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

Prevodilac: Mile Živković Lektor: Milenka Okuka

When I was a kid,

Kad sam bio mali,

the disaster we worried about most was a nuclear war.

katastrofa koje smo se najviše plašili bila je nuklearni rat.

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

Zbog toga smo imali ovakvo bure u podrumu,

filled with cans of food and water.

puno konzervi sa hranom i vodom.

When the nuclear attack came,

Kada bi došlo do nuklearnog napada,

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

trebalo je da trknemo dole, smirimo se i jedemo iz tog bureta.

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 nešto ubije preko 10 miliona ljudi u narednih nekoliko decenija,

it's most likely to be a highly infectious virus

verovatnije je da će to biti izuzetno zarazan virus

rather than a war.

nego rat.

Not missiles, but microbes.

Ne rakete, već mikrobi.

Now, part of the reason for this is that

Delimično je tako

we've invested a huge amount in nuclear deterrents.

jer smo uložili mnogo novca u sprečavanje nuklearne pretnje.

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

Ali smo zapravo uložili veoma malo u sistem za zaustavljanje epidemije.

We're not ready for the next epidemic.

Nismo spremni za narednu 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 čitali o tome u novinama,

lots of tough challenges.

bilo je dosta teških izazova.

I followed it carefully through the case analysis tools

Pomno sam to pratio koristeći alate za analizu slučajeva

we use to track polio eradication.

kojima smo pratili iskorenjavanje dečje paralize.

And as you look at what went on,

Kako gledate šta se dešavalo,

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

problem nije bio u tome da je postojao sistem koji nije radio dovoljno dobro,

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

problem je bio u tome što uopšte nismo imali sistem.

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

Zapravo, prilično je očigledno da nedostaju neki ključni delovi.

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

Nismo imali spremnu grupu epidemiologa, koji bi išli kada treba,

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

videli kakva je zaraza u pitanju, koliko se proširila.

The case reports came in on paper.

Izveštaje o slučaju dobijali smo na papiru.

It was very delayed before they were put online

Njihovo stavljanje na internet dosta se odgađalo

and they were extremely inaccurate.

i bili su veoma neprecizni.

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

Nismo imali spreman medicinski tim.

We didn't have a way of preparing people.

Nismo imali način da pripremimo ljude.

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

Lekari bez granica učinili su sjajan posao upravljajući volonterima.

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

Ali i uz to, bili smo dosta sporiji nego što bismo bili

getting the thousands of workers into these countries.

kada bismo hiljade radnika dopremili u ove zemlje.

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

A velika epidemija bi od nas zahtevala stotine hiljada radnika.

There was no one there to look at treatment approaches.

Tamo nije bilo nikoga da pogleda pristupe lečenju.

No one to look at the diagnostics.

Nikoga da pogleda dijagnozu.

No one to figure out what tools should be used.

Nikoga da otkrije koje alate treba koristiti.

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

Na primer, mogli smo preživelima da izvadimo krv,

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

obradimo je, i tu plazmu vratimo nazad ljudima kako bi ih zaštitili.

But that was never tried.

Ali to nikad nije pokušano.

So there was a lot that was missing.

Tako da je dosta toga nedostajalo.

And these things are really a global failure.

A ovo je zapravo bio globalni neuspeh.

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

Svetska zdravstvena organziacija ima sredstva za nadgledanje epidemija,

ali ne za ovo o čemu sam pričao.

Now, in the movies it's quite different.

U fimovima je dosta drugačije.

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

Postoji grupa zgodnih i spremnih epidemiologa,

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

oni nastupe i spasu stvar, ali to je samo Holivud.

The failure to prepare could allow the next epidemic

Nemogućnost pripreme mogla bi da dozvoli da naredna epidemija

to be dramatically more devastating than Ebola

bude dramatično više razarajuća od ebole.

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

Pogledajmo napredovanje ebole tokom ove godine.

About 10,000 people died,

Umrlo je oko 10 000 ljudi

and nearly all were in the three West African countries.

i skoro svi su bili iz tri zemlje zapadne Afrike.

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

Postoje tri razloga zašto se ona nije još raširila.

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

Prvi je da su zdravstveni radnici herojski radili svoj posao.

They found the people and they prevented more infections.

Pronašli su ljude i sprečili još infekcija.

The second is the nature of the virus.

Drugi je priroda virusa.

Ebola does not spread through the air.

Ebola se ne širi vazdušnim putem.

And by the time you're contagious,

Do trenutka kada se zaraze,

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.

Treće, nije dospela do mnogo urbanih okruženja.

And that was just luck.

To je bila puka sreća.

If it had gotten into a lot more urban areas,

Da je došla u više urbanih okruženja,

the case numbers would have been much larger.

brojevi zaraženih bili bi mnogo veći.

So next time, we might not be so lucky.

Sledećeg puta možda nećemo biti te sreće.

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

Možete imati virus gde se ljudi osećaju dovoljno dobro kada su zarazni

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

da se ukrcaju na avion ili odu na pijacu.

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

Izvor virusa može biti prirodna epidemija, poput ebole,

or it could be bioterrorism.

ili može biti bioterorizam.

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

Postoje stvari koje bi bukvalno pogoršale sve za hiljadu puta.

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

Zapravo, pogledajmo model širenja virusa vazduhom,

like the Spanish Flu back in 1918.

poput španskog gripa iz 1918.

So here's what would happen:

Desilo bi se sledeće:

It would spread throughout the world very, very quickly.

virus bi se proširio svetom veoma, veoma brzo.

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

Možete videti da je od te epidemije umrlo preko 30 miliona ljudi.

So this is a serious problem.

Ovo je ozbiljan problem.

We should be concerned.

Treba da budemo zabrinuti.

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

Zapravo, možemo izgraditi veoma dobar odbrambeni sistem.

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

Imamo prednosti silne nauke i tehnologije o kojima ovde pričamo.

We've got cell phones

Imamo mobilne telefone preko kojih

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

dobijamo informacije od javnosti i šaljemo informacije njima.

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

Imamo satelitske mape gde možemo videti gde se ljudi nalaze i kuda se kreću.

We have advances in biology

Imamo napredak u biologiji

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

koji bi trebalo da dramatično promeni vreme potrebno da se pogleda patogen

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

i da možemo da napravimo lekove i vakcine koji odgovaraju tom patogenu.

So we can have tools,

Možemo imati alate,

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

ali ti alati moraju se postaviti u celokupan globalni zdravstveni sistem.

And we need preparedness.

Potrebna nam je i pripravnost.

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

Mislim da najbolje lekcije o tome kako se pripremiti

are again, what we do for war.

možemo izvući iz toga šta radimo za rat.

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

Imamo vojnike s punim radnim vremenom, spremne za polazak.

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

Imamo rezerve koje idu do velikih cifara.

NATO has a mobile unit that can deploy very rapidly.

NATO ima mobilnu jedinicu koju mogu veoma brzo da rasporede.

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

NATO se dosta igra rata kako bi proverili da li su ljudi spremni.

Do they understand about fuel and logistics

Da li razumeju gorivo i logistiku

and the same radio frequencies?

i iste radio frekvencije?

So they are absolutely ready to go.

Tako da su apsolutno spremni za polazak.

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

To su stvari sa kojima moramo da radimo kada je u pitanju epidemija.

What are the key pieces?

Šta su ključni delovi?

First, we need strong health systems in poor countries.

Prvo su nam potrebni jaki zdravstveni sistemi u siromašnim zemljama.

That's where mothers can give birth safely,

Tamo gde majke mogu bezbedno da se porađaju,

kids can get all their vaccines.

gde deca mogu da se vakcinišu.

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

Ali i tamo gde ćemo u ranom dobu videti epidemiju.

We need a medical reserve corps:

Potrebne su nam medicinske rezervne snage -

lots of people who've got the training and background

dosta ljudi koji imaju obuku

who are ready to go, with the expertise.

i stručnost, i koji su spremni da krenu.

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

Onda te medicinske radnike treba da uparimo sa vojskom,

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

koristeći sposobnost vojske da se brzo kreće, bavi logistikom

and secure areas.

i obezbeđuje područja.

We need to do simulations,

Treba da radimo simulacije,

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

igre bacila, ne igre rata, tako da vidimo gde su rupe.

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

Poslednji put kada su se igre bacila igrale u Sjedinjenim Državama,

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

to je bilo 2001, i nije dobro prošlo.

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

Do sada je rezultat, bacili: 1, ljudi: 0.

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

Konačno, potrebno nam je dosta naprednog istraživanja i razvoja

u poljima vakcina i dijagnostike.

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

Postoje neki veliki napreci, kao kod adeno asociranog virusa,

that could work very, very quickly.

koji bi mogao da proradi veoma brzo.

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

Nemam tačan budžet za to koliko bi ovo moglo da košta,

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

ali prilično sam siguran da je veoma skroman

u poređenju sa potencijalnom štetom.

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

Svetska banka procenjuje da kada bi imali svetsku epidemiju gripa,

global wealth will go down by over three trillion dollars

sredstva u svetu bi se smanjila za preko tri biliona dolara

and we'd have millions and millions of deaths.

i bilo bi na milione mrtvih.

These investments offer significant benefits

Ove investicije nude značajne prednosti

beyond just being ready for the epidemic.

koje su veće od same pripremljenosti na epidemiju.

The primary healthcare, the R&D,

Primarna zdravstvena nega, istraživanje i razvoj,

those things would reduce global health equity

te stvari bi jednakost u globalnom zdravlju povećale

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

i učinile svet pravičnijim koliko i bezbednijim.

So I think this should absolutely be a priority.

Mislim da bi ovo apsolutno trebalo da bude prioritet.

There's no need to panic.

Nema potrebe za panikom.

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

Ne moramo da gomilamo konzerve sa špagetama

ili da se guramo u podrumu.

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

Ali moramo da se pokrenemo, jer vreme nije na našoj strani.

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

Zapravo, postoji jedna pozitivna stvar koja može da proiziđe iz epidemije ebole,

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

to je da ona može da posluži kao rano upozorenje, poziv na akciju.

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

Ako sada počnemo, možemo biti spremni za narednu epidemiju.

Thank you.

Hvala vam.

(Applause)

(Aplauz)