TEDTalks, Larry Brilliant – TED Prize wish: Help stop the next pandemic (2006)

Larry Brilliant – TED Prize wish: Help stop the next pandemic (2006)

Larry Brilliant wants to stop pandemics

I'm the luckiest guy in the world. I got to see the last case of killer smallpox in the world. I was in India this past year, and I may have seen the last cases of polio in the world. There's nothing that makes you feel more -- the blessing and the honor of working in a program like that than to know that something that horrible no longer exists. So, I'm going to tell -- (Applause) -- so, I'm going to show you some dirty pictures. They are difficult to watch, but you should look at them with optimism because the horror of these pictures will be matched by the uplifting quality of knowing that they no longer exist. But first I'm going to tell you a little bit about my own journey.

My background is not exactly the conventional medical education that you might expect. When I was an intern in San Francisco, I heard about a group of Native Americans who had taken over Alcatraz Island, and a Native American who wanted to give birth on that island, and no other doctor wanted to go and help her give birth. I went out to Alcatraz, and I lived on the island for several weeks. She gave birth, I caught the baby, I got off the island, I landed in San Francisco, and all the press wanted to talk to me because my three weeks on the island made me an expert in Indian affairs. I wound up on every television show.

Someone saw me on television, they called me up, and they asked me if I'd like to be in a movie and to play a young doctor for a bunch of rock and roll stars who were traveling in a bus ride from San Francisco to England. And I said, yes, I would do that, so I became the doctor in an absolutely awful movie called "Medicine Ball Caravan." Now, you know from the '60s, you're either on the bus or you're off the bus. I was on the bus. My wife and I, of 37 years, joined the bus. Our bus ride took us from San Francisco to London. We switched buses at the big pond. We then got on two more buses and we drove through Turkey and Iran, Afghanistan, over the Khyber Pass, into Pakistan, like every other young doctor. This is us at the Khyber Pass, and that's our bus. We had some difficulty getting over the Khyber Pass, but we wound up in India. And then, like everyone else in our generation, we went to live in a Himalayan monastery. (Laughter)

This is just like a residency program, for those of you that are in medical school. And we studied with a wise man, a guru named Karoli Baba, who then told me to get rid of the dress, put on a three-piece suit, go join the United Nations as a diplomat and work for the World Health Organization. And he made an outrageous prediction that smallpox would be eradicated, and that this was God's gift to humanity because of the hard work of dedicated scientists. And that prediction came true, and this little girl is Rahima Banu, and she was the last case of killer smallpox in the world. And this document is the certificate that the global commission signed certifying the world to have eradicated the first disease in history. The key to eradicating smallpox was early detection, early response.

I'm going to ask you to repeat that, early detection, early response. Can you say that?

Audience: Early detection, early response.

Larry Brilliant: Smallpox was the worst disease in history.

It killed more people than all the wars in history. In the last century, it killed 500 million people. More than two -- you're reading about Larry Page already, somebody reads very fast. (Laughter) In the year that Larry Page and Sergey Brin -- with whom I have a certain affection and a new affiliation -- in the year in which they were born, two million people died of smallpox. We declared smallpox eradicated in 1980. This is the most important slide that I've ever seen in public health because it shows you to be the richest and the strongest, and to be kings and queens of the world, did not protect you from dying of smallpox. Never can you doubt that we are all in this together. But to see smallpox from the perspective of a sovereign is the wrong perspective. You should see it from the perspective of a mother watching her child develop this disease and standing by helplessly. Day one, day two, day three, day four, day five, day six. You're a mother and you're watching your child, and on day six, you see pustules that become hard. Day seven, they show the classic scars of smallpox umbilication. Day eight. And Al Gore said earlier that the most photographed image in the world, the most printed image in the world, was that of the Earth. But this was in 1974, and as of that moment this photograph was the photograph that was the most widely printed because we printed two billion copies of this photograph, and we took them hand to hand, door to door, to show people and ask them if there was smallpox in their house because that was our surveillance system. We didn't have Google, we didn't have web crawlers, we didn't have computers. By day nine, you look at this picture, and you're horrified.

I look at this picture and I say, "Thank God" because it's clear that this is only an ordinary case of smallpox, and I know this child will live. And by day 13, the lesions are scabbing, his eyelids are swollen, but you know this child has no other secondary infection. And by day 20, while he will be scarred for life, he will live. There are other kinds of smallpox that are not like that.

This is confluent smallpox, in which there isn't a single place on the body where you could put a finger and not be covered by lesions. Flat smallpox, which killed 100 percent of people who got it. And hemorrhagic smallpox, the most cruel of all, which had a predilection for pregnant women. I've probably had 50 women die. They all had hemorrhagic smallpox. I've never seen anybody die from it who wasn't a pregnant woman. In 1967, the WHO embarked on what was an outrageous program to eradicate a disease. In that year, there were 34 countries affected with smallpox. By 1970, we were down to 18 countries. 1974, we were down to five countries. But in that year, smallpox exploded throughout India. And India was the place where smallpox made its last stand. In 1974, India had a population of 600 million. There are 21 linguistic states in India, which is like saying 21 different countries. There are 20 million people on the road at any time in buses and trains, walking, 500,000 villages, 120 million households, and none of them wanted to report if they had a case of smallpox in their house because they thought that smallpox was the visitation of a deity, Shitala Mata, the cooling mother, and it was wrong to bring strangers into your house when the deity was in the house. No incentive to report smallpox. It wasn't just India that had smallpox deities, smallpox deities were prevalent all over the world. So, how we eradicated smallpox was -- max vaccination wouldn't work. You could vaccinate everybody in India, but one year later there'll be 21 million new babies, which was then the population of Canada. It wouldn't do just to vaccinate everyone. You had to find every single case of smallpox in the world at the same time and draw a circle of immunity around it. And that's what we did. In India alone, my 150,000 best friends and I went door to door with that same picture to every single house in India. We made over one billion house calls. And in the process, I learned something very important.

Every time we did a house-to-house search, we had a spike in the number of reports of smallpox. When we didn't search, we had the illusion that there was no disease. When we did search, we had the illusion that there was more disease. A surveillance system was necessary because what we needed was early detection, early response. So, we searched and we searched, and we found every case of smallpox in India. We had a reward. We raised the reward. We continued to increase the reward. We had a scorecard that we wrote on every house. And as we did that, the number of reported cases in the world dropped to zero, and in 1980 we declared the globe free of smallpox. It was the largest campaign in United Nations history until the Iraq war.

150,000 people from all over the world, doctors of every race, religion, culture and nation, who fought side by side, brothers and sisters, with each other, not against each other, in a common cause to make the world better. But smallpox was the fourth disease that was intended for eradication. We failed three other times. We failed against malaria, yellow fever and yaws. But soon we may see polio eradicated. But the key to eradicating polio is early detection, early response. This may be the year we eradicate polio -- that will make it the second disease in history. And David Heymann, who's watching this on the webcast -- David, keep on going. We're close. We're down to four countries. (Applause)

I feel like Hank Aaron. Barry Bonds can replace me any time.

Let's get another disease off the list of terrible things to worry about. I was just in India working on the polio program. The polio surveillance program is four million people going door to door. That is the surveillance system. But we need to have early detection, early response. Blindness, the same thing. The key to discovering blindness is doing epidemiological surveys and finding out the causes of blindness so you can mount the correct response. The Seva Foundation was started by a group of alumni of the smallpox eradication program who, having climbed the highest mountain, tasted the elixir of the success of eradicating a disease, wanted to do it again. And over the last 27 years, Seva's programs in 15 countries have given back sight to more than two million blind people. Seva got started because we wanted to apply these lessons of surveillance and epidemiology to something which nobody else was looking at as a public health issue: blindness, which heretofore had been thought of only as a clinical disease. In 1980, Steve Jobs gave me that computer, which is Apple number 12, and it's still in Kathmandu, and it's still working, and we ought to go get it and auction it off and make more money for Seva. And we conducted the first Nepal survey ever done for health, and the first nationwide blindness survey ever done, and we had astonishing results. Instead of finding out what we thought was the case -- that blindness was caused mostly by glaucoma and trachoma -- we were astounded to find out that blindness was caused instead by cataract. You can't cure or prevent what you don't know is there. In your TED packages there's a DVD, "Infinite Vision," about Dr. V and the Aravind Eye Hospital. I hope that you will take a look at it. Aravind, which started as a Seva project, is now the world's largest and best eye hospital. This year, that one hospital will give back sight to more than 300,000 people in Tamil Nadu, India. (Applause) Bird flu. I stand here as a representative of all terrible things -- this might be the worst. The key to preventing or mitigating pandemic bird flu is early detection and rapid response. We will not have a vaccine or adequate supplies of an antiviral to combat bird flu if it occurs in the next three years. WHO stages the progress of a pandemic. We are now at stage three on the pandemic alert stage, with just a little bit of human-to-human transmission, but no human-to-human-to-human sustained transmission. The moment WHO says we've moved to category four, this will not be like Katrina. The world as we know it will stop. There'll be no airplanes flying. Would you get in an airplane with 250 people you didn't know, coughing and sneezing, when you knew that some of them might carry a disease that could kill you, for which you had no antivirals or vaccine? I did a study of the top epidemiologists in the world in October. I asked them -- these are all fluologists and specialists in influenza -- and I asked them the questions you'd like to ask them. What do you think the likelihood is that there'll be a pandemic? If it happens, how bad do you think it will be? 15 percent said they thought there'd be a pandemic within three years.

But much worse than that, 90 percent said they thought there'd be a pandemic within your children or your grandchildren's lifetime. And they thought that if there was a pandemic, a billion people would get sick. As many as 165 million people would die. There would be a global recession and depression as our just-in-time inventory system and the tight rubber band of globalization broke, and the cost to our economy of one to three trillion dollars would be far worse for everyone than merely 100 million people dying because so many more people would lose their job and their healthcare benefits that the consequences are almost unthinkable. And it's getting worse because travel is getting so much better. Let me show you a simulation of what a pandemic looks like so we know what we're talking about. Let's assume, for example, that the first case occurs in South Asia. It initially goes quite slowly. You get two or three discrete locations. Then there'll be secondary outbreaks, and the disease will spread from country to country so fast that you won't know what hit you. Within three weeks it will be everywhere in the world. Now, if we had an undo button, and we could go back and isolate it and grab it when it first started. If we could find it early, and we had early detection and early response, and we could put each one of those viruses in jail -- that's the only way to deal with something like a pandemic. And let me show you why that is. We have a joke. This is an epidemic curve, and everyone in medicine, I think, ultimately gets to know what it is. But the joke is, an epidemiologist likes to arrive at an epidemic right here and ride to glory on the downhill curve. But you don't get to do that usually. You usually arrive right about here. What we really want is to arrive right here, so we can stop the epidemic. But you can't always do that. But there's an organization that has been able to find a way to learn when the first cases occur, and that is called GPHIN. It's the Global Public Health Information Network. And that simulation that I showed you that you thought was bird flu, that was SARS. And SARS is the pandemic that did not occur. And it didn't occur because GPHIN found the pandemic-to-be of SARS three months before WHO actually announced it, and because of that we were able to stop the SARS pandemic. And I think we owe a great debt of gratitude to GPHIN and to Ron St. John, who I hope is in the audience some place -- over there -- who's the founder of GPHIN. (Applause)

Hello, Ron.

(Applause)

And TED has flown Ron here from Ottawa, where GPHIN is located because not only did GPHIN find SARS early, but you may have seen last week that Iran announced that they had bird flu in Iran, but GPHIN found the bird flu in Iran not February 14 but last September. We need an early warning system to protect us against the things that are humanity's worst nightmare. And so my TED wish is based on the common denominator of these experiences. Smallpox -- early detection, early response. Blindness, polio -- early detection, early response. Pandemic bird flu -- early detection, early response. It is a litany. It is so obvious that our only way of dealing with these new diseases is to find them early and to kill them before they spread. So, my TED wish is for you to help build a global system, an early-warning system, to protect us against humanity's worst nightmares. And what I thought I would call it is Early Detection, but it should really be called Total Early Detection. (Laughter)

(Applause)

But in all seriousness -- because this idea is birthed in TED, I would like it to be a legacy of TED, and I'd like to call it the International System for Total Early Disease Detection. And INSTEDD then becomes our mantra. So instead of a hidden pandemic of bird flu, we find it and immediately contain it. Instead of a novel virus caused by bio-terror or bio-error, or shift or drift, we find it, and we contain it. Instead of industrial accidents like oil spills or the catastrophe in Bhopal, we find them, and we respond to them. Instead of famine, hidden until it is too late, we detect it, and we respond. And instead of a system, which is owned by a government and hidden in the bowels of government, let's build an early detection system that's freely available to anyone in the world in their own language. Let's make it transparent, non-governmental, not owned by any single country or company, housed in a neutral country, with redundant backup in a different time zone and a different continent, and let's build it on GPHIN. Let's start with GPHIN. Let's increase the websites that they crawl from 20,000 to 20 million. Let's increase the languages they crawl from seven to 70, or more. Let's build in outbound confirmation messages using text messages or SMS or instant messaging to find out from people who are within 100 meters of the rumor that you hear if it is in fact valid. And let's add satellite confirmation. And we'll add Gapminder's amazing graphics to the front end. And we'll grow it as a moral force in the world, finding out those terrible things before anybody else knows about them, and sending our response to them. So that next year, instead of us meeting here, lamenting how many terrible things there are in the world, we will have pulled together, used the unique skills and the magic of this community, and be proud that we have done everything we can to stop pandemics, other catastrophes and change the world beginning right now. (Applause)

Chris Anderson: An amazing presentation. First of all, just so everyone understands, you're saying that by building -- by creating, web crawlers, looking on the Internet for patterns, they can detect something suspicious before WHO, before anyone else can see it? Just explain. Give an example of how that could possibly be true.

Larry Brilliant: First of all, you're not mad about the copyright violation?

CA: No. I love it.

LB: Well, you know, as Ron St. John -- I hope you'll go and meet him in the dinner afterwards and talk to him -- When he started GPHIN in 1997, there was an outbreak of bird flu. H5N1. It was in Hong Kong. And a remarkable doctor in Hong Kong responded immediately by slaughtering 1.5 million chickens and birds, and they stopped that outbreak in its tracks. Immediate detection, immediate response. Then a number of years went by, and there were a lot of rumors about bird flu. Ron and his team in Ottawa began to crawl the web, only crawling 20,000 different websites, mostly periodicals, and they read about and heard about a concern of a lot of children who had high fever and symptoms of bird flu. They reported this to WHO. WHO took a little while taking action because WHO will only receive a report from a government, because it's the United Nations. But they were able to point to WHO and let them know that there was this surprising and unexplained cluster of illnesses that looked like bird flu. That turned out to be SARS. That's how the world found out about SARS. And because of that we were able to stop SARS. Now, what's really important is that, before there was GPHIN, 100 percent of all the world's reports of bad things -- whether you're talking about famine or you're talking about bird flu or you're talking about Ebola -- 100 percent of all those reports came from nations. The moment these guys in Ottawa, on a budget of 800,000 dollars a year, got cracking, 75 percent of all the reports in the world came from GPHIN, 25 percent of all the reports in the world came from all the other 180 nations. Now, here's what's real interesting, after they'd been working for a couple years, what do you think happened to those nations? They felt pretty stupid, so they started sending in their reports earlier. Now their reporting percentage is down to 50 percent because other nations have started to report. So, can you find diseases early by crawling the web? Of course you can. Can you find it even earlier than GPHIN does now? Of course you can. You saw that they found SARS using their Chinese web crawler a full six weeks before they found it using their English web crawler. Well, they're only crawling in seven languages. These bad viruses really don't have any intention of showing up first in English or Spanish or French. (Laughter)

http://www.ted.com/index.php/talks/lang/eng/larry_brilliant_wants_to_stop_pandemics.html

Larry Brilliant – TED Prize wish: Help stop the next pandemic (2006) Larry Brilliant - TED-Preis-Wunsch: Helfen Sie, die nächste Pandemie zu stoppen (2006) Larry Brilliant - Ευχή για το βραβείο TED: Βοηθήστε να σταματήσει η επόμενη πανδημία (2006) Larry Brilliant - El deseo del Premio TED: ayudar a detener la próxima pandemia (2006) Larry Brilliant - Prix TED : aider à stopper la prochaine pandémie (2006) Larry Brilliant - Il desiderio del premio TED: aiutare a fermare la prossima pandemia (2006) ラリー・ブリリアント - TED賞受賞の願い：次のパンデミックを食い止めるために (2006) Larry Brilliant - TED Prize-wens: Help de volgende pandemie te stoppen (2006) Larry Brilliant - Życzenie nagrody TED: Pomóż powstrzymać kolejną pandemię (2006) Larry Brilliant - Desejo do Prémio TED: Ajudar a travar a próxima pandemia (2006) Ларри Бриллиант - желание получить премию TED: Помогите остановить следующую пандемию (2006) Larry Brilliant - TED Ödülü dileği: Bir sonraki salgını durdurmaya yardımcı olun (2006) Ларрі Брілліант - побажання премії TED: Допоможіть зупинити наступну пандемію (2006) Larry Brilliant – TED 获奖愿望：帮助阻止下一次大流行（2006 年）

Larry Brilliant wants to stop pandemics |||||大流行病ラリー・ブリリアント、パンデミックを阻止したい Larry Brilliant 想阻止流行病

I’m the luckiest guy in the world. ||el más afortunado|||| 僕は世界一ラッキーな男だよ。 I got to see the last case of killer smallpox in the world. |||||||||天花||| |||||||||Pocken||| |||||||||deadly viral disease||| |||||||||varíola||| 私は世界で最後の天然痘患者を見ることができた。 Мені довелося побачити останній у світі випадок смертельної віспи. I was in India this past year, and I may have seen the last cases of polio in the world. ||||||||||||||||小兒麻痺症||| ||||||||||||||||paralytic viral disease||| Ich war im vergangenen Jahr in Indien und habe vielleicht die letzten Poliofälle der Welt gesehen. 私はこの1年インドに滞在していたが、世界で最後のポリオ患者を見たかもしれない。 There’s nothing that makes you feel more -- the blessing and the honor of working in a program like that than to know that something that horrible no longer exists. あのような恐ろしいものがもはや存在しないと知ることほど、あのようなプログラムで働くことの祝福と名誉を感じられることはない。 So, I’m going to tell -- (Applause) -- so, I’m going to show you some dirty pictures. They are difficult to watch, but you should look at them with optimism because the horror of these pictures will be matched by the uplifting quality of knowing that they no longer exist. ||||||||||||||||||||||||振奮人心|||||||| |||||||||||||||||||wird||übertroffen|||erhebenden|||||||| |||||||||||||||||||||igualada|||edificante|qualidade||||||| Eles são difíceis de assistir, mas você deve olhá-los com otimismo porque o horror dessas imagens será igualado pela qualidade edificante de saber que eles não existem mais. But first I’m going to tell you a little bit about my own journey. |首先||||||||||||

My background is not exactly the conventional medical education that you might expect. Моя освіта не зовсім та традиційна медична освіта, яку ви могли б очікувати. When I was an intern in San Francisco, I heard about a group of Native Americans who had taken over Alcatraz Island, and a Native American who wanted to give birth on that island, and no other doctor wanted to go and help her give birth. ||||||||||||||||||佔領||惡魔島|||||||||給予|||||||||||||||| ||||||San Francisco|San Francisco|||||||||||||Alcatraz-Insel||||||||||||||||||||||||| ||||||||||||||||||||Alcatraz Island||||||||||||||||||||||||| ||||pasantía||||||||||||||||||||||||||||||||||||||||| Als ich ein Praktikum in San Francisco machte, hörte ich von einer Gruppe amerikanischer Ureinwohner, die die Insel Alcatraz übernommen hatten, und von einer amerikanischen Ureinwohnerin, die auf der Insel entbinden wollte, und kein anderer Arzt wollte ihr bei der Geburt helfen. Когда я был стажером в Сан-Франциско, я услышал о группе коренных американцев, которые захватили остров Алькатрас, и коренных американцах, которые хотели рожать на этом острове, и ни один другой врач не хотел идти и помогать ей рожать. I went out to Alcatraz, and I lived on the island for several weeks. Я отправился в Алькатрас и жил на острове несколько недель. She gave birth, I caught the baby, I got off the island, I landed in San Francisco, and all the press wanted to talk to me because my three weeks on the island made me an expert in Indian affairs. ||||接住了||||離開了||||||||||||媒體|||||||||||||||||||印第安事務 sie||||auffing||||||||||||||||||||||weil||||||||||||indische Angelegenheiten| Sie brachte das Kind zur Welt, ich holte es ab, ich verließ die Insel, landete in San Francisco, und die gesamte Presse wollte mit mir sprechen, weil ich durch meine drei Wochen auf der Insel ein Experte für indianische Angelegenheiten geworden war. Она родила, я поймал ребенка, я покинул остров, я приземлился в Сан-Франциско, и вся пресса хотела поговорить со мной, потому что мои три недели на острове сделали меня экспертом в индийских делах. Вона народила, я спіймав дитину, я покинув острів, приземлився в Сан-Франциско, і вся преса хотіла зі мною поговорити, тому що мої три тижні на острові зробили мене експертом у справах Індії. I wound up on every television show. |acabo||||| Ich bin in jeder Fernsehsendung gelandet.

Someone saw me on television, they called me up, and they asked me if I’d like to be in a movie and to play a young doctor for a bunch of rock and roll stars who were traveling in a bus ride from San Francisco to England. |||||||||||||||||||||||||||||一群||||搖滾樂||||||||||||| ||||||||||||||||||||||||||||||||||||||||||||||England -> nach England Кто-то видел меня по телевизору, они позвонили мне и спросили, не хочу ли я быть в кино и сыграть молодого доктора для группы рок-н-ролльных звезд, которые путешествовали на автобусе из Сан-Франциско в Англия. And I said, yes, I would do that, so I became the doctor in an absolutely awful movie called "Medicine Ball Caravan." Und ich sagte, ja, das würde ich machen, also wurde ich der Arzt in einem absolut schrecklichen Film namens "Medicine Ball Caravan". І я сказав, що так, я б це зробив, тому я став лікарем у абсолютно жахливому фільмі під назвою «Караван медичної кулі». Now, you know from the '60s, you’re either on the bus or you’re off the bus. Теперь, вы знаете, с 60-х годов, вы либо в автобусе, либо вы вышли из автобуса. I was on the bus. Ich saß im Bus. My wife and I, of 37 years, joined the bus. Моя жена и я, 37 лет, присоединились к автобусу. Ми з дружиною, 37 років, приєдналися до автобуса. Our bus ride took us from San Francisco to London. Наша поездка на автобусе взяла нас из Сан-Франциско в Лондон. We switched buses at the big pond. |||||großen|Teich Am großen Teich haben wir den Bus gewechselt. Trocamos de ônibus no grande lago. Мы поменяли автобусы у большого пруда. Ми пересадилися на великий ставок. We then got on two more buses and we drove through Turkey and Iran, Afghanistan, over the Khyber Pass, into Pakistan, like every other young doctor. ||nahmen||||Busse||||||||||||||||||| |||||||||||||||||Khyber|||||||| Затем мы сели в еще два автобуса и поехали через Турцию и Иран, Афганистан, через перевал Хайбер в Пакистан, как и любой другой молодой врач. This is us at the Khyber Pass, and that’s our bus. Это мы на перевале Хайбер, и это наш автобус. We had some difficulty getting over the Khyber Pass, but we wound up in India. |||||||||||最終||| Wir hatten einige Schwierigkeiten, den Khyber-Pass zu überqueren, aber wir kamen schließlich in Indien an. And then, like everyone else in our generation, we went to live in a Himalayan monastery. ||||||||||||||喜馬拉雅|修道院 |||||||||||||||Himalaya-Kloster (Laughter)

This is just like a residency program, for those of you that are in medical school. |||||住院醫師計劃||對於|||||||| Bu tıp fakültesinde okuyanlarınız için tıpkı bir ikamet programı gibidir. And we studied with a wise man, a guru named Karoli Baba, who then told me to get rid of the dress, put on a three-piece suit, go join the United Nations as a diplomat and work for the World Health Organization. ||||||智者||導師|||||||||去除||||||||三件式||||||||||外交官||||||| ||||||||Guru||Karoli Baba|Baba||||||||||||||drei||||||||||Diplomat||||||| ||||||||||Karoli|||||||||||||||||||||||||||||||| E estudamos com um homem sábio, um guru chamado Karoli Baba, que então me disse para me livrar do vestido, colocar um terno de três peças, ir para as Nações Unidas como diplomata e trabalhar para a Organização Mundial de Saúde. І ми вчилися з мудрою людиною, гуру на ім’я Каролі Баба, який потім сказав мені позбутися сукні, одягнути костюм-трійку, приєднатися до Організації Об’єднаних Націй як дипломат і працювати у Всесвітній організації охорони здоров’я. And he made an outrageous prediction that smallpox would be eradicated, and that this was God’s gift to humanity because of the hard work of dedicated scientists. ||||離譜的|預言|||||根除|||||||||||||||敬業的| ||||||||||ausgerottet werden|||||||||||||||| Und er machte die ungeheuerliche Vorhersage, dass die Pocken ausgerottet würden und dass dies ein Geschenk Gottes an die Menschheit sei, weil engagierte Wissenschaftler hart gearbeitet hätten. І він зробив обурливий прогноз, що натуральну віспу буде знищено, і що це був Божий дар людству завдяки наполегливій праці відданих науковців. And that prediction came true, and this little girl is Rahima Banu, and she was the last case of killer smallpox in the world. ||Vorhersage||||||||||||||||||||| ||||||||||Rahima|Banu|||||||||||| Und diese Vorhersage wurde wahr, und dieses kleine Mädchen heißt Rahima Banu, und sie war der letzte Fall von tödlichen Pocken auf der Welt. And this document is the certificate that the global commission signed certifying the world to have eradicated the first disease in history. |||||||||委員會|||||||||||| |||||Zertifikat|||||||||||ausgerottet||||| |||||||||||certificando|||||||||| The key to eradicating smallpox was early detection, early response. |||||||偵測|| ||||Die Schlüssel zur Ausrottung der Pocken waren frühe Erkennung und schnelle Reaktion.||||| Ключем до викорінення натуральної віспи було раннє виявлення та раннє реагування.

I’m going to ask you to repeat that, early detection, early response. Can you say that?

Audience: Early detection, early response. Publikum: Frühzeitige Erkennung, frühzeitige Reaktion.

Larry Brilliant: Smallpox was the worst disease in history. ||||||Krankheit||

It killed more people than all the wars in history. |||||||||歷史上 In the last century, it killed 500 million people. ||||||五億| More than two -- you’re reading about Larry Page already, somebody reads very fast. Более двух - вы уже читаете о Ларри Пейдже, кто-то читает очень быстро (Laughter) In the year that Larry Page and Sergey Brin -- with whom I have a certain affection and a new affiliation -- in the year in which they were born, two million people died of smallpox. ||||||||||||||||||||隸屬關係|||||||||||||| ||||||||Sergey Brin|Brin|||||||||||Verbindung|||||||||||||| (Gelächter) In dem Jahr, in dem Larry Page und Sergey Brin - zu denen ich eine gewisse Zuneigung und eine neue Verbindung habe - in dem Jahr, in dem sie geboren wurden, starben zwei Millionen Menschen an den Pocken. (Смех) В тот год, когда Ларри Пейдж и Сергей Брин, к которым у меня есть определенная привязанность и новая принадлежность, - в тот год, когда они родились, два миллиона человек умерли от оспы. (Сміх) У рік, коли Ларрі Пейдж і Сергій Брін, до яких я відчуваю певну прихильність і нову приязнь, у рік, коли вони народилися, два мільйони людей померли від віспи. We declared smallpox eradicated in 1980. This is the most important slide that I’ve ever seen in public health because it shows you to be the richest and the strongest, and to be kings and queens of the world, did not protect you from dying of smallpox. |||||投影片||||||||||||||||||||||||||||||||||| |||||diapositiva más importante||||||||||||||||||||||||||||||||||| Dies ist die wichtigste Folie, die ich je im Bereich der öffentlichen Gesundheit gesehen habe, denn sie zeigt, dass es einen nicht davor schützt, an den Pocken zu sterben, wenn man der Reichste und Stärkste ist, wenn man König und Königin der Welt ist. Это самый важный слайд, который я когда-либо видел в области общественного здравоохранения, потому что он показывает, что вы самый богатый и сильный, а также королями и королевами мира, не защитил вас от смерти от оспы. Never can you doubt that we are all in this together. Man darf nie daran zweifeln, dass wir alle gemeinsam an der Sache dran sind. Никогда не сомневайся, что мы все вместе. But to see smallpox from the perspective of a sovereign is the wrong perspective. |||Pocken||||||Souverän|||| Aber die Pocken aus der Perspektive eines Herrschers zu betrachten, ist die falsche Perspektive. Но видеть оспу с точки зрения суверена - неправильная точка зрения. You should see it from the perspective of a mother watching her child develop this disease and standing by helplessly. |||||||||||||||||||inútilmente Вы должны увидеть это с точки зрения матери, наблюдающей, как ее ребенок развивает эту болезнь, и беспомощно стоящей рядом. Day one, day two, day three, day four, day five, day six. You’re a mother and you’re watching your child, and on day six, you see pustules that become hard. ||||||||||||||Pusteln||| ||||||||||||||pápulas||| Ви мати, ви спостерігаєте за своєю дитиною, і на шостий день ви бачите гнійнички, які стають твердими. Day seven, they show the classic scars of smallpox umbilication. |||||||||Nabelbildung |||||||||umbilicación Am siebten Tag zeigen sie die klassischen Narben der Pockennabelentzündung. День сьомий, вони показують класичні шрами пупка від віспи. Day eight. And Al Gore said earlier that the most photographed image in the world, the most printed image in the world, was that of the Earth. ||||||||fotografierte|||||||||||||||| А Эл Гор говорил ранее, что самым сфотографированным изображением в мире, самым напечатанным изображением в мире, было изображение Земли. But this was in 1974, and as of that moment this photograph was the photograph that was the most widely printed because we printed two billion copies of this photograph, and we took them hand to hand, door to door, to show people and ask them if there was smallpox in their house because that was our surveillance system. |||||zu|||||||||||||weit verbreitet||||||||||||||||||||||||||||||||||||||Überwachungssystem| Mas isso foi em 1974, e a partir desse momento essa fotografia foi a fotografia mais impressa porque imprimimos dois bilhões de cópias dessa fotografia, e as pegamos na mão, de porta em porta, para mostrar às pessoas e perguntar a elas se havia varíola na casa deles, porque esse era o nosso sistema de vigilância. Но это было в 1974 году, и на тот момент эта фотография была самой широко напечатанной фотографией, потому что мы напечатали два миллиарда копий этой фотографии и взяли их из рук в руки, от двери до двери, чтобы показать людям и спросить их если в их доме была оспа, потому что это была наша система наблюдения. Але це було в 1974 році, і на той момент ця фотографія була найбільш широко надрукованою, тому що ми надрукували два мільярди копій цієї фотографії, і ми брали їх із рук в руки, від дверей до дверей, щоб показати людям і запитати їх якщо в їхньому будинку була віспа, тому що це була наша система стеження. We didn’t have Google, we didn’t have web crawlers, we didn’t have computers. ||||||||Webcrawler|||| ||||||||crawlers|||| У нас не було Google, у нас не було веб-сканерів, у нас не було комп’ютерів. By day nine, you look at this picture, and you’re horrified. Am neunten Tag sehen Sie sich dieses Bild an und sind entsetzt.

I look at this picture and I say, "Thank God" because it’s clear that this is only an ordinary case of smallpox, and I know this child will live. Ich sehe mir dieses Bild an und sage: "Gott sei Dank", denn es ist klar, dass es sich nur um einen gewöhnlichen Fall von Pocken handelt, und ich weiß, dass dieses Kind überleben wird. Я дивлюся на це фото і кажу: «Слава Богу», тому що зрозуміло, що це лише звичайний випадок віспи, і я знаю, що ця дитина виживе. And by day 13, the lesions are scabbing, his eyelids are swollen, but you know this child has no other secondary infection. ||||Läsionen||verkrusten||Augenlider|||||||||||| ||||||costrificando|||||||||||||| И к 13 дню поражения протекают, его веки опухшие, но вы знаете, что у этого ребенка нет другой вторичной инфекции. А на 13 день уражені струпи, повіки набряклі, але ви знаєте, що у цієї дитини немає іншої вторинної інфекції. And by day 20, while he will be scarred for life, he will live. |||||||gezeichnet||||| Und am 20. Tag wird er zwar lebenslange Narben haben, aber er wird leben. И к 20 дню, пока он будет страдать от жизни, он будет жить. There are other kinds of smallpox that are not like that.

This is confluent smallpox, in which there isn’t a single place on the body where you could put a finger and not be covered by lesions. ||konfluente||||||||||||||||||||||| ||confluent||||||||||||||||||||||| ||confluente||||||||||||||||||||||| Dabei handelt es sich um konfluente Pocken, bei denen es keine einzige Stelle am Körper gibt, auf die man einen Finger legen könnte, ohne von Läsionen bedeckt zu sein. Це зливна віспа, при якій немає жодного місця на тілі, куди можна було б покласти палець і не покритися поразками. Flat smallpox, which killed 100 percent of people who got it. Fläche||||||||| Flache Pocken, an denen 100 Prozent der Erkrankten sterben. Плоска натуральна віспа, від якої померло 100 відсотків хворих. And hemorrhagic smallpox, the most cruel of all, which had a predilection for pregnant women. |||||||||||Vorliebe||| |hemorrhagic||||||||||preference||| |hemorrágica||||||||||predilección||| Und die hämorrhagischen Pocken, die grausamsten von allen, die mit Vorliebe schwangere Frauen befielen. І геморагічна віспа, найжорстокіша з усіх, якою страждали вагітні жінки. I’ve probably had 50 women die. Ich habe wahrscheinlich 50 Frauen sterben lassen. They all had hemorrhagic smallpox. I’ve never seen anybody die from it who wasn’t a pregnant woman. Ich habe noch nie jemanden sterben sehen, der keine schwangere Frau war. In 1967, the WHO embarked on what was an outrageous program to eradicate a disease. |||begann|||||||||| |||began|||||||||| ||||||||escandaloso||||| В 1967 году ВОЗ приступила к осуществлению возмутительной программы по искоренению болезни. У 1967 році ВООЗ розпочала неймовірну програму знищення хвороби. In that year, there were 34 countries affected with smallpox. By 1970, we were down to 18 countries. 1974, we were down to five countries. But in that year, smallpox exploded throughout India. Але того року по всій Індії спалахнула віспа. And India was the place where smallpox made its last stand. |||||||machte||| E a Índia foi o lugar onde a varíola fez sua última resistência. In 1974, India had a population of 600 million. There are 21 linguistic states in India, which is like saying 21 different countries. ||linguistische||||||||| В Індії є 21 мовний штат, що схоже на 21 різну країну. There are 20 million people on the road at any time in buses and trains, walking, 500,000 villages, 120 million households, and none of them wanted to report if they had a case of smallpox in their house because they thought that smallpox was the visitation of a deity, Shitala Mata, the cooling mother, and it was wrong to bring strangers into your house when the deity was in the house. |||||||||||||||||Haushalte|||||||||||||||||||||||||Heimsuchung|||Gottheit|Shitala Mata|Shitala Mata||||||||||||||||Gottheit|||| ||||||||||||||||||||||||||||||||||||||||||visitas|||deidad|Shitala|Mata||||||||||||||||deidad|||| Há 20 milhões de pessoas na estrada a qualquer momento em ônibus e trens, caminhando, 500.000 aldeias, 120 milhões de famílias, e nenhuma delas quis informar se teve um caso de varíola em sua casa porque pensaram que a varíola era a visitação de uma divindade, Shitala Mata, a mãe fria, e era errado trazer estranhos para sua casa quando a divindade estava na casa. В любое время на дороге, в автобусах и поездах, находятся 20 миллионов человек, ходят пешком, 500 000 деревень, 120 миллионов домохозяйств, и никто из них не хотел сообщать, есть ли у них оспа в их доме, потому что они думали, что оспа была посещением. божества, Шитала Мата, охлаждающая мать, и было неправильно приводить незнакомцев в ваш дом, когда в доме было божество. 20 мільйонів людей у будь-який час у дорозі в автобусах і потягах, ходять пішки, 500 000 сіл, 120 мільйонів домогосподарств, і ніхто з них не хотів повідомити, чи був у них вдома випадок віспи, тому що вони вважали, що віспа є гостем божества, Шитала Мата, охолоджуючої матері, і було неправильно приводити незнайомців у свій дім, коли божество було в домі. No incentive to report smallpox. |Anreiz||| Нет стимула сообщать об оспе. Немає стимулів повідомляти про віспу. It wasn’t just India that had smallpox deities, smallpox deities were prevalent all over the world. |||||||Gottheiten|||||||| |||||||deidades|||||||| Не только в Индии были божества оспы, божества оспы были распространены во всем мире. Не тільки в Індії були божества віспи, божества віспи були поширені в усьому світі. So, how we eradicated smallpox was -- max vaccination wouldn’t work. ||||||Massenimpfung|Impfung|nicht funktionieren würde| Wie wir also die Pocken ausgerottet haben, war - die maximale Impfung würde nicht funktionieren. You could vaccinate everybody in India, but one year later there’ll be 21 million new babies, which was then the population of Canada. ||impfen||||||||es wird geben||||||||||| It wouldn’t do just to vaccinate everyone. You had to find every single case of smallpox in the world at the same time and draw a circle of immunity around it. |||||||||||||||||ziehen|||||| Man musste jeden einzelnen Pockenfall auf der Welt zur gleichen Zeit finden und einen Kreis der Immunität um ihn herum ziehen. Вы должны были найти каждый случай оспы в мире одновременно и нарисовать вокруг него круг иммунитета. And that’s what we did. In India alone, my 150,000 best friends and I went door to door with that same picture to every single house in India. We made over one billion house calls. And in the process, I learned something very important.

Every time we did a house-to-house search, we had a spike in the number of reports of smallpox. Jedes Mal, wenn wir eine Hausdurchsuchung durchführten, stieg die Zahl der gemeldeten Pockenfälle sprunghaft an. Cada vez que fazíamos uma busca de casa em casa, tínhamos um aumento no número de notificações de varíola. Каждый раз, когда мы проводили домашний обыск, у нас наблюдался всплеск количества сообщений об оспе. Кожного разу, коли ми проводили обшук від дому до дому, кількість повідомлень про віспу зростала. When we didn’t search, we had the illusion that there was no disease. Als wir nicht suchten, hatten wir die Illusion, es gäbe keine Krankheit. Когда мы не искали, у нас была иллюзия, что болезни нет. When we did search, we had the illusion that there was more disease. Когда мы действительно искали, у нас была иллюзия, что было больше болезней. A surveillance system was necessary because what we needed was early detection, early response. So, we searched and we searched, and we found every case of smallpox in India. We had a reward. |||Belohnung We raised the reward. Wir haben die Belohnung erhöht. We continued to increase the reward. Wir haben die Belohnung weiter erhöht. We had a scorecard that we wrote on every house. |||Punkteliste|||||| Wir hatten eine Scorecard, die wir für jedes Haus erstellt haben. У нас был оценочный лист, который мы составляли по каждому дому. And as we did that, the number of reported cases in the world dropped to zero, and in 1980 we declared the globe free of smallpox. И когда мы это сделали, число зарегистрированных случаев в мире упало до нуля, и в 1980 году мы объявили глобус свободным от оспы. It was the largest campaign in United Nations history until the Iraq war. Bis zum Irak-Krieg war es die größte Kampagne in der Geschichte der Vereinten Nationen. Это была крупнейшая кампания в истории Организации Объединенных Наций до войны в Ираке.

150,000 people from all over the world, doctors of every race, religion, culture and nation, who fought side by side, brothers and sisters, with each other, not against each other, in a common cause to make the world better. 150 000 человек со всего мира, врачи всех рас, религий, культур и наций, которые сражались бок о бок, братья и сестры друг с другом, а не друг против друга, в общем деле, чтобы сделать мир лучше. But smallpox was the fourth disease that was intended for eradication. ||||||||bestimmt||Ausrottung We failed three other times. Drei weitere Male sind wir gescheitert. Мы потерпели неудачу три раза. We failed against malaria, yellow fever and yaws. |||||||Yaws |||||||yaws Fracassamos contra a malária, a febre amarela e a bouba. Мы потерпели неудачу против малярии, желтой лихорадки и зевок. Ми не впоралися з малярією, жовтою лихоманкою та фрамбезією. But soon we may see polio eradicated. |||||Polio eradiziert| Але незабаром ми можемо побачити поліомієліт знищений. But the key to eradicating polio is early detection, early response. ||||eradicating|||||| Але ключем до викорінення поліомієліту є раннє виявлення, раннє реагування. This may be the year we eradicate polio -- that will make it the second disease in history. Dies könnte das Jahr sein, in dem wir die Kinderlähmung ausrotten - dann wäre sie die zweite Krankheit in der Geschichte. Это может быть год, когда мы ликвидируем полиомиелит - это сделает его второй болезнью в истории And David Heymann, who’s watching this on the webcast -- David, keep on going. ||Heymann||||||Webübertragung|||| ||Heymann||||||transmisión|||| И Дэвид Хейманн, который смотрит это в веб-трансляции - Дэвид, продолжай идти. І Девід Хейманн, який дивиться це на веб-трансляції... Девід, продовжуй. We’re close. Мы близки We’re down to four countries. Мы до четырех стран. (Applause)

I feel like Hank Aaron. |||Hank Aaron| |||Hank| Barry Bonds can replace me any time.

Let’s get another disease off the list of terrible things to worry about. |||Krankheit||||||||| Давайте исключим еще одну болезнь из списка ужасных вещей, о которых нужно беспокоиться I was just in India working on the polio program. |||||working|||| The polio surveillance program is four million people going door to door. That is the surveillance system. But we need to have early detection, early response. ||||||Früherkennung|| ||||||detection|| Blindness, the same thing. Blindheit, dasselbe.||| Сліпота, те саме. The key to discovering blindness is doing epidemiological surveys and finding out the causes of blindness so you can mount the correct response. |||||||epidemiologische|Umfragen|||||||||||geben||| |||||||epidemiological||||||||||||||| Ключом к выявлению слепоты является проведение эпидемиологических обследований и выяснение причин слепоты, чтобы вы могли найти правильный ответ. Ключем до виявлення сліпоти є проведення епідеміологічних обстежень і з’ясування причин сліпоти, щоб ви могли правильно відповісти. The Seva Foundation was started by a group of alumni of the smallpox eradication program who, having climbed the highest mountain, tasted the elixir of the success of eradicating a disease, wanted to do it again. |Seva-Stiftung||||||||Ehemalige Mitglieder|||Pocken|||||||||||Elixier|||||||||||| ||||founded||||||||||||||||||||||||||||||| |Seva|||||||||||||||||||||||||||||||||| Фонд «Сева» был создан группой выпускников программы ликвидации оспы, которая, поднявшись на самую высокую гору, попробовала эликсир успеха в искоренении болезни, захотела сделать это снова. Фонд Сева був заснований групою випускників програми з ліквідації віспи, які, піднявшись на найвищу гору, скуштувавши еліксир успіху у викоріненні хвороби, захотіли зробити це знову. And over the last 27 years, Seva’s programs in 15 countries have given back sight to more than two million blind people. |||||Sevas|||||||||||||| |||||Seva|||||||||||||| Seva got started because we wanted to apply these lessons of surveillance and epidemiology to something which nobody else was looking at as a public health issue: blindness, which heretofore had been thought of only as a clinical disease. |||||||||||||Epidemiologie||||||||||||||||bislang||||||||klinische Krankheit| |||||||||||||||||||||||||||||hasta ahora||||||||| Сева начал, потому что мы хотели применить эти уроки эпиднадзора и эпидемиологии к чему-то, что никто больше не рассматривал как проблему общественного здравоохранения: слепота, которая до сих пор считалась только клинической болезнью. In 1980, Steve Jobs gave me that computer, which is Apple number 12, and it’s still in Kathmandu, and it’s still working, and we ought to go get it and auction it off and make more money for Seva. |||||||||||||||Kathmandu||||||||sollten|||||versteigern||||||Geld|| |||||||||||||||Katmandú||||||||||||||||||||| В 1980 году Стив Джобс дал мне этот компьютер, который является Apple номер 12, и он все еще находится в Катманду, и он все еще работает, и мы должны пойти и продать его с аукциона и заработать больше денег для Севы. У 1980 році Стів Джобс подарував мені той комп’ютер, який є Apple номер 12, і він все ще знаходиться в Катманду, і він все ще працює, і ми повинні піти за ним і продати на аукціоні, щоб заробити більше грошей для Севи. And we conducted the first Nepal survey ever done for health, and the first nationwide blindness survey ever done, and we had astonishing results. |||||Nepal-Umfrage||||||||erste|||Umfrage|je|||||| И мы провели первое в Непале обследование состояния здоровья и первое общенациональное обследование слепоты, и мы получили потрясающие результаты. Instead of finding out what we thought was the case -- that blindness was caused mostly by glaucoma and trachoma -- we were astounded to find out that blindness was caused instead by cataract. ||||was||||||||||||Grüner Star||Trachom.|wir||||||||||||Grauer Star ||||||||||||||||glaucoma||tracoma|||||||||||||catarata Em vez de descobrir o que pensávamos ser o caso - que a cegueira era causada principalmente por glaucoma e tracoma - ficamos surpresos ao descobrir que a cegueira era causada por catarata. Вместо того, чтобы выяснить, что, по нашему мнению, имело место, - что слепота была вызвана главным образом глаукомой и трахомой, - мы были поражены, обнаружив, что слепота была вызвана катарактой. Durumun ne olduğunu - körlüğün çoğunlukla glokom ve trahomdan kaynaklandığını - bulmak yerine, körlüğün katarakttan kaynaklandığını öğrenmek bizi hayrete düşürdü. Замість того, щоб з’ясувати те, що, на нашу думку, було спричинено переважно глаукомою та трахомою, ми були вражені, дізнавшись, що сліпоту спричинила катаракта. You can’t cure or prevent what you don’t know is there. Вы не можете вылечить или предотвратить то, чего вы не знаете. In your TED packages there’s a DVD, "Infinite Vision," about Dr. V and the Aravind Eye Hospital. |||Paket|||DVD|Unendliche Vision|||||||Aravind-Augenklinik|| ||||||||||||||Aravind|| В ваших пакетах TED есть DVD "Infinite Vision" о докторе V и глазной больнице Аравинд I hope that you will take a look at it. Я надеюсь, что вы посмотрите на это. Aravind, which started as a Seva project, is now the world’s largest and best eye hospital. This year, that one hospital will give back sight to more than 300,000 people in Tamil Nadu, India. ||||||||||||||Tamil Nadu|Tamil Nadu| (Applause) Bird flu. (Оплески) Пташиний грип. I stand here as a representative of all terrible things -- this might be the worst. The key to preventing or mitigating pandemic bird flu is early detection and rapid response. |||||mildern||||||||| |||||mitigando||||||||| Ключем до запобігання або пом’якшення пандемії пташиного грипу є раннє виявлення та швидке реагування. We will not have a vaccine or adequate supplies of an antiviral to combat bird flu if it occurs in the next three years. |||||||||||Antivirenmittel|||||||||||| |||||||||||antiviral medication|||||||||||| Wenn die Vogelgrippe in den nächsten drei Jahren ausbricht, haben wir weder einen Impfstoff noch ausreichende Vorräte an antiviralen Mitteln. У нас не будет вакцины или адекватных запасов противовирусного средства для борьбы с птичьим гриппом, если это произойдет в ближайшие три года. WHO stages the progress of a pandemic. |stufen||||| Die WHO stellt den Verlauf einer Pandemie dar. ВОЗ контролирует развитие пандемии. We are now at stage three on the pandemic alert stage, with just a little bit of human-to-human transmission, but no human-to-human-to-human sustained transmission. ||||||||||||||||||||||||||||anhaltende| Wir befinden uns jetzt in der dritten Stufe der Pandemie-Warnstufe, d. h. es gibt nur eine geringe Übertragung von Mensch zu Mensch, aber keine anhaltende Übertragung von Mensch zu Mensch. Сейчас мы находимся на третьем этапе на этапе оповещения о пандемии, с небольшой передачей от человека человеку, но без устойчивой передачи от человека человеку. Зараз ми перебуваємо на третій стадії пандемічного попередження, лише з невеликою часткою передачі від людини до людини, але без постійної передачі від людини до людини до людини. The moment WHO says we’ve moved to category four, this will not be like Katrina. In dem Moment, in dem die WHO sagt, dass wir in die Kategorie vier aufgestiegen sind, wird dies nicht wie Katrina sein. В тот момент, когда ВОЗ говорит, что мы перешли в четвертую категорию, это не будет похоже на Катрину. The world as we know it will stop. Мир, каким мы его знаем, остановится. There’ll be no airplanes flying. |||Es werden keine Flugzeuge fliegen.| Там не будет самолетов. Would you get in an airplane with 250 people you didn’t know, coughing and sneezing, when you knew that some of them might carry a disease that could kill you, for which you had no antivirals or vaccine? |||||||||||husten||niesen|||||||||||||||||||||Antivirale Medikamente||Impfstoff ||||||||||||||||||||||||||||||||||antivirales|| Вы бы сели в самолет с 250 людьми, которых вы не знали, кашляя и чихая, когда вы знали, что у некоторых из них может быть болезнь, которая может убить вас, для которой у вас нет противовирусных препаратов или вакцины? I did a study of the top epidemiologists in the world in October. |||||||Epidemiologen||||| |||||||epidemiologists||||| I asked them -- these are all fluologists and specialists in influenza -- and I asked them the questions you’d like to ask them. ||||||Grippeforscher||Spezialisten||||||||||||| ||||||flu experts||experts||influenza virus||||||||||| ||||||virólogos||||||||||||||| Я спросил их - это все флюологи и специалисты по гриппу - и я задал им вопросы, которые вы хотели бы задать Я запитав у них – це всі флюологи та спеціалісти з грипу – і я поставив їм ті запитання, які б ви хотіли їм поставити. What do you think the likelihood is that there’ll be a pandemic? Как вы думаете, вероятность того, что будет пандемия? If it happens, how bad do you think it will be? 15 percent said they thought there’d be a pandemic within three years. 15 процентов сказали, что думают, что в течение трех лет будет пандемия.

But much worse than that, 90 percent said they thought there’d be a pandemic within your children or your grandchildren’s lifetime. ||||||||||||||||||Enkelkinder| ||||||||||||||||||nietos| Но гораздо хуже, 90% сказали, что думают, что у ваших детей или внуков будет пандемия. And they thought that if there was a pandemic, a billion people would get sick. As many as 165 million people would die. There would be a global recession and depression as our just-in-time inventory system and the tight rubber band of globalization broke, and the cost to our economy of one to three trillion dollars would be far worse for everyone than merely 100 million people dying because so many more people would lose their job and their healthcare benefits that the consequences are almost unthinkable. |||||Rezession||||||||Bestandsverwaltungssystem||||enger|Gummiband|||||||||unserer||||||||||||||||||||||||||||||||||Folgen||| Глобальная рецессия и депрессия повлекут за собой глобальную рецессию и депрессию, а жесткая полоса глобализации сломается, а стоимость нашей экономики от одного до трех триллионов долларов будет намного хуже для всех, чем просто 100 миллионов умирающих потому что намного больше людей потеряют свою работу и свои медицинские льготы, что последствия почти немыслимы. Відбудеться глобальна рецесія та депресія, оскільки наша система своєчасного обліку запасів і туга гумка глобалізації розірвуться, а вартість нашої економіки від одного до трьох трильйонів доларів буде набагато гіршою для всіх, ніж просто смерть 100 мільйонів людей тому що стільки більше людей втратять роботу та медичну допомогу, що наслідки майже немислимі. And it’s getting worse because travel is getting so much better. И это ухудшается, потому что путешествие становится намного лучше. Let me show you a simulation of what a pandemic looks like so we know what we’re talking about. |||||Simulation||||||||||||| Let’s assume, for example, that the first case occurs in South Asia. It initially goes quite slowly. |Anfangs||| You get two or three discrete locations. |||||diskrete| Then there’ll be secondary outbreaks, and the disease will spread from country to country so fast that you won’t know what hit you. ||||Ausbrüche|||Krankheit||||||||||du||||| Within three weeks it will be everywhere in the world. Now, if we had an undo button, and we could go back and isolate it and grab it when it first started. |||||Rückgängig machen||||||||isolieren|||greifen||||| Теперь, если бы у нас была кнопка отмены, и мы могли бы вернуться назад, изолировать ее и взять ее, когда она только началась. If we could find it early, and we had early detection and early response, and we could put each one of those viruses in jail -- that’s the only way to deal with something like a pandemic. ||||||||||||||||||||||Viren||||||||||||| And let me show you why that is. We have a joke. This is an epidemic curve, and everyone in medicine, I think, ultimately gets to know what it is. |||epidemische Kurve|Epidemiekurve||||||||kommt||||| Це крива епідемії, і кожен у медицині, я думаю, зрештою дізнається, що це таке. But the joke is, an epidemiologist likes to arrive at an epidemic right here and ride to glory on the downhill curve. |||||Epidemiologe|||ankommen|||||||fahren|||||abfallenden Kurve| Но шутка в том, что эпидемиологу нравится приходить к эпидемии прямо здесь и кататься к славе на спуске. Але жарт у тому, що епідеміолог любить приїжджати на епідемію прямо сюди і кататися на славу на кривій спуску. But you don’t get to do that usually. Но обычно ты этого не делаешь. You usually arrive right about here. What we really want is to arrive right here, so we can stop the epidemic. But you can’t always do that. But there’s an organization that has been able to find a way to learn when the first cases occur, and that is called GPHIN. ||||||||||||||||||auftreten|||||GPHIN |||||||||||||||||||||||GPHIN Але є організація, яка змогла знайти спосіб дізнатися, коли трапляються перші випадки, і це називається GPHIN. It’s the Global Public Health Information Network. And that simulation that I showed you that you thought was bird flu, that was SARS. І та симуляція, яку я вам показав, і яку ви вважали пташиним грипом, це була SARS. And SARS is the pandemic that did not occur. |SARS||||||| And it didn’t occur because GPHIN found the pandemic-to-be of SARS three months before WHO actually announced it, and because of that we were able to stop the SARS pandemic. And I think we owe a great debt of gratitude to GPHIN and to Ron St. ||||leisten|||Schuld|||||||| ||||||||||||||Ron| John, who I hope is in the audience some place -- over there -- who’s the founder of GPHIN. (Applause)

Hello, Ron.

(Applause)

And TED has flown Ron here from Ottawa, where GPHIN is located because not only did GPHIN find SARS early, but you may have seen last week that Iran announced that they had bird flu in Iran, but GPHIN found the bird flu in Iran not February 14 but last September. |||||||||||||||||||||||||||||kündigte an|||||||||||||Vogelgrippe||||Februar||| Und TED hat Ron aus Ottawa eingeflogen, wo GPHIN seinen Sitz hat, denn GPHIN hat nicht nur SARS früh entdeckt, sondern Sie haben vielleicht letzte Woche gesehen, dass der Iran bekannt gegeben hat, dass er die Vogelgrippe im Iran hat, aber GPHIN hat die Vogelgrippe im Iran nicht am 14. Februar, sondern im letzten September entdeckt. И TED прилетел сюда Роном из Оттавы, где находится GPHIN, потому что GPHIN не только рано обнаружил SARS, но вы, возможно, видели на прошлой неделе, что Иран объявил, что у них был птичий грипп в Иране, но GPHIN обнаружил птичий грипп в Иране не в феврале 14 но в прошлом сентябре. We need an early warning system to protect us against the things that are humanity’s worst nightmare. ||||||||||||||der Menschheit||schlimmster Albtraum And so my TED wish is based on the common denominator of these experiences. ||||||||||Nenner||| ||||||||||common factor||| І тому моє бажання TED базується на спільному знаменнику цих переживань. Smallpox -- early detection, early response. Blindness, polio -- early detection, early response. Blindheit, Polio - früh erkennen, früh reagieren. Pandemic bird flu -- early detection, early response. It is a litany. |||Litanei Це літанія. It is so obvious that our only way of dealing with these new diseases is to find them early and to kill them before they spread. Совершенно очевидно, что наш единственный способ справиться с этими новыми болезнями - это найти их рано и убить до того, как они распространятся. So, my TED wish is for you to help build a global system, an early-warning system, to protect us against humanity’s worst nightmares. And what I thought I would call it is Early Detection, but it should really be called Total Early Detection. (Laughter)

(Applause)

But in all seriousness -- because this idea is birthed in TED, I would like it to be a legacy of TED, and I’d like to call it the International System for Total Early Disease Detection. |||Ernsthaftigkeit|||||geboren||||||||||Vermächtnis|||||||||||||||Früherkennung von Krankheiten| ||||||||nació|||||||||||||||||||||||||| Але якщо серйозно, оскільки ця ідея народилася в TED, я хотів би, щоб вона була спадщиною TED, і я хотів би назвати її Міжнародною системою повного раннього виявлення захворювань. And INSTEDD then becomes our mantra. |Und INSTEDD wird|||| |INSTEDD|||| І тоді INSTEDD стає нашою мантрою. So instead of a hidden pandemic of bird flu, we find it and immediately contain it. Anstelle einer versteckten Pandemie der Vogelgrippe finden wir sie also und können sie sofort eindämmen. Instead of a novel virus caused by bio-terror or bio-error, or shift or drift, we find it, and we contain it. |||||verursacht||biologischem||||||Shift||Abweichung||||||| Anstelle eines neuartigen Virus, das durch Bioterror oder Bioterror oder durch Shift oder Drift verursacht wird, finden wir es und halten es in Schach. Замість нового вірусу, спричиненого біотерором чи біопомилкою, зміною чи дрейфом, ми знаходимо його та стримуємо. Instead of industrial accidents like oil spills or the catastrophe in Bhopal, we find them, and we respond to them. ||industrielle|||Öl|Ölverschmutzungen|||||Bhopal-Katastrophe|||||||| |||||||||||Bhopal|||||||| Замість промислових аварій, таких як розливи нафти чи катастрофи в Бхопалі, ми знаходимо їх і реагуємо на них. Instead of famine, hidden until it is too late, we detect it, and we respond. ||Hungersnot|||||||||||| And instead of a system, which is owned by a government and hidden in the bowels of government, let’s build an early detection system that’s freely available to anyone in the world in their own language. |||||||||||||||Eingeweiden|||||||||||||||||||| |||||||||||||||bowels|||||||||||||||||||| І замість системи, яка є власністю уряду і прихована в надрах уряду, давайте створимо систему раннього виявлення, яка буде вільно доступною для всіх у світі їх рідною мовою. Let’s make it transparent, non-governmental, not owned by any single country or company, housed in a neutral country, with redundant backup in a different time zone and a different continent, and let’s build it on GPHIN. ||||||nicht||||||||||||||überflüssig|||||||||||||||| ||||||||by|||||||||||||||||||||||||||| Давайте зробимо його прозорим, неурядовим, не належить жодній країні чи компанії, розміщеним у нейтральній країні, з резервним резервним копіюванням в іншому часовому поясі та на іншому континенті, і давайте побудуємо його на GPHIN. Let’s start with GPHIN. Let’s increase the websites that they crawl from 20,000 to 20 million. |||Websites|||||| Давайте збільшимо веб-сайти, які вони сканують, з 20 000 до 20 мільйонів. Let’s increase the languages they crawl from seven to 70, or more. Let’s build in outbound confirmation messages using text messages or SMS or instant messaging to find out from people who are within 100 meters of the rumor that you hear if it is in fact valid. |||ausgehende|||||||SMS-Nachrichten|||Nachrichtenübermittlung||||||||||||Gerücht|||||||||gültig |||salida||||||||||||||||||||||||||||||| And let’s add satellite confirmation. And we’ll add Gapminder’s amazing graphics to the front end. |||Gapminders||Grafiken||das|| |||de Gapminder|||||| And we’ll grow it as a moral force in the world, finding out those terrible things before anybody else knows about them, and sending our response to them. So that next year, instead of us meeting here, lamenting how many terrible things there are in the world, we will have pulled together, used the unique skills and the magic of this community, and be proud that we have done everything we can to stop pandemics, other catastrophes and change the world beginning right now. |||||||||lamenting|||||||||||||||||||||||||||||||||||||||||||||| |||||||||lamentando|||||||||||||||||||||||||||||||||||||||||||||| Щоб наступного року, замість того, щоб збиратися тут і нарікати на те, скільки жахливих речей є у світі, ми об’єдналися, використали унікальні навички та магію цієї спільноти та пишалися тим, що зробили все можливе, щоб зупиніть пандемії, інші катастрофи та змініть світ, починаючи прямо зараз. (Applause)

Chris Anderson: An amazing presentation. First of all, just so everyone understands, you’re saying that by building -- by creating, web crawlers, looking on the Internet for patterns, they can detect something suspicious before WHO, before anyone else can see it? |||||||||||||||arañas||||||||||||||||||| First of all, just so everyone understands, you're saying that by building -- by creating, web crawlers, looking on the Internet for patterns, they can detect something suspicious before WHO, before anyone else can see it? По-перше, щоб усі зрозуміли, ви хочете сказати, що створюючи -- створюючи веб-сканери, шукаючи шаблони в Інтернеті, вони можуть виявити щось підозріле раніше, ніж ВООЗ, перш ніж це побачить хтось інший? Just explain. Give an example of how that could possibly be true. Give an example of how that could possibly be true.

Larry Brilliant: First of all, you’re not mad about the copyright violation? Ларрі Брілліант: По-перше, ви не сердитеся через порушення авторських прав?

CA: No. I love it.

LB: Well, you know, as Ron St. <LB: Nun, weißt du>|||||| LB|||||| John -- I hope you’ll go and meet him in the dinner afterwards and talk to him -- When he started GPHIN in 1997, there was an outbreak of bird flu. Джон -- я сподіваюся, що ви підете й зустрінетеся з ним після вечері та поговорите з ним -- Коли він відкрив GPHIN у 1997 році, стався спалах пташиного грипу. H5N1. It was in Hong Kong. |||Hongkong|Hongkong And a remarkable doctor in Hong Kong responded immediately by slaughtering 1.5 million chickens and birds, and they stopped that outbreak in its tracks. ||||||||||||||||||||in|| ||||||||||sacrificando|||||||||||| Immediate detection, immediate response. Then a number of years went by, and there were a lot of rumors about bird flu. Ron and his team in Ottawa began to crawl the web, only crawling 20,000 different websites, mostly periodicals, and they read about and heard about a concern of a lot of children who had high fever and symptoms of bird flu. ||||||||durchforsten||||||||Zeitschriften||||||||||||||||||||||| ||||||||||||||||periodicals||||||||||||||||||||||| Рон і його команда в Оттаві почали сканувати Інтернет, скануючи лише 20 000 різних веб-сайтів, переважно періодичних видань, і вони читали та чули про занепокоєння багатьох дітей, які мали високу температуру та симптоми пташиного грипу. They reported this to WHO. WHO took a little while taking action because WHO will only receive a report from a government, because it’s the United Nations. But they were able to point to WHO and let them know that there was this surprising and unexplained cluster of illnesses that looked like bird flu. |||||||||||||||||||||Krankheitsfälle||||| |||||||||||||||||||cluster||||||| Aber sie waren in der Lage, auf die WHO zu verweisen und ihr mitzuteilen, dass es diese überraschende und unerklärliche Häufung von Krankheiten gab, die wie die Vogelgrippe aussahen. Але вони змогли вказати на ВООЗ і повідомити їм, що існує цей дивовижний і незрозумілий кластер хвороб, які виглядають як пташиний грип. That turned out to be SARS. Es stellte sich heraus, dass es sich um SARS handelte. That’s how the world found out about SARS. And because of that we were able to stop SARS. Now, what’s really important is that, before there was GPHIN, 100 percent of all the world’s reports of bad things -- whether you’re talking about famine or you’re talking about bird flu or you’re talking about Ebola -- 100 percent of all those reports came from nations. ||||||||es|||||||||||||||Hungersnot||||||||||||||||||| The moment these guys in Ottawa, on a budget of 800,000 dollars a year, got cracking, 75 percent of all the reports in the world came from GPHIN, 25 percent of all the reports in the world came from all the other 180 nations. |||||||||||||anfingen|||||||||||||||||||||||||| Now, here’s what’s real interesting, after they’d been working for a couple years, what do you think happened to those nations? They felt pretty stupid, so they started sending in their reports earlier. Now their reporting percentage is down to 50 percent because other nations have started to report. ||Berichterstattung|Berichterstattungsquote||||||||||| Now their reporting percentage is down to 50 percent because other nations have started to report. So, can you find diseases early by crawling the web? ||||Krankheiten||||| Of course you can. Can you find it even earlier than GPHIN does now? ||||||als||| Of course you can. You saw that they found SARS using their Chinese web crawler a full six weeks before they found it using their English web crawler. ||||||||||Web-Crawler||||||||||||| ||||||||||rastreadores||||||||||||| You saw that they found SARS using their Chinese web crawler a full six weeks before they found it using their English web crawler. Ви бачили, що вони виявили SARS за допомогою свого китайського веб-сканера за цілих шість тижнів до того, як вони знайшли його за допомогою англійського веб-сканера. Well, they’re only crawling in seven languages. Well, they're only crawling in seven languages. These bad viruses really don’t have any intention of showing up first in English or Spanish or French. (Laughter)

So, yes, I want to take GPHIN, I want to build on it, I want to add all the languages of the world that we possibly can, I want to make this open to everybody so that the health officer in Nairobi or in Patna, Bihar will have as much access to it as the folks in Ottawa or in CDC, and I want to make it part of our culture that there is a community of people who are watching out for the worst nightmares of humanity, and that it’s accessible to everyone. |||||||||||||||||||||||||||||||||||||||||Nairobi|||Patna, Bihar|Bihar|||||||||||||||Zentrum für Krankheitskontrolle|||||||||||||||||||||||||schlimmsten Albträume||||||zugänglich für alle|| |||||||||||||||||||||||||||||||||||||||||Nairobi|||Patna|Bihar|||||||||||||||||||||||||||||||||||||||||||||||| |||||||||||||||||||||||||||||||||||||||||Nairobi||||Bihar|||||||||||||||CDC|||||||||||||||||||||||||||||||||

http://www.ted.com/index.php/talks/lang/eng/larry_brilliant_wants_to_stop_pandemics.html