BY KRISTIN TOUSSAINT SOURCE: Fast Company All the times Bill Gates has warned us about a deadly pandemic like coronavirus. 3 MINUTE READ For many, the coronavirus pandemic seemed to come out of nowhere, an unexpected crisis that we couldn’t have been prepared for. But some people have actually been warning of a global pandemic—and the fact that we are largely unprepared to handle one—for years. Along with epidemiologists and even the director for medical and biodefense preparedness at the National Security Council, Bill Gates has been saying for a decade that the world was woefully underprepared for an inevitable pandemic. Here are some warnings we could have paid more attention to: 2010 Writing on his blog in January 2010, Gates brought up the H1N1 outbreak that garnered media attention the prior year. Most of the coverage made it sound dangerous, he wrote, “but the real story isn’t how bad H1N1 was. The real story is that we are lucky it wasn’t worse because we were almost completely unprepared for it.” He also referred to that outbreak as a “wake-up call” to invest in better capabilities to track and manage a deadly epidemic, “because more epidemics will come in the decades ahead and there is no guarantee we will be lucky next time.”
2015 At the annual TED conference in Vancouver, Gates gave a TED Talk bluntly titled “ The Next Outbreak? We’re Not Ready .” This talk was given in the midst of the Ebola epidemic, but Gates was already looking ahead to the next deadly illness. “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,” he said. Not preparing now would mean the next epidemic could be more devastating than Ebola. “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,” he said then, aptly predicting an element that makes COVID-19 so dangerous.
2016 In an interview with the BBC , Gates said he crosses his fingers all the time that “some epidemic like a big flu doesn’t come along in the next 10 years” because of how vulnerable the world was (and is). The Ebola and Zika crises both, he noted, showed that the global systems for responding to emergencies were not strong enough.
2017 Speaking at the Munich Security Conference , an annual conference on international security policy, Gates started his speech by saying that he was there because “our worlds are more tightly linked than most people realize,” and that means health security and international security are connected. He noted that epidemiologists have said a fast-moving airborne pathogen could kill more than 30 million people in less than a year, and could occur in the next 10 to 15 years. “I view the threat of deadly pandemics right up there with nuclear war and climate change.” he said. “Getting ready for a global pandemic is every bit as important as nuclear deterrence and avoiding a climate catastrophe.”
2018 Giving the Massachusetts Medical Society’s annual Shattuck Lecture in April 2018, Gates noted that while life has kept getting better for most of the world, “There is one area, though, where the world isn’t making much progress, and that’s pandemic preparedness.” This should concern us, he said, “because if history has taught us anything, it’s that there will be another deadly global pandemic.”
The 2014 Ebola outbreak was a wakeup call, he added; the world was too slow to respond then, so it’s important to have a coordinated global approach at the ready. “The world needs to prepare for pandemics the way the military prepares for war,” he told the medical society. In an interview with Stat around the same time, he reiterated his concern and noted that he brought it up to President Trump. (In May 2018, Trump dissolved the pandemic office at the White House.)
Gates hasn’t been all talk when it comes to his worries over a pandemic, though. In between these speeches, the Bill & Melinda Gates Foundation has funded multiple grants and research programs geared toward developing new vaccines to prevent pandemic influenza. The foundation also invested in the Coalition for Epidemic Preparedness Innovations, an international coalition that launched at Davos in 2017. Gates had even laid out a master plan to stop the next outbreak in its tracks. He wanted us to be prepared, but when it came to COVID-19, we weren’t.
Munich Security Conference
February 17, 2017
AS PREPARED Thank you, David [Miliband]. It's great to be here today. When I decided 20 years ago to make global health the focus of my philanthropic work, I didn't imagine that I'd be speaking at a conference on international security policy. But I'm here today because I believe our worlds are more tightly linked than most people realize. Here's one example. I spend a lot of my time on the effort to eradicate polio. We've made incredible progress. Of the 125 countries where polio was endemic, 122 countries have eliminated the disease. Only Afghanistan, Pakistan, and Nigeria have never been polio-free. And that's no coincidence. War zones and other fragile state settings are the most difficult places to eliminate epidemics. They're also some of the most likely places for them to begin—as we've seen with Ebola in Sierra Leone and Liberia, and with cholera in the Congo Basin and the Horn of Africa. So, to fight global pandemics, we must fight poverty, too. It's also true that the next epidemic could originate on the computer screen of a terrorist intent on using genetic engineering to create a synthetic version of the smallpox virus . . . or a super contagious and deadly strain of the flu. The point is, we ignore the link between health security and international security at our peril. Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10-15 years. It's hard to get your mind around a catastrophe of that scale, but it happened not that long ago. In 1918, a particularly virulent and deadly strain of flu killed between 50 million and 100 million people. You might be wondering how likely these doomsday scenarios really are. The fact that a deadly global pandemic has not occurred in recent history shouldn't be mistaken for evidence that a deadly pandemic will not occur in the future. And even if the next pandemic isn't on the scale of the 1918 flu, we would be wise to consider the social and economic turmoil that might ensue if something like Ebola made its way into a lot of major urban centers. We were lucky that the last Ebola outbreak was contained before it did. The good news is that with advances in biotechnology, new vaccines and drugs can help prevent epidemics from spreading out of control. And, most of the things we need to do to protect against a naturally occurring pandemic are the same things we must prepare for an intentional biological attack. First and most importantly, we have to build an arsenal of new weapons—vaccines, drugs, and diagnostics. Vaccines can be especially important in containing epidemics. But today, it typically takes up to 10 years to develop and license a new vaccine. To significantly curb deaths from a fast-moving airborne pathogen, we would have to get that down considerably—to 90 days or less. We took an important step last month with the launch of a new public-private partnership called the Coalition for Epidemic Preparedness Innovations. The hope is that CEPI will enable the world to produce safe, effective vaccines as quickly as new threats emerge. The really big breakthrough potential is in emerging technology platforms that leverage recent advances in genomics to dramatically reduce the time needed to develop vaccines. This is important because we can't predict whether the next deadly disease will be one we already know, or something we've never seen before. Without getting too technical, these new platform technologies essentially create a delivery vehicle for synthetic genetic material that instructs your cells to make a vaccine inside your own body. And the great thing is that once you've built a vaccine platform for one pathogen, you can use it again for other pathogens. You only need to substitute a few genes. That flexibility and reusability would cut the vaccine development and approval timeline significantly. And we can apply this new vaccine technology to other hard-to-treat diseases like HIV, malaria, and tuberculosis. The $550 million that launched CEPI is just a down payment. We will need considerably more support from governments to fund the R&D necessary to realize the promise of this new technology. Of course, the preventive capacity of a vaccine won't help if a pathogen has already spread out of control. Because epidemics can quickly take root in the places least equipped to fight them, we also need to improve surveillance. That starts with strengthening basic public health systems in the most vulnerable countries. This has a double benefit. It improves our ability to prevent, detect, and respond to epidemics. And it enables us to break the cycle of poverty and disease that is at the root of so much instability in the world. We also have to ensure that every country is conducting routine surveillance to gather and verify disease outbreak intelligence. And we must ensure that countries share information in a timely way, and that there are adequate laboratory resources to identify and monitor suspect pathogens. We can build on the lab network that's in place now for polio, as well as a new network of field sites and labs that will help us better understand the causes of child mortality in poor countries. The third thing we need to do is prepare for epidemics the way the military prepares for war. This includes germ games and other preparedness exercises so we can better understand how diseases will spread, how people will respond in a panic, and how to deal with things like overloaded highways and communications systems. We also need trained medical personnel ready to contain an epidemic quickly, and better coordination with the military to help with logistics and to secure areas. The Ebola epidemic might have been much worse if the U.S. and UK governments had not used military resources to help build health centers, manage logistics, and fly people in and out of affected countries. It is encouraging that global alliances like the G7 and the G20 are beginning to focus on pandemic preparedness, and that leaders like Chancellor Merkel and Prime Minister Solberg are championing health security. By the end of this year, 67 countries are expected to have completed independent assessments of their epidemic readiness. But there isn't enough money to help the poorest countries with epidemic preparation. The irony is that the cost of ensuring adequate pandemic preparedness worldwide is estimated at $3.4 billion a year—yet the projected annual loss from a pandemic could run as high as $570 billion. Pandemics are everyone's problem—and as leaders, we cannot ignore it. Imagine if I told you that somewhere in this world, there's a weapon that exists—or that could emerge—capable of killing tens of thousands, or millions, of people, bringing economies to a standstill, and throwing nations into chaos. You would say that we need to do everything possible to gather intelligence and develop effective countermeasures to reduce the threat. That is the situation we face today with biological threats. We may not know if that weapon is man-made or a product of nature. But one thing we can be almost certain of. A highly lethal global pandemic will occur in our lifetimes. When I was a kid, there was really only one existential threat the world faced. The threat of a nuclear war. By the late 1990s, most reasonable people had come to accept that climate changed represented another major threat to humankind. I view the threat of deadly pandemics right up there with nuclear war and climate change. Getting ready for a global pandemic is every bit as important as nuclear deterrence and avoiding a climate catastrophe. Innovation, cooperation, and careful planning can dramatically mitigate the risks presented by each of these threats. Indeed, the fact that fewer people die in conflicts now than at any time in human history is the direct result of choices made together by the international community—including through efforts like the Munich Security Conference. The global good will evidenced at the historic Paris Climate talks a year ago give us a chance to prevent the worst effects of climate change. The opportunity now is to extend that cooperation to pandemic preparedness. We've gotten a good start on innovation with the launch of CEPI. Reflecting on the lessons learned with Ebola, there is a shared consensus about the things we need to invest in. I'm optimistic that a decade from now, we can be much better prepared for a lethal epidemic—if we're willing to put a fraction of what we spend on defense budgets and new weapons systems into epidemic readiness. When the next pandemic strikes, it could be another catastrophe in the annals of the human race. Or it could be something else altogether. An extraordinary triumph of human will. A moment when we prove yet again that, together, we are capable of taking on the world's biggest challenges to create a safer, healthier, more stable world. Ultimately, the choice is ours. Thank you.