se letos

the deadly pandemic this year

uspeli izogniti smrtonosni pandemiji,

that most of us feared,

ki smo se je bali,

but this threat could reappear at any time.

toda grožnja se lahko kadarkoli spet pojavi.

The good news is that

Na srečo živimo

we're at a moment in time

v obdobju, v katerem

when science, technology, globalization is converging

se znanost, tehnologija in globalizacija združujejo in povezujejo

to create an unprecedented possibility:

ter nam tako omogočajo,

the possibility to make history

da spremenimo zgodovino,

by preventing infectious diseases

tako da preprečimo širjenje nalezljivih bolezni,

that still account for one-fifth of all deaths

ki še vedno povzročijo petino vseh smrti

and countless misery on Earth.

in neskončno trpljenje.

We can do this.

Zmogli bomo.

We're already preventing millions of deaths

Z obstoječimi cepivi

with existing vaccines,

že lahko preprečimo milijone smrti.

and if we get these to more people,

Bolj kot razširimo cepiva med ljudi,

we can certainly save more lives.

več življenj lahko rešimo.

But with new or better vaccines

Z novimi ali boljšimi cepivi

for malaria, TB, HIV,

proti malariji, tuberkulozi, virusu HIV,

pneumonia, diarrhea, flu,

pljučnici, diareji ali gripi

we could end suffering

bi lahko končali trpljenje,

that has been on the Earth since the beginning of time.

ki ga povzročajo nalezljive bolezni.

So, I'm here to trumpet vaccines for you.

Tukaj sem, da vam predstavim cepiva.

But first, I have to explain why they're important

A najprej moram razložiti, zakaj so pomembna.

because vaccines, the power of them,

Moč cepiv je namreč

is really like a whisper.

zelo pretanjena.

When they work, they can make history,

Kadar delujejo, jih vsi poznamo,

but after a while

a sčasoma

you can barely hear them.

utonejo v pozabo.

Now, some of us are old enough

Nekateri tukaj smo dovolj stari,

to have a small, circular scar on our arms

da imamo na rami majhno okroglo brazgotino,

from an inoculation we received as children.

ki je posledica cepljenja v otroštvu.

But when was the last time you worried about smallpox,

Toda kdaj so vas nazadnje skrbele črne koze,

a disease that killed half a billion people last century

ki so v prejšnjem stoletju ubile pol milijarde ljudi,

and no longer is with us?

zdaj pa jih ni več med nami?

Or polio? How many of you remember the iron lung?

Ali pa otroška paraliza - kdo se še spomni železnih pljuč?

We don't see scenes like this anymore

Prav zaradi cepiv takih prizorov

because of vaccines.

ne videvamo več.

Now, it's interesting

Zanimivo je, da poznamo

because there are 30-odd diseases

dobrih 30 bolezni,

that can be treated with vaccines now,

ki jih lahko preprečimo s cepljenjem,

but we're still threatened by things like HIV and flu.

pa vendar nas gripa in HIV še vedno ogrožata.

Why is that?

Zakaj?

Well, here's the dirty little secret.

Naj vam zaupam umazano skrivnost.

Until recently, we haven't had to know

Še do nedavega namreč

exactly how a vaccine worked.

nismo vedeli, kako cepiva delujejo.

We knew they worked through old-fashioned trial and error.

Njihovo delovanje smo odkrili z metodo poskusov in napak.

You took a pathogen, you modified it,

Poiskali smo mikrob in ga v laboratoriju spremenili,

you injected it into a person or an animal

nato smo ga vbrizgali v osebo ali žival

and you saw what happened.

in opazovali, kaj se bo zgodilo.

This worked well for most pathogens,

Pri večini mikrobov se je ta metoda dobro obnesla,

somewhat well for crafty bugs like flu,

pri prebrisanem virusu gripe malo manj,

but not at all for HIV,

pri virusu HIV pa sploh ne,

for which humans have no natural immunity.

ker nanj ljudje niso naravno odporni.

So let's explore how vaccines work.

Poglejmo si torej, kako cepiva delujejo.

They basically create a cache

V telesu ustvarijo nekakšno skladišče

of weapons for your immune system

orožja za vaš imunski sistem,

which you can deploy when needed.

ki ga lahko uporabite, ko je to potrebno.

Now, when you get a viral infection,

Kadar se okužite z virusom,

what normally happens is it takes days or weeks

običajno traja več dni ali tednov,

for your body to fight back

da se vaše telo začne

at full strength,

proti okužbi boriti na vso moč.

and that might be too late.

Takrat je lahko že prepozno.

When you're pre-immunized,

Če ste cepljeni,

what happens is you have forces in your body

je v vašem telesu že prisoten obrambni sistem,

pre-trained to recognize

ki natančno prepozna sovražne mikrobe

and defeat specific foes.

in jih porazi.

So that's really how vaccines work.

Tako torej deluje cepivo.

Now, let's take a look at a video

Poglejmo si video posnetek -

that we're debuting at TED, for the first time,

danes bo premierno predvajan -

on how an effective HIV vaccine might work.

o tem, kako naj bi delovalo učinkovito cepivo proti virusu HIV.

(Music)

(Glasba)

Narrator: A vaccine trains the body in advance

Cepivo vnaprej pripravi telo,

how to recognize and neutralize

da prepozna in uniči

a specific invader.

točno določenega napadalca.

After HIV penetrates the body's mucosal barriers,

Ko HIV preide sluznico,

it infects immune cells to replicate.

okuži imunske celice in se v njih razmnožuje.

The invader draws the attention

Napadalec pritegne pozornost

of the immune system's front-line troops.

celic, ki skrbijo za naravno odpornost.

Dendritic cells, or macrophages,

Dendritične celice oz. makrofagi

capture the virus and display pieces of it.

virus ujamejo in predstavijo njegove delce.

Memory cells generated by the HIV vaccine

Spominske celice, ki nastanejo ob cepljenju,

are activated when they learn

se aktivirajo, ko prepoznajo

HIV is present from the front-line troops.

delce virusa HIV, predstavljene na makrofagih.

These memory cells immediately deploy

Nato nemudoma pripravijo orožje,

the exact weapons needed.

ki je potrebno.

Memory B cells turn into plasma cells,

Spominske celice B se preobrazijo v plazmatke,

which produce wave after wave

ki izdelujejo številna

of the specific antibodies

točno določena protitelesa,

that latch onto HIV

ki se oklenejo virusa HIV

to prevent it from infecting cells,

in mu s tem preprečijo okužbo celic.

while squadrons of killer T cells

Medtem gruče celic T ubijalk

seek out and destroy cells

iščejo in uničijo celice,

that are already HIV infected.

ki so okužene z virusom HIV.

The virus is defeated.

Tako je virus poražen.

Without a vaccine,

Brez cepiva

these responses would have taken more than a week.

se tak odgovor razvije po več kot enem tednu.

By that time, the battle against HIV

Do takrat je boj z virusom HIV

would already have been lost.

že lahko izgubljen.

Seth Berkley: Really cool video, isn't it?

Odličen posnetek, a ne?

The antibodies you just saw in this video,

Protitelesa, ki ste jih videli,

in action, are the ones that make most vaccines work.

so tista, ki omogočijo delovanje cepiva.

So the real question then is:

Vprašati se moramo,

How do we ensure that your body makes

kako naj telo pripravimo do tega,

the exact ones that we need to protect

da bo izdelalo pravilna protitelesa

against flu and HIV?

za boj proti virusom gripe in HIV.

The principal challenge for both of these viruses

Največji izziv nam predstavlja

is that they're always changing.

njihovo stalno spreminjanje.

So let's take a look at the flu virus.

Poglejmo si, kako izgleda virus gripe.

In this rendering of the flu virus,

Na tej shemi vidimo

these different colored spikes are what it uses to infect you.

obarvane dele virusa, ki so odgovorni za okužbo.

And also, what the antibodies use is a handle

Na ista mesta se pritrdijo protitelesa,

to essentially grab and neutralize the virus.

da lahko uničijo virus.

When these mutate, they change their shape,

Ko virus mutira, se njegova oblika spremeni,

and the antibodies don't know what they're looking at anymore.

tako da ga protitelesa ne prepoznajo več.

So that's why every year

Zaradi tega torej vsako leto

you can catch a slightly different strain of flu.

razsaja malo drugačna gripa.

It's also why in the spring,

Zaradi teh sprememb

we have to make a best guess

vsako pomlad ugibamo,

at which three strains are going to prevail the next year,

kateri tip gripe bo prevladal v naslednji sezoni,

put those into a single vaccine

da lahko ustvarimo cepivo

and rush those into production for the fall.

in ga do jeseni proizvedemo v zadostnih količinah.

Even worse,

Še več!

the most common influenza -- influenza A --

Najbolj razširjena vrsta gripe, tip A,

also infects animals

lahko okuži tudi živali,

that live in close proximity to humans,

ki živijo v človekovi bližini

and they can recombine

ter se v njih

in those particular animals.

razmnožuje in spreminja.

In addition, wild aquatic birds

Poleg tega divje vodne ptice

carry all known strains

prenašajo vse poznane

of influenza.

vrste gripe.

So, you've got this situation:

Zgodilo se je naslednje.

In 2003,

Leta 2003

we had an H5N1 virus

je bilo nekaj primerov,

that jumped from birds into humans

ko se je virus H5N1 prenesel

in a few isolated cases

s ptic na ljudi.

with an apparent mortality rate of 70 percent.

Smrtnost je znašala približno 70 odstotkov.

Now luckily, that particular virus,

Na srečo se ta virus,

although very scary at the time,

čeprav se je zdel precej strašen,

did not transmit from person to person

ni z lahkoto prenašal

very easily.

s človeka na človeka.

This year's H1N1 threat

Letošnja grožnja, virus H1N1,

was actually a human, avian, swine mixture

je bil kombinacija človeških, ptičjih in prašičjih virusov,

that arose in Mexico.

izviral pa je iz Mehike.

It was easily transmitted,

Zelo enostavno se je prenašal,

but, luckily, was pretty mild.

a je bil na srečo precej blag.

And so, in a sense,

Zdi se, da se nas

our luck is holding out,

zaenkrat drži sreča,

but you know, another wild bird could fly over at anytime.

a kadarkoli lahko prileti mimo nova divja ptica.

Now let's take a look at HIV.

Poglejmo si zdaj še virus HIV.

As variable as flu is,

Čeprav je virus gripe zelo spremenljiv,

HIV makes flu

se v primerjavi s HIV-om

look like the Rock of Gibraltar.

zdi trden kot skala.

The virus that causes AIDS

Virus, ki povzroča AIDS,

is the trickiest pathogen

je najbolj zafrknjen mikrob,

scientists have ever confronted.

kar so jih znanstveniki odkrili.

It mutates furiously,

Zelo pogosto mutira

it has decoys to evade the immune system,

in je sposoben pretentati imunski sistem.

it attacks the very cells that are trying to fight it

Napade vsako celico, ki se mu skuša upreti,

and it quickly hides itself

nato pa se hitro skrije

in your genome.

v vaš lasten genom.

Here's a slide looking at

Na prosojnici lahko primerjate

the genetic variation of flu

genetske različice gripe

and comparing that to HIV,

in virusa HIV,

a much wilder target.

ki je precej bolj raznolik.

In the video a moment ago,

V prejšnjem video posnetku ste videli

you saw fleets of new viruses launching from infected cells.

številne nove viruse ubežati iz okužene celice.

Now realize that in a recently infected person,

Ne pozabite, da ima na novo okužena oseba

there are millions of these ships;

milijone takih virusov,

each one is just slightly different.

vendar je vsak malenkost drugačen od ostalih.

Finding a weapon that recognizes

Poiskati orožje, ki bi učinkovalo

and sinks all of them

na vse različice,

makes the job that much harder.

je precej težko delo.

Now, in the 27 years since HIV

V zadnjih 27 letih, odkar vemo,

was identified as the cause of AIDS,

da je HIV povzročitelj AIDS-a,

we've developed more drugs to treat HIV

je bilo zanj odkritih več zdravil

than all other viruses put together.

kot za vse ostale viruse skupaj.

These drugs aren't cures,

Kljub temu da bolezni ne ozdravijo,

but they represent a huge triumph of science

so ta zdravila velik dosežek znanosti,

because they take away the automatic death sentence

saj tako diagnoza okužbe s HIV

from a diagnosis of HIV,

ne predstavlja več takojšnje smrtne obsodbe;

at least for those who can access them.

vsaj za tiste, ki si zdravila lahko privoščijo.

The vaccine effort though is really quite different.

Cepiva so povsem druga zgodba.

Large companies moved away from it

Velike farmacevtske družbe so se jih izogibale,

because they thought the science was so difficult

ker je bilo razvijanje cepiva zelo zahtevno

and vaccines were seen as poor business.

in se finančno ni izplačalo.

Many thought that it was just impossible to make an AIDS vaccine,

Mnogi so menili, da je cepivo proti AIDS-u nemogoče izdelati,

but today, evidence tells us otherwise.

a dandanes imamo dokaze, da le ni tako.

In September,

Septembra

we had surprising but exciting findings

so v klinični študiji na Tajskem

from a clinical trial that took place in Thailand.

odkrili nekaj nepričakovanega.

For the first time, we saw an AIDS vaccine work in humans --

Prvič v zgodovini so pokazali, da cepivo

albeit, quite modestly --

proti AIDS-u deluje tudi pri človeku, četudi bolj slabo.

and that particular vaccine was made

To cepivo je bilo izdelano

almost a decade ago.

pred skoraj desetimi leti.

Newer concepts and early testing now

Z novimi koncepti in zgodnjim testiranjem

show even greater promise in the best of our animal models.

pričakujemo na živalskih modelih še boljše rezultate.

But in the past few months, researchers have also isolated

V zadnjih nekaj mesecih so raziskovalci iz krvi

several new broadly neutralizing antibodies

z virusom HIV okuženih posameznikov osamili

from the blood of an HIV infected individual.

številna protitelesa s širokim spektrom delovanja.

Now, what does this mean?

Kaj to pomeni?

We saw earlier that HIV

Že prej smo videli,

is highly variable,

da je HIV zelo raznolik virus.

that a broad neutralizing antibody

Protitelesa s širokim delovanjem

latches on and disables

se vežejo na številne različice virusa

multiple variations of the virus.

in jih onesposobijo.

If you take these and you put them

Če vzamemo ta protitelesa in jih prenesemo

in the best of our monkey models,

v najboljše opičje modele,

they provide full protection from infection.

bodo zagotovili popolno zaščito pred okužbo.

In addition, these researchers found

Poleg tega so isti raziskovalci odkrili

a new site on HIV

še novo mesto na virusu HIV,

where the antibodies can grab onto,

na katerega se lahko vežejo protitelesa.

and what's so special about this spot

To mesto je nekaj posebnega,

is that it changes very little

saj se med mutacijo virusa

as the virus mutates.

zelo malo spreminja.

It's like, as many times

Kot če bi se virus

as the virus changes its clothes,

ves čas preoblačil,

it's still wearing the same socks,

a bi vsakič obdržal iste nogavice.

and now our job is to make sure

Naša naloga je, da prepričamo telo,

we get the body to really hate those socks.

da so tiste nogavice res grozne.

So what we've got is a situation.

Kako torej stojijo stvari?

The Thai results tell us

Rezultati s Tajske pravijo,

we can make an AIDS vaccine,

da je izdelava cepiva proti AIDS-u možna.

and the antibody findings

Odkritja o protitelesih

tell us how we might do that.

nam kažejo, kako bi se tega lotili.

This strategy, working backwards

To, da bi delali "vzvratno" in

from an antibody to create a vaccine candidate,

iz protiteles izdelali cepivo,

has never been done before in vaccine research.

je povsem nova metoda izdelovanja cepiv.

It's called retro-vaccinology,

Retrogradna izdelava cepiva

and its implications extend

ni uporabna le pri virusu HIV,

way beyond that of just HIV.

temveč tudi pri številnih drugih mikrobih.

So think of it this way.

Pomislite.

We've got these new antibodies we've identified,

Odkrili smo nova protitelesa, za katera vemo,

and we know that they latch onto many, many variations of the virus.

da se lahko vežejo na številne različice virusa.

We know that they have to latch onto a specific part,

Vemo, da se vežejo na točno določen del virusa.

so if we can figure out the precise structure of that part,

Če bi lahko ugotovili natančno zgradbo tega dela

present that through a vaccine,

in ga predstavili telesu v obliki cepiva,

what we hope is we can prompt

bi morda lahko spodbudili imunski sistem

your immune system to make these matching antibodies.

k izdelavi enakih protiteles.

And that would create

Tako bi dobili

a universal HIV vaccine.

univerzalno cepivo proti HIV-u.

Now, it sounds easier than it is

Sliši se bolj preprosto, kot je v resnici,

because the structure actually looks more like

saj zgradba izgleda nekako tako

this blue antibody diagram

kot ta ponazoritev modrega protitelesa,

attached to its yellow binding site,

pritrjenega na vezavno mesto, označeno z rumeno.

and as you can imagine, these three-dimensional structures

Lahko si predstavljate, da je s tridimenzionalnimi

are much harder to work on.

zgradbami precej težko delati.

And if you guys have ideas to help us solve this,

Če ima kdo izmed vas kakšno idejo, kako se tega lotiti,

we'd love to hear about it.

kar na dan z njo!

But, you know, the research that has occurred from HIV now

Kljub vsemu je raziskovanje virusa HIV

has really helped with innovation with other diseases.

pripomoglo k boljšemu zdravljenju ostalih bolezni.

So for instance, a biotechnology company

Eno izmed biotehnoloških podjetjij je odkrilo

has now found broadly neutralizing

nova protitelesa s širokim spektrom delovanja,

antibodies to influenza,

ki delujejo proti gripi,

as well as a new antibody target on the flu virus.

pa tudi novo tarčno mesto na virusu samem.

They're currently making a cocktail --

Trenutno je v pripravi mešanica protiteles,

an antibody cocktail -- that can be used to treat

ki bi jo lahko uporabili

severe, overwhelming cases of flu.

za zdravljenje hudih primerov gripe.

In the longer term, what they can do

Dolgoročno gledano bi lahko

is use these tools of retro-vaccinology

z retrogradno metodo pridobivanja cepiv

to make a preventive flu vaccine.

izdelali učinkovito cepivo za gripo.

Now, retro-vaccinology is just one technique

A retrogradna metoda je le ena izmed

within the ambit of so-called rational vaccine design.

t.i. racionalnih metod pridobivanja cepiv.

Let me give you another example.

Poglejmo si še en primer.

We talked about before the H and N spikes

Prej smo govorili o vrhovih H in M,

on the surface of the flu virus.

ki se nahajata na površini virusa gripe.

Notice these other, smaller protuberances.

Poglejte si še te manjše izbokline.

These are largely hidden from the immune system.

Pred imunskim sistemom so zelo dobro skrite.

Now it turns out that these spots

Izkazalo se je, da se tudi ta mesta

also don't change much when the virus mutates.

med mutacijo virusa zelo malo spremenijo.

If you can cripple these with specific antibodies,

Če jih okvarimo s točno določenimi protitelesi,

you could cripple all versions of the flu.

s tem okvarimo vse različice gripe.

So far, animal tests indicate

Zaenkrat testi na živalih kažejo,

that such a vaccine could prevent severe disease,

da bi takšno cepivo sicer preprečilo hudo obliko bolezni,

although you might get a mild case.

a za blažjo obliko bi vseeno lahko zboleli.

So if this works in humans, what we're talking about

Če bo to cepivo delovalo pri ljudeh, dejansko

is a universal flu vaccine,

govorimo o univerzalnem cepivu proti gripi,

one that doesn't need to change every year

ki ga ni treba spreminjati vsako leto,

and would remove the threat of death.

pa se kljub temu izognemo številnim smrtnim žrtvam.

We really could think of flu, then,

Gripa bi tako postala

as just a bad cold.

le malo hujša oblika prehlada.

Of course, the best vaccine imaginable

Jasno, tudi najboljše cepivo

is only valuable to the extent

je koristno le takrat,

we get it to everyone who needs it.

ko ga dobijo vsi, ki ga potrebujejo.

So to do that, we have to combine

Da bi bilo to možno, potrebujemo

smart vaccine design with smart production methods

poleg dobrega cepiva še učinkovite metode izdelave

and, of course, smart delivery methods.

in, seveda, premišljeno razširjanje med ljudi.

So I want you to think back a few months ago.

Spomnite se, kaj se je zgodilo pred nekaj meseci.

In June, the World Health Organization

Junija je Svetovna zdravstvena organizacija

declared the first global

razglasila prvo globalno

flu pandemic in 41 years.

pandemijo gripe po 41 letih.

The U.S. government promised

Vlada ZDA je obljubila,

150 million doses of vaccine

da bo do 15. oktobra zagotovila

by October 15th for the flu peak.

150 milijonov odmerkov cepiva.

Vaccines were promised to developing countries.

Cepivo je bilo obljubljeno državam v razvoju.

Hundreds of millions of dollars were spent

Za pospešeno izdelavo cepiva je bilo

and flowed to accelerating vaccine manufacturing.

porabljenih na stotine milijonov dolarjev.

So what happened?

In kaj se je zgodilo?

Well, we first figured out

Najprej smo torej ugotovili,

how to make flu vaccines, how to produce them,

kako se cepivo izdeluje,

in the early 1940s.

in sicer v zgodnjih štiridesetih letih.

It was a slow, cumbersome process

Proces je bil počasen in naporen

that depended on chicken eggs,

ter odvisen od kokošjih jajc.

millions of living chicken eggs.

Milijonov živih kokošjih jajc!

Viruses only grow in living things,

Virusi namreč živijo le v živih organizmih,

and so it turned out that, for flu,

za gripo pa se je izkazalo,

chicken eggs worked really well.

da še posebej dobro uspeva v jajcih.

For most strains, you could get one to two doses

Pri večini sevov virusa je eno jajce

of vaccine per egg.

zadostovalo za en ali dva odmerka cepiva.

Luckily for us,

Na srečo

we live in an era of breathtaking

živimo v obdobju

biomedical advances.

osupljivih biomedicinskih dosežkov.

So today, we get our flu vaccines from ...

Danes namreč cepivo proti gripi pridobivamo iz ...

chicken eggs,

... kokošjih jajc.

(Laughter)

(Smeh)

hundreds of millions of chicken eggs.

Iz milijonov kokošjih jajc.

Almost nothing has changed.

Veste, skoraj nič se ni spremenilo.

The system is reliable

Ta sistem je zanesljiv.

but the problem is you never know how well

Težavo predstavlja dejstvo, da nikoli

a strain is going to grow.

ne vemo, kako dobro bo določen sev uspeval.

This year's swine flu strain

Sev letošnje prašičje gripe

grew very poorly in early production:

je v zgodnjem obdobju uspeval precej slabo,

basically .6 doses per egg.

dobili smo kakih 0.6 odmerkov na jajce.

So, here's an alarming thought.

Skrbi me naslednje:

What if that wild bird flies by again?

kaj če divje ptice ponovno priletijo tod mimo?

You could see an avian strain

Predstavljajte si sev ptičje gripe,

that would infect the poultry flocks,

ki bi okužil jate perutnine,

and then we would have no eggs for our vaccines.

tako da bi ostali brez jajc za proizvajanje cepiv.

So, Dan [Barber], if you want

Dan [Barber], če hočeš

billions of chicken pellets

za svojo ribjo farmo

for your fish farm,

milijarde kokošjih peletov,

I know where to get them.

vem, kako do njih.

So right now, the world can produce

Trenutno po celem svetu proizvedemo

about 350 million doses

okoli 350 milijonov odmerkov

of flu vaccine for the three strains,

cepiva za tri seve virusa gripe.

and we can up that to about 1.2 billion doses

To bi lahko povečali na 1,2 milijardi odmerkov,

if we want to target a single variant

če bi ciljali na točno določeno različico,

like swine flu.

na primer na prašičjo gripo.

But this assumes that our factories are humming

Seveda, če domnevamo, da tovarne delajo s polno paro.

because, in 2004,

Leta 2004 je bila namreč

the U.S. supply was cut in half

zaloga v ZDA prepolovljena

by contamination at one single plant.

zaradi okuženja v eni sami tovarni.

And the process still takes

Poleg tega proces pridobivanja

more than half a year.

še vedno traja več kot pol leta.

So are we better prepared

Ali smo torej danes

than we were in 1918?

kaj bolje pripravljeni kot leta 1918?

Well, with the new technologies emerging now,

Glede na pojav vedno novih tehnologij

I hope we can say definitively, "Yes."

upam, da lahko odgovorimo z "da".

Imagine we could produce enough flu vaccine

Predstavljajte si, da bi lahko proizvedli zadosti

for everyone in the entire world

cepiva proti gripi za ves svet,

for less than half of what we're currently spending

in to s pol manjšimi stroški,

now in the United States.

kot jih imamo trenutno v ZDA.

With a range of new technologies, we could.

S pomočjo nove tehnologije bi šlo.

Here's an example:

Poglejmo primer.

A company I'm engaged with has found

Podjetje, s katerim delam, je našlo

a specific piece of the H spike of flu

točno določen delček na vrhu H virusa gripe,

that sparks the immune system.

ki spodbuja imunski sistem.

If you lop this off and attach it

Če ta delček odrežemo

to the tail of a different bacterium,

in pritrdimo na drugo bakterijo,

which creates a vigorous immune response,

ta povzroči močan imunski odgovor;

they've created a very powerful flu fighter.

ustvarili so učinkovito cepivo proti gripi.

This vaccine is so small

Tako cepivo je zelo majhno -

it can be grown in a common bacteria, E. coli.

lahko raste v bakteriji E. coli.

Now, as you know, bacteria reproduce quickly --

Kot veste, se bakterije razmnožujejo hitro.

it's like making yogurt --

Kot bi delali jogurt!

and so we could produce enough swine origin flu

Na ta način bi izdelali zadosti prašičje gripe,

for the entire world in a few factories, in a few weeks,

da bi imeli cepivo za ves svet pripravljeno v nekaj tednih

with no eggs,

brez uporabe jajc

for a fraction of the cost of current methods.

in za neprimerno manj denarja.

(Applause)

(Aplavz)

So here's a comparison of several of these new vaccine technologies.

Primerjajmo nekaj novejših metod izdelave cepiva.

And, aside from the radically increased production

Poleg izjemno povečane proizvodnje

and huge cost savings --

in velikih prihrankov - poglejte recimo

for example, the E. coli method I just talked about --

metodo z uporabo E. coli, ki sem jo že omenil -

look at the time saved: this would be lives saved.

je pomemben tudi prihranek na času, ki rešuje življenja.

The developing world,

Svet v razvoju,

mostly left out of the current response,

ki še ni zajet v večino raziskav,

sees the potential of these alternate technologies

se zaveda potenciala novih metod

and they're leapfrogging the West.

in že dohiteva Zahod.

India, Mexico and others are already

Indija, Mehika in druge države

making experimental flu vaccines,

že izdelujejo poskusna cepiva proti gripi,

and they may be the first place

najverjetneje pa bodo prav tam

we see these vaccines in use.

tudi prvič preizkusili njihovo uporabnost.

Because these technologies are so efficient

Ker so nove tehnološke metode zelo učinkovite

and relatively cheap,

in tudi relativno poceni,

billions of people can have access to lifesaving vaccines

imajo lahko odslej milijarde ljudi dostop do cepiva,

if we can figure out how to deliver them.

ki bi jim rešilo življenje - le dostaviti jim ga moramo.

Now think of where this leads us.

Pomislite, kam nas bo to pripeljalo.

New infectious diseases

Vsakih nekaj let se pojavijo

appear or reappear

nove ali pa ponovno že znane

every few years.

nalezljive bolezni.

Some day, perhaps soon,

Nekega dne, verjetno kmalu,

we'll have a virus that is going to threaten all of us.

bo določen virus gripe ogrozil vse nas.

Will we be quick enough to react

Ali se bomo dovolj hitro odzvali,

before millions die?

da ne bodo umrli milijoni ljudi?

Luckily, this year's flu was relatively mild.

Na srečo je bila letošnja gripa precej blaga.

I say, "luckily" in part

"Na srečo" pravim zato,

because virtually no one in the developing world

ker skoraj nihče v državah v razvoju

was vaccinated.

ni bil cepljen.

So if we have the political and financial foresight

Če predvidimo politično in finančno situacijo

to sustain our investments,

ter zavarujemo svoje investicije,

we will master these and new tools of vaccinology,

bomo lahko izkoriščali te in druge metode pri izdelavi cepiv.

and with these tools we can produce

S takimi orodji lahko izdelamo

enough vaccine for everyone at low cost

velike količine poceni cepiva

and ensure healthy productive lives.

in ljudem omogočimo zdravo, kakovostno življenje.

No longer must flu have to kill half a million people a year.

Gripa ne bo več pobila pol milijona ljudi na leto.

No longer does AIDS

AIDS ne bo več pokopal

need to kill two million a year.

dveh milijonov letno.

No longer do the poor and vulnerable

Nalezljive bolezni ne bodo več ogrožale

need to be threatened by infectious diseases,

revnejših slojev prebivalstva.

or indeed, anybody.

Nikogar, pravzaprav.

Instead of having Vaclav Smil's

Namesto da bi doživeli

"massively fatal discontinuity" of life,

"uničujoče motnje" Vaclava Smila,

we can ensure

si lahko zagotovimo

the continuity of life.

zdravo življenje.

What the world needs now are these new vaccines,

Svet potrebuje nova cepiva,

and we can make it happen.

mi pa jih lahko proizvedemo.

Thank you very much.

Najlepša hvala.

(Applause)

(Aplavz)

Chris Anderson: Thank you.

Hvala.

(Applause)

(Aplavz)

Thank you.

Hvala.

So, the science is changing.

Znanost se spreminja.

In your mind, Seth -- I mean, you must dream about this --

Kaj misliš, Seth? Verjetno kdaj sanjariš o tem ...

what is the kind of time scale

Kdaj približno bi,

on, let's start with HIV,

začnimo recimo z virusom HIV,

for a game-changing vaccine that's actually out there and usable?

bilo lahko pripravljeno in dosegljivo uporabno cepivo?

SB: The game change can come at any time,

Ta trenutek lahko pride kadarkoli.

because the problem we have now is

Problem je namreč v tem, da čeprav

we've shown we can get a vaccine to work in humans;

cepivo lahko deluje pri ljudeh,

we just need a better one.

še ni dovolj dobro.

And with these types of antibodies, we know humans can make them.

Vemo tudi, da človeško telo lahko proizvede te vrste protiteles.

So, if we can figure out how to do that,

Ko bomo ugotovili, kako telo pripraviti do tega,

then we have the vaccine,

bomo dobili cepivo.

and what's interesting is there already is

Zanimivo je, da se že dokazano bližamo

some evidence that we're beginning to crack that problem.

rešitvi tega problema.

So, the challenge is full speed ahead.

Približujemo se mu s polno hitrostjo.

CA: In your gut, do you think it's probably going to be at least another five years?

Bi lahko rekel, da bo dosegljivo v naslednjih petih letih?

SB: You know, everybody says it's 10 years,

Vsi pravijo, da bo trajalo kakih 10 let,

but it's been 10 years every 10 years.

vendar tako rečejo vsakih 10 let.

So I hate to put a timeline

Znanstveno odkritje

on scientific innovation,

je težko časovno omejiti,

but the investments that have occurred are now paying dividends.

a dosedanja vlaganja že kažejo rezultate.

CA: And that's the same with universal flu vaccine, the same kind of thing?

Ali za cepivo proti gripi velja podobno?

SB: I think flu is different. I think what happened with flu is

Gripa je drugačna.

we've got a bunch -- I just showed some of this --

Kot ste videli, imamo cel kup inovacij,

a bunch of really cool and useful technologies that are ready to go now.

ki so pripravljene za uporabo.

They look good. The problem has been that,

Zdijo se dobre, a problem je v tem,

what we did is we invested in traditional technologies

da smo vlagali v tradicionalno proizvodnjo,

because that's what we were comfortable with.

ker jo poznamo in je bilo tako najlažje.

You also can use adjuvants, which are chemicals you mix.

Uporabljamo lahko tudi adjuvanse, kemikalije.

That's what Europe is doing, so we could have diluted out

V Evropi to že počnejo - tudi mi bi lahko z adjuvansi

our supply of flu and made more available,

povečali zaloge cepiva,

but, going back to what Michael Specter said,

a če se spomnite, je Michael Specter prej dejal,

the anti-vaccine crowd didn't really want that to happen.

da so aktivisti proti cepljenju to onemogočili.

CA: And malaria's even further behind?

Pri malariji pa še bolj zaostajamo?

SB: No, malaria, there is a candidate

Ne, glede malarije se je v zgodnji študiji

that actually showed efficacy in an earlier trial

izkazalo, da eno izmed cepiv učinkuje;

and is currently in phase three trials now.

ta študija je zdaj v tretji fazi.

It probably isn't the perfect vaccine, but it's moving along.

Verjetno ne bomo dobili popolnega cepiva, a nekaj le bo.

CA: Seth, most of us do work where every month,

Seth, večina nas je zaposlenih in

we produce something;

ob koncu meseca imamo občutek,

we get that kind of gratification.

da smo nekaj storili.

You've been slaving away at this for more than a decade,

Ti pa že več kot desetletje garaš kot črna živina,

and I salute you and your colleagues for what you do.

zato ti iskreno čestitam, prav tako tudi tvojim kolegom.

The world needs people like you. Thank you.

Svet potrebuje ljudi, kot ste vi. Hvala.

SB: Thank you.

Hvala.

(Applause)

(Aplavz)