TED2010
Seth Berkley: HIV and flu -- the vaccine strategy
Set Berkli: HIV i grip -- strategija vakcinisanja
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Set Berkli (Seth Berkley) objašnjava kako nas napredak u dizajnu vakcina, njihovoj produkciji i distribuciji dovodi bliže nego ikada ka eliminisanju globalnih pretnji -- od SIDE i malarije do pandemija gripa.
Seth Berkley - Vaccine visionary
Epidemiologist Seth Berkley is leading the charge to make sure vaccines are available to everyone, including those living in the developing world. Full bio
Epidemiologist Seth Berkley is leading the charge to make sure vaccines are available to everyone, including those living in the developing world. Full bio
Double-click the English transcript below to play the video.
00:17
Do you worry about what is going to kill you?
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Da li brinete o tome šta će vas ubiti?
00:20
Heart disease, cancer,
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Srčana bolest, rak,
00:22
a car accident?
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ili saobraćajna nesreća?
00:24
Most of us worry about things we can't control,
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Većina nas se brineo stvarima koje su van naše kontrole
00:27
like war, terrorism,
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kao što su rat, terorizam,
00:29
the tragic earthquake that just occurred in Haiti.
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ili tragični zemljotres koji se desio na Haitiju.
00:32
But what really threatens humanity?
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Međutim, šta zapravo preti čovečanstvu?
00:36
A few years ago, Professor Vaclav Smil
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Pre nekoliko godina, profesor Vaclav Smil
00:38
tried to calculate the probability
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je pokušao da izračuna verovatnoću
00:40
of sudden disasters
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iznenadnih katastrofa
00:42
large enough to change history.
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dovoljno velikih da promene istoriju.
00:44
He called these,
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Nazvao ih je
00:46
"massively fatal discontinuities,"
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''masovnim pomorima,''
00:48
meaning that they could kill
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što bi značilo da mogu ubiti
00:50
up to 100 million people
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do sto miliona ljudi
00:52
in the next 50 years.
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u narednih pedeset godina.
00:54
He looked at the odds of another world war,
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Razmatrao je mogućnosti za još jedan svetsti rat,
00:57
of a massive volcanic eruption,
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za ogromnu vulkansku erupciju,
00:59
even of an asteroid hitting the Earth.
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čak i za udar asteroida u Zemlju.
01:01
But he placed the likelihood of one such event
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Verovatnoću za ozbiljnu pandemiju gripa je stavio
01:04
above all others
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blizu sto odsto,
01:06
at close to 100 percent,
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što je iznad
01:08
and that is a severe flu pandemic.
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do sada svih nabrojanih katastrofa.
01:12
Now, you might think of flu
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Sada, možete razmišljati o gripu
01:14
as just a really bad cold,
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kao o stvarno lošoj prehladi.
01:17
but it can be a death sentence.
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A takodje može biti i smrtna presuda.
01:19
Every year, 36,000 people in the United States
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Svake godine, 36 hiljada ljudi u Sjedinjenim Američkim Državama
01:22
die of seasonal flu.
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umre od sezonskog gripa.
01:25
In the developing world, the data is much sketchier
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U svetu koji se razvija, podaci su mnogo šarolikiji
01:27
but the death toll is almost
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ali smrtna stopa je skoro
01:29
certainly higher.
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sigurno viša.
01:31
You know, the problem is if
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Znate, problem je kada
01:33
this virus occasionally mutates
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ovaj virus povremeno mutira
01:35
so dramatically,
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toliko dramatično,
01:37
it essentially is a new virus
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da je u suštini novi virus
01:39
and then we get a pandemic.
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pa nas onda zahvati pandemija.
01:43
In 1918, a new virus appeared
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Novi virus koji se pojavio 1918. godine
01:46
that killed some 50 to 100 million people.
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ubio je oko pedeset do sto miliona ljudi.
01:49
It spread like wildfire
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Širio se kao vatra
01:51
and some died within hours of developing symptoms.
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neki su umirali i nekoliko sati nakon pojava simptoma.
01:54
Are we safer today?
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Jesmo li sigurniji danas?
01:56
Well, we seem to have dodged
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Pa, izgleda da smo ove godine
01:58
the deadly pandemic this year
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izbegli smrtnu pandemiju
02:00
that most of us feared,
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koje se većina od nas plašila,
02:02
but this threat could reappear at any time.
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međutim, ova pretnja se može opet pojaviti bilo kada.
02:05
The good news is that
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Dobre vesti su da
02:07
we're at a moment in time
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smo u vremenu
02:09
when science, technology, globalization is converging
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kada nauka, tehnologija, globalizacija teže ka istom
02:12
to create an unprecedented possibility:
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praveći jedinstvenu mogućnost:
02:14
the possibility to make history
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mogućnost stvaranja istorije
02:16
by preventing infectious diseases
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sprečavanjem zaraznih bolesti
02:19
that still account for one-fifth of all deaths
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koje još uvek obuhvataju jednu petinu svih smrtnih slučajeva
02:22
and countless misery on Earth.
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i bezbrojnih beda na Zemlji.
02:25
We can do this.
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Možemo to uraditi.
02:27
We're already preventing millions of deaths
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Već sprečavamo milione smrtnih slučajeva
02:29
with existing vaccines,
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sa postojećim vakcinama,
02:31
and if we get these to more people,
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i ako ih dostavimo do više ljudi,
02:33
we can certainly save more lives.
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sigurno možemo spasiti više života.
02:36
But with new or better vaccines
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Sa novim ili boljim vakcinama
02:38
for malaria, TB, HIV,
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od malarije, TB-a, HIV-a,
02:41
pneumonia, diarrhea, flu,
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zapaljenja pluća, dijareje, gripa,
02:43
we could end suffering
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mogli bismo privesti kraju patnji
02:45
that has been on the Earth since the beginning of time.
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koja je bila prisutna na Zemlji od početka vremena.
02:48
So, I'm here to trumpet vaccines for you.
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Ovde sam da vam razglasim o vakcinama.
02:50
But first, I have to explain why they're important
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Prvo, moram objasniti zašto su one važe
02:53
because vaccines, the power of them,
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jer vakcine, njihova moć,
02:56
is really like a whisper.
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je zapravo kao šapat.
02:58
When they work, they can make history,
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Kada rade, mogu stvarati istoriju,
03:00
but after a while
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dok posle izvesnog vremena
03:02
you can barely hear them.
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jedva da možete da ih čujete.
03:04
Now, some of us are old enough
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Sada, neki od nas su dovoljno stari
03:07
to have a small, circular scar on our arms
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da imaju mali, kružni ožiljak na rukama
03:10
from an inoculation we received as children.
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od vakcinisanja koje smo primili kao deca.
03:13
But when was the last time you worried about smallpox,
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A kada ste se zadnji put zabrinuli o malim boginjama,
03:16
a disease that killed half a billion people last century
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bolesti koja je prošlog veka ubila pola milijarde ljudi,
03:19
and no longer is with us?
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a koja više nije sa nama?
03:21
Or polio? How many of you remember the iron lung?
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Ili dečije paralize? Koliko vas pamti gvozdena pluća?
03:24
We don't see scenes like this anymore
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Više ne vidimo takve situacije
03:27
because of vaccines.
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zbog vakcina.
03:29
Now, it's interesting
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Sada, zanimljivo je
03:31
because there are 30-odd diseases
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pošto postoji tridesetak bolesti
03:34
that can be treated with vaccines now,
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koje možemo tretirati vakcinama,
03:36
but we're still threatened by things like HIV and flu.
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a još uvek smo ugroženi stvarima kao što su HIV i grip.
03:39
Why is that?
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Zbog čega?
03:41
Well, here's the dirty little secret.
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Evo u čemu je tajna.
03:43
Until recently, we haven't had to know
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Donedavno, mi nismo tačno znali
03:45
exactly how a vaccine worked.
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kako su radile vakcine.
03:48
We knew they worked through old-fashioned trial and error.
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Znali smo da su radile preko staromodnih ispitivanja.
03:51
You took a pathogen, you modified it,
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Uzmete patogen, izmenite ga,
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you injected it into a person or an animal
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ubrizgate ga u osobu ili životinju
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and you saw what happened.
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i gledate šta će se dogoditi.
03:58
This worked well for most pathogens,
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Ovo je dobro funkcionizalo za većinu patogena,
04:01
somewhat well for crafty bugs like flu,
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ali manje za lukave bube kao što je grip,
04:04
but not at all for HIV,
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ali nikako nije za HIV,
04:06
for which humans have no natural immunity.
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za koji ljudi nemaju prirodni imunitet.
04:09
So let's explore how vaccines work.
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Istražimo kako vakcine rade.
04:12
They basically create a cache
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One prvenstveno naprave sklonište oružja
04:14
of weapons for your immune system
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za vaš imuni sistem
04:16
which you can deploy when needed.
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koji možete iskoristiti kada je potrebno.
04:19
Now, when you get a viral infection,
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Sada, kada dobijete virusnu infekciju,
04:22
what normally happens is it takes days or weeks
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ono što se obično dešava je da su potrebni dani ili nedelje
04:24
for your body to fight back
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za vaše telo da odreaguje
04:26
at full strength,
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punom snagom,
04:28
and that might be too late.
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što može biti prekasno.
04:30
When you're pre-immunized,
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Kada ste vakcinisani,
04:32
what happens is you have forces in your body
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dešava se to da imate snage u svom telu
04:34
pre-trained to recognize
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istrenirane tako da prepoznaju
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and defeat specific foes.
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i poraze određene uljeze.
04:38
So that's really how vaccines work.
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Tako zapravo rade vakcine.
04:40
Now, let's take a look at a video
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Pogledajmo sada snimak
04:42
that we're debuting at TED, for the first time,
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po prvi put na TED-u
04:45
on how an effective HIV vaccine might work.
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o tome kako efektivne HIV vakcine mogu raditi.
04:49
(Music)
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(Muzika)
04:55
Narrator: A vaccine trains the body in advance
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Pripovedač: vakcina trenira telo unapred
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how to recognize and neutralize
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kako da prepozna i neutrališe
04:59
a specific invader.
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određenog napadača.
05:01
After HIV penetrates the body's mucosal barriers,
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Nakon što HIV probije barijere sluzokože tela,
05:04
it infects immune cells to replicate.
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on zarazi imune ćelije za obnovu.
05:08
The invader draws the attention
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Napadač privlači pažnju
05:10
of the immune system's front-line troops.
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prve linije fronta vojnika imunog sistema.
05:12
Dendritic cells, or macrophages,
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Dendritske ćelije, ili makrofage,
05:14
capture the virus and display pieces of it.
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hvataju virus i prikazuju njegove deliće.
05:18
Memory cells generated by the HIV vaccine
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Memorijske ćelije generisane HIV vakcinom
05:21
are activated when they learn
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se aktiviraju kada saznaju
05:23
HIV is present from the front-line troops.
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za prisustvo HIV-a od strane vojnika iz prve linije fronta.
05:26
These memory cells immediately deploy
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Ove memorijske ćelije odmah isporuče
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the exact weapons needed.
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oružje koje je potrebno.
05:32
Memory B cells turn into plasma cells,
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Memorijske B ćelije se pretvore u plazmocite,
05:35
which produce wave after wave
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koji proizvode talas za talasom
05:37
of the specific antibodies
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određenih antitela
05:39
that latch onto HIV
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koji se pričvršćuju na HIV
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to prevent it from infecting cells,
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i onemogućuju mu inficiranje ćelija,
05:43
while squadrons of killer T cells
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dok eskadrila ubijačkih T ćelija
05:45
seek out and destroy cells
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traži i uništava ćelije
05:47
that are already HIV infected.
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koje su već zaražene HIV-om.
05:50
The virus is defeated.
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Virus je poražen.
05:52
Without a vaccine,
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Bez vakcine,
05:54
these responses would have taken more than a week.
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ovakva reagovanja bi trajala više od nedelju dana.
05:57
By that time, the battle against HIV
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Za to vreme, bitka protiv HIV-a
05:59
would already have been lost.
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bi već bila izgubljena.
06:08
Seth Berkley: Really cool video, isn't it?
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Set Berkli: zaista odličan video, zar ne?
06:11
The antibodies you just saw in this video,
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Antitela u akciji, koje ste malopre videli na ovom snimku,
06:14
in action, are the ones that make most vaccines work.
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su upravo ona koja omogućuju rad većini vakcina.
06:17
So the real question then is:
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Zapravo je pravo pitanje:
06:19
How do we ensure that your body makes
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kako možemo osigurati da vaše telo proizvodi
06:21
the exact ones that we need to protect
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tačno ona antitela koja su nam potrebna za zaštitu
06:23
against flu and HIV?
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protiv gripa i HIV-a?
06:25
The principal challenge for both of these viruses
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Glavni izazov za oba ova virusa
06:28
is that they're always changing.
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je taj da se oni uvek menjaju.
06:30
So let's take a look at the flu virus.
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Pogledajmo na virus gripa.
06:33
In this rendering of the flu virus,
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U ovom prikazu virusa gripa,
06:35
these different colored spikes are what it uses to infect you.
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ovi, različito obojeni, šiljci su ti koje koristi da bi vas zarazio.
06:38
And also, what the antibodies use is a handle
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Takođe i, ono što antitela koriste je ručica
06:41
to essentially grab and neutralize the virus.
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prvenstveno da uhvate i neutrališu virus.
06:44
When these mutate, they change their shape,
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Kada oni mutiraju, promene svoj oblik,
06:47
and the antibodies don't know what they're looking at anymore.
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tako da antitela više ne znaju na šta gledaju.
06:50
So that's why every year
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Upravo zbog toga svake godine
06:53
you can catch a slightly different strain of flu.
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možede dobiti malčice drugačiji oblik gripa.
06:56
It's also why in the spring,
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Takođe zbog toga na proleće,
06:58
we have to make a best guess
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moramo nagađati
07:00
at which three strains are going to prevail the next year,
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koji oblici će biti dominantan sledeće godine,
07:03
put those into a single vaccine
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staviti ih u vakcine
07:05
and rush those into production for the fall.
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i dati ih u proizvodnju za jesen.
07:08
Even worse,
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Još gore,
07:10
the most common influenza -- influenza A --
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najčešći grip -- grip A --
07:13
also infects animals
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takođe inficira i životinje
07:15
that live in close proximity to humans,
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koje žive u ljudskoj blizini,
07:17
and they can recombine
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i koji se mogu rekombinovati
07:19
in those particular animals.
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u tim određenim životinjama.
07:21
In addition, wild aquatic birds
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Dodatno, divlje vodene ptice
07:23
carry all known strains
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nose sve poznate oblike
07:25
of influenza.
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gripa.
07:27
So, you've got this situation:
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Tako da imate sledeću situaciju:
07:29
In 2003,
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imali smo 2003. godine
07:31
we had an H5N1 virus
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H5N1 virus
07:34
that jumped from birds into humans
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koji je prešao sa ptica na ljude
07:37
in a few isolated cases
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u nekoliko izolovanih slučajeva
07:39
with an apparent mortality rate of 70 percent.
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sa jasnom stopom smrtnosti od sedamdeset odsto.
07:42
Now luckily, that particular virus,
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Srećom, ovaj poseban virus,
07:45
although very scary at the time,
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iako jako strašan u to vreme,
07:47
did not transmit from person to person
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nije se prenosio sa osobe na osobu
07:49
very easily.
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tako lako.
07:51
This year's H1N1 threat
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Ovogodišnja pretnja H1N1
07:54
was actually a human, avian, swine mixture
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je zapravo bila mešavina ljudskog, ptičjeg i svinjskog gripa
07:58
that arose in Mexico.
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koji je nastao u Meksiku.
08:00
It was easily transmitted,
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Lako se prenosio,
08:02
but, luckily, was pretty mild.
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ali, srećom, bio je prilično blag.
08:05
And so, in a sense,
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Tako, u nekom smislu,
08:07
our luck is holding out,
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održava nas sreća,
08:09
but you know, another wild bird could fly over at anytime.
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samo da znate, neka druga divlja ptica može preleteti bilo kada.
08:13
Now let's take a look at HIV.
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Pogledajmo sada HIV.
08:15
As variable as flu is,
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Iako promenljiv kao grip,
08:17
HIV makes flu
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HIV čini da grip
08:19
look like the Rock of Gibraltar.
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izgleda kao malo ispupčenje.
08:21
The virus that causes AIDS
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Virus koji uzrokuje SIDU
08:23
is the trickiest pathogen
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je najprevarljiviji patogen
08:25
scientists have ever confronted.
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kome su se naučnici ikada suprotstavili.
08:27
It mutates furiously,
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On opasno mutira,
08:29
it has decoys to evade the immune system,
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ima mamce za izbegavanje imunog sistema,
08:31
it attacks the very cells that are trying to fight it
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napada same ćelije koje pokušavaju da se bore sa njim
08:34
and it quickly hides itself
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i brzo se sakriva
08:36
in your genome.
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u vašem genomu.
08:38
Here's a slide looking at
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Evo slajda sa pogledom na
08:40
the genetic variation of flu
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genetsku varijaciju gripa
08:42
and comparing that to HIV,
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i upoređujući to sa HIV-om,
08:44
a much wilder target.
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mnogo divljijom metom.
08:47
In the video a moment ago,
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U snimku pre nekoliko momenata,
08:49
you saw fleets of new viruses launching from infected cells.
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videli ste flote novih virusa lansiranih iz zaraženih ćelija.
08:52
Now realize that in a recently infected person,
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Shvatite sada da u nedavno zaraženoj osobi,
08:55
there are millions of these ships;
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postoje milioni ovih brodova;
08:57
each one is just slightly different.
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svaki je samo malčice drugačiji.
08:59
Finding a weapon that recognizes
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Pronaći oružie koji ih prepoznaje
09:01
and sinks all of them
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i koje ih sve potapa
09:03
makes the job that much harder.
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čini posao mnogo težim.
09:05
Now, in the 27 years since HIV
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Sada, 27 godina nakon identifikacije HIV-a
09:08
was identified as the cause of AIDS,
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kao uzročnika SIDE,
09:11
we've developed more drugs to treat HIV
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mi smo razvili više lekova za tretman HIV-a
09:13
than all other viruses put together.
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nego za sve druge viruse zajedno.
09:16
These drugs aren't cures,
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Ovi lekovi ne leče,
09:18
but they represent a huge triumph of science
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već predstavljaju veliki trijumf nauke
09:20
because they take away the automatic death sentence
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jer oduzimaju automatsku smrtnu kaznu
09:22
from a diagnosis of HIV,
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od dijagnoze HIV-a,
09:24
at least for those who can access them.
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bar za one koji mogu doći do njih.
09:27
The vaccine effort though is really quite different.
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Dejstvo vakcine je zapravo dosta drugačije.
09:30
Large companies moved away from it
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Velike kompanije su se udaljile od njih
09:32
because they thought the science was so difficult
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jer su mislile da je nauka jako teška
09:35
and vaccines were seen as poor business.
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i vakcine su izgledale kao slab biznis.
09:38
Many thought that it was just impossible to make an AIDS vaccine,
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Mnogi su mislili da je nemoguće proizvesti vakcinu protiv SIDE,
09:41
but today, evidence tells us otherwise.
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međutim, danas nam dokazi drugačije govore.
09:44
In September,
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U septembru,
09:46
we had surprising but exciting findings
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imali smo iznanađujuće i uzbuđujuće zaključke
09:49
from a clinical trial that took place in Thailand.
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iz kliničkog ispitivanja koje je bilo na Tajlandu.
09:52
For the first time, we saw an AIDS vaccine work in humans --
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Po prvi put, videli smo rad vakcina protiv SIDE na ljudima --
09:55
albeit, quite modestly --
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mada, prilično skromno --
09:58
and that particular vaccine was made
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i baš ta vakcina je napravljena
10:00
almost a decade ago.
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skoro pre deset godina.
10:02
Newer concepts and early testing now
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Noviji koncepti i rana testiranja pokazuju sada
10:04
show even greater promise in the best of our animal models.
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mnogo veća obećanja u našim najboljim životinjskim modelima.
10:09
But in the past few months, researchers have also isolated
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U proteklih nekoliko meseci, istraživači su takođe izolovali
10:12
several new broadly neutralizing antibodies
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nekoliko novih, neutralizovanih antitela
10:15
from the blood of an HIV infected individual.
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iz krvi HIV-pozitivnog pojedinca.
10:18
Now, what does this mean?
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Sada, što to znači?
10:20
We saw earlier that HIV
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Videli smo da je HIV
10:22
is highly variable,
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jako promenjljiv,
10:24
that a broad neutralizing antibody
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da se široko neutralizujuće antitelo
10:26
latches on and disables
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zakači i onemogući
10:28
multiple variations of the virus.
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višestruke promene virusa.
10:31
If you take these and you put them
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Ako ih stavite
10:33
in the best of our monkey models,
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na najbolje modele majmuna,
10:35
they provide full protection from infection.
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oni pružaju potpunu zaštitu od zaraze.
10:38
In addition, these researchers found
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Pored toga, ovi istraživači su našli
10:40
a new site on HIV
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novo mesto na HIV-u
10:42
where the antibodies can grab onto,
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za koje se mogu uhvatiti antitela,
10:44
and what's so special about this spot
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i ono što je specifično za ovo mesto je
10:46
is that it changes very little
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da se jako malo menja
10:48
as the virus mutates.
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pri mutaciji virusa.
10:50
It's like, as many times
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To je kao, koliko se puta
10:52
as the virus changes its clothes,
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virus presvuče,
10:54
it's still wearing the same socks,
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on uvek nosi iste čarape,
10:55
and now our job is to make sure
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pa je sada naš posao da osiguramo
10:58
we get the body to really hate those socks.
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da telo zaista zamrzi te čarape.
11:01
So what we've got is a situation.
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Tako da je to problem.
11:03
The Thai results tell us
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Rezultati sa Tajlanda nam ukazuju
11:05
we can make an AIDS vaccine,
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da možemo praviti vakcine protiv SIDE,
11:07
and the antibody findings
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dok nam pronalasci o antitelima
11:09
tell us how we might do that.
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govore o tome kako to možemo učiniti.
11:11
This strategy, working backwards
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Ovakva strategija, radeći unatraške
11:14
from an antibody to create a vaccine candidate,
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od antitela praviti vakcina,
11:16
has never been done before in vaccine research.
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nikada ranije nije bila urađena u istraživanju vakcina.
11:19
It's called retro-vaccinology,
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Zove se retro-vakcinacija,
11:22
and its implications extend
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i njene primene se protežu
11:24
way beyond that of just HIV.
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mnogo dalje od HIV-a.
11:27
So think of it this way.
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Razmišljajte ovako.
11:29
We've got these new antibodies we've identified,
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Imamo ova nova antitela koje smo identifikovali,
11:32
and we know that they latch onto many, many variations of the virus.
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i znamo da se ona pričvršćuju na mnoge, mnoge varijacije virusa.
11:35
We know that they have to latch onto a specific part,
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Znamo da se moraju pričvrstiti na određen deo,
11:38
so if we can figure out the precise structure of that part,
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ako bi mogli da otkrijemo tačnu strukturu tog dela,
11:41
present that through a vaccine,
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predstavljenog putem vakcina,
11:43
what we hope is we can prompt
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ono čemu se nadamo je da možemo brzo navesti
11:45
your immune system to make these matching antibodies.
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vaš imun sistem da pravi ova odgovarajuća antitela.
11:48
And that would create
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To bi stvorilo
11:50
a universal HIV vaccine.
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univerzalnu vakcinu protiv HIV-a.
11:52
Now, it sounds easier than it is
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Ovo zvuči lakše nego što jeste
11:54
because the structure actually looks more like
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zato što struktura zapravo izgleda više kao
11:56
this blue antibody diagram
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ovaj plavi dijagram antitela
11:58
attached to its yellow binding site,
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zakačen na svoje vezivno žuto mesto,
12:00
and as you can imagine, these three-dimensional structures
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i kao što možete pretpostaviti, rad na ovim trodimenzionim strukturama
12:02
are much harder to work on.
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je mnogo teži.
12:04
And if you guys have ideas to help us solve this,
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Ako neko od vas ima ideje kako bi nam pomogao da rešimo ovo,
12:06
we'd love to hear about it.
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rado bismo vas saslušali.
12:08
But, you know, the research that has occurred from HIV now
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Međutim, znate, istraživanje koje se vršilo za HIV sada
12:11
has really helped with innovation with other diseases.
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je zaista pomoglo i sa inovacijom za druge bolesti.
12:14
So for instance, a biotechnology company
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Tako na primer, kompanije biotehnologije
12:16
has now found broadly neutralizing
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su sada pronašla široko neutralizujuća
12:18
antibodies to influenza,
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antitela od gripa,
12:20
as well as a new antibody target on the flu virus.
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kao i nove mete antitela na virus gripa.
12:23
They're currently making a cocktail --
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Oni trenutno prave koktel --
12:26
an antibody cocktail -- that can be used to treat
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koktel antitela -- koji bi mogao da se koristi
12:29
severe, overwhelming cases of flu.
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za lečenje ozbiljnih, nadmoćnih slučajeva gripa.
12:32
In the longer term, what they can do
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Na duži period, oni mogu
12:34
is use these tools of retro-vaccinology
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da iskoriste alate retro-vakcinacije
12:36
to make a preventive flu vaccine.
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za pravljenje preventivnih vakcina od gripa.
12:39
Now, retro-vaccinology is just one technique
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Sada, reto-vakcinacija je samo jedna tehnika
12:42
within the ambit of so-called rational vaccine design.
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u polju, takozvanih racionalnih dizajna vakcina.
12:45
Let me give you another example.
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Dozvolite mi da vam dam još jedan primer.
12:48
We talked about before the H and N spikes
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Ranije smo pričali od H i N šiljcima
12:50
on the surface of the flu virus.
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na površini virusa gripa.
12:52
Notice these other, smaller protuberances.
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Primetite ove druge, manje izbočine.
12:55
These are largely hidden from the immune system.
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One su uglavnom sakrivene od imunog sistema.
12:58
Now it turns out that these spots
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Ispostavlja se sada da se ove tačke
13:00
also don't change much when the virus mutates.
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takođe ne menjaju mnogo pri mutaciji virusa.
13:03
If you can cripple these with specific antibodies,
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Ako bi se one mogle onesposobiti određenim antitelima,
13:05
you could cripple all versions of the flu.
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mogle bi se onesposobiti sve verzije gripa.
13:08
So far, animal tests indicate
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Za sada, testiranje na životinjama ukazuje
13:10
that such a vaccine could prevent severe disease,
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da takve vakcine mogu sprečiti teške bolesti,
13:13
although you might get a mild case.
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mada se mogu dobiti blaži slučajevi.
13:15
So if this works in humans, what we're talking about
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Ako ovo funkcioniše za ljude, ono o čemu pričamo je
13:18
is a universal flu vaccine,
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univerzalna vakcina protiv gripa,
13:20
one that doesn't need to change every year
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jedna koju ne treba menjati svake godine
13:22
and would remove the threat of death.
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i koja bi uklonila sve pretnje smrću.
13:25
We really could think of flu, then,
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Tada bi zaista mogli misliti o gripu,
13:27
as just a bad cold.
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kao o jednoj lošoj prehladi.
13:30
Of course, the best vaccine imaginable
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Naravno, najbolje zamišljena vakcina
13:32
is only valuable to the extent
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je jedino vredna do te mere da je
13:34
we get it to everyone who needs it.
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damo svima kojima je to potrebno.
13:36
So to do that, we have to combine
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Da bismo to uradili, moramo kombinovati
13:38
smart vaccine design with smart production methods
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pametan dizajn vakcine i pametne načine proizvodnje
13:41
and, of course, smart delivery methods.
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i, naravno, pametne načine dostavljanja.
13:44
So I want you to think back a few months ago.
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Želim da razmislite unazad par meseci,
13:46
In June, the World Health Organization
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U junu, Svetska zdravstvena organizacija
13:49
declared the first global
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je objavila prvu globalnu
13:51
flu pandemic in 41 years.
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pandemiju gripa u protekle četrdeset jednu godinu.
13:53
The U.S. government promised
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Vlada SAD-a je obećala
13:55
150 million doses of vaccine
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sto pedeset miliona doza vakcina
13:57
by October 15th for the flu peak.
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do petnaestog oktobra, kada je vrhunac gripa.
13:59
Vaccines were promised to developing countries.
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Vakcine su obećane zemljama u razvoju.
14:01
Hundreds of millions of dollars were spent
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Potrošeno je stotine miliona dolara
14:03
and flowed to accelerating vaccine manufacturing.
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i teklo je ubrzavanje proizvodnje vakcina.
14:06
So what happened?
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Šta se desilo?
14:08
Well, we first figured out
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Prvo smo shvatili
14:10
how to make flu vaccines, how to produce them,
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kako napraviti vakcine protiv gripa, kako ih proizvoditi,
14:13
in the early 1940s.
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ranih 1940-ih godina.
14:15
It was a slow, cumbersome process
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Bio je to spori, ogroman proces
14:18
that depended on chicken eggs,
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koji je zavisio od kokošijih jaja,
14:21
millions of living chicken eggs.
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od miliona živih kokošijih jaja.
14:24
Viruses only grow in living things,
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Virusi rastu samo u živim stvarima,
14:26
and so it turned out that, for flu,
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tako da se ispostavilo da su kokošija jaja
14:28
chicken eggs worked really well.
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za grip, obavljala dobar posao.
14:30
For most strains, you could get one to two doses
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Za većinu vrsta, mogli ste dobiti jednu do dve doze
14:33
of vaccine per egg.
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vakcine po jajetu.
14:35
Luckily for us,
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Srećom po nas,
14:37
we live in an era of breathtaking
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živimo u eri neverovatnih
14:39
biomedical advances.
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biomedicinskih napredaka.
14:41
So today, we get our flu vaccines from ...
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Tako da danas, dobijamo vakcine gipa od ...
14:44
chicken eggs,
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kokošijih jaja,
14:46
(Laughter)
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(smeh)
14:48
hundreds of millions of chicken eggs.
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stotina miliona kokošijih jaja.
14:50
Almost nothing has changed.
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Skoro se ništa nije promenilo.
14:52
The system is reliable
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Sistem je pouzdan
14:54
but the problem is you never know how well
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problem je u tome što nikada ne znate kako će dobro
14:56
a strain is going to grow.
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vrsta da izraste.
14:59
This year's swine flu strain
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Ove godine vrsta svinjskog gripa
15:01
grew very poorly in early production:
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je rasla jako slabo u ranoj proizvodnji:
15:04
basically .6 doses per egg.
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u osnovi, 6 doza po jajetu.
15:08
So, here's an alarming thought.
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Evo uznemirujuće pomisli.
15:10
What if that wild bird flies by again?
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Šta ako ta divlja ptica opry poleti?
15:12
You could see an avian strain
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Mogli biste videti novu vrstu ptičjeg gripa
15:14
that would infect the poultry flocks,
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koji bi zarazio živinu,
15:16
and then we would have no eggs for our vaccines.
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i tada ne bismo imali jaja za naše vakcine.
15:18
So, Dan [Barber], if you want
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Dakle, Den [berberin], ako želite
15:20
billions of chicken pellets
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milijarde kokošjih peleta
15:22
for your fish farm,
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za vaš ribnjak,
15:24
I know where to get them.
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znam gde ih možete nabaviti.
15:26
So right now, the world can produce
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Upravo sada, svet može proizvoditi
15:28
about 350 million doses
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oko 350 miliona doza
15:30
of flu vaccine for the three strains,
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vakcina od gripa za ove tri vrste,
15:33
and we can up that to about 1.2 billion doses
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a može se doći do 1.2 milijardi doza
15:36
if we want to target a single variant
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ako želimo da napadnemo jednu varijantu
15:38
like swine flu.
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kao što je sivinjski grip-
15:40
But this assumes that our factories are humming
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Ali ovo pretpostavlja da naše fabrike bruje
15:43
because, in 2004,
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jer u 2004 godini,
15:45
the U.S. supply was cut in half
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snabdevanje iz SAD-a je bilo prepolovljeno
15:47
by contamination at one single plant.
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kontaminacijom jedne biljke.
15:50
And the process still takes
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Procesu još uvek treba
15:52
more than half a year.
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više od pola godine.
15:54
So are we better prepared
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Jesmo li spremniji
15:56
than we were in 1918?
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nego što smo bili pre 1918.?
15:58
Well, with the new technologies emerging now,
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Zbog novih tehnologija koje su sada u razvoju,
16:00
I hope we can say definitively, "Yes."
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nadam se da možemo konačno reći, ''Da.''
16:02
Imagine we could produce enough flu vaccine
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Zamislite da možemo proizvesti dovoljno vakcina
16:05
for everyone in the entire world
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sa svakoga na celom svetu
16:08
for less than half of what we're currently spending
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za upola manje od onoga što sada trošimo
16:10
now in the United States.
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u SAD-u.
16:12
With a range of new technologies, we could.
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Uz niz novih tehnologija, mogli bismo.
16:15
Here's an example:
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Evo primera:
16:17
A company I'm engaged with has found
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kompanije u kojoj radim je pronašla
16:19
a specific piece of the H spike of flu
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specifičan deo H šiljka gripa
16:21
that sparks the immune system.
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koji podstiče imuni sistem.
16:23
If you lop this off and attach it
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Ako ovo promenite i zakačite
16:25
to the tail of a different bacterium,
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za kraj različitu bakteriju,
16:28
which creates a vigorous immune response,
400
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koja stvara energičan imuni odgovor,
16:30
they've created a very powerful flu fighter.
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napravili ste veoma moćnog borca protiv gripe.
16:32
This vaccine is so small
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Ova vakcina je toliko mala
16:34
it can be grown in a common bacteria, E. coli.
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može se uzgajiti na običnoj bakteriji Ešerihija koli.
16:37
Now, as you know, bacteria reproduce quickly --
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Kao što znate, bakterije se reprodukuju brže --
16:40
it's like making yogurt --
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to je kao pravljenje jogurta --
16:42
and so we could produce enough swine origin flu
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tako da možemo napraviti dovoljno gripa svinjskog porekla
16:44
for the entire world in a few factories, in a few weeks,
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za ceo svet u novim fabrikama, za nekoliko nedelja,
16:47
with no eggs,
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bez jaja,
16:49
for a fraction of the cost of current methods.
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za samo deo troškova od današnjih metoda.
16:52
(Applause)
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(aplauz)
16:57
So here's a comparison of several of these new vaccine technologies.
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Evo poređenja nekoliko ovih novih tehnologija vakcina.
17:00
And, aside from the radically increased production
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Pored radikalno ubrzane proizvodnje
17:03
and huge cost savings --
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i velike uštede --
17:05
for example, the E. coli method I just talked about --
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na primer, metodom Ešerihija koli o kojoj sam malo pre pričao --
17:08
look at the time saved: this would be lives saved.
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pogledajte ušteđeno vreme: ovo bi bili spašeni životi.
17:11
The developing world,
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Svet u razvitku,
17:13
mostly left out of the current response,
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uglavnom izostavljen iz trenutne reakcije,
17:16
sees the potential of these alternate technologies
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vidi potencijal ovih alternativnih tehnologija
17:19
and they're leapfrogging the West.
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i njihovog skoka na zapad.
17:21
India, Mexico and others are already
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Indija, Meksiko i drugi, već prave
17:23
making experimental flu vaccines,
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eksperimentalne vakcine od gripa,
17:25
and they may be the first place
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i mogu biti prvo mesto
17:27
we see these vaccines in use.
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gde ćemo videti korišćenje vakcina.
17:29
Because these technologies are so efficient
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Zbog toga što su ove tehnologije jako efikasne
17:32
and relatively cheap,
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i relativno jeftine,
17:34
billions of people can have access to lifesaving vaccines
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milijarde ljudi mogu imati vakcine koje spašavaju život
17:37
if we can figure out how to deliver them.
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ako smislimo kako da ih razdelimo.
17:39
Now think of where this leads us.
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Razmislimo o tome gde nas ovo vodi.
17:41
New infectious diseases
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Javljaju se nove zarazne bolesti
17:43
appear or reappear
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ili obnavljaju stare
17:45
every few years.
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svakih nekoliko godina.
17:47
Some day, perhaps soon,
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Jednog dana, možda uskoro,
17:49
we'll have a virus that is going to threaten all of us.
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imaćemo virus koji će nam svima zapretiti.
17:52
Will we be quick enough to react
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Da li ćemo biti dovoljno brzi da reagujemo
17:54
before millions die?
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pre nego što milioni umru?
17:56
Luckily, this year's flu was relatively mild.
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Srećom, ovogodišnji grip je bio relativno blag.
17:59
I say, "luckily" in part
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Kažem ''srećom''
18:01
because virtually no one in the developing world
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jer praktično niko u državama u razvitku
18:04
was vaccinated.
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nije bio vakcinisan.
18:06
So if we have the political and financial foresight
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Tako da ako imamo političko i finansijsko predviđanje
18:09
to sustain our investments,
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da održimo naše investicije,
18:11
we will master these and new tools of vaccinology,
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ovladaćemo ovim i novim alatkama vakcinacije
18:14
and with these tools we can produce
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i sa tim alatima ćemo moći proizvoditi
18:16
enough vaccine for everyone at low cost
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dovoljno vakcina za sve po maloj ceni
18:18
and ensure healthy productive lives.
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i osigurati zdrave, produktivne živote.
18:21
No longer must flu have to kill half a million people a year.
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Grip više ne mora ubiti pola miliona ljudi godišnje.
18:24
No longer does AIDS
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SIDA više ne mora
18:26
need to kill two million a year.
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ubiti dva miliona ljudi godišnje.
18:28
No longer do the poor and vulnerable
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Siromašni i osetljivi više ne moraju
18:30
need to be threatened by infectious diseases,
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biti ugroženi zaraznim bolestima,
18:33
or indeed, anybody.
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ili niko, zapravo.
18:35
Instead of having Vaclav Smil's
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Umesto da imamo Vaclav Smilove
18:38
"massively fatal discontinuity" of life,
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''masovne pomore'' života,
18:41
we can ensure
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možemo osigurati
18:43
the continuity of life.
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kontinuitet života.
18:45
What the world needs now are these new vaccines,
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Ono što je sada svetu potrebno su ove vakcine,
18:47
and we can make it happen.
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i mi ih možemo ostvariti.
18:49
Thank you very much.
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Hvala vam mnogo.
18:51
(Applause)
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(aplauz)
18:59
Chris Anderson: Thank you.
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Kris Anderson: Hvala vam.
19:01
(Applause)
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(aplauz)
19:07
Thank you.
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Hvala vam.
19:09
So, the science is changing.
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Dakle, nauka se menja.
19:12
In your mind, Seth -- I mean, you must dream about this --
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Po vašem mišljenju, Set -- mislim, mora da sanjate o tome --
19:15
what is the kind of time scale
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kolika je vremenska skala
19:18
on, let's start with HIV,
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počnimo od HIV-a,
19:20
for a game-changing vaccine that's actually out there and usable?
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za preokret vakcina, da su zapravo na tržištu i upotrebljive?
19:24
SB: The game change can come at any time,
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SB: Preokret može doći bilo kad,
19:26
because the problem we have now is
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jer smo pokazali da da sa problem koji sada imamo
19:28
we've shown we can get a vaccine to work in humans;
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možemo naterati vakcine da funkcionišu za ljude:
19:30
we just need a better one.
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samo su nam potrebne bolje.
19:32
And with these types of antibodies, we know humans can make them.
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Znamo da ljudi mogu proizvesti ove vrste antitela,
19:34
So, if we can figure out how to do that,
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Tako da, ako shvatimo kako da to uradimo,
19:36
then we have the vaccine,
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onda imamo vakcinu,
19:38
and what's interesting is there already is
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a zanimljivo je da već postoje
19:40
some evidence that we're beginning to crack that problem.
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neki dokazi da smo na početku rešavanja problema.
19:42
So, the challenge is full speed ahead.
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Tako da izazov ide punom brzinom napred.
19:44
CA: In your gut, do you think it's probably going to be at least another five years?
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KA: Po vašem mišljenju, trebaće verovatno najmanje još pet godina?
19:46
SB: You know, everybody says it's 10 years,
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SB: Znate, svi kažu da treba deset godina,
19:48
but it's been 10 years every 10 years.
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ali bilo je, na svakih deset godina, deset godina.
19:50
So I hate to put a timeline
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Tako da mrzim stavljati periode
19:52
on scientific innovation,
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na naučna otkrića,
19:54
but the investments that have occurred are now paying dividends.
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ali investicije koje su nastale sada plaćaju dividende.
19:57
CA: And that's the same with universal flu vaccine, the same kind of thing?
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KA: I isto je sa univerzalnom vakcinom od gripa, ista stvar?
20:00
SB: I think flu is different. I think what happened with flu is
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SB: Mislim da je sa gripom drugačije. Mislim da je to šta se događa sa gripom
20:02
we've got a bunch -- I just showed some of this --
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imamo gomilu -- prikazao sam samo nekoliko od njih --
20:04
a bunch of really cool and useful technologies that are ready to go now.
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gomilu zaista dobrih i korisnih tehnologija koji su spremni za pokretanje.
20:07
They look good. The problem has been that,
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Izgledaju dobro. Problem je bio što smo mi
20:09
what we did is we invested in traditional technologies
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ulagali u tradicionalne tehnologije
20:12
because that's what we were comfortable with.
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jer nam je to odgovaralo.
20:14
You also can use adjuvants, which are chemicals you mix.
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Možete takođe koristiti adjuvante - hemikalije koje izmešate.
20:17
That's what Europe is doing, so we could have diluted out
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To je ono što Evropa radi, tako da smo razredili
20:19
our supply of flu and made more available,
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naše zalihe gripa i omogućili ih više dostupnim,
20:21
but, going back to what Michael Specter said,
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dok, vraćajući se na ono što je Majkl Spekter rekao,
20:24
the anti-vaccine crowd didn't really want that to happen.
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grupa koja je protiv vakcina zapravo nije želela da se to desi.
20:27
CA: And malaria's even further behind?
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KA: A malarija je još dalje?
20:29
SB: No, malaria, there is a candidate
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SB: Ne, za malariju postoji kandidat
20:31
that actually showed efficacy in an earlier trial
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koji se pokazao efikasnim u ranom testiranju
20:34
and is currently in phase three trials now.
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i sada je u fazi tri ispitivanja.
20:36
It probably isn't the perfect vaccine, but it's moving along.
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Najverovatnije nije savršena vakcina, ali napreduje.
20:39
CA: Seth, most of us do work where every month,
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KA: Set, većina nas radi posao gde svakog meseca,
20:41
we produce something;
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napravi nešto;
20:43
we get that kind of gratification.
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dobijamo zadovoljstvo.
20:45
You've been slaving away at this for more than a decade,
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Vi se sa time borite više od decenije,
20:48
and I salute you and your colleagues for what you do.
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i pozdravljam Vas i vaše kolege zbog onoga što radite.
20:51
The world needs people like you. Thank you.
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Svetu su potrebni ljudi kao što ste vi. Hvala vam.
20:53
SB: Thank you.
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SB: Hvala vam.
20:55
(Applause)
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(aplauz)
ABOUT THE SPEAKER
Seth Berkley - Vaccine visionaryEpidemiologist Seth Berkley is leading the charge to make sure vaccines are available to everyone, including those living in the developing world.
Why you should listen
Seth Berkley is an epidemiologist and the CEO of Gavi, the Vaccine Alliance, the global health organization protecting lives by improving access to vaccines in developing countries. Seth joined Gavi in 2011 in a period of rapid acceleration of Gavi’s programs. Now, with more than half a billion children immunized, he is leading Gavi’s efforts to reach a further 300 million children in the next five years and build sustainability into country immunization programs. Prior to Gavi, he spearheaded the development of vaccines for HIV as founder and CEO of the International AIDS Vaccine Initiative.
Seth Berkley | Speaker | TED.com