Via The New York Times, an op-ed: Bill Gates: The Ebola Crisis Was Terrible. But Next Time Could Be Much Worse. Excerpt:
Much of the public discussion about the world’s response to Ebola has focused on whether the World Health Organization, the Centers for Disease Control and Prevention and other groups could have responded more effectively. These are worthwhile questions, but they miss the larger point. The problem isn’t so much that the system didn’t work well enough. The problem is that we hardly have a system at all.
To begin with, most poor countries, where a natural epidemic is most likely to start, have no systematic disease surveillance in place. Even once the Ebola crisis was recognized last year, there were no resources to effectively map where cases occurred, or to use people’s travel patterns to predict where the disease might go next.
Then, once it became clear that a serious emergency was underway, trained personnel should have flooded the affected countries within days. Instead it took months. Doctors Without Borders deserves a lot of credit for mobilizing volunteers faster than any government did. But we should not count on nonprofit groups to mount a global response.
Even if we signed up lots of experts and volunteers right away, it’s not clear how we would deploy them quickly into the affected area, or how we would transport patients. Few organizations are capable of moving thousands of people, some of them infected, to different locations on the globe with a week’s notice.
The Ebola epidemic might have been a lot worse if the United States, Britain and other governments had not used military resources to fly people and equipment into and out of affected areas. But we should not assume that the next epidemic will limit itself to countries that welcome Western troops.
Data is another crucial problem. During the Ebola epidemic, the database that tracks cases has not always been accurate. This is partly because the situation is so chaotic, but also because much of the case reporting has been done on paper and then sent to a central location for data entry.
Then there’s our failure to invest in effective medical tools like diagnostic tests, drugs and vaccines. On average it has taken an estimated one to three days for Ebola test results to come back — an eternity when you need to quarantine people until you know whether they’re infected. Drugs that might help stop Ebola were not tested in patients until after the epidemic had peaked, partly because the world has no clear process for expediting drug approvals.
Compare all this to the preparation that nations put into defense. Armies have systems for recruiting, training and equipping soldiers. NATO has a mobile unit that is ready to deploy quickly. Although the system isn’t perfect, NATO members do joint exercises where they work out logistics like how troops will get food and what language they will use to communicate.
Few if any of these approaches exist for an epidemic response. The world does not fund any organization (not even the W.H.O.) to coordinate all the activities needed to stop an epidemic. In short, in a battle against a severe epidemic, we would be taking a knife to a bazooka fight.
I believe that we can solve this problem, just as we’ve solved many others — with ingenuity and innovation.