Transcript
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Introduces how infectious diseases dominated human mortality in the past, especially around childbirth and war. It explains the limited medical tools available before modern bacteriology.
Speaker A
An emerging infectious diseases.
When Edna Parker was born in 1895, the world was very different.
Life expectancy in the United states was below 50 years old.
Most of the people were killed by infectious diseases.
25% of newborn delivery ended up with the death of the mother by bacterial infection.
Child mortality was high at that time.You could not find a lot of cancer, heart disease or Alzheimer's.Those are diseases of older age.And most of the people were not able to reach an older age age.
The doctors had very few tools to deal with infectious diseases.
No significant drugs were available at that time to deal with such a problem.
Here, the doctor was able to offer just sympathy for a child with a health crisis.
And the parents in the shadow understand they are about to lose the child, another child, to infectious diseases.
Speaker B
Most of recorded history is dictated by disease.During the American Civil War, for example, more soldiers died of infection than of any other cause.Thousands were wounded allowing microbes into the body, resulting in infectious disease.Because effective control measures were unknown, doctors had few ways to prevent or treat these infections.The microbes took over, the body couldn't defend itself, and the person often died delivering.Mothers of the time faced the same threat.Deaths from infectious diseases acquired during or soon after childbirth were as high as 25%.
Describes the golden age of bacteriology, virology, and immunology, and how vaccines and antibiotics increased life expectancy. It also notes how pandemics like influenza and HIV can still reverse progress.
Speaker A
However, the last 20 years of the 19th century and the first half of the 20th century were the golden years of bacteriology, virology and immunology.
We were able to develop vaccines, antibiotics, and we were able to reduce dramatically the death from infectious diseases, at least in the developed world.
And as the result of this, in 30 years, life expectancy went up by 20%.
However, This trend can be fragile.One virus which goes out of control, such as the influenza of 1918, can reduce life expectancy quite dramatically.
However, still the general trend is still up.
And this trend is taking place for quite a while here.You can say that we are still increasing life expectancy up to the level of 80 years of age and it's going up.
In hundred years.
We almost double life expectancy here in the United States and Canada.
The implication is that the world population is going up in 40 years.
From 1960 to 2000, the size of our population was doubled, and in 2040, it's going to be tripled as compared to 1960, and the trend is still up.
Not everybody enjoy the prosperity at the same level.
There is a huge gap between life expectancy in rich countries as compared to poor countries to start with.
And on top of this, third world countries, which did better for quite a while, suffered A lot because of the HIV AIDS pandemics that hit them at the most.Life expectancy over there because of AIDS went down to the level that we had during the 50s.One virus, one virus can change the trend, life expectancy in some places during some times.
The influenza of 1918 and HIV AIDS in sub Saharan Africa.
Focuses on HIV, tuberculosis, and malaria, especially in sub-Saharan Africa, and explains the scale of preventable deaths. It argues that relatively modest funding could dramatically expand access to treatment.
Speaker A
Today we are talking about approximately three important diseases that are still killing a lot of people.
First, HIV AIDS, which mainly kills people in Sub Saharan Africa, but the same region is affected at the most by another pathogen by a bacteria named tuberculosis.
So most of the people that are killed are here in sub Saharan Africa.Although we are talking about a disease that is affecting other regions as well.Mainly poor country and malaria.Again the same problem here, Sub Saharan Africa.Most of the people which are affected by malaria are in Sub Saharan Africa, the same region that suffer so much from the other two diseases.
So overall we are talking about death toll of approximately 2 to 3 million people every single year.Especially in those regions that are affected by at the most for the three diseases.We have drugs.We have drugs that can control the progression of HIV to the full blown aids.We have drugs that can reduce the effect of tuberculosis and even cure people from these bacteria.
And we have drugs that can prevent and help people that are living in this malaria rich region.
Drugs cost money.And it was calculated that additional $6 billion can provide a full medical treatment for people with tuberculosis, malaria and HIV to all countries in Africa.
This additional $6 billion are not always available, not by the local governments over there and not by the rich countries.
Just to give you the general idea, what $6 billion mean to us in the western world.Well, this is the annual budget for advertising for flavored soda or the semi annual budget for promotion and advertisement of cigarettes or funding two weeks of the useless war in Iraq that started in 2003 during the second George Bush presidency.
Our priorities are totally mixed up.
Up until 2004, drugs here against HIV were not available for most of the people in Africa.
However, later on something happened that made those drugs to be more and more available to people living in this region that suffers so much from HIV AIDS.
And the question is, what's happened here early 2000s that made us to wake up and to start to do something at the right direction.
In my opinion, the critical event that took place that started this trend is the establishment of of Bill and Melinda Gates Foundation.That's the most important event that took place in 2000.Here we are talking about billions of dollars that became available to deal with a lot of different things.Vaccinations of children in poor countries, drugs, HIV and others, they became more available.It's not just about Bill and Melinda Gates themselves.
It's a trend.And later on, Warren Buffett, which at that time was the second richest person, also gave 85% of his wealth, something like $44 billion gave them to Bill Melinda Gates foundation for them to do the right thing.
And that actually was a trend.And here even the governments of rich countries decided to do something about it as well.
So the next video you're going to see Bill Melinda Gates inviting Cameron to give for the polio eradication program.
And I want you to pay attention first to the amount of money that was given by Bill Gates on the same event, which is hundred millions, much more than Great Britain did.And also what David Cameron is talking about, the other countries which are not donating enough money for such a campaign.
Uses a Gates Foundation event and David Cameron's remarks to show how major donors and governments can support vaccination campaigns. The speaker highlights the political and financial conditions tied to aid.
Speaker C
Well, it's my great pleasure to invite to the stage Prime Minister from the UK David Cameron and my husband Bill Gates.
Speaker D
I mentioned these are tough times in terms of budgets and people will look at aid budgets as part of their review process.And that's why we need to do a good job explaining incredible things that this money can do.A country that's really set a leadership example and someone who I think personally deserves our praise for his personal role is the UK and Prime Minister David Kennedy Cameron.It's really something.And so I'm very pleased to have him here.
Oh, I should mention that our foundation is adding 100 million today to the polio campaign and that's to help close the gap.So let me bring the Prime Minister up to share his thoughts.
Speaker E
How do we take people with us as we do this?But as I've explained, I think actually disease eradication vaccination is one of the easiest things to sell to a skeptical public because you know how much a vaccine costs, you know how many people you can vaccinate, you know how many lives that you can save.And I think it's an incredibly clear argument because people worry about their tax, tax pounds or their tax dollars going in aid, they worry about corruption, they worry about dictators, and they're quite right to worry about that.But with vaccination, you can count the pounds and the pennies, the dollars and the cents, and you can count the vaccinations that take place.And what Britain is going to do is to double our commitment to the polio eradication initiative from $30 million to $60 million.
We're placing.
This will enable us to vaccinate an extra 45 million children.But we're placing two conditions on it and I think these are important.First is it is vital if we're going to eradicate polio, that we make sure vaccination becomes routine in the countries where it has been endemic.And I think it's very important we insist on good policy to follow the, the good money.The second point is this.
The second condition rather is this that we are putting in this money on the basis that each pound that goes in leverages in £5 from other donors.And I make this condition for a very good reason.We have made a difficult decision in the United Kingdom.You might have heard me this morning talking about difficult budget cuts, difficult decisions we have to make to get on top of our deficit.Yet while doing this, we are one country and sadly one of the only countries that are committed to meeting the 0.7% target of gross national income by 2013.
I think it is right, even in difficult times, that we don't break our promises to the poorest people on our planet.And I would also argue there is a strong element of self interest in this.If we give up on the aid and the trade and the development agenda, we will find the problems in those countries visited on our own doorstep.And so I hope that other leaders will be able to make this commitment and by asking that the money we are putting into polio eradication levers in money from other organizations and other countries I hope will make this happen.
Shifts to the beneficial side of microbes, explaining how they shape health from birth onward. It compares vaginal delivery and C-section babies and discusses restoring healthy microbiota.
Speaker A
So what we can learn from David Cameroon, his first, what he was doing there, giving this $60 million to the polio eradication campaign is not something that is being done by other countries so much.
And second, how much it costs to vaccinate a child, less than $2 according to his calculation.
Well, we need to think about it.
And I would say that another lesson that we learned from Gates foundation is that global village that we are all speaking about it so much is not just about buying cheap products and services from the developing countries.
The benefits of Global Village should go both directions.And yes we can.We have drugs, they should be available to anybody on this planet.And that's something that we have a long way to go.Our core thinks about health and diseases which are caused by microbes.
Such diseases have had an historical impact equal to that of all wars, revolutions, an economical crisis combined.
In the 19th century, scientists came to view microbes mainly as enemy and fought hard with good hygiene, vaccines and later on with antibiotics.
However, most microbes are not involved with any disease.And today There is a growing realization that the microscopic world is very much involved with the life of multicellular organisms like us.
That microbes and their genes are partner of each animal life from birth to adulthood.We need them in order to survive and they need us as a comfortable host.
Many of the microbes are responsible for our health.
And our body consists of approximately 30 trillion cell.
But our body inside and out is full with trillions of microbes.Most of them are our friends, helping us to digest food, to develop an appropriate immune system to keep dangerous pathogens from invading our tissues and organs.
They play a major role in keeping us healthy.
However, when the normal composition of our microbial life is thrown off balance, the human host can get into serious troubles such as obesity, inflammation, autoimmunity, allergies, mental conditions and many other health related situations.
So when we are born, we do not have microbes in the body.
The first time that we are exposed to microbes is during the delivery.
Normally we are talking about normal vaginal delivery, but today for many reasons, you can choose to have a C section cesarean section in order to deliver your baby.However, we need to know that when a baby is born by C sections, those C section born babies have more wrong microbiota related diseases such as asthma and autoimmune diseases.When a baby is born, the first exposure to microbes is from the mother.
So here, when babies are born by normal vaginal delivery, they are exposed to microbes the mother have in her vagina.
When the baby is born by C section, the baby is going to bypass the vaginal and it's going to have the first infection with microbes that are not vaginal microbes.
So the reason for the differences in the microbiota in babies who were born by normal vaginal delivery versus C section is the first exposure to microbes which are quite important.
Now during the passage of the baby in the vaginal canal, the baby acquire those microbes which will turn to be the part of the microbiota of the baby.Microbiota is the microbes that the baby normally going to have on the skin.In this situation, C section on the other hand, bypass those microbes and the microbiota of those babies is different.Less vaginal microbes such as Lactobacillus that you have here, but you cannot find them here.But more skin microbes such as Streptococcus.
This article from Nature Medicine is about a simple procedure to deal with this.We can reduce the wrong microbiota related diseases by restoration of vaginal microbiota soon after delivery.In other words, picking up microbes from the mother's vagina and exposing the baby immediately after the baby is delivered by C section.So the baby deliver by C section and immediately after it's going to be exposed mechanically to the microbes that her mother have in the vagina to start with.
So this is a simple procedure.And we know that those babies which are exposed to the vaginal microbes, even if they were born by C section, they are not going to have so much wrong microbiota related diseases.And you can also see, and that you can check a year after the delivery that the baby have on the skin also the Lactobacillus, which are important to help the baby to deal with certain conditions.
So the baby is exposed to microbes from mother's vagina, and the microbes on the baby skin years later consist of normal microbiota found normally after normal vaginal delivery.
Covers the many useful roles of microorganisms in agriculture, waste recycling, food production, and medicine. It also explains how microbes support digestion, vitamin production, and genetic engineering.
Speaker B
Though the organisms microbiologists study are extremely small, the scope of microbiology is vast, touching virtually every aspect of human existence.
In agriculture, microorganisms help break down waste and aid in the fixation of vital nitrogen in the soil that would otherwise come from chemical fertilizers.
Microbes are used to treat sewage, clean up industrial waste, and decompose the garbage in landfills.We use them to make food such as cheese and bread, and yet we do our best to eradicate them from our kitchens.
There are bacteria in our large intestine that synthesize vitamins, allowing them to be absorbed into the bloodstream.And herbivores who depend on cellulose as their major food source, can't digest it on their own.Only the bacteria in their stomach have the enzymes needed to break it down.Cows, sheep and other herbivores get their energy from the byproduct of microbes.
A very tiny minority of microbes act as pathogens or disease causing agents, representing a natural threat not only to humans, but to all life forms.We therefore attempt to control potentially harmful microorganisms to prevent infection, especially in environments such as hospitals.Microorganisms now maintain balance in the environment by playing a key role in the recycling of vital nutrients such as nitrogen, sulfur, phosphorus, carbon and oxygen.
Today, all over the world, plants depend on microorganisms to feed them nutrients.In turn, the plants supply 50% of the oxygen we breathe.The rest comes from marine microbes, especially algae and cyanobacteria.
Speaker A
So what are the beneficial role of microbes?Our environment is totally dependent on microbial life.For example, they are responsible for much of the Oxygen and organic molecules.On this planet, we have plenty of CO2.And this CO2 can be turned into organic molecule.
Organic molecule is molecules with carbon.So carbon can be picked up from CO2 and can be deposited in those type of chemicals, which later on can turn into nucleic acids, amino acids, etc.But there is something else that we need, and this is oxygen.
Oxygen.In some situations, it's a byproduct of this reaction.You have CO2, you are using the C and you are going to be left with O2.
Some bacterial cells don't like this oxygen at all.They prefer to be without oxygen, but they are making this as a byproduct.But in general, there are many type of microorganisms that are making oxygen in such a way, including those tiny small microorganisms that we have in our cells, the chloroplasts in trees.So it's kind of a bacteria in their origin which is responsible for making for us the oxygen.
Everything around you is something that was recycled from something else.
Microbes are responsible for waste breakdown from dead animals, dead trees, leaves that cover Earth every year.Well, I mean, we want them to be recycled, otherwise it's not going to take long time until they're going to cover all life form.
So microbes are very important for recycling of the dead material to make it available to be the components of new life.
So our world, it's totally dependent on the recycling ability, waste breakdown that microbes have in order to keep us as a living planet.
Other things that microbes are helping us, well, I mean, making food, microbes are responsible for making a lot of different food.One of the reasons that we became an agricultural society like 10,000 years ago, that's because of microbes.We learn how to use microbes for our purposes.So microbes, which you see them probably as this whitey stuff on the grapes, are responsible for making wine.
Yeast, well, yeast is not always coming packed in such a way, but you can find yeast everywhere.Yeast in general is helping us to make bread and also beer.Actually, you can use this in two different ways, depend on the conditions and temperature that you are using for their growth.
And cheese and other milk product, well, you can make yogurt quite easily.All you need is just the starter and then every milk that you buy in the store is going to be yogurt afterwards.So yeah, I mean the taste of the cheese is coming from the microbes that you can actually see them over here, smold as you can see it here.So that's the Taste that you have for from wine, bread and cheese and many other things.
And that's made us to be an Agricultural Society 10,000 years ago.
Other beneficial roles of microbes the normal microbiota that we have on the skin and elsewhere provide protections against more virulent microbes.When you are using antibiotics, you can see that you are killing the pathogen in some cases, but you are also coming with secondary infections that can be even more severe than the initial pathogen.Why?Because you kill the normal flora that you have on the skin or elsewhere.You don't have the protection from them any longer.
We are making drugs by using microbes.Penicillin is a product of a mold to start with.So the first penicillin was made by fermentation of mold.
Now we also have another way that we are using microbes, and this is for genetic engineering.You can express human genes in bacteria or yeast, including the insulin gene.So if in the past to treat the patient with diabetes with insulin, require extraction of the insulin from a pancreas of a dog, today you are using genetic engineering in order to make as much insulin as you wish.So insulin purified insulin is available for people that have such a condition that require them to be injected with insulin.
Microbes are responsible for making vitamins such as vitamin K in our gut.Again, when we are using certain type of long term antibiotic treatments, we can have a reduced level of vitamin K. Vitamin K is important for blood coagulation.So it is a very important vitamin that we must have.
Microbes are involved with different levels of digestion in most organisms in general.
Well, when it comes to cows, they have a very important role in the grooming of the cow.That's the first stage that the grass is being digested not by enzymes from the cow, but by enzymes from the microbes.
Explores the evolutionary relationship between microbes and their hosts, using a basement-renter analogy to explain coexistence. It then contrasts harmless microbes with dangerous pathogens.
Speaker A
So the evolution of microbes is linked to our evolution.
Many of the microbes that are infecting our body like to infect us, not something else.Those microbes see us as their home.We are the host of those microbes and they were evolved with us in many ways.For example, the temperature that they like is aware constant 37 degrees Celsius.
We need them, but they also need us.
So we will evolve in a coexistence.
And like in other coexistence situations, microbes need to keep their host alive and happy.
Well, our neighbor is renting the basement on a regular basis to residents that are living there for a year or so.
Most of them are making sure that the basement is going to be kept at the appropriate level.
So that's a typical room of a young person who is renting such a room in the basement.The person is going to stay there for a year or so.So he or she want to keep the room at the best level to allow comfortable life.
The resident probably does not want to cause any severe damage to this room.But you know, maybe some minor adjustments are required.The person maybe want to hang up some pictures so he or she will stuck few nails in the wall.But it's still small, flexible adjustment.
And yes, my neighbor had at certain point someone that make a huge destruction to the wall for some reason.
And this person was supposed to live in his room for a year.And first of all it caused such huge damage, so actually started to suffer living there.There are some bit of wind coming from the outside and they yet suffer from uncomfortable conditions during the winter.And actually the homeowner also wanted to kick him out and the resident in very few ways to protect himself.So it was easy to kick him out when the homeowner decided to do so.
So yes, I'm not talking so much about my neighbor.I'm talking about microbes and us microbes, host equilibrium.Well, we know there are microbial diseases which are quite severe.Smallpox, Ebola, rabies.Those microbes that are causing those diseases are usually affecting us in a very significant way way.
But most microbes are not causing any disease.And other which can cause a disease are doing it without killing the host.Very quickly.Let's talk about two different pathogens.One of them is tuberculosis, the other one is Ebola.
And you're going to say that while tuberculosis have a strong microbe host equilibrium, Ebola virus is not.
Compares tuberculosis, Ebola, SARS, MERS, and COVID-19 to show how pathogen aggressiveness affects transmission. The section argues that microbes often evolve toward less harmful host relationships.
Speaker A
So let's go to the tuberculosis.Tuberculosis from the point of view of the microbe, the bacteria is a very successful organism.It's around for quite a while.We know about the tuberculosis for 10,000 years.We know that today there is a lot of people infected with this pathogen.
20% of the world population, 1.7 billion people are infected with tuberculosis.
So why tuberculosis is so successful?
Well, that's a pathogen that causes a chronic disease, A disease that going to last like 30 years or so.People are infected usually during childhood and they are dead probably towards their 30s.
So this is a bacteria which have the ability to stay in their host for 30 years to infect others from the original host so it can spread.And that's exactly what this pathogen needs.In general, it's going to kill quite a lot of the infected people.But it's after this pathogen was able to get all the benefits from the host.
What about the Ebola?Ebola, it's not a successful and first, we know about this virus for only 50 years.And every time that we see an outbreak, this outbreak is killing not many people.Only few are infected, and only few are being killed after all.So the outbreak, it's quite limited geographically and also the length of the outbreak and the number of people to be infected.
Why?Because Ebola is an acute disease.
The people infected are likely to be killed shortly after the infection.We are talking about a quite aggressive virus that make people to get very, very sick very quickly to die.And again, those viruses that are causing severe diseases are not going to be very comfortable in the sick body in most of the cases.We can see some other examples.But most of the viruses that are making the person to be very sick or not going to have a good life during the time that the person is sick.Temperature goes up, for example.And beside this, you cannot really be transmitted to anybody else when you are buried six feet below the ground with your host.So that's another reason that the Ebola virus is not infecting people everywhere.It's going to infect people in certain regions.It can be controlled more easily.
What we have here is an example of a virus which is not moving very quickly because of its aggressiveness.
If the Ebola virus will turn from very aggressive virus to less aggressive virus, we can see a problem.We can see less people killed, but we have a virus that can be spread more easily.And that's similar to the connection between the coronaviruses that are infecting us in the last 20 years or so, 2003, we had SARS.The SARS scales like 10% of of the infected people confirmed cases.That's quite a lot.
And The SARS of 2003 was able to stay around for a few months and then it's grown entirely.The virus was infecting us during the beginning of 2003.And then by July 2003, it was pretty much gone from human population.You can find the SARS of 2003 in bats over there.This virus have a good equilibrium with this animal, but not with human.
People are not infected with the SARS any longer.But then we had the MERS Middle east respiratory virus, again from the same family, more aggressive than the SARS of 2003.And again, the virus can infect people.Usually it's coming from camels to people, but not many people got infected with this virus.Virus is very aggressive with like 35% of lethality versus infections confirmed cases and then COVID 19 came to our life.
Virus that infect a lot of people.But number of people which are killed by this virus compared to confirmed cases is approximately 1%.Again here we are also talking about certain age groups which are more susceptible.But when you are talking about the general population, you are going to see that this virus is not as aggressive as the MERS and the SARS of 2003.COVID 19 is going to stay.
It's not an aggressive virus.So the equilibrium between COVID 19 and the host is much better as compared to the SARS of 2003 or the MERS.
Explains natural selection in microbes and why killing the host can be a dead end for pathogens. It also returns to the downside of antibiotics, which can remove beneficial bacteria and trigger secondary infections.
Speaker A
The natural evolution of microbes operates on its spreading capacity, not on its ability to cause a disease.
Microbial natural selection, their evolution favors less or non violent microbes.As you are killing less your host, you are going to do better with this host.
The well adapted microbes can live in its host without causing significant damage.And the death of the infected host compromises the survival of the infecting microbe.
General, we can say that many severe disease is taking place.It's an accident for both the microbe and the host.
Microbes are not getting anything out of killing the hosts.And many severe infectious diseases are a failure of the microbe to adapt to its host.
From here we can say that the microbial world can be described as Dr. Jekyll and Mr. Hyde.Microbes are very important to our health, but they can also cause diseases.
So they can cause a lot of problems.And this is a conflict we face when we treat a patient with antibiotics.
They are likely to kill the good bacteria as well, not just the bad bacteria.So those bacterial cells that are responsible for our health are going to be out of the way together with the disease causing agent.But the secondary infection that can come from the disappearance of the good bacterial cells can be sometimes even more severe than what you're going to see from the original pathogen.
Concludes with major historical killers such as smallpox, the Spanish flu, and bubonic plague. It emphasizes their enormous impact on population size and the continuing relevance of infectious disease.
Speaker A
So that's about the good side of microbes.And in our course we will concentrate on those microbes that cause and infectious diseases.
And such pathogens have killed billions over the years.
For example smallpox.
Smallpox killed billions over their.And this is a virus which is effective and causing a human disease for something like 4,000 years.
We are talking about a virus that during the 20th century it was able to kill 300 million people during a time that many countries were able to eradicate this virus already.
So during the 20th century 300 million were killed from smallpox.
And that was the virus that was infecting people throughout the entire history.
It was infecting people in ancient China.4,000 years ago.It was infecting people in ancient Egypt and then made the jump to Europe and to the Americas.The Spanish influenza of 1918, 1919 killed something between 50 to 100 million people worldwide.
Well, we are talking about times that the population on this planet was less than 2 billion people.
Still, you can imagine that a significant amount of people were killed by one virus.
And we can go to the bubonic plague, Yersenia pestis, bubonic plague.It's a bacteria that was involved with the death of like third of Europe population.
The bubonic plague seems to reduce the population of the world from an estimated 40475 million people to 350 million people by the end of the following century.So in the following century we had significantly less people on this planet.
The reason that bubonic plague was so effective was probably related also to social and economical factors.That was the time that many people came from the villages to the newly developed cities.And in many cases the cities were not arranged as yet to deal with the sewage, the poverty and other issues that is related to so many people coming from one environment to another.And the bacteria was able to be transmitted to a lot of people with the help of rats that were infestating this entire environment of the new cities.And that's probably the reason that we had so many people infected and so many people killed.
Today we know that the Yersinia pestis is sensitive to antibiotics in general.So when people are coming with this infection and it's still around in some places, they are going to be treated most likely successfully with antibiotics.
But think about the overall effect of smallpox, Spanish influenza, bubonic plague on the world.Quite amazing, quite significant effect of three microbes that killed so many people.