Практика Shadowing: The next outbreak? We’re not ready | Bill Gates | TED - Изучайте разговорный английский с YouTube

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When I was a kid, the disaster we worried about most was a nuclear war.
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When I was a kid, the disaster we worried about most was a nuclear war.
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That's why we had a barrel like this down in our basement, filled with cans of food and water.
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When the nuclear attack came, we were supposed to go downstairs, hunker down, and eat out of that barrel.
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Today the greatest risk of global catastrophe 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, it's most likely to be a highly infectious virus rather than a war.
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Not missiles, but microbes.
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Now, part of the reason for this is that we've invested a huge amount in nuclear deterrents.
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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, lots of tough challenges.
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I followed it carefully through the case analysis tools we use to track polio eradication.
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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.
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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, who would have gone, seen what the disease was, 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 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 getting the thousands of workers into these countries.
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And a large epidemic would require us to have hundreds of thousands 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, 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, but not to do these things I talked about.
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Now, in the movies it's quite different.
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There's a group of handsome epidemiologists ready to go, they move in, they save the day, but that's just pure Hollywood.
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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.
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About 10,000 people died, 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 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 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, the case numbers would have 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 feel well enough while they're infectious that 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, or it could be bioterrorism.
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So there are things that would literally make things a thousand times worse.
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In fact, let's look at a model of a virus spread through the air, like the Spanish Flu back in 1918.
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So here's what would happen: 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 serious 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 talk about here.
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We've got cell phones to get information from the public and get information out to them.
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We have satellite maps where we can see where people are and where they're moving.
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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.
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So we can have tools, but those tools need to be put into an overall global health system.
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And we need preparedness.
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The best lessons, I think, on how to get prepared are again, what we do for war.
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For soldiers, we have full-time, waiting to go.
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We have reserves that can scale us up to large numbers.
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NATO has a mobile unit that can deploy very rapidly.
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NATO does a lot of war games to check, are people well trained?
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Do they understand about fuel and logistics 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 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 in poor countries.
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That's where mothers can give birth safely, kids can get all their vaccines.
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But, also where we'll see the outbreak very early on.
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We need a medical reserve corps: lots of people who've got the training and background who are ready to go, with the expertise.
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And then we need to pair those medical people with the military.
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taking advantage of the military's ability to move fast, do logistics and secure areas.
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We need to do simulations, germ games, not war games, so that we see where the holes are.
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The last time a germ game was done in the United States 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 in areas of vaccines and diagnostics.
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There are some big breakthroughs, like the Adeno-associated virus, that could work very, very quickly.
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Now I don't have an exact budget for what this would cost, but I'm quite sure it's very modest compared to the potential harm.
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The World Bank estimates that if we have a worldwide flu epidemic, global wealth will go down by over three trillion dollars and we'd have millions and millions of deaths.
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These investments offer significant benefits beyond just being ready for the epidemic.
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The primary healthcare, the R&D, those things would reduce global health equity and make the world more just as well as more safe.
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So I think this should absolutely be a priority.
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There's no need to panic.
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We don't have to hoard cans of spaghetti or go down into the basement.
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But we need to get going, because time is not on our side.
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In fact, if there's one positive thing that can come out of the Ebola epidemic, it's that it can serve as an early warning, a wake-up call, to get ready.
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If we start now, we can be ready for the next epidemic.
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Thank you. (Applause)

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  • эпидемия - epidemic
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  • вакцинация - vaccination
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  • профилактика заболеваний - disease prevention

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