CEFR_C2 (IELTS 8-8.5)

9. Bill Gates_ The next outbreak_ We're not ready (subtitles)

2022-01-09 18:32:05 simyang 0


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00:17

When I was a kid,

00:19

the disaster we worried about most was a nuclear war.

00:23

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

00:27

filled with cans of food and water.

00:30

When the nuclear attack came,

00:31

we were supposed to go downstairs, hunker down, and eat out of that barrel.

00:37

Today the greatest risk of global catastrophe

00:41

doesn't look like this.

00:44

Instead, it looks like this.

00:48

If anything kills over 10 million people in the next few decades,

00:53

it's most likely to be a highly infectious virus

00:57

rather than a war.

00:59

Not missiles, but microbes.

01:03

Now, part of the reason for this is that

01:05

we've invested a huge amount in nuclear deterrents.

01:10

But we've actually invested very little in a system to stop an epidemic.

01:16

We're not ready for the next epidemic.

01:20

Let's look at Ebola.

01:21

I'm sure all of you read about it in the newspaper,

01:25

lots of tough challenges.

01:27

I followed it carefully through the case analysis tools

01:30

we use to track polio eradication.

01:35

And as you look at what went on,

01:37

the problem wasn't that there was a system that didn't work well enough,

01:42

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

01:46

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

01:51

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

01:55

seen what the disease was, seen how far it had spread.

01:59

The case reports came in on paper.

02:02

It was very delayed before they were put online

02:04

and they were extremely inaccurate.

02:07

We didn't have a medical team ready to go.

02:09

We didn't have a way of preparing people.

02:12

Now, Médecins Sans Frontières did a great job orchestrating volunteers.

02:17

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

02:20

getting the thousands of workers in o these countries.

02:24

And a large epidemic would require us to have hundreds of thousands of workers.

02:32

There was no one there to look at treatment approaches.

02:37

No one to look at the diagnostics.

02:38

No one to figure out what tools should be used.

02:42

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

02:45

processed it, and put that plasma back in people to protect them.

02:51

But that was never tried.

02:53

So there was a lot that was missing.

02:55

And these things are really a global failure.

03:00

The WHO is funded to monitor epidemics, but not to do these things I talked about.

03:07

Now, in the movies it's quite different.

03:09

There's a group of handsome epidemiologists ready to go,

03:14

they move in, they save the day, but that's just pure Hollywood.

03:22

The failure to prepare could allow the next epidemic

03:25

to be dramatically more devastating than Ebola

03:30

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

03:36

About 10,000 people died,

03:39

and nearly all were in the three West African countries.

03:43

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

03:46

The first is that there was a lot of heroic work by the health workers.

03:50

They found the people and they prevented more infections.

03:54

The second is the nature of the virus.

03:56

Ebola does not spread through the air.

03:59

And by the time you're contagious,

04:01

most people are so sick that they're bedridden.

04:06

Third, it didn't get in o many urban areas.

04:10

And that was just luck.

04:12

If it had gotten in o a lot more urban areas,

04:14

the case numbers would have been much larger.

04:17

So next time, we might not be so lucky.

04:21

You can have a virus where people feel well enough while they're infectious

04:26

that they get on a plane or they go to a market.

04:29

The source of the virus could be a natural epidemic like Ebola,

04:32

or it could be bioterrorism.

04:34

So there are things that would literally make things a thousand times worse.

04:39

In fact, let's look at a model of a virus spread through the air,

04:45

like the Spanish Flu back in 1918.

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So here's what would happen:

04:51

It would spread throughout the world very, very quickly.

04:55

And you can see over 30 million people died from that epidemic.

05:00

So this is a serious problem.

05:02

We should be concerned.

05:04

But in fact, we can build a really good response system.

05:08

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

05:13

We've got cell phones

05:14

to get information from the public and get information out to them.

05:18

We have satellite maps where we can see where people are and where they're moving.

05:22

We have advances in biology

05:24

that should dramatically change the turnaround time to look at a pathogen

05:28

and be able to make drugs and vaccines that fit for that pathogen.

05:33

So we can have tools,

05:34

but those tools need to be put in o an overall global health system.

05:39

And we need preparedness.

05:41

The best lessons, I think, on how to get prepared

05:44

are again, what we do for war.

05:46

For soldiers, we have full-time, waiting to go.

05:51

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

05:54

NATO has a mobile unit that can deploy very rapidly.

05:58

NATO does a lot of war games to check, are people well trained?

06:01

Do they understand about fuel and logistics

06:03

and the same radio frequencies?

06:06

So they are absolutely ready to go.

06:08

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

06:13

What are the key pieces?

06:15

First, we need strong health systems in poor countries.

06:20

That's where mothers can give birth safely,

06:23

kids can get all their vaccines.

06:25

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

06:30

We need a medical reserve corps:

06:31

lots of people who've got the training and background

06:34

who are ready to go, with the expertise.

06:37

And then we need to pair those medical people with the military.

06:42

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

06:46

and secure areas.

06:48

We need to do simulations,

06:51

germ games, not war games, so that we see where the holes are.

06:55

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

06:58

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

07:02

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

07:07

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

07:13

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

07:17

that could work very, very quickly.

07:21

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

07:24

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

07:29

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

07:33

global wealth will go down by over three trillion dollars

07:37

and we'd have millions and millions of deaths.

07:41

These investments offer significant benefits

07:44

beyond just being ready for the epidemic.

07:46

The primary healthcare, the R&D,

07:48

those things would reduce global health equity

07:51

and make the world more just as well as more safe.

07:55

So I think this should absolutely be a priority.

07:59

There's no need to panic.

08:00

We don't have to hoard cans of spaghetti or go down in o the basement.

08:05

But we need to get going, because time is not on our side.

08:09

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

08:15

it's that it can serve as an early warning, a wake-up call, to get ready.

08:21

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

08:26

Thank you.

08:28

(Applause)


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