“What’s the greatest risk to humanity?” It’s a classic question, one that is sure to ignite debate in the lethargic too-full-to-move hours following a particularly good Sunday lunch. Hollywood likes to play on this question too, with stories featuring aliens hell-bent on destroying the world or natural disasters tearing it apart. But in a recent TED talk (see below) Bill Gates seemed to gloss over the possibility of an imminent Martian attack to instead claim that highly infectious viruses pose the greatest threat to humanity in the coming years.
OK so the lack of aliens isn’t too unbelievable, but what is interesting is how old Bill compares our vulnerability to viruses with the the threat of nuclear disaster, claiming that it’s ‘not missiles but microbes’ that we should be most worried about.
An article published in the Independent during the height of the Ebola outbreak last year reinforces this idea. This was at a time when predictions about the possible death toll were running into the millions and the public were getting frantic. The article quotes a statement from the European Leadership Network (a defence and security advocacy group) that calls for a level of international cooperation that ‘has been done in recent years on issues like the security of weapons using nuclear materials.’
So the five former UK defence secretaries who signed the statement were on the same page as Mr. Gates in elevating the disease response to the same eye-watering threat level normally reserved for WMDs. But the main part of the talk focuses not simply on the danger posed by a possible pandemic, but how we can prepare ourselves to deal with this danger most effectively in the future.
The Ebola outbreak should be used as a wake-up call, Gates claims, jolting policy-makers into taking note of the catastrophes that could be waiting just around the corner. He points to the slow response of epidemiologists and medics to the threat of the disease and the general lack of an effective response system as key failings that need to be addressed.
A piece in the New England Journal of Medicine (NEJM) allowed Gates to expand on the ideas he introduced in the brief TED talk. He describes the sluggish response to Ebola as a ‘global failure’ and criticises the World Health Organisation’s Global Outbreak Alert and Response Network as ‘severely understaffed and underfunded’.
Instead, he writes, we are in desperate need of a new, effective warning and response system, which would:
- be coordinated by a well-funded global institution
- improve detection and early warning systems
- incorporate a reserve corps of volunteers and trained personnel
- strengthen the health systems in low-income countries
- use ‘germ games’ to identify weaknesses in the system
Gates talks enviously about the logistical capabilities of the military and their ability to respond rapidly to any global threat. Ebola has taught us that we are some way away from achieving this kind of response, but some of the above points, such as a reserve corps and early warning systems, would bring the system closer to the mark.
You might now be thinking “what does Bill Gates know? He’s not a virologist!” Although this may be true, few individuals can claim to have had such a direct impact on global disease as Bill Gates, through his charity the Bill and Melinda Gates Foundation. The charity works with partner organisations all over the world to tackle existing threats such as HIV and malaria, as well as implementing measures to prevent disease outbreaks in the future.
As the second richest man in the world, if there’s something Bill Gates definitely does know about, it’s money. In his NEJM article, he references a projection made by the World Bank that puts the cost of a severe flu pandemic at $3 trillion in global economic losses (that’s a staggering 4.8% of GDP). In the same document, the World Bank puts the estimated cost of implementing the global infrastructure we so desperately need at $3.4 billion per year in all developed countries, with an expected benefit of at least $37 billion per year. Now that sounds like a Bill Gates-style investment.
Overall then, it’s clear that we need to start treating the threat of a pandemic in a similar way to the threat of a war. The enemy may be quite a lot smaller and distinctly less human, but that does not make it any less relevant or deadly. We need to switch the perspective and start thinking of the time periods between major pandemic threats as ‘peace-time’, and use them to build up the necessary systems to ensure that we are ready when the inevitable battles commence.