Placeholder Image

Subtitles section Play video

  • 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 basement, filled with cans of food, and water.

  • When the nuclear attack came, we were supposed 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 deterrence.

  • 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 case analysis tools we use to track polio eradication.

  • And as you look at what went on, the problem wasn't that there was a system that 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, seen what the disease was, see how far it had spread.

  • The case 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 these 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 used.

  • As an example, we could have taken the blood of survivors, processed 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 these things are really a global failure.

  • The W.H.O. is funded to monitor epidemics, but not to do these 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.

  • 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's 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 second 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 case numbers would have been much larger.

  • So 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 source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism.

  • So there are things that would literally make things a thousand times worse.

  • 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 see there's over 30 million people died from that epidemic.

  • So this is a serious problem.

  • We should be concerned.

  • But in fact, we can build a really good response 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 see 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 those 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 soldiers, we have full-time, waiting to go.

  • We have reserves 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 those are the kinds of things we need to deal with an epidemic.

  • What are the key pieces?

  • First, is [that] 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 see the outbreak very early on.

  • We need a medical reserve corps: lots of people who've got the training and background who are ready to go, with the expertise.

  • And then we need to pair those medical people with the military.

  • Taking advantage of the military's ability to move fast, do logistics, and secure areas.

  • We need to do simulations, germ games, not war games, so that we see where the holes are.

  • The last time a germ game was done in the United States was back in 2001, and it didn'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.

  • These investments offer significant benefits beyond just being ready for the epidemic.

  • The primary health care, the R&D, those 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.

  • There's no need to panic.

  • We don't have to hoard cans of spaghetti or go down into the basement.

  • But we need to get going, because time is not on our side.

  • In fact, if there's one positive thing that can come out of the Ebola epidemic, it's that it can serve as an early warning, a wake-up call, to get ready.

  • If we start now, we can be ready for the next epidemic.

  • Thank you.

When I was a kid, the disaster we worried about most was a nuclear war.

Subtitles and vocabulary

Operation of videos Adjust the video here to display the subtitles

B1 US TED epidemic ebola people global war

【TED】Bill Gates: The next outbreak? We’re not ready

  • 22725 1386
    Jeng-Lan Lee posted on 2020/04/23
Video vocabulary