TED2006
Larry Brilliant: My wish: Help me stop pandemics
Larry Brilliant想要防止大流行病(瘟疫)傳播
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當2006年(Larry Brilliant博士接受TED獎時,談如何消滅天花，且呼籲成立一個新的國際組織來防止大流行在世界傳播開來。
Larry Brilliant - Epidemiologist, philanthropist
TED Prize winner Larry Brilliant has spent his career solving the ills of today -- from overseeing the last smallpox cases to saving millions from blindness -- and building technologies of the future. Now, as Chair of the Skoll Global Threats Fund, he's redefining how we solve the world's biggest problems. Full bio
TED Prize winner Larry Brilliant has spent his career solving the ills of today -- from overseeing the last smallpox cases to saving millions from blindness -- and building technologies of the future. Now, as Chair of the Skoll Global Threats Fund, he's redefining how we solve the world's biggest problems. Full bio
Double-click the English transcript below to play the video.
00:25
I'm the luckiest guy in the world.
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我是這世界上最幸運的人。
00:28
I got to see the last case of killer smallpox in the world.
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我有機會看到世界上最後一宗致命天花的案例。
00:32
I was in India this past year,
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去年我在印度
00:34
and I may have seen the last cases of polio in the world.
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可能也看到世上最後一宗小兒痲痹案例。
00:40
There's nothing that makes you feel more -- the blessing and the honor
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沒有什麼比這感覺更好的：有這樣的福氣及榮耀
00:44
of working in a program like that than to know
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可以在這樣一個團隊中工作
00:48
that something that horrible no longer exists.
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知道這麼恐怖的東西不復存在。
00:52
So, I'm going to tell -- (Applause) --
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所以，我要說 （掌聲）
00:56
so, I'm going to show you some dirty pictures.
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所以，我要給你們看一些可怕的圖片。
00:59
They are difficult to watch, but you should look at them with optimism
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看這些圖片很難熬，但你們應該抱以樂觀的態度
01:05
because the horror of these pictures will be matched
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因為圖片恐怖的程度
01:10
by the uplifting quality of knowing that they no longer exist.
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與知道它們不復存在所帶來的振奮感相當。
01:15
But first I'm going to tell you a little bit about my own journey.
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但我要先告訴你們一些我經歷的事。
01:20
My background is not exactly the conventional medical education
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我的背景不完全像你們預期的
01:23
that you might expect.
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傳統醫學教育。
01:27
When I was an intern in San Francisco,
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我在舊金山實習的時候，
01:30
I heard about a group of Native Americans
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我聽說有一群美國原住民（美洲印第安人）
01:33
who had taken over Alcatraz Island,
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居住在惡魔島（Alcatraz Island），
01:35
and a Native American who wanted to give birth on that island,
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有一個印地安人在島上要生小孩，
01:38
and no other doctor wanted to go and help her give birth.
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但沒有醫生想去那裡幫她接生。
01:42
I went out to Alcatraz, and I lived on the island for several weeks.
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我去了惡魔島，在那住了幾個禮拜。
01:46
She gave birth; I caught the baby; I got off the island;
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她生了小孩，我接生了嬰兒，然後我離開那個島。
01:49
I landed in San Francisco; and all the press wanted to talk to me
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我回到舊金山，所有媒體都想要訪問我，
01:53
because my three weeks on the island made me an expert in Indian affairs.
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因為在那兒的三個禮拜,讓我成為印地安問題的專家。
01:58
I wound up on every television show.
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我上了每個電視節目。
02:00
Someone saw me on television; they called me up; and they asked me
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有人看到我在節目上，打電話問我
02:03
if I'd like to be in a movie and to play a young doctor
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願不願意在一部電影中演個
02:06
for a bunch of rock and roll stars who were traveling in a bus ride
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一群搭車由舊金山前往英國的搖滾樂星們
02:09
from San Francisco to England. And I said, yes, I would do that,
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的隨隊年輕醫生。我說：「好，我可以。」
02:13
so I became the doctor in an absolutely awful movie
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所以我成為一部大爛片中的醫生，
02:17
called "Medicine Ball Caravan."
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這部片叫「Medicine Ball Caravan」。
02:20
Now, you know from the '60s,
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好，你知道在六零年代，
02:22
you're either on the bus or you're off the bus.
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你要不是在車上旅行; 就是根本不在車上。(摘錄Ken Kesey 的名言,指跟 Kesey 同陣線或不同)
02:25
I was on the bus. My wife and I, of 37 years, joined the bus.
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我在車上。我太太和我，共37年，加入了車隊(指這事業)。
02:28
Our bus ride took us from San Francisco to London.
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我們的車帶我們從舊金山到倫敦。
02:31
We switched buses at the big pond. We then got on two more buses
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我們在大西洋換了車。然後又換了兩次車
02:35
and we drove through Turkey and Iran, Afghanistan,
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我們開過土耳其、伊朗、阿富汗、
02:38
over the Khyber Pass, into Pakistan, like every other young doctor.
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穿過開伯爾山口進入巴基斯坦，就跟其他年輕醫生一樣。
02:43
This is us at the Khyber Pass, and that's our bus.
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這是我們在開伯爾山口，那是我們的車。
02:45
We had some difficulty getting over the Khyber Pass,
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我們在穿越開伯爾山口時遇到些困難，
02:49
but we wound up in India.
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但我們最後到了印度。
02:52
And then, like everyone else in our generation,
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然後，跟所有我們這輩的人一樣，
02:54
we went to live in a Himalayan monastery.
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我們住在喜馬拉雅山脈的修道院內。
02:56
(Laughter)
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（笑聲）
03:00
This is just like a residency program,
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這是我們的駐院醫師實習訓練，
03:02
for those of you that are in medical school.
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跟醫學院的學生所應受的駐院實習訓練一樣.
03:04
And we studied with a wise man, a guru named Karoli Baba,
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我們跟一個很有智慧的人學習，叫Karoli Baba的古魯（印度教的導師），
03:10
who then told me to get rid of the dress,
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他告訴我們脫下袍子
03:13
put on a three-piece suit,
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穿上西裝
03:15
go join the United Nations as a diplomat
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去加入聯合國當個外交官
03:18
and work for the World Health Organization.
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為世界衛生組織工作。
03:21
And he made an outrageous prediction that smallpox would be eradicated,
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他還不可思議的預測天花可以被消滅，
03:25
and that this was God's gift to humanity
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而這是上帝給人類的禮物，
03:28
because of the hard work of dedicated scientists.
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因為在這些科學家的努力下
03:31
And that prediction came true, and this little girl is Rahima Banu,
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這個預測成真了。這個小女孩是Rahima Banu，
03:36
and she was the last case of killer smallpox in the world.
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她是最後一宗致命天花的患者。
03:40
And this document is the certificate that the global commission signed
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這是一張世界委員會開的證明文件
03:45
certifying the world to have eradicated the first disease in history.
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證明史上第一次消滅一種疾病。
03:51
The key to eradicating smallpox was early detection, early response.
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消滅天花最重要的是早發現、早行動。
03:57
I'm going to ask you to repeat that: early detection, early response.
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我要你們重複這個「早發現、早行動」
04:01
Can you say that?
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你們可以說嗎？
04:03
Audience: Early detection, early response.
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觀眾：早發現、早行動。
04:05
Larry Brilliant: Smallpox was the worst disease in history.
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Larry Brilliant：天花是史上最嚴重的疾病。
04:08
It killed more people than all the wars in history.
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它殺死的人比任何戰爭都多。
04:11
In the last century, it killed 500 million people.
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在上個世紀，有五億人死於天花。
04:17
More than two -- you're reading about Larry Page already,
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超過兩個--你已經在看Larry Page了，
04:20
somebody reads very fast. (Laughter)
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有些人看得很快。（笑聲）
04:22
In the year that Larry Page and Sergey Brin --
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在Larry Page和Sergey Brinn--
04:25
with whom I have a certain affection and a new affiliation --
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我和他們有些關係和最近的新組織--
04:28
in the year in which they were born,
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在他們出生那年，
04:30
two million people died of smallpox.
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兩百萬人死於天花。
04:33
We declared smallpox eradicated in 1980.
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我們在1980年宣布天花被消滅了。
04:38
This is the most important slide that I've ever seen in public health
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這是我在公衛上看過最重要的投影片，
04:42
because it shows you to be the richest and the strongest,
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因為它告訴你:就算你是最富有,最有強壯的人、
04:46
and to be kings and queens of the world,
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是世界上最有權的國王皇后(埃及法老照片:死於天花)
04:48
did not protect you from dying of smallpox.
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也沒辦法讓你不受害於天花。
04:50
Never can you doubt that we are all in this together.
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無法否認, 我們大家在同一條船上.
04:55
But to see smallpox from the perspective of a sovereign
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以一個最高統治者的角度來看天花
04:59
is the wrong perspective.
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是錯誤的。
05:01
You should see it from the perspective of a mother
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你應該以一個母親的角色
05:04
watching her child develop this disease and standing by helplessly.
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看他的孩子染病卻束手無策。
05:08
Day one, day two, day three, day four, day five, day six.
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第一天、第二天、第三天、第四天、第五天、第六天。
05:19
You're a mother and you're watching your child,
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你是個母親而你正在看你的小孩，
05:22
and on day six, you see pustules that become hard.
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在第六天，你看到膿包變硬。
05:27
Day seven, they show the classic scars of smallpox umbilication.
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第七天，你看到天花經典的臍狀疤。
05:33
Day eight.
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第八天。
05:34
And Al Gore said earlier that the most photographed image in the world,
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高爾之前說世界上最常被拍照的、
05:39
the most printed image in the world,
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最常被印出來的圖片
05:41
was that of the Earth. But this was in 1974,
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是地球。但在1974年，
05:44
and as of that moment this photograph was the photograph
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這張照片才是
05:47
that was the most widely printed
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曝光率最高的.
05:49
because we printed two billion copies of this photograph,
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因為我們為這張照片印了二十億張
05:52
and we took them hand to hand, door to door,
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我們拿著它們挨家挨戶
05:55
to show people and ask them if there was smallpox in their house
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給人們看並問他們家中有沒有天花病患.
06:00
because that was our surveillance system. We didn't have Google;
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因為那是我們的監控系統。我們沒有Google、
06:04
we didn't have web crawlers; we didn't have computers.
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我們沒有網路爬蟲(自動化瀏覽網路)、我們沒有電腦。
06:08
By day nine, you look at this picture, and you're horrified.
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到了第九天，你看這張圖片，你會驚駭。
06:13
I look at this picture and I say, "Thank God"
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我看這張圖片而我會說：「感謝上帝」
06:15
because it's clear that this is only an ordinary case of smallpox,
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因為這代表了這只是普通的天花病例，
06:19
and I know this child will live.
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而我知道這個小孩會活下來。
06:22
And by day 13, the lesions are scabbing, his eyelids are swollen,
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到了第十三天，傷口長滿疙瘩、他的眼皮還是腫脹，
06:27
but you know this child has no other secondary infection.
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但這個孩子沒有繼發性感染。
06:31
And by day 20, while he will be scarred for life, he will live.
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到第二十天，雖然他會一生帶疤，但他會活下來。
06:36
There are other kinds of smallpox that are not like that.
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還有其它種天花不是這樣的。
06:40
This is confluent smallpox,
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這是個融合性天花，
06:42
in which there isn't a single place on the body where you could put a finger
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病人全身上下沒有任何一個地方有超過
06:46
and not be covered by lesions.
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手指頭大小的完好肌膚。
06:49
Flat smallpox, which killed 100 percent of people who got it.
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扁平天花，得病者百分之百死亡。
06:53
And hemorrhagic smallpox, the most cruel of all,
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出血性天花，最殘忍的，
06:57
which had a predilection for pregnant women.
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易感染於懷孕女性。
07:00
I've probably had 50 women die. They all had hemorrhagic smallpox.
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我看過大約五十個女人死亡，她們全都染了出血性天花。
07:04
I've never seen anybody die from it who wasn't a pregnant woman.
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我從來沒有看過一個出血性天花死亡者不是懷孕女性。
07:09
In 1967, the WHO embarked on what was an outrageous program
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在1967年，WHO開始了一個不可思議的計畫
07:12
to eradicate a disease.
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要消滅一個疾病。
07:14
In that year, there were 34 countries affected with smallpox.
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在那年，34個國家有天花病例。
07:18
By 1970, we were down to 18 countries.
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到了1970年，只剩下18個國家。
07:22
1974, we were down to five countries.
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1974年，只剩下五個國家。
07:24
But in that year, smallpox exploded throughout India.
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但在那年，天花在印度爆發。
07:29
And India was the place where smallpox made its last stand.
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印度也成為天花最後病例的所在地。
07:34
In 1974, India had a population of 600 million.
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1974年，印度有六億人口。
07:37
There are 21 linguistic states in India,
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那時印度有21個語言區，
07:40
which is like saying 21 different countries.
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就像是說有21個不同國家一樣。
07:43
There are 20 million people on the road at any time in buses
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任何時間都有兩千萬人在路上, 在搭著車、火車、
07:46
and trains, walking, 500,000 villages, 120 million households,
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走路，有五十萬村莊、一億兩千萬戶人家，
07:52
and none of them wanted to report if they had a case of smallpox in their house
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但沒有任何人願意告訴我們:他們家裡有天花病人
07:57
because they thought that smallpox was the visitation of a deity,
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因為他們認為天花是女神Shitala Mata
08:00
Shitala Mata, the cooling mother,
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（降溫女神）的拜訪，
08:02
and it was wrong to bring strangers into your house
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當女神來訪的時候不該讓陌生人進家門。
08:06
when the deity was in the house. No incentive to report smallpox.
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所以沒有任何匯報天花役疫情的意願。
08:11
It wasn't just India that had smallpox deities;
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不是只有印度有天花女神，
08:14
smallpox deities were prevalent all over the world.
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這種"天花神"的迷信在全世界各地普遍存在的。
08:18
So, how we eradicated smallpox was -- max vaccination wouldn't work.
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所以我們要如何消滅天花？大眾接種是沒有用的。
08:23
You could vaccinate everybody in India,
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你可以讓印度每個人都接種，
08:25
but one year later there'll be 21 million new babies,
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但一年後又有兩千一百萬新生兒，
08:28
which was then the population of Canada.
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在當時等於加拿大的人口。
08:30
It wouldn't do just to vaccinate everyone.
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為每個人打疫苗是沒有用的。
08:33
You had to find every single case of smallpox in the world
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你必須在同一時間找到全世界每一宗天花案例
08:36
at the same time and draw a circle of immunity around it.
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且在每個案例周圍建立防疫圈。
08:39
And that's what we did.
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我們就是這麼做的。
08:42
In India alone, my 150,000 best friends and I
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光在印度，我和我的十五萬好朋友們
08:45
went door to door with that same picture
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拿著同樣的照片在印度
08:49
to every single house in India. We made over one billion house calls.
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挨家挨戶拜訪。我們拜訪了超過一千萬家庭。
08:54
And in the process, I learned something very important.
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在過程中，我學到一件重要的事情：
08:58
Every time we did a house-to-house search,
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我們每做一次門戶搜索，
09:02
we had a spike in the number of reports of smallpox.
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天花病例的數目就突然高起來一次。
09:08
When we didn't search, we had the illusion that there was no disease.
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當我們沒有搜索時，我們有了疾病被消除的假象。
09:12
When we did search, we had the illusion that there was more disease.
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當我們搜索時，我們有疾病病例增加的假象。
09:17
A surveillance system was necessary
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一個監控系統是必須的，
09:19
because what we needed was early detection, early response.
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因為我們需要的是早發現,早行動。
09:26
So, we searched and we searched, and we found
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所以我們一直找一直找，找到
09:29
every case of smallpox in India. We had a reward.
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印度的每一宗天花。我們提供獎勵。
09:32
We raised the reward. We continued to increase the reward.
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然後我們提高獎勵。我們繼續提高獎勵。
09:36
We had a scorecard that we wrote on every house.
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我們在每一棟房子牆上記錄到訪的日期(像計分表一樣)。
09:40
And as we did that, the number of reported cases in the world dropped to zero,
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當我們一直這麼做時，天花病例的數目最後也降到零。
09:45
and in 1980 we declared the globe free of smallpox.
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在1980年，我們宣布天花不復存在。
09:51
It was the largest campaign in United Nations history until the Iraq war.
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這是聯合國在伊拉克戰爭前最大的活動，
09:57
150,000 people from all over the world,
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十五萬人來自世界各地
10:02
doctors of every race, religion, culture and nation,
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及不同種族、不同宗教、不同國家的醫生們，
10:05
who fought side by side, brothers and sisters, with each other,
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肩並肩，互相幫助而無紛爭，
10:10
not against each other, in a common cause to make the world better.
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完成一個讓世界更美好的任務。
10:16
But smallpox was the fourth disease that was intended for eradication.
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但天花是我們試著消滅的第四個疾病。
10:20
We failed three other times.
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我們之前失敗了三次。
10:22
We failed against malaria, yellow fever and yaws.
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在瘧疾、黃熱病和雅司(熱帶莓疹)病上我們都失敗了。
10:25
But soon we may see polio eradicated.
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不過很快的，小兒痲痹也會被消滅的。
10:29
But the key to eradicating polio is early detection, early response.
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消滅小兒痲痹的金鑰是：早發現,早行動。
10:35
This may be the year we eradicate polio --
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今年有可能是我們消滅小兒痲痹的一年，
10:38
that will make it the second disease in history.
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這就會是史上第二個被消滅的疾病。
10:41
And David Heymann, who's watching this on the webcast --
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David Heymann, 如果你透過網路轉播看這場演講。
10:45
David, keep on going. We're close. We're down to four countries.
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David, 繼續努力。我們快要做到了，我們只剩下四個國家。
10:50
(Applause)
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（掌聲）
10:56
I feel like Hank Aaron. Barry Bonds can replace me any time.
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我覺得我跟Hank Aaron（美國棒球球員）一樣, 會很快的被Barry Bonds（棒球球員）追上取代。
11:00
Let's get another disease off the list of terrible things to worry about.
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讓我們再把一個疾病從我們耽心的清單中移除。
11:05
I was just in India working on the polio program.
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我才在印度參與消滅小兒痲痹的工作。
11:08
The polio surveillance program is four million people going door to door.
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小兒痲痹的監控系統是四百萬人挨家挨戶去尋找。
11:14
That is the surveillance system.
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那是我們的監控系統。
11:16
But we need to have early detection, early response.
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我們需要早發現,早行動。
11:20
Blindness, the same thing. The key to discovering blindness
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失明，一樣的。發現失明的鑰匙是
11:24
is doing epidemiological surveys and finding out the causes of blindness
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做流行病學問卷並找出失明的原因，
11:29
so you can mount the correct response.
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方能做出正確的反應。
11:32
The Seva Foundation was started by a group of alumni
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賽瓦基金會是由一群
11:36
of the smallpox eradication program who,
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曾參與消滅天花的人組成的。
11:39
having climbed the highest mountain,
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這群人爬到了頂峰
11:42
tasted the elixir of the success of eradicating a disease,
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嘗了消滅一種疾病的成功滋味，
11:47
wanted to do it again.
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且想要再做一次。
11:49
And over the last 27 years, Seva's programs in 15 countries
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在過去的27年當中，賽瓦基金在十五個國家
11:53
have given back sight to more than two million blind people.
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已經幫兩百萬失明人士找回光明。
11:57
Seva got started because we wanted to apply these lessons
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賽瓦的開始是因為我們想要將
12:01
of surveillance and epidemiology
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監控系統和流行病學理論
12:03
to something which nobody else was looking at
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用在其他人都不認為是
12:06
as a public health issue: blindness,
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公衛的問題：失明。
12:09
which heretofore had been thought of only as a clinical disease.
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在這之前只被認為是個臨床疾病。
12:12
In 1980, Steve Jobs gave me that computer, which is Apple number 12,
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1980年賈伯斯給我一台電腦，蘋果第十二號，
12:18
and it's still in Kathmandu, and it's still working,
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它現在還在加德滿都（尼泊爾首都）運作著。
12:21
and we ought to go get it and auction it off and make more money for Seva.
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我們應該把它拿來拍賣,為賽瓦籌得到更多錢。
12:26
And we conducted the first Nepal survey ever done for health,
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我們做了史上第一個尼泊爾的健康問卷，
12:30
and the first nationwide blindness survey ever done,
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也是第一個全國性的失明問卷，
12:33
and we had astonishing results.
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而結果另我們吃驚。
12:35
Instead of finding out what we thought was the case --
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我們以為會得到的結果是:
12:38
that blindness was caused mostly by glaucoma and trachoma --
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青光眼和沙眼是造成失明主要的原因.
12:42
we were astounded to find out that blindness was caused instead by cataract.
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但我們驚訝的發現失明竟多數是由白內障造成的。
12:48
You can't cure or prevent what you don't know is there.
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你不可能醫治或預防你不知道的東西。
12:55
In your TED packages there's a DVD, "Infinite Vision,"
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在你們的TED包裹中有一片DVD「無限視覺」，
12:59
about Dr. V and the Aravind Eye Hospital.
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在講V醫生和Aravind眼科醫院。
13:02
I hope that you will take a look at it.
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我希望你們能看一看。
13:04
Aravind, which started as a Seva project,
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Aravind一開始是賽瓦的一個計畫，
13:06
is now the world's largest and best eye hospital.
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現在是世界上最大最好的眼科醫院。
13:09
This year, that one hospital will give back sight
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今年，這間醫院會在印度
13:12
to more than 300,000 people in Tamil Nadu, India.
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塔米德邦為三十萬人恢復視力。
13:16
(Applause)
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（掌聲）
13:20
Bird flu. I stand here as a representative of all terrible things --
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禽流感。我在這裡為這些恐怖的事情發言--
13:24
this might be the worst.
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這有可能是最遭的。
13:27
The key to preventing or mitigating pandemic bird flu
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防止或是減輕禽流感流行的鑰匙是
13:31
is early detection and rapid response.
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早發現、早行動。
13:34
We will not have a vaccine or adequate supplies of an antiviral
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在未來的三年中，我們不會有疫苗或是
13:39
to combat bird flu if it occurs in the next three years.
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足夠的抗病毒素來對抗禽流感。
13:43
WHO stages the progress of a pandemic.
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這是世界衛生組織將大流行病分級表。
13:47
We are now at stage three on the pandemic alert stage,
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我們現在在警戒區第三級，
13:51
with just a little bit of human-to-human transmission,
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只有一些些的人傳人病例，
13:55
but no human-to-human-to-human sustained transmission.
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但沒有大量人傳人病例。
13:59
The moment WHO says we've moved to category four,
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當世界衛生組織宣布我們在第四級時，
14:03
this will not be like Katrina. The world as we know it will stop.
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這不會像科特莉娜颶風只局部在一區。我們知道的世界將會停擺。
14:08
There'll be no airplanes flying.
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不會有任何飛機飛行。
14:10
Would you get in an airplane with 250 people you didn't know,
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你會願意搭乘一架有250個陌生人的飛機
14:13
coughing and sneezing, when you knew that some of them
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有人正在咳嗽和擤鼻涕，而你知道其中幾個
14:16
might carry a disease that could kill you,
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有可能帶有致人於死地的傳染病，
14:18
for which you had no antivirals or vaccine?
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而你沒有機會得到抗病毒素或疫苗嗎？
14:21
I did a study of the top epidemiologists in the world in October.
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我在十月的時候對世界頂尖的流行病學家做了問卷。
14:26
I asked them -- these are all fluologists and specialists in influenza --
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我問他們，這些人是流感病學家和流感病毒專家，
14:30
and I asked them the questions you'd like to ask them.
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我問他們你們也想問他們的問題。
14:33
What do you think the likelihood is that there'll be a pandemic?
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你覺得流感流行的可能性有多大？
14:36
If it happens, how bad do you think it will be?
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如果發生了，你覺得會有多嚴重？
14:39
15 percent said they thought there'd be a pandemic within three years.
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百分之十五認為在三年內會發生流感。
14:44
But much worse than that,
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但更遭的是，
14:46
90 percent said they thought there'd be a pandemic
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百分之九十認為我們下一代
14:49
within your children or your grandchildren's lifetime.
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或下下一代也會有大流感流行。
14:53
And they thought that if there was a pandemic,
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而且他們認為如果流行了，
14:57
a billion people would get sick.
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會有十億人生病。
15:00
As many as 165 million people would die.
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大約一億六千五百萬人會死亡。
15:03
There would be a global recession and depression
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會發生全球蕭條及衰退，
15:06
as our just-in-time inventory system
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當恰好足夠的存貨系統,
15:08
and the tight rubber band of globalization broke,
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和全球緊密的架構崩潰，
15:12
and the cost to our economy of one to three trillion dollars
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將造成十到三十兆經濟損失，
15:16
would be far worse for everyone than merely 100 million people dying
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會比一億人死亡更遭的是，
15:21
because so many more people would lose their job
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更多人會沒有工作，
15:24
and their healthcare benefits
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他們的健保也沒了，
15:26
that the consequences are almost unthinkable.
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後果不堪設想。
15:30
And it's getting worse because travel is getting so much better.
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而且情況這會越來越遭,因為旅遊越來越容易。(更易傳染)
15:37
Let me show you a simulation of what a pandemic looks like
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讓我模擬一個流感的模型給你們看，
15:42
so we know what we're talking about.
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所以大家知道我在講甚麼。
15:45
Let's assume, for example, that the first case occurs in South Asia.
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讓我們預設，舉例來說，第一宗病例發生在亞洲南方。
15:50
It initially goes quite slowly.
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一開始非常緩慢。
15:52
You get two or three discrete locations.
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然後傳到兩到三個不同的地方。
15:57
Then there'll be secondary outbreaks, and the disease will spread
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會有個二度爆發，然後疾病會在
16:02
from country to country so fast that you won't know what hit you.
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國家跟國家之間傳播，快到你都不知道發生什麼事。
16:06
Within three weeks it will be everywhere in the world.
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三週內，全球各處都染上了。
16:10
Now, if we had an "undo" button, and we could go back and isolate it
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現在，如果我們有個還原鍵，我們可以回去並在疾病一開始時
16:16
and grab it when it first started. If we could find it early,
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便抓住隔離它。如果我們可以早發現，
16:19
and we had early detection and early response,
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且我們有早探測到,早行動，
16:22
and we could put each one of those viruses in jail --
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這樣我們可以把每一個病毒關到牢裡，
16:25
that's the only way to deal with something like a pandemic.
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那是唯一可以阻止大流行(瘟疫)的方法。
16:32
And let me show you why that is.
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讓我給你們看為什麼。
16:35
We have a joke. This is an epidemic curve, and everyone in medicine,
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我們有個笑話。這是流行病曲線。每個在醫學的人，
16:39
I think, ultimately gets to know what it is.
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我想都會知道這是什麼。
16:41
But the joke is, an epidemiologist likes to arrive at an epidemic
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笑話是這樣的：一個流行病學家喜歡來到流行病曲線
16:45
right here and ride to glory on the downhill curve.
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的這裡, 然後享受隨曲線下滑的榮耀。
16:49
But you don't get to do that usually.
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但大部份時候不是這樣的。
16:51
You usually arrive right about here.
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大部份時候你會來到這裡。
16:54
What we really want is to arrive right here, so we can stop the epidemic.
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我們想要的是來到這裡，這樣我們可以阻止疾病流行。
16:59
But you can't always do that. But there's an organization
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但你不是永遠都做得到的。幸好有個組織
17:02
that has been able to find a way to learn when the first cases occur,
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找到一個可以得知第一宗病例發生的方法，
17:07
and that is called GPHIN.
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這個組織叫做GPHIN。
17:09
It's the Global Public Health Information Network.
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Global Public Health Information Network (世界公衛資訊系統）
17:12
And that simulation that I showed you that you thought was bird flu --
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我剛剛給你們看的模擬，你們認為是禽流感的，
17:16
that was SARS. And SARS is the pandemic that did not occur.
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那是SARS。SARS 是一個沒有發生的大流感。
17:20
And it didn't occur because GPHIN found the pandemic-to-be of SARS
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它沒有發生因為GPHIN在世界衛生組織
17:27
three months before WHO actually announced it,
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宣布前三個月就發現了這可能的未來大流感: SARS。
17:33
and because of that we were able to stop the SARS pandemic.
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也因此我們能夠阻止SARS的蔓延。
17:37
And I think we owe a great debt of gratitude to GPHIN and to Ron St. John,
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我認為我們欠GPHIN和Ron St. John很多。
17:42
who I hope is in the audience some place -- over there --
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我希望他在觀眾席中--在那--
17:45
who's the founder of GPHIN.
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他是GPHIN的創辦人。
17:47
(Applause)
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（掌聲）
17:48
Hello, Ron.
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哈囉Ron。
17:50
(Applause)
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（掌聲）
17:58
And TED has flown Ron here from Ottawa, where GPHIN is located,
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TED將Ron從渥太華也就是GPHIN的所在地接過來。
18:03
because not only did GPHIN find SARS early, but
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因為GPHIN不只提早發現SARS，
18:08
you may have seen last week that Iran announced that they had bird flu in Iran,
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你可能有看到前幾個禮拜伊朗宣布境內有禽流感,
18:14
but GPHIN found the bird flu in Iran not February 14 but last September.
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但GPHIN不是在二月十四,而是在去年九月就發現伊朗有禽流感。
18:20
We need an early-warning system
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我們需要一個早期警告系統
18:22
to protect us against the things that are humanity's worst nightmare.
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來保護我們免於被這種人類惡夢(大流行)的迫害。
18:27
And so my TED wish is based on the common denominator of these experiences.
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所以我的TED願望就是根據這些經驗而來的
18:33
Smallpox -- early detection, early response.
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天花：早發現、早行動。
18:35
Blindness, polio -- early detection, early response.
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失明、小兒痲痹：早發現、早行動。
18:39
Pandemic bird flu -- early detection, early response. It is a litany.
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禽流感：早發現、早行動。這是祈禱文。
18:44
It is so obvious that our only way of dealing with these new diseases
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很明顯的我們唯一可行的方法是
18:49
is to find them early and to kill them before they spread.
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早期發現且在流行起來前殺盡致病菌。
18:54
So, my TED wish is for you to help build a global system,
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所以，我的TED願望是希望你們都能幫忙建造一個全球系統，
18:58
an early-warning system,
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一個早期警告系統，
19:00
to protect us against humanity's worst nightmares.
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來使我們免於人類最糟惡夢的迫害。
19:04
And what I thought I would call it is "Early Detection,"
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我想我可以叫它「Early Detection」（早期發現）
19:11
but it should really be called "Total Early Detection."
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但它應該叫做「Total Early Detection」（完全早期發現）(TED)
19:16
(Laughter)
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（笑聲）
19:18
(Applause)
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（掌聲）
19:31
But in all seriousness --
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真的! 認真來說--
19:33
because this idea is birthed in TED,
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因為這個點子來自TED，
19:36
I would like it to be a legacy of TED, and I'd like to call it
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我希望它成為TED的傳說，所以我要叫他
19:42
the "International System for Total Early Disease Detection."
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「International System for Total Early Disease Detection」（完全早期發現國際組織）
19:51
And INSTEDD then becomes our mantra.
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然後INSTEDD成為我們的六字大明咒(觀世音咒)。(救苦救難真言)
19:58
So instead of a hidden pandemic of bird flu,
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與其隱匿不知禽流感流行,
20:01
we find it and immediately contain it.
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我們應早期發現、馬上控制住疫情.
20:04
Instead of a novel virus caused by bio-terror or bio-error,
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與其在小說中憶測由生物恐怖、生物失誤造成的新型病毒。
20:08
or shift or drift, we find it, and we contain it.
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我們應早期發現、馬上控制住此新型病毒。
20:13
Instead of industrial accidents like oil spills or the catastrophe in Bhopal,
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以早發現、早行動取代
20:18
we find them, and we respond to them.
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像伯帕爾漏油事件的工業意外。
20:22
Instead of famine, hidden until it is too late, we detect it, and we respond.
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以早發現、早行動取代發現時已來不及的飢荒。
20:29
And instead of a system,
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與其由政府組成的一個系統、
20:31
which is owned by a government and hidden in the bowels of government,
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一個被埋在政府五臟六腑的系統內，
20:35
let's build an early detection system
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讓我們打造一個早期偵測系統，
20:37
that's freely available to anyone in the world in their own language.
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一個世界上每一個人都可以自由地用自己的語言來使用。
20:42
Let's make it transparent, non-governmental,
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讓它透明化、非政府化、
20:47
not owned by any single country or company,
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不屬於任何一個國家或公司擁有、
20:50
housed in a neutral country, with redundant backup
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建立在一個中立國家、且在每個不同時區、
20:53
in a different time zone and a different continent,
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每個大洲都有備份。
20:57
and let's build it on GPHIN. Let's start with GPHIN.
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讓我們以GPHIN為基礎，從GPHIN出發。
21:01
Let's increase the websites that they crawl from 20,000 to 20 million.
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讓我們將他們的網站數從兩千萬提高到兩百億。
21:06
Let's increase the languages they crawl from seven to 70, or more.
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讓我們將他們使用的語言從七種提高到七十種或更多。
21:12
Let's build in outbound confirmation messages
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讓我們建造向外的確認方法，
21:15
using text messages or SMS or instant messaging
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用簡訊或SMS或即時訊息，
21:19
to find out from people who are within 100 meters of the rumor that you hear
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從謠言所在地100公尺內的人身上得知
21:23
if it is, in fact, valid.
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謠言是否是真的。
21:25
And let's add satellite confirmation.
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讓我們再加上衛星確認。
21:27
And we'll add Gapminder's amazing graphics to the front end.
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並在前端加上Gapminder引人入勝的圖表。
21:31
And we'll grow it as a moral force in the world,
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我們要讓它成為一個道德力量且持續成長，
21:35
finding out those terrible things before anybody else knows about them,
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在任何人根本還未知前,提早找出這些可怕的事件，
21:40
and sending our response to them. So that next year,
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且採取行動。所以明年，
21:44
instead of us meeting here,
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在這裡再見面, 我們不會
21:46
lamenting how many terrible things there are in the world,
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哀悼曾有多少可怕的事情發生過，
21:49
we will have pulled together, used the unique skills
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我們會團結一起運用我們特有的能力、
21:52
and the magic of this community,
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和這個群體不可思議的力量
21:56
and be proud that we have done everything we can to stop pandemics,
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自豪的說:我們做了所有我們能做的來阻止大流行(大瘟疫).
21:59
other catastrophes, and change the world beginning right now.
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及其它大災害。讓我們從現在開始改變世界。
22:04
(Applause)
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（掌聲）
22:23
Chris Anderson: An amazing presentation. First of all,
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Chris Anderson:很精彩的演講。首先，
22:27
just so everyone understands, you're saying that by building --
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只是讓大家更瞭解。你說建造--
22:31
by creating web crawlers, looking on the Internet for patterns,
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設計網路爬蟲(自動化瀏覽網路的程式)、只是經由網路模式，
22:36
they can detect something suspicious before WHO,
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他們可以在世界衛生組織之前發現可疑的事件，
22:42
before anyone else can see it?
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在任何人之前？
22:44
Just explain. Give an example of how that could possibly be true.
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解釋一下。給一個例子解釋這怎麼可能。
22:47
Larry Brilliant: First of all, you're not mad about the copyright violation?
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Larry Brilliant:首先，你沒有因為侵犯智慧財產權生氣吧？
22:50
CA: No. I love it. (Laughter)
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CA:沒有。我很喜歡。
22:53
LB: Well, you know, as Ron St. John -- I hope you'll go and meet him
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LB:好的,嗯, 當Ron St. John--我希望你
22:56
in the dinner afterwards and talk to him --
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等會的晚餐上會去跟他碰面講講話--
22:59
When he started GPHIN -- In 1997, there was an outbreak of bird flu.
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當他1997年成立GPHIN的時候，那時禽流感剛爆發時，是H5N1種。
23:05
H5N1. It was in Hong Kong. And a remarkable doctor in Hong Kong
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發生在香港。而一個卓越的香港醫生
23:09
responded immediately by slaughtering 1.5 million chickens and birds,
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馬上匯報，經由殺了一百五十萬隻家禽和小鳥,
23:15
and they stopped that outbreak in its tracks.
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他們阻止了禽流感持續傳染爆發。
23:18
Immediate detection, immediate response.
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馬上發現、馬上行動。
23:21
Then a number of years went by,
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然後幾年過去了，
23:23
and there were a lot of rumors about bird flu.
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有很多禽流感的謠言。
23:25
Ron and his team in Ottawa began to crawl the web,
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Ron和他的團隊開始在渥太華瀏覽監控網路，
23:29
only crawling 20,000 different websites, mostly periodicals,
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只瀏覽監控兩萬個不同的網站，大部分是(醫學)期刊。
23:34
and they read about and heard about a concern of a lot of children
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他們讀到聽到有關於很多小孩發燒
23:39
who had high fever and symptoms of bird flu.
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且有禽流感的症狀。
23:42
They reported this to WHO. WHO took a little while taking action
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他們報告給WHO。WHO花了一些時間才行動，
23:47
because WHO will only receive a report from a government,
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因為WHO只接受從政府來的報告，
23:52
because it's the United Nations.
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因為WHO屬於聯合國。
23:54
But they were able to point to WHO and let them know
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但他們有能力能指出地區讓WHO知道
23:58
that there was this surprising and unexplained cluster of illnesses
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那兒有無法解釋的許多病例,
24:02
that looked like bird flu.
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而症狀類似禽流感.
24:04
That turned out to be SARS.
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結果就是SARS。
24:06
That's how the world found out about SARS.
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那是這世界怎麼知道SARS的。
24:08
And because of that we were able to stop SARS.
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也因此我們可以阻止SARS。
24:12
Now, what's really important is that, before there was GPHIN,
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現在，很重要的是，在GPHIN之前，
24:15
100 percent of all the world's reports of bad things --
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世上所有壞事的報導--
24:19
whether you're talking about famine or you're talking about bird flu
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不管是飢荒或是禽流感
24:22
or you're talking about Ebola --
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或是伊波拉病毒--
24:24
100 percent of all those reports came from nations.
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全部來自各國官方報導。
24:27
The moment these guys in Ottawa, on a budget of 800,000 dollars a year,
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當這些在渥太華預算只有每年八十萬元的人開始做事時，
24:32
got cracking, 75 percent of all the reports in the world came from GPHIN,
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百分之75的報導來自GPHIN，
24:38
25 percent of all the reports in the world
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剩下的25來自
24:40
came from all the other 180 nations.
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世界各地180個國家。
24:43
Now, here's what's real interesting,
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現在，有趣的是，
24:45
after they'd been working for a couple years,
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他們開始工作幾年後，
24:48
what do you think happened to those nations?
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你覺得那些國家怎麼了？
24:51
They felt pretty stupid, so they started sending in their reports earlier.
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他們覺得自己很蠢，所以開始早點送出報告。
24:54
Now their reporting percentage is down to 50 percent
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現在他們的報告佔了百分之五十，
24:57
because other nations have started to report.
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因為這些國家開始報導了。
25:00
So, can you find diseases early by crawling the web?
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所以你可以藉由網路找到疾病嗎？
25:04
Of course you can. Can you find it even earlier than GPHIN does now?
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當然可以。你可以比GPHIN更早發現嗎？
25:09
Of course you can. You saw that they found SARS
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當然可以。你知道嗎? 用中文找到SARS的資訊
25:12
using their Chinese web crawler a full six weeks
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比用英文找到的資訊
25:16
before they found it using their English web crawler.
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足足早了六個禮拜。
25:20
Well, they're only crawling in seven languages.
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現在他們只用七種語言。
25:22
These bad viruses really don't have any intention of showing up
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這些可惡的病毒並沒有意願
25:25
first in English or Spanish or French.
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以英文或西班牙文或法文現身。
25:27
(Laughter)
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（笑聲）
25:28
So, yes, I want to take GPHIN; I want to build on it;
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所以，是的，我要以GPHIN為基礎，繼續建造，
25:34
I want to add all the languages of the world that we possibly can;
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我想要盡我們所能加進世界上所有語言。
25:38
I want to make this open to everybody
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我想要讓每個人都有使用它，
25:40
so that the health officer in Nairobi or in Patna, Bihar
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這樣奈洛比或巴特那或比哈爾省的健康官員
25:43
will have as much access to it as the folks in Ottawa or in CDC;
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可以如渥太華或美國疾病防治中心的人一樣使用，
25:48
and I want to make it part of our culture that there is a community
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而且我希望讓它成為我們文化的一部份，
25:52
of people who are watching out for the worst nightmares of humanity,
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就是有一群人正在守護著、讓我們遠離人類最可怕的惡夢，
25:56
and that it's accessible to everyone.
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而且是每個人都能使用的。
ABOUT THE SPEAKER
Larry Brilliant - Epidemiologist, philanthropistTED Prize winner Larry Brilliant has spent his career solving the ills of today -- from overseeing the last smallpox cases to saving millions from blindness -- and building technologies of the future. Now, as Chair of the Skoll Global Threats Fund, he's redefining how we solve the world's biggest problems.
Why you should listen
Larry Brilliant's career path, as unlikely as it is inspirational, has proven worthy of his surname. Trained as a doctor, he was living in a Himalayan monastery in the early 1970s when his guru told him he should help rid the world of smallpox. He joined the World Health Organization's eradication project, directed efforts to eliminate the disease in India and eventually presided over the last case of smallpox on the planet.
Not content with beating a single disease, he founded the nonprofit Seva Foundation, which has cured more than two million people of blindness in 15 countries through innovative surgery, self-sufficient eye care systems and low-cost manufacturing of intraocular lenses. Outside the medical field, he found time to cofound the legendary online community The Well, and run two public tech companies. Time and WIRED magazines call him a "technology visionary."
His 2006 TED Prize wish drew on both sides of his career: He challenged the TED community to help him build a global early-response system to spot new diseases as quickly as they emerge. Called InSTEDD, the system has grown into a network of 100 digital detection partners, which provide tools that help the UN, WHO and CDC track potential pandemics.
Shortly after he won the TED Prize, Google executives asked Brilliant to run their new philanthropic arm, Google.org. So, between consulting on the WHO's polio eradication project and designing a disease-surveillance network, he harnessed Google's brains and billions in a mix of for-profit and nonprofit ventures tackling the global problems of disease, poverty and climate change. Today, Brilliant is Chair of the Skoll Global Threats Fund, where he heads a team whose mission is to confront global threats imperiling humanity: pandemics, climate change, water security, nuclear proliferation and Middle East conflict.
Larry Brilliant | Speaker | TED.com