The Next Outbreak? We’re Not Ready
Bill Gates
南京cad培训When I was a kid, the disaster we worried about most was a nuclear war. That’s why we had a barrel like this down in our bament, filled with cans of food and water. When the nuclear attack came, we were suppod to go downstairs, hunker down, and eat out of that barrel. Today, the greatest risk of global catastrophe doesn’t look like this. Instead, it looks like this. If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes. Now, part of the reason for this is that we’ve invested a huge amount in nuclear deterrents, but we’ve actually invested very little in a system to stop an epidemic. We’re not ready for the next epidemic.
Let’s look at Ebola. I’m sure all of you read about it in the newspaper, lots of tough challenges. I followed it carefully through the ca analysis tools we u to track polio eradication. And as you look at what went on, the problem wasn’t that there was a system t
hat didn’t work well enough, the problem was that we didn’t have a system at all. In fact, there’s some pretty obvious key missing pieces. We didn’t have a group of epidemiologists ready to go, who would have gone, en what the dia was, en how far it had spread. The ca reports came in on paper. It was very delayed before they were put online, and they were extremely inaccurate. We didn’t have a medical team ready to go. We didn’t have a way of preparing people. Now, Médecins Sans Frontières did a great job orchestrating volunteers. But even so, we were far slower than we should have been getting the thousands of workers into the countries. And a large epidemic would require us to have hundreds of thousands of workers.
There was no one there to look at treatment approaches; no one to look at the diagnostics; no one to figure out what tools should be ud. As an example, we could have taken the blood of survivors, procesd it, and put that plasma back in people to protect them. But that was never tried. So there was a lot that was missing. And the things are really a global failure.
university of toronto
你在眺望着谁The WHO is funded to monitor epidemics, but not to do the things I talked about. Now, in the movies, it’s quite different. There’s a group of handsome epidemiologists ready to go, they move in, they save the day, but that’s just pure Hollywood. The failure to prepare could allow the next epidemic to be dramatically more devastating than Ebola.月底英文
Let’s look at the progression of Ebola over this year. About 10,000 people died, and nearly all were in the three West African countries. There’re three reasons why it didn’t spread more. The first is that there was a lot of heroic work by the health workers. They found the people and they prevented more infections. The cond is the nature of the virus. Ebola does not spread through the air. And by the time you’re contagious, most people are so sick that they’re bedridden. Third, it didn’t get into many urban areas. And that was just luck. If it had gotten into a lot more urban areas, the ca numbers would have been much larger.fatal
routinesSo next time, we might not be so lucky. You can have a virus where people feel well enough while they’re infectious that they get on a plane or they go to a market. The sourc
e of the virus could be a natural epidemic like Ebola, or it could be bioterrorism. And so there are things that would literally make things a thousand times wor.
In fact, let’s look at a model of a virus spread through the air, like the Spanish Flu back in 1918. So here’s what would happen: It would spread throughout the world very, very quickly. And you can e there’s over 30 million people [that/who] died from that epidemic. So this is a rious problem. We should be concerned.
But in fact, we can build a really good respon system. We have the benefits of all the science and technology that we talk about here. We’ve got cell phones to get information from the public and get information out to them. We have satellite maps where we can e where people are and where they’re moving. We have advances in biology that should dramatically change the turnaround time to look at a pathogen and be able to make drugs and vaccines that fit for that pathogen. So we can have tools, but tho tools need to be put into an overall global health system. And we need preparedness.
The best lessons, I think, on how to get prepared are again, what we do for war. For soldi
ers, we have full-time, waiting to go. We have rerves that can scale us up to large numbers. NATO has a mobile unit that can deploy very rapidly. NATO does a lot of war games to check, are people well-trained? Do they understand about fuel and logistics and the same radio frequencies? So they are absolutely ready to go.
So tho are the kinds of things we need to deal with an epidemic. What are the key pieces?
First is we need strong health systems in poor countries. That’s where mothers can give birth safely, kids can get all their vaccines, but also where we’ll e the outbreak very early on. We need a medical rerve corps: lots of people who’ve got the training and background who are ready to go, with the experti. And then we need to pair tho medical people with the military, taking advantage of the military’s ability to move fast, do logistics and cure areas.
We need to do simulations, germ games, not war games, so that we e where the holes are. The last time a germ game was done in the United States was back in 2001, and it diranks>什么是自考
dn’t go so well. So far, the score is germs: 1, people: 0.
Finally, we need lots of advanced R&D in areas of vaccines and diagnostics. There are some big breakthroughs, like the Adeno-associated virus, that could work very, very quickly. Now I don’t have an exact budget for what this would cost, but I’m quite sure it’s very modest compared to the potential harm. The World Bank estimates that if we have a worldwide flu epidemic, global wealth will go down by over three trillion dollars and we’d have millions and millions of deaths.
The investments offer significant benefits beyond just being ready for the epidemic. The primary healthcare, the R&D – tho things would reduce global health equity and make the world more just as well as more safe. So I think this should absolutely be a priority.
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