• Seth Buckley - Seth berkley -: *** and flu - the vaccine strategy - British double subtitles

你是否擔心自己將會命喪何種事故？ Do you worry about what is going to kill you? 心臟病？癌症？ Heart disease, cancer, 還是車禍呢？ a car accident? 大部分我們擔心的，都不是我們能控制的， Most of us worry about things we can't control 像是戰爭、恐怖攻擊、 like war, terrorism, 或像海地的那種大地震。 the tragic earthquake that just occurred in Haiti. 有哪些是真正威脅到人類的？ But what really threatens humanity? 幾年前，瓦茨‧拉夫史米爾教授 A few years ago, Professor Vaclav Smil 試著去計算 tried to calculate the probability 世界上足以改變人類歷史的災害 of sudden disasters 所出現的機率。 large enough to change history. 他稱之為 He called these 嚴重的致命不連續性 (massively fatal discontinuities)， massively fatal discontinuities, 意味著這些事故 meaning that they could kill 在未來的 50 年內 up to 100 million people 最多可能導致一億人喪命。 in the next 50 years. 他也研究了第三次世界大戰發生的機率、 He looked at the odds of another world war, 大規模火山爆發的機率、 of a massive volcanic eruption, 甚至小行星撞地球的機率。 even of an asteroid hitting the Earth. 但是他把某個事件發生的可能性 But he placed the likelihood of one such event 放在第一位， above all others, 幾乎 100% 會發生， at close to 100 percent, 這個事件就是嚴重的全球性流感。 and that is a severe flu pandemic. 現在，你可能會覺得流感 Now, you might think of flu 只是一種比較嚴重的感冒而已。 as just a really bad cold. 但是，它能取你性命， But it can be a death sentence. 每年有三萬六千名美國人 Every year, 36,000 people in the United States 死於季節性的流感。 die of seasonal flu. 在開發中國家，雖然資料很粗略， In the developing world, the data is much sketchier, 不過死亡人數 but the death toll is almost 一定都比帳面上的還要高。 certainly higher. 各位應該要瞭解，問題就在 You know, the problem is if 流感病毒偶爾會產生 this virus occasionally mutates 劇烈的突變。 so dramatically, 本質上可將其視為一種新的病毒， it essentially is a new virus. 然後就會導致全球性大流行。 And then we get a pandemic. 1918 年，出現了一種新病毒（註：西班牙流感） In 1918, a new virus appeared 導致五千萬到一億人喪命， that killed some 50 to 100 million people. 它的蔓延速度跟野火一樣快， It spread like wildfire. 有些人在症狀顯現後數小時內即死亡。 And some died within hours of developing symptoms. 現在我們有比較安全嗎？ Are we safer today? 嗯，看起來今年 Well, we seem to have dodged 我們已經避開了 the deadly pandemic this year 很多人害怕的死亡性流感， that most of us feared, 但是這種威脅隨時可能再出現。 but this threat could reappear at any time. 好消息是， The good news is that 此時此刻， we're at a moment in time 科學、技術、全球化的匯集， when science, technology, globalization is converging 創造了前所未有的可能性。 to create an unprecedented possibility, 在傳染性疾病的預防上 the possibility to make history 我們也有創造歷史的可能。 by preventing infectious diseases 傳染性疾病所導致的死亡案例佔人類死亡總數的 1/5， that still account for one-fifth of all deaths 同時帶來無窮盡的痛苦。 and countless misery on Earth. 我們能做得到。 We can do this. 我們已經用疫苗 We're already preventing millions of deaths 拯救了數以百萬的生命。 with existing vaccines. 如果我們能提供疫苗給更多人 And if we get these to more people, 我們就能拯救更多生命。 we can certainly save more lives. 現在有許多最新、最棒的疫苗， But with new or better vaccines 像是瘧疾疫苗、肺結核疫苗、愛滋病疫苗 for malaria, TB, ***, 肺炎疫苗、痢疾疫苗、流感疫苗。 pneumonia, diarrhea, flu, 我們能阻止 we could end suffering 那從古老紀元以來就有的苦難 that has been on the Earth since the beginning of time. 所以我到這裡，來告訴各位疫苗的好處。 So I'm here to trumpet vaccines for you. 首先，我要跟各位解釋為什麼這些疫苗如此重要。 But first, I have to explain why they're important. 疫苗的威力 Because vaccines, the power of them, 非常低調。 is really like a whisper. 它們起了作用，它們創造了歷史。 When they work, they can make history, 但過沒多久， but after awhile, 你可能就很少再聽到人們討論疫苗。 you can barely hear them. 年紀稍大一點的人， Now, some of us are old enough 都應該有一個小小的圓形疤痕在我們的手臂上， to have a small, circular scar on our arms 這是我們小時候就接種的疫苗痕跡。 from an inoculation we received as children. 我們上一次害怕得天花是什麼時候？ But when was the last time you worried about smallpox, 這個在上個世紀奪走數億人命的疾病 a disease that killed half a billion people last century 就這樣消失了嗎？ and no longer is with us? 小兒痲痺，還有多少人記得鐵肺這個東西？ Or polio -- how many of you remember the iron lung? 這種情景不會再發生了， We don't see scenes like this anymore 這都是疫苗帶來的功勞。 because of vaccines. 令人感到有趣的是， Now, you know, it's interesting 目前有卅種古老的疾病 because there are 30-odd diseases 可以用疫苗來防範。 that can be treated with vaccines now, 但我們卻依然受到愛滋病和流感的威脅， but we're still threatened by things like *** and flu. 為什麼會這樣？ Why is that? 嗯，是因為有不可告人的秘密。 Well, here's the dirty little secret. 直到最近，我們還無法完全瞭解 Until recently, we haven't had to know 要如何找到有效的疫苗。 exactly how a vaccine worked. 我們是透過試誤法來尋找有效的疫苗， We knew they worked through old-fashioned trial and error. 我們培養病原體，稍微調整病原體的特性， You took a pathogen, you modified it, 然後把它注射到人或動物體內， you injected it into a person or an animal, 等看看有什麼結果發生。 and you saw what happened. 這套方法對大部分的疾病治療很有用， This worked well for most pathogens, 對付像流感這種奸詐系的病毒有時候有效， somewhat well for crafty bugs like flu, 但對會讓人類失去免疫系統的愛滋病毒而言， but not at all for ***, 這套方法完全沒用。 for which humans have no natural immunity. 讓我們來探索疫苗運作的原理， So let's explore how vaccines work. 基本上，疫苗幫助免疫系統 They basically create a cache 建立一套快取式的防禦武器， of weapons for your immune system 好讓你在需要的時候能在體內快速部屬。 which you can deploy when needed. 當你感染到病毒， Now, when you get a viral infection, 通常需要數天或數星期， what normally happens is it takes days or weeks 你身體的免疫系統才能 for your body to fight back 全力反擊， at full strength, 那時候可能就太遲了。 and that might be too late. 若你接受預防接種， When you're pre-immunized, 免疫系統因為已經接受過「事前訓練」 what happens is you have forces in your body 所以能很快辨認出該病毒， pre-trained to recognize 同時消滅它們， and defeat specific foes. 這是疫苗的功用。 So that's really how vaccines work. 讓我們先看段影片， Now, let's take a look at a video 我們選擇在 TED 大會上公開首映這個影片， that we're debuting at TED, for the first time, 影片探討有效的愛滋病疫苗該如何運作。 on how an effective *** vaccine might work. （音樂） (Music) 旁白：疫苗會事先鍛鍊身體， Narrator: A vaccine trains the body in advance 讓身體能辨認與壓制 how to recognize and neutralize 特殊的入侵者。 a specific invader. 當愛滋病病毒滲透了體內的黏膜屏障時， After *** penetrates the body's mucosal barriers, 它感染免疫細胞然後開始複製， it infects immune cells to replicate. 這些病毒的入侵 The invader draws the attention 會立刻吸引免疫系統第一道防線的注意， of the immune system's front-line troops. 樹突狀細胞，或巨噬細胞 Dendritic cells, or macrophages, 會開始追捕病毒，並公告身體各機關。 capture the virus and display pieces of it. 當愛滋病毒 Memory cells generated by the *** vaccine 接觸到免疫系統的第一道防線， are activated when they learn 過去接種的疫苗會刺激身體，產生記憶細胞。 *** is present from the front line troops. 這些記憶細胞 These memory cells immediately deploy 會立刻部屬用來對付該病毒的武器。 the exact weapons needed. 記憶 B 細胞會變成漿細胞， Memory B cells turn into plasma cells, 這些漿細胞會產生一波又一波的 which produce wave after wave 特定抗體， of specific antibodies 以纏住病毒， that latch on to *** 防止病毒感染其他細胞。 to prevent it from infecting cells T 細胞這群殺手部隊， while squadrons of killer T cells 會找出並摧毀 seek out and destroy cells 已被愛滋病病毒感染的細胞， that are already *** infected. 病毒就是這樣被打敗。 The virus is defeated. 若沒有疫苗， Without a vaccine, 身體要一星期以上，才會有前述的反應， these responses would have taken more than a week. 等到那時候 By that time, the battle against *** 這場對付愛滋病病毒的戰爭早就輸了。 would already have been lost. 非常棒的影片，對吧？ Seth Berkley: Really cool video, isn't it? 剛剛各位都在影片中看到抗體是如何作用的， The antibodies you just saw in this video, 而這些抗體是大多數疫苗帶來的成果。 in action, are the ones that make most vaccines work. 真正令人好奇的是， So the real question then is: 我們如何保證自己的身體 How do we insure that your body makes 能夠確實地產生 the exact ones that we need to protect 抵抗流感或是愛滋病的抗體？ against flu and ***? 對付這二種病毒的主要挑戰是 The principal challenge for both of these viruses 它們會一直改變， is that they're always changing. 讓我們先來觀察流感這種病毒。 So let's take a look at the flu virus. 在這個流感病毒示意圖中， In this rendering of the flu virus, 不同顏色的棘蛋白是用來感染你的武器。 these different colored spikes are what is uses to infect you. 而抗體之所以能夠捉住、中和病毒， And also, what the antibodies use is a handle 也是靠病毒上的這些棘蛋白。 to essentially grab and neutralize the virus. 當病毒突變時，它們會改變整個外觀， When these mutate, they change their shape, 讓抗體沒有辦法從外觀來辨認出病毒， and the antibodies don't know what they're looking at anymore. 這就是為什麼每一年 So that's why, every year, 你會得到稍微不同的流感病株。 you can catch a slightly different strain of flu. 這也是為什麼在春天時， It's also why, in the spring, 我們就要開始猜測 we have to make a best guess 來年的流感可能會有哪些病株， at which three strains are going to prevail the next year, 而將這些病株置入單一疫苗的製作， put those into a single vaccine 然後倉促的量產，以在秋天做好準備。 and rush those into production for the fall. 更糟的是， Even worse, 大多的普通流感、A 型流感， the most common influenza, influenza A, 也會感染給 also infects animals 跟人類相當親近的動物們。 that live in close proximity to humans, 這些病毒會在動物體內 and they can recombine 重新合成。 in those particular animals. 此外，野生水鳥 In addition, wild aquatic birds 是帶來許多已知流感病毒的 carry all known strains 源頭之一， of influenza. 大家都瞭解這種情況， So, you've got this situation. 在 2003 年 In 2003, 我們發現了 H5N1 病毒， we had an H5N1 virus 這是從鳥類轉移到人類的 that jumped from birds into humans 少數個別案例之一。 in a few isolated cases 人類感染後的死亡率高達 70%， with an apparent mortality rate of 70 percent. 幸運的是，這種特殊病毒 Now luckily, that particular virus, 雖然在當時有引起一陣恐慌， although very scary at the time, 但它不容易產生 did not transmit from person to person 人傳人的情形。 very easily. 今年 H1N1 的威脅， This year's H1N1 threat 實際上是經過人、鳥、豬的混合體， was actually a human, avian, swine mixture 並在墨西哥爆發開來， that arose in Mexico. 這種病毒在傳播上就非常容易， It was easily transmitted, 不過還好它的症狀就溫和多了。 but luckily, was pretty mild. 就某種意義上來說， And so, in a sense, 我們的運氣一直不錯， our luck is holding out, 不過野鳥可是帶著這病毒飛來飛去的。 but you know, another wild bird could fly over at anytime. 現在來看愛滋病毒， Now let's take a look at ***. 跟流感一樣有多變性， As variable as flu is, 愛滋病毒會讓小小感冒， *** makes flu 變得像個固若金湯的堡壘 (Rock of Gibraltar)。 look like the Rock of Gibraltar. 這種病毒所引起的愛滋病， The virus that causes AIDS 成為科學家到目前為止 is the trickiest pathogen 所面對最棘手的問題。 scientists have ever confronted. 它會瘋狂地變異， It mutates furiously. 釋放出誘餌以躲避免疫系統， It has decoys to evade the immune system. 同時瘋狂的攻擊體內想反抗的細胞。 It attacks the very cells that are trying to fight it. 而且它會很快地 And it quickly hides itself 躲在你的染色體裡面。 in your genome. 現在這張投影片， Here's a slide looking at 是流感和愛滋病病毒 the genetic variation of flu 基因變異程度的比較， and comparing that to ***, 你會發現愛滋病病毒的變異程度非常誇張， a much wilder target. 剛剛的影片中都有看到， In the video a moment ago, 體內被感染的細胞，會增生一批又一批的病毒艦隊。 you saw fleets of new viruses launching from infected cells. 現在的愛滋病患者 Now realize that in a recently infected person, 體內就有這數百萬的病毒艦隊， there are millions of these ships, 而且每一艘都長得不一樣。 each one is just slightly different. 要找到適當的武器， Finding a weapon that recognizes 去辨認並同時摧毀這些艦隊 and sinks all of them 是非常困難的。 makes the job that much harder. 自從 27 年前愛滋病病毒 Now, in the 27 years since *** 被確認是引起愛滋病的元兇之後， was identified as the cause of AIDS, 我們針對愛滋病所開發出來的藥物， we've developed more drugs to treat *** 比其他疾病所開發的藥品總和還要多， than all other viruses put together. 雖然這些藥還無法治癒愛滋病， These drugs aren't cures, 但它們代表了現代科學的重大勝利。 but they represent a huge triumph of science, 因為這些藥避免了 because they take away the automatic death sentence 得愛滋等於被判死刑的悲劇， from a diagnosis of ***, 至少感染者還有一線生機。 at least for those who can access them. 疫苗的開發就不一樣了， The vaccine effort though is really quite different. 大公司都不願投入疫苗研究， Large companies moved away from it 因為他們認為這方面的技術太難， because they thought the science was so difficult 而且認為疫苗是窮人生意， and vaccines were seen as poor business. 有部份的公司認為開發愛滋病疫苗是不可能的。 Many thought that it was just impossible to make an AIDS vaccine, 但今日，證據顯示事實並非如此。 but today, evidence tells us otherwise. 在 9 月的時候， In September, 在泰國的臨床實驗中， we had surprising, but exciting findings 我們得到了意外，但令人興奮的發現。 from a clinical trial that took place in Thailand. 這是第一次，愛滋病疫苗在人體上起了作用， For the first time, we saw an AIDS vaccine work in humans, 儘管效果並不顯著。 albeit, quite modestly. 這款特別的疫苗 And that particular vaccine was made 大約十年前就製造出來了。 almost a decade ago. 新的概念和過去的實驗成果結合， Newer concepts and early testing now 並從動物實驗中取得了重大的成果。 show even greater promise in the best of our animal models. 過去幾個月，科學家從愛滋病患的血液中 But in the past few months, researchers have also isolated 成功地分離出 several new broadly neutralizing antibodies 數種新的廣效中和抗體。 from the blood of an *** infected individual. 這是什麼意思？ Now, what does this mean? 我們剛提到愛滋病毒 We saw earlier that *** 是非常多變化的， is highly variable, 而這具中和力的抗體 that a broad neutralizing antibody 能夠同時拴住樣貌不同的愛滋病毒， latches on and disables 並使它們無效化。 multiple variations of the virus. 如果把這種疫苗 If you take these and you put them 注射到一個健康的猴子體內， in the best of our monkey models, 這些猴子就不會再感染愛滋病。 they provide full protection from infection. 此外， In addition, these researchers found 科學家在愛滋病毒上發現了一個特徵， a new site on *** 抗體可以抓到這個特徵。 where the antibodies can grab onto. 特別的是， And what's so special about this spot 當愛滋病毒突變時， is that it changes very little 這個特徵幾乎不會改變。 as the virus mutates. 這就像， It's like, as many times 不管病毒換穿幾件不同款式的衣服， as the virus changes its clothes, 它依舊會穿同一雙襪子。 it's still wearing the same socks, 所以我們的工作就是確保 and now our job is to make sure 讓身體討厭這些襪子就好， we get the body to really hate those socks. 我們正朝這方面努力。 So what we've got is a situation. 泰國的實驗結果告訴我們， The Thai results tell us 我們可以成功製作出愛滋病疫苗。 we can make an AIDS vaccine. 而抗體的發現 And the antibody findings 告訴我們可行的策略。 tell us how we might do that. 這個策略是由 This strategy, working backwards 抗體倒推到疫苗候選株的， from an antibody to create a vaccine candidate, 這個策略在疫苗的研發中是首例。 has never been done before in vaccine research. 我們稱之為反向疫苗學 (retro-vaccinology) It's called retro-vaccinology, 而這研究的影響 and its implications extend 不僅只於愛滋病的研究。 way beyond that of just ***. 你可以這樣想： So think of it this way. 我們已經發現了這些新的抗體， We've got these new antibodies we've identified, 而且已知這些抗體可以有效地辨認許多不同的病毒變異株。 and we know that they latch on to many, many variations of the virus. 抗體會糾纏住病毒的某部份， We know that they have to latch on to a specific part, 所以如果我們可以清楚地描繪出那部份的結構， so if we can figure out the precise structure of that part, 再透過疫苗 present that through a vaccine, 去刺激免疫系統， what we hope is we can prompt 讓免疫系統自己製造出此種抗體。 your immune system to make these matching antibodies. 使用這種方法， And that would create 能製造出廣效性疫苗。 a universal *** vaccine. 這方法聽起來比之前的簡單多了。 Now, it sounds easier than it is 就像圖中 because the structure actually looks more like 藍色的抗體， this blue antibody diagram 要去吸附那隱藏在病毒底下的黃色部份。 attached to its yellow binding site. 你們可以想像得到，要解開這些東西的立體結構 And as you can imagine, these three-dimensional structures 並不是那麼地容易。 are much harder to work on. 如果各位有能幫助我們解決這問題的點子， And if you guys have ideas to help us solve this, 我們很樂意傾聽。 we'd love to hear about it. 但是，你知道，這從愛滋病毒研究開始的反向疫苗學， But, you know, the research that has occurred from ***, now, 現在也大大地幫助了其他疾病研究的創新。 has really helped with innovation for other diseases. 舉例來說，生技公司 So for instance, a biotechnology company 目前已經找到了流感的 has now found broadly neutralizing 廣效性中和抗體， antibodies to influenza 也找到了流感病毒上可以用來鎖定的新抗體目標物。 as well as a new antibody target on the flu virus. 他們目前正在製造混合劑， They're currently making a cocktail, 一種抗體的混合劑， an antibody cocktail, that can be used to treat 可以治療非常嚴重的流感。 severe, overwhelming cases of flu. 對長期來說，他們能做的 Now, in the longer term, what they can do 就是使用反向疫苗學的工具 is use these tools of retro-vaccinology 去製造出保護性的流感疫苗。 to make a preventive flu vaccine. 在所謂循理性地疫苗設計中， Now, retro-vaccinology is just one technique 反向疫苗學只是其中地一項技術而已。 within the ambit of so-called rational vaccine design. 讓我另外跟各位舉個例， Let me give you another example. 之前提過流感病毒表面的兩種棘蛋白 We talked about before the H and M spikes 分別叫 H 棘蛋白和 M 棘蛋白， on the surface of the flu virus. 注意到表面其他較小的突點， Notice these other, smaller protuberances. 免疫系統是看不太到它們的。 These are largely hidden from the immune system. 而病毒突變時，這些小突點 Now it turns out that these spots 也不會有太大地改變。 also don't change much when the virus mutates. 若能發展出特殊的抗體，專門偵測這些小突點， If you can cripple these with specific antibodies, 你就能偵測到整個病毒。 you could cripple all versions of the flu. 目前為止， So far, animal tests indicate 動物實驗已經證明，這種疫苗可以防止重大疾病發生， that such a vaccine could prevent severe disease, 雖然接種疫苗時，可能會產生輕微的症狀。 although you might get a mild case. 因此若這疫苗在人體中也有同樣的效果， So if this works in humans, what we're talking about 那我們現在所討論的就是大一統的流感疫苗， is a universal flu vaccine, 一種不需要每年重新研發， one that doesn't need to change every year 並能移除死亡威脅的疫苗。 and would remove the threat of death. 我們真的可以把流感想像成 We really could think of flu then 比較嚴重的普通感冒。 as just a bad cold. 當然，再棒的疫苗， Of course, the best vaccine imaginable 也要能發放給所需要的人， is only valuable to the extent 才會有價值。 we get it to everyone who needs it. 為了做到這點，我們必須將 So to do that, we have to combine 最有效的疫苗設計和有效率的生產方法結合在一起， smart vaccine design with smart production methods 當然，還要有傑出的物流系統。 and, of course, smart delivery methods. 我請各位回想一下幾個月前的情形， So I want you to think back a few months ago. 2009 年六月，世界衛生組織 In June, the World Health Organization 公告了首波全球性流感， declared the first global 是 41 年來首例。 flu pandemic in 41 years. 美國政府承諾 The U.S. government promised 在流感達到高峰的十月 15 日前， 150 million doses of vaccine 會製造出一億五千萬支疫苗， by October 15th for the flu peak. 疫苗會被送到開發中國家。 Vaccines were promised to developing countries. 花費了數百萬美金， Hundreds of millions of dollars were spent 投入到疫苗的製造工廠以加速疫苗生產。 and flowed to accelerating vaccine manufacturing. 那又怎樣？ So what happened? 我們第一次 Well, we first figured out 學到如何製造流感疫苗，如何生產疫苗， how to make flu vaccines, how to produce them, 是在 1940 年代早期。 in the early 1940s. 當時的生產流程非常地笨重且速度緩慢， It was a slow, cumbersome process 那時的流感疫苗是要從 that depended on chicken eggs, 數百萬個受精雞蛋中培養， millions of living chicken eggs. 因為病毒只能在活體中成長。 Viruses only grow in living things, 經過實驗證明， and so it turned out that, for flu, 流感病毒能在雞蛋裡成長。 chicken eggs worked really well. 對多數流感病株來說， For most strains, you could get one to two doses 平均一顆蛋，可以製造 1~2 劑疫苗。 of vaccine per egg. 運氣很好的是， Luckily for us, 我們生長在這個 we live in an era of breathtaking 生物醫學超先進的時代。 biomedical advances. 恩，現在生產疫苗的來源 So today, we get our flu vaccines from ... ....... 還是雞蛋。 ... chicken eggs, （笑聲） (Laughter) 我們還是需要上億個雞蛋。 hundreds of millions of chicken eggs. 你知道，幾乎沒有改變， You know, almost nothing has changed. 你說，這方法是可依賴的。 You know, the system is reliable. 但問題是， But the problem is, you never know how well 你不知道雞蛋內的病株成長情形。 a strain is going to grow. 今年的豬流感病株， This year's swine flu strain 在雞蛋裡的生長狀況就很糟。 grew very poorly in early production, 平均一個雞蛋只能製造 0.6 支疫苗， basically .6 doses per egg. 這可響起警訊了， So here's an alarming thought. 萬一禽流感再來襲怎麼辦？ What if that wild bird flies by again? 你知道禽流感病株 You could see an avian strain 會感染成千上萬的家禽， that would infect the poultry flocks, 然後我們會連用來製造疫苗的雞蛋也沒有了。 and then we would have no eggs for our vaccines. 所以，丹‧巴伯（名廚師）， So, Dan [Barber], if you want 如果你想用大量的雞肉丸 billions of chicken pellets 來當作你的魚飼料， for your fish farm, 我知道哪兒找得到。 I know where to get them. 目前，全世界能製造三億五千萬支 So right now, the world can produce 含有三種去活化病毒株的 about 350 million doses 流感疫苗。 of flu vaccine for the three strains. 如果我們能鎖定一種病毒變異株， And we can up that to about 1.2 billion doses, 譬如像是豬流感 if we want to target a single variant 那產量可以達到一兆二千億支。 like swine flu. 但這是假設全部的工廠都在運作， But this assumes that our factories are humming 因為 2004 年時， because, in 2004, 美國的疫苗供應量減半， the U.S. supply was cut in half 只是因為一間疫苗工廠受汙染無法運作。 by contamination at one single plant. 再加上整個培養過程， And the process still takes 仍需要半年以上的時間。 more than half a year. 所以， So are we better prepared 我們現在的情況有比 1918 年好嗎？ than we were in 1918? 恩，在現代的新技術下 Well, with the new technologies emerging now, 我希望我們能肯定的說：「沒錯，比1918年好」 I hope we can say definitively, "Yes." 想像一下，如果我們能生產足夠的流感疫苗， Imagine if we could produce enough flu vaccine 並提供給全世界的人， for everyone in the entire world 而且只需要目前美國疫苗工廠的 for less that half of what we're currently spending 一半時間。 now in the United States. 在新技術的發展下，我們可以做到的。 With a range of new technologies, we could. 這裡有個例子， Here's an example. 有家公司發現， A company I'm engaged with has found 流感 H 棘蛋白上的特殊片段 a specific piece of the H spike flu 可以誘導免疫系統作用。 that sparks the immune system. 若把這片段切下， If you lop this off and attach it 並將之附著在另一個不同細菌的尾端， to the tail of a different bacterium 會導致激烈的免疫反應。 which creates a vigorous immune response, 他們已經用此製造出非常強大的流感戰士。 they've created a very powerful flu fighter. 這種疫苗的片段非常的小， This vaccine is so small, 因此能在普通的實驗用細菌 — 大腸桿菌內培養。 it can be grown in a common bacteria, E. coli. 如你所知，細菌能快速增殖。 Now, as you know, bacteria reproduce quickly. 就像做優格一樣簡單。 It's like making yogurt. 這樣，我們就能製造足夠的豬流感原病株疫苗給世界各地， And so we could produce enough swine origin flu 只需要少數的工廠生產，只需要短短的幾周 for the entire world in a few factories, in a few weeks 而且不再需要雞蛋了， with no eggs 所需要的成本也少了很多。 for a fraction of the cost of current methods. （掌聲） (Applause) 這是數種新疫苗科計的對照表。 So here's a comparison of several of these new vaccine technologies. 剛剛說到的大腸桿菌培養法， And, aside from the radically increased production 除了能讓產量激增， and huge cost savings, 成本大量下降， for example, the E. coli method I just talked about, 還有時間的節省，這也意味著能拯救更多的生命。 look at the time saved -- this would be lives saved. 開發中國家， The developing world, 排除各方異見， mostly left out of the current response, 看見了這種有潛力的替代性技術， sees the potential of these alternate technologies, 他們直接跳過西方國家的支援， and they're leapfrogging the West. 印度、墨西哥等等國家 India, Mexico and others are already 都已經研發出許多實驗性的疫苗。 making experimental flu vaccines, 這些地方也可能將會是 and they may be the first place 第一批實驗性疫苗率先施打的地區。 we see these vaccines in use. 因為這些技術非常有效率， Because these technologies are so efficient 也相對便宜， and relatively cheap, 若我們能想辦法把疫苗交到需要的人的手上， billions of people can have access to lifesaving vaccines, 那數億的人將因此得救。 if we can figure out how to deliver them. 想想看這對我們的未來有什麼樣的影響。 Now think of where this leads us. 新型的傳染病， New infectious diseases 每隔幾年， appear or reappear 就會一而再的出現。 every few years. 有一天，也許就快了， Some day, perhaps soon, 某個病毒傳染病將會威脅全人類。 we'll have a virus that is going to threaten all of us. 在數百萬的生命消逝之前， Will we be quick enough to react 我們是否有足夠的時間反應呢？ before millions die? 運氣好，今年的流感比較溫和。 Luckily, this year's flu was relatively mild. 我說「運氣好」，有部分是因為 I say, "luckily" in part 實際上在開發中國家， because virtually no one in the developing world 幾乎沒有人接種流感疫苗。 was vaccinated. 因此，若我們在政治和財務上有遠見， So if we have the political and financial foresight 持續的投資疫苗研發， to sustain our investments, 我們就能駕馭新的疫苗技術。 we will master these and new tools of vaccinology. 利用這些技術， And with these tools, we can produce 我們就能用超低的成本，製造出足以供應全人類的疫苗， enough vaccine for everyone at low cost 確保健康有益的生活。 and insure healthy productive lives. 流感不會再每年奪走 50 萬人的生命， No long must flu have to kill half a million people a year. 愛滋病 No longer does AIDS 也不會再每年奪走 200 萬人的生命。 need to kill two million a year. 窮人或是體弱的人 No longer do the poor and vulnerable 不會再被傳染病威脅生命， need to be threatened by infectious diseases 或者說，任何人都不會。 or, indeed, anybody. 不會出現瓦茨拉夫‧史米爾教授所說的 Instead of having Vaclav Smil's 「大量致命的不連續性」時期， massively fatal discontinuity of life, 取而代之的是，我們能確保 we can ensure 生生不息的生命。 the continuity of life. 當今世界需要的是這些防止疾病的新疫苗， What the world needs now are these new vaccines, 我們可以做得到。 and we can make it happen. 感謝各位的聆聽。 Thank you very much. （掌聲） (Applause) 克里斯：謝謝你 Chris Anderson: Thank you. （掌聲） (Applause) 感謝你帶來的演說。 Thank you. 科學正在劇變中， So, the science is changing. 在你心中，賽思，你一直有這樣的夢想， In your mind, Seth -- I mean, you must dream about this -- 在這樣的時間框架下... what is the kind of time scale 喔，我還是從愛滋病說起好了， on, let's start with ***, 治療愛滋的革命性疫苗，是否真的會出現？ for a game-changing vaccine that's actually out there and usable? SB：這種革命性疫苗隨時會出現， SB: The game change can come at any time 現在的問題是， because the problem we have now is 我們已能研發出提供人類使用的疫苗， we've shown we can get a vaccine to work in humans, 但我們需要更優良的疫苗。 we just need a better one. 現在有了這些新的抗體，我們知道我們可以製造出這些抗體， And with these types of antibodies, we know humans can make them. 所以，若我們能想清楚如何去做， So, if we can figure out how to do that, 我們就會得到疫苗。 then we have the vaccine. 另人感興趣的是， And what's interesting is there already is 有越來越多的證據顯示，我們即將解決這個問題。 some evidence that we're beginning to crack that problem. 所以目前的挑戰是要加快研發進度。 So the challenge is full speed ahead. CA：就你的直覺，你認為五年內能辦到嗎？ CA: In your gut, do you think it's probably going to be at least another five years? SB：很多專家都是說十年內就能， SB: You know, everybody says it's 10 years, 結果時間是十年又十年地過去了。 but it's been 10 years every 10 years. 所以，我並不喜歡為科學革新 So I hate to put a time line 訂定時間表， on scientific innovation, 但是過去的投資都開始獲利了。 but the investments that have occurred are now paying dividends. CA：愛滋病疫苗跟流感疫苗是否相似呢？ CA: And that's the same with universal flu vaccine, the same kind of thing? SB：我認為流感是不同的，我想流感的問題是， SB: I think flu is different. I think what happened with flu is 我們在流感疫苗上已經有了突破，就像我剛說的， we've got a bunch -- I just showed some of this -- 我們有很棒且實用的技術，已經準備好，隨時可以應用上。 a bunch of really cool and useful technologies that are ready to go now. 這聽起來不錯，但問題就是， They look good. The problem has been that, 我們都一直投資在傳統的生產技術上， what we did was we invested in traditional technologies 因為這套方法讓我們感到安心。 because that's what we were comfortable with. 你也可以使用免疫輔助劑，那是跟抗原混合在一起的化合物。 You also can use adjuvants, which are chemicals you mix. 這是歐洲各國正在做的，我們可以在疫苗中加入輔助劑， And that's what Europe is doing, so we could have diluted out 這樣現有的流感疫苗劑量可以提供給更多的人使用， our supply of flu and made more available, 不過，麥可‧斯佩克特曾說過（紐約時報專欄作者）， but, going back to what Michael Specter said, 反對疫苗的群眾並不希望如此。 the antivaccine crowd didn't really want for that to happen. CA：瘧疾疫苗的研發是否進度落後呢？ CA: And malaria's even further behind? SB：不，對於瘧疾，已經有種方法 SB: No, malaria, there is a candidate 在早期臨床試驗就已經展現出功效， that actually showed efficacy in an earlier trial 目前已經進入第三階段的臨床試驗， and is currently in phase three trials now. 它也許還不是完美的疫苗，但遲早會是的。 It probably isn't the perfect vaccine, but it's moving along. CA：賽思，像我們這樣的人每天都在工作， CA: Seth, most of us do work where every month 某方面來說我們都在製造某種東西， we kind of, you know, we produce something, 我們想從工作中得到某種滿足。 we get that kind of gratification. 但像你這樣的人已經在這個領域奉獻了十年， You've been slaving away at this for more than a decade, 我必須要向你和你的同事們致上敬意。 and I salute you and your colleagues for what you do. 這世界就是需要像你們這樣的人，謝謝你。 The world needs people like you. Thank you. SB：謝謝。 SB: Thank you. （掌聲） (Applause)