TED2015
Seth Berkley: The troubling reason why vaccines are made too late ... if they're made at all
Seth Berkley: Miks vaktsiinid valmivad liiga hilja ... kui üldse kunagi.
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Jääb mulje, et selleks, et tõsiselt hakataks tegelema mõne vaktsiini väljatöötamisega, tuleb enne teha läbi laastav ja ohvriterohke haiguspuhang. Seth Berkley heidab valgust sellele, millised turujõud ja -riskid on põhjuseks, et meil puuduvad seni asjakohased vaktsiinid maailmas levinuimate haiguste vastu.
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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Esimesed sümptomid on lapsel
00:15
with mild fever, headache, muscle pains,
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kerge palavik, peavalu ja lihasevalu,
00:18
followed by vomiting and diarrhea,
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millele järgneb
oksendamine ja kõhulahtisus,
oksendamine ja kõhulahtisus,
00:21
then bleeding from the mouth,
nose and gums.
nose and gums.
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seejärel hakkavad veritsema
tema suu, nina ja igemed.
tema suu, nina ja igemed.
00:25
Death follows in the form of organ failure
from low blood pressure.
from low blood pressure.
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Surm saabub madalast vererõhust tingitud elundipuudulikkuse tagajärjel.
00:31
Sounds familiar?
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Tuleb tuttav ette?
00:33
If you're thinking this is Ebola,
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Kui arvad, et see on ebola,
00:36
actually, in this case, it's not.
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siis antud juhul pole see nii.
00:38
It's an extreme form of dengue fever,
a mosquito-born disease
a mosquito-born disease
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See on raskekujuline dengue palavik,
sääskedega leviv haigus,
sääskedega leviv haigus,
00:43
which also does not have
an effective therapy or a vaccine,
an effective therapy or a vaccine,
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millele samuti pole tõhusat
ravi ega vaktsiini
ravi ega vaktsiini
00:48
and kills 22,000 people each year.
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ja millesse sureb
22 000 inimest aastas.
22 000 inimest aastas.
00:52
That is actually twice
the number of people
the number of people
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Seda on tegelikult
kaks korda rohkem kui neid,
kaks korda rohkem kui neid,
00:54
that have been killed by Ebola
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kes on surnud ebolasse
00:56
in the nearly four decades
that we've known about it.
that we've known about it.
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ligi nelja aastakümne jooksul,
mil seda haigust on tuntud.
mil seda haigust on tuntud.
01:00
As for measles, so much
in the news recently,
in the news recently,
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Leetrite puhul, millest on
nüüd uudistes palju juttu,
nüüd uudistes palju juttu,
01:04
the death toll is actually tenfold higher.
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on suremus kümme korda suuremgi.
01:09
Yet for the last year,
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Viimasel aastal
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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on aga ebola hõivanud
kõik esiküljed ja külvanud hirmu.
kõik esiküljed ja külvanud hirmu.
01:17
Clearly, there is something
deeply rooted about it,
deeply rooted about it,
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On näha, et ebola puudutab meid väga sügaval tasandil,
01:19
something which scares us
and fascinates us
and fascinates us
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ta on ühtaegu hirmutav ja
paeluv
paeluv
01:22
more than other diseases.
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palju enam kui teised haigused.
01:24
But what is it, exactly?
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Mis see siis täpselt on?
01:27
Well, it's hard to acquire Ebola,
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Ebolasse pole lihtne haigestuda,
01:29
but if you do, the risk
of a horrible death is high.
of a horrible death is high.
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ent kui sa haigestud, siis on suur tõenäosus, et sured piinarikkalt.
01:33
Why?
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Miks?
01:34
Because right now, we don't have any
effective therapy or vaccine available.
effective therapy or vaccine available.
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Sest praegu pole olemas sellele
mingit tõhusat ravi või vaktsiini.
mingit tõhusat ravi või vaktsiini.
01:40
And so, that's the clue.
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See annabki vihje.
01:43
We may have it someday.
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Me võime ühel päeval
sellesse haigestuda.
sellesse haigestuda.
01:45
So we rightfully fear Ebola,
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Seepärast me kardame
õigusega ebolat,
õigusega ebolat,
01:48
because it doesn't kill
as many people as other diseases.
as many people as other diseases.
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sest ... see küll ei tapa
nii paljusid kui teised haigused.
nii paljusid kui teised haigused.
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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Tegelikult on see palju vähem
nakkav kui gripp või leetrid.
nakkav kui gripp või leetrid.
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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Aga me kardame ebolat, sest see
on surmav ja me ei oska seda ravida.
on surmav ja me ei oska seda ravida.
02:05
We fear the certain inevitability
that comes with Ebola.
that comes with Ebola.
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Me kardame seda paratamatust,
mis ebolaga kaasneb.
mis ebolaga kaasneb.
02:08
Ebola has this inevitability
that seems to defy modern medical science.
that seems to defy modern medical science.
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Ebolat saadab teatav paratamatus, mis
esitab tänapäeva arstiteadusele väljakutse
esitab tänapäeva arstiteadusele väljakutse
Miks on see aga nii?
02:14
But wait a second, why is that?
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02:16
We've known about Ebola since 1976.
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Oleme olnud ebolast teadlikud
1976. aastast alates.
1976. aastast alates.
02:20
We've known what it's capable of.
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Me teame, milleks ta on võimeline.
02:22
We've had ample opportunity to study it
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Meil on olnud ohtralt võimalusi
seda uurida
seda uurida
02:24
in the 24 outbreaks that have occurred.
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seni aset leidnud 24 haiguspuhangu jooksul,
02:27
And in fact, we've actually had
vaccine candidates available now
vaccine candidates available now
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Ja tegelikult on meil olnud ka võimalikud
vaktsiinid olemas
vaktsiinid olemas
02:31
for more than a decade.
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juba üle kümne aasta.
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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Miks on need vaktsiinid alles
kliiniliste katsete etapis?
kliiniliste katsete etapis?
02:38
This goes to the fundamental
problem we have
problem we have
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Siit tulenebki aga meie põhiprobleem
02:41
with vaccine development
for infectious diseases.
for infectious diseases.
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nakkushaiguste vaktsiinide
väljatöötamises.
väljatöötamises.
02:45
It goes something like this:
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Ma sõnastaksin selle nii:
02:47
The people most at risk for these diseases
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inimesed, kel on suurem oht
neisse haigustesse haigestuda
neisse haigustesse haigestuda
02:50
are also the ones least able
to pay for vaccines.
to pay for vaccines.
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on need, kel on vähem võimalusi
vaktsiinide eest maksta.
vaktsiinide eest maksta.
02:55
This leaves little in the way
of market incentives
of market incentives
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Tootajate meelest
pole selliste vaktsiinide
pole selliste vaktsiinide
02:59
for manufacturers to develop vaccines,
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tootmine majanduslikult tulus enne,
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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kui haigus ei ohusta
jõukamate riikide elanikke.
jõukamate riikide elanikke.
03:07
It's simply too commercially risky.
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Majanduslikus mõttes liiga riskantne äri.
03:11
As for Ebola, there is absolutely
no market at all,
no market at all,
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Ebolast rääkides pole turgu
ollagi.
ollagi.
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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Ainus põhjus, miks kaks vaktsiini
on kliiniliste katsete lõppfaasis,
on kliiniliste katsete lõppfaasis,
03:21
is actually because
of a somewhat misguided fear.
of a somewhat misguided fear.
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on tegelikult
mõneti alusetu hirm.
mõneti alusetu hirm.
03:24
Ebola was relatively ignored
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Ebolat ignoreeriti
03:27
until September 11
and the anthrax attacks,
and the anthrax attacks,
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kuni 11. septembri
ja antraksi rünnakuteni,
ja antraksi rünnakuteni,
03:32
when all of a sudden,
people perceived Ebola
people perceived Ebola
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mil ühtäkki inimesed
adusid, et ebolat
adusid, et ebolat
03:34
as, potentially, a bioterrorism weapon.
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võidakse kasutada biorelvana.
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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Miks polnud ebola vaktsiini
selleks ajaks välja töötatud?
selleks ajaks välja töötatud?
Osaliselt seepärast,
et oli väga raske -
et oli väga raske -
03:42
Well, partially, because
it was really difficult --
it was really difficult --
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03:44
or thought to be difficult --
to weaponize the virus,
to weaponize the virus,
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või peeti väga raskeks -
viirust relvaks muuta,
viirust relvaks muuta,
03:47
but mainly because
of the financial risk in developing it.
of the financial risk in developing it.
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kuid põhiliselt, kuna arendusega
kaasnes finantsrisk.
kaasnes finantsrisk.
Ja selles asi ongi.
03:53
And this is really the point.
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On kurb tõsiasi,
et vaktsiine arendatakse
et vaktsiine arendatakse
03:55
The sad reality is, we develop vaccines
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03:58
not based upon the risk
the pathogen poses to people,
the pathogen poses to people,
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mitte tulenevalt haigustekitaja ohtlikkusest,
04:02
but on how economically risky it is
to develop these vaccines.
to develop these vaccines.
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vaid hinnates riski, kuivõrd see äriliselt ära tasuks.
04:06
Vaccine development
is expensive and complicated.
is expensive and complicated.
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Vaktsiini väljatöötamine
on kallis ja keeruline.
on kallis ja keeruline.
04:09
It can cost hundreds
of millions of dollars
of millions of dollars
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Võib kuluda sadu miljoneid dollareid,
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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et muuta ka mõni tuntud antigeen
toimivaks vaktsiiniks.
toimivaks vaktsiiniks.
Õnneks saame ebola sarnaste
haiguste puhul
haiguste puhul
04:17
Fortunately for diseases like Ebola,
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04:19
there are things we can do
to remove some of these barriers.
to remove some of these barriers.
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midagi teha ära selleks, et neid
takistusi kõrvaldada.
takistusi kõrvaldada.
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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Esiteks tuleb ära tunda,
millal eksisteerib turutõrge.
millal eksisteerib turutõrge.
04:27
In that case, if we want vaccines,
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Sel juhul, kui me soovime vaktsiine,
04:30
we have to provide incentives
or some type of subsidy.
or some type of subsidy.
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tuleb pakkuda stiimuleid
või võimaldada toetust.
või võimaldada toetust.
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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Samuti on vaja rohkem pingutada, et suudaksime kindlaks teha,
04:40
which are the diseases
that most threaten us.
that most threaten us.
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haigused, mis meid enim ohustavad.
04:43
By creating capabilities within countries,
we then create the ability
we then create the ability
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Toetades riikide võimekust
anname neile võimaluse
anname neile võimaluse
04:48
for those countries to create
epidemiological and laboratory networks
epidemiological and laboratory networks
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ehitada üles epidemioloogiline
ja laboratoorne võrgustik,
ja laboratoorne võrgustik,
04:52
which are capable of collecting
and categorizing these pathogens.
and categorizing these pathogens.
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mis suudaks patogeene
koguda ja tuvastada.
koguda ja tuvastada.
04:58
The data from that then can be used
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Nende andmeid saab siis
kasutada selleks,
kasutada selleks,
05:00
to understand the geographic
and genetic diversity,
and genetic diversity,
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et mõista geograafilisi ja
geneetilisi erinevusi,
geneetilisi erinevusi,
05:03
which then can be used
to help us understand
to help us understand
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mida omakorda saab kasutada
selleks, et mõista,
selleks, et mõista,
05:06
how these are being changed
immunologically,
immunologically,
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kuidas need on muutunud
immunoloogiliselt
immunoloogiliselt
05:10
and what type of reactions they promote.
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ja milliseid reaktsioone
need tekitavad.
need tekitavad.
05:13
So these are the things that can be done,
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Seda kõike on võimalik teha,
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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kuid selleks, et tulla toime täieliku turutõrke olukorras,
05:19
we have to change the way
we view and prevent infectious diseases.
we view and prevent infectious diseases.
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tuleb muuta senist ennetustööd ja suhtumist nakkushaigustesse.
05:24
We have to stop waiting
until we see evidence
until we see evidence
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Pole aega oodata, kuni on ilmselge,
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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et haigus on levinud globaalselt enne kui me sellest arugi saame.
05:34
So, for Ebola,
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Ebola puhul sundis paranoiline hirm nakkuse ees,
05:36
the paranoid fear
of an infectious disease,
of an infectious disease,
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05:40
followed by a few cases
transported to wealthy countries,
transported to wealthy countries,
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mille järgnesid vaid üksikud haigusjuhud
jõukamates riikides,
jõukamates riikides,
05:45
led the global community to come together,
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globaalset üldsust tegema ühiseid jõupingutusi.
05:48
and with the work
of dedicated vaccine companies,
of dedicated vaccine companies,
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Koostöös vaktsiinifirmadega
05:51
we now have these:
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oleme saavutanud selle:
05:54
Two Ebola vaccines in efficacy trials
in the Ebola countries --
in the Ebola countries --
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kaks ebola vaktsiini, mida katsetatakse
ebola kolletega riikides, ...
ebola kolletega riikides, ...
06:00
(Applause)
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(Aplaus)
06:06
and a pipeline of vaccines
that are following behind.
that are following behind.
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... ja tulemas on
veel hulk vaktsiine.
veel hulk vaktsiine.
06:10
Every year, we spend billions of dollars,
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Igal aastal me kulutame
miljardeid dollareid,
miljardeid dollareid,
06:13
keeping a fleet of nuclear submarines
permanently patrolling the oceans
permanently patrolling the oceans
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et hoida tuumaallveelaevu
ookeanides patrullimas
ookeanides patrullimas
06:18
to protect us from a threat
that almost certainly will never happen.
that almost certainly will never happen.
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ja kaitsmas meid ohu eest,
mida ilmselt mitte kunagi ei tekigi.
mida ilmselt mitte kunagi ei tekigi.
06:23
And yet, we spend virtually nothing
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Samas ei kuluta me
praktiliselt sentigi sellele,
praktiliselt sentigi sellele,
06:26
to prevent something as tangible
and evolutionarily certain
and evolutionarily certain
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et hoida ära midagi meid otseselt puudutavat
ja evolutsiooniliselt tõenäolist
ja evolutsiooniliselt tõenäolist
06:31
as epidemic infectious diseases.
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nagu seda on nakkushaiguste epideemiad.
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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Siin pole kahtlust, et küsimus on pigem
millal see juhtub, mitte kas see juhtub.
millal see juhtub, mitte kas see juhtub.
06:38
These bugs are going to continue to evolve
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Viirused arenevad pidevalt
06:41
and they're going to threaten the world.
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ja ohustavad jätkuvalt kogu maailma.
06:44
And vaccines are our best defense.
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Ja vaktsiinid on meie parim kaitse.
06:47
So if we want to be able to prevent
epidemics like Ebola,
epidemics like Ebola,
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Kui me tahame vältida selliseid
epideemiaid nagu ebola,
epideemiaid nagu ebola,
06:51
we need to take on the risk
of investing in vaccine development
of investing in vaccine development
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tuleb meil riskida investeerimisega
vaktsiinide väljatöötamisse
vaktsiinide väljatöötamisse
06:55
and in stockpile creation.
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ja nende varude soetamisse.
06:58
And we need to view this, then,
as the ultimate deterrent --
as the ultimate deterrent --
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Peaksime suhtuma vaktsiinidesse kui
ülimasse heidutusvahendisse -
ülimasse heidutusvahendisse -
07:02
something we make sure is available,
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midagi, mis peaks kindlasti
olemas olema,
olemas olema,
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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kuid mida poleks loodetavasti
vaja kunagi kasutada.
vaja kunagi kasutada.
07:09
Thank you.
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Aitäh.
07:10
(Applause)
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(Aplaus)
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