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  • The child's symptoms begin

  • with mild fever, headache, muscle pains,

  • followed by vomiting and diarrhea,

  • then bleeding from the mouth, nose and gums.

  • Death follows in the form of organ failure from low blood pressure.

  • Sounds familiar?

  • If you're thinking this is Ebola,

  • actually, in this case, it's not.

  • It's an extreme form of dengue fever, a mosquito-born disease

  • which also does not have an effective therapy or a vaccine,

  • and kills 22,000 people each year.

  • That is actually twice the number of people

  • that have been killed by Ebola

  • in the nearly four decades that we've known about it.

  • As for measles, so much in the news recently,

  • the death toll is actually tenfold higher.

  • Yet for the last year,

  • it has been Ebola that has stolen all of the headlines and the fear.

  • Clearly, there is something deeply rooted about it,

  • something which scares us and fascinates us

  • more than other diseases.

  • But what is it, exactly?

  • Well, it's hard to acquire Ebola,

  • but if you do, the risk of a horrible death is high.

  • Why?

  • Because right now, we don't have any effective therapy or vaccine available.

  • And so, that's the clue.

  • We may have it someday.

  • So we rightfully fear Ebola,

  • because it doesn't kill as many people as other diseases.

  • In fact, it's much less transmissible than viruses such as flu or measles.

  • We fear Ebola because of the fact that it kills us and we can't treat it.

  • We fear the certain inevitability that comes with Ebola.

  • Ebola has this inevitability that seems to defy modern medical science.

  • But wait a second, why is that?

  • We've known about Ebola since 1976.

  • We've known what it's capable of.

  • We've had ample opportunity to study it

  • in the 24 outbreaks that have occurred.

  • And in fact, we've actually had vaccine candidates available now

  • for more than a decade.

  • Why is that those vaccines are just going into clinical trials now?

  • This goes to the fundamental problem we have

  • with vaccine development for infectious diseases.

  • It goes something like this:

  • The people most at risk for these diseases

  • are also the ones least able to pay for vaccines.

  • This leaves little in the way of market incentives

  • for manufacturers to develop vaccines,

  • unless there are large numbers of people who are at risk in wealthy countries.

  • It's simply too commercially risky.

  • As for Ebola, there is absolutely no market at all,

  • so the only reason we have two vaccines in late-stage clinical trials now,

  • is actually because of a somewhat misguided fear.

  • Ebola was relatively ignored

  • until September 11 and the anthrax attacks,

  • when all of a sudden, people perceived Ebola

  • as, potentially, a bioterrorism weapon.

  • Why is it that the Ebola vaccine wasn't fully developed at this point?

  • Well, partially, because it was really difficult --

  • or thought to be difficult -- to weaponize the virus,

  • but mainly because of the financial risk in developing it.

  • And this is really the point.

  • The sad reality is, we develop vaccines

  • not based upon the risk the pathogen poses to people,

  • but on how economically risky it is to develop these vaccines.

  • Vaccine development is expensive and complicated.

  • It can cost hundreds of millions of dollars

  • to take even a well-known antigen and turn it into a viable vaccine.

  • Fortunately for diseases like Ebola,

  • there are things we can do to remove some of these barriers.

  • The first is to recognize when there's a complete market failure.

  • In that case, if we want vaccines,

  • we have to provide incentives or some type of subsidy.

  • We also need to do a better job at being able to figure out

  • which are the diseases that most threaten us.

  • By creating capabilities within countries, we then create the ability

  • for those countries to create epidemiological and laboratory networks

  • which are capable of collecting and categorizing these pathogens.

  • The data from that then can be used

  • to understand the geographic and genetic diversity,

  • which then can be used to help us understand

  • how these are being changed immunologically,

  • and what type of reactions they promote.

  • So these are the things that can be done,

  • but to do this, if we want to deal with a complete market failure,

  • we have to change the way we view and prevent infectious diseases.

  • We have to stop waiting until we see evidence

  • of a disease becoming a global threat before we consider it as one.

  • So, for Ebola,

  • the paranoid fear of an infectious disease,

  • followed by a few cases transported to wealthy countries,

  • led the global community to come together,

  • and with the work of dedicated vaccine companies,

  • we now have these:

  • Two Ebola vaccines in efficacy trials in the Ebola countries --

  • (Applause)

  • and a pipeline of vaccines that are following behind.

  • Every year, we spend billions of dollars,

  • keeping a fleet of nuclear submarines permanently patrolling the oceans

  • to protect us from a threat that almost certainly will never happen.

  • And yet, we spend virtually nothing

  • to prevent something as tangible and evolutionarily certain

  • as epidemic infectious diseases.

  • And make no mistake about it -- it's not a question of "if," but "when."

  • These bugs are going to continue to evolve

  • and they're going to threaten the world.

  • And vaccines are our best defense.

  • So if we want to be able to prevent epidemics like Ebola,

  • we need to take on the risk of investing in vaccine development

  • and in stockpile creation.

  • And we need to view this, then, as the ultimate deterrent --

  • something we make sure is available,

  • but at the same time, praying we never have to use it.

  • Thank you.

  • (Applause)

The child's symptoms begin

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TED】ワクチンはなぜ作られるのが遅すぎるのか?もし作られているならば|セス・バークリー|TED Talks (【TED】Why Vaccines are Made Too Late... If They’re Made At All | Seth Berkley | TED Talks)

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    Max Lin に公開 2021 年 01 月 14 日
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