Larry Brilliant: TED Prize wish: Help stop the next pandemic

247,694 views ・ 2007-01-16

TED


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譯者: Joan Liu 審譯者: Inder Peng(彭)
00:25
I'm the luckiest guy in the world.
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我是這世界上最幸運的人。
00:27
I got to see the last case of killer smallpox in the world.
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我有機會看到世界上最後一宗致命天花的案例。
去年我在印度
00:33
I was in India this past year,
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可能也看到世上最後一宗小兒痲痹案例。
00:35
and I may have seen the last cases of polio in the world.
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00:40
There's nothing that makes you feel more --
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沒有什麼比這感覺更好的:有這樣的福氣及榮耀
00:43
the blessing and the honor of working in a program like that --
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可以在這樣一個團隊中工作
00:48
than to know that something that horrible no longer exists.
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知道這麼恐怖的東西不復存在。
00:52
So I'm going to tell you --
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所以,我要說 (掌聲)
00:53
(Applause)
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00:56
so I'm going to show you some dirty pictures.
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所以,我要給你們看一些可怕的圖片。
00:59
They are difficult to watch, but you should look at them with optimism,
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看這些圖片很難熬,但你們應該抱以樂觀的態度
01:05
because the horror of these pictures will be matched
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因為圖片恐怖的程度
01:10
by the uplifting quality of knowing that they no longer exist.
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與知道它們不復存在所帶來的振奮感相當。
01:15
But first, I'm going to tell you a little bit about my own journey.
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但我要先告訴你們一些我經歷的事。
01:20
My background is not exactly the conventional medical education
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我的背景不完全像你們預期的
01:23
that you might expect.
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傳統醫學教育。
01:26
When I was an intern in San Francisco,
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我在舊金山實習的時候,
我聽說有一群美國原住民(美洲印第安人)
01:31
I heard about a group of Native Americans who had taken over Alcatraz Island,
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居住在惡魔島(Alcatraz Island),
01:34
and a Native American who wanted to give birth on that island,
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有一個印地安人在島上要生小孩,
01:38
and no other doctor wanted to go and help her give birth.
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但沒有醫生想去那裡幫她接生。
01:42
I went out to Alcatraz, and I lived on the island for several weeks.
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我去了惡魔島,在那住了幾個禮拜。
01:46
She gave birth; I caught the baby; I got off the island;
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她生了小孩,我接生了嬰兒,然後我離開那個島。
01:49
I landed in San Francisco;
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我回到舊金山,所有媒體都想要訪問我,
01:51
and all the press wanted to talk to me,
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01:53
because my three weeks on the island made me an expert in Indian affairs.
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因為在那兒的三個禮拜,讓我成為印地安問題的專家。
01:57
(Laughter)
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01:58
I wound up on every television show.
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我上了每個電視節目。
02:00
Someone saw me on television; they called me up; and they asked me
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有人看到我在節目上,打電話問我
02:03
if I'd like to be in a movie and to play a young doctor
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願不願意在一部電影中演個
02:06
for a bunch of rock and roll stars who were traveling in a bus ride
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一群搭車由舊金山前往英國的搖滾樂星們
02:09
from San Francisco to England.
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的隨隊年輕醫生。我說:「好,我可以。」
02:11
And I said, yes, I would do that,
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02:13
so I became the doctor in an absolutely awful movie
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所以我成為一部大爛片中的醫生,
02:17
called "Medicine Ball Caravan."
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這部片叫「Medicine Ball Caravan」。
02:19
(Laughter)
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02:20
Now, you know from the '60s,
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好,你知道在六零年代,
02:21
you're either on the bus or you're off the bus; I was on the bus.
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你要不是在車上旅行; 就是根本不在車上。(摘錄Ken Kesey 的名言,指跟 Kesey 同陣線或不同)
02:24
My wife of 37 years and I joined the bus.
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我在車上。我太太和我,共37年,加入了車隊(指這事業)。
02:27
Our bus ride took us from San Francisco to London,
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我們的車帶我們從舊金山到倫敦。
02:30
then we switched buses at the big pond.
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我們在大西洋換了車。然後又換了兩次車
02:32
We then got on two more buses
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我們開過土耳其、伊朗、阿富汗、
02:36
and we drove through Turkey and Iran, Afghanistan,
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穿過開伯爾山口進入巴基斯坦,就跟其他年輕醫生一樣。
02:39
over the Khyber Pass into Pakistan, like every other young doctor.
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02:43
This is us at the Khyber Pass, and that's our bus.
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這是我們在開伯爾山口,那是我們的車。
02:45
We had some difficulty getting over the Khyber Pass.
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我們在穿越開伯爾山口時遇到些困難,
02:49
But we wound up in India.
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但我們最後到了印度。
02:51
And then, like everyone else in our generation,
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然後,跟所有我們這輩的人一樣,
02:53
we went to live in a Himalayan monastery.
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我們住在喜馬拉雅山脈的修道院內。
02:56
(Laughter)
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(笑聲)
02:59
This is just like a residency program,
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這是我們的駐院醫師實習訓練,
03:01
for those of you that are in medical school.
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跟醫學院的學生所應受的駐院實習訓練一樣.
03:03
(Laughter)
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我們跟一個很有智慧的人學習,叫Karoli Baba的古魯(印度教的導師),
03:05
And we studied with a wise man, a guru named Karoli Baba,
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03:10
who then told me to get rid of the dress,
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他告訴我們脫下袍子
03:13
put on a three-piece suit,
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穿上西裝
03:15
go join the United Nations as a diplomat
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去加入聯合國當個外交官
為世界衛生組織工作。
03:19
and work for the World Health Organization.
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03:21
And he made an outrageous prediction that smallpox would be eradicated,
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他還不可思議的預測天花可以被消滅,
03:25
and that this was God's gift to humanity,
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而這是上帝給人類的禮物,
03:28
because of the hard work of dedicated scientists.
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因為在這些科學家的努力下
03:31
And that prediction came true.
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這個預測成真了。這個小女孩是Rahima Banu,
03:34
This little girl is Rahima Banu,
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03:36
and she was the last case of killer smallpox in the world.
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她是最後一宗致命天花的患者。
03:40
And this document is the certificate that the global commission signed,
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這是一張世界委員會開的證明文件
03:45
certifying the world to have eradicated the first disease in history.
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證明史上第一次消滅一種疾病。
03:51
The key to eradicating smallpox was early detection, early response.
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消滅天花最重要的是早發現、早行動。
03:57
I'm going to ask you to repeat that: early detection, early response.
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我要你們重複這個「早發現、早行動」
04:01
Can you say that?
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你們可以說嗎?
04:02
Audience: Early detection, early response.
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觀眾:早發現、早行動。
04:05
Larry Brilliant: Smallpox was the worst disease in history.
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Larry Brilliant:天花是史上最嚴重的疾病。
04:08
It killed more people than all the wars in history.
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它殺死的人比任何戰爭都多。
04:11
In the last century, it killed 500 million people.
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在上個世紀,有五億人死於天花。
04:17
You're reading about Larry Page already.
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超過兩個--你已經在看Larry Page了,
04:19
Somebody reads very fast.
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有些人看得很快。(笑聲)
04:21
(Laughter)
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在Larry Page和Sergey Brinn--
04:23
In the year that Larry Page and Sergey Brin --
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04:25
with whom I have a certain affection and a new affiliation --
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我和他們有些關係和最近的新組織--
04:28
in the year in which they were born,
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在他們出生那年,
兩百萬人死於天花。
04:31
two million people died of smallpox.
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我們在1980年宣布天花被消滅了。
04:34
We declared smallpox eradicated in 1980.
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04:38
This is the most important slide that I've ever seen in public health,
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這是我在公衛上看過最重要的投影片,
04:42
[Sovereigns killed by smallpox] because it shows you
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因為它告訴你:就算你是最富有,最有強壯的人、
04:44
to be the richest and the strongest,
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04:46
and to be kings and queens of the world,
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是世界上最有權的國王皇后(埃及法老照片:死於天花)
04:48
did not protect you from dying of smallpox.
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也沒辦法讓你不受害於天花。
04:50
Never can you doubt that we are all in this together.
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無法否認, 我們大家在同一條船上.
04:55
But to see smallpox from the perspective of a sovereign
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以一個最高統治者的角度來看天花
04:59
is the wrong perspective.
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是錯誤的。
05:01
You should see it from the perspective of a mother,
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你應該以一個母親的角色
05:04
watching her child develop this disease and standing by helplessly.
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看他的孩子染病卻束手無策。
05:07
Day one, day two, day three,
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第一天、第二天、第三天、第四天、第五天、第六天。
05:13
day four, day five, day six.
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05:19
You're a mother and you're watching your child,
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你是個母親而你正在看你的小孩,
05:22
and on day six, you see pustules that become hard.
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在第六天,你看到膿包變硬。
第七天,你看到天花經典的臍狀疤。
05:28
Day seven, they show the classic scars of smallpox umbilication.
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05:33
Day eight.
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第八天。
05:34
And Al Gore said earlier
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高爾之前說世界上最常被拍照的、
05:36
that the most photographed image in the world,
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05:39
the most printed image in the world,
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最常被印出來的圖片
05:40
was that of the Earth.
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是地球。但在1974年,
05:42
But this was in 1974, and as of that moment,
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這張照片才是
05:45
this photograph was the photograph that was the most widely printed,
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曝光率最高的.
05:49
because we printed two billion copies of this photograph,
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因為我們為這張照片印了二十億張
05:52
and we took them hand to hand, door to door,
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我們拿著它們挨家挨戶
給人們看並問他們家中有沒有天花病患.
05:56
to show people and ask them if there was smallpox in their house,
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06:00
because that was our surveillance system.
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因為那是我們的監控系統。我們沒有Google、
06:03
We didn't have Google, we didn't have web crawlers,
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我們沒有網路爬蟲(自動化瀏覽網路)、我們沒有電腦。
06:05
we didn't have computers.
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06:08
By day nine -- you look at this picture and you're horrified;
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到了第九天,你看這張圖片,你會驚駭。
06:12
I look at this picture and I say, "Thank God,"
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我看這張圖片而我會說:「感謝上帝」
06:15
because it's clear that this is only an ordinary case of smallpox,
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因為這代表了這只是普通的天花病例,
06:19
and I know this child will live.
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而我知道這個小孩會活下來。
06:22
And by day 13, the lesions are scabbing, his eyelids are swollen,
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到了第十三天,傷口長滿疙瘩、他的眼皮還是腫脹,
06:27
but you know this child has no other secondary infection.
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但這個孩子沒有繼發性感染。
到第二十天,雖然他會一生帶疤,但他會活下來。
06:32
And by day 20, while he will be scarred for life, he will live.
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還有其它種天花不是這樣的。
06:37
There are other kinds of smallpox that are not like that.
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06:40
This is confluent smallpox,
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這是個融合性天花,
06:42
in which there isn't a single place on the body where you could put a finger
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病人全身上下沒有任何一個地方有超過
06:46
and not be covered by lesions.
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手指頭大小的完好肌膚。
06:49
Flat smallpox, which killed 100 percent of people who got it.
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扁平天花,得病者百分之百死亡。
06:53
And hemorrhagic smallpox, the most cruel of all,
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出血性天花,最殘忍的,
06:56
which had a predilection for pregnant women.
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易感染於懷孕女性。
06:59
I've probably had 50 women die.
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我看過大約五十個女人死亡,她們全都染了出血性天花。
07:02
They all had hemorrhagic smallpox.
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07:04
I've never seen anybody die from it who wasn't a pregnant woman.
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我從來沒有看過一個出血性天花死亡者不是懷孕女性。
07:08
In 1967, the WHO embarked on what was an outrageous program
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在1967年,WHO開始了一個不可思議的計畫
07:12
to eradicate a disease.
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要消滅一個疾病。
07:14
In that year, there were 34 countries affected with smallpox.
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在那年,34個國家有天花病例。
07:18
By 1970, we were down to 18 countries.
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到了1970年,只剩下18個國家。
07:21
1974, we were down to five countries.
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1974年,只剩下五個國家。
07:24
But in that year, smallpox exploded throughout India.
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但在那年,天花在印度爆發。
印度也成為天花最後病例的所在地。
07:30
And India was the place where smallpox made its last stand.
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07:34
In 1974, India had a population of 600 million.
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1974年,印度有六億人口。
07:37
There are 21 linguistic states in India,
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那時印度有21個語言區,
07:40
which is like saying 21 different countries.
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就像是說有21個不同國家一樣。
07:43
There are 20 million people on the road at any time,
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任何時間都有兩千萬人在路上, 在搭著車、火車、
07:46
in buses and trains, walking; 500,000 villages, 120 million households,
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走路,有五十萬村莊、一億兩千萬戶人家,
07:52
and none of them wanted to report
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但沒有任何人願意告訴我們:他們家裡有天花病人
07:54
if they had a case of smallpox in their house,
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07:57
because they thought that smallpox was the visitation of a deity,
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因為他們認為天花是女神Shitala Mata
08:00
Shitala Mata, the cooling mother,
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(降溫女神)的拜訪,
08:02
and it was wrong to bring strangers into your house
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當女神來訪的時候不該讓陌生人進家門。
08:06
when the deity was in the house.
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所以沒有任何匯報天花役疫情的意願。
08:09
No incentive to report smallpox.
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08:11
It wasn't just India that had smallpox deities;
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不是只有印度有天花女神,
08:14
smallpox deities were prevalent all over the world.
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這種"天花神"的迷信在全世界各地普遍存在的。
08:18
So, how we eradicated smallpox was --
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所以我們要如何消滅天花?大眾接種是沒有用的。
08:21
mass vaccination wouldn't work.
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08:23
You could vaccinate everybody in India,
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你可以讓印度每個人都接種,
08:25
but one year later there'd be 21 million new babies,
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但一年後又有兩千一百萬新生兒,
08:28
which was then the population of Canada.
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在當時等於加拿大的人口。
08:30
It wouldn't do just to vaccinate everyone.
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為每個人打疫苗是沒有用的。
08:32
You had to find every single case of smallpox in the world
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你必須在同一時間找到全世界每一宗天花案例
08:36
at the same time, and draw a circle of immunity around it.
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且在每個案例周圍建立防疫圈。
08:39
And that's what we did.
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我們就是這麼做的。
08:42
In India alone, my 150,000 best friends and I went door to door,
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光在印度,我和我的十五萬好朋友們
拿著同樣的照片在印度
08:47
with that same picture,
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08:49
to every single house in India.
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挨家挨戶拜訪。我們拜訪了超過一千萬家庭。
08:51
We made over one billion house calls.
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08:54
And in the process, I learned something very important.
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在過程中,我學到一件重要的事情:
08:58
Every time we did a house-to-house search,
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我們每做一次門戶搜索,
天花病例的數目就突然高起來一次。
09:03
we had a spike in the number of reports of smallpox.
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09:07
When we didn't search, we had the illusion that there was no disease.
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當我們沒有搜索時,我們有了疾病被消除的假象。
09:12
When we did search, we had the illusion that there was more disease.
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當我們搜索時,我們有疾病病例增加的假象。
09:17
A surveillance system was necessary,
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一個監控系統是必須的,
09:19
because what we needed was early detection, early response.
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因為我們需要的是早發現,早行動。
09:26
So we searched and we searched,
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所以我們一直找一直找,找到
09:28
and we found every case of smallpox in India.
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印度的每一宗天花。我們提供獎勵。
09:31
We had a reward. We raised the reward.
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然後我們提高獎勵。我們繼續提高獎勵。
09:34
We continued to increase the reward.
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09:36
We had a scorecard that we wrote on every house.
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我們在每一棟房子牆上記錄到訪的日期(像計分表一樣)。
09:40
And as we did that,
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當我們一直這麼做時,天花病例的數目最後也降到零。
09:42
the number of reported cases in the world dropped to zero.
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在1980年,我們宣布天花不復存在。
09:46
And in 1980, we declared the globe free of smallpox.
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09:51
It was the largest campaign in United Nations history,
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這是聯合國在伊拉克戰爭前最大的活動,
09:56
until the Iraq war.
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十五萬人來自世界各地
09:58
150,000 people from all over the world --
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10:02
doctors of every race, religion, culture and nation,
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及不同種族、不同宗教、不同國家的醫生們,
10:04
who fought side by side, brothers and sisters,
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肩並肩,互相幫助而無紛爭,
10:09
with each other, not against each other,
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完成一個讓世界更美好的任務。
10:13
in a common cause to make the world better.
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10:16
But smallpox was the fourth disease that was intended for eradication.
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但天花是我們試著消滅的第四個疾病。
10:20
We failed three other times.
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我們之前失敗了三次。
10:22
We failed against malaria, yellow fever and yaws.
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在瘧疾、黃熱病和雅司(熱帶莓疹)病上我們都失敗了。
10:25
But soon we may see polio eradicated.
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不過很快的,小兒痲痹也會被消滅的。
10:29
But the key to eradicating polio is early detection, early response.
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消滅小兒痲痹的金鑰是:早發現,早行動。
10:35
This may be the year we eradicate polio.
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今年有可能是我們消滅小兒痲痹的一年,
10:38
That will make it the second disease in history.
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這就會是史上第二個被消滅的疾病。
10:41
And David Heymann, who's watching this on the webcast --
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David Heymann, 如果你透過網路轉播看這場演講。
10:45
David, keep on going. We're close!
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David, 繼續努力。我們快要做到了,我們只剩下四個國家。
10:48
We're down to four countries.
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10:50
(Applause)
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(掌聲)
10:56
I feel like Hank Aaron.
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我覺得我跟Hank Aaron(美國棒球球員)一樣, 會很快的被Barry Bonds(棒球球員)追上取代。
10:57
Barry Bonds can replace me any time.
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10:59
Let's get another disease off the list of terrible things to worry about.
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讓我們再把一個疾病從我們耽心的清單中移除。
11:04
I was just in India working on the polio program.
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我才在印度參與消滅小兒痲痹的工作。
11:08
The polio surveillance program is four million people going door to door.
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小兒痲痹的監控系統是四百萬人挨家挨戶去尋找。
11:13
That is the surveillance system.
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那是我們的監控系統。
11:16
But we need to have early detection, early response.
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我們需要早發現,早行動。
11:20
Blindness, the same thing.
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失明,一樣的。發現失明的鑰匙是
11:21
The key to discovering blindness is doing epidemiological surveys
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做流行病學問卷並找出失明的原因,
11:26
and finding out the causes of blindness,
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11:29
so you can mount the correct response.
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方能做出正確的反應。
11:32
The Seva Foundation was started by a group of alumni
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賽瓦基金會是由一群
11:36
of the Smallpox Eradication Programme,
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曾參與消滅天花的人組成的。
11:39
who, having climbed the highest mountain,
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這群人爬到了頂峰
11:42
tasted the elixir of the success of eradicating a disease,
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嘗了消滅一種疾病的成功滋味,
11:47
wanted to do it again.
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且想要再做一次。
11:49
And over the last 27 years, Seva's programs in 15 countries
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在過去的27年當中,賽瓦基金在十五個國家
11:53
have given back sight to more than two million blind people.
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已經幫兩百萬失明人士找回光明。
11:57
Seva got started because we wanted to apply these lessons
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賽瓦的開始是因為我們想要將
12:01
of surveillance and epidemiology
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監控系統和流行病學理論
12:03
to something which nobody else was looking at as a public health issue:
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用在其他人都不認為是
公衛的問題:失明。
12:07
blindness, which heretofore had been thought of only as a clinical disease.
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在這之前只被認為是個臨床疾病。
12:12
In 1980, Steve Jobs gave me that computer, which is Apple number 12,
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1980年賈伯斯給我一台電腦,蘋果第十二號,
它現在還在加德滿都(尼泊爾首都)運作著。
12:19
and it's still in Kathmandu, and it's still working,
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12:21
and we ought to go get it and auction it off and make more money for Seva.
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我們應該把它拿來拍賣,為賽瓦籌得到更多錢。
12:26
And we conducted the first Nepal survey ever done for health,
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我們做了史上第一個尼泊爾的健康問卷,
12:30
and the first nationwide blindness survey ever done,
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也是第一個全國性的失明問卷,
12:33
and we had astonishing results.
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而結果另我們吃驚。
12:35
Instead of finding out what we thought was the case --
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我們以為會得到的結果是:
12:38
that blindness was caused mostly by glaucoma and trachoma --
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青光眼和沙眼是造成失明主要的原因.
12:42
we were astounded to find out
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但我們驚訝的發現失明竟多數是由白內障造成的。
12:44
that blindness was caused instead by cataract.
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你不可能醫治或預防你不知道的東西。
12:49
You can't cure or prevent what you don't know is there.
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12:55
In your TED packages there's a DVD, "Infinite Vision,"
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在你們的TED包裹中有一片DVD「無限視覺」,
12:59
about Dr. V and the Aravind Eye Hospital.
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在講V醫生和Aravind眼科醫院。
13:02
I hope that you will take a look at it.
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我希望你們能看一看。
13:04
Aravind, which started as a Seva project,
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Aravind一開始是賽瓦的一個計畫,
13:06
is now the world's largest and best eye hospital.
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現在是世界上最大最好的眼科醫院。
13:09
This year, that one hospital will give back sight
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今年,這間醫院會在印度
13:12
to more than 300,000 people in Tamil Nadu, India.
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塔米德邦為三十萬人恢復視力。
13:16
(Applause)
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(掌聲)
13:20
Bird flu.
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禽流感。我在這裡為這些恐怖的事情發言--
13:21
I stand here as a representative of all terrible things --
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13:24
this might be the worst.
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這有可能是最遭的。
13:26
The key to preventing or mitigating pandemic bird flu
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防止或是減輕禽流感流行的鑰匙是
13:31
is early detection and rapid response.
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早發現、早行動。
13:34
We will not have a vaccine or adequate supplies of an antiviral
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在未來的三年中,我們不會有疫苗或是
13:39
to combat bird flu if it occurs in the next three years.
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足夠的抗病毒素來對抗禽流感。
13:43
WHO stages the progress of a pandemic.
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這是世界衛生組織將大流行病分級表。
13:47
We are now at stage three on the pandemic alert stage,
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我們現在在警戒區第三級,
13:51
with just a little bit of human-to-human transmission,
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只有一些些的人傳人病例,
13:55
but no human-to-human-to-human sustained transmission.
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但沒有大量人傳人病例。
13:59
The moment WHO says we've moved to category four --
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當世界衛生組織宣布我們在第四級時,
14:03
this will not be like Katrina.
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這不會像科特莉娜颶風只局部在一區。我們知道的世界將會停擺。
14:05
The world as we know it will stop.
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14:07
There'll be no airplanes flying.
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不會有任何飛機飛行。
14:10
Would you get in an airplane with 250 people you didn't know,
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你會願意搭乘一架有250個陌生人的飛機
14:13
coughing and sneezing,
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有人正在咳嗽和擤鼻涕,而你知道其中幾個
14:14
when you knew that some of them might carry a disease that could kill you,
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有可能帶有致人於死地的傳染病,
14:17
for which you had no antivirals or vaccine?
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而你沒有機會得到抗病毒素或疫苗嗎?
14:21
I did a study of the top epidemiologists in the world in October.
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我在十月的時候對世界頂尖的流行病學家做了問卷。
14:25
I asked them -- these are all fluologists and specialists in influenza --
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我問他們,這些人是流感病學家和流感病毒專家,
14:30
and I asked them the questions you'd like to ask them:
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我問他們你們也想問他們的問題。
14:32
What do you think the likelihood is that there'll be a pandemic?
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你覺得流感流行的可能性有多大?
14:36
If it happens, how bad do you think it will be?
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如果發生了,你覺得會有多嚴重?
14:39
Fifteen percent said they thought there'd be a pandemic within three years.
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百分之十五認為在三年內會發生流感。
14:43
But much worse than that,
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但更遭的是,
14:45
90 percent said they thought there'd be a pandemic
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百分之九十認為我們下一代
14:49
within your children or your grandchildren's lifetime.
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或下下一代也會有大流感流行。
14:53
And they thought that if there was a pandemic,
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而且他們認為如果流行了,
14:56
a billion people would get sick.
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會有十億人生病。
14:59
As many as 165 million people would die.
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大約一億六千五百萬人會死亡。
15:03
There would be a global recession and depression
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會發生全球蕭條及衰退,
15:06
as our just-in-time inventory system
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當恰好足夠的存貨系統,
15:08
and the tight rubber band of globalization broke,
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和全球緊密的架構崩潰,
15:12
and the cost to our economy of one to three trillion dollars
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將造成十到三十兆經濟損失,
15:16
would be far worse for everyone than merely 100 million people dying,
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會比一億人死亡更遭的是,
更多人會沒有工作,
15:22
because so many more people would lose their job
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15:24
and their healthcare benefits,
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他們的健保也沒了,
15:26
that the consequences are almost unthinkable.
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後果不堪設想。
15:30
And it's getting worse, because travel is getting so much better.
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而且情況這會越來越遭,因為旅遊越來越容易。(更易傳染)
15:36
Let me show you a simulation of what a pandemic looks like.
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讓我模擬一個流感的模型給你們看,
15:42
So we know what we're talking about.
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所以大家知道我在講甚麼。
15:45
Let's assume, for example, that the first case occurs in South Asia.
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讓我們預設,舉例來說,第一宗病例發生在亞洲南方。
15:50
It initially goes quite slowly.
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一開始非常緩慢。
15:52
You get two or three discrete locations.
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然後傳到兩到三個不同的地方。
15:57
Then there'll be secondary outbreaks, and the disease will spread
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會有個二度爆發,然後疾病會在
16:01
from country to country so fast that you won't know what hit you.
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國家跟國家之間傳播,快到你都不知道發生什麼事。
16:06
Within three weeks it will be everywhere in the world.
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三週內,全球各處都染上了。
16:10
Now, if we had an "undo" button, and we could go back and isolate it
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現在,如果我們有個還原鍵,我們可以回去並在疾病一開始時
16:16
and grab it when it first started -- if we could find it early,
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便抓住隔離它。如果我們可以早發現,
16:19
and we had early detection and early response,
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且我們有早探測到,早行動,
16:22
and we could put each one of those viruses in jail --
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這樣我們可以把每一個病毒關到牢裡,
16:25
that's the only way to deal with something like a pandemic.
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那是唯一可以阻止大流行(瘟疫)的方法。
16:32
And let me show you why that is.
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讓我給你們看為什麼。
16:35
We have a joke.
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我們有個笑話。這是流行病曲線。每個在醫學的人,
16:36
This is an epidemic curve, and everyone in medicine,
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16:39
I think, ultimately gets to know what it is.
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我想都會知道這是什麼。
16:41
But the joke is,
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笑話是這樣的:一個流行病學家喜歡來到流行病曲線
16:42
an epidemiologist likes to arrive at an epidemic right here
291
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16:45
and ride to glory on the downhill curve.
292
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的這裡, 然後享受隨曲線下滑的榮耀。
16:48
(Laughter)
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1103
16:49
But you don't get to do that usually.
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但大部份時候不是這樣的。
16:51
You usually arrive right about here.
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大部份時候你會來到這裡。
16:53
What we really want is to arrive right here, so we can stop the epidemic.
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我們想要的是來到這裡,這樣我們可以阻止疾病流行。
16:59
But you can't always do that.
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但你不是永遠都做得到的。幸好有個組織
17:01
But there's an organization that has been able to find a way
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找到一個可以得知第一宗病例發生的方法,
17:04
to learn when the first cases occur,
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17:07
and that is called GPHIN;
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這個組織叫做GPHIN。
17:09
it's the Global Public Health Information Network.
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Global Public Health Information Network (世界公衛資訊系統)
17:12
And that simulation that I showed you
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我剛剛給你們看的模擬,你們認為是禽流感的,
17:14
that you thought was bird flu -- that was SARS.
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17:16
And SARS is the pandemic that did not occur.
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那是SARS。SARS 是一個沒有發生的大流感。
17:20
And it didn't occur
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它沒有發生因為GPHIN在世界衛生組織
17:21
because GPHIN found the pandemic-to-be of SARS
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宣布前三個月就發現了這可能的未來大流感: SARS。
17:28
three months before WHO actually announced it, and because of that,
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也因此我們能夠阻止SARS的蔓延。
17:34
we were able to stop the SARS pandemic.
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17:37
And I think we owe a great debt of gratitude
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我認為我們欠GPHIN和Ron St. John很多。
17:39
to GPHIN and to Ron St. John,
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17:41
who I hope is in the audience some place -- over there --
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我希望他在觀眾席中--在那--
17:45
who's the founder of GPHIN.
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他是GPHIN的創辦人。
17:47
(Applause)
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(掌聲)
17:48
Hello, Ron!
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哈囉Ron。
17:50
(Applause)
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(掌聲)
17:58
And TED has flown Ron here from Ottawa, where GPHIN is located,
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TED將Ron從渥太華也就是GPHIN的所在地接過來。
18:03
because not only did GPHIN find SARS early,
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因為GPHIN不只提早發現SARS,
18:07
but you may have seen last week
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你可能有看到前幾個禮拜伊朗宣布境內有禽流感,
18:09
that Iran announced that they had bird flu in Iran,
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4331
18:14
but GPHIN found the bird flu in Iran not February 14 --
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但GPHIN不是在二月十四,而是在去年九月就發現伊朗有禽流感。
18:17
but last September.
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18:19
We need an early-warning system
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我們需要一個早期警告系統
18:22
to protect us against the things that are humanity's worst nightmare.
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來保護我們免於被這種人類惡夢(大流行)的迫害。
18:27
And so my TED wish is based on the common denominator
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所以我的TED願望就是根據這些經驗而來的
18:31
of these experiences.
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18:32
Smallpox -- early detection, early response.
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天花:早發現、早行動。
18:35
Blindness, polio -- early detection, early response.
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失明、小兒痲痹:早發現、早行動。
18:39
Pandemic bird flu -- early detection, early response.
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禽流感:早發現、早行動。這是祈禱文。
18:43
It is a litany.
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18:44
It is so obvious that our only way of dealing with these new diseases
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很明顯的我們唯一可行的方法是
18:49
is to find them early and to kill them before they spread.
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早期發現且在流行起來前殺盡致病菌。
18:54
So, my TED wish is for you to help build a global system --
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所以,我的TED願望是希望你們都能幫忙建造一個全球系統,
18:58
an early-warning system --
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一個早期警告系統,
19:00
to protect us against humanity's worst nightmares.
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來使我們免於人類最糟惡夢的迫害。
19:04
And what I thought I would call it is "Early Detection,"
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我想我可以叫它「Early Detection」(早期發現)
19:11
But it should really be called ...
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但它應該叫做「Total Early Detection」(完全早期發現)(TED)
19:15
"Total Early Detection." [TED]
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19:16
(Laughter)
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(笑聲)
19:18
What?
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(掌聲)
19:19
(Applause)
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19:26
What?
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19:27
(Applause)
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19:31
But in all seriousness,
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真的! 認真來說--
19:33
because this idea is birthed in TED,
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因為這個點子來自TED,
19:36
I would like it to be a legacy of TED, and I'd like to call it
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我希望它成為TED的傳說,所以我要叫他
19:42
the "International System for Total Early Disease Detection."
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「International System for Total Early Disease Detection」(完全早期發現國際組織)
19:47
[INSTEDD]
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19:50
And INSTEDD then becomes our mantra.
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然後INSTEDD成為我們的六字大明咒(觀世音咒)。(救苦救難真言)
19:58
So instead of a hidden pandemic of bird flu,
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與其隱匿不知禽流感流行,
20:00
we find it and immediately contain it.
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我們應早期發現、馬上控制住疫情.
20:03
Instead of a novel virus caused by bio-terror or bio-error,
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與其在小說中憶測由生物恐怖、生物失誤造成的新型病毒。
20:08
or shift or drift, we find it and we contain it.
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我們應早期發現、馬上控制住此新型病毒。
20:13
Instead of industrial accidents like oil spills
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以早發現、早行動取代
20:15
or the catastrophe in Bhopal,
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20:18
we find them, and we respond to them.
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像伯帕爾漏油事件的工業意外。
20:21
Instead of famine, hidden until it is too late,
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以早發現、早行動取代發現時已來不及的飢荒。
20:24
we detect it, and we respond.
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20:29
And instead of a system which is owned by a government,
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與其由政府組成的一個系統、
一個被埋在政府五臟六腑的系統內,
20:32
and hidden in the bowels of government,
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20:34
let's build an early detection system
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讓我們打造一個早期偵測系統,
20:37
that's freely available to anyone in the world in their own language.
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一個世界上每一個人都可以自由地用自己的語言來使用。
20:41
Let's make it transparent, non-governmental,
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讓它透明化、非政府化、
20:46
not owned by any single country or company,
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不屬於任何一個國家或公司擁有、
20:49
housed in a neutral country, with redundant backup
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建立在一個中立國家、且在每個不同時區、
20:53
in a different time zone and a different continent.
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每個大洲都有備份。
20:57
And let's build it on GPHIN.
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讓我們以GPHIN為基礎,從GPHIN出發。
20:59
Let's start with GPHIN.
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21:01
Let's increase the websites that they crawl
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讓我們將他們的網站數從兩千萬提高到兩百億。
21:03
from 20,000 to 20 million.
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21:06
Let's increase the languages they crawl
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讓我們將他們使用的語言從七種提高到七十種或更多。
21:09
from seven to 70, or more.
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21:12
Let's build in outbound confirmation messages,
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讓我們建造向外的確認方法,
21:15
using text messages or SMS or instant messaging
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用簡訊或SMS或即時訊息,
21:19
to find out from people who are within 100 meters
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從謠言所在地100公尺內的人身上得知
21:21
of the rumor that you hear,
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21:23
if it is, in fact, valid.
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謠言是否是真的。
21:25
And let's add satellite confirmation.
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讓我們再加上衛星確認。
21:27
And we'll add Gapminder's amazing graphics to the front end.
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並在前端加上Gapminder引人入勝的圖表。
21:31
And we'll grow it as a moral force in the world,
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我們要讓它成為一個道德力量且持續成長,
21:35
finding out those terrible things
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在任何人根本還未知前,提早找出這些可怕的事件,
21:37
before anybody else knows about them,
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21:39
and sending our response to them,
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且採取行動。所以明年,
21:42
so that next year, instead of us meeting here,
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在這裡再見面, 我們不會
21:45
lamenting how many terrible things there are in the world,
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哀悼曾有多少可怕的事情發生過,
21:49
we will have pulled together,
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我們會團結一起運用我們特有的能力、
21:51
used the unique skills and the magic of this community,
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和這個群體不可思議的力量
21:55
and be proud that we have done everything we can to stop pandemics,
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自豪的說:我們做了所有我們能做的來阻止大流行(大瘟疫).
21:59
other catastrophes, and change the world, beginning right now.
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及其它大災害。讓我們從現在開始改變世界。
(掌聲)
22:05
(Applause)
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22:23
Chris Anderson: An amazing presentation.
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Chris Anderson:很精彩的演講。首先,
22:26
First of all, just so everyone understands:
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只是讓大家更瞭解。你說建造--
22:29
you're saying that by creating web crawlers,
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設計網路爬蟲(自動化瀏覽網路的程式)、只是經由網路模式,
22:33
looking on the Internet for patterns,
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22:36
they can detect something suspicious
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他們可以在世界衛生組織之前發現可疑的事件,
22:40
before WHO, before anyone else can see it?
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在任何人之前?
22:44
Give an example of how that could possibly be true.
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解釋一下。給一個例子解釋這怎麼可能。
Larry Brilliant:首先,你沒有因為侵犯智慧財產權生氣吧?
22:48
Larry Brilliant: You're not mad about the copyright violation?
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CA:沒有。我很喜歡。
22:51
CA: No. I love it.
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22:52
(Laughter)
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22:53
LB: Well, as Ron St. John --
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LB:好的,嗯, 當Ron St. John--我希望你
22:55
I hope you'll go and meet him in the dinner afterwards and talk to him.
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等會的晚餐上會去跟他碰面講講話--
22:58
When he started GPHIN --
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當他1997年成立GPHIN的時候,那時禽流感剛爆發時,是H5N1種。
23:01
In 1997, there was an outbreak of bird flu -- H5N1.
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23:05
It was in Hong Kong.
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發生在香港。而一個卓越的香港醫生
23:06
And a remarkable doctor in Hong Kong responded immediately,
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馬上匯報,經由殺了一百五十萬隻家禽和小鳥,
23:10
by slaughtering 1.5 million chickens and birds,
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23:14
and they stopped that outbreak in its tracks.
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他們阻止了禽流感持續傳染爆發。
23:17
Immediate detection, immediate response.
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馬上發現、馬上行動。
23:21
Then a number of years went by,
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然後幾年過去了,
23:22
and there were a lot of rumors about bird flu.
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有很多禽流感的謠言。
23:25
Ron and his team in Ottawa began to crawl the web --
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Ron和他的團隊開始在渥太華瀏覽監控網路,
23:29
only crawling 20,000 different websites, mostly periodicals --
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只瀏覽監控兩萬個不同的網站,大部分是(醫學)期刊。
23:34
and they read about and heard about a concern,
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他們讀到聽到有關於很多小孩發燒
23:37
of a lot of children who had high fever and symptoms of bird flu.
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且有禽流感的症狀。
23:42
They reported this to WHO.
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他們報告給WHO。WHO花了一些時間才行動,
23:45
WHO took a little while taking action,
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23:47
because WHO will only receive a report from a government,
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因為WHO只接受從政府來的報告,
23:51
because it's the United Nations.
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因為WHO屬於聯合國。
23:54
But they were able to point to WHO and let them know
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但他們有能力能指出地區讓WHO知道
23:57
that there was this surprising and unexplained cluster of illnesses
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那兒有無法解釋的許多病例,
24:02
that looked like bird flu.
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而症狀類似禽流感.
24:04
That turned out to be SARS.
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結果就是SARS。
24:05
That's how the world found out about SARS.
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那是這世界怎麼知道SARS的。
24:08
And because of that, we were able to stop SARS.
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也因此我們可以阻止SARS。
24:11
Now, what's really important is that, before there was GPHIN,
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現在,很重要的是,在GPHIN之前,
24:15
100 percent of all the world's reports of bad things --
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世上所有壞事的報導--
24:19
whether you're talking about famine
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不管是飢荒或是禽流感
24:21
or you're talking about bird flu or you're talking about Ebola --
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或是伊波拉病毒--
24:24
100 percent of all those reports came from nations.
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全部來自各國官方報導。
24:27
The moment these guys in Ottawa --
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當這些在渥太華預算只有每年八十萬元的人開始做事時,
24:29
on a budget of 800,000 dollars a year -- got cracking,
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百分之75的報導來自GPHIN,
24:33
75 percent of all the reports in the world came from GPHIN,
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24:37
25 percent of all the reports in the world
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剩下的25來自
24:40
came from all the other 180 nations.
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世界各地180個國家。
24:43
Now, here's what's really interesting:
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現在,有趣的是,
24:45
after they'd been working for a couple years,
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他們開始工作幾年後,
24:48
what do you think happened to those nations?
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你覺得那些國家怎麼了?
24:50
They felt pretty stupid.
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24:51
So they started sending in their reports early.
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他們覺得自己很蠢,所以開始早點送出報告。
24:53
And now, their reporting percentage is down to 50 percent,
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現在他們的報告佔了百分之五十,
24:57
because other nations have started to report.
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因為這些國家開始報導了。
25:00
So, can you find diseases early by crawling the web?
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所以你可以藉由網路找到疾病嗎?
25:04
Of course you can.
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當然可以。你可以比GPHIN更早發現嗎?
25:05
Can you find it even earlier than GPHIN does now?
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25:08
Of course you can.
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25:09
You saw that they found SARS using their Chinese web crawler
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當然可以。你知道嗎? 用中文找到SARS的資訊
比用英文找到的資訊
25:14
a full six weeks before they found it using their English web crawler.
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足足早了六個禮拜。
25:19
Well, they're only crawling in seven languages.
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現在他們只用七種語言。
25:22
These bad viruses really don't have any intention
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這些可惡的病毒並沒有意願
25:24
of showing up first in English or Spanish or French.
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以英文或西班牙文或法文現身。
25:27
(Laughter)
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(笑聲)
所以,是的,我要以GPHIN為基礎,繼續建造,
25:29
So yes, I want to take GPHIN, I want to build on it.
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25:34
I want to add all the languages of the world that we possibly can.
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我想要盡我們所能加進世界上所有語言。
25:37
I want to make this open to everybody,
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我想要讓每個人都有使用它,
25:40
so that the health officer in Nairobi or in Patna, Bihar
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這樣奈洛比或巴特那或比哈爾省的健康官員
25:43
will have as much access to it as the folks in Ottawa or in CDC.
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可以如渥太華或美國疾病防治中心的人一樣使用,
25:47
And I want to make it part of our culture
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而且我希望讓它成為我們文化的一部份,
25:50
that there is a community of people who are watching out
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就是有一群人正在守護著、讓我們遠離人類最可怕的惡夢,
25:53
for the worst nightmares of humanity,
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25:56
and that it's accessible to everyone.
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而且是每個人都能使用的。
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