OPINION — Editorial

Words from the wise

Bill Gates, the world's richest man, who has devoted much of his philanthropy to improving global public health, gave a speech the other day at the Munich Security Conference that should have caught everyone's attention. Gates insisted that world leaders think differently about public health and national security. They should listen.

In 2001 bioterrorism became a very real security problem. After the anthrax attacks that year, the United States spent billions of dollars to develop and stockpile medical counter-measures and build warning systems. But in the years that followed, the villain causing death and illness was not a bioterrorist but Mother Nature in a series of naturally occurring outbreaks: severe acute respiratory syndrome (SARS), swine flu, and Ebola, among others. Each could not be stopped by existing therapeutics or vaccines, raising the question: How can nations and societies defend against fast-moving waves of peril? It is impossible and too expensive to develop counter-measures in advance of every possible threat. Moreover, effective therapeutics, vaccines and diagnostics require long lead times, while a pandemic demands a rapid response.

Gates insists that the pandemic threat be taken as urgently as major national security issues. This has often not been the case. Public-health systems, especially in poor and war-torn nations, have long suffered under-funding and neglect. The world was late in attacking Ebola. Just last year in the United States, Congress dithered for months over money to fight the Zika virus. Why, Gates asks, does the world not approach pandemic risk on a level with preventing nuclear war or climate change? "We ignore the link between health security and international security at our peril," he declared.

Much more can be done before another disaster strikes. Gates noted that vaccines, so important in stopping an epidemic, typically take up to 10 years to develop, but recent advances in genomics offer the prospect of vaccines that could be created on the fly. This has long been a dream of biomedicine, and Gates is right that it will need a lot more support and research to become reality. He also called for devoting more time and resources to surveillance so that disease outbreaks can be spotted sooner. Finally, he suggested preparing for epidemics "the way the military prepares for war," with exercises and training.

Editorial on 02/27/2017

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