The Bill & Melinda Gates Foundation took a major role in trying to find a vaccine to treat Ebola, even providing funding to Durham-based Chimerix. Now, Bill Gates is warning that the world must prepare for future epidemics. If we are smart, we will listen to what he has to say and learn from the epidemic that has killed some 10,000 people.

“Perhaps the only good news from the tragic Ebola epidemic in Guinea, Sierra Leone, and Liberia is that it may serve as a wake-up call: we must prepare for future epidemics of diseases that may spread more effectively than Ebola,” Bill Gates, the co-founder of Microsoft, wrote earlier this week in The New England Journal of Medicine.

“There is a significant chance that an epidemic of a substantially more infectious disease will occur sometime in the next 20 years; after all, we saw major epidemics during the 20th century, including the Spanish influenza epidemic of 1918–1919 and the ongoing pandemic of human immunodeficiency virus. In fact, of all the things that could kill more than 10 million people around the world, the most likely is an epidemic stemming from either natural causes or bioterrorism.”

A report from The Associated Press on Friday about how The World Health Organization reacted initially to the Ebola outbreaks raises even more concerns about a future epidemic might be handled. If political considerations impede scientists and delay reaction …

Here’s the top part of The AP report:

“In a delay that some say may have cost lives, the World Health Organization resisted calling the Ebola outbreak in West Africa a public health emergency until last summer, two months after staff raised the possibility and long after a senior manager called for a drastic change in strategy, The Associated Press has learned.

“Among the reasons the United Nations agency cited in internal deliberations: worries that declaring such an emergency — akin to an international SOS — could anger the African countries involved, hurt their economies or interfere with the Muslim pilgrimage to Mecca.

“Those arguments struck critics, experts and several former WHO staff as wrong-headed.

“That’s like saying you don’t want to call the fire department because you’re afraid the fire trucks will create a disturbance in the neighborhood,” said Michael Osterholm, a prominent infectious diseases expert at the University of Minnesota.

“In public comments, WHO Director-General Dr. Margaret Chan has repeatedly said the epidemic caught the world by surprise.”

Gates’ call for a “NATO” of sorts reaction

Written ahead of The AP story’s publication, Gates warned that preparation is essential and that delays in the future “could result in a global disaster.”

Gates wrote:

“It’s instructive to compare our preparations for epidemics with our preparations for another sort of global threat — war. The North Atlantic Treaty Organization (NATO) has a mobile unit that is ready to deploy quickly. Although the system is not perfect, NATO countries participate in joint exercises in which they work out logistics such as how fuel and food will be provided, what language they will speak, and what radio frequencies will be used. Few, if any, such measures are in place for response to an epidemic. The world does not fund any organization to manage the broad set of coordinated activities required in an epidemic. The last serious simulation of an epidemic in the United States, the Dark Winter exercise, took place in 2001. And few countries have met their commitments under the International Health Regulations, which were adopted by the United Nations after the 2002–2003 outbreak of the severe acute respiratory syndrome (SARS) and were intended to improve the world’s ability to prevent and contain outbreaks.

“Because there was so little preparation, the world lost time in the current epidemic trying to answer basic questions about combating Ebola. In the next epidemic, such delays could result in a global disaster.”

A 13-page analysis

Gates wrote much more than just an “Op/Ed” at the Journal. (A shorter version was also published in The New York Times.) The full version of his analysis and recommendation about how he believes the world should prepare for the next epidemic runs 13 pages.

Here are his key recommendations:

“The world needs to build a warning and response system for outbreaks. This system should

• Be coordinated by a global institution that is given enough authority and funding to be effective,

• Enable fast decision making at a global level,

• Expand investment in research and development and clarify regulatory pathways for developing new tools and approaches,

• Improve early warning and detection systems, including scalable everyday systems that can be expanded during an epidemic,

• Involve a reserve corps of trained personnel and volunteers,

• Strengthen health systems in low- and middle-income countries, and

• Incorporate preparedness exercises to identify the ways in which the response system needs to improve.”

What will happen next?

Earlier this week, a top GSK executive said that the drug giant had a social responsibility to contribute to the Ebola fight and pointed out that company assets were taken from other projects to support the fight.

North Carolina was deeply involved in the Ebola fight on multiple fronts, from the Charlotte missionaries and others who became ill to Chimerix and BioCryst, another Triangle biotech, as well as researchers at UNC-Chapel Hill who helped meet the need for a key point Gates stressed in his review: The need for fast, accurate data.

If we as a people are smart, we will listen and react to what Gates has to say.

Read Gates’ full article online at: