WEBVTT

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Here's a scenario 
that I keep on questioning:

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I fall ill, I make a doctor's appointment

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and I have the appointment the next day.

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The day of the visit, the doctor
diagnoses me by observation,

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since he doesn't have
access to bodily fluids,

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and he considers two or three 
possible infections.

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Then, he either prescribes me
a broad-spectrum treatment

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to cover all eventualities,

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or, he tries an illness-specific treatment

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and if that does not work, 
it's changed at the next appointment.

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Next, he calls for blood tests.

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So, I have the blood tests 
on the morning of the third day,

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and I get the results on the fourth day.

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I call the doctor,

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and I have my second appointment
with the results on the fifth day.

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Do you know how long it takes an organism
to react to an infection?

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A few hours.

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The information we need
to tell us what is wrong with us

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is available in our blood 
within a few hours.

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But the doctor does not have access
to this information until five days later.

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It's too long, inefficient,
and it costs a lot of money.

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During my PhD thesis, which I wrote
at the University of Lille, France,

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I always thought


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that big analysis laboratories
were a bit like phone boxes of the 80s -

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it's a comparison which will speak
more to those over 30 -

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I thought that medical tests 
would go the same way

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and that we would end up having
our own self-testing kits at home.

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What I didn't understand,

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while home pregnancy tests
have been on the market since 1970,

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in 2013 we have still not
been able to apply this concept

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to infectious diseases.

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After my PhD thesis, and a period
spent at the University of California,

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I joined the University of Washington,

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where I started to work 
specifically on self-testing.

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It was then that I understood
that there were two major obstacles


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which prevent this technology
from being scaled up.

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First of all, the issue of sensitivity.

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In the majority of infections,

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the molecules we want to detect
are found in very small concentrations,

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which means that the tests 
have to be very sensitive.

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Because of this problem,
it wasn't until 2012

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that the first home testing kit
was authorised in the USA.

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That was the HIV test.

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France has only just issued 
a favourable report

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on their commercialisation 
a few weeks ago.

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The problem with these tests

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is that they are based
on a rectangular, paper test strip.

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Which is the cause of a certain
limitation on sensitivity.

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What is more, HIV tests


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can only be used
three months after infection,

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since the virus needs time to multiply
and reach sufficient concentrations,

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and in the meantime, it wreaks havoc.

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So, to avoid losing time,

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and to be able to detect 
very weak concentrations,

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we have developed a different approach
over the course of the last year.

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As usual, the true challenge of technology

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is not in finding
a solution to the problem,

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but in finding a simple solution.

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So, instead of cutting
the paper into a rectangle,

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we have cut it into a many-pointed star.

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With this principle, you just have to put 
your sample in the centre of the star,

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and the sample will separate itself
into several components.

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For example, with blood,
red blood cells will go to one side,

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and viruses, if the patient is infected,
will go to the other side.

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After separation, viruses will move
from the centre towards the points.

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Once at the points,

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the water quickly evaporates,
leaving the viruses behind to accumulate.

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This accumulation will greatly increase
the concentration of the viruses,

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which allows us to achieve sensitivities

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a billion times higher
than the traditional test.

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Once the viruses are at the points,
we have to detect them,

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and to do that, we have to use antibodies.

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And it is there where we find
the second obstacle in self-testing,

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which is the delicateness
and high cost of natural antibodies.

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So an alternative had to be found.

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To understand our work,

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you must first of all understand
how an antibody works.

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When someone is infected by a virus,

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the organism reacts
by producing antibodies.

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These antibodies are capable
of recognising and catching the virus,

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thanks to three properties:

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Firstly, the antibody has to have
spatial conformation;

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a complementary shape to the virus.

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It is somewhat similar to a key in a lock,
the key being the virus.

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Secondly, the surface of the antibody


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must have positive and negative charges
which, to put it simply,

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are the opposite of what is present
on the surface of the virus.

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So it is a very exacting phenomenon.

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And finally, the virus
must be flexible enough

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to adapt to the small variations in shape.

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The principal is very simple,
but what is complicated,

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is carrying it out on a nanometric scale.

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What you see here
is a nanoparticle of gold,

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which is 1,000 times finer than a hair.

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If you want to make a synthetic antibody
which replaces natural antibodies,

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you have to reproduce
these three properties.

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So what we have done is this:

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to make an antibody
which can recognise a virus,

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we first of all attach
the virus to this particle.

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The technique I'm describing
is called "molecular imprinting."

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So, before going onto the next step,
I'll explain in a few words.

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Think of a virus as something
which you can hold in your hand.

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If you put this virus in modelling clay
and then take it out again,

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you will leave behind an imprint
whose shape complements the virus.

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This imprint is now capable
of recognising the same type of virus,

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it's a synthetic antibody.

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So, to make a synthetic antibody
which can recognise a virus,

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firstly we attach the virus,
we then expand this polymer,

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which is a sort of modelling clay,
in order to surround the virus.

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We take the virus out,
and we get this magic imprint,

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which is able to recognise
the same type of virus.

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Why do we use gold nanoparticles for this?

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Because when the synthetic antibody 
recognises the virus,

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the nanoparticles start to collect.

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And when these particles collect,
they change colour.

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This change of colour can show up
as a coloured strip on your test.

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What I have just described

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is an example of what we can call:
preventive medical technologies.

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These technologies will help you
to understand your health risks,

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and to follow their progression
personally and in real-time.

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I have talked to you
about two technical problems

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which we have resolved in the laboratory.

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But, in fact, the true problem,
the main obstacle, is not even scientific.

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It is an obstacle which is common
to all preventive medical technologies.

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I'll quickly tell you about two more
preventive medical technologies,

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and explain where the main obstacle lies,

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and why all of that is so important
for the medicine of the future.

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The second technology
is portable devices or implants.

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To give another example,

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these days, diabetics control
their blood sugar through self-testing.

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In the future, they will have devices
implanted under their skin,

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which both measure and regulate
the physiological parameters,

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including blood sugar levels,

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and which transmit this information
to the patient's phone,

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as well as to the doctor.

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What is new and important here

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is not the fact of having
a device implanted.

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The first pacemaker was implanted in 1958,

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and that's what you see here in the heart.

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So, what is new and important,
is this capacity to collect information

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directly from this device
and send it to the doctor,

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and the fact that the doctor
can control the devices from a distance.

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It's the convergence of technologies.

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So, this technology has the potential
to completely remove patients

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from the centralised systems of hospitals,

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whilst still maintaining
a link with the doctor.

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The third and last technology
is even more impressive.

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If someone offers you a box
and tells you that inside,

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there are three illnesses
that you risk getting in your life

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if you do nothing.

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How many of you would open the box?

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Remember, this box doesn't contain
three illnesses that you're going to have,

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but the illnesses that you are 
at risk of, if you do nothing.

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In order to do something,
I, personally, would open the box.

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You've all received this box,
it's your genetic inheritance.

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We're all predisposed
to certain illnesses,

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and you have to know the risks
to prevent the consequences.

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Ten years ago, you needed
10 million dollars and several months

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to sequence a human genome.

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Today, you can do it
for 100 dollars, or 72 pounds,

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and receive a list of your
genetic predispositions in a few weeks.

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I know there are some issues
with ethics and regulation,

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but faced with the technology,
the only viable response

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is not banning it, but regulating it.

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These technologies need to be regulated,

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and I'm sure you've all seen, like me,

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that in recent years,
all the governments around the world

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are complaining about incontrollable costs
of health and social security systems.

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But with every new reform,

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we revert to the same health model,
and look for a new way of financing it.

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My belief is as follows:
it's not a budgeting problem.

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The only way for us to construct
a sustainable health model

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is to shift our focus from curative care
towards preventive technologies.

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From centralised, reactive medicine,
to personalised, preventive medicine.

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The patient must become the key player
in the monitoring of their own health.

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It's more than just
an alternative, it's a necessity.

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Thank you for listening.

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(Applause)