How to Prevent the Next Pandemic

Governments, businesses, and individuals around the world are thinking about what happens after the COVID-19 pandemic. Can we hope to not only ward off another COVID-like disaster but also eliminate all respiratory diseases, including the flu? Bill Gates, one of our greatest and most effective thinkers and activists, believes the answer is yes.

The author of the #1 New York Times best seller How to Avoid a Climate Disaster *lays out clearly and convincingly what the world should have learned from COVID-19 and what all of us can do to ward off another catastrophe like it. Relying on the shared knowledge of the world s foremost experts and on his own experience of combating fatal diseases through the Gates Foundation, Gates first helps us understand the science of infectious diseases. Then he shows us how the nations of the world, working in conjunction with one another *and with the private sector, how we can prevent a new pandemic from killing millions of people and devastating the global economy.

Here is a clarion call strong, comprehensive, and of the gravest importance.

Auteur

BILL GATES is a technologist, business leader, and philanthropist. In 1975, he cofounded Microsoft with his childhood friend Paul Allen. Today, he is cochair of the Bill & Melinda Gates Foundation, where he has spent more than twenty years working on global health and development issues, including pandemic prevention, disease eradication, and problems concerning water, sanitation, and hygiene. He has three children.

Résumé
From the author of the #1 New York Times best seller How to Avoid a Climate Disaster: The COVID-19 pandemic isn’t over, but even as governments around the world strive to put it behind us, they’re also starting to talk about what happens next. How can we prevent a new pandemic from killing millions of people and devastating the global economy? Can we even hope to accomplish this?

Bill Gates believes the answer is yes, and in this book he lays out clearly and convincingly what the world should have learned from COVID-19 and what all of us can do to ward off another disaster like it. Relying on the shared knowledge of the world’s foremost experts and on his own experience of combating fatal diseases through the Gates Foundation, he first helps us understand the science of infectious diseases. Then he shows us how the nations of the world, working in conjunction with one another and with the private sector, can not only ward off another COVID-like catastrophe but also eliminate all respiratory diseases, including the flu.
 
Here is a clarion call—strong, comprehensive, and of the gravest importance—from one of our greatest and most effective thinkers and activists.

Échantillon de lecture
Introduction

I was having dinner on on a Friday night in mid-February 2020 when I realized that COVID-19 would become a global disaster.

For several weeks, I had been talking with experts at the Gates Foundation about a new respiratory disease that was circulating in China and had just begun to spread elsewhere. We’re lucky to have a team of world-class people with decades of experience in tracking, treating, and preventing infectious diseases, and they were following COVID-19 closely. The virus had begun to emerge in Africa, and based on the foundation’s early assessment and requests from African governments, we had made some grants to help keep it from spreading further and to help other countries prepare in case it took off. Our thinking was as follows: We hope this virus won’t go global, but we have to assume it will until we know otherwise.

At that point, there was still reason to believe that the virus could be contained and wouldn’t become a pandemic. The Chinese government had taken unprecedented safety measures to lock down Wuhan, the city where the virus emerged—schools and public places were closed, and citizens were issued permission cards that allowed them to leave their homes every other day for thirty minutes at a time. And the virus was still limited enough that countries were letting people travel freely. I had flown to South Africa earlier in February for a charity tennis match.

When I got back from South Africa, I wanted to have an in-depth conversation about COVID-19 at the foundation. There was one central question I could not stop thinking about and wanted to explore at length: Could it? be contained, or would it go global?

I turned to a favorite tactic that I’ve been relying on for years: the working dinner. You don’t bother with an agenda; you simply invite a dozen or so smart people, provide the food and drinks, tee up a few questions, and let them start thinking out loud. I’ve had some of the best conversations of my working life with a fork in my hand and a napkin in my lap.

So a couple of days after returning from South Africa, I sent an email about scheduling something for the coming Friday night: “We could try and do a dinner with the people involved with coronavirus work to touch base.” Almost everyone was nice enough to say yes—despite the timing and their busy schedules—and that Friday, a dozen experts from the foundation and other organizations came to my office outside Seattle for dinner. Over short ribs and salads, we turned to that key question: Would COVID-19 turn into a pandemic?

As I learned that night, the numbers were not in humanity’s favor. Especially because COVID-19 spread through the air—making it more transmissible than, say, a virus that is spread through contact, like HIV or Ebola—there was little chance of containing it to a few countries. Within months, millions of people all over the world were going to contract this disease, and millions would die from it.

I was struck that governments weren’t more concerned about this looming disaster. I asked, “Why aren’t governments acting more urgently?”

One scientist on the team, a South African researcher named Keith Klugman, who came to our foundation from Emory University, simply said: “They should be.”

Infectious diseases—both the kind that turn into pandemics and the kind that don’t—are something of an obsession for me. Unlike the subjects of my previous books, software and climate change, deadly infectious diseases are not generally something that people want to think about. (COVID-19 is the exception that proves the rule.) I’ve had to learn to temper my enthusiasm for talking about AIDS treatments and a malaria vaccine at parties.

My passion for the subject goes back twenty-five years, to January 1997, when Melinda and I read an article in The New York Times by Nicholas Kristof. Nick reported that diarrhea was killing 3.1 million people every year, almost all of them children. We were shocked. Three million kids a year! How could that many children be dying from something that was, as far as we knew, little more than an uncomfortable inconvenience?

We learned that the simple lifesaving treatment for diarrhea—an inexpensive liquid that replaces the nutrients lost during an episode—wasn’t reaching millions of children. That seemed like a problem we could help with, and we started making grants to get the treatment out more broadly and to support work on a vaccine that would prevent diarrheal diseases in the first place.

I wanted to know more. I reached out to Dr. Bill Foege, one of the epidemiologists responsible for the eradication of smallpox and a former head of the Centers for Disease Control and Prevention. Bill gave me a stack of eighty-one textbooks and journal articles on smallpox, malaria, and public health in poor countries; I read them as fast as I could and asked for more. One of the most influential for…