WEBVTT

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Antibiotics were the wonder drugs
of the 20th century.

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Now, amazingly antibiotics are responsible

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for extending the average human life
about ten years.

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But we are currently in the middle
of a global crisis where

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antibiotics are loosing their effectiveness

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against infectious diseases.

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The headlines, if you can see them,
are very alarming.

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Bacteria are rapidly becoming resistant

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to all of the antibiotics that we currently use.

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Now, in order to understand
the nature of this problem,

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you have to understand bacteria.

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We live in a world filled with bacteria.

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Bacteria are everywhere.

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Everything that you look at,

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everything you touch,

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everything you put in your mouth,

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everything you sit on

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is covered with millions and millions of bacteria.

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They're so small

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that you can't see them
without a microscope.

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But they're there.
And they are literally everywhere.

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You can find them at the bottom
of the deepest part of the ocean.

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You can find them
at the top of the tallest mountain.

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You can even find them
in the polar ice caps.

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They can live in places
where there is no sunlight,

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no oxygen, no food.

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They can grow in radioactive waste,

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and in toxic chemicals,

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and in boiling hot springs.

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When bacteria find a place
where they can survive,

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they'll multiply fast to very high numbers.

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Now, one of the places
that bacteria like to call home

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is the human body.

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A recent survey by microbiologists

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identified over ten thousand different microbes

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that live on, or in the human body.

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In fact, there are more bacterial cells in you

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than there are human cells.

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And there are more bacteria genes in you

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than human genes.

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So you can argue that each one of you

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is actually more bacterium
than you are human.

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(Laughter)

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So, now we have established that

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I am talking to a room full of bacteria --

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(Laughter)

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-- I'm going to flatter the audience
here a little bit

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and tell you that bacteria
are amazing organisms.

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And one of the things
that makes them so amazing

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is their ability to share genes
with each other.

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Now, I need to describe this a little bit more.

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Because this lies at the heart of how

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bacteria become resistant to antibiotics.

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And I don't have any slides,

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so I'll have to describe it to you.

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As you probably know:

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Who you are lies in your genes.

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So, for example,
if you're tall or you have blue eyes

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is because you have genes
that make you tall

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or that give you blue eyes.

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And likewise bacteria that can live
in Antarctica

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have genes that make them resistant
to the cold.

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And bacteria that are not killed by penicillin

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have genes that make them resistant
to penicillin.

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So where did these genes come from?

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Well, you are familiar with humans,

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who are born with a set of genes,

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that they inherit from their parents.

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And they keep the same genes
until the day that they die.

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So, for example, if you're born
with brown eyes,

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even if you wish that you have blue eyes,

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your eyes will remain brown
until the day that you die.

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Because these were the genes
that you born with.

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But this is not true for bacteria,

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who are in a habit of sharing
genes with each other

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in some pretty incredible ways.

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And one of the ways

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the bacteria will share genes
with each other,

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is through picking genes up
from their surroundings.

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And they usually do this after
one of their neighbors has died.

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So we're going to refer to this technique
as the funeral grab.

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OK, bacteria Number 1 dies

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and releases it's genes
into the surroundings,

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and now bacteria Number 2
will pick up some of these genes

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and pull them in.

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So now bacteria Number 2
can do something

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that previously
only bacteria Number 1 could do.

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So this is equivalent
of you going to the funeral

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of someone who had blue eyes,

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taking a piece of their body out of the casket

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and eating it.

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And hey! You have blue eyes too.

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But now imagine that instead of blue eyes,

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you now are resistant to tetracycline.

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Another way that bacteria have

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to share genes is through viruses.

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So, yes, bacteria get
their version of the flu too.

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And there are a lot of viruses
that will infect bacteria.

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So, we're going to call this technique:
the viral pass.

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A virus will infect bacteria Number 1

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and pick up some of its genes,

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and then inject these genes
into bacteria Number 2.

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Now bacteria Number 2
can do something

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that previously only bacteria Number 1
could do.

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So this is the equivalent
of you catching the flu

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from someone who has blue eyes.

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And after catch the flu,
your eyes turn blue too.

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But, now imagine that instead of blue eyes,

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you're now resistant to methacycline.

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And the third way that bacteria share genes
is through sex.

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So, yes, bacteria have sex too.

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And they're actually pretty promiscuous.

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So, we're going to refer to this technique

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as makin' whoopee.
(Laughter)

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So bacteria Number 1, the donor,

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builds a bridge to bacteria Number 2,
the recipient,

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through which genes are passed

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from the donor to the recipient -

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much like sexual activity you're familiar with.

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But at the end of this sexual activity,

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bacteria Number 2
can now do something,

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that previously only bacteria Number 1
could do before sex.

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So this is the equivalent of having sex
with the blue-eyed partner.

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And after sex, you eyes turn blue too.

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(Laughter)

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But now imagine instead of blue eyes,

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now you are resistant to vancomycin.

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(Laughter)

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So you see bacteria have lots of ways

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to share genes among each other.

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And with over ten thousand
different types of bacteria

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in the human body alone,

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not to mention the millions
of bacteria everywhere that you look,

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this is a huge community

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that's sharing antibiotic-resistant genes
with each other.

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So, now in order to understand
antibiotic resistence,

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you have to understand
how antibiotics actually work.

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So, in many ways bacteria
are very different than humans.

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And what this means is they have
a lot of components

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that can be target by specific chemicals.

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So antibiotics are fantastic drugs.

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Because they can kill bacterium
without harming the human

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by recognizing something very specific
in the bacterium

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and not the human.

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They work like a key and a lock,

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very specifically finding and binding their target

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which leads to inactivation of the bacterium.

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But bacteria have evolved a number

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of different defensive maneuvers

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to avoid being killed by antibiotics.

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So we're going to talk about three ways

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that bacteria can become resistant.

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And the first way
we are going to call the "up-chuck".

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The antibiotic targets something specific

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inside the bacterial cell.

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But as soon as the antibiotic gets inside,

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the bacterium barfs it right back out.

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Preventing it from finding its target.

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This is a technique that bacteria use

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to be resistant to tetracycline.

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Another way we're going to call
the "stealth mode".

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So the antibiotic recognizes something
specifically again in the bacterial cell.

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So the bacterium changes
the target just enough,

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so that the antibiotic no longer recognizes it.

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The target is in stealth mode.

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The antibiotic has no effect.

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And the bacterium is resistant.

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This is a technique that bacteria use

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to be resistant to streptomycin.

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And the third way we're going to call
"the ballistic missile defense".

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The bacteria makes a type of weapon

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that goes out and finds the antibiotic

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before the antibiotic can find its target.

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The bacterium sends out waves of this missiles

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that breakdown the antibiotic

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and allow the bacterium to survive.

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So this is a technique that bacteria actually use

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to be resistant to penicillin.

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So you can see that the bacteria have

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lots of simple and effective ways

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to avoid being killed by antibiotics,

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that include things like:
upchucks, stealth modes

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and ballistic missiles.

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And the genes for these
antibiotic resistant mechanisms

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are shared among the bacteria.

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Through funeral grabs, viral passes,
and makin' whoopee.

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So remember the important atributes
of bacteria:

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they are small,

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they multiply fast,
and they share genes.

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Your body is chock-full

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of millions of good, innocent bacteria,

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that cause you no harm,

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they live in a peaceful
gated community inside of you.

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(Laughter)

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But now let's imagine that

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some bad bugs
move into this neighborhood,

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and start causing trouble,
being obnoxious,

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playing loud music,
trashing the neighborhood.

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You feel sick.

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You go to the doctor.

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You get some antibiotics,
and you take them.

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The antibiotics kill off
most of the bad bugs

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and a lot of good bugs as well.

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So now you're feeling better,

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so you stop taking the antibiotics
before the doctor prescribed.

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So what happens next?

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Well, let's say that one of the good bacteria
was already resistant.

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So when half of the neighborhood dies off

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from this antibiotic armageddon,

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it multiplies fast to occupy
all the empty houses.

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As in any war, in order to win,

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we need to develop new
and more powerful weapons

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to fight and defeat them.

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And the time to invest
in new antibiotic is now,

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before we're completely out of weapons.

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This needs to be a continuous,
sustained effort.

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One that really should be considered

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a global health arms race.

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With funding support,

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new antibiotic
can be developed continuously,

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and released continuously into the market.

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As you can now appreciate,

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it is inevitable bacteria will eventually
become resistant to the next antibiotic.

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But by this time,
the next antibiotic will be ready.

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A sobering thought is that

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a number of people in this room

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are only here today,

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because antibiotics saved your lives

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at some point in the past.

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We need to avoid returning
to the pre-antibiotic era,

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where common bacterial infections,

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resulting from things like a cut,
or a scratch,

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or a struck throat,

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could sometimes be a death sentence.

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In this manner, with new antibiotics,

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we can maintain the upper hand

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against the rise of the superbugs.

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Thank you.

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(Applause)