The Next Pandemic
Mr. Gates, a co-chair of the Bill and Melinda Gates Foundation, is the author of “How to Prevent the Next Pandemic.”
Imagine there’s a small fire in your kitchen. Your fire alarm goes off, warning everyone nearby about the danger. Someone calls 911. You try to put the fire out yourself — maybe you even have a fire extinguisher under the sink. If that doesn’t work, you know how to safely evacuate. By the time you get outside, a fire truck is already pulling up. Firefighters use the hydrant in front of your house to extinguish the flames before any of your neighbors’ homes are ever at risk of catching fire.
We need to prepare to fight disease outbreaks just as we prepare to fight fires. If a fire is left to burn out of control, it poses a threat not only to one home but to an entire community. The same is true for infectious diseases, except on a much bigger scale. As we know all too well from Covid, an outbreak in one town can quickly spread across an entire 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 worry that we’re making the same mistakes again. The world hasn’t done as much to get ready for the next pandemic as I’d 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 a moment’s notice when danger emerges. We need a fire department for pandemics.
I’m optimistic about a network that the W.H.O. and its partners are building called the Global Health Emergency Corps. This network of the world’s top health emergency leaders will work together to get ready for the next pandemic. Just as firefighters run drills to practice responding to a fire, the Emergency Corps plans to run drills to practice for outbreaks. The exercises will make sure that everyone — governments, health care providers, emergency health workers — knows what to do when a potential outbreak emerges.
One of the most important jobs of the corps will be to take quick action to stop the spread of a pathogen. The speed of action requires countries to have large-scale testing capabilities that identify potential threats early. Environmental surveillance like sewage testing is key, since many pathogens show up in human waste. If a sewage sample comes back positive, a rapid response team would deploy to the affected area to find people who might be infected, carry out a response plan and kick off the necessary community education about what to look for and how to stay protected.
As Covid-19 demonstrated, a pandemic is a trillion-dollar problem, and mitigating this challenge should not depend on volunteers. We need a corps 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 networks of experts and be led by people like the heads of national public health agencies and their leads for epidemic response. It’s difficult for any one country to stop a disease from spreading on its own; many of the most meaningful actions require coordination from the highest levels of government. The world needs to prepare for a multiple-alarm fire, the type of fire response that requires different units and departments.
These kinds of blazes are rare, but when they happen, there’s no time to waste. Local responders need to know they can count on a surge of well-trained firefighters who will work seamlessly together. They can’t arrive on the scene only to discover that their hoses don’t fit on the closest hydrant or that they have a completely different approach from the other units. The Emergency Corps will make sure countries and health systems are coordinated in advance of an emergency, so that everything runs smoothly during times of crisis.
This is where practice makes perfect. By running drills and simulations, the corps will uncover the areas where countries and leaders are not ready and help us fix them now. It’s important to practice for lots of different types of pathogens, too. Human respiratory diseases are a huge concern, because they can go global so quickly. (Just look at how fast Covid spread.) But they are far from the only threat. What if the next pandemic-potential pathogen spreads through surface droplets? Or if it is sexually transmitted like H.I.V.? What if it’s the result of bioterrorism? Each scenario requires a different response, and the Emergency Corps can help the world get ready for all of them.
We can’t afford to get caught flat-footed again. The world must take action now to make sure Covid-19 becomes the last pandemic, and one of the biggest moves we can make is to support the world’s principal health experts — the W.H.O. — and invest in the Global Health Emergency Corps so it can live up to its full potential.
This will require two things: First, public health leaders from all countries need to participate. The next pandemic could emerge anywhere, and so the Emergency Corps must have expertise from every corner of the globe, including from national disease and research agencies like the Centers for Disease Control and Prevention and the National Institutes of Health in the United States. Second, we need wealthier countries to step up and provide funding to make this a reality.
I believe the W.H.O. remains our best tool for helping countries stop disease outbreaks, and the Global Health Emergency Corps will represent massive progress toward a pandemic-free future. The question is whether we have the foresight to invest in that future now before it’s too late.
Bill Gates, is a co-chair of the Bill and Melinda Gates Foundation and the founder of Breakthrough Energy. He founded Microsoft in 1975 with his childhood friend Paul Allen. He is the author of “How to Prevent the Next Pandemic.”