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: 為什麼疫苗太慢做出來令人苦惱的原因 - 它們到底被製作了沒?

Filmed:
1,053,228 views

在我們變得認真為疾病製作出疫苗前,看起來我們像是在等待重大疫情的爆發;塞斯.伯克利揭露了為什麼我們無法來給世界最大宗的疾病做出疫苗,以及其背後市場的現實與失衡的風險。
- 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症狀 begin開始
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小孩子的症狀
一開始有些發燒、頭痛、肌肉酸痛,
00:15
with mild溫和 fever發熱, headache頭痛, muscle肌肉 pains辛勞,
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00:18
followed其次 by vomiting嘔吐 and diarrhea腹瀉,
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接著嘔吐和腹瀉,
00:21
then bleeding流血的 from the mouth,
nose鼻子 and gums齒齦.
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然後是嘴巴、鼻子、牙齦出血,
00:25
Death死亡 follows如下 in the form形成 of organ器官 failure失敗
from low blood血液 pressure壓力.
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因血壓低帶來的
器官衰竭樣貌伴隨著死亡。
00:31
Sounds聲音 familiar?
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聽起來很耳熟嗎?
00:33
If you're thinking思維 this is Ebola埃博拉病毒,
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如果你正想著這是「伊波拉病毒」的話,
00:36
actually其實, in this case案件, it's not.
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事實上這個案例並不是的;
00:38
It's an extreme極端 form形成 of dengue登革熱 fever發熱,
a mosquito-born蚊子出生 disease疾病
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它是一種登革熱的極端樣態 -
一種蚊子所帶來的疾病,
00:43
which哪一個 also does not have
an effective有效 therapy治療 or a vaccine疫苗,
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這東西同樣沒有行得通的
藥方或是疫苗,
00:48
and kills殺死 22,000 people each year.
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而且每年奪走 22,000 條人命!
00:52
That is actually其實 twice兩次
the number of people
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在我們已經知道登革熱近四十年來
00:54
that have been killed殺害 by Ebola埃博拉病毒
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那確實是喪命於伊波拉病毒人數的兩倍。
00:56
in the nearly幾乎 four decades幾十年
that we've我們已經 known已知 about it.
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01:00
As for measles麻疹, so much
in the news新聞 recently最近,
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至於近來如此大量登上新聞的麻疹,
01:04
the death死亡 toll收費 is actually其實 tenfold十倍 higher更高.
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死亡總計實際上高出十倍;
01:09
Yet然而 for the last year,
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然而去年一整年裡
01:11
it has been Ebola埃博拉病毒 that has stolen被盜
all of the headlines新聞頭條 and the fear恐懼.
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「伊波拉」已經搶走所有的頭條和恐懼。
01:17
Clearly明確地, there is something
deeply rooted about it,
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很清楚地有某種東西深植於其中,
01:19
something which哪一個 scares恐慌 us
and fascinates著迷 us
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某種遠比其他疾病還要嚇人
以及使我們著迷的東西。
01:22
more than other diseases疾病.
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01:24
But what is it, exactly究竟?
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但是那到底是什麼呢?
01:27
Well, it's hard to acquire獲得 Ebola埃博拉病毒,
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要染上「伊波拉」是很難的,
01:29
but if you do, the risk風險
of a horrible可怕 death死亡 is high.
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不過要是你染上了 -
不得好死的風險很高,
01:33
Why?
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為什麼呢?
01:34
Because right now, we don't have any
effective有效 therapy治療 or vaccine疫苗 available可得到.
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因為此時我們沒有任何行得通的
藥方或疫苗是可到手的,
01:40
And so, that's the clue線索.
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這就是線索了,
01:43
We may可能 have it someday日後.
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我們也許到哪天會有藥方、疫苗;
01:45
So we rightfully理所當然 fear恐懼 Ebola埃博拉病毒,
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所以我們理該害怕伊波拉病毒,
01:48
because it doesn't kill
as many許多 people as other diseases疾病.
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它並沒有如同其他疾病奪走了許多人命,
01:53
In fact事實, it's much less transmissible傳播
than viruses病毒 such這樣 as flu流感 or measles麻疹.
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事實上它比起流行感冒或是
麻疹等病毒更不會轉傳出去,
01:59
We fear恐懼 Ebola埃博拉病毒 because of the fact事實
that it kills殺死 us and we can't treat對待 it.
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我們害怕伊波拉是因為它會奪走
我們的性命而我們不能治好它的事實,
02:05
We fear恐懼 the certain某些 inevitability必然性
that comes with Ebola埃博拉病毒.
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我們懼怕伴隨著伊波拉的
必然無可倖免性,
02:08
Ebola埃博拉病毒 has this inevitability必然性
that seems似乎 to defy違抗 modern現代 medical science科學.
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伊波拉有著看似否定
現代醫療科學的無可倖免性。
02:14
But wait a second第二, why is that?
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不過慢著 - 那是為什麼呢?
02:16
We've我們已經 known已知 about Ebola埃博拉病毒 since以來 1976.
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我們自從 1976 年以來
就知道伊波拉病毒了,
02:20
We've我們已經 known已知 what it's capable of.
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我們知道它有什麼能耐,
02:22
We've我們已經 had ample充足 opportunity機會 to study研究 it
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我們早就有充分的機會
02:24
in the 24 outbreaks爆發 that have occurred發生.
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在 24 個已經出現過伊波拉的
爆發區來研究它,
02:27
And in fact事實, we've我們已經 actually其實 had
vaccine疫苗 candidates候選人 available可得到 now
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而且事實上我們確實已經有可到手的
疫苗候選劑超過十年以上,
02:31
for more than a decade.
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02:33
Why is that those vaccines疫苗
are just going into clinical臨床 trials試驗 now?
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為什麼那些疫苗現在才正要
進入臨床測試呢?
02:38
This goes to the fundamental基本的
problem問題 we have
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這要講到我們在研發給
傳染性疾病用的疫苗
02:41
with vaccine疫苗 development發展
for infectious傳染病 diseases疾病.
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現有的根本問題,
02:45
It goes something like this:
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要講到像這些東西 -
02:47
The people most at risk風險 for these diseases疾病
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「對這些疾病最有風險的人,
02:50
are also the ones那些 least最小 able能夠
to pay工資 for vaccines疫苗.
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同樣也是最買不起疫苗的人!」,
02:55
This leaves樹葉 little in the way
of market市場 incentives獎勵
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這留下很少的市場誘因
02:59
for manufacturers製造商 to develop發展 vaccines疫苗,
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給廠商來研發疫苗;
03:02
unless除非 there are large numbers數字 of people
who are at risk風險 in wealthy富裕 countries國家.
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除非在富裕的國家裡有著
一大堆人處於風險之下,
03:07
It's simply只是 too commercially商業 risky有風險.
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研發疫苗絕對是商業上太冒風險的。
03:11
As for Ebola埃博拉病毒, there is absolutely絕對
no market市場 at all,
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至於伊波拉病毒是絕對
絲毫市場誘因也沒有,
03:15
so the only reason原因 we have two vaccines疫苗
in late-stage後期 clinical臨床 trials試驗 now,
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所以我們現在會有兩個在
後段臨床測試的疫苗,
03:21
is actually其實 because
of a somewhat有些 misguided誤導 fear恐懼.
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唯一的理由確實是因為
某種被誤導的恐懼。
03:24
Ebola埃博拉病毒 was relatively相對 ignored忽視
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伊波拉病毒直到 911 和炭疽病攻擊前
03:27
until直到 September九月 11
and the anthrax炭疽病 attacks攻擊,
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相對之下是被輕忽的,
03:32
when all of a sudden突然,
people perceived感知 Ebola埃博拉病毒
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但是突然間染上伊波拉病毒的人
03:34
as, potentially可能, a bioterrorism生物恐怖主義 weapon武器.
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就如同潛在性生物恐怖攻擊武器。
03:37
Why is it that the Ebola埃博拉病毒 vaccine疫苗
wasn't fully充分 developed發達 at this point?
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為什麼伊波拉疫苗在這時候
沒有被完全地研發出來呢?
03:42
Well, partially部分, because
it was really difficult --
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有一部分是因為它確實很難,
03:44
or thought to be difficult --
to weaponize武器化 the virus病毒,
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或是被想成很難 - 把病毒武器化,
03:47
but mainly主要 because
of the financial金融 risk風險 in developing發展 it.
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不過主要是因為要開發它的財務風險,
03:53
And this is really the point.
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而這真的就是關鍵。
03:55
The sad傷心 reality現實 is, we develop發展 vaccines疫苗
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令人難過的現實就是我們研發疫苗
03:58
not based基於 upon the risk風險
the pathogen病原 poses姿勢 to people,
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不是基於病原體對人體造成的風險,
04:02
but on how economically經濟 risky有風險 it is
to develop發展 these vaccines疫苗.
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卻是基於研發這些疫苗
經濟上是如何冒風險的;
04:06
Vaccine疫苗 development發展
is expensive昂貴 and complicated複雜.
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疫苗的研發是既昂貴又繁瑣的,
04:09
It can cost成本 hundreds數以百計
of millions百萬 of dollars美元
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它可以花到上億美元
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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把一個就算相當清楚的抗體
轉變成大有機會的疫苗。
04:17
Fortunately幸好 for diseases疾病 like Ebola埃博拉病毒,
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幸好對類似於「伊波拉」的疾病來講,
04:19
there are things we can do
to remove去掉 some of these barriers障礙.
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有著我們能移除些許阻礙的事情可做。
04:23
The first is to recognize認識
when there's a complete完成 market市場 failure失敗.
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首先是認知到當那裡
市場完全失能的時候,
04:27
In that case案件, if we want vaccines疫苗,
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在那個案例裡如果我們想要疫苗,
04:30
we have to provide提供 incentives獎勵
or some type類型 of subsidy補貼.
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我們得提供誘因或是某類補助,
04:36
We also need to do a better job工作
at being存在 able能夠 to figure數字 out
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我們同樣需要在有辦法弄清楚
04:40
which哪一個 are the diseases疾病
that most threaten威脅 us.
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威脅我們最大的疾病有哪些
這檔事上做得更好;
04:43
By creating創建 capabilities功能 within countries國家,
we then create創建 the ability能力
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透過在國與國之間催生多種本事,
04:48
for those countries國家 to create創建
epidemiological流行病學 and laboratory實驗室 networks網絡
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我們接著為那些國家催生能力
來建立流行病學和實驗室的網絡,
04:52
which哪一個 are capable of collecting蒐集
and categorizing歸類 these pathogens病原體.
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該網絡有辦法收集和歸類這些病原體。
04:58
The data數據 from that then can be used
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從那裡得來的資料稍後可以被用來
理解地理和基因的歧異性,
05:00
to understand理解 the geographic地理
and genetic遺傳 diversity多樣,
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05:03
which哪一個 then can be used
to help us understand理解
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那些接著可以被用來幫助我們理解
05:06
how these are being存在 changed
immunologically免疫,
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這些病原體是如何在免疫學上被更改了,
05:10
and what type類型 of reactions反應 they promote促進.
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以及它們會促發什麼樣的反應。
05:13
So these are the things that can be doneDONE,
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這些是可以被做到的事情,
05:15
but to do this, if we want to deal合同
with a complete完成 market市場 failure失敗,
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不過要做到 - 假使我們想要解決
市場完全失能的話,
05:19
we have to change更改 the way
we view視圖 and prevent避免 infectious傳染病 diseases疾病.
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我們得要改變我們看待
以及防治傳染病的方式,
05:24
We have to stop waiting等候
until直到 we see evidence證據
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我們必須停止直到我們看見
疾病之證據前的空等 -
05:28
of a disease疾病 becoming變得 a global全球 threat威脅
before we consider考慮 it as one.
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早在我們認定之前形成全球威脅。
05:34
So, for Ebola埃博拉病毒,
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所以拿伊波拉病毒來說,
05:36
the paranoid偏執 fear恐懼
of an infectious傳染病 disease疾病,
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對一種傳染病疑神疑鬼的懼怕、
05:40
followed其次 by a few少數 cases
transported to wealthy富裕 countries國家,
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接下來極少數的病例
被轉送到富裕的國家去,
05:45
led the global全球 community社區 to come together一起,
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導致全球社會來攜手合作;
05:48
and with the work
of dedicated專用 vaccine疫苗 companies公司,
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而且有了盡職的疫苗公司在做事,
05:51
we now have these:
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我們現在有了這些東西 -
05:54
Two Ebola埃博拉病毒 vaccines疫苗 in efficacy功效 trials試驗
in the Ebola埃博拉病毒 countries國家 --
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在出現伊波拉的國家中有了
兩種臨床療效試驗中的伊波拉疫苗,
06:00
(Applause掌聲)
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(掌聲)
06:06
and a pipeline管道 of vaccines疫苗
that are following以下 behind背後.
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以及源源不絕的疫苗緊接其後。
06:10
Every一切 year, we spend billions數十億 of dollars美元,
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每一年我們花費掉數十億美元
06:13
keeping保持 a fleet艦隊 of nuclear submarines潛艇
permanently永久 patrolling巡邏 the oceans海洋
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維持核子潛艇艦隊不間斷地巡防大洋,
06:18
to protect保護 us from a threat威脅
that almost幾乎 certainly當然 will never happen發生.
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以保護我們遠離幾乎鐵定
永遠不會發生的威脅,
06:23
And yet然而, we spend virtually實質上 nothing
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再加上我們實際上沒花錢
06:26
to prevent避免 something as tangible有形
and evolutionarily進化 certain某些
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來避免某種碰得到的
以及肯定會進化的流行傳染病。
06:31
as epidemic疫情 infectious傳染病 diseases疾病.
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06:35
And make no mistake錯誤 about it --
it's not a question of "if," but "when."
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而且別搞錯了 - 這不是「會不會」
而是「何時」的問題,
06:38
These bugs蟲子 are going to continue繼續 to evolve發展
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這些病菌將會繼續進化,
06:41
and they're going to threaten威脅 the world世界.
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而且它們將會威脅到全世界,
06:44
And vaccines疫苗 are our best最好 defense防禦.
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而疫苗就是我們最佳的庇護。
06:47
So if we want to be able能夠 to prevent避免
epidemics流行病 like Ebola埃博拉病毒,
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因此要是我們想要能夠避免
像伊波拉一般的傳染病,
06:51
we need to take on the risk風險
of investing投資 in vaccine疫苗 development發展
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我們必須冒投資在疫苗研發
06:55
and in stockpile儲存 creation創建.
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以及產生囤積的風險。
06:58
And we need to view視圖 this, then,
as the ultimate最終 deterrent威懾 --
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我們必須正視這個然後
當做終極遏制 -
07:02
something we make sure is available可得到,
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我們要確保那是到手的東西,
07:05
but at the same相同 time,
praying祈禱 we never have to use it.
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不過同一時間祈禱我們永遠用不上它!
07:09
Thank you.
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謝謝大家!
07:10
(Applause掌聲)
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(掌聲)
Translated by Harry Chen
Reviewed by Ricardo Jack

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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