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American businessman and philanthropist Bill Gates makes a speech at the Malaria Summit at 8 Northumberland Avenue on April 18, 2018 in London, England. The Malaria Summit is being held today to urge Commonwealth leaders to commit to halve cases of malaria across the Commonwealth within the next five years with a target to 650,000 lives. 

  • The next deadly disease that will cause a global pandemic is coming, Bill Gates said on Friday at a discussion of epidemics.
  • We’re not ready.
  • An illness like the pandemic 1918 influenza could kill 30 million people within six months, Gates said, adding that the next disease might not even be a flu, but something we’ve never seen.
  • The world should prepare as it does for war, Gates said.
  • If there’s one thing that we know from history, it’s that a deadly new disease will arise and spread around the globe.

That could happen easily within the next decade. And as Bill Gates told listeners on Friday at a discussion about epidemics hosted by the Massachusetts Medical Society and the New England Journal of Medicine, we’re not ready.

Gates acknowledged that he’s usually the optimist in the room, reminding people that we’re lifting children out of poverty around the globe and getting better at eliminating diseases like polio and malaria.

But “there’s one area though where the world isn’t making much progress,” Gates said, “and that’s pandemic preparedness.”

The likelihood that such a disease will appear continues to rise. New pathogens emerge all the time as the world population increases and humanity encroaches on wild environments. It’s becoming easier and easier for individual people or small groups to create weaponized diseases that could spread like wildfire around the globe.

According to Gates, a small non-state actor could build an even deadlier form of smallpox in a lab.

And in our interconnected world, people are always hopping on planes, crossing from cities on one continent to those on another in a matter of hours.

Gates presented a simulation by the Institute for Disease Modeling that found that a new flu like the one that killed 50 million people in the 1918 pandemic would now most likely kill 30 million people within six months.

And the disease that next takes us by surprise is likely to be one we see for the first time at the start of an outbreak, like what happened recently with SARS and MERS viruses.

If you were to tell the world’s governments that weapons that could kill 30 million people were under construction right now, there’d be a sense of urgency about preparing for the threat, Gates said.

“In the case of biological threats, that sense of urgency is lacking,” he said. “The world needs to prepare for pandemics in the same serious way it prepares for war.”

pandemic disease ebola
Doctors Without Borders (MSF) staffer Alex Eilert Paulsen watches as mattresses and bed frames burn at the Ebola Treatment Unit (ETU) on January 31, 2015 in Paynesville, Liberia. 

Stopping the next pandemic

The one time the military tried a sort of simulated war game against a smallpox pandemic, the final score was “smallpox one, humanity zero,” Gates said.

But he reiterated that he’s an optimist, saying he thinks we could better prepare for the next viral or bacterial threat.

In some ways, we’re better prepared now than we were for previous pandemics. We have antiviral drugs that can in many cases do at least something to improve survival rates. We have antibiotics that can treat secondary infections like pneumonia associated with the flu.

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