Bill Gates: Infectious disease must be attacked like war
This article was originally published in Scrip
There is a significant chance an epidemic much more infectious than Ebola could occur sometime in the next two decades and the world's health systems are unprepared to handle it, warned computer mogul-turned-philanthropist Bill Gates.
Even if the system the world has today had worked perfectly for the Ebola outbreak, in which nearly 25,000 people have been infected and about 10,200 have died, it would fail to contain a more infectious disease, like a flu pandemic, Mr Gates said in dual op-eds in the New England Journal of Medicine and the New York Times.
Because there was so little preparation, the world lost time in the current Ebola epidemic trying to answer basic questions about combating virus, he asserted.
"In the next epidemic, such delays could result in a global disaster, Mr Gates declared.
He said the world needs to build a warning and response system for outbreaks – whether ignited by nature or bioterrorism.
Mr Gates, the co-founder of Microsoft and the co-chairman of the Bill & Melinda Gates Foundation, which has donated millions of dollars to the Ebola response, insisted infectious diseases need to be attacked much like another global threat – war.
He pointed to the system run by the North Atlantic Treaty Organization (NATO), which has the capability to quickly deploy personnel and resources, as an example of what's needed to combat infectious diseases on a global scale.
"Although the system is not perfect, NATO countries participate in joint exercises in which they work out logistics such as how fuel and food will be provided, what language they will speak and what radio frequencies will be used," Mr Gates said. "Few, if any, such measures are in place for response to an epidemic."
Indeed, the world does not fund any organization to manage the broad set of coordinated activities required to address an epidemic.
While the World Health Organization has a global outbreak alert and response network, it is "severely understaffed and underfunded," Mr Gates charged.
He said an effective warning and response system should be coordinated by a global institution that is given enough authority and funding to be effective.
Any such system should enable fast decision making at the global level and have the capability to expand investment in research and development and to clarify regulatory pathways for developing new tools and approaches, Mr Gates said.
It also should involve a reserve corps of trained personnel and volunteers and should have the capability to strengthen health systems in low- and middle-income countries, he explained.
Under such a system, the world should be able to improve its early warning and detection systems, including scalable everyday systems that can be expanded during an epidemic, Mr Gates said.
The outbreaks warning and response system should also incorporate preparedness exercises to identify the ways in which the response system needs to improve, he said.
While Mr Gates said he did not have an estimate of the cost of building such a system, he noted the World Bank has projected that a worldwide influenza epidemic could reduce global wealth by an estimated $3tn.
Among the known pathogens, influenza is the one most likely to cause a large epidemic, he said. But, Mr Gates lamented, it’s “disappointing that we don’t have a vaccine for all influenza strains.”
While he noted there is work being done on a universal flu vaccine, “it has garnered nowhere near the resources that it deserves.”
“Ideally, vaccine research would be funded in such a way that during an outbreak, a vaccine could be designed, tested for safety and ready for manufacture at scale within a few months,” Mr Gates said.