TED2015
Bill Gates: The next outbreak? We're not ready
Bil Gejts (Bill Gates): Nova epidemija? Nismo spremni
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Godine 2014, svet je izbegao stravično izbijanje epidemije ebole svetskih razmera, zahvaljujući hiljadama nesebičnih zdravstvenih radnika - kao i velikoj količini sreće, da budemo iskreni. Iz ove perspektive, znamo šta je trebalo da uradimo bolje. Sada je vreme, predlaže nam Bil Gejts, da sve dobre ideje sprovedemo u delo, počevši od planiranja scenarija, preko ispitivanja vakcine, pa sve do obuke zdravstvenih radnika. I kao što on kaže: „Ne treba da paničimo... ali treba da se pokrenemo.“
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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Kad sam bio mali,
00:19
the disaster we worried about most
was a nuclear war.
was a nuclear war.
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katastrofa koje smo se najviše plašili
bila je nuklearni rat.
bila je 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
ovakvo bure u podrumu,
ovakvo bure u podrumu,
00:27
filled with cans of food and water.
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puno konzervi sa hranom i vodom.
00:30
When the nuclear attack came,
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Kada bi došlo do nuklearnog napada,
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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trebalo je da trknemo dole,
smirimo se i jedemo iz tog bureta.
smirimo se i jedemo iz tog bureta.
00:37
Today the greatest risk
of global catastrophe
of global catastrophe
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Danas najveći rizik 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 nešto ubije preko 10 miliona ljudi
u narednih nekoliko decenija,
u narednih nekoliko decenija,
00:53
it's most likely to be
a highly infectious virus
a highly infectious virus
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verovatnije je da će to biti
izuzetno zarazan virus
izuzetno zarazan virus
00:57
rather than a war.
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nego rat.
00:59
Not missiles, but microbes.
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Ne rakete, već mikrobi.
01:03
Now, part of the reason for this is that
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Delimično je tako
01:05
we've invested a huge amount
in nuclear deterrents.
in nuclear deterrents.
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jer smo uložili mnogo novca
u sprečavanje nuklearne pretnje.
u sprečavanje nuklearne pretnje.
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 smo zapravo uložili veoma malo
u sistem za zaustavljanje epidemije.
u sistem za zaustavljanje epidemije.
01:16
We're not ready for the next epidemic.
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Nismo spremni za narednu 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 čitali
o tome u novinama,
o tome u novinama,
01:25
lots of tough challenges.
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bilo je dosta teških izazova.
01:27
I followed it carefully
through the case analysis tools
through the case analysis tools
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Pomno sam to pratio
koristeći alate za analizu slučajeva
koristeći alate za analizu slučajeva
01:30
we use to track polio eradication.
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kojima smo pratili iskorenjavanje
dečje paralize.
dečje paralize.
01:35
And as you look at what went on,
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Kako gledate šta se dešavalo,
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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problem nije bio u tome da je postojao
sistem koji nije radio dovoljno dobro,
sistem 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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problem je bio u tome
što uopšte nismo imali sistem.
što uopšte nismo imali sistem.
01:46
In fact, there's some pretty obvious
key missing pieces.
key missing pieces.
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Zapravo, prilično je očigledno
da nedostaju neki ključni delovi.
da nedostaju neki ključni delovi.
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 spremnu grupu epidemiologa,
koji bi išli kada treba,
koji bi išli kada treba,
01:55
seen what the disease was,
seen how far it had spread.
seen how far it had spread.
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videli kakva je zaraza u pitanju,
koliko se proširila.
koliko se proširila.
01:59
The case reports came in on paper.
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Izveštaje o slučaju
dobijali smo na papiru.
dobijali smo na papiru.
02:02
It was very delayed
before they were put online
before they were put online
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Njihovo stavljanje na internet
dosta se odgađalo
dosta se odgađalo
02:04
and they were extremely inaccurate.
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i bili su veoma neprecizni.
02:07
We didn't have a medical team ready to go.
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Nismo imali spreman medicinski tim.
02:09
We didn't have a way of preparing people.
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Nismo imali način da pripremimo ljude.
02:12
Now, Médecins Sans Frontières
did a great job orchestrating volunteers.
did a great job orchestrating volunteers.
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Lekari bez granica učinili su sjajan posao
upravljajući volonterima.
upravljajući volonterima.
02:17
But even so, we were far slower
than we should have been
than we should have been
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Ali i uz to, bili smo dosta sporiji
nego što bismo bili
nego što bismo bili
02:20
getting the thousands of workers
into these countries.
into these countries.
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kada bismo hiljade radnika
dopremili u ove zemlje.
dopremili u ove zemlje.
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 bi od nas zahtevala
stotine hiljada radnika.
stotine hiljada radnika.
02:32
There was no one there
to look at treatment approaches.
to look at treatment approaches.
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Tamo nije bilo nikoga da pogleda
pristupe lečenju.
pristupe lečenju.
02:37
No one to look at the diagnostics.
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Nikoga da pogleda dijagnozu.
02:38
No one to figure out
what tools should be used.
what tools should be used.
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Nikoga da otkrije
koje alate treba koristiti.
koje alate treba koristiti.
02:42
As an example, we could have
taken the blood of survivors,
taken the blood of survivors,
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Na primer, mogli smo preživelima
da izvadimo krv,
da izvadimo krv,
02:45
processed it, and put that plasma
back in people to protect them.
back in people to protect them.
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obradimo je, i tu plazmu vratimo
nazad ljudima kako bi ih zaštitili.
nazad ljudima kako bi ih zaštitili.
02:51
But that was never tried.
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Ali to nikad nije pokušano.
02:53
So there was a lot that was missing.
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Tako da je dosta toga nedostajalo.
02:55
And these things
are really a global failure.
are really a global failure.
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A ovo je zapravo bio globalni neuspeh.
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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Svetska zdravstvena organziacija ima
sredstva za nadgledanje epidemija,
sredstva za nadgledanje epidemija,
ali ne za ovo o čemu sam pričao.
U fimovima je dosta drugačije.
U fimovima je dosta drugačije.
03:07
Now, in the movies it's quite different.
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03:09
There's a group of handsome
epidemiologists ready to go,
epidemiologists ready to go,
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Postoji grupa
zgodnih i spremnih epidemiologa,
zgodnih i spremnih epidemiologa,
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 nastupe i spase stvar,
ali to je samo Holivud.
ali to je samo Holivud.
03:22
The failure to prepare
could allow the next epidemic
could allow the next epidemic
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Nemogućnost pripreme mogla bi
da dozvoli da naredna epidemija
da dozvoli da naredna epidemija
03:25
to be dramatically
more devastating than Ebola
more devastating than Ebola
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bude dramatično 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 napredovanje ebole
tokom ove godine.
tokom ove godine.
03:36
About 10,000 people died,
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Umrlo je oko 10 000 ljudi
03:39
and nearly all were in the three
West African countries.
West African countries.
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i skoro svi su bili
iz tri zemlje zapadne Afrike.
iz tri zemlje zapadne Afrike.
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 ona nije još raširila.
zašto se ona nije još raširila.
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 je da su zdravstveni radnici
herojski radili svoj posao.
herojski radili svoj posao.
03:50
They found the people and they
prevented more infections.
prevented more infections.
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Pronašli su ljude
i sprečili još infekcija.
i sprečili još infekcija.
03:54
The second is the nature of the virus.
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Drugi je priroda virusa.
03:56
Ebola does not spread through the air.
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Ebola se ne širi vadušnim putem.
03:59
And by the time you're contagious,
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Do trenutka kada se zaraze,
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.
da su vezani za krevet.
04:06
Third, it didn't get
into many urban areas.
into many urban areas.
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Treće, nije dospela
do mnogo urbanih okruženja.
do mnogo urbanih okruženja.
04:10
And that was just luck.
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To je bila puka sreća.
04:12
If it had gotten into a lot
more urban areas,
more urban areas,
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Da je došla u više urbanih okruženja,
04:14
the case numbers
would have been much larger.
would have been much larger.
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brojevi zaraženih bili bi mnogo veći.
04:17
So next time, we might not be so lucky.
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Sledećeg puta možda nećemo biti te sreće.
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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Možete imati virus gde se ljudi
osećaju dovoljno dobro kada su zarazni
osećaju dovoljno dobro kada 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 se ukrcaju na avion ili odu na pijacu.
04:29
The source of the virus could be
a natural epidemic like Ebola,
a natural epidemic like Ebola,
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Izvor virusa može biti
prirodna epidemija, poput ebole,
prirodna epidemija, poput ebole,
04:32
or it could be bioterrorism.
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ili može biti 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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Postoje stvari koje bi bukvalno
pogoršale sve za hiljadu puta.
pogoršale sve za hiljadu puta.
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
širenja virusa vazduhom,
širenja virusa vazduhom,
04:45
like the Spanish Flu back in 1918.
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poput španskog gripa iz 1918.
04:49
So here's what would happen:
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Desilo bi se sledeće:
04:51
It would spread throughout the world
very, very quickly.
very, very quickly.
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virus bi se proširio svetom
veoma, veoma brzo.
veoma, veoma brzo.
04:55
And you can see over 30 million people
died from that epidemic.
died from that epidemic.
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Možete videti da je od te epidemije
umrlo preko 30 miliona ljudi.
umrlo preko 30 miliona ljudi.
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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Treba da budemo zabrinuti.
05:04
But in fact, we can build
a really good response system.
a really good response system.
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Zapravo, možemo izgraditi
veoma dobar odbrambeni sistem.
veoma dobar odbrambeni sistem.
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 prednosti silne nauke
i tehnologije o kojima ovde pričamo.
i tehnologije o kojima ovde pričamo.
05:13
We've got cell phones
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Imamo mobilne telefone preko kojih
05:14
to get information from the public
and get information out to them.
and get information out to them.
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dobijamo informacije od javnosti
i šaljemo informacije njima.
i šaljemo informacije njima.
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 gde možemo videti
gde se ljudi nalaze i kuda se kreću.
gde se ljudi nalaze i kuda se kreću.
05:22
We have advances in biology
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Imamo 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 trebalo da dramatično promeni
vreme potrebno da se pogleda patogen
vreme potrebno da se pogleda 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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i da možemo da napravimo lekove i vakcine
koji odgovaraju tom patogenu.
koji odgovaraju tom patogenu.
05:33
So we can have tools,
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Možemo imati alate,
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 ti alati moraju se postaviti
u celokupan globalni zdravstveni sistem.
u celokupan globalni zdravstveni sistem.
05:39
And we need preparedness.
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Potrebna nam je i pripravnost.
05:41
The best lessons, I think,
on how to get prepared
on how to get prepared
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Mislim da najbolje lekcije
o tome kako se pripremiti
o tome kako se pripremiti
05:44
are again, what we do for war.
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možemo izvući iz toga šta radimo za rat.
05:46
For soldiers, we have full-time,
waiting to go.
waiting to go.
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Imamo vojnike s punim radnim vremenom,
spremne za polazak.
spremne za polazak.
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 idu do velikih cifara.
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
koju mogu veoma brzo da rasporede.
koju mogu veoma brzo da rasporede.
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 se dosta igra rata kako bi proverili
da li su ljudi spremni.
da li su ljudi spremni.
06:01
Do they understand
about fuel and logistics
about fuel and logistics
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Da li razumeju gorivo i logistiku
06:03
and the same radio frequencies?
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i iste radio frekvencije?
06:06
So they are absolutely ready to go.
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Tako da su apsolutno spremni za polazak.
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 sa kojima moramo da radimo
kada je u pitanju epidemija.
kada je u pitanju epidemija.
06:13
What are the key pieces?
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Šta su ključni delovi?
06:15
First, we need strong health systems
in poor countries.
in poor countries.
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Prvo su nam potrebni jaki zdravstveni
sistemi u siromašnim zemljama.
sistemi u siromašnim zemljama.
06:20
That's where mothers
can give birth safely,
can give birth safely,
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Tamo gde majke mogu
bezbedno da se porađaju,
bezbedno da se porađaju,
06:23
kids can get all their vaccines.
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gde deca mogu da se vakcinišu.
06:25
But, also where we'll see
the outbreak very early on.
the outbreak very early on.
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Ali i tamo gde ćemo u ranom dobu
videti epidemiju.
videti epidemiju.
06:30
We need a medical reserve corps:
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Potrebne su nam medicinske
rezervne snage -
rezervne snage -
06:31
lots of people who've got
the training and background
the training and background
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dosta ljudi koji imaju obuku
06:34
who are ready to go, with the expertise.
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i stručnost, i koji su spremni da krenu.
06:37
And then we need to pair those
medical people with the military.
medical people with the military.
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Onda te medicinske radnike treba
da uparimo sa vojskom,
da uparimo sa vojskom,
06:42
taking advantage of the military's ability
to move fast, do logistics
to move fast, do logistics
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koristeći sposobnost vojske
da se brzo kreće, bavi logistikom
da se brzo kreće, bavi logistikom
06:46
and secure areas.
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i obezbeđuje područja.
06:48
We need to do simulations,
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Treba da radimo 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 bacila, ne igre rata,
tako da vidimo gde su rupe.
tako da vidimo gde su rupe.
06:55
The last time a germ game
was done in the United States
was done in the United States
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Poslednji put kada su se igre bacila
igrale u Sjedinjenim državama,
igrale u Sjedinjenim državama,
06:58
was back in 2001,
and it didn't go so well.
and it didn't go so well.
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to je bilo 2001, i nije dobro prošlo.
07:02
So far the score is germs: 1, people: 0.
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Do sada je rezultat, bacili: 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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Konačno, potrebno nam je
dosta naprednog istraživanja i razvoja
dosta naprednog istraživanja i razvoja
u poljima vakcina i dijagnostike.
07:13
There are some big breakthroughs,
like the Adeno-associated virus,
like the Adeno-associated virus,
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Postoje neki veliki napreci,
kao kod adeno asociranog virusa,
kao kod adeno asociranog virusa,
07:17
that could work very, very quickly.
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koji bi mogao da proradi veoma 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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Nemam tačan budžet za to
koliko bi ovo moglo da košta,
koliko bi ovo moglo da košta,
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 prilično sam siguran
da je veoma skroman
da je veoma skroman
u poređenju sa 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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Svetska banka procenjuje da
kada bi imali svetsku epidemiju gripa,
kada bi imali svetsku epidemiju gripa,
07:33
global wealth will go down
by over three trillion dollars
by over three trillion dollars
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sredstva u svetu bi se smanjila
za preko tri biliona dolara
za preko tri biliona dolara
07:37
and we'd have millions
and millions of deaths.
and millions of deaths.
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i bilo bi na milione mrtvih.
07:41
These investments
offer significant benefits
offer significant benefits
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Ove investicije nude značajne prednosti
koje su veće od same
pripremljenosti na epidemiju.
pripremljenosti na epidemiju.
07:44
beyond just being ready for the epidemic.
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07:46
The primary healthcare, the R&D,
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Primarna zdravstvena nega,
istraživanje i razvoj,
istraživanje i razvoj,
07:48
those things would reduce
global health equity
global health equity
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te stvari bi jednakost
u globalnom zdravlju povećale
u globalnom zdravlju povećale
07:51
and make the world more just
as well as more safe.
as well as more safe.
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i učinile svet pravičnijim
koliko i bezbednijim.
koliko i bezbednijim.
07:55
So I think this should absolutely
be a priority.
be a priority.
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Mislim da bi ovo apsolutno
trebalo da bude prioritet.
trebalo da bude prioritet.
07:59
There's no need to panic.
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Nema potrebe za panikom.
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 moramo da gomilamo
konzerve sa špagetama
konzerve sa špagetama
ili da se guramo u podrumu.
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 da se pokrenemo,
jer vreme nije na našoj strani.
jer vreme 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, postoji jedna pozitivna stvar
koja može da proiziđe iz epidemije ebole,
koja može da proiziđe 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 da ona može da posluži
kao rano upozorenje, poziv na akciju.
kao rano upozorenje, poziv na akciju.
08:21
If we start now, we can be ready
for the next epidemic.
for the next epidemic.
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Ako sada počnemo, možemo biti spremni
za narednu epidemiju.
za narednu epidemiju.
08:26
Thank you.
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Hvala vam.
08:28
(Applause)
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(Aplauz)
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