Speaking at the Munich Security Conference, the billionaire Microsoft co-founder turned philanthropist, Bill Gates warned the world of the raging threat of wide-scale bio-terrorism against mankind and the dire need to invest in vaccine innovation.
Gates who decided to make global health the focus of his philanthropic work 20 years back strongly believes that our worlds are more tightly linked than most people realize and aimed to justify this belief by qouting an example from his experience while working on an effort to eradicate polio. He blames war zones and other fragile state settings such as poverty as the major factor behind persistent epidemics. He qouted " Of the 125 countries where polio was endemic, 122 countries have eliminated the disease. Only Afghanistan, Pakistan, and Nigeria have never been polio-free. And that’s no coincidence. War zones and other fragile state settings are the most difficult places to eliminate epidemics. They're also some of the most likely places for them to begin—as we've seen with Ebola in Sierra Leone and Liberia, and with cholera in the Congo Basin and the Horn of Africa. So, to fight global pandemics, we must fight poverty, too."
He pointed out that we often tend to ignore the link between health security and international security and warned the world against the reasonable possibility of the next-generation epidemic that could be originated on the computer screen of a terrorist intent on using genetic engineering to create a synthetic version of the smallpox virus or a super contagious and deadly strain of the flu. He says that "Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10-15 years."
Stating facts, Gates mentioned the last such catastrophe that took place in 1918 where a particularly virulent and deadly strain of flu killed between 50 million and 100 million people and further warned the world that "even if the next pandemic isn't on the scale of the 1918 flu, we would be wise to consider the social and economic turmoil that might ensue if something like Ebola made its way into a lot of major urban centers. We were lucky that the last Ebola outbreak was contained before it did.
However, according to him the biggest sigh of relief is that the advances in biotechnology, new vaccines and drugs can help prevent epidemics from spreading out of control. But in order to do so, first and most importantly, an arsenal of new weapons—vaccines, drugs, and diagnostics needs to be built. And not just need to be build but also be built in less than a period of 90-days as opposed to the current period of 10 years taken to develop and license a new vaccine in order to significantly curb deaths from a fast-moving airborne pathogen. One such initiative was taken last month with the launch of a new public-private partnership called the Coalition for Epidemic Preparedness Innovations with a hope to enable the world to produce safe, effective vaccines as quickly as new threats emerge.
The biggest breakthrough potential as Gates pointed out is in emerging technology platforms that leverage recent advances in genomics to dramatically reduce the time needed to develop vaccines. These new platform technologies essentially create a delivery vehicle for synthetic genetic material that instructs your cells to make a vaccine inside your own body and once built, the vaccine platform for one pathogen can be used again for other pathogens by only substituting a few genes. This flexibility and reusability would not only cut the vaccine development and approval timeline significantly but can also be applied to other hard-to-treat diseases like HIV, malaria, and tuberculosis. But the $550 million that launched CEPI is just a down payment and more
support from governments to fund the necessary R&D will be needed.
However, the preventive capacity of a vaccine alone won't help if a pathogen has already spread out of control as epidemics can quickly take root in the places least equipped to fight them and so we also need to improve surveillance. That starts with strengthening basic public health systems in the most vulnerable countries which would further improve our ability to prevent, detect, and respond to epidemics.
In order to support this endeavour and make it a beneficial possibility, it is also important to ensure that every country not only conducts routine surveillance to gather and verify disease outbreak intelligence but countries also share information in a timely way. This would require adequate laboratory resources to identify and monitor suspect pathogens. For this, Gates suggests we can build on the existing lab network that's in place now for polio, as well as a new network of field sites and labs that will help to better understand the causes of child mortality in poor countries.
The third thing required is to prepare for epidemics and includes ways to better understand how diseases will spread, how people will respond in a panic, and how to deal with things like overloaded highways and communications systems. Special focus on training medical personnel ready to contain an epidemic quickly, and better coordination with the military to help with logistics and to secure areas is also important. He explains this by stating how worse the situation could have been during the time when Ebola epidemic had hit UK and U.S. if the government had not taken the right measures. "It might have been much worse if the U.S. and UK governments had not used military resources to help build health centers,
manage logistics, and fly people in and out of affected countries."
By the end of this year, 67 countries are expected to have completed independent assessments of their epidemic readiness. While acknowledging that he also raises serious concerns about lack of funds to help the poorest countries with epidemic preparation. The cost of ensuring adequate pandemic preparedness worldwide is estimated at $3.4 billion a year—yet the projected annual
loss from a pandemic could run as high as $570 billion.
The Microsoft founder also spoke about how things were comparatively simpler when he was a kid and there existed only one kind of existential threat - The threat of a nuclear war. By the late 1990s, most reasonable people had come to accept that climate change represented another major threat to humankind and according to him, the threat of deadly pandemics is
as life-threatning. According to him, getting ready for a global pandemic is every bit as important as nuclear deterrence and avoiding a climate catastrophe. Innovation, cooperation, and careful planning can dramatically mitigate the risks presented by each of these threats.
Gates firmly believes that a decade from now, we can be much better prepared for a lethal epidemic if we're willing to put a fraction of what we spend on defense budgets and new weapons systems into epidemic readiness.