The next outbreak? We’re not ready | Bill Gates

Translator: Luan Morina Reviewer: Besiana Zekaj When I was a child, the greatest danger we feared was nuclear war. That's why we keep a barrel like this in the basement, full of food and water. When the nuclear attack happened, we would go to the basement, sit down and feed ourselves from that barrel. Today, the greatest risk of a global catastrophe does not seem so. But it seems that if there is any cause for the deaths of 10 million people in the coming decades, it will most likely be a highly infectious virus and not a war. Not rockets, but microbes.

One of the reasons this happens is that we have invested a lot of money in preventing nuclear attacks. But we have invested very little in epidemic prevention systems. We are not prepared for the

next

epidemic. Let's look at Ebola. I'm sure you've all read about it in the papers, lots of difficult challenges. I followed it carefully using case analysis tools that we used to eradicate polio. And when you look at how the process went, the problem wasn't that there wasn't a system that didn't work well enough, the problem was that we didn't have a system. In fact, some basic things were missing.

We didn't have a group of epidemiologists

ready

to go see what the disease was and how far it had spread. Case reports appeared in newspapers. They took a long time to connect and were very inaccurate. We did not have a medical team

ready

. We had no way to prepare people. Now, Doctors Without Borders did a great job with volunteering. But still, we were much slower than we dared to send thousands of workers to these countries. And a widespread epidemic would require hundreds and thousands of workers. There was no one to control the provision of treatments. Nobody for diagnoses.

Nobody knew what tools to use. For example, we could have taken the blood of survivors, processed it, and returned that plasma to humans to protect them. But this was not even attempted. So many things were missing. And these things are actually a global failure. The WHO is funded to monitor epidemics, not to do what I said. It's different in the movies. There are some beautiful epidemiologists ready for action, go save them, but this is Hollywood. If they do not prepare, the

next

epidemic could be much more devastating than Ebola. Let's look at the progress of Ebola this year.

Some 10,000 dead, and almost all in just three West African countries. There are three reasons why it was not expanded further. The first is that there were enough heroic workers in the health sector. They found the people and prevented further infections. The second is the nature of the virus. Ebola does not spread through the air. And when a person is infected, most of those affected are in bed. Thirdly, it did not spread much in the cities. And that was just luck. If it had spread to the cities, the number of people affected would have been much higher.

So next time we might not be so lucky. There may be viruses where people feel so good while infected that they get on a plane or go to the grocery store. The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism. Then there are things that would make the situation a thousand times worse. In fact, let's see how the virus spreads through the air, like the Spanish flu in 1918. So this is what will happen: it will spread around the world very, very quickly. And we can see more than 30 million people dead because of this epidemic.

So it's a serious problem. We should be worried. But we can actually build a very good management system. We have the benefits of science and technology that we talk about here. We have mobile phones to inform the public and inform the public. We have satellite maps where we can see where people are and where they are going. We have advances in biology that dramatically change the time for researching the cause of disease and making drugs and vaccines against that cause. So we have the tools, but these tools must be incorporated into the global health system. And we must be prepared.

However, I think the best lessons on how to prepare are the ones we learn for war. We have regular soldiers, always ready for war. We have reserves in large quantities. NATO has a mobile unit that can be activated very quickly. Does NATO conduct many war exercises to control the trained? Do they know enough about fuel and logistics, as well as radio frequencies? Then they are ready for action. These are things we have to deal with in an epidemic. What are the main things? First, we need a strong health system in poor countries. System where mothers can give birth safely, where children can be vaccinated.

But also where we can notice a very early epidemic

outbreak

. We need medical reserve corps: many trained and informed people, ready for action and experienced. And then we have to connect the doctors with the military, using the military to move quickly, establishing logistics and securing areas. We need simulations, germ games, not war games, to be able to see where the deficiencies are. The last time such an exercise was conducted in the United States was in 2001 and it didn't go so well. So far the result is microbes: 1, humans: 0. In the end, a lot of advanced research and development is needed for vaccines and diagnostics in these areas.

There are some very advanced viruses, like the glandular virus, that I can run very, very quickly. Now I don't have the exact estimate for its cost, but I'm pretty sure it's very modest compared to the potential damage. The World Bank estimates that if we have a global flu epidemic, global wealth will fall by more than three trillion dollars and we will have millions and millions of deaths. These investments offer significant benefits beyond epidemic preparedness. Basic healthcare, research and development could reduce global health inequality and make the world even safer. So, I think it should be a top priority.

There is no need to panic. We don't need to pile up spaghetti and hide in the basement. But we have to start, because time is not on our side. Unfortunately, if there is something positive about the Ebola epidemic, it is that it can serve as a warning, as a last call, to prepare. If we start now, we will be prepared for the next epidemic. Thank you. (Applause)