TED2010
Seth Berkley: HIV and flu -- the vaccine strategy
Seth Berley:HIV 和流感——疫苗策略
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Seth Berkley 向我们展示疫苗设计、生产、销售进展过程的智慧演变是如何让我们前所未有地接近消灭一系列全球威胁——流感、疟疾、艾滋病。
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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你是否曾经担心过什么将置于你于死地？
00:20
Heart disease, cancer,
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心脏病或者癌症
00:22
a car accident?
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还是车祸呢？
00:24
Most of us worry about things we can't control,
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我们大多数担心一些我们无法控制的事情
00:27
like war, terrorism,
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比如战争、恐怖主义、
00:29
the tragic earthquake that just occurred in Haiti.
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或者是刚刚在海地发生的悲惨的地震。
00:32
But what really threatens humanity?
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那么到底是什么真正地威胁着我们人类呢？
00:36
A few years ago, Professor Vaclav Smil
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几年前，Vaclav Smil教授
00:38
tried to calculate the probability
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就试图结算一种可能性来自于®
00:40
of sudden disasters
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突发性大灾难。
00:42
large enough to change history.
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这种灾难足使人类的历史得以改变。
00:44
He called these,
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他称其这类灾难为
00:46
"massively fatal discontinuities,"
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“大规模致命间断性灾难”
00:48
meaning that they could kill
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其意思就是它们将会造成
00:50
up to 100 million people
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超过一亿人的死亡。
00:52
in the next 50 years.
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这将发生在在将来50年里。
00:54
He looked at the odds of another world war,
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他观察到另一场世界大战
00:57
of a massive volcanic eruption,
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大规模火山爆发
00:59
even of an asteroid hitting the Earth.
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甚至是小行星撞击地球的某种可能会发生的机会。
01:01
But he placed the likelihood of one such event
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他对比所有可能相似的事件
01:04
above all others
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从所有的事件当中，其中
01:06
at close to 100 percent,
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最为接近可能发生的事件就是
01:08
and that is a severe flu pandemic.
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严重的流感大流行。
01:12
Now, you might think of flu
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尽管你们可能认为流感
01:14
as just a really bad cold,
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只是很严重的感冒罢啦。
01:17
but it can be a death sentence.
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但是它是致命的。
01:19
Every year, 36,000 people in the United States
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每年在美国有36000人
01:22
die of seasonal flu.
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死于季节性流感。
01:25
In the developing world, the data is much sketchier
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在发展中国家，这个数据更为高一些，
01:27
but the death toll is almost
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其死亡的总数应该
01:29
certainly higher.
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高出美国的死亡人数一大节。
01:31
You know, the problem is if
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所存在的问题就是
01:33
this virus occasionally mutates
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如果病毒偶尔变异
01:35
so dramatically,
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甚至更为急剧的变异，
01:37
it essentially is a new virus
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从根本上来说，它就是一个新的病毒。
01:39
and then we get a pandemic.
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那么之后，我们又将迎来新的流感大流行。
01:43
In 1918, a new virus appeared
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在1989年，一种新的病毒出现
01:46
that killed some 50 to 100 million people.
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这种病毒已经夺走了5000万到1亿人的性命。
01:49
It spread like wildfire
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它的传播就像死野火一样迅速。
01:51
and some died within hours of developing symptoms.
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一些人的流感症状正出现不久就死掉了。
01:54
Are we safer today?
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难道我们今天更为安全了吗？
01:56
Well, we seem to have dodged
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然而，我们看起来似乎逃过了一劫——
01:58
the deadly pandemic this year
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发生在今年的致命性大流感。
02:00
that most of us feared,
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却让我们极为恐惧。
02:02
but this threat could reappear at any time.
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这样流感会在任何时候再次爆发。
02:05
The good news is that
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有一个好消息是：
02:07
we're at a moment in time
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我们在一个新的时代
02:09
when science, technology, globalization is converging
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这个时代聚合了科学、技术、全球化
02:12
to create an unprecedented possibility:
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创造了史无前例的可能性。
02:14
the possibility to make history
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这种可能性就是创造历史
02:16
by preventing infectious diseases
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通过阻止传染病得以实现。
02:19
that still account for one-fifth of all deaths
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然而由传染病造成的死亡人数占全球总死亡人数的五分之一，
02:22
and countless misery on Earth.
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它还将在我们这个星球上创造无数悲剧。
02:25
We can do this.
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我们所要做的就是这些。
02:27
We're already preventing millions of deaths
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我们正在阻止这几百人死去，
02:29
with existing vaccines,
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运用现有的疫苗。
02:31
and if we get these to more people,
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如果我们可以让更多的人接种疫苗的话，
02:33
we can certainly save more lives.
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我们当然肯定可以挽救更多人的生命。
02:36
But with new or better vaccines
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但是我们要是能使用最新的、更好的疫苗
02:38
for malaria, TB, HIV,
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来预防疟疾、肺结核、艾滋病、
02:41
pneumonia, diarrhea, flu,
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肺炎、痢疾、流感，
02:43
we could end suffering
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我们结束这种苦难。
02:45
that has been on the Earth since the beginning of time.
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这种困难一直存在我们之上。
02:48
So, I'm here to trumpet vaccines for you.
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所以我在这里向你们介绍一下疫苗。
02:50
But first, I have to explain why they're important
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第一点，我得解释为什么它们这么对我们如此之重要。
02:53
because vaccines, the power of them,
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因为疫苗的威力
02:56
is really like a whisper.
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正如低声细语一般。
02:58
When they work, they can make history,
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它们起作用的时候，它们正在改变着历史。
03:00
but after a while
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可是之后
03:02
you can barely hear them.
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你们几乎很难听见它们了。
03:04
Now, some of us are old enough
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现在，我们中一些在年龄够大的人
03:07
to have a small, circular scar on our arms
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手臂上会留下一个小的、圆形的小疤痕。
03:10
from an inoculation we received as children.
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这是因为我们在小时候接种疫苗时候留下的印记。
03:13
But when was the last time you worried about smallpox,
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你最后一次担心天花疾病的时候，
03:16
a disease that killed half a billion people last century
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这种疾病在上个世纪已经夺走了近5亿人的性命。
03:19
and no longer is with us?
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但现在难道已经不存在我们身边了吗？
03:21
Or polio? How many of you remember the iron lung?
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或者说小儿麻痹症——有多少人还记得铁肺？
03:24
We don't see scenes like this anymore
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我们从没有看到这样的现象。
03:27
because of vaccines.
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是因为疫苗的出现。
03:29
Now, it's interesting
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现在你会感觉着挺有趣。
03:31
because there are 30-odd diseases
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因为新的30种奇特病毒
03:34
that can be treated with vaccines now,
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已经能被疫苗预防住了。
03:36
but we're still threatened by things like HIV and flu.
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但是我们仍然受到艾滋病毒和流感的威胁。
03:39
Why is that?
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这又是为什么呢？
03:41
Well, here's the dirty little secret.
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这里我想让你们知道一个小小的但是有些肮脏的秘密。
03:43
Until recently, we haven't had to know
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直到如今，我们从没有去了解过
03:45
exactly how a vaccine worked.
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疫苗到底是怎样起作用的。
03:48
We knew they worked through old-fashioned trial and error.
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我们所知道的是它们是通过旧式的反复试验得以实现其作用的。
03:51
You took a pathogen, you modified it,
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你得到一个病原体，你改良它。
03:53
you injected it into a person or an animal
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之后你把它注入人体或者动物身体里，
03:56
and you saw what happened.
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这时你会看到发生什么。
03:58
This worked well for most pathogens,
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这个可以对付大多数的病原体，
04:01
somewhat well for crafty bugs like flu,
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即使是一些狡诈的病原体，像流感病毒。
04:04
but not at all for HIV,
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但是对付艾滋病毒就不行了。
04:06
for which humans have no natural immunity.
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因为人类对艾滋病毒没有天然的免疫性。
04:09
So let's explore how vaccines work.
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所以我们探索疫苗的起作用的方式。
04:12
They basically create a cache
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基本上来说，它们是创造一个
04:14
of weapons for your immune system
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为你的免疫系统武器的隐藏所之类的东西。
04:16
which you can deploy when needed.
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当你需要的时候，你就可以通过它来部署武器。
04:19
Now, when you get a viral infection,
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现在，当你病毒感染了，
04:22
what normally happens is it takes days or weeks
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一切正常运转的是它会用几天或者几周的时间
04:24
for your body to fight back
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为你的身体奋力还击，
04:26
at full strength,
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它们会全力以赴去做。
04:28
and that might be too late.
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也许这太晚了些。
04:30
When you're pre-immunized,
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如果你提前免疫的话，
04:32
what happens is you have forces in your body
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那么你将增强你身体的实力
04:34
pre-trained to recognize
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预先训练识别、
04:36
and defeat specific foes.
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并且击败这些诡异的病毒。
04:38
So that's really how vaccines work.
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这就是疫苗怎样起作用的。
04:40
Now, let's take a look at a video
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现在，让我们来看看一段视频
04:42
that we're debuting at TED, for the first time,
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这是我们在TED上初次亮相。
04:45
on how an effective HIV vaccine might work.
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将向你们展示感染性艾滋病毒怎样发生的。
04:49
(Music)
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（音乐）
04:55
Narrator: A vaccine trains the body in advance
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叙述者：疫苗预先训练我们身体
04:57
how to recognize and neutralize
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怎样识别和压制
04:59
a specific invader.
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特殊的入侵者。
05:01
After HIV penetrates the body's mucosal barriers,
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一旦艾滋病毒穿过身体黏膜障碍，
05:04
it infects immune cells to replicate.
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它就开始破坏免疫细胞不断进行自我复制。
05:08
The invader draws the attention
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入侵者会吸引
05:10
of the immune system's front-line troops.
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人体免疫系统“前线部队”的注意力。
05:12
Dendritic cells, or macrophages,
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如：树突细胞、巨噬细胞，
05:14
capture the virus and display pieces of it.
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抓住病毒，同时展现它的每一部分。
05:18
Memory cells generated by the HIV vaccine
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艾滋病毒产生的记忆细胞
05:21
are activated when they learn
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一旦他们学会了，就会被激活。
05:23
HIV is present from the front-line troops.
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艾滋病病毒碰到人体的“前线部队”
05:26
These memory cells immediately deploy
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艾滋病病毒的记忆细胞迅速分派
05:29
the exact weapons needed.
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适当的武器。
05:32
Memory B cells turn into plasma cells,
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记忆细胞B变成血浆细胞，
05:35
which produce wave after wave
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而血浆细胞会产生一波又一波
05:37
of the specific antibodies
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特殊抗体。
05:39
that latch onto HIV
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这些抗体将会抓住艾滋病病毒
05:41
to prevent it from infecting cells,
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以其组织艾滋病病毒感染其他的细胞。
05:43
while squadrons of killer T cells
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杀手T细胞中队
05:45
seek out and destroy cells
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会寻找并破坏
05:47
that are already HIV infected.
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被艾滋病病毒感染的细胞。
05:50
The virus is defeated.
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病毒就这样被打败了。
05:52
Without a vaccine,
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如果没有疫苗，
05:54
these responses would have taken more than a week.
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我们身体可能会要一周多时间才会对病毒作出反应。
05:57
By that time, the battle against HIV
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到那时，与艾滋病病毒的战斗
05:59
would already have been lost.
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必然是失败的了。
06:08
Seth Berkley: Really cool video, isn't it?
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Seth Berkley：非常酷的视频，难道不是吗？
06:11
The antibodies you just saw in this video,
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你们刚刚所看到视频里的抗体的行为
06:14
in action, are the ones that make most vaccines work.
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那就是大部分疫苗起作用的过程。
06:17
So the real question then is:
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所以真正的问题就是：
06:19
How do we ensure that your body makes
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我们怎眼确保我们的身体能产生
06:21
the exact ones that we need to protect
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我们所需要的抗体
06:23
against flu and HIV?
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抵抗流感和艾滋病病毒呢？
06:25
The principal challenge for both of these viruses
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面对大部分病毒最大的挑战就是
06:28
is that they're always changing.
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病毒总是在变换。
06:30
So let's take a look at the flu virus.
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我们一起来看一看流感病毒。
06:33
In this rendering of the flu virus,
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在这个流感病毒示意图中，
06:35
these different colored spikes are what it uses to infect you.
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那些不同颜色尖状物就是病毒用来感染你的身体的。
06:38
And also, what the antibodies use is a handle
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同样也是抗体用来
06:41
to essentially grab and neutralize the virus.
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抓住并且压制这些病毒。
06:44
When these mutate, they change their shape,
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一旦病毒开始变异，它们开始改变自己形状，
06:47
and the antibodies don't know what they're looking at anymore.
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抗体这时候就难以识别这些病毒。
06:50
So that's why every year
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所以这就是每一年，为什么
06:53
you can catch a slightly different strain of flu.
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你总是感染这些与众不同的流感病毒的原因了。
06:56
It's also why in the spring,
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这也就是，为什么每年春天
06:58
we have to make a best guess
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我们可以做好的设想一下，
07:00
at which three strains are going to prevail the next year,
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至少三类病毒会在明年流行的原因。
07:03
put those into a single vaccine
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我们把这些病毒制作出一种疫苗，
07:05
and rush those into production for the fall.
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在秋季加紧投入生产。
07:08
Even worse,
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可是更糟糕的是，
07:10
the most common influenza -- influenza A --
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大部分流感病毒，流感病毒A
07:13
also infects animals
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会感染动物。
07:15
that live in close proximity to humans,
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而那些动物就是生活在人类身边。
07:17
and they can recombine
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病毒会在
07:19
in those particular animals.
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这些动物中再次 重组。
07:21
In addition, wild aquatic birds
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还有就是，野生水生鸟类
07:23
carry all known strains
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会携带众所周知
07:25
of influenza.
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多种流行性感冒病毒。
07:27
So, you've got this situation:
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你们已经处在这种情况当中了。
07:29
In 2003,
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2003年，
07:31
we had an H5N1 virus
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我们遭遇一种H5N1病毒。
07:34
that jumped from birds into humans
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它能从鸟类传染到人类
07:37
in a few isolated cases
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在一些个例中出现这种情况。
07:39
with an apparent mortality rate of 70 percent.
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这种病毒造成了70%的死亡率。
07:42
Now luckily, that particular virus,
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现在幸运的是尽管一些特殊的病毒
07:45
although very scary at the time,
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在一段时间令人恐惧害怕，
07:47
did not transmit from person to person
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但是它们不会在人与人之间传播
07:49
very easily.
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那样轻易地传播。
07:51
This year's H1N1 threat
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今年的H1N1病毒
07:54
was actually a human, avian, swine mixture
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其实是人类、飞禽、猪的混合病毒。
07:58
that arose in Mexico.
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这种病毒首先在墨西哥产生。
08:00
It was easily transmitted,
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这种病毒很容易传播，
08:02
but, luckily, was pretty mild.
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但幸运的是，它传染性并没有那没强。
08:05
And so, in a sense,
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所以，在某种意义上，
08:07
our luck is holding out,
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我们仍是很幸运的，
08:09
but you know, another wild bird could fly over at anytime.
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但是你们知道，在任何时候，另一只鸟就从天空飞过。
08:13
Now let's take a look at HIV.
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现在我们来看看艾滋病病毒。
08:15
As variable as flu is,
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正如流感一样多变的
08:17
HIV makes flu
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艾滋病毒让流感病毒
08:19
look like the Rock of Gibraltar.
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相形见绌就像直布罗陀海峡的岩石不起眼。
08:21
The virus that causes AIDS
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艾滋病毒
08:23
is the trickiest pathogen
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是最狡猾，最难缠的病毒
08:25
scientists have ever confronted.
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也是科学家面对的最难对付的病毒。
08:27
It mutates furiously,
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艾滋病毒急剧变异。
08:29
it has decoys to evade the immune system,
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它甚至可以躲骗过免疫系统。
08:31
it attacks the very cells that are trying to fight it
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它会攻击那些抗击它的免疫细胞。
08:34
and it quickly hides itself
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之后它会迅速的隐藏自己。
08:36
in your genome.
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艾滋病毒隐藏在你的基因组里。
08:38
Here's a slide looking at
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这里幻灯片向我们展示的是
08:40
the genetic variation of flu
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流感基因多变性
08:42
and comparing that to HIV,
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相比艾滋病毒，
08:44
a much wilder target.
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艾滋病毒是一个更为使人迷惑的目标。
08:47
In the video a moment ago,
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在之前你们在视频中
08:49
you saw fleets of new viruses launching from infected cells.
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看到从感染细胞中产生出一组新的病毒。
08:52
Now realize that in a recently infected person,
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现在我们意识到这样的情形发生在每一个感染的人身体内，
08:55
there are millions of these ships;
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它们有成千上百万个，
08:57
each one is just slightly different.
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但是每一个都稍有不同。
08:59
Finding a weapon that recognizes
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所以要寻找到识别
09:01
and sinks all of them
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并且击败所有的病毒的有效的武器
09:03
makes the job that much harder.
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这是一件更为艰难的事。
09:05
Now, in the 27 years since HIV
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自从艾滋病毒被确认为
09:08
was identified as the cause of AIDS,
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引起艾滋病的原凶以来，已经有27年了。
09:11
we've developed more drugs to treat HIV
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我们已经研制了越来越多的药物来治疗艾滋病
09:13
than all other viruses put together.
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然而艾滋病毒会所有的病毒聚集起来。
09:16
These drugs aren't cures,
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这使这些药物难以达到治疗效果。
09:18
but they represent a huge triumph of science
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但是这已经表明我们科学的（在对艾滋病毒的战斗中） 巨大的胜利
09:20
because they take away the automatic death sentence
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因为这些药物让艾滋病不再等同于
09:22
from a diagnosis of HIV,
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宣判死刑
09:24
at least for those who can access them.
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至少对于那些能接触到药物的人来说
09:27
The vaccine effort though is really quite different.
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尽管疫苗的作用实际上完全不同。
09:30
Large companies moved away from it
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一些大公司也不再做疫苗之类，
09:32
because they thought the science was so difficult
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因为他们认为科学如此艰难
09:35
and vaccines were seen as poor business.
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而做疫苗却又是这样不赚钱的业务。
09:38
Many thought that it was just impossible to make an AIDS vaccine,
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很多人都认为研制出艾滋病毒的疫苗简直是天方夜谭。
09:41
but today, evidence tells us otherwise.
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但是现在，证据显示这是有可能的。
09:44
In September,
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今年九月，
09:46
we had surprising but exciting findings
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我们有一个令人惊奇和令人兴奋的发现。
09:49
from a clinical trial that took place in Thailand.
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在泰国的临床实验中得以这一发现的。
09:52
For the first time, we saw an AIDS vaccine work in humans --
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这是我们第一次发现艾滋病毒在人体中怎样进行的，
09:55
albeit, quite modestly --
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尽管我们的发现是有限的。
09:58
and that particular vaccine was made
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一种特殊的疫苗在十多年前
10:00
almost a decade ago.
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就研制出来了。
10:02
Newer concepts and early testing now
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更新的理念和最近的测试
10:04
show even greater promise in the best of our animal models.
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显示在动物样本中有着很好的前景。
10:09
But in the past few months, researchers have also isolated
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但是在过去的几个月中，研究人员已经从
10:12
several new broadly neutralizing antibodies
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感染艾滋病毒个体的血液中分离出
10:15
from the blood of an HIV infected individual.
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新的一种有着明显的防御能力的抗体。
10:18
Now, what does this mean?
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那这意味着什么呢？
10:20
We saw earlier that HIV
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早些时候我们看到艾滋病毒是
10:22
is highly variable,
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急剧变化的病毒。
10:24
that a broad neutralizing antibody
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这种具有广泛中和能力的抗体
10:26
latches on and disables
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能依附并并且破坏
10:28
multiple variations of the virus.
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病毒的多种变化能力。
10:31
If you take these and you put them
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如果你取得这样疫苗并且把它注入
10:33
in the best of our monkey models,
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猴子样本中，
10:35
they provide full protection from infection.
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抗体应对感染提供全面的保护。
10:38
In addition, these researchers found
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另外，这些研究院发现
10:40
a new site on HIV
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艾滋病毒新的点
10:42
where the antibodies can grab onto,
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抗体抓住的地方。
10:44
and what's so special about this spot
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这一点特别就是
10:46
is that it changes very little
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抗体不会改变
10:48
as the virus mutates.
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在病毒变异的时候。
10:50
It's like, as many times
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这就好像 尽管
10:52
as the virus changes its clothes,
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病毒换了自己衣服，
10:54
it's still wearing the same socks,
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但是它仍然穿着同样的短袜。
10:55
and now our job is to make sure
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现在我们的工作就是
10:58
we get the body to really hate those socks.
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让我们的身体厌恶这些短袜。
11:01
So what we've got is a situation.
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这就是我们现在处境。
11:03
The Thai results tell us
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泰国实验结果告诉我们
11:05
we can make an AIDS vaccine,
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我们能研制出艾滋病毒疫苗。
11:07
and the antibody findings
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抗体的发现
11:09
tell us how we might do that.
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告诉我们我们能做到。
11:11
This strategy, working backwards
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这样的策略，我们返回我们之前工作
11:14
from an antibody to create a vaccine candidate,
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从抗体到制造出预选疫苗。
11:16
has never been done before in vaccine research.
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在疫苗研究之前这从未这样做过。
11:19
It's called retro-vaccinology,
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我们称这一过程为还原接种疫苗学。
11:22
and its implications extend
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这一理论的应用
11:24
way beyond that of just HIV.
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已经超出艾滋病领域。
11:27
So think of it this way.
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所以我们想到这中方法。
11:29
We've got these new antibodies we've identified,
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我们已经取得了这些我们确认的新的抗体
11:32
and we know that they latch onto many, many variations of the virus.
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我们知道这些疫苗能抓住很多多变的病毒。
11:35
We know that they have to latch onto a specific part,
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我们知道疫苗能抓住特殊的病毒。
11:38
so if we can figure out the precise structure of that part,
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所以我们能构想出这些病毒更为精确的结构
11:41
present that through a vaccine,
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通过疫苗就可以做到。
11:43
what we hope is we can prompt
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我们希望我们能促使
11:45
your immune system to make these matching antibodies.
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你们的免疫系统产生相匹配的抗体。
11:48
And that would create
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这样能将产生
11:50
a universal HIV vaccine.
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一种通用的艾滋病毒疫苗。
11:52
Now, it sounds easier than it is
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现在，这听起来挺容易的。
11:54
because the structure actually looks more like
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因为它的结构的确看起来像
11:56
this blue antibody diagram
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这种蓝色抗体简图一样
11:58
attached to its yellow binding site,
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粘附在黄色节点。
12:00
and as you can imagine, these three-dimensional structures
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正如你们可以想象的，这些三位结构图
12:02
are much harder to work on.
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是非常更为难以制作的。
12:04
And if you guys have ideas to help us solve this,
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如果你们能有想法帮助我们解决这问题，
12:06
we'd love to hear about it.
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我们很愿意听听你的想法。
12:08
But, you know, the research that has occurred from HIV now
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但是，现在，我们对艾滋病研究
12:11
has really helped with innovation with other diseases.
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的确帮助我们发明其他病毒的疫苗。
12:14
So for instance, a biotechnology company
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例如，一个生物科技公司
12:16
has now found broadly neutralizing
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现在已经发现对付流感
12:18
antibodies to influenza,
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广泛中和能力的抗体。
12:20
as well as a new antibody target on the flu virus.
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以及针对流感病毒的新的抗体。
12:23
They're currently making a cocktail --
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他们正在研制一种鸡尾酒
12:26
an antibody cocktail -- that can be used to treat
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一种鸡尾酒类型的抗体。这种能抗体能治疗
12:29
severe, overwhelming cases of flu.
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严重的流感例子。
12:32
In the longer term, what they can do
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现在，长远来看，我们能做的
12:34
is use these tools of retro-vaccinology
300
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使用还原接种技术
12:36
to make a preventive flu vaccine.
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来生产防御性流感疫苗。
12:39
Now, retro-vaccinology is just one technique
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现在，还原接种技术是一种
12:42
within the ambit of so-called rational vaccine design.
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在所谓理性疫苗设计范围内的技术。
12:45
Let me give you another example.
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我再给你另一个例子。
12:48
We talked about before the H and N spikes
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我们之前所说到 在流感病毒表面
12:50
on the surface of the flu virus.
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的H和M的刺突。
12:52
Notice these other, smaller protuberances.
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注意看到这些其他的更小的突起物。
12:55
These are largely hidden from the immune system.
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这些突起物都隐藏在疫苗系统里。
12:58
Now it turns out that these spots
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现在结果证明的这些节点
13:00
also don't change much when the virus mutates.
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在病毒变异之时并没有改变。
13:03
If you can cripple these with specific antibodies,
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如果你的身体特定的抗体能损害这些病毒，
13:05
you could cripple all versions of the flu.
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那么你的身体就能抵抗所有这类的流感。
13:08
So far, animal tests indicate
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到现在为止，动物测试显示
13:10
that such a vaccine could prevent severe disease,
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这样一种疫苗能抵抗预防这些病毒。
13:13
although you might get a mild case.
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尽管你会感染一些轻微的流感。
13:15
So if this works in humans, what we're talking about
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如果这些疫苗子运用在人身体中，
13:18
is a universal flu vaccine,
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我们说道的就是一种通用的疫苗。
13:20
one that doesn't need to change every year
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这样我们不要每年在去研制改变。
13:22
and would remove the threat of death.
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最终我们会抹掉这种死亡威胁。
13:25
We really could think of flu, then,
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实际上，我们认为这样流感
13:27
as just a bad cold.
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就仅仅是一次重感冒。
13:30
Of course, the best vaccine imaginable
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当然，可以想象的最好的疫苗
13:32
is only valuable to the extent
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在某种程度上是有价值的。
13:34
we get it to everyone who needs it.
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我们给疫苗给那些需要的每一个人。
13:36
So to do that, we have to combine
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所以为了达到这样目的，我们不得不
13:38
smart vaccine design with smart production methods
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把巧妙的疫苗设计与精细生产方法以及
13:41
and, of course, smart delivery methods.
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聪明的销售方式相结合。
13:44
So I want you to think back a few months ago.
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你们回想几个月前。
13:46
In June, the World Health Organization
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六月份，世界卫生组织
13:49
declared the first global
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宣布41年来第一个
13:51
flu pandemic in 41 years.
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全球流感病毒。
13:53
The U.S. government promised
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美国政府承诺
13:55
150 million doses of vaccine
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15亿剂疫苗将会
13:57
by October 15th for the flu peak.
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在10月15日生产出来以应对流感高峰。
13:59
Vaccines were promised to developing countries.
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同样也承诺会向发展中国家提供这些疫苗。
14:01
Hundreds of millions of dollars were spent
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数亿美元将会花费在
14:03
and flowed to accelerating vaccine manufacturing.
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提高疫苗的产量上。
14:06
So what happened?
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在之前我们又是怎样的？
14:08
Well, we first figured out
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那时我们首先想到
14:10
how to make flu vaccines, how to produce them,
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怎样研制疫苗，怎样生产这些疫苗。
14:13
in the early 1940s.
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那是在20世纪40年代初期。
14:15
It was a slow, cumbersome process
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那是一段缓慢而复杂的过程。
14:18
that depended on chicken eggs,
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因为我们整个过程都要依赖鸡蛋，
14:21
millions of living chicken eggs.
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上百万的活鸡蛋。
14:24
Viruses only grow in living things,
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病毒只能通过这样活鸡蛋才能生长。
14:26
and so it turned out that, for flu,
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的确最后也证明这一点。
14:28
chicken eggs worked really well.
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对于流感，鸡蛋相当有用。
14:30
For most strains, you could get one to two doses
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对于大部分种类病毒，你可能每个鸡蛋
14:33
of vaccine per egg.
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会产出一到两剂疫苗。
14:35
Luckily for us,
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我们是幸运的。
14:37
we live in an era of breathtaking
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我们生活在
14:39
biomedical advances.
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生物医药飞速发展的时代。
14:41
So today, we get our flu vaccines from ...
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即使是今天，我们的流感疫苗也是来自
14:44
chicken eggs,
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这些鸡蛋。
14:46
(Laughter)
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（笑声）
14:48
hundreds of millions of chicken eggs.
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来自这些数以亿计的鸡蛋。
14:50
Almost nothing has changed.
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这些几乎没有改变过。
14:52
The system is reliable
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系统是可靠的。
14:54
but the problem is you never know how well
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但是现在问题是，你们不知道
14:56
a strain is going to grow.
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一种病毒是怎样生产的。
14:59
This year's swine flu strain
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今年猪流感病毒
15:01
grew very poorly in early production:
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在早期生产中很难生产
15:04
basically .6 doses per egg.
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基本上，每只蛋产6剂疫苗。
15:08
So, here's an alarming thought.
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这可是一种令人害怕的想法。
15:10
What if that wild bird flies by again?
365
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如果野生飞禽又飞回来，那又会怎么样呢？
15:12
You could see an avian strain
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你可能都知道禽流感病毒
15:14
that would infect the poultry flocks,
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能感染家禽。
15:16
and then we would have no eggs for our vaccines.
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那时，我们就没有生产疫苗的鸡蛋了。
15:18
So, Dan [Barber], if you want
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Dan，如果你想
15:20
billions of chicken pellets
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要上百亿个鸡蛋
15:22
for your fish farm,
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来自你们的农场。
15:24
I know where to get them.
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我知道哪里可以得到这些鸡蛋。
15:26
So right now, the world can produce
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现在全球能生产
15:28
about 350 million doses
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3.5亿剂
15:30
of flu vaccine for the three strains,
375
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3种流感病毒的疫苗。
15:33
and we can up that to about 1.2 billion doses
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我们能提产到12亿剂疫苗。
15:36
if we want to target a single variant
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如果我们只生产一类病毒的疫苗
15:38
like swine flu.
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例如猪流感。
15:40
But this assumes that our factories are humming
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但是我们想到我们的工厂正在热火生产
15:43
because, in 2004,
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因为，2004年，
15:45
the U.S. supply was cut in half
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美国产量减产一般
15:47
by contamination at one single plant.
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是由于一种疫苗受到污染。
15:50
And the process still takes
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这一生产过程需要
15:52
more than half a year.
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半年多的时间。
15:54
So are we better prepared
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我们现在是否比
15:56
than we were in 1918?
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我们1918年那时准备更好吗？
15:58
Well, with the new technologies emerging now,
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当然，随着新科技兴起，
16:00
I hope we can say definitively, "Yes."
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我希望我们可以确定的说“是”。
16:02
Imagine we could produce enough flu vaccine
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想象一下，如果我们能为全球
16:05
for everyone in the entire world
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生产足够的流感疫苗。
16:08
for less than half of what we're currently spending
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但是我们只要花费
16:10
now in the United States.
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现在在美国疫苗生产费用一半还好少。
16:12
With a range of new technologies, we could.
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我们运用新技术这是可以实现的。
16:15
Here's an example:
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这里有一个例子。
16:17
A company I'm engaged with has found
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我之前工作过家公司已经发现
16:19
a specific piece of the H spike of flu
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一种H刺突流感病毒。
16:21
that sparks the immune system.
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这种病毒能激发免疫系统。
16:23
If you lop this off and attach it
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如果你能消除这种病毒，并且把它
16:25
to the tail of a different bacterium,
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粘附在另一种不同细菌的尾巴上。
16:28
which creates a vigorous immune response,
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这样就可以激起免疫系统的反应。
16:30
they've created a very powerful flu fighter.
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他们已经研制出一种强有力的流感病毒战士。
16:32
This vaccine is so small
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这种疫苗相当的微小。
16:34
it can be grown in a common bacteria, E. coli.
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这种疫苗能普通的细菌中就能产生。
16:37
Now, as you know, bacteria reproduce quickly --
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现在这种细菌繁殖非常快速。
16:40
it's like making yogurt --
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这就好像制造酸奶一样。
16:42
and so we could produce enough swine origin flu
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所以我们能在几个工厂就能
16:44
for the entire world in a few factories, in a few weeks,
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在几周内生产猪流感病毒。
16:47
with no eggs,
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但是我们并不需要使用鸡蛋。
16:49
for a fraction of the cost of current methods.
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而且我们只要花费现在生产方式的费用的一小部分就可以了。
16:52
(Applause)
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（鼓掌）
16:57
So here's a comparison of several of these new vaccine technologies.
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这只是几种疫苗新科技的比较。
17:00
And, aside from the radically increased production
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除了根本上提高产量和
17:03
and huge cost savings --
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大幅度节约生产成本之外，
17:05
for example, the E. coli method I just talked about --
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就我们刚才说道的E.coli方法，
17:08
look at the time saved: this would be lives saved.
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这种方法还节约了时间，这就意味着拯救更多生命。
17:11
The developing world,
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发展中国家
17:13
mostly left out of the current response,
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大部分发展中国家脱离了时代的潮流，
17:16
sees the potential of these alternate technologies
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他们却看到了这种替代技术的巨大潜力。
17:19
and they're leapfrogging the West.
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他们正在超越西方的发达国家。
17:21
India, Mexico and others are already
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印度、墨西哥以及其他发展中国家
17:23
making experimental flu vaccines,
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正在做流感疫苗的实验。
17:25
and they may be the first place
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他们也许处于领先地位。
17:27
we see these vaccines in use.
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我们看到这种疫苗的用途性
17:29
Because these technologies are so efficient
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因为这些技术如此高效率
17:32
and relatively cheap,
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而且相对便宜。
17:34
billions of people can have access to lifesaving vaccines
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那么几十亿的普通大众也能接种这种救命的疫苗。
17:37
if we can figure out how to deliver them.
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如果我们构想出销售这些疫苗方式。
17:39
Now think of where this leads us.
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最近我们在想我们在研究的
17:41
New infectious diseases
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新的感染性的疾病
17:43
appear or reappear
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一次又一次的出现。
17:45
every few years.
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每隔几年都会出现。
17:47
Some day, perhaps soon,
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某一天，也许很快
17:49
we'll have a virus that is going to threaten all of us.
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又会出现一种威胁我们的新的病毒。
17:52
Will we be quick enough to react
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然而这次我们将最快作出反应
17:54
before millions die?
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在百万人逝去之前，我们将做到。
17:56
Luckily, this year's flu was relatively mild.
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幸运的是，今年的流感病毒相对微弱。
17:59
I say, "luckily" in part
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我刚说“幸运”
18:01
because virtually no one in the developing world
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因为在过去发展中国家几乎没有一人
18:04
was vaccinated.
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接种过疫苗。
18:06
So if we have the political and financial foresight
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如果那些有着政治和金融远见的投资者
18:09
to sustain our investments,
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来持续我们对疫苗生产的投资。
18:11
we will master these and new tools of vaccinology,
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我们将掌握疫苗技术的新工具。
18:14
and with these tools we can produce
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运用这些新工具，我们能
18:16
enough vaccine for everyone at low cost
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生产出低廉的，普通大众都买得起的疫苗。
18:18
and ensure healthy productive lives.
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这样可以保障那些健康而充实有效的生命。
18:21
No longer must flu have to kill half a million people a year.
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每年流感不会再夺走50多万的生命了。
18:24
No longer does AIDS
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每年艾滋病也不会再
18:26
need to kill two million a year.
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夺走200多万的生命。
18:28
No longer do the poor and vulnerable
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不论是贫穷或嬴弱的人们
18:30
need to be threatened by infectious diseases,
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也不会在受到感染性疾病的威胁饿了。
18:33
or indeed, anybody.
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的确，不会威胁到任何人。
18:35
Instead of having Vaclav Smil's
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然而不会再有Vaclav Smil’s
18:38
"massively fatal discontinuity" of life,
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这样的大规模非持续性致命疾病了。
18:41
we can ensure
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我们能保证
18:43
the continuity of life.
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生命的延续。
18:45
What the world needs now are these new vaccines,
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现在世界需要的就是这些新的疫苗，
18:47
and we can make it happen.
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我们能生产出来。
18:49
Thank you very much.
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非常感谢！
18:51
(Applause)
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（掌声）
18:59
Chris Anderson: Thank you.
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Chris Anderson ：谢谢。
19:01
(Applause)
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（掌声）
19:07
Thank you.
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谢谢
19:09
So, the science is changing.
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科学日新月异变化着。
19:12
In your mind, Seth -- I mean, you must dream about this --
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在你看来，我的意思是，你在想
19:15
what is the kind of time scale
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什么时候，
19:18
on, let's start with HIV,
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就拿艾滋病毒来说，
19:20
for a game-changing vaccine that's actually out there and usable?
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我们会使用上这种已经存在的游戏替换式疫苗呢？
19:24
SB: The game change can come at any time,
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SB：任何时候游戏不断替换。
19:26
because the problem we have now is
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因为我们现在的面对的问题是
19:28
we've shown we can get a vaccine to work in humans;
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正如我们刚才向你们展现疫苗在人体如何工作的。
19:30
we just need a better one.
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我们需要更好的一种。
19:32
And with these types of antibodies, we know humans can make them.
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人类的身体可以使用这类抗体就可以对抗病毒。
19:34
So, if we can figure out how to do that,
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2000
如果我们知道它们怎么工作的，
19:36
then we have the vaccine,
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之后我们就研制出疫苗。
19:38
and what's interesting is there already is
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正真有趣的是
19:40
some evidence that we're beginning to crack that problem.
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有些迹象证明我们已经开始解决这些问题。
19:42
So, the challenge is full speed ahead.
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所以研制速度仍是我们的一大挑战。
19:44
CA: In your gut, do you think it's probably going to be at least another five years?
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CA：在你开来，你是否认为还要五年的时间才研制出下一种疫苗呢？
19:46
SB: You know, everybody says it's 10 years,
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SB：每个人都说要十年，
19:48
but it's been 10 years every 10 years.
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但是几十年已经过去了。
19:50
So I hate to put a timeline
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我个人不喜欢给
19:52
on scientific innovation,
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科学发明一种时间限制。
19:54
but the investments that have occurred are now paying dividends.
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那是那些投入研究的资金正在用于支付股东红利。
19:57
CA: And that's the same with universal flu vaccine, the same kind of thing?
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CA：它们与通用的流感疫苗是同样的吗？
20:00
SB: I think flu is different. I think what happened with flu is
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SB：我认为流感是不同的。
20:02
we've got a bunch -- I just showed some of this --
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一旦我们遇到一大股的流感时——正如我们刚刚展示的，
20:04
a bunch of really cool and useful technologies that are ready to go now.
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我们有一批相当酷而且非常有用的技术已经准备好了。
20:07
They look good. The problem has been that,
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它们看起来不错。还有一个问题
20:09
what we did is we invested in traditional technologies
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我们过去投资在传统技上。
20:12
because that's what we were comfortable with.
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因为那是过去合适的方式。
20:14
You also can use adjuvants, which are chemicals you mix.
491
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你也能用一种你混合化学用品的佐剂。
20:17
That's what Europe is doing, so we could have diluted out
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这也正是欧洲国家在做的，要是我们能稀释出
20:19
our supply of flu and made more available,
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我们提供的流感病毒，然后研制出更多的。
20:21
but, going back to what Michael Specter said,
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但是，说道MichaelSpecter 说的话，
20:24
the anti-vaccine crowd didn't really want that to happen.
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抗疫苗的病毒可不希望这样的事 发生。
20:27
CA: And malaria's even further behind?
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CA：疟疾疫苗实现当落后了吧？
20:29
SB: No, malaria, there is a candidate
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SB：不，疟疾，
20:31
that actually showed efficacy in an earlier trial
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我们已经早期试验中发现一种疟疾疫苗候选者表现非常有效。
20:34
and is currently in phase three trials now.
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现在已经进入了第三阶段的实验。
20:36
It probably isn't the perfect vaccine, but it's moving along.
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它现在可能不是那没完美的疫苗，但是它正在改进中。
20:39
CA: Seth, most of us do work where every month,
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CA：Seth，像我们大家一样每个月工作
20:41
we produce something;
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像我们一样，制作一些东西。
20:43
we get that kind of gratification.
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我们会感到非常快乐。
20:45
You've been slaving away at this for more than a decade,
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你们已经投入研究这一领域有十多年了。
20:48
and I salute you and your colleagues for what you do.
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我得向你和你的同事致敬，以及你们的研究成果。
20:51
The world needs people like you. Thank you.
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这个世界需要像你们这样的一类人。谢谢你们！
20:53
SB: Thank you.
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SB：谢谢。
20:55
(Applause)
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（掌声）
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