Frederick Balagadde 談微晶片上的生物實驗室

==================================
講者：Frederick Balagadde
2010年2月演講，2010年4月在TED上線
MyOOPS開放式課程
翻譯：洪曉慧
編輯：劉契良
簡繁轉換：陳盈
後製：洪曉慧
字幕影片後制：謝旻均
----------------
Frederick Balagadde 談微晶片上的生物實驗室
全球醫療最大的諷刺就是，最貧窮的國家卻擁有最大的疾病負擔。如果以我們國家占全球利益主體規模的比例來說，可以看到，撒哈拉以南非洲地區是愛滋病最氾濫的地區。愛滋病是當今最具毀滅性的流行病。我們還知道，這個地區最缺乏處理疾病的能力，僅有極少數醫生。坦率地說，這些國家沒有必備的資源來應付這種流行病。
所以西方國家－這些已發展國家很慷慨地提議，免費供應藥物給第三世界國家的人民；他們確實買不起這些藥物。這已拯救了數百萬人的生命，並阻止了撒哈拉以南非洲地區整體經濟崩盤。
但有一個根本問題，抹殺了與這種疾病抗爭所做的努力。因為如果不斷將藥物給予沒有醫療診斷服務的人民，最後會產生抗藥性的問題；這已經開始發生在撒哈拉以南非洲地區。這個問題已開始成為第三世界的悲劇，也很容易就會成為全球性問題。我們最不希望看到的是，愛滋病毒抗藥菌株突然出現在世界各地。因為它會使治療更加昂貴，還會使得原始愛滋病毒的具體功能恢復。
當我還是個烏干達高中學生時，親身經歷這一切。這是在90年代，正值愛滋病流行高峰，在任何[不清楚]出現在撒哈拉以南非洲之前。因為愛滋病的緣故，在這期間我失去了許多親人及教導我的老師。這成了驅策我生命熱情的動力之一，急欲想幫助找到真正的解決辦法，突顯出這些類型的問題。
我們都知道微型化的奇蹟。過去，電腦曾是佔滿整個房間，人們確實得在電腦內進行工作；但電子微型化使人們能夠將技術縮小到手機上。我敢肯定，這裡每個人都有手機；手機也確實使用於世界上偏遠地區，像是第三世界國家。好消息是，使電子產品微型化的同樣技術，現在已可使我們的生物實驗室微型化。
所以，現在我們確實可以在微流體晶片上，使生物和化學實驗室微型化。我很幸運在高中之後來到美國，能夠在這個技術方面努力，並開發出一些設備。這是一個我開發的微流體晶片，仔細觀察一下，這個技術是如何運行的？這些管道約是人類頭髮大小，必須將閥門、幫浦、攪拌器和注入閥整合在一起；所以你可以將整個診斷實驗，放置到一個微流體系統中。
我打算如何使用這個技術？就是實際使用當前最新技術，在一個微流體系統上，製造出愛滋病毒試劑。如此，只要用一個大小像iPhone一樣的微流體晶片，就可以同時實際診斷100個病人。對於每一個病人，我們將能夠進行多達 100種不同的病毒測試。僅僅4小時，就可以得出結果；比目前最先進的技術快50倍；與目前使用的方法相較之下，成本便宜5至500倍。這使我們能創造出第三世界的個人化藥物，且成本合宜；這可使世界成為一個更安全的地方。
我希望你能關心這個議題，並參與其中，推動這個願景，使它能實際施行。
感謝聆聽。
（掌聲）。
==================================
以下為系統擷取之英文原文
About this talk
Drugs alone can't stop disease in sub-Saharan Africa: We need diagnostic tools to match. TED Senior Fellow Frederick Balagadde shows how we can multiply the power and availability of an unwieldy, expensive diagnostic lab -- by miniaturizing it to the size of a chip.

About Frederick Balagadde

TED Senior Fellow Frederick Balagadde invented the micro-chemostat, a first-of-its-kind, dime-sized piece of transparent plastic that can orchestrate the behavior of living cells. Full bio and more links

Transcript

The greatest irony in global health is that the poorest countries carry the largest disease burden. If we size the countries of the globe in proportion to the subject of interest, we see that sub-Saharan Africa is the worst hit region by HIV/AIDS. This is the most devastating epidemic of our time. We also see that this region has the least capability in terms of dealing with the disease. There are very few doctors and, quite frankly, these countries do not have the resources that are needed to cope with such epidemics.

So what the Western countries, developed countries, have generously done is they have proposed to provide free drugs to all people in Third World countries who actually can't afford these medications. And this has already saved millions of lives, and it has prevented entire economies from capsizing in sub-Saharan Africa.

But there is a fundamental problem. That is, killing the efforts in fighting this disease. Because, if you keep throwing drugs out at people who don't have diagnostic services, you end up creating a problem of drug resistance. This is already beginning to happen in sub-Saharan Africa. The problem is that, what begins as a tragedy in the Third World, could easily become a global problem. and the last thing we want to see is drug-resistant strains of HIV popping up all over the world because it will make treatment more expensive, and it could also restore the [unclear] of HIV/AIDS.

I experienced this firsthand as a high school student in Uganda. This was in the 90s, during the peak of the HIV epidemic, before there were any [unclear] in sub-Saharan Africa. And during that time, I actually lost more relatives, as well as the teachers who taught me, to HIV/AIDS. So this became one of the driving passions of my life, to help find real solutions that could address these kinds of problems.

We all know about the miracle of miniaturization. Back in the day, computers used to fill this entire room, and people actually used to work inside the computers. But what electronic miniaturization has done is that it has allowed people to shrink technology into a cellphone. And I'm sure everyone here enjoys cellphones that can actually be used in the remote areas of the world, in the Third world countries. The good news is that the same technology that allowed miniaturization of electronics, is now allowing us to miniaturize biological laboratories.

So, right now, we can actually miniaturize biological and chemistry laboratories onto microfluidic chips. I was very lucky to come to the U.S. right after high school, and was able to work on this technology and develop some devices. This is a microfluidic chip that I developed. A close look at how the technology works: These are channels that are about the size of a human hair. So you have integrated valves, pumps, mixers and injectors, So you can fit entire diagnostic experiments onto a microfluidic system.

So what I plan to do with this technology is actually take the current state of the technology, and build and HIV kit in a microfluidic system, so with one microfluidic chip, which is the size of an iPhone, you can actually diagnose 100 patients at the same time. For each patient, we will be able to do up to 100 different viral loads per patient. And this is only done in four hours, 50 times faster that the current state of the art, at a cost that will be five to 500 times cheaper than the current options. So this will allow us to create personalized medicines in the Third World at a cost that is actually achievable and make the world a safer place.

I invite your interest as well as your involvement in driving this vision to a point of practical reality.

Thank you very much.

(Applause)
--------------------------------------------------------------------------------