0:00:05.774,0:00:09.298
When I was a kid, the disaster[br]we worried about most

0:00:09.298,0:00:12.029
was a nuclear war.

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

0:00:15.085,0:00:18.456
filled with cans of 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 [br]of global catastrophe

0:00:29.924,0:00:32.301
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[br]in the next few decades,

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it's most likely to be [br]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 is that[br]

0:00:53.878,0:00:58.081
we've invested a huge amount[br]in nuclear deterrants.

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But we've actually invested very little [br]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 [br]it in the newspaper,

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lots of tough challenges.

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I followed it carefully through [br]the case analysis tools we use

0:01:19.676,0:01:23.721
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[br]a system that didn't work well enough,

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

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

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We didn't have a group of epidemiologists[br]ready to go who would have gone,

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seen what the disease was,[br]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[br]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 [br]great job orchestrating volunteers.

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

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getting the thousands of workers[br]into these countries.

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And a large epidemic would require us[br]

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to have hundreds of thousands of workers.

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There was noone there to look[br]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[br]should be used.

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

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processed it, and put that plasma[br]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 [br]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 [br]handsome epidemiologists

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ready to go, they move in, [br]they save the day.

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But that's just pure Hollywood.

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The failure to prepare could allow[br]the next epidemic

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to be dramatically [br]more devastating than Ebola

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

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About 10,000 people died, [br]

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and nearly all were in the three[br]West African countries.

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

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The first is that there was [br]a lot of heroic work

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by the health workers.

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They found the people and they [br]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,[br]most people are so sick

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that they're bedridden.

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

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And that was just luck.

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If it had gotten into a lot [br]more urban areas,

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the case numbers would have [br]been much larger.

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So next time, we might not be so lucky.

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

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that they get on a plane[br]or they go to a market.

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The source of the virus could be [br]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 [br]literally make things

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a thousand times worse.

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In fact, let's look at a model[br]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[br]very, very quickly.

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And you can see, over 30 million people[br]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[br]a really good response system.

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We have the benefits of all the science[br]and technology that we talk about here.

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

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and get information out to them.

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We have satellite maps where [br]we can see where people are

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and where they're moving.

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We have advances in biology[br]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[br]that fit for that pathogen.

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So we can have tools, but those tools[br]need to be put into

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an overall global health system.

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And we need preparedness.

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The best lessons, I think, on how [br]to get prepared

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are, again, what we do for war.

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For soldiers, we have them full-time,[br]ready to go.

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We have reserves that can scale us up[br]to large numbers.

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NATO has a mobile unit [br]that can deploy very rapidly.

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NATO does a lot of war games to check, [br]"Are people well trained?

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Do they understand about fuel[br]and logistics

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and the same radio frequencies?"

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So they are absolutely ready to go.

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So those are the kinds of things[br]we need to deal with an epidemic.

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What are the key pieces?

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First, we need strong health systems[br]for countries.

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That's where mothers can give birth safely,

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kids can get all their vaccines.

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But, also where we'll see[br]the outbreak very early on.

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We need a medical reserve corps:

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lots of people who've got the training[br]and background

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who are ready to go, with the expertise.

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And then we need to pair those[br]medical people

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with the military,

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taking advantage of the military's ability[br]to move fast, do logistics

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and secure areas.

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We need to do simulations: germs games,[br]not war games,

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so that we see where the holes are.

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The last time a germ game was done[br]in the United States

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was back in 2001, and it didn't go so well.

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So far the score is germs: 1, people: 0.

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Finally, we need lots of advanced R&D[br]in areas of vaccines and diagnostics.

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There are some big breakthroughs, [br]like the Adeno-associated virus,

0:07:05.246,0:07:09.229
that could work very, very quickly.

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Now I don't have an exact budget[br]for what this would cost,[br]

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but I'm quite sure that it's very modest[br]compared to the potential harm.

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The World Bank estimates that [br]if we have a worldwide flu epidemic,

0:07:21.740,0:07:25.465
global wealth would go down[br]by over 3 trillion dollars.

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We'd have millions and millions of deaths.

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These investments offer [br]significant benefits beyond just

0:07:32.927,0:07:34.648
being ready for an epidemic.

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The primary healthcare, the R&D,[br]those things[br]

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would reduce global health equity[br]and make the world more just,

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as well as more safe.

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So I think this should absolutely[br]be a priority.

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There's no need to panic.

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We don't have to horde cans[br]or spaghetti

0:07:51.119,0:07:53.728
or go down into the basement.

0:07:53.728,0:07:55.173
But we need to get going,

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because time is not on our side.

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In fact, if there's one positive thing[br]that can come out of the Ebola epidemic,

0:08:03.524,0:08:09.880
it's that can serve as an early warning,[br]a wake-up call, to get ready.

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If we start now, we can be ready [br]for the next epidemic.

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Thank you.

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(Applause)