TED2015
Seth Berkley: The troubling reason why vaccines are made too late ... if they're made at all
Seth Berkeley: Problematični razlog zbog kojeg cjepiva proizvodimo prekasno...ako uopće proizvodimo
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Izgleda da čekamo pojavu užasne bolesti prije no što počnemo ozbiljno razmišljati o razvijanju cjepiva protiv iste. Seth Berkeley prikazuje tržišnu stvarnost i neuravnotežene rizike zbog kojih ne razvijamo cijepiva za najveće svjetske bolesti.
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. Full bio
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 symptoms begin
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Dječji simptomi počinju
00:15
with mild fever, headache, muscle pains,
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s blagom groznicom,
glavoboljom, bolovima u mišićima,
glavoboljom, bolovima u mišićima,
00:18
followed by vomiting and diarrhea,
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nakon čega slijede povraćanje i proljev,
00:21
then bleeding from the mouth,
nose and gums.
nose and gums.
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zatim krvarenje iz usta,
nosa i desni.
nosa i desni.
00:25
Death follows in the form of organ failure
from low blood pressure.
from low blood pressure.
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Slijedi smrt u obliku zatajenja organa
zbog niskog krvnog tlaka.
zbog niskog krvnog tlaka.
00:31
Sounds familiar?
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Zvuči poznato?
00:33
If you're thinking this is Ebola,
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Ako mislite da je to ebola,
00:36
actually, in this case, it's not.
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zapravo, u ovom slučaju, nije.
00:38
It's an extreme form of dengue fever,
a mosquito-born disease
a mosquito-born disease
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To je ekstremni oblik dengi groznice,
bolesti koju uzrokuju komarci
bolesti koju uzrokuju komarci
00:43
which also does not have
an effective therapy or a vaccine,
an effective therapy or a vaccine,
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i za koju također ne postoji
učinkovita terapija ili cjepivo
učinkovita terapija ili cjepivo
00:48
and kills 22,000 people each year.
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i koja ubija 22,000 ljudi godišnje.
00:52
That is actually twice
the number of people
the number of people
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To je zapravo dvostruko više ljudi
00:54
that have been killed by Ebola
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od onih ubijenih ebolom
00:56
in the nearly four decades
that we've known about it.
that we've known about it.
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u gotovo četiri desetljeća
koliko znamo za nju.
koliko znamo za nju.
01:00
As for measles, so much
in the news recently,
in the news recently,
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Što se tiče ospica, koje su često na
vijestima u posljednje vrijeme,
vijestima u posljednje vrijeme,
01:04
the death toll is actually tenfold higher.
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smrtnost je zapravo deset puta veća.
01:09
Yet for the last year,
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Ipak, protekle godine
01:11
it has been Ebola that has stolen
all of the headlines and the fear.
all of the headlines and the fear.
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ebola je zauzela sve naslove i strah.
01:17
Clearly, there is something
deeply rooted about it,
deeply rooted about it,
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Očito postoji neki razlog,
01:19
something which scares us
and fascinates us
and fascinates us
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nešto što nas plaši i fascinira
01:22
more than other diseases.
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više nego druge bolesti.
01:24
But what is it, exactly?
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Ali što je to točno?
01:27
Well, it's hard to acquire Ebola,
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Pa, teško je zaraziti se ebolom,
01:29
but if you do, the risk
of a horrible death is high.
of a horrible death is high.
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ali ako se to dogodi,
rizik užasne smrti je visok.
rizik užasne smrti je visok.
01:33
Why?
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Zašto?
01:34
Because right now, we don't have any
effective therapy or vaccine available.
effective therapy or vaccine available.
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Zato što trenutno nemamo nikakvu
učinkovitu terapiju ili dostupno cjepivo.
učinkovitu terapiju ili dostupno cjepivo.
01:40
And so, that's the clue.
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Dakle, to je ključ.
01:43
We may have it someday.
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Jednog dana možda ćemo imati.
01:45
So we rightfully fear Ebola,
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Dakle, s pravom se bojimo ebole
01:48
because it doesn't kill
as many people as other diseases.
as many people as other diseases.
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zato što ne ubija toliko ljudi
poput drugih bolesti.
poput drugih bolesti.
01:53
In fact, it's much less transmissible
than viruses such as flu or measles.
than viruses such as flu or measles.
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Zapravo, puno se teže prenosi od drugih
virusa, kao na primjer gripe ili ospica.
virusa, kao na primjer gripe ili ospica.
01:59
We fear Ebola because of the fact
that it kills us and we can't treat it.
that it kills us and we can't treat it.
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Bojimo se ebole zbog činjenice da nas
ubija i da ju ne možemo izliječiti.
ubija i da ju ne možemo izliječiti.
02:05
We fear the certain inevitability
that comes with Ebola.
that comes with Ebola.
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Bojimo se određene neizbježnosti
koja dolazi s ebolom.
koja dolazi s ebolom.
02:08
Ebola has this inevitability
that seems to defy modern medical science.
that seems to defy modern medical science.
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Ebola posjeduje neizbježnost koja kao
da prkosi današnjoj modernoj medicini.
da prkosi današnjoj modernoj medicini.
02:14
But wait a second, why is that?
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Ali čekajte malo, zašto je tome tako?
02:16
We've known about Ebola since 1976.
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Znamo za ebolu od 1976.
02:20
We've known what it's capable of.
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Znamo za što je sposobna.
02:22
We've had ample opportunity to study it
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Imali smo dovoljno prilika da ju proučimo
02:24
in the 24 outbreaks that have occurred.
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u 24 epidemije koje su se zbile.
02:27
And in fact, we've actually had
vaccine candidates available now
vaccine candidates available now
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I zapravo imamo moguća
cjepiva koja su dostupna
cjepiva koja su dostupna
02:31
for more than a decade.
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već preko deset godina.
02:33
Why is that those vaccines
are just going into clinical trials now?
are just going into clinical trials now?
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Zašto da cjepiva tek sada
prolaze klinička testiranja?
prolaze klinička testiranja?
02:38
This goes to the fundamental
problem we have
problem we have
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Ovome je razlog osnovni problem koji imamo
02:41
with vaccine development
for infectious diseases.
for infectious diseases.
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s razvojem cjepiva za zarazne bolesti.
Glasi ovako nekako:
02:45
It goes something like this:
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02:47
The people most at risk for these diseases
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Ljudi koji su najrizičnija
skupina za te bolesti
skupina za te bolesti
02:50
are also the ones least able
to pay for vaccines.
to pay for vaccines.
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su ujedno i ljudi koji su najmanje
u mogućnosti platiti cjepiva.
u mogućnosti platiti cjepiva.
02:55
This leaves little in the way
of market incentives
of market incentives
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Zbog toga tržište nema inicijativu
02:59
for manufacturers to develop vaccines,
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za proizvodnju i razvoj cjepiva
03:02
unless there are large numbers of people
who are at risk in wealthy countries.
who are at risk in wealthy countries.
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osim ako velik broj ljudi koji riskiraju
oboljenje nije u bogatim zemljama.
oboljenje nije u bogatim zemljama.
03:07
It's simply too commercially risky.
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Jednostavno je tržišno preriskantno.
03:11
As for Ebola, there is absolutely
no market at all,
no market at all,
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Što se ebole tiče,
ne postoji nikakvo tržište,
ne postoji nikakvo tržište,
03:15
so the only reason we have two vaccines
in late-stage clinical trials now,
in late-stage clinical trials now,
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tako da je jedini razlog što imamo dva
cjepiva u stadiju kliničkih istraživanja
cjepiva u stadiju kliničkih istraživanja
03:21
is actually because
of a somewhat misguided fear.
of a somewhat misguided fear.
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zapravo strah u nekoj zabludi.
03:24
Ebola was relatively ignored
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Ebolu se relativno ignoriralo
03:27
until September 11
and the anthrax attacks,
and the anthrax attacks,
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do 11. rujna i napada bedrenicom,
03:32
when all of a sudden,
people perceived Ebola
people perceived Ebola
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kada su ljudi odjednom
počeli doživljavati ebolu
počeli doživljavati ebolu
03:34
as, potentially, a bioterrorism weapon.
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kao potencijalno oružje bioterorizma.
03:37
Why is it that the Ebola vaccine
wasn't fully developed at this point?
wasn't fully developed at this point?
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Zbog čega onda cjepivo protiv ebole
još nije potpuno razvijeno?
još nije potpuno razvijeno?
03:42
Well, partially, because
it was really difficult --
it was really difficult --
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Pa ,djelomično zato
što je stvarno teško --
što je stvarno teško --
03:44
or thought to be difficult --
to weaponize the virus,
to weaponize the virus,
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ili se smatra teškim --
naoružati virus,
naoružati virus,
03:47
but mainly because
of the financial risk in developing it.
of the financial risk in developing it.
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ali uglavnom zbog financijskog
rizika razvijanja tog cjepiva.
rizika razvijanja tog cjepiva.
03:53
And this is really the point.
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I tu je zapravo poanta.
03:55
The sad reality is, we develop vaccines
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Tužna stvarnost je da razvijemo cjepiva,
03:58
not based upon the risk
the pathogen poses to people,
the pathogen poses to people,
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ne prema riziku koji
patogen predstavlja za ljude,
patogen predstavlja za ljude,
04:02
but on how economically risky it is
to develop these vaccines.
to develop these vaccines.
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nego prema ekonomskom
riziku razvoja cjepiva.
riziku razvoja cjepiva.
04:06
Vaccine development
is expensive and complicated.
is expensive and complicated.
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Razvoj cjepiva je skup i kompliciran.
04:09
It can cost hundreds
of millions of dollars
of millions of dollars
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Može koštati stotine milijuna dolara
04:11
to take even a well-known antigen
and turn it into a viable vaccine.
and turn it into a viable vaccine.
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da se čak vrlo dobro poznat antigen
pretvori u učinkovito cjepivo.
pretvori u učinkovito cjepivo.
04:17
Fortunately for diseases like Ebola,
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Srećom, za bolesti kao što je ebola
04:19
there are things we can do
to remove some of these barriers.
to remove some of these barriers.
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postoje načini kojima možemo
ukloniti neke od prepreka.
ukloniti neke od prepreka.
04:23
The first is to recognize
when there's a complete market failure.
when there's a complete market failure.
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Prvi način je prepoznati
potpuni neuspjeh tržišta.
potpuni neuspjeh tržišta.
04:27
In that case, if we want vaccines,
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U tom slučaju, ako želimo cjepiva,
04:30
we have to provide incentives
or some type of subsidy.
or some type of subsidy.
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moramo dati poticaj ili neku
vrstu novčane subvencije.
vrstu novčane subvencije.
04:36
We also need to do a better job
at being able to figure out
at being able to figure out
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Također moramo biti bolji u dokučivanju
04:40
which are the diseases
that most threaten us.
that most threaten us.
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koje nas bolesti najviše ugrožavaju.
04:43
By creating capabilities within countries,
we then create the ability
we then create the ability
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Stvaranjem mogućnosti u državama,
stvaramo mogućnost
stvaramo mogućnost
04:48
for those countries to create
epidemiological and laboratory networks
epidemiological and laboratory networks
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za te države da stvore epidemiološke
i laboratorijske veze
i laboratorijske veze
04:52
which are capable of collecting
and categorizing these pathogens.
and categorizing these pathogens.
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koje su u mogućnosti prikupiti
i kategorizirati te patogene.
i kategorizirati te patogene.
04:58
The data from that then can be used
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Podaci iz toga se tada mogu iskoristiti
05:00
to understand the geographic
and genetic diversity,
and genetic diversity,
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za razumijevanje zamljopisne
i genetske raznolikosti,
i genetske raznolikosti,
05:03
which then can be used
to help us understand
to help us understand
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koji se zatim mogu iskoristiti
za razumijevanje
za razumijevanje
05:06
how these are being changed
immunologically,
immunologically,
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kako se mijenjaju imunološki
05:10
and what type of reactions they promote.
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i koji tip reakcija uzrokuju.
05:13
So these are the things that can be done,
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To možemo napraviti,
05:15
but to do this, if we want to deal
with a complete market failure,
with a complete market failure,
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ali da bismo to učinili, ako se želimo
suočiti s potpunim neuspjehom tržišta,
suočiti s potpunim neuspjehom tržišta,
05:19
we have to change the way
we view and prevent infectious diseases.
we view and prevent infectious diseases.
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moramo promijeniti način kako gledamo
na zarazne bolesti i njihovu prevenciju.
na zarazne bolesti i njihovu prevenciju.
05:24
We have to stop waiting
until we see evidence
until we see evidence
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Moramo prestati čekati dokaze
05:28
of a disease becoming a global threat
before we consider it as one.
before we consider it as one.
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da je bolest postala globalna prijetnja
prije no što ju smatramo prijetnjom.
prije no što ju smatramo prijetnjom.
05:34
So, for Ebola,
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Dakle, što se ebole tiče,
05:36
the paranoid fear
of an infectious disease,
of an infectious disease,
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paranoični strah od zarazne bolesti,
05:40
followed by a few cases
transported to wealthy countries,
transported to wealthy countries,
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kojeg prati par slučajeva
prijenosa u bogate zemlje,
prijenosa u bogate zemlje,
05:45
led the global community to come together,
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poveo je globalno društvo u jedinstvo
05:48
and with the work
of dedicated vaccine companies,
of dedicated vaccine companies,
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i radom posvećenih kompanija
za razvoj cjepiva
za razvoj cjepiva
05:51
we now have these:
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sada imamo ovo:
05:54
Two Ebola vaccines in efficacy trials
in the Ebola countries --
in the Ebola countries --
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Dva cjepiva protiv ebole na testiranju
učinkovitosti u zemljama pogođenim ebolom
učinkovitosti u zemljama pogođenim ebolom
06:00
(Applause)
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(Pljesak)
06:06
and a pipeline of vaccines
that are following behind.
that are following behind.
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i niz cjepiva koja slijede.
06:10
Every year, we spend billions of dollars,
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Svake godine, trošimo milijarde dolara
06:13
keeping a fleet of nuclear submarines
permanently patrolling the oceans
permanently patrolling the oceans
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održavajući flotu nuklearnih podmornica
u stalnoj ophodnji oceana
u stalnoj ophodnji oceana
06:18
to protect us from a threat
that almost certainly will never happen.
that almost certainly will never happen.
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da nas zaštite od prijetnje koja se gotovo
sigurno nikada neće obistiniti.
sigurno nikada neće obistiniti.
06:23
And yet, we spend virtually nothing
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Istovremeno, gotovo ništa ne trošimo
06:26
to prevent something as tangible
and evolutionarily certain
and evolutionarily certain
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da se zaštitimo od nečeg toliko
bliskog i evolucijski sigurnog
bliskog i evolucijski sigurnog
06:31
as epidemic infectious diseases.
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kao epidemijske zarazne bolesti.
06:35
And make no mistake about it --
it's not a question of "if," but "when."
it's not a question of "if," but "when."
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I nemojte pogrešno misliti -- ovo nije
pitanje "ako", nego pitanje "kada".
pitanje "ako", nego pitanje "kada".
06:38
These bugs are going to continue to evolve
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Ovi će virusi nastaviti evoluirati
06:41
and they're going to threaten the world.
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i prijetit će svijetu.
06:44
And vaccines are our best defense.
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A cjepiva su naša najbolja obrana.
06:47
So if we want to be able to prevent
epidemics like Ebola,
epidemics like Ebola,
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Dakle, ako želimo spriječiti
epidemije kao što je ebola,
epidemije kao što je ebola,
06:51
we need to take on the risk
of investing in vaccine development
of investing in vaccine development
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moramo riskirati ulaganjem u razvoj
06:55
and in stockpile creation.
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i masovnu proizvodnju cjepiva.
06:58
And we need to view this, then,
as the ultimate deterrent --
as the ultimate deterrent --
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I moramo na ovo gledati
kao na posljednju opomenu --
kao na posljednju opomenu --
07:02
something we make sure is available,
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nešto za što se trebamo
pobrinuti da bude dostupno,
pobrinuti da bude dostupno,
07:05
but at the same time,
praying we never have to use it.
praying we never have to use it.
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ali istovremeno se moleći da
to nikada nećemo morati iskoristiti.
to nikada nećemo morati iskoristiti.
07:09
Thank you.
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Hvala vam.
07:10
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Seth Berkley - Vaccine visionaryEpidemiologist 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.
Seth Berkley | Speaker | TED.com