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How to Prevent the Next Pandemic Kindle Edition

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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 Disasterlays out clearly and convincingly what the world should have learned from COVID-19 and what all of us can do to ward off another catastrophelike 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.

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“In this concise and lucid book, global health activist Gates reflects on the current COVID-19 pandemic, considers future ones, and renders several sensible recommendations for prevention . . . Passionate but never preachy, Gates delivers an expert, well-reasoned, and robust appeal for the world to unite in averting upcoming pandemics.” —Booklist (starred review)

“Gates delivers a thoughtful exploration of how lessons learned from Covid-19 can inform future global public health policies. In accessible prose, he spells out steps for preventing future pandemics, among them creating a global task force dedicated to doing so . . . Gates is realistic about what he’s up against . . . but he does a good job of making [the task force’s] $1 billion price tag seem reasonable.” —Publishers Weekly

About the Author

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. He also launched Breakthrough Energy, an effort to commercialize clean energy and other climate-related technologies. He has three children.
--This text refers to an alternate kindle_edition edition.

Excerpt. © Reprinted by permission. All rights reserved.

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 me had a mundane title: World Development Report 1993: Investing in Health, Volume 1. My obsession with infectious diseases—and particularly with infectious diseases in low- and middle-income countries—had begun.

When you start reading up on infectious diseases, it isn’t long before you come to the subject of outbreaks, epidemics, and pandemics. There aren’t strict definitions for these terms. A good rule of thumb is that an outbreak is when a disease spreads locally, through a community or small region; an epidemic is when an outbreak goes national; and a pandemic is when an epidemic goes global, affecting more than one continent. And some diseases don’t come and go, but stay consistently in a specific location—those are known as endemic diseases. Malaria, for instance, is endemic to many equatorial regions. If COVID-19 never goes away completely, it’ll be classified as an endemic disease.

It’s not at all unusual to discover a new pathogen. In the past fifty years, according to the World Health Organization (WHO), scientists have identified more than 1,500 of them; most began in animals and then spread to humans.

Some never caused much harm; others, such as HIV, have been catastrophes. HIV/AIDS has killed more than 36 million people, and more than 37 million people are living with HIV today. There were 1.5 million new cases in 2020, though there are fewer new cases each year because people who are being properly treated with antiviral drugs don’t spread the disease.

And with the exception of smallpox—the only human disease ever eradicated—old infectious diseases are still hanging around. Even plague, a disease most of us associate with ancient times, is still with us. It struck Madagascar in 2017, infecting more than 2,400 people and killing more than 200. The WHO receives reports of at least 40 cholera outbreaks every year. Between 1976 and 2018, there were 24 localized outbreaks and one epidemic of Ebola. If you include small ones, there are probably more than 200 outbreaks of infectious diseases every year.

AIDS and other “silent epidemics,” as they came to be known—tuberculosis, malaria, and others—are the focus of the foundation’s global health work, along with diarrheal diseases and maternal mortality. In 2000, these diseases killed more than 15 million people in all, many of them children, and yet shockingly little money was being spent on them. Melinda and I saw this as the area in which our resources and our knowledge of how to build teams to create new innovations could make the biggest difference.

This is the subject of a common misconception about our foundation’s health work. It’s not concentrated on protecting people in rich countries from diseases. It’s concentrated on the gap in health between high-income countries and low-income ones. Now, in the course of that work, we learn a lot about diseases that can affect the rich world, and some of our funding will help with these diseases, but they are not a focus of our grantmaking. The private sector, rich-country governments, and other philanthropists put a lot of resources into that work.

Pandemics, of course, affect all countries, and I have worried a lot about them since I began studying infectious diseases. Respiratory viruses, including the influenza family and the coronavirus family, are particularly dangerous because they can spread so quickly.

And the odds that a pandemic will strike are only going up. That’s partly because, with urbanization, humans are invading natural habitats at a growing rate, interacting with animals more often, and creating more opportunities for a disease to jump from them to us. It’s also because international travel is skyrocketing (or at least it was before COVID slowed its growth): In 2019, before COVID, tourists around the world made 1.4 billion international arrivals every year—up from just 25 million since 1950. The fact that the world had gone a century since a catastrophic pandemic—the most recent one, the flu of 1918, killed something like 50 million people—is largely a matter of luck.

Before COVID, the possibility of a flu pandemic was, relatively speaking, well known; many people had at least heard of the 1918 flu, and they might have remembered the swine flu pandemic of 2009–10. But a century is a long time, so almost no one alive had lived through the flu pandemic, and the swine flu pandemic didn’t turn out to be a huge problem because it wasn’t much more fatal than the normal flu. At the time I was learning all this, in the early 2000s, coronaviruses—which are one of three virus types that cause most common colds—weren’t discussed nearly as often as the flu.

The more I learned, the more I realized just how unprepared the world was for a serious respiratory virus epidemic. I read a report on the WHO’s response to the 2009 swine flu epidemic that concluded, prophetically: “The world is ill-prepared to respond to a severe influenza pandemic or to any similarly global, sustained and threatening public-health emergency.” The report laid out a step-by-step plan for getting prepared. Few of the steps were taken.

The next year, my friend Nathan Myhrvold started telling me about some research he was doing into the greatest threats faced by humanity. Although his biggest worry was an engineered bioweapon—a disease made in a lab—naturally occurring viruses were high on the list.

I’ve known Nathan for decades: He created Microsoft’s cutting-edge research division and is a polymath who has done research on cooking (!), dinosaurs, and astrophysics, among other things. He’s not prone to exaggerating risks. So when he argued that governments around the world were doing essentially nothing to prepare for pandemics of any kind, either natural or intentionally created, we talked about how to change that.

Nathan uses an analogy that I like. Right now, the building you are sitting in (assuming you’re not reading this book at the beach) is probably fitted with smoke detectors. Now, the odds that the building you’re in will burn down today are very low—in fact, it might go 100 years without burning down. But that building isn’t the only one around, of course, and somewhere in the world, at this very moment, a building is burning down. That constant reminder is why people install smoke detectors: to protect against something that’s rare but potentially very destructive.

When it comes to pandemics, the world is one big building fitted with smoke detectors that aren’t especially sensitive and have trouble communicating with one another. If there’s a fire in the kitchen, it might spread to the dining room before enough people hear about it to go put it out. Plus, the alarm only goes off about every 100 years, so it is easy to forget that the risk is there.

It’s hard to get your head around just how quickly a disease can spread, because exponential growth isn’t something that most of us encounter in our day-to-day lives. But consider the math. If 100 people have an infectious disease on Day 1, and if the number of cases doubles every day, the entire population of the earth will be infected by Day 27.

In the spring of 2014, I started getting emails from the health team at the foundation about an outbreak that sounded ominous: A few cases of Ebola virus had been identified in southeastern Guinea. By that July, there had been Ebola cases in Conakry, the capital of Guinea, and in the capital cities of Guinea’s neighbors, Liberia and Sierra Leone. Eventually the virus would spread to seven other countries, including the United States, and more than 11,000 people would die.

Ebola is a scary disease—it frequently causes patients to bleed from their orifices—but its rapid onset and immobilizing symptoms mean that it can’t infect tens of millions of people. Ebola spreads only through physical contact with the bodily fluids of an infected person, and by the time you’re really infectious, you’re too sick to move around. The biggest risks were to people who were taking care of Ebola patients, either at home or in the hospital, and during funeral rites, when someone would wash the body of a person who had died of the disease.

Even though Ebola wasn’t going to kill many Americans, it did remind them that an infectious disease can travel long distances. In the Ebola outbreak, a frightening disease had come to the United States as well as the United Kingdom and Italy—places that American tourists liked to visit. The fact that there had been a total of six cases and one death in those three countries, versus more than 11,000 in West Africa, didn’t matter. Americans were paying attention to epidemics, at least for the moment.

I thought it might be an opportunity to highlight the fact that the world wasn’t ready to handle an infectious disease that really could cause a pandemic. If you think Ebola is bad, let me tell you what the flu could do. Over the Christmas holidays of 2014, I started writing a memo about the gaps in the world’s readiness that had been highlighted by Ebola.

The gaps were enormous. There was no systematic way to monitor the progress of disease through communities. Diagnostic tests, when they were available, took days to return results—an eternity when you need to isolate people if they’re infected. There was a volunteer network of brave infectious-disease experts who went to help authorities in the affected countries, but there wasn’t a large full-time team of paid experts. And even if there had been such a team, there was no plan in place to move them to where they needed to be.

In other words, the problem was not that there was some system in place that didn’t work well enough. The problem was that there was hardly any system at all. --This text refers to an alternate kindle_edition edition.

Product details

ASIN ‏ : ‎ B09MT3H6XT
Publisher ‏ : ‎ Vintage (May 3, 2022)
Publication date ‏ : ‎ May 3, 2022
Language ‏ : ‎ English
File size ‏ : ‎ 32749 KB
Text-to-Speech ‏ : ‎ Enabled
Screen Reader ‏ : ‎ Supported
Enhanced typesetting ‏ : ‎ Enabled
X-Ray ‏ : ‎ Enabled
Word Wise ‏ : ‎ Enabled
Sticky notes ‏ : ‎ On Kindle Scribe
Print length ‏ : ‎ 297 pages

Best Sellers Rank: #705,008 in Kindle Store (See Top 100 in Kindle Store)
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Bill Gates

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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. He also launched Breakthrough Energy, an effort to commercialize clean energy and other climate-related technologies.

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Practical and Sound Approach

Reviewed in the United States on May 29, 2022

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How to Prevent the Next Pandemic by Bill Gates

“How to Prevent the Next Pandemic” is a practical approach on preventing pandemics. Bill Gates, provides readers with lessons learned from COVID-19 and what we can do to prevent a similar disaster. This useful 297-page book includes the following nine chapters: 1. Learn from COVID, 2. Create a pandemic prevention team, 3. Get better at detecting outbreaks early, 4. Help people protect themselves right away, 5. Find new treatments fast, 6. Get ready to make vaccines, 7. Practice, practice, practice, 8. Close the health gap between rich and poor countries, and 9. Make—and fund—a plan for preventing pandemics.

Positives:
1. A professionally written book. It’s direct, and covers the most important aspects of a pandemic.
2. The fascinating topic of pandemics.
3. An easy book to follow. Gates does a great job of simplifying terms and focusing on the world of the possible. The tone is hopeful and positive.
4. A good use of charts and photos to complement the narrative.
5. The Introduction lays out what this book is about. “In this book you’ll read about some of these innovations, because great new products only do the most good if they reach the people who need them most—and in health, that often requires working with governments, which even in the poorest countries are nearly always the entities that provide public services.”
6. Describes the U.S. response to COVID-19. “The White House’s response in 2020 was disastrous. The president and his senior aides downplayed the pandemic and gave the public terrible advice. Incredibly, federal agencies refused to share data with one another.”
7. The government’s role. “It’s the government’s role to invest in the basic research that leads to major innovations, adopt policies that let new ideas flourish, and create markets and incentives (the way the United States accelerated vaccine work with Operation Warp Speed).”
8. Describes the importance of creating a Pandemic Prevention Team. “What we need is a well-funded global organization with enough full-time experts in all the necessary areas, the credibility and authority that come with being a public institution, and a clear remit to focus on preventing pandemics.”
9. Persuasive description on how to prepare for the next pandemic. “Ultimately, we need diagnostic tools that are accurate, accessible for many people around the world, and quick to produce results that feed into the public health system.”
10. Interesting findings disclosed. “Studies show that even though the COVID virus may be able to survive for a few hours, or even days, it’s quite rare for people to get sick from touching a contaminated surface. In fact, even if someone does happen to touch a fomite, the chances that the person will get infected are less than 1 in 10,000.”
11. What worked against COVID-19. “The real benefit comes with universal masking, where both people are double masking or improving the fit of their surgical masks: It reduces the risk of exposure by 96 percent. That’s an incredibly effective intervention that can be manufactured for just a few cents.”
12. Addresses misinformation. “Its director-general said, “We’re not just fighting an epidemic; we’re fighting an infodemic,” and its website began featuring a myth-busting section that had to be constantly updated in order to debunk false claims.”
13. Explains why the vaccine was successful against COVID-19. “Fortunately, COVID is relatively easy to target with a vaccine, partly because the spike on its surface is not as camouflaged as the proteins on some other viruses. That’s why the success rate for COVID vaccines has been unusually high.”
14. Describes vaccine hesitancy. “Many Black Americans, for example, are generally skeptical of the government’s good intentions when it comes to health, and understandably so. For forty years, the U.S. Public Health Service ran the infamous Tuskegee Study—a horrific experiment in which it looked at the effect of syphilis on hundreds of Black men, without giving them their true diagnosis, and even withholding treatment once it became available eleven years into the study.”
15. The six areas that should be priorities for funding and research.
16. Find out the biggest mistake in America.
17. How to close the health gap between rich and poor countries. “Created in 2002 to bolster the fight against HIV, TB, and malaria in low- and middle-income countries, the Global Fund has been a rousing success.”
18. Describes four priorities to eradicate respiratory diseases and prevent pandemics. “Ultimately, our goal should be to develop novel vaccines that fully protect against entire families of viruses, particularly respiratory viruses—that’s the key to eradicating flu and coronaviruses.”
19. Glossary provided.
20. Notes and links provided.

Negatives:
1. No bibliography.

In summary, I really enjoyed this book. Bill Gates provides readers with a practical approach on how to prevent pandemics. Gates’ passion on this topic and his reliance on subject matter experts provides readers with sound technical solutions to pandemics. His approach is hopeful and based on the best of our current knowledge. Overall, this is a very practical and useful book that will provide readers with hope. I highly recommend it.

Further recommendations: “Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-Science” by Peter J. Hotez, “The Great Influenza” by John M. Barry, “Pandemic 1918” by Catharine Arnold, “Flu” by Gina Kolata, and “Influenza” by Jeremy Brown.

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S. Corte

Informative, encouraging, and yet cautionary

Reviewed in the United States on June 2, 2022

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In the course of making recommendations for preparing for future pandemics, the author gives detailed and well-explained information about the current state of preparedness, the history of pandemic preparation, how drugs and vaccines are developed, why it has been difficult to produce and distribute them everywhere they are needed, and how we could do a better job of this and other aspects of preparation and response. Overall, I was encouraged to learn that really impressive progress has been made over the past decades in dealing with disease world-wide. However, as this book points out, there is a real danger that once we are past this pandemic, we will go back to worrying about other things and fail to use what we have learned from this one to help us prepare for the (inevitable) next pandemic.
Also, I had no idea the inner bark of the Chilean soap-bark tree was so useful.

One person found this helpful

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Collin Cannon

Straightforward, prudent, accessible

Reviewed in the United States on July 31, 2022

It’s unfortunate that so many reviewers of this book clearly didn’t read it. Like the book on climate chan he before it, I found this piece to be accessible and useful for a lay reader like myself. It’s a fast read packed with much useful information: about respiratory viruses broadly, about the infrastructure needed to respond to them and prevent them, as well as about the political and economic ecosystems that responses occur within. It’s a good read for anyone interested in getting a start in this territory without needing a degree in public health. Glad to have read it.

One person found this helpful

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George Peter Beck

Not the Best of Gates

Reviewed in the United States on August 30, 2023

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I have read numerous Gate’s printings.I pre ordered this book with high expectations.Saddly those Expectations were never met.

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Stefan Masuhr

Applying science to risk management!

Reviewed in the United States on May 13, 2022

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Risk management, seeing what can inherently go wrong, taking a scientific view to analyze mitigants and then speaking frankly about strategies about how to bring residual risk to acceptable levels is so much more needed than belief and identity driven agendas. Well done, Bill. I wouldn’t agree with all points and would like to see potential conflict of interests managed well too, but overall a really valuable contribution to moving the baseline of what humanity can do further out

3 people found this helpful

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Renato Robles

Nice warning, thank you P5YCH0

Reviewed in Mexico on September 23, 2023

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Bill Gates thank you for the warnings ¡!!,
I label the book as: AKA 'the warnings from the real USA 🇺🇲 owner and psycho boss of the health industry himself' where he confesses in advance part of his plans to stricke against humanity again,

Easy to read and plenty of hidden warnings, what a better way to protect oneself than with a glance of how the attacker plans to hit us with next ☝️👀 ¡!

Pretty nice read and really worth buying and sharing, many many Thanks ¡!!!!!
👏☕🙂❤️👍

Rubens José

Acho o tema muito importante e reflexivo sobre nosso futuro!

Reviewed in Brazil on July 13, 2022

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The media could not be loaded.

Ainda não li o livro, mas na próxima oportunidade direi o que achei sobre o tema que Bill Gates lançou em seu livro: "How to preventiva the next pandemic!

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Andrea

Da leggere

Reviewed in Italy on December 7, 2023

Verified Purchase

La raccomandazione perfetta per quell'amico o familiare che inizia praticamente ogni conversazione sul COVID con: "Non capisco proprio come...".

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Kindle Customer

Excellent

Reviewed in India on November 23, 2022

Verified Purchase

Gained more knowledge about what we need what to do next thanks bill gates.. I'm very happy to read this..

Christians Lesesessel

Ich hatte mir etwas mehr erhofft

Reviewed in Germany on August 22, 2022

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Sicherlich ein Thema mit viel Zündstoff, Meinungen und Diskussionsbedarf. So habe ich auch meine persönliche Meinung.

Einige Vorschläge finde ich gut, z. B. das ein Frühwarnsystem für Pandemien geben sollte und das Du es global organisiert sein muss.

Auf der anderen Seite vertraut Bill Gates komplett auf Technologie und Innovation. Da kann ich nicht immer zustimmen.

Aber das Buch hat mir geholfen, meine Meinung zu hinterfragen, zu verifizieren und an der einen oder anderen Stelle zu ändern.

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