TED2015
Maryn McKenna: What do we do when antibiotics don't work any more?
Maryn McKenna: Što ćemo napraviti kada antibiotici više ne budu djelovali?
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Readability: 4.6
1,800,584 views
Penicilin je promijenio sve. Infekcije koje su prethodno ubijale postale su izlječive u kratkom roku. No, kako Maryn McKenna izlaže u ovom trezvenom govoru, spiskali smo pogodnosti koje su nam osiguravali taj i kasniji antibiotici. Bakterije otporne na lijekove označavaju ulazak u post-antibiotički svijet, koji neće biti tako ugodan. Postoje, međutim, koraci koje možemo učiniti... ako počnemo odmah.
Maryn McKenna - Public health journalist
Maryn McKenna recounts the often terrifying stories behind emerging drug-resistant diseases that medical science is barely keeping at bay. Full bio
Maryn McKenna recounts the often terrifying stories behind emerging drug-resistant diseases that medical science is barely keeping at bay. Full bio
Double-click the English transcript below to play the video.
00:12
This is my great uncle,
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Ovo je moj prastric,
00:14
my father's father's younger brother.
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mlađi brat mog djeda po očevoj strani.
00:17
His name was Joe McKenna.
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1966
Zvao se Joe McKenna.
00:20
He was a young husband
and a semi-pro basketball player
and a semi-pro basketball player
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Bio je mlad, oženjen,
poluprofesionalni igrač bejzbola
poluprofesionalni igrač bejzbola
00:25
and a fireman in New York City.
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i vatrogasac u New Yorku.
00:29
Family history says
he loved being a fireman,
he loved being a fireman,
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Obiteljska predaja kaže
da je volio svoj posao,
da je volio svoj posao,
00:32
and so in 1938, on one of his days off,
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i tijekom jednog svog
slobodnog dana 1938. godine
slobodnog dana 1938. godine
00:35
he elected to hang out at the firehouse.
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provodio je vrijeme u vatrogasnoj postaji.
00:39
To make himself useful that day,
he started polishing all the brass,
he started polishing all the brass,
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Da bude koristan, primio se
laštenja mjedenih predmeta,
laštenja mjedenih predmeta,
00:43
the railings on the fire truck,
the fittings on the walls,
the fittings on the walls,
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ograde na vatrogasnom vozilu,
opreme na zidovima.
opreme na zidovima.
00:46
and one of the fire hose nozzles,
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jedna od glava vatrogasnih šmrkova,
00:48
a giant, heavy piece of metal,
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koja je ogroman i težak metalni predmet,
00:51
toppled off a shelf and hit him.
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pala je s police na njega.
00:55
A few days later,
his shoulder started to hurt.
his shoulder started to hurt.
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Poslije par dana počelo ga je boliti rame.
00:59
Two days after that, he spiked a fever.
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Dva dana kasnije, dobio je vrućicu.
01:02
The fever climbed and climbed.
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Vrućica mu se pogoršavala.
01:05
His wife was taking care of him,
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Supruga ga je njegovala,
01:07
but nothing she did made a difference,
and when they got the local doctor in,
and when they got the local doctor in,
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no ništa nije pomagalo,
a kada su pozvali liječnika
a kada su pozvali liječnika
01:11
nothing he did mattered either.
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ni on nije mogao pomoći.
01:14
They flagged down a cab
and took him to the hospital.
and took him to the hospital.
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Odvezli su ga taksijem u bolnicu.
01:17
The nurses there recognized right away
that he had an infection,
that he had an infection,
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Medicinske sestre su odmah
shvatile da se radi o infekciji,
shvatile da se radi o infekciji,
01:21
what at the time they would
have called "blood poisoning,"
have called "blood poisoning,"
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što se u to vrijeme zvalo "otrovanje krvi"
01:26
and though they probably didn't say it,
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i iako to vjerojatno nisu rekle,
01:28
they would have known right away
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sigurno su odmah znale
01:30
that there was nothing they could do.
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da mu ni na koji način ne mogu pomoći.
01:33
There was nothing they could do
because the things we use now
because the things we use now
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Nisu mu mogle pomoći jer
sredstva koja mi danas koristimo
sredstva koja mi danas koristimo
01:36
to cure infections didn't exist yet.
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za liječenje infekcija,
tada još nisu postojala.
tada još nisu postojala.
01:39
The first test of penicillin,
the first antibiotic,
the first antibiotic,
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Prvi test za penicilin, prvi antibiotik,
01:43
was three years in the future.
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došao je tek tri godine kasnije.
01:45
People who got infections
either recovered, if they were lucky,
either recovered, if they were lucky,
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Ljudi koji su se inficirali,
ili su bili te sreće da se oporave,
ili su bili te sreće da se oporave,
01:50
or they died.
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ili su umirali.
01:52
My great uncle was not lucky.
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Moj prastric nije imao sreće.
01:54
He was in the hospital for a week,
shaking with chills,
shaking with chills,
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Tjedan dana je proveo u
bolnici, drhteći od zimice,
bolnici, drhteći od zimice,
01:57
dehydrated and delirious,
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dehidriran i u bunilu,
01:59
sinking into a coma as his organs failed.
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tonući u komu dok su mu otkazivali organi.
02:02
His condition grew so desperate
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Stanje su se toliko pogoršalo
02:04
that the people from his firehouse
lined up to give him transfusions
lined up to give him transfusions
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da su njegovi kolege iz vatrogasne stanice
čekali u redu da bi mu dali transfuziju,
čekali u redu da bi mu dali transfuziju,
02:09
hoping to dilute the infection
surging through his blood.
surging through his blood.
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nadajući se da će razrijediti infekciju
koja je kolala u njegovim žilama.
koja je kolala u njegovim žilama.
02:13
Nothing worked. He died.
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Ništa nije pomoglo. Umro je.
02:17
He was 30 years old.
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Imao je 30 godina.
02:20
If you look back through history,
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Ako pogledate kroz povijest,
02:22
most people died the way
my great uncle died.
my great uncle died.
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većina ljudi umirala je
poput mog prastrica.
poput mog prastrica.
02:25
Most people didn't die
of cancer or heart disease,
of cancer or heart disease,
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Većina ih nije umirala od
raka ili srčanih bolesti,
raka ili srčanih bolesti,
02:28
the lifestyle diseases that afflict us
in the West today.
in the West today.
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od čega danas boluju ljudi na Zapadu.
02:32
They didn't die of those diseases
because they didn't live long enough
because they didn't live long enough
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Nisu umirali od tih bolesti jer
nisu živjeli dovoljno dugo
nisu živjeli dovoljno dugo
02:36
to develop them.
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da bi ih razvili.
02:38
They died of injuries --
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Umirali su od ozljeda:
02:40
being gored by an ox,
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teško ih je ranio vol,
02:42
shot on a battlefield,
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bili su propucani na bojištu,
02:44
crushed in one of the new factories
of the Industrial Revolution --
of the Industrial Revolution --
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zdrobljeni u novim
tvornicama industrijske revolucije,
tvornicama industrijske revolucije,
02:48
and most of the time from infection,
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a većinu vremena od infekcije,
02:51
which finished what those injuries began.
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koja bi dovršila što su
one ozljede započele.
one ozljede započele.
02:56
All of that changed
when antibiotics arrived.
when antibiotics arrived.
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Sve se to promijenilo pojavom antibiotika.
03:00
Suddenly, infections that had
been a death sentence
been a death sentence
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Odjednom su se infekcije,
koje su nekoć bile smrtonosne,
koje su nekoć bile smrtonosne,
03:04
became something
you recovered from in days.
you recovered from in days.
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mogle izliječiti u nekoliko dana.
03:07
It seemed like a miracle,
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To je bilo poput čuda,
03:10
and ever since, we have been living inside
the golden epoch of the miracle drugs.
the golden epoch of the miracle drugs.
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i otada živimo u zlatnom
dobu čudesnih lijekova.
dobu čudesnih lijekova.
03:17
And now, we are coming to an end of it.
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A sada se primičemo njegovu kraju.
03:21
My great uncle died in the last days
of the pre-antibiotic era.
of the pre-antibiotic era.
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Moj prastric umro je u posljednim
danima pred-antibiotičke ere.
danima pred-antibiotičke ere.
03:26
We stand today on the threshold
of the post-antibiotic era,
of the post-antibiotic era,
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Danas se nalazimo na pragu
post-antibiotičke ere,
post-antibiotičke ere,
03:31
in the earliest days of a time
when simple infections
when simple infections
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u najranijim danima kada
će najjednostavnije infekcije,
će najjednostavnije infekcije,
03:35
such as the one Joe had
will kill people once again.
will kill people once again.
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poput one koju je imao Joe,
ponovo usmrćivati ljude.
ponovo usmrćivati ljude.
03:40
In fact, they already are.
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To se zapravo već i događa.
03:44
People are dying of infections again
because of a phenomenon
because of a phenomenon
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Ljudi ponovo umiru od
infekcija zbog fenomena
infekcija zbog fenomena
03:47
called antibiotic resistance.
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koji se naziva rezistencija
na antibiotike.
na antibiotike.
03:50
Briefly, it works like this.
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To, ukratko, djeluje ovako.
03:52
Bacteria compete against each other
for resources, for food,
for resources, for food,
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Bakterije se međusobno bore za hranu,
03:57
by manufacturing lethal compounds
that they direct against each other.
that they direct against each other.
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tako da proizvode smrtonosne
spojeve kojima se međusobno napadaju.
spojeve kojima se međusobno napadaju.
04:01
Other bacteria, to protect themselves,
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Druge bakterije, kako bi se zaštitile,
04:04
evolve defenses against
that chemical attack.
that chemical attack.
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razvijaju zaštitu protiv
tih kemijskih napada.
tih kemijskih napada.
04:07
When we first made antibiotics,
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Kada smo prvi put stvorili antibiotike,
04:09
we took those compounds into the lab
and made our own versions of them,
and made our own versions of them,
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uzeli smo te spojeve u laboratorij
i od njih napravili naše verzije,
i od njih napravili naše verzije,
04:13
and bacteria responded to our attack
the way they always had.
the way they always had.
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a bakterije su na naš napad odgovorile
jednako kao što uvijek čine.
jednako kao što uvijek čine.
04:19
Here is what happened next:
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Evo što se potom dogodilo:
04:22
Penicillin was distributed in 1943,
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Penicilin se počeo izdavati 1943.,
04:25
and widespread penicillin resistance
arrived by 1945.
arrived by 1945.
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a već do 1945. raširila se
rezistencija bakterija na penicilin.
rezistencija bakterija na penicilin.
04:30
Vancomycin arrived in 1972,
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Vankomicin je proizveden 1972.,
04:33
vancomycin resistance in 1988.
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a rezistentnost na njega 1988.
04:37
Imipenem in 1985,
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Imipenem je razvijen 1985.,
04:39
and resistance to in 1998.
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a rezistentnost na njega 1998.
04:42
Daptomycin, one of
the most recent drugs, in 2003,
the most recent drugs, in 2003,
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Daptomicin, jedan od najnovijih
lijekova, razvijen je 2003.,
lijekova, razvijen je 2003.,
04:45
and resistance to it
just a year later in 2004.
just a year later in 2004.
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a rezistentnost na njega samo
godinu nakon toga - 2004.
godinu nakon toga - 2004.
04:50
For 70 years, we played
a game of leapfrog --
a game of leapfrog --
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Natezali smo se s bakterijama 70 godina,
04:54
our drug and their resistance,
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naš lijek i njihova rezistencija,
04:57
and then another drug,
and then resistance again --
and then resistance again --
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onda drugi lijek, i potom
ponovo rezistencija,
ponovo rezistencija,
05:00
and now the game is ending.
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a sada se to primiče kraju.
05:03
Bacteria develop resistance so quickly
that pharmaceutical companies
that pharmaceutical companies
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Bakterije razvijaju rezistenciju toliko
brzo da su farmaceutske tvrtke
brzo da su farmaceutske tvrtke
05:07
have decided making antibiotics
is not in their best interest,
is not in their best interest,
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odlučile da im se više ne isplati
proizvoditi nove antibiotike,
proizvoditi nove antibiotike,
05:11
so there are infections
moving across the world
moving across the world
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pa se svijetom šire infekcije
05:14
for which, out of the more
than 100 antibiotics
than 100 antibiotics
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za koje, od više od sto antibiotika
05:18
available on the market,
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dostupnih na tržištu,
05:20
two drugs might work with side effects,
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dva lijeka možda djeluju s nuspojavama,
05:23
or one drug,
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ili jedan lijek,
05:26
or none.
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ili nijedan.
05:28
This is what that looks like.
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Ovako to izgleda.
05:30
In 2000, the Centers for Disease
Control and Prevention, the CDC,
Control and Prevention, the CDC,
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2000. godine, Centar za
kontrolu i prevenciju bolesti,
kontrolu i prevenciju bolesti,
05:34
identified a single case
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identificirao je
05:36
in a hospital in North Carolina
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u bolnici u Sjevernoj Karolini
05:38
of an infection resistant
to all but two drugs.
to all but two drugs.
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infekciju rezistentnu
na sve osim dva lijeka.
na sve osim dva lijeka.
05:42
Today, that infection, known as KPC,
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Ta se infekcija, zvana KCP, do danas
05:47
has spread to every state but three,
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raširila na sve savezne
američke države osim tri,
američke države osim tri,
05:49
and to South America, Europe
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kao i na Južnu Ameriku, Europu
05:52
and the Middle East.
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i Bliski Istok.
05:54
In 2008, doctors in Sweden
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Liječnici u Švedskoj su 2008. godine
05:57
diagnosed a man from India
with a different infection
with a different infection
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dijagnosticirali čovjeku iz
Indije jednu drugu infekciju
Indije jednu drugu infekciju
05:59
resistant to all but one drug that time.
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koja je je otporna na
sve osim jednog lijeka.
sve osim jednog lijeka.
06:03
The gene that creates that resistance,
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Gen koji stvara tu rezistentnost,
06:05
known as NDM, has now spread
from India into China, Asia, Africa,
from India into China, Asia, Africa,
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zvan NDM, proširio se iz
Indije na Kinu, Aziju, Afriku,
Indije na Kinu, Aziju, Afriku,
06:12
Europe and Canada, and the United States.
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Europu, Kanadu i SAD.
06:17
It would be natural to hope
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Normalno je nadati se
06:19
that these infections
are extraordinary cases,
are extraordinary cases,
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da su te infekcije iznimke,
06:23
but in fact,
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no u stvarnosti,
06:25
in the United States and Europe,
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u SAD-u i Europi
06:27
50,000 people a year
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50.000 ljudi godišnje
06:30
die of infections which no drugs can help.
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umre od infekcija kojima nema lijeka.
06:34
A project chartered
by the British government
by the British government
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Britanska vlada pokrenula je projekt
06:38
known as the Review
on Antimicrobial Resistance
on Antimicrobial Resistance
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zvan Pregled antimikrobske rezistencije
06:41
estimates that the worldwide toll
right now is 700,000 deaths a year.
right now is 700,000 deaths a year.
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koji procjenjuje da trenutno 700.000 ljudi
na svijetu godišnje umre od ovoga.
na svijetu godišnje umre od ovoga.
06:50
That is a lot of deaths,
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To je jako puno smrtnih slučajeva,
06:54
and yet, the chances are good
that you don't feel at risk,
that you don't feel at risk,
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no mi se uglavnom ne osjećamo ugroženo,
06:57
that you imagine these people
were hospital patients
were hospital patients
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jer vjerujemo da su ti ljudi
bili pacijenti u bolnici,
bili pacijenti u bolnici,
07:00
in intensive care units
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na odjelima intenzivne njege,
07:02
or nursing home residents
near the ends of their lives,
near the ends of their lives,
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ili se približavali kraju života
u staračkim domovima.
u staračkim domovima.
07:06
people whose infections
are remote from us,
are remote from us,
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Ljudi čije infekcije su daleko od nas,
07:09
in situations we can't identify with.
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u situacijama s kojima se
ne možemo poistovjetiti.
ne možemo poistovjetiti.
07:14
What you didn't think about,
none of us do,
none of us do,
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No nitko od nas nije razmišljao o tome
07:17
is that antibiotics support
almost all of modern life.
almost all of modern life.
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da se gotovo čitav moderan život
oslanja na antibiotike.
oslanja na antibiotike.
07:23
If we lost antibiotics,
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Da izgubimo antibiotike,
07:25
here's what else we'd lose:
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izgubili bismo i sljedeće:
07:27
First, any protection for people
with weakened immune systems --
with weakened immune systems --
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Bilokakvu zaštitu za pacijente
s oslabljenim imunosustavom:
s oslabljenim imunosustavom:
07:32
cancer patients, AIDS patients,
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pacijente s rakom, AIDS-om,
07:35
transplant recipients, premature babies.
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primatelje novih organa, nedonošćad.
07:39
Next, any treatment that installs
foreign objects in the body:
foreign objects in the body:
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Nadalje, bilokakva terapija kojom
se ugrađuju strana tijela u organizam:
se ugrađuju strana tijela u organizam:
07:44
stents for stroke, pumps for diabetes,
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stentovi za moždani udar,
pumpe za šećernu bolest,
pumpe za šećernu bolest,
07:48
dialysis, joint replacements.
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dijalizu, nadomjesci za zglobove.
07:52
How many athletic baby boomers
need new hips and knees?
need new hips and knees?
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Koliko 50-70-godišnjaka koji se bave
sportom treba novi kuk ili koljeno?
sportom treba novi kuk ili koljeno?
07:55
A recent study estimates
that without antibiotics,
that without antibiotics,
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Nedavna studija procjenjuje
da bi bez antibiotika
da bi bez antibiotika
07:58
one out of ever six would die.
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svaka šesta osoba umrla.
08:02
Next, we'd probably lose surgery.
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Vjerojatno ne bismo više imali kirurgiju.
08:05
Many operations are preceded
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Prije mnogih operacija pacijentima se daju
08:08
by prophylactic doses of antibiotics.
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profilaktičke doze antibiotika.
08:11
Without that protection,
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Bez te zaštite,
08:12
we'd lose the ability to open
the hidden spaces of the body.
the hidden spaces of the body.
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ne bismo više mogli
otvarati tijela pacijenata.
otvarati tijela pacijenata.
08:17
So no heart operations,
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Ne bi bilo operacija srca,
08:19
no prostate biopsies,
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biopsije prostate,
08:22
no Cesarean sections.
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carskog reza.
08:25
We'd have to learn to fear infections
that now seem minor.
that now seem minor.
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Morali bismo se priviknuti na strah od
zaraza koje nam se sada čine beznačajne.
zaraza koje nam se sada čine beznačajne.
08:30
Strep throat used to cause heart failure.
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Streptokokna upala grla prije
je uzrokovala zatajenje srca.
je uzrokovala zatajenje srca.
08:34
Skin infections led to amputations.
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Kožne infekcije vodile su do amputacija.
08:37
Giving birth killed,
in the cleanest hospitals,
in the cleanest hospitals,
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Žene su umirale tijekom rađanja,
u najčišćim bolnicama,
u najčišćim bolnicama,
08:40
almost one woman out of every 100.
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gotovo svaka stota žena.
08:43
Pneumonia took three children
out of every 10.
out of every 10.
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Troje od desetero djece
umiralo je od upale pluća.
umiralo je od upale pluća.
08:49
More than anything else,
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Više od ičega drugog,
08:51
we'd lose the confident way
we live our everyday lives.
we live our everyday lives.
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izgubili bismo sigurnost s kojom
živimo svakodnevni život.
živimo svakodnevni život.
08:56
If you knew that any injury
could kill you,
could kill you,
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Da znate da vas bilokakva
ozljeda može ubiti,
ozljeda može ubiti,
09:01
would you ride a motorcycle,
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biste li vozili motor,
09:04
bomb down a ski slope,
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jurili na skijalištu,
09:07
climb a ladder to hang
your Christmas lights,
your Christmas lights,
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penjali se na ljestve da
objesite božićne lampice,
objesite božićne lampice,
09:10
let your kid slide into home plate?
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dopustili svome djetetu da se
baca po nogometnom terenu?
baca po nogometnom terenu?
09:15
After all, the first person
to receive penicillin,
to receive penicillin,
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Naposljetku, prva osoba
koja je primila penicilin,
koja je primila penicilin,
09:18
a British policeman named
Albert Alexander,
Albert Alexander,
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britanski policajac Albert Alexander,
09:22
who was so ravaged by infection
that his scalp oozed pus
that his scalp oozed pus
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kojeg je toliko uništila infekcija
da mu je iz lubanje curio gnoj,
da mu je iz lubanje curio gnoj,
09:26
and doctors had to take out an eye,
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i liječnici su mu morali izvaditi oko,
09:29
was infected by doing
something very simple.
something very simple.
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zarazio se radeći nešto
vrlo jednostavno.
vrlo jednostavno.
09:34
He walked into his garden
and scratched his face on a thorn.
and scratched his face on a thorn.
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Ušetao se u svoj vrt i
ogrebao lice trnom.
ogrebao lice trnom.
09:40
That British project I mentioned
which estimates that the worldwide toll
which estimates that the worldwide toll
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Onaj britanski projekt koji sam spomenula
prema kojemu trenutno na svijetu
prema kojemu trenutno na svijetu
09:44
right now is 700,000 deaths a year
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svake godine umire 700.000 ljudi
09:48
also predicts that if we can't
get this under control by 2050,
get this under control by 2050,
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također predviđa da će, ako ovu situaciju
ne stavimo pod kontrolu do 2050. godine,
ne stavimo pod kontrolu do 2050. godine,
09:54
not long, the worldwide toll
will be 10 million deaths a year.
will be 10 million deaths a year.
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u kratkom roku godišnje
umirati 10 milijuna ljudi.
umirati 10 milijuna ljudi.
10:02
How did we get to this point
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Kako smo došli do ove situacije
10:04
where what we have to look forward to
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u kojoj predviđamo
10:06
is those terrifying numbers?
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takve strašne brojke?
10:10
The difficult answer is,
we did it to ourselves.
we did it to ourselves.
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Teška je istina da smo
si sami to prouzročili.
si sami to prouzročili.
10:14
Resistance is an inevitable
biological process,
biological process,
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Rezistencija je neizbježan
biološki proces,
biološki proces,
10:17
but we bear the responsibility
for accelerating it.
for accelerating it.
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no mi smo odgovorni za njeno ubrzavanje.
10:22
We did this by squandering antibiotics
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To smo prouzročili
dijeljenjem antibiotika
dijeljenjem antibiotika
10:26
with a heedlessness
that now seems shocking.
that now seems shocking.
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takvom bezbrižnošću koja
nam se sada čini šokantnom.
nam se sada čini šokantnom.
10:31
Penicillin was sold
over the counter until the 1950s.
over the counter until the 1950s.
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Penicilin se prodavao
bez recepta do 1950-ih.
bez recepta do 1950-ih.
10:35
In much of the developing world,
most antibiotics still are.
most antibiotics still are.
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Većina antibiotika još uvijek se tako
prodaje diljem razvijenog svijeta.
prodaje diljem razvijenog svijeta.
10:39
In the United States, 50 percent
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U SAD-u 50 posto
10:42
of the antibiotics given
in hospitals are unnecessary.
in hospitals are unnecessary.
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antibiotika koji se daju
u bolnicama su nepotrebni.
u bolnicama su nepotrebni.
10:46
Forty-five percent of the prescriptions
written in doctor's offices
written in doctor's offices
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45 posto recepata koje izdaju liječnici
10:51
are for conditions
that antibiotics cannot help.
that antibiotics cannot help.
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daje se za stanja kojima
antibiotici ne pomažu.
antibiotici ne pomažu.
10:56
And that's just in healthcare.
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I to je samo stanje u zdravstvu.
10:59
On much of the planet, most meat animals
get antibiotics every day of their lives,
get antibiotics every day of their lives,
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Diljem planeta, većina životinja uzgajana
za meso dobiva antibiotike svaki dan,
za meso dobiva antibiotike svaki dan,
11:04
not to cure illnesses,
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ne radi izlječenja bolesti,
11:06
but to fatten them up
and to protect them against
and to protect them against
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već da ih se ugoji i zaštiti od
11:09
the factory farm conditions
they are raised in.
they are raised in.
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uvjeta na farmi na kojoj su uzgajana.
11:13
In the United States, possibly 80 percent
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U SAD-u oko 80 posto antibiotika
11:16
of the antibiotics sold every year
go to farm animals, not to humans,
go to farm animals, not to humans,
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prodanih svake godine najmjenjeno
je životinjama na farmama, a ne ljudima,
je životinjama na farmama, a ne ljudima,
11:23
creating resistant bacteria
that move off the farm
that move off the farm
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stvarajući tako rezistentne
bakterije koje sa farmi odlaze
bakterije koje sa farmi odlaze
11:27
in water, in dust,
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u vodu, prašinu
11:29
in the meat the animals become.
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i meso koje te životinje postaju.
11:32
Aquaculture depends on antibiotics too,
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Akvakultura također ovisi o antibioticima,
11:35
particularly in Asia,
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posebice u Aziji,
11:37
and fruit growing relies on antibiotics
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i uzgoj voća oslanja se na antibiotike
11:40
to protect apples, pears,
citrus, against disease.
citrus, against disease.
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radi zaštite jabuka, krušaka
i citrusa protiv bolesti.
i citrusa protiv bolesti.
11:46
And because bacteria can pass
their DNA to each other
their DNA to each other
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S obzirom da bakterije mogu
međusobno prenositi svoj DNK
međusobno prenositi svoj DNK
11:52
like a traveler handing off
a suitcase at an airport,
a suitcase at an airport,
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poput putnika koji predaje
putnu torbu u zračnoj luci,
putnu torbu u zračnoj luci,
11:56
once we have encouraged
that resistance into existence,
that resistance into existence,
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jednom kada izazovemo tu rezistenciju,
12:01
there is no knowing where it will spread.
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ne možemo znati kamo
će se sve ona raširiti.
će se sve ona raširiti.
12:05
This was predictable.
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Ovo smo mogli predvidjeti.
12:07
In fact, it was predicted
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To je zaista i predvidio
12:10
by Alexander Fleming,
the man who discovered penicillin.
the man who discovered penicillin.
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Alexander Fleming, čovjek
koji je okrio penicilin.
koji je okrio penicilin.
12:14
He was given the Nobel Prize
in 1945 in recognition,
in 1945 in recognition,
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Za priznanje je 1945. godine
dobio Nobelovu nagradu,
dobio Nobelovu nagradu,
12:18
and in an interview shortly after,
this is what he said:
this is what he said:
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a u intervjuu koji je nedugo
potom dao, evo što je izjavio:
potom dao, evo što je izjavio:
12:23
"The thoughtless person playing
with penicillin treatment
with penicillin treatment
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"Bezumna osoba koja se
igra terapijom penicilinom
igra terapijom penicilinom
12:27
is morally responsible
for the death of a man
for the death of a man
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moralno je odgovorna za smrt čovjeka
12:30
who succumbs to infection
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koji podlegne infekciji
12:33
with a pencillin-resistant organism."
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uzrokovanom organizmom
koji je rezistentan na penicilin."
koji je rezistentan na penicilin."
12:36
He added, "I hope this evil
can be averted."
can be averted."
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Dodaje: "Nadam se da
se ovo zlo može izbjeći."
se ovo zlo može izbjeći."
12:40
Can we avert it?
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Možemo li to izbjeći?
12:43
There are companies working
on novel antibiotics,
on novel antibiotics,
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Neke tvrtke rade na novim antibioticima,
12:47
things the superbugs
have never seen before.
have never seen before.
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stvarima koje superbakterije
nisu nikada vidjele.
nisu nikada vidjele.
12:51
We need those new drugs badly,
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Jako su nam potrebni ti novi lijekovi,
12:53
and we need incentives:
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i trebamo poticaje:
12:56
discovery grants, extended patents,
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subvencije za otkrića, proširene patente,
12:58
prizes, to lure other companies
into making antibiotics again.
into making antibiotics again.
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nagrade, kako bismo privukli druge tvrtke
da ponovo počnu proizvoditi antibiotike.
da ponovo počnu proizvoditi antibiotike.
13:05
But that probably won't be enough.
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No to vjerojatno neće biti dovoljno.
13:08
Here's why: Evolution always wins.
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Zato što evolucija uvijek pobjeđuje.
13:12
Bacteria birth a new generation
every 20 minutes.
every 20 minutes.
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Svakih 20 minuta stvara se
nova generacija bakterija.
nova generacija bakterija.
13:16
It takes pharmaceutical chemistry
10 years to derive a new drug.
10 years to derive a new drug.
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Farmaceutskim tvrtkama treba
deset godina da naprave novi lijek.
deset godina da naprave novi lijek.
13:21
Every time we use an antibiotic,
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Svaki put kada koristimo antibiotik,
13:24
we give the bacteria billions of chances
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dajemo bakterijama milijardu šansi
13:27
to crack the codes
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da razbiju šifre
13:29
of the defenses we've constructed.
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zaštita koje smo izgradili.
13:32
There has never yet been a drug
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Dosad nije bilo lijeka
13:34
they could not defeat.
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kojeg nisu uspjele pobijediti.
13:37
This is asymmetric warfare,
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Ovo je neravnopravno ratovanje,
13:40
but we can change the outcome.
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ali možemo izmijeniti njegov ishod.
13:45
We could build systems to harvest data
to tell us automatically and specifically
to tell us automatically and specifically
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Možemo izgraditi sustave za prikupljanje
podataka koji nam automatski i konkretno
podataka koji nam automatski i konkretno
13:52
how antibiotics are being used.
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govore kako se antibiotici koriste.
13:55
We could build gatekeeping
into drug order systems
into drug order systems
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Možemo izgraditi kontrolu
nad pisanjem recepata
nad pisanjem recepata
13:58
so that every prescription
gets a second look.
gets a second look.
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tako da se svaki recept pregledava.
14:01
We could require agriculture
to give up antibiotic use.
to give up antibiotic use.
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Mogli bismo tražiti od poljoprivrede
da više ne koristi antibiotike.
da više ne koristi antibiotike.
14:08
We could build surveillance systems
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Mogli bismo izgraditi nadzorne sustave
14:11
to tell us where resistance
is emerging next.
is emerging next.
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koji bi otkrivali gdje se
pojavila nova rezistencija.
pojavila nova rezistencija.
14:15
Those are the tech solutions.
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To su tehnološka rješenja.
14:18
They probably aren't enough either,
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Ni ona vjerojatno nisu dovoljna,
14:20
unless we help.
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osim ako mi ne pomognemo.
14:27
Antibiotic resistance is a habit.
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Rezistencija na antibiotike je navika.
14:30
We all know how hard it is
to change a habit.
to change a habit.
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Svi znamo koliko je
teško izmijeniti naviku.
teško izmijeniti naviku.
14:33
But as a society,
we've done that in the past.
we've done that in the past.
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No, to smo kao društvo već ranije radili.
14:38
People used to toss litter
into the streets,
into the streets,
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Ljudi su običavali bacati smeće po cesti,
14:41
used to not wear seatbelts,
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nisu vezali sigurnosni pojas u autima,
14:43
used to smoke inside public buildings.
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pušili su u javnim zgradama.
14:48
We don't do those things anymore.
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Više to ne radimo.
14:51
We don't trash the environment
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Ne zagađujemo okoliš,
14:53
or court devastating accidents
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ne izazivamo strašne nesreće,
14:56
or expose others
to the possibility of cancer,
to the possibility of cancer,
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niti ne izlažemo druge
mogućem oboljenju od raka,
mogućem oboljenju od raka,
14:59
because we decided those things
were expensive,
were expensive,
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jer smo zaključili da nam je to skupo,
15:03
destructive, not in our best interest.
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destruktivno i da nam nije u interesu.
15:07
We changed social norms.
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Promijenili smo društvene norme.
15:11
We could change social norms
around antibiotic use too.
around antibiotic use too.
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Mogli bismo promijeniti društvene
norme i kod uporabe antibiotika.
norme i kod uporabe antibiotika.
15:17
I know that the scale
of antibiotic resistance
of antibiotic resistance
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Znam da se razina
rezistencije na antibiotike
rezistencije na antibiotike
15:19
seems overwhelming,
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čini nepobjediva,
15:21
but if you've ever bought
a fluorescent lightbulb
a fluorescent lightbulb
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no ako ste ikada kupili štednu žarulju
15:25
because you were concerned
about climate change,
about climate change,
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2716
jer se brinete zbog klimatskih promjena,
15:27
or read the label on a box of crackers
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ili ste pročitali sastav
namirnica na kutiji krekera
namirnica na kutiji krekera
15:30
because you think about
the deforestation from palm oil,
the deforestation from palm oil,
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jer razmišljate o deforestaciji
zbog palminog ulja,
zbog palminog ulja,
15:35
you already know what it feels like
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već znate kako je to kada
15:38
to take a tiny step to address
an overwhelming problem.
an overwhelming problem.
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učinite malen korak radi
naoko nepobjedivog problema.
naoko nepobjedivog problema.
15:43
We could take those kinds of steps
for antibiotic use too.
for antibiotic use too.
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Mogli bismo poduzeti takve
korake i u uporabi antibiotika.
korake i u uporabi antibiotika.
15:48
We could forgo giving an antibiotic
if we're not sure it's the right one.
if we're not sure it's the right one.
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Mogli bismo odustati od davanja nekog
antibiotika ako nismo sigurni da je dobar.
antibiotika ako nismo sigurni da je dobar.
15:56
We could stop insisting on a prescription
for our kid's ear infection
for our kid's ear infection
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Mogli bismo prestati inzistirati na
receptu ako nam dijete ima upalu uha
receptu ako nam dijete ima upalu uha
16:02
before we're sure what caused it.
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prije nego utvrdimo što ju je uzrokovalo.
16:05
We could ask every restaurant,
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Mogli bismo pitati svaki restoran,
16:09
every supermarket,
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svaki supermarket,
16:10
where their meat comes from.
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odakle dolazi njihovo meso.
16:12
We could promise each other
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Mogli bismo jedni drugima obećati
16:14
never again to buy chicken
or shrimp or fruit
or shrimp or fruit
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da nikada više nećemo
kupiti piletinu, škampe ili voće
kupiti piletinu, škampe ili voće
16:18
raised with routine antibiotic use,
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uzgajane uz pomoć
rutinske uporabe antibiotika,
rutinske uporabe antibiotika,
16:21
and if we did those things,
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i ako se toga držimo,
16:24
we could slow down the arrival
of the post-antibiotic world.
of the post-antibiotic world.
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mogli bismo usporiti dolazak
post-antibiotičkog svijeta.
post-antibiotičkog svijeta.
16:29
But we have to do it soon.
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No to moramo učiniti brzo.
16:33
Penicillin began
the antibiotic era in 1943.
the antibiotic era in 1943.
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4505
Penicilin je 1943. godine
započeo eru antibiotika.
započeo eru antibiotika.
16:38
In just 70 years, we walked ourselves
up to the edge of disaster.
up to the edge of disaster.
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U samo 70 godina doveli
smo se do ruba propasti.
smo se do ruba propasti.
16:44
We won't get 70 years
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Nećemo imati dodatnih 70 godina
16:46
to find our way back out again.
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da pronađemo izlaz iz ovoga.
16:50
Thank you very much.
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Hvala vam.
16:52
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Maryn McKenna - Public health journalistMaryn McKenna recounts the often terrifying stories behind emerging drug-resistant diseases that medical science is barely keeping at bay.
Why you should listen
Maryn McKenna’s harrowing stories of hunting down anthrax with the CDC and her chronicle of antibiotic-resistant staph infections in Superbug earned her the nickname “scary disease girl” among her colleagues.
But her investigations into public health don’t stop there: she blogs and writes on the history of epidemics and the public health challenges posed by factory farming. For her forthcoming book, McKenna is researching the symbiotic history of food production and antibiotics, and how their use impacts our lives, societies and the potential for illness.
Maryn McKenna | Speaker | TED.com