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TED2009

Hans Rosling: Insights on HIV, in stunning data visuals

Hans Rosling om HIV: Nye fakta og slående visuelle framstillinger av data

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Hans Rosling viser nye dataframstillinger som viser de komplekse risikofaktorene til en av verdens dødeligste (og mest misforståtte) sykdommer: HIV. Han viser at å hindre smitte -- ikke sykdomsbehandling -- er nøkkelen til å stoppe epidemien.

- Global health expert; data visionary
In Hans Rosling’s hands, data sings. Global trends in health and economics come to vivid life. And the big picture of global development—with some surprisingly good news—snaps into sharp focus. Full bio

(Applause)
(Applaus)
00:12
AIDS was discovered 1981; the virus, 1983.
AIDS ble oppdaget i 1981, viruset i 1983
00:18
These Gapminder bubbles show you
Disse Gapminder boblene viser dere
00:23
how the spread of the virus was in 1983 in the world,
hvordan den globale spredningen var i 1983
00:25
or how we estimate that it was.
eller hvordan vi beregner at den var.
00:29
What we are showing here is --
Hva vi viser her --
00:31
on this axis here, I'm showing percent of infected adults.
på denne aksen her viser jeg prosenten smittede voksne.
00:33
And on this axis, I'm showing dollars per person in income.
Og på denne aksen viser jeg dollar per person i inntekt.
00:40
And the size of these bubbles, the size of the bubbles here,
Og størrelsen på disse boblene, størrelsen på disse boblene her,
00:45
that shows how many are infected in each country,
viser hvor mange som er smittet i hvert land,
00:49
and the color is the continent.
og fargen viser hvilket kontinent.
00:52
Now, you can see United States, in 1983,
Dere kan se at USA, i 1983,
00:54
had a very low percentage infected,
hadde en veldig lav prosent smittede,
00:56
but due to the big population, still a sizable bubble.
men på grunn av stor befolkning, fremdeles en rimelig stor boble.
00:59
There were quite many people infected in the United States.
Det var ganske mange smittede i USA.
01:03
And, up there, you see Uganda.
Og her oppe, ser dere Uganda
01:06
They had almost five percent infected,
De hadde nesten fem prosent smittede,
01:08
and quite a big bubble in spite of being a small country, then.
og en ganske stor boble til tross for at de var et lite land da.
01:11
And they were probably the most infected country in the world.
Og de var sannsynligvis det mest smittede landet i verden.
01:14
Now, what has happened?
Hva har skjedd nå?
01:19
Now you have understood the graph
Nå har du forstått grafen,
01:21
and now, in the next 60 seconds,
og nå, i løpet av de neste 60 sekundene,
01:23
we will play the HIV epidemic in the world.
skal vi spille HIV epidemien i verden.
01:26
But first, I have a new invention here.
Men først har jeg en ny oppfinnelse her.
01:29
(Laughter)
(Latter)
01:34
I have solidified the beam of the laser pointer.
Jeg har solidifisert strålen fra laser pekeren.
01:39
(Laughter)
(Latter)
01:43
(Applause)
(Applaus)
01:46
So, ready, steady, go!
Så, klar, ferdig, gå.
01:52
First, we have the fast rise in Uganda and Zimbabwe.
Først så har vi økningen i Uganda og Zimbabwe.
01:56
They went upwards like this.
De gikk oppover slik.
02:00
In Asia, the first country to be heavily infected was Thailand --
I Asia, var det første landet som ble tungt smittet Thailand.
02:02
they reached one to two percent.
De nådde en til to prosent.
02:06
Then, Uganda started to turn back,
Så begynte Uganda å snu,
02:08
whereas Zimbabwe skyrocketed,
mens Zimbabwe tok av,
02:10
and some years later South Africa had a terrible rise of HIV frequency.
og noen år etterpå hadde Sør Afrika en fryktelig økning av HIV smitte.
02:12
Look, India got many infected,
Se, India fikk mange smittet,
02:16
but had a low level.
men hadde ett lavt nivå.
02:18
And almost the same happens here.
Og nesten det samme skjer her.
02:20
See, Uganda coming down, Zimbabwe coming down,
Se, Uganda kommer ned, Zimbabwe kommer ned,
02:22
Russia went to one percent.
Russland gikk til en prosent.
02:25
In the last two to three years,
I de siste to til tre årene
02:27
we have reached a steady state of HIV epidemic in the world.
har vi nådd et stabilt nivå av HIV epidemien i verden.
02:30
25 years it took.
25 år tok det.
02:34
But, steady state doesn't mean that things are getting better,
Men et stabilt nivå betyr ikke at ting blir bedre,
02:37
it's just that they have stopped getting worse.
det betyr bare at de har sluttet å bli verre.
02:40
And it has -- the steady state is, more or less,
Og det har det -- mer eller mindre,
02:43
one percent of the adult world population is HIV-infected.
en prosent av verdens voksne befolkning er HIV smittet.
02:47
It means 30 to 40 million people,
Det betyr 30 til 40 millioner mennesker,
02:51
the whole of California -- every person,
tilsvarende hele California, alle sammen,
02:54
that's more or less what we have today in the world.
det er mer eller mindre slik det er i verden idag.
02:56
Now, let me make a fast replay of Botswana.
La meg vise dere en reprise av Botswana.
02:58
Botswana -- upper middle-income country in southern Africa,
Botswana -- øvre-middels inntektsnivå land sør i Afrika,
03:03
democratic government, good economy,
demokratisk regjering, god økonomi,
03:07
and this is what happened there.
og dette er det som skjedde der.
03:10
They started low, they skyrocketed,
De startet lavt og så tok av,
03:12
they peaked up there in 2003,
nådde høydepunktet i 2003,
03:14
and now they are down.
og nå er de nede.
03:17
But they are falling only slowly,
Men det går sakte nedover,
03:19
because in Botswana, with good economy and governance,
fordi i Botswana, men god økonomi og styresett,
03:21
they can manage to treat people.
kan de behandle folk.
03:23
And if people who are infected are treated, they don't die of AIDS.
Og hvis folk som er smittet blir behandlet, så dør de ikke av AIDS.
03:26
These percentages won't come down
Disse prosentene kommer ikke ned
03:29
because people can survive 10 to 20 years.
fordi folk kan overleve i 10 til 20 år.
03:32
So there's some problem with these metrics now.
Så det er problemer med disse tallene nå.
03:34
But the poorer countries in Africa, the low-income countries down here,
Men i de fattigere landene i Afrika, lavinntekts landene her nede,
03:37
there the rates fall faster, of the percentage infected,
faller prosenten smittede fortere
03:41
because people still die.
fordi folk dør fremdeles.
03:47
In spite of PEPFAR, the generous PEPFAR,
Til tross for PEPFAR, generøse PEPFAR,
03:49
all people are not reached by treatment,
blir ikke alle nådd for behandling,
03:52
and of those who are reached by treatment in the poor countries,
og blant de som blir nådd med behandling i de fattige landene,
03:55
only 60 percent are left on treatment after two years.
er kun 60 prosent fremdeles på behandlingen etter to år.
03:57
It's not realistic with lifelong treatment
Det er ikke realistisk med livslang behandling
04:00
for everyone in the poorest countries.
for alle i de fattige landene.
04:04
But it's very good that what is done is being done.
Men det er veldig bra at det som blir gjort blir gjort.
04:06
But focus now is back on prevention.
Men fokuset er nå tilbake på forebygging.
04:09
It is only by stopping the transmission
Det er kun ved å stoppe smitte
04:13
that the world will be able to deal with it.
at verden kan takle problemet.
04:16
Drugs is too costly -- had we had the vaccine,
Medisiner er for dyre -- om vi hadde hatt vaksinen
04:19
or when we will get the vaccine, that's something more effective --
eller når vi får vaksinen, så er det mer effektivt --
04:21
but the drugs are very costly for the poor.
men medisinene er veldig dyre for de fattige.
04:24
Not the drug in itself, but the treatment
Ikke medisinen i seg selv, men behandlingen
04:26
and the care which is needed around it.
og omsorgen som trengs rundt den.
04:28
So, when we look at the pattern,
Når vi ser på mønsteret
04:32
one thing comes out very clearly:
står en ting frem veldig tydelig.
04:35
you see the blue bubbles
dere ser de blå boblene
04:37
and people say HIV is very high in Africa.
og folk sier HIV er veldig utbredt i Afrika.
04:39
I would say, HIV is very different in Africa.
Jeg ville sagt; HIV er veldig annerledes i Afrika.
04:41
You'll find the highest HIV rate in the world
Dere finner de høyeste HIV nivåene i verden
04:44
in African countries,
i afrikanske land,
04:48
and yet you'll find Senegal, down here --
og likevel finner dere Senegal der nede
04:50
the same rate as United States.
med samme nivået som USA
04:52
And you'll find Madagascar,
Og dere finner Madagaskar,
04:54
and you'll find a lot of African countries
og dere vil finne mange afrikanske land
04:56
about as low as the rest of the world.
med like lavt nivå som resten av verden.
04:58
It's this terrible simplification that there's one Africa
Det er denne fryktelige overforenklingen at det er ett Afrika
05:01
and things go on in one way in Africa.
og ting går bare en vei i Afrika.
05:05
We have to stop that.
Vi må slutte med det.
05:07
It's not respectful, and it's not very clever
Det er ikke respektfullt og ikke særlig smart
05:09
to think that way.
å tenke slik.
05:12
(Applause)
(Applaus)
05:14
I had the fortune to live and work for a time in the United States.
Jeg var heldig nok til å jobbe en stund i USA.
05:18
I found out that Salt Lake City and San Francisco were different.
Jeg fant ut at Salt Lake City og San Francisco var forskjellig.
05:21
(Laughter)
(Latter)
05:25
And so it is in Africa -- it's a lot of difference.
Og slik er det i Afrika også -- store forskjeller.
05:27
So, why is it so high? Is it war?
Så hvorfor er det så høyt? Er det krig?
05:30
No, it's not. Look here.
Nei, det er det ikke. Se her.
05:32
War-torn Congo is down there -- two, three, four percent.
Krigsherjede Kongo er her nede -- to, tre, fire, prosent
05:34
And this is peaceful Zambia, neighboring country -- 15 percent.
Og dette er fredelige Zambia, naboland -- 15 prosent.
05:37
And there's good studies of the refugees coming out of Congo --
Og det er gode studier av flyktinger fra Kongo --
05:41
they have two, three percent infected,
de hadde rundt to, tre prosent smittede.
05:44
and peaceful Zambia -- much higher.
og fredelige Zambia -- mye høyere.
05:46
There are now studies clearly showing
Det finnes nå studier som klart viser
05:48
that the wars are terrible, that rapes are terrible,
at krigene er fryktelig, voldtektene er fryktelige.
05:50
but this is not the driving force for the high levels in Africa.
Men det er ikke den drivende kraften bak de høye nivåene i Afrika.
05:53
So, is it poverty?
Så er det fattigdom?
05:56
Well if you look at the macro level,
Vel, hvis dere ser på det store bildet
05:58
it seems more money, more HIV.
så ser det ut som om: mer penger, mer HIV.
06:00
But that's very simplistic,
Men det er overforenklet,
06:02
so let's go down and look at Tanzania.
så la oss ta en titt på Tanzania.
06:05
I will split Tanzania in five income groups,
Jeg deler Tanzania inn i fem inntektsgrupper,
06:07
from the highest income to the lowest income,
fra lavest inntekt til høyest inntekt,
06:11
and here we go.
så setter vi igang.
06:13
The ones with the highest income, the better off -- I wouldn't say rich --
De med høyest inntekt, de velstående, jeg ville ikke sagt rike,
06:15
they have higher HIV.
de har mer HIV.
06:18
The difference goes from 11 percent down to four percent,
Forskjellen går fra 11 prosent ned til fire prosent,
06:20
and it is even bigger among women.
og forskjellen er enda større blant kvinner.
06:23
There's a lot of things that we thought, that now, good research,
Det er mange ting vi trodde, som nå, med god forsking,
06:25
done by African institutions and researchers
utført av afrikanske institusjoner og forskere
06:29
together with the international researchers, show that that's not the case.
sammen med internasjonale forskere, viser seg å ikke stemme.
06:32
So, this is the difference within Tanzania.
Så, dette er forskjellen i Tanzania.
06:35
And, I can't avoid showing Kenya.
Og jeg kan ikke unngå å vise Kenya.
06:37
Look here at Kenya.
Se her på Kenya
06:39
I've split Kenya in its provinces.
Jeg har delt Kenya inn i sine provinser.
06:41
Here it goes.
Nå starter vi.
06:43
See the difference within one African country --
Se forskjellen innad i ett afrikansk land --
06:45
it goes from very low level to very high level,
det går fra veldig lavt til veldig høyt,
06:48
and most of the provinces in Kenya is quite modest.
og de fleste provinsene i Kenya er rimelig lave.
06:51
So, what is it then?
Så hva er det da?
06:54
Why do we see this extremely high levels in some countries?
Hvorfor ser vi disse ekstreme høye nivåene i noen land?
06:56
Well, it is more common with multiple partners,
Vel, det er mer vanlig med flere partnere,
07:00
there is less condom use,
det er mindre bruk av kondomer,
07:03
and there is age-disparate sex --
og det er sex med høy aldersforskjell --
07:06
that is, older men tend to have sex with younger women.
det vi si, som regel eldre menn som har sex med yngre kvinner.
07:09
We see higher rates in younger women than younger men
Vi ser høyere nivåer blant unge kvinner enn unge menn
07:12
in many of these highly affected countries.
i mange av disse høyst smittede landene.
07:15
But where are they situated?
Men hvor ligger de?
07:17
I will swap the bubbles to a map.
Jeg bytter ut boblene med ett kart.
07:19
Look, the highly infected are four percent of all population
Se, de høyt smittede er fire prosent av all befolkningen
07:21
and they hold 50 percent of the HIV-infected.
og de har 50 prosent av befolkningen.
07:25
HIV exists all over the world.
HIV eksisterer over hele verden.
07:28
Look, you have bubbles all over the world here.
Se, det er bobler over hele verden her.
07:31
Brazil has many HIV-infected.
Brazil har mange HIV smittede.
07:33
Arab countries not so much, but Iran is quite high.
Arabiske land har ikke så høyt nivå, men Iran ligger ganske høyt.
07:36
They have heroin addiction and also prostitution in Iran.
De har heroin avhengige og prostitusjon i Iran.
07:39
India has many because they are many.
India har mange fordi de er mange.
07:43
Southeast Asia, and so on.
Sør-øst Asia, og så videre.
07:45
But, there is one part of Africa --
Men det er en del av Afrika --
07:47
and the difficult thing is, at the same time,
og det vanskelige er å samtidig
07:49
not to make a uniform statement about Africa,
ikke komme med en generalisert uttalelse om Afrika,
07:51
not to come to simple ideas of why it is like this, on one hand.
å ikke komme til enkle ideer om hvorfor det er slik,
07:55
On the other hand, try to say that this is not the case,
men samtidig innrømme at det er et alvorlig tilfelle,
07:59
because there is a scientific consensus about this pattern now.
fordi det er et vitenskaplig konsensus om dette mønsteret nå.
08:02
UNAIDS have done good data available, finally,
UNAIDS har endelig gitt ut gode data
08:06
about the spread of HIV.
om spredningen av HIV.
08:09
It could be concurrency.
Det kan være flere partnere.
08:12
It could be some virus types.
Det kan være noen virus typer.
08:15
It could be that there is other things
Det kan være at det er andre ting
08:18
which makes transmission occur in a higher frequency.
som gjør at spredning skjer i høyere frekvens.
08:22
After all, if you are completely healthy and you have heterosexual sex,
Når det kommer til stykket, så dersom du er sunn og har heteroseksuell sex,
08:25
the risk of infection in one intercourse is one in 1,000.
Så er sjansen for smitte ved samleie en av 1,000.
08:28
Don't jump to conclusions now on how to
Ikke trekk forhastede konklusjoner nå;
08:33
behave tonight and so on.
oppfør dere ikveld og så videre.
08:35
(Laughter)
(Latter)
08:37
But -- and if you are in an unfavorable situation,
Men -- hvis du er i en mindre fordelaktig situasjon
08:39
more sexually transmitted diseases, it can be one in 100.
flere kjønnssykdommer, så kan sjansen være en av 100.
08:42
But what we think is that it could be concurrency.
Men vi tror det er overlappende forhold.
08:45
And what is concurrency?
Hva er det med overlappende forhold?
08:48
In Sweden, we have no concurrency.
I Sverige har vi som regel ikke overlappende forhold.
08:50
We have serial monogamy.
Vi har serie monogami.
08:52
Vodka, New Year's Eve -- new partner for the spring.
Vodka, Nyttårsaften -- ny partner for våren.
08:54
Vodka, Midsummer's Eve -- new partner for the fall.
Vodka, midtsommersnatt -- ny partner for høsten.
08:56
Vodka -- and it goes on like this, you know?
Vodka -- og det fortsetter slik.
08:58
And you collect a big number of exes.
Og du samler et stort antall ekser.
09:00
And we have a terrible chlamydia epidemic --
Og vi har en fryktelig klamydia epidemi --
09:03
terrible chlamydia epidemic which sticks around for many years.
en fryktelig klamydia epidemi som varer i mange år.
09:05
HIV has a peak three to six weeks after infection
HIV har en topp av smittefare tre til seks uker etter smitte
09:09
and therefore, having more than one partner in the same month
og derfor er det å ha mer enn en partner i måneden
09:12
is much more dangerous for HIV than others.
mye farligere for HIV overføring enn andre infeksjoner.
09:15
Probably, it's a combination of this.
Sannsynligvis er det en kombinasjon av disse.
09:18
And what makes me so happy is that we are moving now
Og det som gjør meg så glad er at vi beveger oss nå
09:20
towards fact when we look at this.
mot fakta når vi ser på dette.
09:23
You can get this chart, free.
Dere kan få denne oversikten, gratis.
09:25
We have uploaded UNAIDS data on the Gapminder site.
Vi har lastet opp UNAIDS data på Gapminder.org.
09:27
And we hope that when we act on global problems in the future
Og vi håper at når vi håndterer globale problemer i framtiden
09:30
we will not only have the heart,
så har vi ikke bare hjertet,
09:34
we will not only have the money,
ikke bare pengene,
09:37
but we will also use the brain.
men vi skal også bruke hjernen.
09:39
Thank you very much.
Takk så mye.
09:42
(Applause)
(Applaus)
09:44
Translated by Jan Tore Stensvoll
Reviewed by Martin Hassel

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About the speaker:

Hans Rosling - Global health expert; data visionary
In Hans Rosling’s hands, data sings. Global trends in health and economics come to vivid life. And the big picture of global development—with some surprisingly good news—snaps into sharp focus.

Why you should listen

Even the most worldly and well-traveled among us will have their perspectives shifted by Hans Rosling. A professor of global health at Sweden's Karolinska Institute, his current work focuses on dispelling common myths about the so-called developing world, which (he points out) is no longer worlds away from the West. In fact, most of the Third World is on the same trajectory toward health and prosperity, and many countries are moving twice as fast as the west did.

What sets Rosling apart isn't just his apt observations of broad social and economic trends, but the stunning way he presents them. Guaranteed: You've never seen data presented like this. By any logic, a presentation that tracks global health and poverty trends should be, in a word: boring. But in Rosling's hands, data sings. Trends come to life. And the big picture — usually hazy at best — snaps into sharp focus.

Rosling's presentations are grounded in solid statistics (often drawn from United Nations data), illustrated by the visualization software he developed. The animations transform development statistics into moving bubbles and flowing curves that make global trends clear, intuitive and even playful. During his legendary presentations, Rosling takes this one step farther, narrating the animations with a sportscaster's flair.

Rosling developed the breakthrough software behind his visualizations through his nonprofit Gapminder, founded with his son and daughter-in-law. The free software — which can be loaded with any data — was purchased by Google in March 2007. (Rosling met the Google founders at TED.)

Rosling began his wide-ranging career as a physician, spending many years in rural Africa tracking a rare paralytic disease (which he named konzo) and discovering its cause: hunger and badly processed cassava. He co-founded Médecins sans Frontièrs (Doctors without Borders) Sweden, wrote a textbook on global health, and as a professor at the Karolinska Institut in Stockholm initiated key international research collaborations. He's also personally argued with many heads of state, including Fidel Castro.

As if all this weren't enough, the irrepressible Rosling is also an accomplished sword-swallower — a skill he demonstrated at TED2007.


More profile about the speaker
Hans Rosling | Speaker | TED.com