TED2015
Bill Gates: The next outbreak? We're not ready
Bill Gates: Epidemije u budućnosti? Mi nismo spremni.
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U 2014, svijet je izbjegao katastrofalno globalno izbijanje ebole, zahvaljujući tisućama nesebičnih zdravstvenih radnika, ali isto tako i zbog čiste sreće. Kada se osvrnemo na ovu epidemiju, znamo što smo mogli napravitii bolje. Sada je vrijeme, predlaže Bill Gates, da stavimo sve naše dobre ideje u praksu; od planiranja scenarija do istrazivanja cjepiva, te do treniranja zdravstvenih radnika. Kao što on kaže:" Nema potrebe za panikom, ali moramo se pokrenuti."
Bill Gates - Philanthropist
A passionate techie and a shrewd businessman, Bill Gates changed the world while leading Microsoft to dizzying success. Now he's doing it again with his own style of philanthropy and passion for innovation. Full bio
A passionate techie and a shrewd businessman, Bill Gates changed the world while leading Microsoft to dizzying success. Now he's doing it again with his own style of philanthropy and passion for innovation. Full bio
Double-click the English transcript below to play the video.
00:17
When I was a kid,
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Kada sam bio dijete
00:19
the disaster we worried about most
was a nuclear war.
was a nuclear war.
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katastrofa o kojoj smo najviše
brinuli je bio nuklearni rat.
brinuli je bio nuklearni rat.
00:23
That's why we had a barrel like this
down in our basement,
down in our basement,
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Zbog toga smo imali bačvu
poput ove u našem podrumu
poput ove u našem podrumu
00:27
filled with cans of food and water.
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napunjenu s konzervama hrane i vode.
00:30
When the nuclear attack came,
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Kada bi došlo do nuklearnog rata
00:31
we were supposed to go downstairs,
hunker down, and eat out of that barrel.
hunker down, and eat out of that barrel.
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trebali smo sići u podrum,
sakriti se, i jesti iz te bačve.
sakriti se, i jesti iz te bačve.
00:37
Today the greatest risk
of global catastrophe
of global catastrophe
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Danas, najveći rizik
od globalne katastrofe
od globalne katastrofe
00:41
doesn't look like this.
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ne izgleda ovako.
00:44
Instead, it looks like this.
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Zapravo, izgleda ovako.
00:48
If anything kills over 10 million people
in the next few decades,
in the next few decades,
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Ako postoji išta što će ubiti 10 mil.
ljudi u idućih nekoliko desetljeća,
ljudi u idućih nekoliko desetljeća,
00:53
it's most likely to be
a highly infectious virus
a highly infectious virus
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najvjerojatnije je da će
to biti vrlo zarazni virus,
to biti vrlo zarazni virus,
00:57
rather than a war.
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a ne rat.
00:59
Not missiles, but microbes.
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Ne rakete, nego mikrobi.
01:03
Now, part of the reason for this is that
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Dio razloga za ovo je činjenica
01:05
we've invested a huge amount
in nuclear deterrents.
in nuclear deterrents.
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da smo uložili puno novca u
odvraćanje od nuklearnog oružja.
odvraćanje od nuklearnog oružja.
01:10
But we've actually invested very little
in a system to stop an epidemic.
in a system to stop an epidemic.
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Ali zapravo smo uložili jako malo
u sustav za zaustavljanje epidemije.
u sustav za zaustavljanje epidemije.
01:16
We're not ready for the next epidemic.
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Nismo spremni za sljedeću epidemiju.
01:20
Let's look at Ebola.
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Pogledajmo ebolu.
01:21
I'm sure all of you read about it
in the newspaper,
in the newspaper,
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Siguran sam da ste svi vi
pročitali o njoj u novinama;
pročitali o njoj u novinama;
01:25
lots of tough challenges.
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puno teških izazova.
01:27
I followed it carefully
through the case analysis tools
through the case analysis tools
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Ja sam je pažljivo pratio
kroz sredstva za analizu slučaja
kroz sredstva za analizu slučaja
01:30
we use to track polio eradication.
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koje koristimo kako bi pratili
istrebljenje dječje paralize.
istrebljenje dječje paralize.
01:35
And as you look at what went on,
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I kako pratite događaje,
01:37
the problem wasn't that there was a system
that didn't work well enough,
that didn't work well enough,
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vidi se da problem nije u tome što nije
bilo sustava koji nije radio dovoljno dobro,
bilo sustava koji nije radio dovoljno dobro,
01:42
the problem was that we
didn't have a system at all.
didn't have a system at all.
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nego je problem bio u tome što
uopće nismo imali sustav.
uopće nismo imali sustav.
01:46
In fact, there's some pretty obvious
key missing pieces.
key missing pieces.
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Zapravo, postoje neki
poprilično vidljivi nedostaci.
poprilično vidljivi nedostaci.
01:51
We didn't have a group of epidemiologists
ready to go, who would have gone,
ready to go, who would have gone,
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Nismo imali grupu epidemiologa
spremnih da reagiraju
spremnih da reagiraju
01:55
seen what the disease was,
seen how far it had spread.
seen how far it had spread.
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i vide o kojoj je bolesti riječ,
i koliko se raširila.
i koliko se raširila.
01:59
The case reports came in on paper.
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Izvješća su došla.
02:02
It was very delayed
before they were put online
before they were put online
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Bila su odgađana dok nisu
postavljena na internet
postavljena na internet
02:04
and they were extremely inaccurate.
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i bila su strašno netočna.
02:07
We didn't have a medical team ready to go.
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Nismo imali medicinski
tim spreman za reakciju.
tim spreman za reakciju.
02:09
We didn't have a way of preparing people.
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Nismo znali kako pripremiti ljude.
02:12
Now, Médecins Sans Frontières
did a great job orchestrating volunteers.
did a great job orchestrating volunteers.
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Doktori Bez Granica su radili
odličan posao u orkestriranju volontera,
odličan posao u orkestriranju volontera,
02:17
But even so, we were far slower
than we should have been
than we should have been
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ali čak i tada smo bili puno
sporiji nego što smo trebali
sporiji nego što smo trebali
02:20
getting the thousands of workers
into these countries.
into these countries.
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u prebacivanju tisuća
radnika u ove države.
radnika u ove države.
02:24
And a large epidemic would require us
to have hundreds of thousands of workers.
to have hundreds of thousands of workers.
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A velika epidemija zahtijeva od nas da
imamo stotine tisuća radnika.
imamo stotine tisuća radnika.
02:32
There was no one there
to look at treatment approaches.
to look at treatment approaches.
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Nismo imali nikoga da nadgleda terapije.
02:37
No one to look at the diagnostics.
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Nikoga da pregleda dijagnostiku.
02:38
No one to figure out
what tools should be used.
what tools should be used.
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Nikoga tko bi shvatio kakvi
bi alati trebali biti korišteni.
bi alati trebali biti korišteni.
02:42
As an example, we could have
taken the blood of survivors,
taken the blood of survivors,
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Na primjer, mogli
smo uzeti krv preživjelih,
smo uzeti krv preživjelih,
02:45
processed it, and put that plasma
back in people to protect them.
back in people to protect them.
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obraditi je, te ubrizgati plazmu
nazad u ljude kako bi ih zaštitili.
nazad u ljude kako bi ih zaštitili.
02:51
But that was never tried.
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Ali to nikada nije oprobano.
02:53
So there was a lot that was missing.
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Tako da smo imali puno nedostataka.
02:55
And these things
are really a global failure.
are really a global failure.
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I ove stvari su zapravo globalni neuspjeh.
03:00
The WHO is funded to monitor epidemics,
but not to do these things I talked about.
but not to do these things I talked about.
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WHO je financirana da nadgleda epidemije,
ali ne da radi stvari o kojima sam pričao.
ali ne da radi stvari o kojima sam pričao.
03:07
Now, in the movies it's quite different.
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Naravno, u filmovima je
sve bitno drugačije.
sve bitno drugačije.
03:09
There's a group of handsome
epidemiologists ready to go,
epidemiologists ready to go,
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U filmovima imate grupu zgodnih
epidemiologa spremnih za akciju.
epidemiologa spremnih za akciju.
03:14
they move in, they save the day,
but that's just pure Hollywood.
but that's just pure Hollywood.
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Oni krenu i spase dan;
ali to je samo Hollywood.
ali to je samo Hollywood.
03:22
The failure to prepare
could allow the next epidemic
could allow the next epidemic
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Neuspjeh u pripremanju bi
mogao dozvoliti idućoj epidemiji
mogao dozvoliti idućoj epidemiji
03:25
to be dramatically
more devastating than Ebola
more devastating than Ebola
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da bude dramatično
više razarajuća od ebole.
više razarajuća od ebole.
03:30
Let's look at the progression
of Ebola over this year.
of Ebola over this year.
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Pogledajmo napredak
ebole tokom ove godine.
ebole tokom ove godine.
03:36
About 10,000 people died,
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Oko 10,000 mrtvih
03:39
and nearly all were in the three
West African countries.
West African countries.
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od kojih su skoro svi bili u
tri zapadno afričke države.
tri zapadno afričke države.
03:43
There's three reasons why
it didn't spread more.
it didn't spread more.
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Postoje tri razloga zašto
se nije još proširila.
se nije još proširila.
03:46
The first is that there was a lot
of heroic work by the health workers.
of heroic work by the health workers.
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Prvi razlog je zato što smo imali
puno heroizma među zdravstvenim radnicima.
puno heroizma među zdravstvenim radnicima.
03:50
They found the people and they
prevented more infections.
prevented more infections.
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Oni su našli ljude i spriječili
su daljne infekcije.
su daljne infekcije.
03:54
The second is the nature of the virus.
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Drugi razlog je sama priroda virusa.
03:56
Ebola does not spread through the air.
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Ebola se ne širi kroz zrak.
03:59
And by the time you're contagious,
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Tako da do vremena kada su zarazni,
04:01
most people are so sick
that they're bedridden.
that they're bedridden.
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većina ljudi je toliko
bolesna da su vezani za krevet.
bolesna da su vezani za krevet.
04:06
Third, it didn't get
into many urban areas.
into many urban areas.
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Treći razlog je to što
nije dospjela u urbana područja.
nije dospjela u urbana područja.
04:10
And that was just luck.
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No, to je bila samo sreća.
04:12
If it had gotten into a lot
more urban areas,
more urban areas,
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Da je penetrirala dublje
u urbana područja,
u urbana područja,
04:14
the case numbers
would have been much larger.
would have been much larger.
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brojevi slučaja zaraze bi bili mnogo veći.
04:17
So next time, we might not be so lucky.
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Idući put možda nećemo biti ovako sretni.
04:21
You can have a virus where people
feel well enough while they're infectious
feel well enough while they're infectious
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Mogli bi imati virus gdje će se
ljudi osjećati dobro iako su zarazni
ljudi osjećati dobro iako su zarazni
04:26
that they get on a plane
or they go to a market.
or they go to a market.
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da će onda putovati zrakoplovima
ili će ići na tržnice.
ili će ići na tržnice.
04:29
The source of the virus could be
a natural epidemic like Ebola,
a natural epidemic like Ebola,
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Izvor potencijalnog virusa bi mogla
biti prirodna epidemija poput ebole,
biti prirodna epidemija poput ebole,
04:32
or it could be bioterrorism.
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ali bi mogao biti i bioterorizam.
04:34
So there are things that would literally
make things a thousand times worse.
make things a thousand times worse.
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Tako da postoji mogućnost
da stvari budu tisuću puta gore.
da stvari budu tisuću puta gore.
04:39
In fact, let's look at a model
of a virus spread through the air,
of a virus spread through the air,
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Zapravo, pogledajmo model
virusa koji se širi kroz zrak,
virusa koji se širi kroz zrak,
04:45
like the Spanish Flu back in 1918.
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poput Španjolske gripe iz 1918.
04:49
So here's what would happen:
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Ovo bi se dogodilo.
04:51
It would spread throughout the world
very, very quickly.
very, very quickly.
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Kroz svijet bi se proširio
velikom brzinom.
velikom brzinom.
04:55
And you can see over 30 million people
died from that epidemic.
died from that epidemic.
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Vidite da bi oko 30 milijuna
ljudi umrlo od epidemije.
ljudi umrlo od epidemije.
05:00
So this is a serious problem.
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Ovo je ozbiljan problem.
05:02
We should be concerned.
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I trebali bi biti zabrinuti.
05:04
But in fact, we can build
a really good response system.
a really good response system.
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Ali zapravo, mi možemo
napraviti jako dobar sustav za odgovor.
napraviti jako dobar sustav za odgovor.
05:08
We have the benefits of all the science
and technology that we talk about here.
and technology that we talk about here.
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Imamo sve znanstvene i tehnološke
beneficije o kojima možemo pričati ovdje.
beneficije o kojima možemo pričati ovdje.
05:13
We've got cell phones
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Imamo mobilne telefone
05:14
to get information from the public
and get information out to them.
and get information out to them.
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kojima bi mogli dobiti informacije
od javnosti, ali i davati ih.
od javnosti, ali i davati ih.
05:18
We have satellite maps where we can see
where people are and where they're moving.
where people are and where they're moving.
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Imamo satelitske mape preko kojih možemo
vidjeti gdje su ljudi i kuda se kreću.
vidjeti gdje su ljudi i kuda se kreću.
05:22
We have advances in biology
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Postoji napredak u biologiji
05:24
that should dramatically change
the turnaround time to look at a pathogen
the turnaround time to look at a pathogen
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koji bi trebao dramatično promijeniti brzinu
vremena potrebnog da pregledamo patogen
vremena potrebnog da pregledamo patogen
05:28
and be able to make drugs and vaccines
that fit for that pathogen.
that fit for that pathogen.
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te bi bilo bi moguće napraviti lijekove
i cjepiva koje odgovaraju tom patogenu.
i cjepiva koje odgovaraju tom patogenu.
05:33
So we can have tools,
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Mi imamo sredstva,
05:34
but those tools need to be put
into an overall global health system.
into an overall global health system.
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ali ta sredstva trebaju biti stavljena
u cjelokupni globalni zdravstveni sustav.
u cjelokupni globalni zdravstveni sustav.
05:39
And we need preparedness.
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I trebamo pripravnost.
05:41
The best lessons, I think,
on how to get prepared
on how to get prepared
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Po mom mišljenju, najbolje
lekcije kako da se pripremimo
lekcije kako da se pripremimo
05:44
are again, what we do for war.
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dobijamo iz načina na koji ratujemo.
05:46
For soldiers, we have full-time,
waiting to go.
waiting to go.
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Za vojnike imamo puno vrijeme dok čekaju.
05:51
We have reserves that can scale
us up to large numbers.
us up to large numbers.
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Imamo rezerve koje se
mjere u ogromnim brojkama.
mjere u ogromnim brojkama.
05:54
NATO has a mobile unit
that can deploy very rapidly.
that can deploy very rapidly.
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NATO ima mobilnu jedinicu
koja može krenuti vrlo brzo.
koja može krenuti vrlo brzo.
05:58
NATO does a lot of war games
to check, are people well trained?
to check, are people well trained?
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NATO pravi puno ratnih igrica
kako bi testirali jesu li ljudi spremni.
kako bi testirali jesu li ljudi spremni.
06:01
Do they understand
about fuel and logistics
about fuel and logistics
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Također, testira
znaju li o gorivima i logistici
znaju li o gorivima i logistici
06:03
and the same radio frequencies?
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i je li razumiju iste radio frekvencije,
06:06
So they are absolutely ready to go.
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Tako da su oni spremni za akciju.
06:08
So those are the kinds of things
we need to deal with an epidemic.
we need to deal with an epidemic.
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To su stvari koje trebamo imati kako bi
bili spremni za sučeljavanje s epidemijom.
bili spremni za sučeljavanje s epidemijom.
06:13
What are the key pieces?
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Koji su ključni dijelovi?
06:15
First, we need strong health systems
in poor countries.
in poor countries.
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Prvo, trebamo jake zdravstvene
sustave u siromašnim državama.
sustave u siromašnim državama.
06:20
That's where mothers
can give birth safely,
can give birth safely,
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Tako da bi majke mogle sigurno rađati
06:23
kids can get all their vaccines.
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i djeca bi mogla
dobiti sva cjepiva .
dobiti sva cjepiva .
06:25
But, also where we'll see
the outbreak very early on.
the outbreak very early on.
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Ali također, mogli bismo predvidjeti
izbijanje epidemije vrlo rano.
izbijanje epidemije vrlo rano.
06:30
We need a medical reserve corps:
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Trebamo rezervne medicinske korpuse;
06:31
lots of people who've got
the training and background
the training and background
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mnogo ljudi koji bi
dobili trening i temelje
dobili trening i temelje
06:34
who are ready to go, with the expertise.
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kako bi bili spremni za
polazak sa znanjem.
polazak sa znanjem.
06:37
And then we need to pair those
medical people with the military.
medical people with the military.
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I onda trebamo upariti
to medicinsko osoblje s vojskom
to medicinsko osoblje s vojskom
06:42
taking advantage of the military's ability
to move fast, do logistics
to move fast, do logistics
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kako bi imali vojnu prednost i logistiku,
06:46
and secure areas.
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i kako bi mogli osiguravati područja.
06:48
We need to do simulations,
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Moramo raditi simulacije,
06:51
germ games, not war games,
so that we see where the holes are.
so that we see where the holes are.
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"igre mikroba", ne igre ratova kako bi
vidjeli gdje su rupe u sustavu.
vidjeli gdje su rupe u sustavu.
06:55
The last time a germ game
was done in the United States
was done in the United States
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Zadnji put kada smo
imali "igru mikroba" u Americi
imali "igru mikroba" u Americi
06:58
was back in 2001,
and it didn't go so well.
and it didn't go so well.
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je bilo 2001, i nije prošlo dobro.
07:02
So far the score is germs: 1, people: 0.
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Sadašnji rezultat je
mikrobi : 1 - ljudi : 0.
mikrobi : 1 - ljudi : 0.
07:07
Finally, we need lots of advanced R&D
in areas of vaccines and diagnostics.
in areas of vaccines and diagnostics.
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Naposljetku, trebamo puno naprednog
I&R u cijepljenju i dijagnostici.
I&R u cijepljenju i dijagnostici.
07:13
There are some big breakthroughs,
like the Adeno-associated virus,
like the Adeno-associated virus,
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Postoje veliki napretci poput
onih koji su povezani s Adeno virusom,
onih koji su povezani s Adeno virusom,
07:17
that could work very, very quickly.
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a koji bi mogli raditi vrlo, vrlo brzo.
07:21
Now I don't have an exact budget
for what this would cost,
for what this would cost,
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Ja nemam točan proračun koji
bi odredio koliko bi ovo koštalo,
bi odredio koliko bi ovo koštalo,
07:24
but I'm quite sure it's very modest
compared to the potential harm.
compared to the potential harm.
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ali sam veoma siguran da je poprilično
jeftin u usporedbi s potencijalnom štetom.
jeftin u usporedbi s potencijalnom štetom.
07:29
The World Bank estimates that
if we have a worldwide flu epidemic,
if we have a worldwide flu epidemic,
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Svjetska banka procjenjuje da, kada
bi imali epidemiju gripe širom svijeta,
bi imali epidemiju gripe širom svijeta,
07:33
global wealth will go down
by over three trillion dollars
by over three trillion dollars
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svjetsko bogatstvo bi opalo
za više od tri trilijuna dolara,
za više od tri trilijuna dolara,
07:37
and we'd have millions
and millions of deaths.
and millions of deaths.
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i imali bi milijune i milijune mrtvih.
07:41
These investments
offer significant benefits
offer significant benefits
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Ovakve investicije nude
značajne beneficije
značajne beneficije
07:44
beyond just being ready for the epidemic.
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koje nadilaze spremnost za epidemiju.
07:46
The primary healthcare, the R&D,
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Osnovno zdravstvo,
istraživanje i razvoj (R&D)
istraživanje i razvoj (R&D)
07:48
those things would reduce
global health equity
global health equity
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Ovakve stvari bi umanjile
trošak svjetskog zdravstva
trošak svjetskog zdravstva
07:51
and make the world more just
as well as more safe.
as well as more safe.
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i napravile bi svijet puno sigurnijim.
07:55
So I think this should absolutely
be a priority.
be a priority.
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Zbog ovoga mislim da bi
napomenuto trebalo biti prioritet.
napomenuto trebalo biti prioritet.
07:59
There's no need to panic.
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Ne trebamo paničariti.
08:00
We don't have to hoard cans of spaghetti
or go down into the basement.
or go down into the basement.
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Ne trebamo skupljati limenke
špageta niti silaziti u podrume.
špageta niti silaziti u podrume.
08:05
But we need to get going,
because time is not on our side.
because time is not on our side.
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Ali moramo otpočeti s radom
zato što vrijeme nije na našoj strani.
zato što vrijeme nije na našoj strani.
08:09
In fact, if there's one positive thing
that can come out of the Ebola epidemic,
that can come out of the Ebola epidemic,
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Zapravo, ako postoji jedna pozitivna stvar
koja može proizaći iz epidemije ebole,
koja može proizaći iz epidemije ebole,
08:15
it's that it can serve as an early
warning, a wake-up call, to get ready.
warning, a wake-up call, to get ready.
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to je nekakva vrsta uranjenog
upozorenja, poziva na buđenje i pripremu.
upozorenja, poziva na buđenje i pripremu.
08:21
If we start now, we can be ready
for the next epidemic.
for the next epidemic.
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Ako počnemo sada, možemo biti
spremni za sljedeću epidemiju.
spremni za sljedeću epidemiju.
08:26
Thank you.
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Hvala Vam.
08:28
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Bill Gates - PhilanthropistA passionate techie and a shrewd businessman, Bill Gates changed the world while leading Microsoft to dizzying success. Now he's doing it again with his own style of philanthropy and passion for innovation.
Why you should listen
Bill Gates is the founder and former CEO of Microsoft. A geek icon, tech visionary and business trailblazer, Gates' leadership -- fueled by his long-held dream that millions might realize their potential through great software -- made Microsoft a personal computing powerhouse and a trendsetter in the Internet dawn. Whether you're a suit, chef, quant, artist, media maven, nurse or gamer, you've probably used a Microsoft product today.
In summer of 2008, Gates left his day-to-day role with Microsoft to focus on philanthropy. Holding that all lives have equal value (no matter where they're being lived), the Bill and Melinda Gates Foundation has now donated staggering sums to HIV/AIDS programs, libraries, agriculture research and disaster relief -- and offered vital guidance and creative funding to programs in global health and education. Gates believes his tech-centric strategy for giving will prove the killer app of planet Earth's next big upgrade.
Read a collection of Bill and Melinda Gates' annual letters, where they take stock of the Gates Foundation and the world. And follow his ongoing thinking on his personal website, The Gates Notes. His new paper, "The Next Epidemic," is published by the New England Journal of Medicine.
Bill Gates | Speaker | TED.com