TED2015
Bill Gates: The next outbreak? We're not ready
Bill Gates: Penyebaran epidemi berikutnya? Kita tidaklah siap
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Di tahun 2014, dunia terhindar dari penyebaran parah virus Ebola, berkat para pekerja kesehatan yang hebat — termasuk, berkat keberuntungan. Padahal, kita tahu kita bisa menanganinya dengan lebih baik. Jadi, sekaranglah saatnya, Bill Gates menyarankan untuk memberikan seluruh ide terbaik kita, dari perencanaan skenario hingga riset vaksin termasuk pelatihan pekerja kesehatan. Dia mengatakan "Tidak perlu panik ... tapi kita perlu untuk terus berjalan."
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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Ketika saya masih anak-anak,
00:19
the disaster we worried about most
was a nuclear war.
was a nuclear war.
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bencana yang paling kami takuti
adalah perang nuklir.
adalah perang nuklir.
Itulah mengapa saya memiliki drum
seperti ini di ruang bawah tanah,
seperti ini di ruang bawah tanah,
00:23
That's why we had a barrel like this
down in our basement,
down in our basement,
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00:27
filled with cans of food and water.
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berisi berkaleng-kaleng makanan dan air.
00:30
When the nuclear attack came,
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Ketika serangan nuklir datang,
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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kami harus turun ke bawah, berlindung
dan makan di drum itu.
dan makan di drum itu.
00:37
Today the greatest risk
of global catastrophe
of global catastrophe
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Hari ini resiko terbesar
dari kekacauan global
dari kekacauan global
00:41
doesn't look like this.
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tidak terlihat sepert ini.
00:44
Instead, it looks like this.
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Namun terlihat sepert ini.
00:48
If anything kills over 10 million people
in the next few decades,
in the next few decades,
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Jika sesuatu yang bisa membunuh 10 juta
orang dalam beberapa dekade kedepan,
orang dalam beberapa dekade kedepan,
00:53
it's most likely to be
a highly infectious virus
a highly infectious virus
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yang paling memungkinkan adalah
sebuah virus yang berbahaya
sebuah virus yang berbahaya
00:57
rather than a war.
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ketimbang sebuah perang.
00:59
Not missiles, but microbes.
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Bukan misil, namun mikroba.
01:03
Now, part of the reason for this is that
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Sekarang, alasannya adalah
01:05
we've invested a huge amount
in nuclear deterrents.
in nuclear deterrents.
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kita telah berinvestasi banyak
untuk pencegahan nuklir.
untuk pencegahan nuklir.
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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Namun ternyata kita sedikit berinvestasi
dalam sistem pengendali epidemi.
dalam sistem pengendali epidemi.
01:16
We're not ready for the next epidemic.
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Kita tidak siap untuk epidemi berikutnya.
01:20
Let's look at Ebola.
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Lihatlah Ebola.
01:21
I'm sure all of you read about it
in the newspaper,
in the newspaper,
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Saya yakin Anda semua sudah
membacanya di koran,
membacanya di koran,
01:25
lots of tough challenges.
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banyak sekali tantangan sulit.
01:27
I followed it carefully
through the case analysis tools
through the case analysis tools
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Saya mengikuti kasus dengan cermat
melalui alat-alat analisis
melalui alat-alat analisis
01:30
we use to track polio eradication.
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yang kami gunakan untuk memantau
pemberantasan polio.
pemberantasan polio.
01:35
And as you look at what went on,
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Dan ketika Anda melihat arahnya,
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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permasalahannya bukanlah pada sistem
yang tidak berjalan dengan benar,
yang tidak berjalan dengan benar,
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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masalahnya adalah kita tidak
memiliki sistem sama sekali.
memiliki sistem sama sekali.
01:46
In fact, there's some pretty obvious
key missing pieces.
key missing pieces.
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Faktanya, ada beberapa kepingan
penting yang hilang.
penting yang hilang.
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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Kita tidak memiliki kelompok epidemiologi
di lapangan yang siap siaga untuk pergi
di lapangan yang siap siaga untuk pergi
01:55
seen what the disease was,
seen how far it had spread.
seen how far it had spread.
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melihat apa penyakitnya,
melihat seberapa jauh ia tersebar.
melihat seberapa jauh ia tersebar.
01:59
The case reports came in on paper.
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Laporan kasusnya tercatat di atas kertas.
Laporannya sangat terlambat
sebelum diunggah online
sebelum diunggah online
02:02
It was very delayed
before they were put online
before they were put online
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02:04
and they were extremely inaccurate.
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dan laporan itu sama sekali tidak akurat.
02:07
We didn't have a medical team ready to go.
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Kami tidak memiliki tim
medis yang siap siaga.
medis yang siap siaga.
Kami tidak memiliki cara untuk
mempersiapkan tenaga ahli.
mempersiapkan tenaga ahli.
02:09
We didn't have a way of preparing people.
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02:12
Now, Médecins Sans Frontières
did a great job orchestrating volunteers.
did a great job orchestrating volunteers.
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Meski Médecins Sans Frontières mengatur
para relawan dengan hebat.
para relawan dengan hebat.
02:17
But even so, we were far slower
than we should have been
than we should have been
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Namun tetap saja, kita jauh lebih
lamban dari yang seharusnya
lamban dari yang seharusnya
02:20
getting the thousands of workers
into these countries.
into these countries.
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untuk menempatkan ribuan pekerja
di negara-negara itu.
di negara-negara itu.
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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Dan sebuah epidemi besar akan
membutuhkan ratusan ribu pekerja.
membutuhkan ratusan ribu pekerja.
02:32
There was no one there
to look at treatment approaches.
to look at treatment approaches.
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Tidak ada seroangpun di sana untuk melihat
upaya penanganan.
upaya penanganan.
Tidak seorangpun melihat diagnosisnya.
02:37
No one to look at the diagnostics.
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02:38
No one to figure out
what tools should be used.
what tools should be used.
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Tidak ada seorangpun menentukan
alat apa yang harus digunakan.
alat apa yang harus digunakan.
02:42
As an example, we could have
taken the blood of survivors,
taken the blood of survivors,
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Sebagai contoh, kami bisa mengambil
darah orang yang selamat,
darah orang yang selamat,
02:45
processed it, and put that plasma
back in people to protect them.
back in people to protect them.
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memprosesnya, dan memberikan plasma
untuk melindungi mereka.
untuk melindungi mereka.
02:51
But that was never tried.
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Namun itu tidak pernah dicoba.
02:53
So there was a lot that was missing.
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Jadi banyak hal yang tidak tepat.
02:55
And these things
are really a global failure.
are really a global failure.
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Dan ketidaktepatan itu adalah
sebuah kegagalan global.
sebuah kegagalan global.
03:00
The WHO is funded to monitor epidemics,
but not to do these things I talked about.
but not to do these things I talked about.
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WHO dibiayai untuk mengawasi epidemi,
namun tidak melakukan hal
yang Saya sebutkan tadi.
yang Saya sebutkan tadi.
Dan yang terjadi di film agak berbeda.
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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Ada sekelompok epidemiologi tampan siaga,
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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mereka bergerak, mereka selamatkan dunia,
tapi itulah Hollywood.
tapi itulah Hollywood.
03:22
The failure to prepare
could allow the next epidemic
could allow the next epidemic
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Kegagalan untuk mempersiapkan
dapat mengakibatkan epidemi berikutnya
dapat mengakibatkan epidemi berikutnya
03:25
to be dramatically
more devastating than Ebola
more devastating than Ebola
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jauh lebih mengerikan dari pada Ebola
03:30
Let's look at the progression
of Ebola over this year.
of Ebola over this year.
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Mari melihat perkembangan Ebola tahun ini.
03:36
About 10,000 people died,
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Sekitar 10.000 orang meninggal,
03:39
and nearly all were in the three
West African countries.
West African countries.
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dan hampir semuanya berada
di negara-negara Afrika Barat.
di negara-negara Afrika Barat.
Ada tiga alasan mengapa Ebola
tidak tersebar lebih jauh.
tidak tersebar lebih jauh.
03:43
There's three reasons why
it didn't spread more.
it didn't spread more.
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Pertama karena ada banyak
pekerja kesehatan yang heroik.
pekerja kesehatan yang heroik.
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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03:50
They found the people and they
prevented more infections.
prevented more infections.
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Mereka menangani orang yang terjangkit
dan mencegah infeksi lanjutan.
dan mencegah infeksi lanjutan.
03:54
The second is the nature of the virus.
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Kedua adalah sifat alami dari virus.
03:56
Ebola does not spread through the air.
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Ebola tidak menyebar melalui udara.
03:59
And by the time you're contagious,
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Dan ketika terjangkit,
04:01
most people are so sick
that they're bedridden.
that they're bedridden.
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Anda akan sangat lemah sehingga
harus beristirahat.
harus beristirahat.
04:06
Third, it didn't get
into many urban areas.
into many urban areas.
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Ketiga, Ebola tidak banyak mencapai
wilayah perkotaan.
wilayah perkotaan.
04:10
And that was just luck.
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Dan itu adalah keberuntungan semata.
04:12
If it had gotten into a lot
more urban areas,
more urban areas,
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Jika itu tersebar di banyak perkotaan,
04:14
the case numbers
would have been much larger.
would have been much larger.
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angka kasusnya akan lebih besar lagi.
04:17
So next time, we might not be so lucky.
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Jadi di masa depan, kita mungkin
tidak seberuntung itu.
tidak seberuntung itu.
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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Anda akan menemukan virus yang
menjangkiti orang yang cukup sehat
menjangkiti orang yang cukup sehat
04:26
that they get on a plane
or they go to a market.
or they go to a market.
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lalu mereka naik pesawat atau
mereka pergi ke pasar.
mereka pergi ke pasar.
Sumber dari virusnya bisa
jadi dari alam seperti Ebola,
jadi dari alam seperti Ebola,
04:29
The source of the virus could be
a natural epidemic like Ebola,
a natural epidemic like Ebola,
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04:32
or it could be bioterrorism.
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atau bisa jadi terorisme biologi.
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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Jadi banyak hal yang sebenarnya bisa
membuat situasi ribuan kali lebih buruk.
membuat situasi ribuan kali lebih buruk.
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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Faktanya, mari melihat model dari virus
yang tersebar melalui udara,
yang tersebar melalui udara,
04:45
like the Spanish Flu back in 1918.
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seperti Flu Spanyol di tahun 1918.
04:49
So here's what would happen:
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Jadi ini yang akan terjadi:
04:51
It would spread throughout the world
very, very quickly.
very, very quickly.
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Virusnya akan menyebar ke seluruh
dunia dengan sangat cepat.
dunia dengan sangat cepat.
04:55
And you can see over 30 million people
died from that epidemic.
died from that epidemic.
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Dan Anda melihat 30 juta orang
meninggal karena epidemi itu.
meninggal karena epidemi itu.
05:00
So this is a serious problem.
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Jadi ini adalah masalah yang serius.
05:02
We should be concerned.
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Kita harus memperhatikannya.
05:04
But in fact, we can build
a really good response system.
a really good response system.
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Sebenarnya, kita bisa membangun
sistem respon yang baik.
sistem respon yang baik.
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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Kita memiliki banyak keunggulan sains
dan teknologi yang kita bicarakan di sini.
dan teknologi yang kita bicarakan di sini.
Kita punya telepon genggam
05:13
We've got cell phones
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05:14
to get information from the public
and get information out to them.
and get information out to them.
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untuk mendapat informasi dari publik
dan memberikan informasi.
dan memberikan informasi.
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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Kita punya peta satelit yang bisa melihat
dimana orang berada dan
kemana mereka pergi.
kemana mereka pergi.
05:22
We have advances in biology
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Kita ahli dalam biologi
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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yang seharusnya mengubah situasi
untuk melihat patogen
untuk melihat 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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dan mampu untuk membuat obat
dan vaksin yang cocok untuk patogen itu.
dan vaksin yang cocok untuk patogen itu.
05:33
So we can have tools,
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Jadi kita memiliki peralatan,
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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namun peralatan itu harus dipergunakan
dalam sistem kesehatan global.
dalam sistem kesehatan global.
05:39
And we need preparedness.
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Dan kita perlu kesiapan.
05:41
The best lessons, I think,
on how to get prepared
on how to get prepared
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Pelajaran berharga, adalah
tentang bagaimana bersiap
tentang bagaimana bersiap
05:44
are again, what we do for war.
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sama seperti yang
kita lakukan untuk perang.
kita lakukan untuk perang.
05:46
For soldiers, we have full-time,
waiting to go.
waiting to go.
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Pasukan-pasukan selalu siap siaga.
05:51
We have reserves that can scale
us up to large numbers.
us up to large numbers.
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Kita memiliki tenaga yang banyak.
05:54
NATO has a mobile unit
that can deploy very rapidly.
that can deploy very rapidly.
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NATO memiliki unit mobilitas yang bisa
dikirim dengan cepat.
dikirim dengan cepat.
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 melakukan banyak permainan perang
untuk memeriksa apakah
pasukannya terlatih?
pasukannya terlatih?
06:01
Do they understand
about fuel and logistics
about fuel and logistics
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Apakah mereka paham soal bahan bakar
dan logistik
dan logistik
06:03
and the same radio frequencies?
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dan berada di frekuensi radio yang sama?
06:06
So they are absolutely ready to go.
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Jadi mereka benar-benar siap untuk terjun.
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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Hal-hal seperti itulah yang kita
perlu siapkan untuk sebuah epidemi.
perlu siapkan untuk sebuah epidemi.
06:13
What are the key pieces?
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Apa saja bagian-bagian terpentingnya?
06:15
First, we need strong health systems
in poor countries.
in poor countries.
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Pertama, kita membutuhkan sistem
kesehatan yang kuat
kesehatan yang kuat
di negara-negara miskin.
Sehingga para ibu bisa
melahirkan dengan selamat,
melahirkan dengan selamat,
06:20
That's where mothers
can give birth safely,
can give birth safely,
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anak-anak bisa mendapatkan vaksin.
06:23
kids can get all their vaccines.
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06:25
But, also where we'll see
the outbreak very early on.
the outbreak very early on.
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Tapi juga kita bisa mencegah penjangkitan
masal dengan lebih dini.
masal dengan lebih dini.
06:30
We need a medical reserve corps:
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Kita membutuhkan korps pasukan medis:
06:31
lots of people who've got
the training and background
the training and background
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banyak tenaga yang mendapat pelatihan
06:34
who are ready to go, with the expertise.
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dan siap di lapangan dengan keahliannya.
06:37
And then we need to pair those
medical people with the military.
medical people with the military.
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Dan kemudian kita perlu memasangkan
orang-orang medis itu dengan militer.
orang-orang medis itu dengan militer.
06:42
taking advantage of the military's ability
to move fast, do logistics
to move fast, do logistics
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menggabungkan kemampuan militer
untuk bergerak cepat mengirim logistik
untuk bergerak cepat mengirim logistik
06:46
and secure areas.
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dan mengamankan wilayah.
06:48
We need to do simulations,
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Kita perlu melakukan banyak simulasi,
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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permainan kuman, bukan permainan perang,
sehingga kita bisa melihat celah-celahnya.
sehingga kita bisa melihat celah-celahnya.
Terakhir kali diadakan permainan kuman
ada di Amerika Serikat
ada di Amerika Serikat
06:55
The last time a germ game
was done in the United States
was done in the United States
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06:58
was back in 2001,
and it didn't go so well.
and it didn't go so well.
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adalah tahun 2001, dan itu
tidak berjalan dengan baik.
tidak berjalan dengan baik.
07:02
So far the score is germs: 1, people: 0.
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Sejauh ini skornya adalah
kuman : 1, manusia : 0.
kuman : 1, manusia : 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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Terakhir, kita membutuhkan banyak riset
dan pengembangan
dan pengembangan
di bidang vaksin dan diagnosis.
07:13
There are some big breakthroughs,
like the Adeno-associated virus,
like the Adeno-associated virus,
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Ada banyak terobosan, seperti Virus Adeno,
07:17
that could work very, very quickly.
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yang dapat menyebar sangat, sangat cepat.
07:21
Now I don't have an exact budget
for what this would cost,
for what this would cost,
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Sekarang Saya tidak tahu berapa
biaya yang dibutuhkan,
biaya yang dibutuhkan,
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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namun Saya cukup yakin biayanya rendah
dibanding dengan potensi ancamannya.
dibanding dengan potensi ancamannya.
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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Bank Dunia mengestimasi jika kita
mengalami epidemi flu di seluruh dunia,
mengalami epidemi flu di seluruh dunia,
07:33
global wealth will go down
by over three trillion dollars
by over three trillion dollars
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kekayaan dunia akan menurun
lebih dari tiga triliun dolar
lebih dari tiga triliun dolar
07:37
and we'd have millions
and millions of deaths.
and millions of deaths.
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dan kita akan mendapatkan
berjuta-juta kematian.
berjuta-juta kematian.
07:41
These investments
offer significant benefits
offer significant benefits
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Investasi ini menawarkan
keuntungan yang signifikan
keuntungan yang signifikan
jauh melebihi sekedar kesiapan
menghadapi epidemi.
menghadapi epidemi.
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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Perawatan kesehatan yang prima,
riset dan pengembangan,
riset dan pengembangan,
07:48
those things would reduce
global health equity
global health equity
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keduanya akan mengurangi
ketimpangan kesehatan global
ketimpangan kesehatan global
07:51
and make the world more just
as well as more safe.
as well as more safe.
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dan membuat dunia menjadi lebih aman.
07:55
So I think this should absolutely
be a priority.
be a priority.
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Jadi saya pikir hal ini harus
menjadi prioritas.
menjadi prioritas.
07:59
There's no need to panic.
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Tidak perlu panik.
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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Kita tidak perlu menyimpan banyak spageti
atau berlindung di ruang bawah tanah.
atau berlindung di ruang bawah tanah.
Tapi kita perlu bergerak, karena waktu
tidak berada di pihak kita.
tidak berada di pihak kita.
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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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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Bahkan jika ada satu hal positif
yang bisa diambil dari epidemi Ebola,
yang bisa diambil dari epidemi Ebola,
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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adalah Ebola menjadi peringatan awal,
panggilan, untuk bersiap.
panggilan, untuk bersiap.
08:21
If we start now, we can be ready
for the next epidemic.
for the next epidemic.
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Jika kita memulai sekarang, kita akan
siap untuk epidemi berikutnya.
siap untuk epidemi berikutnya.
08:26
Thank you.
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Terima kasih.
08:28
(Applause)
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(Tepuk tangan)
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