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1、When I was a kid, the disaster we worried about most was a nuclear war. Thats 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.0:36Today the greatest risk o
2、f global catastrophe doesnt look like this. Instead, it looks like this. If anything kills over 10 million people in the next few decades, its 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 weve invested a huge amou
3、nt in nuclear deterrents. But weve actually invested very little in a system to stop an epidemic. Were not ready for the next epidemic.1:19Lets look at Ebola. Im sure all of you read about it in the newspaper, lots of tough challenges. I followed it carefully through the case analysis tools we use t
4、o track polio eradication. And as you look at what went on, the problem wasnt that there was a system that didnt work well enough, the problem was that we didnt have a system at all. In fact, theres some pretty obvious key missing pieces.推荐精选1:50We didnt have a group of epidemiologists ready to go,
5、who would have gone, seen what the disease was, seen how far it had spread. The case reports came in on paper. It was very delayed before they were put online and they were extremely inaccurate. We didnt have a medical team ready to go. We didnt have a way of preparing people. Now, Mdecins Sans Fron
6、tires did a great job orchestrating volunteers. But even so, we were far slower than we should have been getting the thousands of workers into these countries. And a large epidemic would require us to have hundreds of thousands of workers. There was no one there to look at treatment approaches. No o
7、ne to look at the diagnostics. No one to figure out what tools should be used. As an example, we could have taken the blood of survivors, processed it, and put that plasma back in people to protect them. But that was never tried.推荐精选2:52So there was a lot that was missing. And these things are reall
8、y a global failure. The WHO is funded to monitor epidemics, but not to do these things I talked about. Now, in the movies its quite different. Theres a group of handsome epidemiologists ready to go, they move in, they save the day, but thats just pure Hollywood.3:21The failure to prepare could allow
9、 the next epidemic to be dramatically more devastating than Ebola Lets look at the progression of Ebola over this year. About 10,000 people died, and nearly all were in the three West African countries. Theres three reasons why it didnt spread more. The first is that there was a lot of heroic work b
10、y the health workers. They found the people and they prevented more infections. The second is the nature of the virus. Ebola does not spread through the air. And by the time youre contagious, most people are so sick that theyre bedridden. Third, it didnt get into many urban areas. And that was just
11、luck. If it had gotten into a lot more urban areas, the case numbers would have been much larger.推荐精选4:16So next time, we might not be so lucky. You can have a virus where people feel well enough while theyre infectious that they get on a plane or they go to a market. The source of the virus could b
12、e a natural epidemic like Ebola, or it could be bioterrorism. So there are things that would literally make things a thousand times worse.推荐精选4:38In fact, lets look at a model of a virus spread through the air, like the Spanish Flu back in 1918. So heres what would happen: It would spread throughout
13、 the world very, very quickly. And you can see over 30 million people died from that epidemic. So this is a serious problem. We should be concerned.5:03But in fact, we can build a really good response system. We have the benefits of all the science and technology that we talk about here. Weve got ce
14、ll phones to get information from the public and get information out to them. We have satellite maps where we can see where people are and where theyre moving. 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
15、 that fit for that pathogen. So we can have tools, but those tools need to be put into an overall global health system. And we need preparedness.推荐精选5:40The best lessons, I think, on how to get prepared are again, what we do for war. For soldiers, we have full-time, waiting to go. We have reserves t
16、hat can scale us up to large numbers. NATO has a mobile unit that can deploy very rapidly. NATO does a lot of war games to check, are people well trained? Do they understand about fuel and logistics and the same radio frequencies? So they are absolutely ready to go. So those are the kinds of things we need to deal with an epidemic.6:12What are the key pieces? First, we need strong health systems in poor
