ABOUT THE SPEAKER
Edsel Salvaña - Infectious disease specialist, molecular epidemiologist
TED Fellow Edsel Salvaña studies the genetics of HIV, and he worries that we are just a few mutations away from the next deadly pandemic.

Why you should listen

Dr. Edsel Salvaña discovered that the driving force behind a new AIDS epidemic in the Philippines is the entry and spread of a deadlier strain of HIV -- a situation that can easily occur anywhere in the world.

Salvaña is an infectious disease specialist, molecular epidemiologist and is the director of the Institute of Molecular Biology and Biotechnology at the National Institutes of Health at the University of the Philippines in Manila. He is using next-generation sequencing and other cutting-edge genetic tools to study HIV viral diversity and superinfection. He is looking at how HIV develops drug resistance to better understand why his country suddenly has the fastest growing HIV epidemic in Asia; and why HIV treatment that works well in developed countries is failing on emerging HIV strains in the Philippines and resource-limited settings. He trains doctors in infectious diseases, and supervises the care of several thousand HIV patients at the Philippine General Hospital. He has been a national force in the formulation of HIV treatment guidelines, campaigning against stigma, and raising awareness.

Salvaña's advocacy work has been featured in Science, and he has been recognized with numerous national and international awards including the "Ten Outstanding Young Persons of the World" from JCI International and the Young Physician Leader Award from the Interacademy Medical Panel of the World Academy of Sciences. He was named a TED Fellow in 2017.

More profile about the speaker
Edsel Salvaña | Speaker | TED.com
TEDGlobal 2017

Edsel Salvaña: The dangerous evolution of HIV

Edsel Salvaña: 人類免疫缺陷病毒嘅危險進化

Filmed:
1,348,118 views

覺得我哋已經贏咗人類免疫缺陷病毒(HIV)?可能唔係,因為下一波抗藥性變異病毒浪潮即將到來。喺一場別開生面嘅 TED 演講中,TED 講者 Edsel Salvaña 講述強勁嘅 HIV AE 亞種正在肆虐佢嘅祖國菲律賓。佢警醒我哋輕易觸發一種全球性傳染病嘅可能因素。
- Infectious disease specialist, molecular epidemiologist
TED Fellow Edsel Salvaña studies the genetics of HIV, and he worries that we are just a few mutations away from the next deadly pandemic. Full bio

Double-click the English transcript below to play the video.

00:12
The Philippines菲律賓: an idyllic田園 country國家
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菲律賓係一個田園國家
00:15
with some of the clearest清晰 water
and bluest skies天空 on the planet星球.
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擁有地球上最乾淨嘅水和最藍嘅天空
00:19
It is also the epicenter震中
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同時都係世界上
00:20
of one of the fastest-growing增長最快
HIVHiv epidemics流行 in the world世界.
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HIV 傳染病例增長最快嘅重災區之一
00:24
On the surface表面, it seems好似
as if we are just a late bloomer大器晚成.
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表面上睇,菲律賓
似乎只係一個遲爆發 HIV 嘅國家
00:28
However然而, the reasons原因
for our current當前 epidemic流行
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但係,事實上造成我哋疫情嘅原因
00:31
are much more complicated複雜
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要複雜得多
00:33
and may可能 foreshadow預示
a global全球 resurgence復興 of HIVHiv.
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而且疫情可能預示著
HIV 會再次喺全球爆發
但全球 HIV 總體新病例數
正持續下降
00:38
While overall整體 new新增功能 cases of HIVHiv
continue繼續 to drop下降 in the world世界,
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00:42
this trend趨勢 may可能 be short-lived短命
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呢個趨勢可能唔會持續
00:45
when the next wave of more aggressive積極
and resistant viruses病毒 arrive到達.
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但係,下一輪嘅病毒
將會更強烈、抗藥性更强
00:49
HIVHiv has a potential to transform變換 itself本身
into a new新增功能 and different不同 virus病毒
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每當 HIV 侵染一個細胞
佢都可能將自己變異成一種新病毒
00:55
every time it infects感染 a cell細胞.
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00:57
Despite儘管 the remarkable顯著 progress進展
we've我哋都 made作出 in reversing扭轉 the epidemic流行,
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雖然我哋同 HIV 傳染病嘅仗
已經取得顯著進展
01:01
the truth真理 is that we are just a few幾個
viral病毒 mutations突變 away from disaster災難.
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事實上,只要病毒再變異幾次
災難就可能會再次來襲
01:07
To appreciate欣賞 the profound深刻 way
in which HIVHiv transforms變換 itself本身
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為咗更加清楚咁瞭解
HIV 每次增殖后顯著嘅基因變異
01:11
every time it reproduces再現,
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01:12
let's make a genetic遺傳 comparison比較.
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我哋嚟做一個基因對比
01:15
If we look at the DNADna variation變化
among之間 humans人類 of different不同 races種族
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如果我哋去睇各個大洲
唔同人種之間嘅 DNA 多樣性
01:18
from different不同 continents大洲,
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01:20
the actual實際 DNADna difference差異
is only 0.1 percent百分比.
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事實上只有百分之零點一嘅差別
01:24
If we look at the genetic遺傳 difference差異
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如果係人類、人科猿、 普通獼猴三者
01:26
between之間 humans人類, great apes,
and rhesus恆河 macaques獼猴,
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基因差別係百分之七
01:30
that number數量 is seven percent百分比.
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01:33
In contrast對比, the genetic遺傳 difference差異
between之間 HIVHiv subtypes
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相比之下,喺唔同病人身上嘅 HIV 亞種
01:37
from different不同 patients患者
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基因差別會高達百分之三十五
01:39
may可能 be as much as 35 percent百分比.
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01:42
Within a person infected感染 with HIVHiv,
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同一個 HIV 患者身上
01:44
the genetic遺傳 difference差異
between之間 an infecting感染 mother母親 virus病毒
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親代同子代病毒之間嘅基因差異
01:48
and subsequent隨後 daughter女兒 viruses病毒
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有百分之五噉多
01:50
has been shown顯示 to be
as much as five percent百分比.
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01:53
This is the equivalent等傚 of a gorilla大猩猩
giving birth出生 to a chimpanzee黑猩猩,
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親子代之間噉大嘅基因變異
就相當於大猩猩生黑猩猩
01:58
then to an orangutan猩猩,
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再生紅猩猩
01:59
then to a baboon狒狒,
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然後生狒狒
02:01
then to any random隨機 great ape
within its lifetime一生.
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又再喺生命之中生任何一種人猿
02:04
There are nearly 100 subtypes of HIVHiv,
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HIV 病毒有將近一百個亞種
02:08
with new新增功能 subtypes
being discovered發現 regularly定期.
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仲有新亞種被持續發現
02:11
HIVHiv in the developed開發 world世界
is almost爭 D all of one subtype:
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發達國家嘅 HIV 幾乎
都係同一個亞種︰
02:16
subtype B.
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B 亞種
02:18
Mostly主要 everything we know
and do to treat治療 HIVHiv
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我哋對 HIV 一切嘅瞭解同治療
02:22
is based基於 on studies研究 on subtype B,
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幾乎都係基於對 B 亞種嘅研究
02:26
even though雖然 it only
accounts帳戶 for 12 percent百分比
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雖然佢只占全世界 HIV 病例
嘅百分之十二
02:28
of the total number數量
of cases of HIVHiv in the world世界.
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02:33
But because of the profound深刻
genetic遺傳 difference差異
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但由於唔同亞種之間
顯著嘅基因差異
02:35
among之間 different不同 subtypes,
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02:38
some subtypes are more likely可能
to become成為 drug-resistant抵藥性
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一啲亞種產生抗藥性嘅可能性會更高
02:42
or progress進展 to AIDS爱滋病 faster更快.
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甚至會更快發展成愛滋病
02:44
We discovered發現 that the explosion爆炸
of HIVHiv cases in the Philippines菲律賓
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我哋發現菲律賓嘅 HIV 病例嘅爆發
02:49
is due由于 to a shift轉變
from the Western西方 subtype B
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係由於西部 B 亞種
02:53
to a more aggressive積極
Southeast東南 Asian亞洲 subtype AEAe.
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變異成一種更強勁嘅
東南亞 AE 亞種
02:58
We are seeing看到 younger年輕 and sicker病情加重 patients患者
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我哋發現更後生、病情更嚴重嘅病人
03:01
with high rates of drug藥物 resistance電阻.
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有更高嘅抗藥性比率
03:04
Initial初始 encroachment侵犯 of this subtype
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呢個亞種已經入侵發達國家
03:07
is already occurring發生
in developed開發 countries國家,
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03:09
including包括 Australia澳洲,
Canada加拿大 and the United聯合 States國家.
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包括澳洲、加拿大同美國
03:13
We may可能 soon好快 see a similar類似
explosion爆炸 of cases in these countries國家.
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可能好快,類似菲律賓嘅 HIV 疫情
就會喺呢啲國家發生
03:19
And while we think that HIVHiv is done
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如果我哋以為 HIV 大潮已經退去
就錯啦
03:22
and that the tide has turned打開 for it,
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事實上佢會返嚟
03:24
just like with real真正 tides潮汐,
it can come right back.
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就好似真正嘅潮水會回潮
03:27
In the early早期 1960s,
malaria瘧疾 was on the ropes.
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十八世紀六十年代早期
瘧疾大潮消退
03:31
As the number數量 of cases dropped下降,
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病例數下降
03:33
people and governments政府
stopped停止 paying支付 attention注意.
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人們同政府轉移咗注意力
03:36
The result結果 was a deadly致命 resurgence復興
of drug-resistant抵藥性 malaria瘧疾.
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結果抗藥性瘧疾又捲土重來
03:41
We need to think of HIVHiv
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我哋唔可以將 HIV 睇成
03:43
not as a single virus病毒
that we think we've我哋都 figured out,
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一種已經瞭解透徹嘅單一病毒
03:46
but as a collection收集 of rapidly迅速 evolving進化
and highly高度 unique獨特 viruses病毒,
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而係一系列進化快速、高度獨特嘅病毒
03:53
each每個 of which can set設置 off
the next deadly致命 epidemic流行.
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其中任何一種都有可能
引發下一次致命嘅疫情
03:56
We are incorporating結合
more powerful強大 and new新增功能 tools工具
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依家我哋藉助更強大、更新嘅工具
04:00
to help us detect檢測
the next deadly致命 HIVHiv strain應變,
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去檢測下一個致命 HIV
04:03
and this needs需要 to go hand in hand
with urgent緊急 research研究
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噉又需要同時進行
對非 B 亞種嘅緊急研究同適當治療
04:07
on the behavior行為 and proper適當 treatment治療
of non-B非 B subtypes.
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04:12
We need to convince說服 our governments政府
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我哋需要令我哋嘅政府、基金會相信
04:14
and our funding資金 agencies機構
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04:15
that HIVHiv is not yet尚未 done.
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人類同 HIV 嘅惡戰仍未結束
04:20
Over 35 million people have died of HIVHiv.
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超過三千五百萬人死於 HIV
04:25
We are on the verge邊緣
of an AIDS-free冇爱滋病 generation生成.
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我哋將邁入「零愛滋」嘅年代
04:28
We need to pay支付 attention注意.
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我哋需要時刻關注
04:30
We need to remain保持 vigilant警惕
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我哋需要保持警惕,及時跟進
04:33
and follow遵循 through透過.
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04:34
Otherwise否則, millions数百万 more will die.
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唔係嘅話,仲會有千千萬萬個人喪生
04:37
Thank you.
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多謝
04:38
(Applause掌聲)
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(掌聲)
Translated by 潘 可儿
Reviewed by Sylvia He

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ABOUT THE SPEAKER
Edsel Salvaña - Infectious disease specialist, molecular epidemiologist
TED Fellow Edsel Salvaña studies the genetics of HIV, and he worries that we are just a few mutations away from the next deadly pandemic.

Why you should listen

Dr. Edsel Salvaña discovered that the driving force behind a new AIDS epidemic in the Philippines is the entry and spread of a deadlier strain of HIV -- a situation that can easily occur anywhere in the world.

Salvaña is an infectious disease specialist, molecular epidemiologist and is the director of the Institute of Molecular Biology and Biotechnology at the National Institutes of Health at the University of the Philippines in Manila. He is using next-generation sequencing and other cutting-edge genetic tools to study HIV viral diversity and superinfection. He is looking at how HIV develops drug resistance to better understand why his country suddenly has the fastest growing HIV epidemic in Asia; and why HIV treatment that works well in developed countries is failing on emerging HIV strains in the Philippines and resource-limited settings. He trains doctors in infectious diseases, and supervises the care of several thousand HIV patients at the Philippine General Hospital. He has been a national force in the formulation of HIV treatment guidelines, campaigning against stigma, and raising awareness.

Salvaña's advocacy work has been featured in Science, and he has been recognized with numerous national and international awards including the "Ten Outstanding Young Persons of the World" from JCI International and the Young Physician Leader Award from the Interacademy Medical Panel of the World Academy of Sciences. He was named a TED Fellow in 2017.

More profile about the speaker
Edsel Salvaña | Speaker | TED.com