ABOUT THE SPEAKER
Seth Berkley - Vaccine visionary
Epidemiologist Seth Berkley is leading the charge to make sure vaccines are available to everyone, including those living in the developing world.

Why you should listen

Seth Berkley is an epidemiologist and the CEO of Gavi, the Vaccine Alliance, the global health organization protecting lives by improving access to vaccines in developing countries. Seth joined Gavi in 2011 in a period of rapid acceleration of Gavi’s programs. Now, with more than half a billion children immunized, he is leading Gavi’s efforts to reach a further 300 million children in the next five years and build sustainability into country immunization programs. Prior to Gavi, he spearheaded the development of vaccines for HIV as founder and CEO of the International AIDS Vaccine Initiative.

More profile about the speaker
Seth Berkley | Speaker | TED.com
TED2015

Seth Berkley: The troubling reason why vaccines are made too late ... if they're made at all

塞斯•伯克利: 为什么疫苗研制出来得总是太迟

Filmed:
1,053,228 views

似乎我们总是要等到灾难性的疾病爆发之后才会认真考虑研制相应的疫苗。塞斯•伯克利揭示了为什么我们没有为世界上最严重的疾病研制疫苗,以及背后的市场困境和不平衡的风险。
- Vaccine visionary
Epidemiologist Seth Berkley is leading the charge to make sure vaccines are available to everyone, including those living in the developing world. Full bio

Double-click the English transcript below to play the video.

00:13
The child's孩子的 symptoms症状 begin开始
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这个患儿的症状首先是
00:15
with mild温和 fever发热, headache头痛, muscle肌肉 pains辛劳,
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低烧、头痛和肌肉痛,
00:18
followed其次 by vomiting呕吐 and diarrhea腹泻,
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之后出现呕吐和腹泻,
00:21
then bleeding流血的 from the mouth,
nose鼻子 and gums齿龈.
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后来口、鼻和牙龈开始出血,
00:25
Death死亡 follows如下 in the form形成 of organ器官 failure失败
from low blood血液 pressure压力.
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最终由于低血压引起器官衰竭,导致死亡
00:31
Sounds声音 familiar?
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是不是听起来很熟悉?
00:33
If you're thinking思维 this is Ebola埃博拉病毒,
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如果你觉得这会不会是埃博拉,
00:36
actually其实, in this case案件, it's not.
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实际上,就本例来说并不是。
00:38
It's an extreme极端 form形成 of dengue登革热 fever发热,
a mosquito-born蚊子出生 disease疾病
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本例是登革热的极端形式,
这是一种通过蚊子传播的疾病,
00:43
which哪一个 also does not have
an effective有效 therapy治疗 or a vaccine疫苗,
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它也没有有效的治疗方法或疫苗,
00:48
and kills杀死 22,000 people each year.
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并且每年杀死2.2万人。
00:52
That is actually其实 twice两次
the number of people
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其实,这一数字相当于
埃博拉病毒,在自我们知道它以来的
00:54
that have been killed杀害 by Ebola埃博拉病毒
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00:56
in the nearly几乎 four decades几十年
that we've我们已经 known已知 about it.
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近40年里,所杀死的人数的两倍
01:00
As for measles麻疹, so much
in the news新闻 recently最近,
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而近期新闻中频繁提到的麻疹
01:04
the death死亡 toll收费 is actually其实 tenfold十倍 higher更高.
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死亡人数实际上是登革热的十倍之多。
01:09
Yet然而 for the last year,
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然而在去年,
01:11
it has been Ebola埃博拉病毒 that has stolen被盗
all of the headlines新闻头条 and the fear恐惧.
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占据所有头条,引起所有恐慌的
却是埃博拉。
01:17
Clearly明确地, there is something
deeply rooted about it,
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显然,有某种东西深深地根植其中,
01:19
something which哪一个 scares恐慌 us
and fascinates着迷 us
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这种东西让我们如此害怕,
成为了挥之不去的阴影,
01:22
more than other diseases疾病.
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没有其它疾病能做到这一点。
01:24
But what is it, exactly究竟?
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而它到底是什么呢?
01:27
Well, it's hard to acquire获得 Ebola埃博拉病毒,
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其实,得上埃博拉是很不容易的,
01:29
but if you do, the risk风险
of a horrible可怕 death死亡 is high.
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但如果真的患病,
以可怕的死状离去,是极有可能的。
01:33
Why?
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为什么?
01:34
Because right now, we don't have any
effective有效 therapy治疗 or vaccine疫苗 available可得到.
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因为现在我们没有任何有效的治疗方法或疫苗可用。
01:40
And so, that's the clue线索.
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所以,这就是原因。
01:43
We may可能 have it someday日后.
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可能我们终将研制出来。
01:45
So we rightfully理所当然 fear恐惧 Ebola埃博拉病毒,
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所以我们害怕埃博拉,是合情合理的,
01:48
because it doesn't kill
as many许多 people as other diseases疾病.
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因为它杀死的人没有其它疾病那么多,
01:53
In fact事实, it's much less transmissible传播
than viruses病毒 such这样 as flu流感 or measles麻疹.
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实际上,它的传染性比
流感和麻疹之类的病毒,低多了。
01:59
We fear恐惧 Ebola埃博拉病毒 because of the fact事实
that it kills杀死 us and we can't treat对待 it.
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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。
02:05
We fear恐惧 the certain某些 inevitability必然性
that comes with Ebola埃博拉病毒.
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我们害怕伴随埃博拉而来的某种不可避免性。
02:08
Ebola埃博拉病毒 has this inevitability必然性
that seems似乎 to defy违抗 modern现代 medical science科学.
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埃博拉的这种不可避免性
似乎是在挑战现代医学。
02:14
But wait a second第二, why is that?
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等一下,为什么会这样?
02:16
We've我们已经 known已知 about Ebola埃博拉病毒 since以来 1976.
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从1976年起我们就知道埃博拉了,
02:20
We've我们已经 known已知 what it's capable of.
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我们知道它有多厉害,
02:22
We've我们已经 had ample充足 opportunity机会 to study研究 it
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我们也有足够的机会来研究它,
02:24
in the 24 outbreaks爆发 that have occurred发生.
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因为一共出现了24起爆发的病例。
02:27
And in fact事实, we've我们已经 actually其实 had
vaccine疫苗 candidates候选人 available可得到 now
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而实际上,
现在我们手上已经有了候选疫苗,
02:31
for more than a decade.
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在十多年前就有了。
02:33
Why is that those vaccines疫苗
are just going into clinical临床 trials试验 now?
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那为什么这些疫苗到现在才进行临床实验?
02:38
This goes to the fundamental基本的
problem问题 we have
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这就遇到了研制感染性疾病的疫苗时
02:41
with vaccine疫苗 development发展
for infectious传染病 diseases疾病.
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面临的根本问题。
02:45
It goes something like this:
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大致情况是这样:
02:47
The people most at risk风险 for these diseases疾病
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患上这些疾病风险最高的人
02:50
are also the ones那些 least最小 able能够
to pay工资 for vaccines疫苗.
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也是最无力支付疫苗的一群人。
02:55
This leaves树叶 little in the way
of market市场 incentives奖励
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这就导致几乎没有市场动力
02:59
for manufacturers制造商 to develop发展 vaccines疫苗,
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来推动生产商研制疫苗,
03:02
unless除非 there are large numbers数字 of people
who are at risk风险 in wealthy富裕 countries国家.
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除非在富国有大量人群面临风险。
03:07
It's simply只是 too commercially商业 risky有风险.
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简单来说,商业风险过高。
03:11
As for Ebola埃博拉病毒, there is absolutely绝对
no market市场 at all,
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至于埃博拉,则完全没有市场,
03:15
so the only reason原因 we have two vaccines疫苗
in late-stage后期 clinical临床 trials试验 now,
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所以,如今我们能有两种疫苗进入后期临床实验,
03:21
is actually其实 because
of a somewhat有些 misguided误导 fear恐惧.
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唯一的原因是,有点被误导的恐惧。
03:24
Ebola埃博拉病毒 was relatively相对 ignored忽视
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相对来说,埃博拉一直以来被忽视了,
03:27
until直到 September九月 11
and the anthrax炭疽病 attacks攻击,
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直到911和炭疽袭击,
03:32
when all of a sudden突然,
people perceived感知 Ebola埃博拉病毒
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突然之间,人们意识到
03:34
as, potentially可能, a bioterrorism生物恐怖主义 weapon武器.
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埃博拉是一种潜在的,具有生物恐怖袭击性的武器。
03:37
Why is it that the Ebola埃博拉病毒 vaccine疫苗
wasn't fully充分 developed发达 at this point?
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为什么这时埃博拉疫苗还没有完全研制出来?
03:42
Well, partially部分, because
it was really difficult --
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部分是因为非常困难--
03:44
or thought to be difficult --
to weaponize武器化 the virus病毒,
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或者说觉得很困难--
来使病毒武器化。
03:47
but mainly主要 because
of the financial金融 risk风险 in developing发展 it.
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但主要原因是研制疫苗的财务风险。
03:53
And this is really the point.
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这一点是问题真正所在。
03:55
The sad伤心 reality现实 is, we develop发展 vaccines疫苗
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现实的可悲之处在于,
03:58
not based基于 upon the risk风险
the pathogen病原 poses姿势 to people,
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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,
04:02
but on how economically经济 risky有风险 it is
to develop发展 these vaccines疫苗.
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而是考虑研制疫苗的经济风险有多大。
04:06
Vaccine疫苗 development发展
is expensive昂贵 and complicated复杂.
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研制疫苗既昂贵又复杂,
04:09
It can cost成本 hundreds数以百计
of millions百万 of dollars美元
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要花费高达数亿美元
04:11
to take even a well-known知名 antigen抗原
and turn it into a viable可行 vaccine疫苗.
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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。
04:17
Fortunately幸好 for diseases疾病 like Ebola埃博拉病毒,
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幸运的是,对于像埃博拉这样的疾病,
04:19
there are things we can do
to remove去掉 some of these barriers障碍.
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我们还是可以做一些事情
来打破这些壁垒的。
04:23
The first is to recognize认识
when there's a complete完成 market市场 failure失败.
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首先,要承认市场已经完全不起作用的现状,
04:27
In that case案件, if we want vaccines疫苗,
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在这种情况下,如果我们想得到疫苗,
04:30
we have to provide提供 incentives奖励
or some type类型 of subsidy补贴.
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就必须提供奖励措施,或某种形式的补贴。
04:36
We also need to do a better job工作
at being存在 able能够 to figure数字 out
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我们也需要更加努力,
04:40
which哪一个 are the diseases疾病
that most threaten威胁 us.
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来找出对我们威胁最大的疾病有哪些。
04:43
By creating创建 capabilities功能 within countries国家,
we then create创建 the ability能力
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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,
04:48
for those countries国家 to create创建
epidemiological流行病学 and laboratory实验室 networks网络
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04:52
which哪一个 are capable of collecting搜集
and categorizing归类 these pathogens病原体.
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有了这些,
我们就有能力采集这些病原体,并进行分类。
04:58
The data数据 from that then can be used
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由此而来的数据
05:00
to understand理解 the geographic地理
and genetic遗传 diversity多样,
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可用于了解其地理分布和遗传多样性,
05:03
which哪一个 then can be used
to help us understand理解
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有助于帮助我们了解
05:06
how these are being存在 changed
immunologically免疫,
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这些免疫学上的变化是如何产生的
05:10
and what type类型 of reactions反应 they promote促进.
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以及促进了哪种类型的反应。
05:13
So these are the things that can be doneDONE,
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所以说,这些事情是可以做的,
05:15
but to do this, if we want to deal合同
with a complete完成 market市场 failure失败,
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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,
05:19
we have to change更改 the way
we view视图 and prevent避免 infectious传染病 diseases疾病.
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就必须改变我们看待、预防传染性疾病的方法。
05:24
We have to stop waiting等候
until直到 we see evidence证据
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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。
05:28
of a disease疾病 becoming变得 a global全球 threat威胁
before we consider考虑 it as one.
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当我们认为它是的时候,就应该行动起来
05:34
So, for Ebola埃博拉病毒,
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所以,对于埃博拉来说,
05:36
the paranoid偏执 fear恐惧
of an infectious传染病 disease疾病,
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对传染性疾病的极度恐慌,
05:40
followed其次 by a few少数 cases
transported to wealthy富裕 countries国家,
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出现于几例传染者转移至富裕国家之后。
05:45
led the global全球 community社区 to come together一起,
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这种恐慌促使全球各国携起手来,
05:48
and with the work
of dedicated专用 vaccine疫苗 companies公司,
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加上专门的疫苗公司的努力,
05:51
we now have these:
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我们才有了现在的结果:
05:54
Two Ebola埃博拉病毒 vaccines疫苗 in efficacy功效 trials试验
in the Ebola埃博拉病毒 countries国家 --
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两种埃博拉疫苗正在发病国家进行疗效试验,
06:00
(Applause掌声)
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(掌声)
06:06
and a pipeline管道 of vaccines疫苗
that are following以下 behind背后.
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后续还会有疫苗不断地生产出来。
06:10
Every一切 year, we spend billions数十亿 of dollars美元,
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每年我们花费数十亿美元,
06:13
keeping保持 a fleet舰队 of nuclear submarines潜艇
permanently永久 patrolling巡逻 the oceans海洋
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以维持核潜艇舰队,
在海洋中持续巡逻,
06:18
to protect保护 us from a threat威胁
that almost几乎 certainly当然 will never happen发生.
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而这支舰队所预防的威胁,
几乎可以肯定绝不会出现。
06:23
And yet然而, we spend virtually实质上 nothing
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然而,我们又实际上几乎没有花费多少钱
06:26
to prevent避免 something as tangible有形
and evolutionarily进化 certain某些
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来预防流行性传染病这样的问题,
06:31
as epidemic疫情 infectious传染病 diseases疾病.
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这个问题切实存在,并且一定是不断进化的。
06:35
And make no mistake错误 about it --
it's not a question of "if," but "when."
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对此不应当犯错--
这不是“如果”的问题,而是“什么时候”的问题。
06:38
These bugs虫子 are going to continue继续 to evolve发展
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这些病毒还会不断进化,
06:41
and they're going to threaten威胁 the world世界.
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还会威胁整个世界,
06:44
And vaccines疫苗 are our best最好 defense防御.
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而疫苗是我们的最佳防御手段。
06:47
So if we want to be able能够 to prevent避免
epidemics流行病 like Ebola埃博拉病毒,
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所以如果我们想要预防譬如埃博拉的蔓延,
06:51
we need to take on the risk风险
of investing投资 in vaccine疫苗 development发展
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我们就必须承担风险,
06:55
and in stockpile储存 creation创建.
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向疫苗研制与物资储备投入资金。
06:58
And we need to view视图 this, then,
as the ultimate最终 deterrent威慑 --
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而且我们应当,把它看作最终防线--
07:02
something we make sure is available可得到,
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我们确保有效的良方,
07:05
but at the same相同 time,
praying祈祷 we never have to use it.
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而与此同时,
祈祷永远不要用到它。
07:09
Thank you.
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谢谢大家。
07:10
(Applause掌声)
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(掌声)
Translated by Tian Ye
Reviewed by Chen Livia

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ABOUT THE SPEAKER
Seth Berkley - Vaccine visionary
Epidemiologist Seth Berkley is leading the charge to make sure vaccines are available to everyone, including those living in the developing world.

Why you should listen

Seth Berkley is an epidemiologist and the CEO of Gavi, the Vaccine Alliance, the global health organization protecting lives by improving access to vaccines in developing countries. Seth joined Gavi in 2011 in a period of rapid acceleration of Gavi’s programs. Now, with more than half a billion children immunized, he is leading Gavi’s efforts to reach a further 300 million children in the next five years and build sustainability into country immunization programs. Prior to Gavi, he spearheaded the development of vaccines for HIV as founder and CEO of the International AIDS Vaccine Initiative.

More profile about the speaker
Seth Berkley | Speaker | TED.com