Reviews | Bill Gates: how to prepare for the next pandemic

Imagine there is a small fire in your kitchen. Your fire alarm goes off, warning everyone nearby of the danger. Someone calls 911. You try to put out the fire yourself, maybe you even have a fire extinguisher under the sink. If that doesn’t work, you know how to evacuate safely. By the time you exit, the fire truck is already pulling over. Firefighters use the fire hydrant in front of your house to put out the flames before any of your neighbors’ houses are in danger of catching fire.

‌We must prepare to fight epidemics just as we prepare to fight fires. If left to burn out of control, a fire poses a threat not just to a home, but to an entire community. The same is true for infectious diseases, except on a much larger scale. As we know all too well from Covid, an outbreak in one city can quickly spread across a whole country and then around the world.

When the World Health Organization first described Covid-19 as a pandemic just over three years ago, it marked the culmination of a collective failure to prepare for pandemics despite many warnings. And I’m afraid we’ll make those same mistakes again. The world hasn’t done as much to prepare for the next pandemic as I had hoped. But ‌‌it’s not too late to stop history from repeating itself. The world needs a well-funded system that is ready to spring into action at any time when danger emerges. ‌We need a pandemic fire department.

I am optimistic about a network that WHO and its partners are building called Global Health Emergency Corps. This network of the world’s top health emergency leaders will work together to prepare for the next ‌‌pandemic. Just as firefighters hold drills to practice responding to a fire, the Emergency Corps plans to hold drills to practice in the event of an outbreak. The drills will ensure everyone – governments, healthcare providers, emergency health workers – knows what to do when a potential outbreak emerges.

One of the most important tasks of the body will be to ‌‌take quick action to stop the spread of a pathogen. Rapidity of action requires countries to have large-scale testing capabilities that quickly identify potential threats. Environmental monitoring, such as sewage testing, is essential because many pathogens appear in human waste. If a sewage sample comes back positive, a rapid response team will deploy to the affected area to find people who may be infected, implement a response plan‌‌ and initiate necessary community education on what to look for and how to stay protected.

As C‌ovid-19 has demonstrated, a pandemic is a trillion dollar problem, and mitigating that challenge shouldn’t depend on volunteers. We need a body of professionals from every country and region, and the world needs to find a way to compensate them for the time they spend preparing for and responding to transnational threats. They must be able to deploy teams of professionals on standby to help control outbreaks where they start.

To be successful, the Emergency Corps must build on existing expert networks and be led by people such as the heads of national public health agencies and their outbreak response managers. ‌It is difficult‌‌for any country to stop a disease from spreading on its own – many of the most meaningful actions require‌‌coordination from the highest levels of government. The world must prepare for a multi-alarm fire – the type of fire response that requires different units and departments. These types of fires are rare, but when they do occur there is no time to waste. Local responders need to know they can count on a wave of well-trained firefighters who will work together seamlessly. They can’t arrive on the scene only to find that their hoses won’t fit the nearest fire hydrant or that they have a completely different approach than other units. The Emergency Corps will ensure that countries and health systems are coordinated before an emergency, so that everything runs smoothly in times of crisis.

This is where practice makes perfect. By running exercises and simulations, the corps will uncover areas where countries and leaders are not ready and help us address them now. ‌It is also important to train for many different types of pathogens. Human respiratory diseases are a major concern because they can spread so quickly globally. (Just look at how fast Covid has spread.) But they’re far from the only threat. What if the next pathogen with pandemic potential is spread by surface droplets? Or is it sexually transmitted like HIV? What if it was the result of bioterrorism? Each scenario requires a different response, and the Emergency Corps can help the world prepare for each one.

We cannot afford to be caught off guard again. The world must act now to ensure Covid-19 becomes the last pandemic, and one of the biggest steps we can take is to support the world’s leading health experts – the WHO – and invest in the Global Health Emergency Corps so that it can live up to its full potential.

‌‌This will require two things: First, public health officials from all countries must participate. The next ‌pandemic could emerge anywhere, so the Emergency Corps must have expertise from all corners of the globe, including national disease control and research agencies like the CDC and NIH. in the USA. Second, we need richer countries to step up and provide funding to make this a reality.

‌‌I believe the WHO remains our best tool to help countries stop outbreaks, and the Global Health Emergency Corps will represent massive progress towards a pandemic-free future. The ‌question‌‌is whether we have the foresight to invest in that future now before it’s too late.

Bill Gates, is co-chair of the Bill and Melinda Gates Foundation and founder of Breakthrough Energy. Mr. Gates founded Microsoft in 1975 with his childhood friend Paul Allen. He is the author of “How to Prevent the Next Pandemic”.


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