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According to philanthropist Bill Gates, the greatest risk of global catastrophe today is an outbreak.

“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,” he says. “Not missiles, but microbes.”

After analyzing how we dealt with last year’s Ebola outbreak, Gates says the problem is that there is no system, and he cites several key areas where improvement necessary:

• Without a team of epidemiologists, there was no way to monitor the spreading of the disease.
• Case reports coming in on paper were often inaccurate and delayed online communications.
• Without a medical team ready to go, there was no way of preparing people – a large epidemic would require hundreds of thousands of workers.
• There was no analysis of treatment approaches or diagnostics to help determine what tools should have been used. “We could have taken the blood of survivors, processed it and put that plasma back into people to protect them,” he says. “That was never tried.”

Nearly 10 thousand people died in western Africa in last year’s Ebola epidemic, and Gates worries that the next epidemic could be worse, especially if it can spread through air, if we don’t create a proper response system.

Using today’s science and technology, he says, we have cell phones to get information from the public and get information out to them, we have satellite maps to see where people are and where they’re moving, and we have advances in biology to look at pathogens and make vaccines, but with all these tools we still need an overall global health system and we need to be prepared.

Gates says we should take a lesson from the military and create a medical corps that’s ready to go, with a reserve to boost numbers. They should be paired with the military, which has the ability to move fast and secure areas. They should participate in germ game simulations to discover where the system needs improvements. And there should be investment in R&D in the areas of vaccines and diagnostics. The cost, he says, would be modest compared to the alternative – besides millions of deaths, a worldwide flu epidemic would cause a $3 trillion loss to global wealth.

“If there’s one positive thing that can come out of the Ebola epidemic,” says Gates, “it’s that it can serve as an early warning, a wakeup call to get ready. If we start now, we can be ready for the next epidemic.”

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