B1 · Intermediate
11 min
global healthinfectious diseasevaccine developmenthumanitarian crisis
Seventy Thousand Vials, One Impossible Delivery
La vacuna existe. Llegar allí es otra historia.
The WHO has announced that seventy thousand doses of an Ebola vaccine are headed to the Democratic Republic of the Congo. Fletcher and Octavio go past the headline: the long history of the virus there, the scientific miracle of having a vaccine at all, and why getting it to the right people remains one of the hardest problems on earth.
La Organización Mundial de la Salud anuncia que setenta mil dosis de la vacuna contra el ébola van a llegar a la República Democrática del Congo. Fletcher y Octavio van más allá del titular: hablan de la historia del virus en el Congo, del milagro científico de tener una vacuna, y de por qué llevarla a las personas correctas sigue siendo uno de los problemas más difíciles del mundo.
6 essential B1-level terms from this episode, with translations and example sentences in Spanish.
| Spanish | English | Example |
|---|---|---|
| brote | outbreak; sprout | El brote de ébola comenzó en el este del país. |
| vacuna | vaccine | La vacuna protegió a casi todas las personas que la recibieron. |
| confianza | trust; confidence | Sin la confianza de la comunidad, es muy difícil responder a una epidemia. |
| cadena de frío | cold chain | Mantener la cadena de frío es uno de los problemas más grandes en la distribución de vacunas. |
| combatir | to combat; to fight against | Los trabajadores de salud combatieron el brote con pocos recursos. |
| repentino | sudden | La aparición repentina de la enfermedad sorprendió a todos. |
There was a line buried in a news dispatch this morning that I keep coming back to.
Seventy thousand doses of an Ebola vaccine, heading to the Democratic Republic of the Congo.
And my first reaction was, wait, we have an Ebola vaccine?
Sí, Fletcher, tenemos una vacuna.
Yes, Fletcher, we have a vaccine.
Se llama ERVEBO y Merck la desarrolló hace algunos años.
It's called ERVEBO and Merck developed it some years ago.
Pero tienes razón en que mucha gente no lo sabe.
But you're right that many people don't know this.
The WHO is coordinating this shipment to fight what they're calling a new outbreak.
But here's what I want to understand, because this isn't the first time the Congo has dealt with this.
How many times has this happened?
El Congo tuvo más de diez brotes de ébola entre 1976 y hoy.
The Congo has had more than ten Ebola outbreaks between 1976 and today.
El primero fue en 1976, cerca del río Ébola.
The first was in 1976, near the Ebola River.
Por eso el virus tiene ese nombre.
That's why the virus has that name.
Named after a river.
There's something almost poetic and terrible about that at the same time.
Exacto.
Exactly.
Y el Congo es un lugar especial para el ébola, no solo por la historia.
And the Congo is a special place for Ebola, not just because of history.
Es que el virus vive en animales del bosque, y la gente que vive cerca del bosque tiene contacto con esos animales.
The virus lives in forest animals, and people who live near the forest have contact with those animals.
The reservoir host question.
Scientists still aren't entirely certain which animal species it primarily lives in, though bats are the leading candidate.
This has been one of the central frustrations in Ebola research for fifty years.
Sí, y mientras no sabemos dónde vive exactamente, no podemos parar el problema desde el principio.
Yes, and while we don't know exactly where it lives, we can't stop the problem from the start.
Solo podemos responder cuando aparece en personas.
We can only respond when it appears in people.
Which is a reactive posture, not a preventive one.
I covered the tail end of the West Africa outbreak in 2014, 2015.
That was a different beast entirely in terms of scale.
Sí, ese brote fue el más grande de la historia.
Yes, that outbreak was the largest in history.
Más de once mil personas murieron.
More than eleven thousand people died.
Fue en Guinea, Sierra Leona y Liberia, no en el Congo.
It was in Guinea, Sierra Leone, and Liberia, not the Congo.
Pero ese brote cambió todo para la ciencia.
But that outbreak changed everything for science.
Because that's when the pressure to develop a vaccine became impossible to ignore.
You had a disease with a fifty percent fatality rate spreading through cities, not just remote villages.
Correcto.
Correct.
Y Merck desarrolló ERVEBO durante el siguiente brote grande, que fue en el Congo entre 2018 y 2020.
And Merck developed ERVEBO during the next major outbreak, which was in the Congo between 2018 and 2020.
Ese brote fue el segundo más grande de la historia, con más de dos mil muertos.
That outbreak was the second largest in history, with more than two thousand dead.
And they actually deployed the vaccine during that outbreak, before it was fully licensed in some countries.
That's genuinely unusual in vaccine history.
Sí, fue una situación de emergencia.
Yes, it was an emergency situation.
La vacuna funcionó bien.
The vaccine worked well.
Los datos mostraron que protegió a casi todas las personas que la recibieron.
The data showed it protected almost everyone who received it.
Fue un momento importante para la medicina.
It was an important moment for medicine.
So the science worked.
Which makes you want to ask the obvious question: if we have an effective vaccine, why are we still having outbreaks that require emergency shipments of seventy thousand doses?
Bueno, porque la vacuna tiene problemas prácticos.
Well, because the vaccine has practical problems.
Primero, necesita temperaturas muy frías para conservarse bien.
First, it needs very cold temperatures to stay good.
Antes necesitaba entre menos sesenta y menos ochenta grados.
Before, it needed between minus sixty and minus eighty degrees.
Eso es muy difícil en el Congo.
That's very difficult in the Congo.
The cold chain problem.
Which anyone who followed the COVID vaccine rollout will remember.
But negative sixty to negative eighty degrees in a country where reliable electricity is already a challenge in many areas, that's not a logistical hurdle, that's a wall.
Ahora hay una versión nueva que necesita temperaturas menos extremas.
Now there's a new version that needs less extreme temperatures.
Eso ayuda mucho.
That helps a lot.
Pero el segundo problema es más difícil: el conflicto armado.
But the second problem is harder: armed conflict.
The eastern Congo specifically.
There are dozens of armed groups operating in North Kivu and South Kivu, some of them have been fighting for twenty-five, thirty years.
And the 2018-2020 outbreak was centered right in that region.
Exacto.
Exactly.
Los trabajadores de salud no podían llegar a algunos pueblos porque era peligroso.
Health workers couldn't reach some villages because it was dangerous.
A veces los atacaron.
Sometimes they were attacked.
Hubo trabajadores de salud que murieron durante esa respuesta.
There were health workers who died during that response.
That detail doesn't get enough attention.
We talk about vaccines and logistics, but the human dimension, people going into active conflict zones with a cooler full of vials, that takes a particular kind of courage.
Y después hay un tercer problema, que quizás es el más complicado de todos.
And then there's a third problem, which is perhaps the most complicated of all.
La confianza.
Trust.
En 2018, muchas personas en el Congo no confiaban en los trabajadores de salud extranjeros.
In 2018, many people in the Congo didn't trust foreign health workers.
Tell me more about that, because this is something I find genuinely puzzling from the outside.
You have a deadly disease, someone arrives offering a free vaccine, and people refuse.
What's driving that?
Mira, la historia explica mucho.
Look, history explains a lot.
El Congo tiene una historia larga de extranjeros que llegaron y tomaron cosas, no que dieron cosas.
The Congo has a long history of foreigners who came and took things, not gave things.
La gente tenía miedo.
People were afraid.
Algunos pensaban que la vacuna era en realidad el virus.
Some thought the vaccine was actually the virus.
Colonial memory embedded in public health responses.
Which sounds abstract but it's completely concrete: it meant people were dying from a preventable disease partly because of distrust rooted in things that happened generations earlier.
Sí, y no es solo historia antigua.
Yes, and it's not just old history.
El Congo fue una colonia belga con condiciones muy crueles.
The Congo was a Belgian colony with very cruel conditions.
Y en el siglo veinte hubo experimentos médicos en África sin el permiso de la gente.
And in the twentieth century there were medical experiments in Africa without people's permission.
La memoria de eso todavía existe.
The memory of that still exists.
This came up during COVID too, and not just in the Congo.
Vaccine hesitancy in certain communities in the United States, in France, in Brazil, some of it traces back to real documented abuses.
It's not irrational fear, it's historically informed suspicion.
Totalmente de acuerdo.
Totally agree.
Y la respuesta correcta no es ignorar esa desconfianza.
And the right response isn't to ignore that distrust.
La respuesta es trabajar con la comunidad, usar trabajadores de salud locales, personas que la gente ya conoce y respeta.
The response is to work with the community, use local health workers, people that the community already knows and respects.
Which is slower and more expensive than just showing up with a cooler and a needle.
But apparently it works.
Funciona mucho mejor.
It works much better.
Y la estrategia de vacunación que usaron se llama vacunación en anillo.
And the vaccination strategy they used is called ring vaccination.
No vacunas a todo el mundo al mismo tiempo.
You don't vaccinate everyone at the same time.
Primero identificas a una persona infectada y vacunas a todos las personas cerca de ella.
First you identify an infected person and vaccinate everyone close to them.
Ring vaccination.
Like drawing a circle around the fire before it spreads.
They used a version of this to eradicate smallpox in the seventies, it's a beautifully elegant public health idea.
Exactamente.
Exactly.
Y con el ébola es especialmente útil porque el virus no se transmite antes de que la persona tiene síntomas.
And with Ebola it's especially useful because the virus doesn't spread before the person has symptoms.
Entonces puedes encontrar los contactos de la persona enferma y vacunarlos a tiempo.
So you can find the contacts of the sick person and vaccinate them in time.
Unlike COVID, where you could be infectious before you felt sick.
Which made ring vaccination almost impossible to use there.
The biology of each disease shapes what's possible.
Sí.
Yes.
Entonces ahora la pregunta es: ¿setenta mil dosis son suficientes?
So now the question is: are seventy thousand doses enough?
Probablemente no para toda la población en riesgo.
Probably not for the entire at-risk population.
Pero es un buen comienzo si las usan bien, con la estrategia correcta.
But it's a good start if they use them well, with the right strategy.
The DRC has a population of over a hundred million people.
Even if the outbreak is geographically contained, seventy thousand doses sounds modest against that backdrop.
Sí, pero el ébola no se extiende como la gripe.
Yes, but Ebola doesn't spread like the flu.
Se necesita contacto directo con los fluidos de una persona enferma.
You need direct contact with the fluids of a sick person.
Entonces la estrategia de anillo puede funcionar con ese número si la logística es buena.
So the ring strategy can work with that number if the logistics are good.
And there we are back at logistics.
Which is what makes me think the real story here isn't the vaccine itself.
The real story is the gap between a scientific solution existing and that solution reaching the people who need it.
That gap is political, economic, historical.
Completamente.
Completely.
Y eso no va a cambiar con una vacuna sola.
And that's not going to change with a vaccine alone.
El Congo necesita sistemas de salud más fuertes, más hospitales, más trabajadores de salud locales bien pagados.
The Congo needs stronger health systems, more hospitals, more well-paid local health workers.
La vacuna es importante, pero es solo una parte.
The vaccine is important, but it's just one part.
And yet, let's not undersell what happened.
Twenty years ago there was no vaccine at all.
The fact that ERVEBO exists, that it's effective, that seventy thousand doses can be mobilized in response to an outbreak, that's genuinely different from where we were.
Sí, eso es verdad.
Yes, that's true.
Y creo que la lección más importante es esta: cuando el mundo invierte en ciencia y en preparación, los resultados llegan.
And I think the most important lesson is this: when the world invests in science and in preparation, results come.
El problema es que el mundo solo invierte en serio después de una crisis grande.
The problem is that the world only invests seriously after a big crisis.
Which is structurally insane if you think about it for thirty seconds.
Prevention is always cheaper than response.
But prevention is invisible and response is a headline.
Exactamente.
Exactly.
Y mientras tanto, en el Congo, hay personas que esperan esas setenta mil dosis.
And in the meantime, in the Congo, there are people waiting for those seventy thousand doses.
Espero que lleguen rápido y que funcionen bien.
I hope they arrive quickly and work well.
Octavio, I want to pick up on something you said earlier that I've been sitting with.
You used the word 'brote' for outbreak.
And my brain keeps trying to connect that to something in English but I can't quite get there.
Ah, sí.
Ah, yes.
'Brote' es una palabra interesante.
'Brote' is an interesting word.
Normalmente significa el comienzo de una planta, como cuando una planta empieza a crecer en primavera.
Normally it means the beginning of a plant, like when a plant starts to grow in spring.
Pero también usamos la misma palabra para una enfermedad que aparece de repente.
But we use the same word for a disease that appears suddenly.
So a disease outbreak and a plant sprouting are the same word in Spanish.
That's almost poetic.
English does something similar, 'outbreak' has that same sense of something bursting through the surface.
Sí, los dos idiomas piensan en la enfermedad como algo que 'sale' o 'crece'.
Yes, both languages think of disease as something that 'comes out' or 'grows'.
También puedes decir un brote de violencia, un brote de protestas.
You can also say a brote of violence, a brote of protests.
Siempre es algo que aparece de manera repentina.
It's always something that appears suddenly.
So next time I'm confidently mispronouncing something at a Spanish dinner table, at least I'll be able to correctly say that a 'brote' is happening.
Progress, Octavio.
Genuine progress.
Sí, Fletcher, es progreso.
Yes, Fletcher, it's progress.
Aunque todavía recuerdo muy bien el día que dijiste 'muy embarazado' a mi madre.
Although I still remember very well the day you said 'muy embarazado' to my mother.
Ese fue un brote de algo diferente.
That was a brote of something different.