Sonia Shah: 3 reasons we still haven't gotten rid of malaria

Prevodilac: Matija Sabadoš Lektor: Mile Živković

So over the long course of human history,

Tokom ljudske istorije,

the infectious disease that's killed more humans

zarazna bolest koja je ubila najviše

than any other is malaria.

ljudi je malarija.

It's carried in the bites of infected mosquitos,

Prenosi se ubodima zaraženih komaraca,

and it's probably our oldest scourge.

i verovatno je naša najstarija pošast.

We may have had malaria since we evolved from the apes.

Moguće je da smo imali malariju od naše evolucije iz majmuna.

And to this day, malaria takes a huge toll on our species.

Do dana današnjeg malarija uzima ogroman danak našoj vrsti.

We've got 300 million cases a year

Imamo preko 300 miliona slučajeva godišnje

and over half a million deaths.

sa preko pola miliona smrtnih slučajeva.

Now this really makes no sense.

Ovo je stvarno besmisleno.

We've known how to cure malaria

Znamo lek za malariju

since the 1600s.

još od 17. veka.

That's when Jesuit missionaries in Peru

Tada su jezuitski misionari u Peruu

discovered the bark of the cinchona tree,

otkrili koru drveta kinina,

and inside that bark was quinine,

a unutar kore se nalazio kinin,

still an effective cure for malaria to this day.

i dan danas učinkovit lek za malariju.

So we've known how to cure malaria for centuries.

Dakle već vekovima znamo kako da izlečimo malariju.

We've known how to prevent malaria since 1897.

Od 1897 znamo kako da sprečimo malariju.

That's when the British army surgeon Ronald Ross

Tada je britanski vojni hirurg, Ronald Ros,

discovered that it was mosquitos that carried malaria,

otkrio da komarci prenose malariju,

not bad air or miasmas, as was previously thought.

a ne loš vazduh ili mijazme, kao što se smatralo.

So malaria should be a relatively simple disease to solve,

Dakle malarija bi trebala biti jednostavno rešiva bolest,

and yet to this day, hundreds of thousands of people

ali i dan danas će stotine hiljada ljudi

are going to die from the bite of a mosquito.

umreti od uboda komarca.

Why is that?

Zašto?

This is a question that's

Ovo pitanje me

personally intrigued me for a long time.

lično intrigira već dugo vremena.

I grew up as the daughter of Indian immigrants

Odrasla sam kao ćerka indijskih imigranata

visiting my cousins in India every summer,

posećujući svakog leta rođake u Indiji,

and because I had no immunity to the local malarias,

a pošto nisam imala imunitet protiv lokalnih malarija,

I was made to sleep under this hot, sweaty mosquito net every night

morala sam svako veče da spavam pod vrućom, znojavom mrežom za komarce

while my cousins, they were allowed to sleep

dok su moji rođaci smeli da spavaju

out on the terrace and have

na terasi i da

this nice, cool night breeze wafting over them.

nad njima lebdi fini, hladni večernji povetarac.

And I really hated the mosquitos for that.

Zbog toga sam stvarno mrzela komarce.

But at the same time, I come from a Jain family,

Ali istovremeno dolazim iz Džain porodice,

and Jainism is a religion that espouses

a Džainizam je religija koja propoveda

a very extreme form of nonviolence.

veoma ekstreman oblik nenasilja.

So Jains are not supposed to eat meat.

Džainjani ne smeju jesti meso.

We're not supposed to walk on grass,

Ne bismo smeli hodati po travi,

because you could, you know,

jer biste mogli

inadvertently kill some insects when you walk on grass.

slučajno ubiti insekte kada šetate po travi.

We're certainly not supposed to swat mosquitos.

A sigurno ne smemo ubijati komarce.

So the fearsome power of this little insect

Dakle strahopoštovanje prema ovom insektu

was apparent to me from a very young age,

mi je bilo jasno od malena, i predstavlja

and it's one reason why I spent five years as a journalist

jedan od razloga zašto sam provela pet godina kao novinar

trying to understand, why has malaria

pokušavajući da shvatim, zašto je malarija

been such a horrible scourge for all of us for so very long?

već tako dugo tako stravična pošast za sve nas?

And I think there's three main reasons why.

I mislim da postoje tri glavna razloga za to.

Those three reasons add up to the fourth reason,

Ta tri razloga čine četvrti razlog, koji je najverovatnije

which is probably the biggest reason of all.

najveći razlog od svih.

The first reason is certainly scientific.

Prvi razlog je sigurno naučan.

This little parasite that causes malaria,

Mali parazit koji uzrokuje malariju,

it's probably one of the most complex

je verovatno jedan od najsloženijih

and wily pathogens known to humankind.

i najlukavijih patogena poznatih čovečanstvu.

It lives half its life inside the cold-blooded mosquito

Živi polovinu života u hladnokrvnom komarcu

and half its life inside the warm-blooded human.

i polovinu života u toplokrvnom čoveku.

These two environments are totally different,

Ove dve okoline su potpuno drukčije,

but not only that, they're both utterly hostile.

ne samo to, nego su i krajnje neprijateljske.

So the insect is continually trying to fight off the parasite,

Insekt neprekidno pokušava da suzbije parazita,

and so is the human body continually trying to fight it off.

a takođe ga i ljudsko telo neprekidno suzbija.

This little creature survives under siege like that,

Ovo malo stvorenje opstaje pod takvom opsadom,

but not only does it survive, it has thrived.

ne samo da opstaje, već buja.

It has spread. It has more ways to evade attack than we know.

Raširilo se. Ima više načina da izbegne napad nego što smo svesni.

It's a shape-shifter, for one thing.

Prvo, menja oblike.

Just as a caterpillar turns into a butterfly,

Kao što se gusenica pretvara u leptira,

the malaria parasite transforms itself like that

parazit malarije se tako transformiše sedam puta

seven times in its life cycle.

tokom svog životnog ciklusa.

And each of those life stages not only looks totally different from each other,

A sve te životne etape, ne samo što se potpuno razlikuju jedna od druge,

they have totally different physiology.

nego imaju potpuno drugačiju fiziologiju.

So say you came up with some great drug

Pretpostavimo da izmislite neki odličan lek

that worked against one stage of the parasite's life cycle.

koji deluje protiv jedne etape životnog ciklusa parazita.

It might do nothing at all to any of the other stages.

Možda uopšte neće delovati protiv drugih etapa.

It can hide in our bodies, undetected,

Može se neprimetno skrivati u našim telima,

unbeknownst to us, for days, for weeks,

danima, nedeljama, mesecima, godinama,

for months, for years, in some cases even decades.

čak i decenijama, a da toga nismo svesni.

So the parasite is a very big scientific challenge to tackle,

Ovaj parazit predstavlja veoma veliki naučni izazov,

but so is the mosquito that carries the parasite.

jednako kao i komarac koji ga prenosi.

Only about 12 species of mosquitos

Svega 12 vrsta komaraca

carry most of the world's malaria,

prenose većinu svetske malarije,

and we know quite a bit about the kinds of

a znamo dosta o vrstama vodenih

watery habitats that they specialize in.

staništa koja su im najpogodnija.

So you might think, then, well, why don't we just

Pomislili biste, zašto onda jednostavno

avoid the places where the killer mosquitos live? Right?

ne izbegavamo mesta gde smrtonosni komarci žive? Zar ne?

We could avoid the places where the killer grizzly bears live

Mogli bismo izbegavati mesta gde žive smrtonosni grizli medvedi

and we avoid the places where the killer crocodiles live.

i izbegavamo mesta gde žive smrtonosni krokodili.

But say you live in the tropics

No, recimo da živite u tropskom području

and you walk outside your hut one day

i jednog dana izađete iz svoje kolibe

and you leave some footprints in the soft dirt

i ostavite tragove u mekom tlu

around your home.

oko vašeg doma.

Or say your cow does, or say your pig does,

Ili recimo da to uradi krava, ili vaša svinja,

and then, say, it rains,

a potom padne kiša,

and that footprint fills up with a little bit of water.

i taj trag se napuni sa malo vode.

That's it. You've created the perfect

To je to. Stvorili ste savršeno stanište

malarial mosquito habitat that's right outside your door.

za malaričnog komarca tik ispred svojih vrata.

So it's not easy for us to extricate ourselves from these insects.

Dakle, nije nam lako da se odvojimo od ovih insekata.

We kind of create places that they love to live

Nekako, samim svojim življenjem stvaramo mesta

just by living our own lives.

u kojima oni vole da žive.

So there's a huge scientific challenge,

Dakle, postoji ogromni naučni izazov,

but there's a huge economic challenge too.

ali i ogroman ekonomski izazov.

Malaria occurs in some of the poorest

Malarija se javlja u najsiromašnijim

and most remote places on Earth,

i najudaljenijim mestima na Zemlji,

and there's a reason for that.

a postoji razlog za to.

If you're poor, you're more likely to get malaria.

Ako ste siromašni, verovatnije je da ćete dobiti malariju.

If you're poor, you're more likely to live

Ako ste siromašni, verovatnije je da živite

in rudimentary housing on marginal land that's poorly drained.

u trošnom domu na udaljenom zemljištu koje ima slab odvod vode.

These are places where mosquitos breed.

Na takvim mestima se komarci množe.

You're less likely to have door screens or window screens.

Manje je verovatno da imate mrežu na vratima ili prozorima.

You're less likely to have electricity

Manje je verovatno da imate struju

and all the indoor activities that electricity makes possible,

i sve aktivnosti koje struja omogućuje i stoga

so you're outside more.

ste više van kuće.

You're getting bitten by mosquitos more.

Više vas bodu komarci.

So poverty causes malaria,

Dakle, siromaštvo izaziva malariju,

but what we also know now is that malaria itself

ali takođe znamo da i sama malarija

causes poverty.

izaziva siromaštvo.

For one thing, it strikes hardest during harvest season,

Kao prvo, najizraženija je tokom žetve,

so exactly when farmers need to be out in the fields

dakle, baš kada seljaci moraju biti vani, sakupljati

collecting their crops, they're home sick with a fever.

letinu u poljima, oni su kod kuće ophrvani groznicom.

But it also predisposes people to death

Takođe, čini ljude sklonijim smrti

from all other causes.

od raznih drugih uzroka.

So this has happened historically.

Dakle, ovo je istorijski sled događaja.

We've been able to take malaria out of a society.

Uspeli smo da uklonimo malariju iz društva.

Everything else stays the same,

Sve ostalo ostaje isto,

so we still have bad food, bad water, bad sanitation,

i dalje imamo lošu hranu, vodu, sanitarije,

all the things that make people sick.

sve što ljude čini bolesnima.

But just if you take malaria out,

Samim uklanjanjem malarije,

deaths from everything else go down.

smanjuju se smrtni slučajevi od svega ostalog.

And the economist Jeff Sachs has actually quantified

Ekonomista Džef Saks je čak i izračunao

what this means for a society.

šta ovo znači za društvo.

What it means is, if you have malaria in your society,

To znači da ukoliko imate malariju u svom društvu,

your economic growth is depressed

vaš ekonomski rast je umanjen za 1,3 procenta

by 1.3 percent every year,

svake godine,

year after year after year, just this one disease alone.

godinu za godinom za godinom, samo od ove jedne bolesti.

So this poses a huge economic challenge,

Ovo je ogroman ekonomski izazov,

because say you do come up with your great drug

jer ako, recimo, otkrijete odličan lek

or your great vaccine -- how do you deliver it

ili odličnu vakcinu - kako ih isporučiti

in a place where there's no roads,

na mestima gde nema puteva,

there's no infrastructure,

infrastrukture,

there's no electricity for refrigeration to keep things cold,

struje za firižidere koji hlade stvari,

there's no clinics, there's no clinicians

bolnica, doktora

to deliver these things where they're needed?

da pruže ove stvari tamo gde su neophodne?

So there's a huge economic challenge in taming malaria.

Postoji ogroman ekonomski izazov u obuzdavanju malarije.

But along with the scientific challenge and the economic challenge,

Pored naučnog i ekonomskog izazova,

there's also a cultural challenge,

postoji i kulturološki izazov,

and this is probably the part about malaria

a to je najverovatnije deo o malariji

that people don't like to talk about.

o kojem ljudi ne vole da pričaju.

And it's the paradox that the people

Paradoks je to što su ljudi

who have the most malaria in the world

koji imaju najviše malarije na svetu

tend to care about it the least.

skloni da najmanje brinu o njoj.

This has been the finding of medical anthropologists again and again.

Ovo je iznova i iznova rezultat istraživanja medicinskih antropologa.

They ask people in malarious parts of the world,

Pitaju ljude u malaričnim delovima sveta:

"What do you think about malaria?"

"Šta mislite o malariji?"

And they don't say, "It's a killer disease. We're scared of it."

Odgovori nisu: "To je smrtonosna bolest. Bojimo je se."

They say, "Malaria is a normal problem of life."

Odgovor je: "Malarija je normalni životni problem."

And that was certainly my personal experience.

A to je zasigurno bilo i moje lično iskustvo.

When I told my relatives in India

Kada sam govorila rođacima u Indiji

that I was writing a book about malaria,

da pišem knjigu o malariji,

they kind of looked at me like

gledali su me kao da sam

I told them I was writing a book about warts or something.

im rekla da pišem knjigu o bradavicama ili slično.

Like, why would you write about something so boring,

Zašto želiš da pišeš o nečemu tako dosadnom,

so ordinary? You know?

tako običnom? Razumete?

And it's simple risk perception, really.

Zapravo se radi o precepciji rizika.

A child in Malawi, for example,

Devojčica u Malaviju, na primer,

she might have 12 episodes of malaria before the age of two,

može imati 12 epizoda malarije pre svoje druge godine,

but if she survives,

ali ako preživi,

she'll continue to get malaria throughout her life,

nastaviće da dobija malariju tokom života,

but she's much less likely to die of it.

ali će verovatnoća smrti biti mnogo manja.

And so in her lived experience,

Kroz njeno proživljeno iskustvo,

malaria is something that comes and goes.

malarija je nešto što dolazi i prolazi.

And that's actually true for most of the world's malaria.

A to je istinito za većinu svetske malarije.

Most of the world's malaria comes and goes on its own.

Većina svetske malarije dolazi i prolazi sama od sebe.

It's just, there's so much malaria

Samo što ima tako puno malarije

that this tiny fraction of cases that end in death

da ovaj sitni deo slučajeva sa smrtnim ishodom

add up to this big, huge number.

upotpunjuje taj ogromni broj.

So I think people in malarious parts of the world

Mislim da ljudi u malaričnom delu sveta

must think of malaria the way

sigurno misle o malariji kao što

those of us who live in the temperate world

mi koji živimo u umerenom delu sveta

think of cold and flu. Right?

mislimo o prehladi i gripu. Zar ne?

Cold and flu have a huge burden on our societies

Prehlada i grip su veliki teret za naša društva

and on our own lives,

i naše živote,

but we don't really even take

ali mi ne preduzimamo

the most rudimentary precautions against it because

ni najosnovnije mere opreza protiv njih jer smatramo

we consider it normal to get cold and flu

normalnim da se prehladimo ili dobijemo grip

during cold and flu season.

tokom sezone prehlade i gripa.

And so this poses a huge cultural challenge in taming malaria,

Ovo predstavlja ogroman kulturološki izazov u obuzdavanju malarije,

because if people think it's normal to have malaria,

jer ako ljudi misle da je normalno imati malariju,

then how do you get them to run to the doctor

kako ih onda naterati da idu doktoru da im

to get diagnosed, to pick up their prescription,

postavi dijagonozu, da preuzmu svoje recepte,

to get it filled, to take the drugs,

da preuzmu lekove, da uzimaju lekove,

to put on the repellents, to tuck in the bed nets?

da uključe sredstvo protiv komaraca, koriste mreže?

This is a huge cultural challenge in taming this disease.

Ovo je ogroman kulturološki izazov u obuzdavanju ove bolesti.

So take all that together.

Sveukupno, imamo

We've got a disease. It's scientifically complicated,

jednu bolest koja je naučno komplikovana,

it's economically challenging to deal with,

ekonomski zahtevna,

and it's one for which the people who stand

i koja najmanje interesuje ljude koji

to benefit the most care about it the least.

mogu imati najviše koristi.

And that adds up to the biggest problem of all,

Sve to zajedno predstavlja najveći problem od svih,

which, of course, is the political problem.

koji je, naravno, politički problem.

How do you get a political leader to do anything

Kako pokrenuti političare da urade nešto

about a problem like this?

u vezi sa ovakvim problemom?

And the answer is, historically, you don't.

A odgovor je, istorijski, ništa.

Most malarious societies throughout history

Većina malaričnih društava je tokom istorije

have simply lived with the disease.

jednostavno živela sa ovom bolešću.

So the main attacks on malaria have come

Glavni udari na malariju su dolazili

from outside of malarious societies,

izvan malaričnih društava,

from people who aren't constrained

od ljudi koji nisu sputani

by these rather paralyzing politics.

ovakvom parališućom politikom.

But this, I think, introduces a whole host of other kinds of difficulties.

Mislim da ovo pak uvodi potpuno novu grupu teškoća

The first concerted attack against malaria

Prvi organizovani udar na malariju

started in the 1950s.

je otpočeo 1950-ih.

It was the brainchild of the U.S. State Department.

Bio je zamisao američkog Stejt Dipartmenta.

And this effort well understood the economic challenge.

Ovaj pokušaj je dobro razumeo ekonomski izazov.

They knew they had to focus on cheap, easy-to-use tools,

Znali su da su morali da se fokusiraju na jeftino i lako upotrebljivo oruđe,

and they focused on DDT.

i fokusirali su se na DDT.

They understood the cultural challenge.

Razumeli su kulturološki izazov.

In fact, their rather patronizing view was that

Zapravo, imali su prilično pokroviteljski stav u tome

people at risk of malaria shouldn't be asked to do anything at all.

što su smatrali da ljudi izloženi riziku od malarije ne bi trebalo ništa da rade.

Everything should be done to them and for them.

Sve treba biti učinjeno njima i za njih.

But they greatly underestimated the scientific challenge.

Ali su jako potcenili naučni izazov.

They had so much faith in their tools

Imali su toliko vere u svoja oruđa

that they stopped doing malaria research.

da su prestali da istražuju malariju.

And so when those tools started to fail,

A kada su ta oruđa postala nedovoljna,

and public opinion started to turn against those tools,

i javno mnjenje počelo da se protivi tim oruđima,

they had no scientific expertise to figure out what to do.

nisu imali naučno znanje kako bi pronašli rešenje.

The whole campaign crashed, malaria resurged back,

Ceo projekat se srušio, malarija se vratila,

but now it was even worse than before

ali je sada bila gora nego ranije

because it was corralled into the hardest-to-reach places

jer se zabarikadirala u nepristupačnim predelima

in the most difficult-to-control forms.

u oblicima najtežim za kontrolu.

One WHO official at the time actually called that whole campaign

Jedan zvaničnik SZO u to doba je čak nazvao ceo projekat

"one of the greatest mistakes ever made in public health."

"jednom od najvećih grešaka ikada napravljenih u javnom zdravstvu."

The latest effort to tame malaria started in the late 1990s.

Poslednji pokušaj da se obuzda malarija je otpočeo kasnih 1990-ih.

It's similarly directed and financed primarily

I njegovo finansiranje i usmeravanje dolazi

from outside of malarious societies.

izvan malaričnih društava.

Now this effort well understands the scientific challenge.

Ali ovaj pokušaj dobro razume naučni izazov.

They are doing tons of malaria research.

Obavljaju hrpu istraživanja malarije.

And they understand the economic challenge too.

Takođe, razumeju i ekonomski izazov.

They're focusing on very cheap, very easy-to-use tools.

Usredsređuju se na veoma jeftina, lako upotrebljiva oruđa.

But now, I think, the dilemma is the cultural challenge.

Ali mislim da je ovaj put dilema kulturološki izazov.

The centerpiece of the current effort is the bed net.

Centralni pojam u aktuelnom pokušaju je mreža za krevet.

It's treated with insecticides.

Tretira se insekticidima.

This thing has been distributed across the malarious world

Distribuira se širom malaričnog sveta

by the millions.

u milionima.

And when you think about the bed net,

A kad razmislite o mreži za krevet,

it's sort of a surgical intervention.

ona je neka vrsta hirurške intervencije.

You know, it doesn't really have any value

Nema neku stvarnu vrednost

to a family with malaria except that it helps prevent malaria.

porodici sa malarijom izuzev što pomaže u sprečavanju malarije.

And yet we're asking people to use these nets every night.

A ipak tražimo od ljudi da ih koriste svaku noć.

They have to sleep under them every night.

Moraju da spavaju pod njima svaku noć.

That's the only way they are effective.

Samo tako su delotvorne.

And they have to do that

A to moraju raditi čak

even if the net blocks the breeze,

i ako mreža sprečava povetarac,

even if they might have to get up in the middle of the night

čak i ako moraju ustati tokom noći

and relieve themselves,

da se olakšaju,

even if they might have to move all their furnishings

čak i ako bi to značilo da moraju da pomere sav svoj nameštaj

to put this thing up,

kako bi je okačili,

even if, you know, they might live in a round hut

čak i ako žive u okrugloj kolibi

in which it's difficult to string up a square net.

u kojoj je teško postaviti četvrtastu mrežu.

Now that's no big deal if you're fighting a killer disease.

To nije nikakav problem ako se borite protiv smrtonosne bolesti.

I mean, these are minor inconveniences.

Hoću reći, to su manje nelagodnosti.

But that's not how people with malaria think of malaria.

Ali ljudi sa malarijom ne razmišljaju tako o malariji.

So for them, the calculus must be quite different.

Dakle, njihova računica je sigurno drukčija.

Imagine, for example, if a bunch of well-meaning Kenyans

Zamislite, na primer, da grupa dobronamernih Kenijaca

came up to those of us in the temperate world and said,

kaže nama koji smo u umerenoj klimi:

"You know, you people have a lot of cold and flu.

"Znate, vi imate mnogo prehlade i gripa.

We've designed this great, easy-to-use, cheap tool,

Dizajnirali smo jedno odlično, lako za upotrebu, jeftino oruđe,

we're going to give it to you for free.

koje ćemo vam dati besplatno.

It's called a face mask,

Zove se maska za lice,

and all you need to do is

i sve što treba da radite je

wear it every day during cold and flu season

da je nosite svaki dan u školi ili na poslu

when you go to school and when you go to work."

tokom sezone prehlade i gripa."

Would we do that?

Da li bismo to uradili?

And I wonder if that's how people

Pitam se da li su tako ljudi

in the malarious world thought of those nets

u malaričnom svetu mislili o tim mrežama

when they first received them?

kada su ih dobili prvi put?

Indeed, we know from studies

Zaista, znamo iz istraživanja

that only 20 percent of the bed nets

da je stvarno upotrebljeno svega 20 procenata

that were first distributed were actually used.

mreža za krevet koje su isporučene na početku.

And even that's probably an overestimate,

A čak je i to najverovatnije precenjeno,

because the same people who distributed the nets

jer su isti ljudi koji su raspodelili mreže bili ti

went back and asked the recipients,

koji su se vratili i pitali primaoce,

"Oh, did you use that net I gave you?"

"Oh, da li ste upotrebili mrežu koju sam vam dao?"

Which is like your Aunt Jane asking you,

Što je kao da vas je vaša tetka Džejn pitala,

"Oh, did you use that vase I gave you for Christmas?"

"Oh, da li si upotrebila onu vazu što sam ti dala za Božić?"

So it's probably an overestimate.

Dakle, najverovatnije je precenjeno.

But that's not an insurmountable problem.

Ali to nije nepremostiv problem.

We can do more education,

Možemo vršiti više obrazovanja,

we can try to convince these people to use the nets.

možemo pokušati da ubedimo ljude da koriste mreže.

And that's what happening now.

A to se i dešava trenutno.

We're throwing a lot more time and money

Bacamo više vremena i novca

into workshops and trainings and musicals and plays

u radionice i obuku i mjuzikle i predstave

and school meetings,

i školske sastanke,

all these things to convince people

sve ove stvari kako bismo ubedili ljude

to use the nets we gave you.

da koriste mreže koje smo im dali.

And that might work.

To možda upali.

But it takes time. It takes money.

Ali potrebno je vreme. Novac.

It takes resources. It takes infrastructure.

Potrebni su resursi. Infrastruktura.

It takes all the things that that cheap,

Potrebne su sve te stvari koje ona jeftina,

easy-to-use bed net was not supposed to be.

mreža za krevet koja je laka za upotrebu nije trebala da bude.

So it's difficult to attack malaria from inside malarious societies,

Teško je napadati malariju unutar malaričnih društava,

but it's equally tricky when we try to attack it

ali je jednako nezgodno kada mi pokušavamo da je napadnemo

from outside of those societies.

sa oboda tih društava.

We end up imposing our own priorities

Završimo tako što namećemo svoje prioritete

on the people of the malarious world.

ljudima u malaričnom svetu.

That's exactly what we did in the 1950s,

Upravo to smo uradili 1950-ih,

and that effort backfired.

i taj pokušaj nam se obio o glavu.

I would argue today,

Rekla bih danas da,

when we are distributing tools that we've designed

kada raspodeljujemo oruđa koja smo mi dizajnirali

and that don't necessarily make sense in people's lives,

i koja ne moraju imati smisla u životima ljudi,

we run the risk of making the same mistake again.

rizikujemo da ponovimo istu grešku.

That's not to say that malaria is unconquerable,

To ne znači da malarija nije pobediva,

because I think it is,

jer mislim da jeste,

but what if we attacked this disease

ali šta ako napadnemo ovu bolest

according to the priorities of the people who lived with it?

u skladu sa prioritetima ljudi koji žive sa njom?

Take the example of England and the United States.

Uzimo primer Engleske i SAD.

We had malaria in those countries for hundreds of years,

Stotinama godina smo imali malariju u ovim zemljama,

and we got rid of it completely,

i u potpunosti smo je se otarasili,

not because we attacked malaria. We didn't.

ne zato što smo napali malariju. Nismo.

We attacked bad roads and bad houses

Napali smo loše puteve, loše kuće

and bad drainage and lack of electricity and rural poverty.

i loš odvod vode i nedostatak struje i seosko siromaštvo.

We attacked the malarious way of life,

Napali smo malarični način života,

and by doing that, we slowly built malaria out.

i čineći to, lagano izopštili malariju.

Now attacking the malarious way of life,

Sad, napadanje malaričnog načina života,

this is something -- these are things people care about today.

- to su stvari do kojih je ljudima danas stalo.

And attacking the malarious way of life,

I napadanje malaričnog načina života,

it's not fast, it's not cheap, it's not easy,

nije brzo, nije jeftino, nije lako,

but I think it's the only lasting way forward.

ali mislim da je jedini održivi put napred.

Thank you so much.

Mnogo vam hvala.

(Applause)

(Aplauz)