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 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 missles, but microbes.
Now part of the reason for this
is that we've invested a huge amount in nuclear deterrants.
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 touch 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,
seen 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 WHO is funded to monitor epidemics,
but not to do these things I talked about.
Now in the movies, it's quiet 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 may not be so lucky.
You can have a virus where people feel well enough while they're infectious,
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.
And 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, over 30 million people died from that epidemic.
So this is a seriousl 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 talked 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 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 them full-time, ready 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, we need strong health systems for 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: germs 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