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

翻译人员: Tian Ye 校对人员: Chen Livia

The child's symptoms begin

这个患儿的症状首先是

with mild fever, headache, muscle pains,

低烧、头痛和肌肉痛，

followed by vomiting and diarrhea,

之后出现呕吐和腹泻，

then bleeding from the mouth, nose and gums.

后来口、鼻和牙龈开始出血，

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

最终由于低血压引起器官衰竭，导致死亡

Sounds familiar?

是不是听起来很熟悉？

If you're thinking this is Ebola,

如果你觉得这会不会是埃博拉，

actually, in this case, it's not.

实际上，就本例来说并不是。

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

本例是登革热的极端形式， 这是一种通过蚊子传播的疾病，

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

它也没有有效的治疗方法或疫苗，

and kills 22,000 people each year.

并且每年杀死2.2万人。

That is actually twice the number of people

其实，这一数字相当于

that have been killed by Ebola

埃博拉病毒，在自我们知道它以来的

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

近40年里，所杀死的人数的两倍

As for measles, so much in the news recently,

而近期新闻中频繁提到的麻疹

the death toll is actually tenfold higher.

死亡人数实际上是登革热的十倍之多。

Yet for the last year,

然而在去年，

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

占据所有头条，引起所有恐慌的 却是埃博拉。

Clearly, there is something deeply rooted about it,

显然，有某种东西深深地根植其中，

something which scares us and fascinates us

这种东西让我们如此害怕， 成为了挥之不去的阴影，

more than other diseases.

没有其它疾病能做到这一点。

But what is it, exactly?

而它到底是什么呢？

Well, it's hard to acquire Ebola,

其实，得上埃博拉是很不容易的，

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

但如果真的患病， 以可怕的死状离去，是极有可能的。

Why?

为什么？

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

因为现在我们没有任何有效的治疗方法或疫苗可用。

And so, that's the clue.

所以，这就是原因。

We may have it someday.

可能我们终将研制出来。

So we rightfully fear Ebola,

所以我们害怕埃博拉，是合情合理的，

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

因为它杀死的人没有其它疾病那么多，

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

实际上，它的传染性比 流感和麻疹之类的病毒，低多了。

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

我们害怕埃博拉是因为这一事实： 它能杀死我们，我们却无能为力。

We fear the certain inevitability that comes with Ebola.

我们害怕伴随埃博拉而来的某种不可避免性。

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

埃博拉的这种不可避免性 似乎是在挑战现代医学。

But wait a second, why is that?

等一下，为什么会这样？

We've known about Ebola since 1976.

从1976年起我们就知道埃博拉了，

We've known what it's capable of.

我们知道它有多厉害，

We've had ample opportunity to study it

我们也有足够的机会来研究它，

in the 24 outbreaks that have occurred.

因为一共出现了24起爆发的病例。

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

而实际上， 现在我们手上已经有了候选疫苗，

for more than a decade.

在十多年前就有了。

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

那为什么这些疫苗到现在才进行临床实验？

This goes to the fundamental problem we have

这就遇到了研制感染性疾病的疫苗时

with vaccine development for infectious diseases.

面临的根本问题。

It goes something like this:

大致情况是这样：

The people most at risk for these diseases

患上这些疾病风险最高的人

are also the ones least able to pay for vaccines.

也是最无力支付疫苗的一群人。

This leaves little in the way of market incentives

这就导致几乎没有市场动力

for manufacturers to develop vaccines,

来推动生产商研制疫苗，

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

除非在富国有大量人群面临风险。

It's simply too commercially risky.

简单来说，商业风险过高。

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

至于埃博拉，则完全没有市场，

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

所以，如今我们能有两种疫苗进入后期临床实验，

is actually because of a somewhat misguided fear.

唯一的原因是，有点被误导的恐惧。

Ebola was relatively ignored

相对来说，埃博拉一直以来被忽视了，

until September 11 and the anthrax attacks,

直到911和炭疽袭击，

when all of a sudden, people perceived Ebola

突然之间，人们意识到

as, potentially, a bioterrorism weapon.

埃博拉是一种潜在的，具有生物恐怖袭击性的武器。

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

为什么这时埃博拉疫苗还没有完全研制出来？

Well, partially, because it was really difficult --

部分是因为非常困难--

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

或者说觉得很困难-- 来使病毒武器化。

but mainly because of the financial risk in developing it.

但主要原因是研制疫苗的财务风险。

And this is really the point.

这一点是问题真正所在。

The sad reality is, we develop vaccines

现实的可悲之处在于，

not based upon the risk the pathogen poses to people,

我们研制一种疫苗， 并非是考虑病原体对人类的风险有多大，

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

而是考虑研制疫苗的经济风险有多大。

Vaccine development is expensive and complicated.

研制疫苗既昂贵又复杂，

It can cost hundreds of millions of dollars

要花费高达数亿美元

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

才能选出一种，甚至是已经熟知的抗原， 将它转化为可用的疫苗。

Fortunately for diseases like Ebola,

幸运的是，对于像埃博拉这样的疾病，

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

我们还是可以做一些事情 来打破这些壁垒的。

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

首先，要承认市场已经完全不起作用的现状，

In that case, if we want vaccines,

在这种情况下，如果我们想得到疫苗，

we have to provide incentives or some type of subsidy.

就必须提供奖励措施，或某种形式的补贴。

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

我们也需要更加努力，

which are the diseases that most threaten us.

来找出对我们威胁最大的疾病有哪些。

By creating capabilities within countries, we then create the ability

首先确立这些国家内部的研发力量，在此基础上

我们帮助这些国家建起 创立流行病学和实验室网络的能力，

for those countries to create epidemiological and laboratory networks

which are capable of collecting and categorizing these pathogens.

有了这些， 我们就有能力采集这些病原体，并进行分类。

The data from that then can be used

由此而来的数据

to understand the geographic and genetic diversity,

可用于了解其地理分布和遗传多样性，

which then can be used to help us understand

有助于帮助我们了解

how these are being changed immunologically,

这些免疫学上的变化是如何产生的

and what type of reactions they promote.

以及促进了哪种类型的反应。

So these are the things that can be done,

所以说，这些事情是可以做的，

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

但要做到这些， 如果我们想要在市场无力的情况下解决问题，

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

就必须改变我们看待、预防传染性疾病的方法。

We have to stop waiting until we see evidence

我们不能在看到疾病成为全球性威胁的证据之前， 总是袖手旁观。

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

当我们认为它是的时候，就应该行动起来

So, for Ebola,

所以，对于埃博拉来说，

the paranoid fear of an infectious disease,

对传染性疾病的极度恐慌，

followed by a few cases transported to wealthy countries,

出现于几例传染者转移至富裕国家之后。

led the global community to come together,

这种恐慌促使全球各国携起手来，

and with the work of dedicated vaccine companies,

加上专门的疫苗公司的努力，

we now have these:

我们才有了现在的结果：

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

两种埃博拉疫苗正在发病国家进行疗效试验，

(Applause)

（掌声）

and a pipeline of vaccines that are following behind.

后续还会有疫苗不断地生产出来。

Every year, we spend billions of dollars,

每年我们花费数十亿美元，

keeping a fleet of nuclear submarines permanently patrolling the oceans

以维持核潜艇舰队， 在海洋中持续巡逻，

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

而这支舰队所预防的威胁， 几乎可以肯定绝不会出现。

And yet, we spend virtually nothing

然而，我们又实际上几乎没有花费多少钱

to prevent something as tangible and evolutionarily certain

来预防流行性传染病这样的问题，

as epidemic infectious diseases.

这个问题切实存在，并且一定是不断进化的。

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

对此不应当犯错-- 这不是“如果”的问题，而是“什么时候”的问题。

These bugs are going to continue to evolve

这些病毒还会不断进化，

and they're going to threaten the world.

还会威胁整个世界，

And vaccines are our best defense.

而疫苗是我们的最佳防御手段。

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

所以如果我们想要预防譬如埃博拉的蔓延，

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

我们就必须承担风险，

and in stockpile creation.

向疫苗研制与物资储备投入资金。

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

而且我们应当，把它看作最终防线--

something we make sure is available,

我们确保有效的良方，

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

而与此同时， 祈祷永远不要用到它。

Thank you.

谢谢大家。

(Applause)

（掌声）