BillGates(下次的疫情暴發(fā)我們還沒(méi)準(zhǔn)備好).doc

1、When I was a kid, the disaster we worried about most was a nuclear war. That why we had a barrel like this down in our basement filled with cans of 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 glo

2、bal catastro phe does n look like this. In stead, 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 missiles, but microbes. Now, part of the reason for this is that we vere not readyin vested

3、a huge amount in nu clear deterre nts. But we vctuallyin vested very little in a system to stop a n ep idemic. Wefor the n ext ep idemic. Lets look at Ebola. I m sure all of you reaabout it in the n ews pap er, lots of tough challe nges. Ifollowed itcarefully through the case analysis tools we use t

4、otrack polioeradication. And as you look at what went on, the problem wasnthat there was a system that did nt work well eno ugh, the p roblemwas that we didn t hyetam at all. In fact, theresome prettye obvious key missing pieces. We didn have a group of ep idemiologists ready to go, who would have g

5、one, see n what the disease was, see n how far it had sp read. The case rep orts came in on our paper. It was very delayed before they are put online, and they were extremely in accurate. We did n have a medical team ready to go. We didn have a way of preparing people. Now,Medic ines Sans Fron tiere

6、s did a great job orchestrat ing volun teers.But eve n so, we were far slower tha n we should have bee n gett ing the thousa nds of workers into these coun tries. And a large ep idemic would require us to have hun dreds of thousa nds of workers. There was no one there to look at treatme nt app roach

7、es. No one to look at the diag no stics. No one to figure out what tools should be used.As an example, we could have taken the blood of survivors, p rocessed it, and put that p lasma back in people to p rotect them.But that was n ever tried. So there was a lot that was miss ing. And these things are

8、 really a global failure. The WHO is funded to mon itor ep idemics, but not to do these things I talked about. Now, in the movies it quite different. There as group of handsome ep idemiologists ready to go, they move in, they save the day, but that s just pure Hollywod. The failure to prepare could

9、allow next ep idemic to be dramatically more devastati ng tha n Ebola. Let at the p rogressi on of Ebola over this year. About 10,000 people died, and nearly all were in the three West Afri can countries. There rethree reas ons why it did nt spread more. The first is that there wasa lot of heroic wo

10、rk by the health workers. They found the people and they p reve nt more in fecti ons. The sec ond is the n ature of the virus. Ebola does not sp read through the air. And by the time youcon tagious, most people are so sick that theyre bedridden. Third, itre infectiouthousa nd times worse. In fact, l

11、ets look at a model of a virus spreaddidn t get into many urban areas. And that was just luck. If it had gotte n into a lot more urba n areas, the case nu mbers would have bee n much larger. So n ext time, we might not be so lucky. You can have a virus where people feel well eno ugh while they that

12、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. So there are things that would literally make things athrough the air, like the Spanish Flu back in 1918. So here what would happen: It would spread throughout the

13、world very, very quickly. And you can see there over 30 million people die from that ep idemic. So this is a serious p roblem we should be concerned.But in fact, we can build a really good response system. We have the ben efits of all the scie nee and tech no logy that we talk about here.we vegot ce

14、ll phones to get information from the public and getin formati on out to them. We have satellite maps where we can see biology that should dramatically change the turnaround time to look at a p athoge n and be able to make drugs and vacc ines that fit for that p athoge n. So we can have tools, but t

15、hose tools n eed to be put into an overall global health system. And we n eed prep ared ness.where people are and where theyre moving. We have adva nces inThe best less on s, I think, on how to get prep ared are aga in what we do for war. For soldiers, we have full-time wait ing to go. We have reser

16、ves that can scale us up to large nu mbers. NATO has a mobile unit that can deploy very rap idly. NATO does a lot of war games to check, are people well train ed? Do they un dersta nd about fuel and logistics and the same radio frequencies? So they are absolutely ready to go. So those are the kinds

17、of things we n eed to deal with an ep idemic. What are the key p ieces? First, we n eed strong healthll see the outbrsystem in poor coun tries. That where mcsthers can give birth safely, kids can get all their vacc in es. But also where we very early on. We need a medical reserve corps. Lots of peop

18、le who ve got the training and backgro und who are ready to go, withs ability to move fast,the exp ertise. And the n we n eed to p air those medical people with the military tak ing adva ntage of the military do logistics and secure areas. We need to do simulations, germ games, not war games, so tha

19、t we see where the holes are. The last time a germ game was done in the Un ited States was back in 2001, and it didn go so well. So far the score is germs: 1, people: 0.Fin ally, we n eed lots of adva need R&D in areas of vacc ines and diag no stics. There are some big breakthroughs, like theAdeno-a

20、ssociated virus that could work very, very quickly. Now I don t have an exact budget for what this would cost, but I sure it vsry modest compared to the potential harm. The WorldBank estimates that if we have a worldwide flu epidemic, global wealth will go down by over three trillion dollars, and we dhave millio ns and