WEBVTT

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

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was a nuclear war.

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That's why we had a barrel like this
down in our basement,

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filled with food and water.

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When the nuclear attack came,

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we were supposed to go downstairs,

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hunker down, and eat out of that barrel.

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Today the greatest risk 
of global catastrophe


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doesn't look like this.

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Instead, it looks like this.

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If anything kills over 10 million people
in the next few decades,

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it's most likely to be 
a highly infectious virus

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rather than a war.

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Not missles, but microbes.

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Now part of the reason for this


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is that we've invested a huge amount
in nuclear deterrants.

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But we've actually invested very little 
in a system to stop an epidemic.

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We're not ready for the next epidemic.

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Let's look at Ebola.

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I'm sure all of you read about 
it in the newspaper,

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lots of touch challenges.

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I followed it carefully through 
the case analysis tools we use

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to track polio eradication.

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And as you look at what went on,

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the problem wasn't that there was
a system that didn't work well enough,

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the problem was that we didn't have
a system at all.

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In fact, there's some pretty obvious
key missing pieces.

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We didn't have a group of epidemiologists
ready to go

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who would have gone, 
seen what the disease was,

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seen how far it had spread.

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The case reports came in on paper.

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It was very delayed before they
were put online

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and they were extremely inaccurate.

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We didn't have a medical team ready to go.

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We didn't have a way of preparing people.

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Now Médecins Sans Frontières did a 
great job orchestrating volunteers.

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But even so, we were far slower
than we should have been

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getting the thousands of workers
into these countries.

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And a large epidemic would require
us to have hundreds of thousands

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of workers.

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There was no one there to look
at treatment approaches.

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No one to look at the diagnostics.

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No one to figure out what tools
should be used.

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As an example, we could have taken
the blood of survivors,

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processed it, and put that plasma
back in people to protect them.

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But that was never tried.

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So there was a lot that was missing.

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And these things are really 
a global failure.

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The WHO is funded to monitor epidemics,

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but not to do these things I talked about.

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Now in the movies, it's quiet different.

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There's a group of 
handsome epidemiologists

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ready to go, they move in, 
they save the day.

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But that's just pure Hollywood.

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The failure to prepare could allow
the next epidemic

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to be dramatically more devastating
than Ebola.

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Let's look at the progression of Ebola
over this year.

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About 10,000 people died, 


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and nearly all were in the three
West African countries.

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There's three reasons why
it didn't spread more.

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The first is that there was 
a lot of heroic work

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by the health workers.

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They found the people and they 
prevented more infections.

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The second is the nature of the virus.

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Ebola does not spread through the air.

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And by the time you're contagious,
most people are so sick

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that they're bedridden.

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Third, it didn't get into many urban areas.

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And that was just luck.

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If it had gotten into a lot more
urban areas,

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the case numbers would have 
been much larger.

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So next time, we may not be so lucky.

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You can have a virus where people 
feel well enough while they're infectious,

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they get on a plane or they go to a market.

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The source of the virus could be 
a natural epidemic like Ebola,

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or it could be bioterrorism.

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And so there are things that would
literally make things 


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a thousand times worse.

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In fact, let's look at a model
of a virus spread through the air,

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like the Spanish Flu back in 1918.

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So here's what would happen:

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it would spread throughout the world
very, very quickly.

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And you can see, over 30 million people
died from that epidemic.

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So this is a seriousl problem.

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We should be concerned.

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But in fact, we can build a really good
response system.

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We have the benefits of all the science
and technology that we talked about here.

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We've got cell phones to get information
from the public

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and get information out to them.

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We have satellite maps where we can see
where we can see where people are

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and where they're moving.

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We have advances in biology
that should dramatically change

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the turnaround time to look at a pathogen

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and be able to make drugs and vaccines
that fit for that pathogen.

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So we can have tools, but those tools
need to be put into an overall