TED2015
Maryn McKenna: What do we do when antibiotics don't work any more?
Marin Mekena (Maryn McKenna): Šta da radimo kada antibiotici ne budu više delovali?
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Readability: 4.6
1,800,584 views
Penicilin je promenio sve. Infekcije koje su ranije ubijale odjednom su postale brzo izlečive. Ipak, kako Marin Mekena deli sa nama u ovom otrežnjujućem govoru, protraćili smo prednosti koje nam on pruža, kao i kasniji antibiotici. Bakterije otporne na antibiotike označavaju ulazak u postantibiotički svet - a to neće biti lepo. Postoje, međutim, stvari možemo da uradimo... ako počnemo odmah.
Maryn McKenna - Public health journalist
Maryn McKenna recounts the often terrifying stories behind emerging drug-resistant diseases that medical science is barely keeping at bay. Full bio
Maryn McKenna recounts the often terrifying stories behind emerging drug-resistant diseases that medical science is barely keeping at bay. Full bio
Double-click the English transcript below to play the video.
00:12
This is my great uncle,
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Ovo je moj prastric,
00:14
my father's father's younger brother.
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mlađi brat oca mog oca.
00:17
His name was Joe McKenna.
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Zvao se Džo Mekena.
00:20
He was a young husband
and a semi-pro basketball player
and a semi-pro basketball player
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Bio je mlad suprug
i poluprofesionalni košarkaš
i poluprofesionalni košarkaš
00:25
and a fireman in New York City.
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i vatrogasac u Njujorku.
00:29
Family history says
he loved being a fireman,
he loved being a fireman,
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Porodična istorija kaže
da je voleo da bude vatrogasac,
da je voleo da bude vatrogasac,
00:32
and so in 1938, on one of his days off,
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pa je tako 1938. godine,
kada je imao slobodan dan,
kada je imao slobodan dan,
00:35
he elected to hang out at the firehouse.
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odabrao da provede vreme
u vatrogasnom domu.
u vatrogasnom domu.
00:39
To make himself useful that day,
he started polishing all the brass,
he started polishing all the brass,
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Da bi bio koristan tog dana,
počeo je da polira sav mesing,
počeo je da polira sav mesing,
00:43
the railings on the fire truck,
the fittings on the walls,
the fittings on the walls,
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ogradu na vatrogasnom vozilu,
armature na zidovima,
armature na zidovima,
00:46
and one of the fire hose nozzles,
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a jedna od mlaznica vatrogasnog creva,
00:48
a giant, heavy piece of metal,
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ogroman, teški komad metala,
00:51
toppled off a shelf and hit him.
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srušila se sa police i udarila ga.
00:55
A few days later,
his shoulder started to hurt.
his shoulder started to hurt.
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Nekoliko dana kasnije,
počelo je da ga boli rame.
počelo je da ga boli rame.
00:59
Two days after that, he spiked a fever.
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Dva dana nakon toga,
izbila mu je temperatura.
izbila mu je temperatura.
01:02
The fever climbed and climbed.
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Groznica se pojačavala i pojačavala.
01:05
His wife was taking care of him,
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Njegova žena je brinula o njemu,
01:07
but nothing she did made a difference,
and when they got the local doctor in,
and when they got the local doctor in,
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ali nije vredelo šta god da je činila,
a kada su doveli lokalnog lekara,
a kada su doveli lokalnog lekara,
01:11
nothing he did mattered either.
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nije vredelo ni ono što je on činio.
01:14
They flagged down a cab
and took him to the hospital.
and took him to the hospital.
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Zaustavili su taksi i odveli ga u bolnicu.
01:17
The nurses there recognized right away
that he had an infection,
that he had an infection,
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Medicinske sestre su tamo odmah prepoznale
da on ima infekciju,
da on ima infekciju,
01:21
what at the time they would
have called "blood poisoning,"
have called "blood poisoning,"
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ono što su u to vreme zvali
„trovanje krvi”,
„trovanje krvi”,
01:26
and though they probably didn't say it,
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i mada verovatno to nisu rekli,
01:28
they would have known right away
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znali su odmah
01:30
that there was nothing they could do.
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da se ništa ne može učiniti.
01:33
There was nothing they could do
because the things we use now
because the things we use now
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Nisu mogli ništa da učine
jer stvari koje danas koristimo
jer stvari koje danas koristimo
01:36
to cure infections didn't exist yet.
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da izlečimo infekcije
tada još nisu postojale.
tada još nisu postojale.
01:39
The first test of penicillin,
the first antibiotic,
the first antibiotic,
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Prvo testiranje penicilina,
prvog antibiotika,
prvog antibiotika,
01:43
was three years in the future.
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bilo je tri godine kasnije.
01:45
People who got infections
either recovered, if they were lucky,
either recovered, if they were lucky,
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Ljudi koji bi dobili infekciju
ili bi se oporavili, ako su imali sreće,
ili bi se oporavili, ako su imali sreće,
01:50
or they died.
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ili bi umrli.
01:52
My great uncle was not lucky.
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Moj prastric nije imao sreće.
01:54
He was in the hospital for a week,
shaking with chills,
shaking with chills,
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Bio je u bolnici nedelju dana,
tresući se od groznice,
tresući se od groznice,
01:57
dehydrated and delirious,
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dehidriran i u delirijumu,
01:59
sinking into a coma as his organs failed.
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upadao u komu dok su mu organi otkazivali.
02:02
His condition grew so desperate
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Njegovo stanje je postalo
toliko beznadežno
toliko beznadežno
02:04
that the people from his firehouse
lined up to give him transfusions
lined up to give him transfusions
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da su se ljudi iz vatrogasnog doma
poređali da mu daju krv,
poređali da mu daju krv,
02:09
hoping to dilute the infection
surging through his blood.
surging through his blood.
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nadajući se da će razblažiti infekciju
koja juri kroz njegovu krv.
koja juri kroz njegovu krv.
02:13
Nothing worked. He died.
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Ništa nije delovalo. Umro je.
02:17
He was 30 years old.
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Imao je 30 godina.
02:20
If you look back through history,
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Ako pogledate unazad kroz istoriju,
02:22
most people died the way
my great uncle died.
my great uncle died.
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većina ljudi je umrla
na način na koji je moj prastric umro.
na način na koji je moj prastric umro.
02:25
Most people didn't die
of cancer or heart disease,
of cancer or heart disease,
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Većina ljudi nije umrla
od raka ili bolesti srca,
od raka ili bolesti srca,
02:28
the lifestyle diseases that afflict us
in the West today.
in the West today.
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oboljenja vezanih za način života
koja nas danas pogađaju na zapadu.
koja nas danas pogađaju na zapadu.
02:32
They didn't die of those diseases
because they didn't live long enough
because they didn't live long enough
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Nisu umrli od tih bolesti
zato što nisu živeli dovoljno dugo
zato što nisu živeli dovoljno dugo
02:36
to develop them.
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da bi ih razvili.
02:38
They died of injuries --
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Umrli su od povreda -
02:40
being gored by an ox,
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tako što bi ih probo vo,
02:42
shot on a battlefield,
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bili bi pogođeni na bojnom polju,
02:44
crushed in one of the new factories
of the Industrial Revolution --
of the Industrial Revolution --
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smrskani u jednoj od novih fabrika
industrijske revolucije -
industrijske revolucije -
02:48
and most of the time from infection,
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i većinom od infekcija,
02:51
which finished what those injuries began.
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koje bi dokrajčile
ono što bi povrede započele.
ono što bi povrede započele.
02:56
All of that changed
when antibiotics arrived.
when antibiotics arrived.
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Sve se to promenilo
kada su stigli antibiotici.
kada su stigli antibiotici.
03:00
Suddenly, infections that had
been a death sentence
been a death sentence
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Odjednom, infekcije
koje su pre bile smrtna presuda
koje su pre bile smrtna presuda
03:04
became something
you recovered from in days.
you recovered from in days.
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postale su nešto od čega se oporavlja
za nekoliko dana.
za nekoliko dana.
03:07
It seemed like a miracle,
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Delovalo je kao čudo,
03:10
and ever since, we have been living inside
the golden epoch of the miracle drugs.
the golden epoch of the miracle drugs.
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i od tada živimo u zlatnoj epohi
čudesnih lekova,
čudesnih lekova,
03:17
And now, we are coming to an end of it.
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a sada, približavamo se njenom kraju.
03:21
My great uncle died in the last days
of the pre-antibiotic era.
of the pre-antibiotic era.
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Moj prastric je umro
poslednjih dana preantibiotičke ere.
poslednjih dana preantibiotičke ere.
03:26
We stand today on the threshold
of the post-antibiotic era,
of the post-antibiotic era,
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Danas stojimo na pragu
postantibiotičke ere,
postantibiotičke ere,
03:31
in the earliest days of a time
when simple infections
when simple infections
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najranijih dana vremena
kada će obične infekcije,
kada će obične infekcije,
03:35
such as the one Joe had
will kill people once again.
will kill people once again.
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poput one koju je Džo imao,
ponovo ubijati ljude.
ponovo ubijati ljude.
03:40
In fact, they already are.
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U stvari, već ih ubijaju.
03:44
People are dying of infections again
because of a phenomenon
because of a phenomenon
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Ljudi ponovo umiru od infekcija
zbog fenomena
zbog fenomena
03:47
called antibiotic resistance.
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zvanog otpornost na antibiotike.
03:50
Briefly, it works like this.
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Ukratko, dešava se sledeće.
03:52
Bacteria compete against each other
for resources, for food,
for resources, for food,
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Bakterije se međusobno nadmeću
zbog sredstava, zbog hrane,
zbog sredstava, zbog hrane,
03:57
by manufacturing lethal compounds
that they direct against each other.
that they direct against each other.
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proizvodeći smrtonosna jedinjenja
koja usmeravaju jedna protiv druge.
koja usmeravaju jedna protiv druge.
04:01
Other bacteria, to protect themselves,
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Druge bakterije, da bi se zaštitile.
04:04
evolve defenses against
that chemical attack.
that chemical attack.
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razviju odbrane
protiv tog hemijskog napada.
protiv tog hemijskog napada.
04:07
When we first made antibiotics,
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Kada smo prvi put napravili antibiotike,
04:09
we took those compounds into the lab
and made our own versions of them,
and made our own versions of them,
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odneli smo ta jedinjenja u laboratoriju
i napravili njihove verzije,
i napravili njihove verzije,
04:13
and bacteria responded to our attack
the way they always had.
the way they always had.
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a bakterije su uzvratile na naš napad
kao što su to uvek činile.
kao što su to uvek činile.
04:19
Here is what happened next:
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Evo šta se zatim dogodilo.
04:22
Penicillin was distributed in 1943,
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Penicilin je distribuiran 1943. godine,
04:25
and widespread penicillin resistance
arrived by 1945.
arrived by 1945.
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a rasprostranjena otpornost na penicilin
nastupila je do 1945. godine.
nastupila je do 1945. godine.
04:30
Vancomycin arrived in 1972,
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Vankomicin je stigao 1972. godine,
04:33
vancomycin resistance in 1988.
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otpornost na vankomicin - 1988. godine.
04:37
Imipenem in 1985,
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Imipenem - 1985. godine,
04:39
and resistance to in 1998.
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a otpornost na njega - 1998. godine.
04:42
Daptomycin, one of
the most recent drugs, in 2003,
the most recent drugs, in 2003,
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Daptomicin, među skorijim lekovima,
2003. godine,
2003. godine,
04:45
and resistance to it
just a year later in 2004.
just a year later in 2004.
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a otpornost na njega
samo jednu godinu kasnije, 2004. godine.
samo jednu godinu kasnije, 2004. godine.
04:50
For 70 years, we played
a game of leapfrog --
a game of leapfrog --
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Sedamdeset godina se igramo trule kobile -
04:54
our drug and their resistance,
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naš lek i otpornost na njega,
04:57
and then another drug,
and then resistance again --
and then resistance again --
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a onda drugi lek, pa ponovo otpornost -
05:00
and now the game is ending.
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i sada se igra završava.
05:03
Bacteria develop resistance so quickly
that pharmaceutical companies
that pharmaceutical companies
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Bakterije razvijaju otpornost tako brzo
da su farmaceutske kompanije
da su farmaceutske kompanije
05:07
have decided making antibiotics
is not in their best interest,
is not in their best interest,
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odlučile da pravljenje antibiotika
nije u njihovom najboljem interesu,
nije u njihovom najboljem interesu,
05:11
so there are infections
moving across the world
moving across the world
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tako da se svetom šire infekcije
05:14
for which, out of the more
than 100 antibiotics
than 100 antibiotics
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za koje, od preko 100 antibiotika
05:18
available on the market,
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dostupnih na tržištu,
05:20
two drugs might work with side effects,
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dva leka bi mogla delovati uz nuspojave,
05:23
or one drug,
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ili jedan lek,
05:26
or none.
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ili nijedan.
05:28
This is what that looks like.
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Ovako to izgleda.
05:30
In 2000, the Centers for Disease
Control and Prevention, the CDC,
Control and Prevention, the CDC,
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Godine 2000, Centar za kontrolu
i prevenciju bolesti, CDC,
i prevenciju bolesti, CDC,
05:34
identified a single case
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identifikovao je jedinstveni slučaj
05:36
in a hospital in North Carolina
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u bolnici u Severnoj Karolini
05:38
of an infection resistant
to all but two drugs.
to all but two drugs.
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infekcije otporne na sve osim dva leka.
05:42
Today, that infection, known as KPC,
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Danas se ta infekcija, poznata kao KPC,
05:47
has spread to every state but three,
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proširila na svaku državu osim tri,
05:49
and to South America, Europe
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na Južnu Ameriku, Evropu
05:52
and the Middle East.
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i na Srednji Istok.
05:54
In 2008, doctors in Sweden
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Godine 2008, doktori u Švedskoj
05:57
diagnosed a man from India
with a different infection
with a different infection
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dijagnostikovali su kod čoveka iz Indije
drugačiju infekciju,
drugačiju infekciju,
05:59
resistant to all but one drug that time.
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otpornu na sve osim jednog leka.
06:03
The gene that creates that resistance,
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Gen koji stvara tu otpornost,
06:05
known as NDM, has now spread
from India into China, Asia, Africa,
from India into China, Asia, Africa,
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poznat kao NDM, sada se proširio
iz Indije u Kinu, Aziju, Afriku,
iz Indije u Kinu, Aziju, Afriku,
06:12
Europe and Canada, and the United States.
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Evropu, Kanadu, i SAD.
06:17
It would be natural to hope
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Bilo bi prirodno nadati se
06:19
that these infections
are extraordinary cases,
are extraordinary cases,
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da su te infekcije izuzetni slučajevi,
06:23
but in fact,
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ali u stvari,
06:25
in the United States and Europe,
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u Sjedinjenim Državama i Evropi,
06:27
50,000 people a year
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50 000 ljudi godišnje
06:30
die of infections which no drugs can help.
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umre od infekcije
kojoj nikakvi lekovi ne mogu pomoći.
kojoj nikakvi lekovi ne mogu pomoći.
06:34
A project chartered
by the British government
by the British government
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Projekat koji je osnovala britanska vlada
06:38
known as the Review
on Antimicrobial Resistance
on Antimicrobial Resistance
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poznat kao
Pregled otpornosti na antibiotike
Pregled otpornosti na antibiotike
06:41
estimates that the worldwide toll
right now is 700,000 deaths a year.
right now is 700,000 deaths a year.
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procenjuje da je svetski gubitak
u ovom trenutku 700 000 smrti godišnje.
u ovom trenutku 700 000 smrti godišnje.
06:50
That is a lot of deaths,
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To je mnogo smrtnih slučajeva,
pa ipak, dobri su izgledi
da ne osećate da ste pod rizikom,
da ne osećate da ste pod rizikom,
06:54
and yet, the chances are good
that you don't feel at risk,
that you don't feel at risk,
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06:57
that you imagine these people
were hospital patients
were hospital patients
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da zamišljate da su ti ljudi
bili bolnički pacijenti
bili bolnički pacijenti
07:00
in intensive care units
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na intenzivnoj nezi
07:02
or nursing home residents
near the ends of their lives,
near the ends of their lives,
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ili stanari staračkog doma
pri kraju svog života,
pri kraju svog života,
07:06
people whose infections
are remote from us,
are remote from us,
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ljudi čije su infekcije udaljene od nas,
07:09
in situations we can't identify with.
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u situacijama
u kojima se ne možemo pronaći.
u kojima se ne možemo pronaći.
07:14
What you didn't think about,
none of us do,
none of us do,
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Ono što niste pomislili, niko od nas nije,
07:17
is that antibiotics support
almost all of modern life.
almost all of modern life.
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je da antibiotici igraju ulogu
u skoro čitavom savremenom životu.
u skoro čitavom savremenom životu.
07:23
If we lost antibiotics,
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Ako izgubimo antibiotike,
07:25
here's what else we'd lose:
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evo šta bismo još izgubili:
07:27
First, any protection for people
with weakened immune systems --
with weakened immune systems --
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prvo, svaku zaštitu za ljude
sa oslabljenim imunim sistemom -
sa oslabljenim imunim sistemom -
07:32
cancer patients, AIDS patients,
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pacijente obolele od raka i side,
07:35
transplant recipients, premature babies.
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pacijente sa izvršenom transplantacijom,
prerano rođene bebe.
prerano rođene bebe.
07:39
Next, any treatment that installs
foreign objects in the body:
foreign objects in the body:
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Zatim, svaki tretman kojim se unose
strani objekti u telo:
strani objekti u telo:
07:44
stents for stroke, pumps for diabetes,
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stentovi kod moždanog udara,
pumpe kod dijabetesa,
pumpe kod dijabetesa,
07:48
dialysis, joint replacements.
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dijalizu, artroplastiku.
Za koliko atletskih pripadnika
bejbi bum generacije
bejbi bum generacije
07:52
How many athletic baby boomers
need new hips and knees?
need new hips and knees?
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su potrebni novi kukovi i kolena?
07:55
A recent study estimates
that without antibiotics,
that without antibiotics,
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Skorije istraživanje pokazuje
da bi bez antibiotika
da bi bez antibiotika
07:58
one out of ever six would die.
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umro jedan od svakih šest.
08:02
Next, we'd probably lose surgery.
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Potom bismo verovatno izgubili hirurgiju.
08:05
Many operations are preceded
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Mnogim operacijama prethode
08:08
by prophylactic doses of antibiotics.
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profilaktičke doze antibiotika.
08:11
Without that protection,
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Bez te zaštite,
08:12
we'd lose the ability to open
the hidden spaces of the body.
the hidden spaces of the body.
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izgubili bismo mogućnost
da otvaramo skrivena mesta u telu.
da otvaramo skrivena mesta u telu.
08:17
So no heart operations,
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Dakle, nema operacija na srcu,
08:19
no prostate biopsies,
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nema biopsija prostate,
08:22
no Cesarean sections.
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nema carskog reza.
08:25
We'd have to learn to fear infections
that now seem minor.
that now seem minor.
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Morali bismo da naučimo da se bojimo
infekcija koje se sada čine neznatnim.
infekcija koje se sada čine neznatnim.
08:30
Strep throat used to cause heart failure.
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Upala grla je ranije izazivala
otkazivanje rada srca.
otkazivanje rada srca.
08:34
Skin infections led to amputations.
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Infekcije kože su dovodile do amputacija.
08:37
Giving birth killed,
in the cleanest hospitals,
in the cleanest hospitals,
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Porođaj je ubijao,
u najčistijim bolnicama,
u najčistijim bolnicama,
08:40
almost one woman out of every 100.
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skoro jednu ženu na svakih sto.
08:43
Pneumonia took three children
out of every 10.
out of every 10.
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Upala pluća je odnosila
troje dece od svakih 10.
troje dece od svakih 10.
08:49
More than anything else,
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Više od svega,
08:51
we'd lose the confident way
we live our everyday lives.
we live our everyday lives.
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izgubili bismo siguran način
na koji vodimo naše živote svakog dana.
na koji vodimo naše živote svakog dana.
08:56
If you knew that any injury
could kill you,
could kill you,
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Kada biste znali
da bi vas bilo koja povreda mogla ubiti,
da bi vas bilo koja povreda mogla ubiti,
da li biste vozili motor,
09:01
would you ride a motorcycle,
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09:04
bomb down a ski slope,
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survali se niz skijašku stazu,
09:07
climb a ladder to hang
your Christmas lights,
your Christmas lights,
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peli se uz merdevine
da okačite božićne lampice,
da okačite božićne lampice,
09:10
let your kid slide into home plate?
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dozvolili svom detetu
da se strmoglavi u bejzbol utakmici?
da se strmoglavi u bejzbol utakmici?
09:15
After all, the first person
to receive penicillin,
to receive penicillin,
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Uostalom, prva osoba
koja je primila penicilin,
koja je primila penicilin,
09:18
a British policeman named
Albert Alexander,
Albert Alexander,
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britanski policajac
po imenu Albert Aleksander,
po imenu Albert Aleksander,
09:22
who was so ravaged by infection
that his scalp oozed pus
that his scalp oozed pus
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koga je toliko razorila infekcija
da mu je iz kože na glavi curio gnoj
da mu je iz kože na glavi curio gnoj
09:26
and doctors had to take out an eye,
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i doktori su morali da izvade oko,
09:29
was infected by doing
something very simple.
something very simple.
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zadobio je infekciju
radeći nešto vrlo jednostavno.
radeći nešto vrlo jednostavno.
09:34
He walked into his garden
and scratched his face on a thorn.
and scratched his face on a thorn.
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Ušetao je u svoju baštu
i ogrebao lice o trn.
i ogrebao lice o trn.
Onaj britanski projekat koji sam pomenula
koji procenjuje da je svetski gubitak
koji procenjuje da je svetski gubitak
09:40
That British project I mentioned
which estimates that the worldwide toll
which estimates that the worldwide toll
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09:44
right now is 700,000 deaths a year
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700 000 smrti godišnje u ovom trenutku
09:48
also predicts that if we can't
get this under control by 2050,
get this under control by 2050,
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takođe predviđa da ako ne budemo mogli
to da kontrolišemo do 2050. godine,
to da kontrolišemo do 2050. godine,
09:54
not long, the worldwide toll
will be 10 million deaths a year.
will be 10 million deaths a year.
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ne dugo, danak će iznositi
10 miliona smrti godišnje.
10 miliona smrti godišnje.
10:02
How did we get to this point
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Kako smo došli do ove tačke
10:04
where what we have to look forward to
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na kojoj očekujemo
10:06
is those terrifying numbers?
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te zastrašujuće brojeve?
10:10
The difficult answer is,
we did it to ourselves.
we did it to ourselves.
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Težak odgovor je:
sami sebi smo to uradili.
sami sebi smo to uradili.
10:14
Resistance is an inevitable
biological process,
biological process,
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Otpornost je neizbežni biološki proces,
10:17
but we bear the responsibility
for accelerating it.
for accelerating it.
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ali mi nosimo odgovornost
za njegovo ubrzanje.
za njegovo ubrzanje.
10:22
We did this by squandering antibiotics
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Uradili smo to rasipajući antibiotike
10:26
with a heedlessness
that now seems shocking.
that now seems shocking.
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sa nepažljivošću
koja sada deluje šokantno.
koja sada deluje šokantno.
10:31
Penicillin was sold
over the counter until the 1950s.
over the counter until the 1950s.
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Penicilin je bio
u slobodnoj prodaji do 1950-ih.
u slobodnoj prodaji do 1950-ih.
10:35
In much of the developing world,
most antibiotics still are.
most antibiotics still are.
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U mnogim zemljama u razvoju,
većina antibiotika je još uvek.
većina antibiotika je još uvek.
10:39
In the United States, 50 percent
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U Sjedinjenim Državama,
50 posto antibiotika
datih u bolnicama je nepotrebno,
datih u bolnicama je nepotrebno,
10:42
of the antibiotics given
in hospitals are unnecessary.
in hospitals are unnecessary.
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10:46
Forty-five percent of the prescriptions
written in doctor's offices
written in doctor's offices
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45 posto recepata
propisanih u doktorskim ordinacijama
propisanih u doktorskim ordinacijama
10:51
are for conditions
that antibiotics cannot help.
that antibiotics cannot help.
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su za stanja kojima antibiotici
ne mogu pomoći,
ne mogu pomoći,
10:56
And that's just in healthcare.
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a to je samo u oblasti zdravstva.
10:59
On much of the planet, most meat animals
get antibiotics every day of their lives,
get antibiotics every day of their lives,
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U većem delu planete,
većina životinja koje daju meso
većina životinja koje daju meso
dobija antibiotike svakodnevno,
11:04
not to cure illnesses,
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ne da bi se izlečile bolesti,
11:06
but to fatten them up
and to protect them against
and to protect them against
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već da bi ih ugojili i da bi ih zaštitili
od uslova fabričke farme
u kojoj su uzgajane.
u kojoj su uzgajane.
11:09
the factory farm conditions
they are raised in.
they are raised in.
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11:13
In the United States, possibly 80 percent
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U Sjedinjenim Državama, verovatno 80 posto
11:16
of the antibiotics sold every year
go to farm animals, not to humans,
go to farm animals, not to humans,
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antibiotika prodatih svake godine
odlaze životinjama sa farme, ne ljudima,
odlaze životinjama sa farme, ne ljudima,
11:23
creating resistant bacteria
that move off the farm
that move off the farm
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stvarajući otpornu bakteriju
koja se premešta sa farme
koja se premešta sa farme
11:27
in water, in dust,
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u vodu, prašinu,
11:29
in the meat the animals become.
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u meso koje životinje postaju.
11:32
Aquaculture depends on antibiotics too,
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Akvakultura takođe zavisi od antibiotika,
11:35
particularly in Asia,
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naročito u Aziji,
11:37
and fruit growing relies on antibiotics
195
685559
3343
i uzgajanje voća se oslanja na antibiotike
11:40
to protect apples, pears,
citrus, against disease.
citrus, against disease.
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da bi se jabuke, kruške i citrusi
zaštitili od bolesti.
zaštitili od bolesti.
11:46
And because bacteria can pass
their DNA to each other
their DNA to each other
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A pošto bakterije mogu da prenose
svoj DNK jedna na drugu
svoj DNK jedna na drugu
11:52
like a traveler handing off
a suitcase at an airport,
a suitcase at an airport,
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700117
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kao putnik koji predaje
svoj prtljag na aerodromu,
svoj prtljag na aerodromu,
11:56
once we have encouraged
that resistance into existence,
that resistance into existence,
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jednom kada podstaknemo tu otpornost,
ne zna se gde će se raširiti.
12:01
there is no knowing where it will spread.
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12:05
This was predictable.
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To se moglo predvideti.
12:07
In fact, it was predicted
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Zapravo, to je i predvideo
12:10
by Alexander Fleming,
the man who discovered penicillin.
the man who discovered penicillin.
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4435
Aleksandar Fleming,
čovek koji je otkrio penicilin.
čovek koji je otkrio penicilin.
Dobio je Nobelovu nagradu
1945. godine kao priznanje
1945. godine kao priznanje
12:14
He was given the Nobel Prize
in 1945 in recognition,
in 1945 in recognition,
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12:18
and in an interview shortly after,
this is what he said:
this is what he said:
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i u intervjuu ubrzo nakon toga,
ovo je izjavio:
ovo je izjavio:
12:23
"The thoughtless person playing
with penicillin treatment
with penicillin treatment
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„Nepromišljena osoba koja se igra
sa penicilinskim lečenjem
sa penicilinskim lečenjem
12:27
is morally responsible
for the death of a man
for the death of a man
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3274
je moralno odgovorna za smrt čoveka
12:30
who succumbs to infection
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2324
koji podlegne infekciji
12:33
with a pencillin-resistant organism."
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741147
2903
izazvanoj organizmom
otpornim na penicilin.”
otpornim na penicilin.”
12:36
He added, "I hope this evil
can be averted."
can be averted."
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Dodao je: „Nadam se
da se to zlo može izbeći.”
da se to zlo može izbeći.”
12:40
Can we avert it?
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Možemo li ga izbeći?
12:43
There are companies working
on novel antibiotics,
on novel antibiotics,
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Postoje kompanije
koje rade na novim antibioticima,
koje rade na novim antibioticima,
12:47
things the superbugs
have never seen before.
have never seen before.
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stvarima kakve superbube
nikada pre nisu videle.
nikada pre nisu videle.
12:51
We need those new drugs badly,
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Veoma su nam potrebni ti novi lekovi
12:53
and we need incentives:
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i potrebni su nam podsticaji:
12:56
discovery grants, extended patents,
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donacije za otkrića,
produženi patenti, nagrade,
produženi patenti, nagrade,
12:58
prizes, to lure other companies
into making antibiotics again.
into making antibiotics again.
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da bismo privukli druge kompanije
da ponovo prave antibiotike.
da ponovo prave antibiotike.
13:05
But that probably won't be enough.
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Međutim, to verovatno neće biti dovoljno.
13:08
Here's why: Evolution always wins.
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Evo zašto: evolucija uvek pobeđuje.
13:12
Bacteria birth a new generation
every 20 minutes.
every 20 minutes.
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Bakterije rađaju novu generaciju
svakih 20 minuta.
svakih 20 minuta.
13:16
It takes pharmaceutical chemistry
10 years to derive a new drug.
10 years to derive a new drug.
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Farmaceutskoj hemiji je potrebno 10 godina
da bi se proizveo novi lek.
da bi se proizveo novi lek.
13:21
Every time we use an antibiotic,
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2856
Svaki put kada koristimo antibiotik,
13:24
we give the bacteria billions of chances
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dajemo bakterijama milijardu prilika
13:27
to crack the codes
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da provale šifru odbrana
13:29
of the defenses we've constructed.
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koje smo izgradili.
13:32
There has never yet been a drug
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Još nije bilo leka
13:34
they could not defeat.
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2554
koji nisu uspele da poraze.
13:37
This is asymmetric warfare,
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Ovo je asimetrično ratovanje,
13:40
but we can change the outcome.
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ali mi možemo izmeniti ishod.
13:45
We could build systems to harvest data
to tell us automatically and specifically
to tell us automatically and specifically
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6405
Možemo da izgradimo
sisteme za prikupljanje podataka
sisteme za prikupljanje podataka
koji će nam automatski i konkretno reći
kako se antibiotici koriste.
kako se antibiotici koriste.
13:52
how antibiotics are being used.
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Možemo izgraditi kontrolu pristupa
u sistemima poretka lekova
u sistemima poretka lekova
13:55
We could build gatekeeping
into drug order systems
into drug order systems
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13:58
so that every prescription
gets a second look.
gets a second look.
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tako da svaki recept bude preispitan.
14:01
We could require agriculture
to give up antibiotic use.
to give up antibiotic use.
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Mogli bismo da zahtevamo da poljoprivreda
odustane od korišćenja antibiotika.
odustane od korišćenja antibiotika.
14:08
We could build surveillance systems
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3032
Mogli bismo da izgradimo sistem nadzora
14:11
to tell us where resistance
is emerging next.
is emerging next.
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koji bi nam rekao
gde se javlja sledeća otpornost.
gde se javlja sledeća otpornost.
14:15
Those are the tech solutions.
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To su tehnološka rešenja.
14:18
They probably aren't enough either,
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Verovatno ni ona nisu dovoljna,
14:20
unless we help.
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3229
osim ukoliko mi pomognemo.
14:27
Antibiotic resistance is a habit.
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2314
Otpornost na antibiotike je navika.
14:30
We all know how hard it is
to change a habit.
to change a habit.
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Svi znamo koliko je teško
promeniti naviku,
promeniti naviku,
14:33
But as a society,
we've done that in the past.
we've done that in the past.
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4530
ali činili smo to u prošlosti,
kao društvo.
kao društvo.
14:38
People used to toss litter
into the streets,
into the streets,
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3575
Ljudi su nekada bacali đubre po ulici,
14:41
used to not wear seatbelts,
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1765
nisu koristili sigurnosne pojaseve,
14:43
used to smoke inside public buildings.
245
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4257
pušili su u javnim zgradama.
14:48
We don't do those things anymore.
246
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2220
Više ne radimo te stvari.
14:51
We don't trash the environment
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2322
Ne razbacujemo đubre po okolini
14:53
or court devastating accidents
248
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3157
niti prizivamo nesagledive nesreće,
14:56
or expose others
to the possibility of cancer,
to the possibility of cancer,
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2972
niti izlažemo druge
mogućnostima da dobiju rak,
mogućnostima da dobiju rak,
14:59
because we decided those things
were expensive,
were expensive,
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jer smo presudili
da su te stvari skupo koštale,
da su te stvari skupo koštale,
15:03
destructive, not in our best interest.
251
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4073
da su bile razarajuće, da nisu bile
u našem najboljem interesu.
u našem najboljem interesu.
15:07
We changed social norms.
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2900
Promenili smo društvene norme.
15:11
We could change social norms
around antibiotic use too.
around antibiotic use too.
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4144
Možemo promeniti i društvene norme
vezane za korišćenje antibiotika.
vezane za korišćenje antibiotika.
15:17
I know that the scale
of antibiotic resistance
of antibiotic resistance
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Znam da se razmere
otpornosti na antibiotike
otpornosti na antibiotike
15:19
seems overwhelming,
255
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1904
čine nesavladivim,
15:21
but if you've ever bought
a fluorescent lightbulb
a fluorescent lightbulb
256
909678
3460
ali ako ste ikada kupili
fluorescentnu sijalicu
fluorescentnu sijalicu
jer ste bili zabrinuti
zbog klimatskih promena,
zbog klimatskih promena,
15:25
because you were concerned
about climate change,
about climate change,
257
913138
2716
15:27
or read the label on a box of crackers
258
915854
3135
ili ste pročitali deklaraciju
na kutiji krekera
na kutiji krekera
15:30
because you think about
the deforestation from palm oil,
the deforestation from palm oil,
259
918989
4481
jer razmišljate o seči šuma
radi dobijanja palminog ulja,
radi dobijanja palminog ulja,
15:35
you already know what it feels like
260
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2879
već znate kakav je osećaj
15:38
to take a tiny step to address
an overwhelming problem.
an overwhelming problem.
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kada preduzmete mali korak
da biste se bavili ogromnim problemom.
da biste se bavili ogromnim problemom.
15:43
We could take those kinds of steps
for antibiotic use too.
for antibiotic use too.
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4481
Mogli bismo da preduzmemo takve korake
i u upotrebi antibiotika.
i u upotrebi antibiotika.
15:48
We could forgo giving an antibiotic
if we're not sure it's the right one.
if we're not sure it's the right one.
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7637
Možemo odustati od davanja antibiotika
ako nismo sigurni da je to pravo rešenje.
ako nismo sigurni da je to pravo rešenje.
15:56
We could stop insisting on a prescription
for our kid's ear infection
for our kid's ear infection
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Mogli bismo da prestanemo
da insistiramo na propisivanju recepta
da insistiramo na propisivanju recepta
za infekciju uha svog deteta
dok ne budemo sigurni šta ju je izazvalo.
dok ne budemo sigurni šta ju je izazvalo.
16:02
before we're sure what caused it.
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16:05
We could ask every restaurant,
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3367
Mogli bismo da pitamo svaki restoran,
16:09
every supermarket,
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1811
svaki supermarket,
16:10
where their meat comes from.
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1620
odakle dolazi njihovo meso.
16:12
We could promise each other
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Mogli bismo da obećamo jedni drugima
16:14
never again to buy chicken
or shrimp or fruit
or shrimp or fruit
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4105
da nećemo nikada više kupiti
piletinu, škampe ili voće
piletinu, škampe ili voće
16:18
raised with routine antibiotic use,
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2884
odgajane uz rutinsku upotrebu antibiotika,
16:21
and if we did those things,
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2694
i ako bismo to radili,
16:24
we could slow down the arrival
of the post-antibiotic world.
of the post-antibiotic world.
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4492
mogli bismo usporiti dolazak
postantibiotičkog sveta,
postantibiotičkog sveta,
16:29
But we have to do it soon.
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4133
ali moramo to da uradimo ubrzo.
16:33
Penicillin began
the antibiotic era in 1943.
the antibiotic era in 1943.
275
981680
4505
Penicilin je započeo
antibiotičku eru 1943. godine.
antibiotičku eru 1943. godine.
16:38
In just 70 years, we walked ourselves
up to the edge of disaster.
up to the edge of disaster.
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Za samo 70 godina,
došli smo do ruba propasti.
došli smo do ruba propasti.
16:44
We won't get 70 years
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Nećemo dobiti još 70 godina
16:46
to find our way back out again.
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da ponovo nađemo izlaz.
16:50
Thank you very much.
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Mnogo vam hvala.
(Aplauz)
16:52
(Applause)
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ABOUT THE SPEAKER
Maryn McKenna - Public health journalistMaryn McKenna recounts the often terrifying stories behind emerging drug-resistant diseases that medical science is barely keeping at bay.
Why you should listen
Maryn McKenna’s harrowing stories of hunting down anthrax with the CDC and her chronicle of antibiotic-resistant staph infections in Superbug earned her the nickname “scary disease girl” among her colleagues.
But her investigations into public health don’t stop there: she blogs and writes on the history of epidemics and the public health challenges posed by factory farming. For her forthcoming book, McKenna is researching the symbiotic history of food production and antibiotics, and how their use impacts our lives, societies and the potential for illness.
Maryn McKenna | Speaker | TED.com