[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,When I was a kid, the disaster\Nwe worried about most
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,was a nuclear war.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,That's why we had a barrel like this\Ndown in our basement,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,filled with food and water.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,When the nuclear attack came,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,we were supposed to go downstairs,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,hunker down, and eat out of that barrel.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Today the greatest risk \Nof global catastrophe\N
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,doesn't look like this.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Instead, it looks like this.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,If anything kills over 10 million people\Nin the next few decades,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,it's most likely to be \Na highly infectious virus
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,rather than a war.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Not missles, but microbes.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Now part of the reason for this\N
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,is that we've invested a huge amount\Nin nuclear deterrants.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,But we've actually invested very little \Nin a system to stop an epidemic.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We're not ready for the next epidemic.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Let's look at Ebola.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,I'm sure all of you read about \Nit in the newspaper,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,lots of touch challenges.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,I followed it carefully through \Nthe case analysis tools we use
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,to track polio eradication.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And as you look at what went on,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,the problem wasn't that there was\Na system that didn't work well enough,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,the problem was that we didn't have\Na system at all.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,In fact, there's some pretty obvious\Nkey missing pieces.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We didn't have a group of epidemiologists\Nready to go
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,who would have gone, \Nseen what the disease was,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,seen how far it had spread.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The case reports came in on paper.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,It was very delayed before they\Nwere put online
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and they were extremely inaccurate.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We didn't have a medical team ready to go.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We didn't have a way of preparing people.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Now Médecins Sans Frontières did a \Ngreat job orchestrating volunteers.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,But even so, we were far slower\Nthan we should have been
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,getting the thousands of workers\Ninto these countries.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And a large epidemic would require\Nus to have hundreds of thousands
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,of workers.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,There was no one there to look\Nat treatment approaches.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,No one to look at the diagnostics.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,No one to figure out what tools\Nshould be used.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,As an example, we could have taken\Nthe blood of survivors,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,processed it, and put that plasma\Nback in people to protect them.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,But that was never tried.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So there was a lot that was missing.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And these things are really \Na global failure.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The WHO is funded to monitor epidemics,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,but not to do these things I talked about.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Now in the movies, it's quiet different.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,There's a group of \Nhandsome epidemiologists
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,ready to go, they move in, \Nthey save the day.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,But that's just pure Hollywood.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The failure to prepare could allow\Nthe next epidemic
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,to be dramatically more devastating\Nthan Ebola.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Let's look at the progression of Ebola\Nover this year.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,About 10,000 people died, \N
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and nearly all were in the three\NWest African countries.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,There's three reasons why\Nit didn't spread more.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The first is that there was \Na lot of heroic work
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,by the health workers.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,They found the people and they \Nprevented more infections.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The second is the nature of the virus.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Ebola does not spread through the air.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And by the time you're contagious,\Nmost people are so sick
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,that they're bedridden.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Third, it didn't get into many urban areas.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And that was just luck.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,If it had gotten into a lot more\Nurban areas,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,the case numbers would have \Nbeen much larger.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So next time, we may not be so lucky.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,You can have a virus where people \Nfeel well enough while they're infectious,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,they get on a plane or they go to a market.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The source of the virus could be \Na natural epidemic like Ebola,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,or it could be bioterrorism.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And so there are things that would\Nliterally make things \N
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,a thousand times worse.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,In fact, let's look at a model\Nof a virus spread through the air,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,like the Spanish Flu back in 1918.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So here's what would happen:
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,it would spread throughout the world\Nvery, very quickly.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And you can see, over 30 million people\Ndied from that epidemic.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So this is a seriousl problem.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We should be concerned.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,But in fact, we can build a really good\Nresponse system.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We have the benefits of all the science\Nand technology that we talked about here.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We've got cell phones to get information\Nfrom the public
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and get information out to them.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We have satellite maps where we can see\Nwhere we can see where people are
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and where they're moving.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We have advances in biology\Nthat should dramatically change
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,the turnaround time to look at a pathogen
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and be able to make drugs and vaccines\Nthat fit for that pathogen.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So we can have tools, but those tools\Nneed to be put into
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,an overall global health system.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And we need preparedness.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The best lessons, I think, on how \Nto get prepared
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,are, again, what we do for war.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,For soldiers, we have them full-time,\Nready to go.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We have reserves that can scale us up\Nto large numbers.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,NATO has a mobile unit \Nthat can deploy very rapidly.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,NATO does a lot of war games to check, \N"Are people well trained?
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Do they understand about fuel\Nand logistics
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and the same radio frequencies?"
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So they are absolutely ready to go.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So those are the kinds of things\Nwe need to deal with an epidemic.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,What are the key pieces?
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,First, we need strong health systems\Nfor countries.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,That's where mothers can give birth safely,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,kids can get all their vaccines.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,But, also where we'll see\Nthe outbreak very early on.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We need a medical reserve corps:
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,lots of people who've got the training\Nand background
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,who are ready to go, with the expertise.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,And then we need to pair those\Nmedical people
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,with the military,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,taking advantage of the military's ability\Nto move fast, do logistics
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,and secure areas.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We need to do simulations: germs games,\Nnot war games,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,so that we see where the holes are.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The last time a germ game was done\Nin the United States
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,was back in 2001, and it didn't go so well.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So far the score is germs: 1, people: 0.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Finally, we need lots of advanced R&D\Nin areas of vaccines and diagnostics.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,There are some big breakthroughs, \Nlike the Adeno-associated virus,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,that could work very, very quickly.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,Now I don't have an exact budget\Nfor what this would cost,\N
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,but I'm quite sure that it's very modest\Ncompared to the potential harm.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The World Bank estimates that \Nif we have a worldwide flu epidemic,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,global wealth would go down\Nby over 3 trillion dollars.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We'd have millions and millions of deaths.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,These investments offer \Nsignificant benefits beyond just
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,being ready for an epidemic.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,The primary healthcare, the R&D,\Nthose things\N
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,would reduce global health equity\Nand make the world more just,
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,as well as more safe.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,So I think this should absolutely\Nbe a priority.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,There's no need to panic.
Dialogue: 0,9:59:59.99,9:59:59.99,Default,,0000,0000,0000,,We don't have