We Can Make COVID-19 the Last Pandemic | Bill Gates | TED

Summary

Bill Gates discusses lessons from the COVID-19 pandemic and proposes the creation of a Global Epidemic Response and Mobilization (GERM) team to prevent future pandemics. He highlights the importance of early detection, better diagnostics, and equitable healthcare systems, drawing parallels to Rome's fire prevention system. Gates envisions investments in pandemic preparedness tools, vaccines, and improved health systems, which could not only prevent pandemics but also enhance global health equity. He calls for global cooperation and funding to establish this preventive infrastructure, aiming to make COVID-19 the last pandemic while promoting a healthier, fairer world.

Takeaways

• 🔥 In 6 CE, Emperor Augustus established the first permanent team of firefighters in Rome, highlighting the importance of community efforts in disaster management.
• 🌐 The COVID-19 pandemic has been a global catastrophe, exacerbating health disparities and affecting economies worldwide.
• 🏥 The pandemic has underscored the need for a global, coordinated approach to prevent future health crises.
• 🧯 Bill Gates proposes the creation of a GERM team (Global Epidemic Response and Mobilization), similar to firefighters, to prevent pandemics before they escalate.
• 🌟 The GERM team would be composed of experts like epidemiologists, data scientists, and logistics experts, emphasizing the need for diverse skills in pandemic response.
• 💼 The cost of the GERM team is estimated to be over a billion dollars annually, highlighting the significant investment required for effective pandemic prevention.
• 🌍 The team would work closely with the WHO and be stationed in various locations worldwide, especially in lower-income countries.
• 📈 Gates emphasizes the importance of the first 100 days in an outbreak, where early intervention can drastically reduce the spread of a disease.
• 🛠️ Investment in better diagnostic tools, therapeutics, and vaccines is crucial for pandemic prevention and can also improve overall health systems.
• 💉 The development of innovative vaccines that are easier to deliver and provide broad protection could help prevent future pandemics and reduce the burden of common diseases.
• 💼 The investment in pandemic prevention is compared to an insurance policy, where spending billions now could save trillions in the future and improve global health equity.

Q & A

What significant event occurred in Rome in 6 CE that prompted Emperor Augustus to create a permanent team of firefighters?

In 6 CE, a devastating fire in Rome led Emperor Augustus to create a permanent team of firefighters, which was a novel concept at the time.

How does the speaker compare the COVID-19 pandemic to a global fire?

The speaker likens the COVID-19 pandemic to a global fire due to its widespread devastation, affecting millions of lives and economies, emphasizing the need for a collective response similar to firefighting efforts.

What was the main message of the speaker's 2015 speech, and how does it relate to the COVID-19 pandemic?

In the speaker's 2015 speech, they warned about the unpreparedness for a pandemic and the need to get ready. This message is relevant to COVID-19 as it highlights the failure to act on that warning and the resulting consequences.

What is the GERM team proposed by the speaker, and what would be its primary function?

The GERM team, or Global Epidemic Response and Mobilization, is a proposed full-time team dedicated to pandemic prevention. Its primary function would be to stop outbreaks before they become pandemics.

How does the speaker suggest we can make COVID-19 the last pandemic?

The speaker suggests making COVID-19 the last pandemic by investing in disease monitoring, developing better diagnostic tools and vaccines, and improving health systems worldwide.

What are the key roles envisioned for the GERM team members?

GERM team members would include epidemiologists, data scientists, logistics experts, and other specialists, focusing on pandemic prevention and responding rapidly to outbreaks.

How does the speaker describe the importance of practice and drills for the GERM team?

The speaker emphasizes that practice and drills are crucial for the GERM team to ensure a quick response, similar to how firefighters maintain readiness.

What is the estimated annual cost of supporting the GERM team?

The estimated annual cost of supporting the GERM team is over a billion dollars to support approximately 3,000 team members.

How does the speaker propose to fund the GERM team?

The speaker proposes that rich-world governments should fund the GERM team, similar to how they fund other aid initiatives.

What is the significance of the first 100 days in preventing the spread of a virus according to the speaker?

The speaker highlights that the first 100 days are critical in virus spread prevention because viruses spread exponentially, and early intervention can stop the spread and save lives.

What are some of the innovative tools and approaches the speaker suggests for disease monitoring and prevention?

The speaker suggests tools like the Lumira diagnostic machine, inhalable drugs to block infections, and broad-spectrum vaccines as innovative approaches for disease monitoring and prevention.

Outlines

00:00

🧯 The Birth of Firefighting and Pandemic Prevention

The paragraph discusses the historical response of Emperor Augustus to the fire that devastated Rome in 6 CE by creating the first permanent team of firefighters. It draws a parallel to the current global crisis of COVID-19, emphasizing the need for community action and preparedness. The speaker argues for the creation of a global system to prevent future pandemics, highlighting the disparities in health outcomes during the pandemic and the importance of learning from the past to build a healthier future. The analogy of fire prevention is used to illustrate the necessity of a well-funded and well-practiced system for pandemic prevention.

05:01

🌐 Introducing the GERM Team for Pandemic Response

This section introduces the concept of the GERM team, which stands for Global Epidemic Response and Mobilization. The team is envisioned as a full-time, diverse group of specialists including epidemiologists, data scientists, and logistics experts, whose sole mission is to prevent pandemics. The speaker outlines the costs and structure of such a team, emphasizing the importance of practice and drills to ensure a rapid and effective response to outbreaks. The GERM team would be coordinated by the World Health Organization (WHO) and would work closely with national health teams, particularly in low-income countries, to strengthen health systems and respond to potential pandemics within the critical first 100 days.

10:03

💉 Advancing Tools and Health Systems for Pandemic Prevention

The final paragraph focuses on the broader investment needed to prevent future pandemics, including disease monitoring through GERM, the development of better diagnostic tools and vaccines, and the improvement of health systems globally. The speaker highlights the cost-effectiveness of these investments, comparing the billions needed for prevention to the trillions lost due to COVID-19. The potential benefits of these investments extend beyond pandemic prevention, including improved health equity and the reduction of diseases like HIV and malaria. The speaker concludes by emphasizing the opportunity to learn from the current pandemic and to create a healthier, more equitable world.

Keywords

💡Emperor Augustus

Emperor Augustus was the first Roman Emperor who, in response to a devastating fire in Rome in 6 CE, established the first permanent team of firefighters. This historical event is used in the script to draw a parallel to the need for a global response team for pandemics. The creation of this team by Augustus signifies a shift from individual to community-based solutions, which is central to the video's theme of collective action against global threats.

💡Firefighters

Firefighters are professionals trained to extinguish fires and rescue individuals from dangerous situations. In the script, they symbolize a community's preparedness and collective effort to combat a common threat. The analogy of firefighters is used to advocate for the formation of a global pandemic response team, emphasizing the importance of training, preparedness, and community involvement in disaster management.

💡COVID-19

COVID-19 is the disease caused by the SARS-CoV-2 virus, which has led to a global pandemic with significant loss of life and economic upheaval. The script uses COVID-19 as a case study to highlight the inadequacies of the current global health system in responding to pandemics and to argue for the creation of a new, proactive system to prevent future pandemics.

💡Health Inequities

Health inequities refer to unfair and avoidable differences in health status seen within and between populations. The script mentions that survival during the COVID-19 pandemic was partly dependent on factors like income, race, and neighborhood, illustrating how health inequities were exacerbated by the pandemic. This concept underscores the importance of creating a more equitable global health system.

💡GERM team

The GERM team is a proposed global group dedicated to pandemic prevention, analogous to the role of firefighters in preventing fires. The acronym stands for Global Epidemic Response and Mobilization. The team would consist of specialists like epidemiologists, data scientists, and logistics experts, emphasizing the need for diverse expertise in combating pandemics. The script suggests that such a team could prevent future pandemics by responding quickly to outbreaks.

💡Epidemiologists

Epidemiologists are scientists who study the distribution and determinants of diseases in populations. In the context of the script, epidemiologists would be key members of the proposed GERM team, responsible for investigating disease outbreaks and working to prevent their spread. Their role is crucial in understanding the patterns and causes of diseases, which is vital for effective pandemic response.

💡Vaccines

Vaccines are biological preparations that provide active acquired immunity to certain infectious diseases. The script discusses the critical role vaccines played in saving millions of lives during the COVID-19 pandemic. It also calls for the development of better vaccines that are easier to deliver, more effective, and can provide broad-spectrum protection against emerging variants.

💡Diagnostics

Diagnostics refer to the detection and identification of disease or pathogens. In the script, better diagnostics are highlighted as a key tool in pandemic prevention, with the example of the Lumira machine, which is a more accessible and affordable diagnostic tool. The importance of diagnostics lies in their ability to quickly identify disease outbreaks, allowing for a faster and more effective response.

💡Health Systems

Health systems encompass all organizations, people, and actions whose primary intent is to promote, restore, or maintain health. The script argues for the strengthening of health systems as a critical investment to prevent future pandemics. Robust health systems can detect and respond to disease outbreaks more effectively, serving as the first line of defense against emerging health threats.

💡Innovation

Innovation in the context of the script refers to the development of new technologies, methods, and ideas to solve problems, particularly in the realm of public health. The speaker advocates for innovation in areas such as diagnostics, therapeutics, and vaccines to better prepare for and prevent future pandemics. Innovation is portrayed as a key driver of progress in pandemic prevention and response.

💡Equity

Equity in health refers to the fair and just distribution of health resources and opportunities. The script discusses the goal of creating a healthier and more equitable world, where everyone has a chance to live a healthy and productive life. Equity is central to the message of the video, as it highlights the need to address disparities in health outcomes and ensure that all people have access to necessary health services.

Highlights

Emperor Augustus created the first permanent team of firefighters in 6 CE, marking a significant step in communal safety.

The COVID pandemic has exposed and exacerbated health inequities, with survival chances linked to income, race, and neighborhood.

The speaker emphasizes the need to create a world where everyone has the opportunity for a healthy and productive life, free from the fear of future pandemics.

The speaker reflects on the lack of preparedness for pandemics despite warnings, highlighting the importance of learning from the past.

The analogy of fire prevention is used to illustrate the need for a well-funded and well-understood system to prevent pandemics.

The United States has 370,000 full-time firefighters and almost nine million fire hydrants, showcasing the scale of investment in fire prevention.

The proposal for a GERM team (Global Epidemic Response and Mobilization) is introduced as a full-time, diverse group dedicated to pandemic prevention.

The GERM team would consist of epidemiologists, data scientists, logistics experts, and would require both scientific and communication skills.

The cost of the GERM team is estimated to be over a billion dollars a year, supporting 3,000 specialists.

The GERM team would be coordinated by the WHO and stationed in public health agencies around the world, with a focus on low-income countries.

The importance of practice and drills for the GERM team is emphasized, drawing a parallel to the training of firefighters.

The speaker discusses the potential for the GERM team to work on other infectious diseases and strengthen health systems during periods without risky outbreaks.

The first 100 days of an outbreak are critical in stopping the spread of a virus, with early intervention potentially saving over 98% of lives.

Australia is highlighted as an example of a country that managed the pandemic effectively through diagnostic capacity and distancing policies.

The speaker calls for investments in better diagnostics, therapeutics, and vaccines to prepare for future pandemics.

The Lumira, a低成本 and accurate diagnostic machine, is presented as an example of the type of tool needed globally.

The need for vaccines that are easier to deliver, broad spectrum, and capable of blocking infections is discussed.

The speaker advocates for the eradication of entire families of viruses through innovative vaccines, such as the flu and coronavirus families.

Investments in disease monitoring, R&D tools, and improved health systems are proposed as a cost-effective insurance policy against future pandemics.

The speaker concludes by emphasizing the potential to make COVID-19 the last pandemic and build a healthier, more equitable world.

Transcripts

In the year 6 CE,

a fire devastated Rome.

In response,

Emperor Augustus did something that had never been done before

in the history of the Empire.

He created a permanent team of firefighters

who used buckets just like this one.

Augustus understood that individuals alone can't protect themselves from fires.

They need help from the community.

When one person's house is on fire,

that creates a risk for everyone else's homes.

And so what we've had these last few years is like a horrific global fire.

The COVID pandemic has killed millions and upended economies,

and we want to stop that from happening again.

COVID, it's hard to overstate how awful it's been.

It's increased the health inequities between the rich and the poor.

Survival depended partly on your income, your race,

the neighborhood you lived in.

And so we should seize this opportunity

to create a world where everyone has a chance

to live a healthy and productive life.

Also a life free from the fear of the next COVID-19.

When I was on this stage in 2015,

I was one of many people who said

we weren't ready and we needed to get ready.

We didn't.

The speech actually was watched by a lot of people.

But 90 percent of the views were after it was too late.

(Laughter)

So now I hope the need is clear.

And of course, we've learned a lot.

During this pandemic,

a lot of things worked well, a lot of things didn't work well.

And so we have all that knowledge to build a prevention system.

COVID-19 can be the last pandemic if we take the right steps.

So how, what are these steps?

Well, let's go back and look at what the Romans did.

Think about how, over time, we've gotten good at preventing big fires.

Fire prevention is kind of this pervasive thing.

It's well funded.

It's well understood.

If an alarm went off right now,

everyone here would know we're supposed to calmly gather,

go out and wait instructions.

We'd know that help would be on the way

because we have lots of trained firefighters who practice.

The United States alone has 370,000 full-time firefighters,

even more than I guessed that number would be.

We also have access to water.

The United States, for example, has almost nine million fire hydrants.

And so that type of investment, that type of practice,

that type of system is what we need to stop pandemics.

Now, often in movies, we'll have pandemics.

And I'm always impressed with what takes place.

Let's look at an example of this rapid response.

[Motaba River Valley, Zaire]

(Helicopter rotors whirring)

Well, that's quite impressive.

We don't need the music,

but otherwise we saw exactly what should happen.

An outbreak’s detected.

Very quickly, literally within days,

doctors are dispatched.

They have a helicopter to get into exactly ground zero.

They go in there, and they’ve got the right tools.

And this is what should happen when an outbreak is spotted.

But we don't have that team, we don't have those resources.

And if an outbreak took place in a low-income country,

it could be literally months

before we started to orchestrate those resources.

So despite what you see in movies,

there is no group of experts standing by to prevent this disaster.

So we have to create a new team.

I believe we should create what I call the GERM team.

Germ stands for Global Epidemic Response and Mobilization.

This group is full-time.

Their only priority is pandemic prevention.

It's made up of a diverse set of specialists

with a lot of different realms of expertise:

epidemiologists, data scientists,

logistics experts.

And it's not just scientific and medical knowledge.

They also have to have communication and diplomacy skills.

The cost of this team is significant.

It's over a billion a year

to support the 3,000 people who would be on this team.

And its mission is to stop outbreaks before they become pandemics.

The work would be coordinated by the WHO.

They'd be present in many locations around the world,

stationed in public health agencies.

They'd work closely with the national teams,

depending on the income level.

They'd have more in the lower-income countries.

You know, for example, we could have GERM members

say an epidemiologist, working out of the Africa CDC office in Abuja.

And a very important thing is that like firefighters,

a GERM team would do drills.

When you want to have quick response,

when you want to make sure you have all the pieces there

and you can move very quickly, practice is key.

That's how you make sure everyone knows what to do.

Now, this team, there could be periods where there's no risky outbreak

and they can keep their skills strong

by working on some of the other infectious diseases,

but that would be a second priority.

They would work with countries to strengthen their health systems.

The health systems are the front line.

You need to know if, say,

a lot of people show up with a new kind of cough,

that’s when GERM needs to look into it and say, is this an outbreak?

Is there a new pathogen here?

What is the sequence of that?

And so for all of this, the first 100 days are key.

Viruses spread exponentially.

And so if you get in there when the infection rate is fairly small,

you can actually stop the spread.

You know, in this epidemic,

if we'd been able to stop it within 100 days,

we would have saved over 98 percent of the lives.

Now, we did have countries that did a good job.

Australia is an example.

They orchestrated diagnostic capacity.

They came up with distancing policies and quarantine policies.

And so their overall death rate per capita will be well less

than a 10th of other countries.

But we did not, as a world, contain it.

And that's what we have to do next time.

When COVID struck, we were almost like Rome

before they had fire buckets and firefighters.

We didn't have the people, the systems or the tools we need.

Now, with the right investments,

we can have a whole new generation of tools,

better diagnostics, therapeutics and vaccines.

A good example in the diagnostic area is this little machine,

this is called the Lumira.

We can have these all over the world that can test for any number of diseases.

It’s a 10th as expensive as PCR,

it’s absolutely as accurate, and it’s simple.

So it can be used anywhere.

We need other R&D investments.

One that I'm very excited about is the idea of a drug

that you inhale that blocks you from getting infected.

It can be pathogen-independent and trigger your immune system

so that you'll be protected.

A lot of the tools, the diagnostic tools

and those infection-blocking tools are important

because they can be staged in advance.

Now, we also need vaccines,

but we want to stop the outbreak

before we have to do a global vaccination campaign.

And so vaccines can play a couple of different roles,

but not the primary role.

We have to invest in more than just that.

When we look at vaccines, they were the miracle of this epidemic.

They saved millions of lives, but they can be far better.

We need to invent easier-to-deliver vaccines

that are just a patch you put on your arm

or something that you inhale.

We need vaccines that actually block infections.

In this case, there were lots of breakthrough infections.

We need vaccines that are broad spectrum,

so they work against most of the emerging variants,

which we did not have this time.

And we also need factories that are standing by

so we can build enough vaccines for the entire world

within six months

and achieve far better equity.

The vaccines can also do something that would be super helpful,

which is to help us eradicate entire families of viruses.

Innovative new vaccines used properly could get rid of the flu family,

the coronavirus family.

And there's a huge burden of those,

even in non-pandemic years,

and if we get rid of it, it can never cause a pandemic.

So I'm talking about investments in three broad areas:

Disease monitoring,

that's GERM.

The R and D tools that are far better.

And finally, and the most expensive, is improved health systems.

This won't be cheap, but it'll save lives.

And even it'll save money in the long run.

It's like an insurance policy.

The cost to prevent the next pandemic will be tens of billions of dollars.

But let's compare that to what we just went through.

The IMF estimates that COVID has cost nearly 14 trillion dollars.

And so we need to spend billions in order to save trillions.

And here's the best part of this.

Even when we're not having an outbreak, these investments like the Lumira,

those new vaccines,

they will make people healthier.

They'll shrink the gap, the health equity gap,

which is gigantic, between rich and poor countries.

For example, we can detect more HIV cases and do a better job of treatment.

We can reduce deaths from malaria.

We can get more people high-quality care.

And so this is not just a downer

about how to stop things from getting worse,

but also a chance to make things better.

If we take the right steps,

we can make COVID-19 the last pandemic,

and we can build a healthier, more equitable world for everyone.

Thank you.

(Applause)

Helen Walters: Thank you so much.

I have a few follow-up questions

and one is really about the formal status of GERM.

So you mentioned this would cost a billion dollars,

you mentioned it comes through the WHO,

but exactly who's running this, how does this work,

how do we make this happen?

BG: Well, GERM does not exist.

It's a proposal I'm putting forward that hopefully over the next year,

while the pain of the pandemic is still clear in people's minds,

will get a global consensus.

The rich-world governments will have to step up

like they do with all the aid things and come up with that money.

The way the personnel systems works, so that it's under WHO,

but a really top-notch team,

there will be a lot of debate about how to do that well.

So, you know, I'm putting it forward

and hopefully within the next year we'll get that consensus.

HW: Who do you need to pick that up next?

BG: Well, it's really the rich-world governments.

The WHO has this big yearly meeting, the World Health Assembly,

and at some point somebody will put forward a resolution

and we'll see if the extra resources can be put in for that.

After World War II, we did a lot.

You know, we created the United Nations, we talked a lot about war.

So I'd be stunned, although, you know,

so far the action has been less than I would have expected,

I'd be stunned if we don't go forward with something pretty close

to what I'm laying out there.

HW: This has been pretty personal for you.

You know, the anti-vaxxers are out there, they are loud,

and this has become personal.

I just wanted to ask, like, how are you managing that?

BG: Well, it's kind of weird.

(Laughter)

(Applause)

Now, our foundation, the Gates Foundation, is very involved in vaccines,

the invention of new vaccines, funding vaccines.

And we're very proud that through joint efforts like GAVI,

that saved tens of millions of lives.

So it's somewhat ironic to have somebody turn around and say, no, you know,

we're using vaccines to kill people or to make money or, you know,

we started the pandemic,

even some strange things like, that I somehow want to track, you know,

the location of individuals

because I'm so deeply desirous to know where everybody is.

(Laughter)

I'm not sure what I'm going to do with that information.

(Laughter)

You know, does this turn into something where, you know,

there's constantly crazy people showing up?

Who knows?

But, you know, hopefully, as the pandemic calms down,

people are more rational about, hey,

vaccines are a miracle and there's a lot more we can do.

HW: So the future is in our hands in the present.

Bill Gates, thank you so much for being here.

BG: Thank you.

(Applause)