When I was a kid, the disaster we worried about1 most
was a nuclear war. That's why2
we had a barrel like this3
down in our basement4,
filled with5 cans6 of food and
water. When the nuclear attack came, we
were supposed to go downstairs7, hunker down8, and eat out of that barrel.
Today the greatest risk of global catastrophe doesn't look like this9.
Instead10, it
looks like this. If anything11
kills over 10 million people in the next few decades, it's most likely to be12 a highly infectious13 virus rather than14 a war. Not missiles, but microbes.
Now, part of the reason for this is that we've invested a huge amount15 in nuclear deterrents16. But we've actually17 invested very little in a system to
stop an epidemic. We're not ready for18
the next epidemic.
Let's look at Ebola. I'm sure all of you read about it19 in the
newspaper, lots of tough challenges20.
I followed it carefully21
through22 the case
analysis tools23
we use to track polio eradication. And as you look at what went on24, the problem wasn't that there was25 a system
that didn't work well enough26
the problem was that we didn't have a system at all27. In
fact28, there's some pretty obvious key missing pieces29.
We didn't have a group of epidemiologists ready
to go, who would have gone, seen what the disease was, seen how far it had spread30.
The case reports came in on paper. It was very delayed31 before they were put online and they
were extremely inaccurate32.
We didn't have a medical team ready to go. We didn't have a way of preparing
people. Now, Médecins Sans Frontières did a great job orchestrating volunteers33. But even so34, we were far slower than we should have been35
getting36 the
thousands of workers into these countries. And a large epidemic would require us to have37
hundreds of thousands of workers.There was no
one38 there to look at treatment
approaches. No one to look at the diagnostics. No one to figure out40 what
tools should be used41.
As an example, we could have taken42
the blood of survivors43
,processed it, and put that plasma back in people to protect them. But that was
never tried.
So there was a lot that was missing44. And these
things are really a global failure. The WHO is funded45 to monitor epidemics, but not to do
these things I talked about. Now, in the movies it's quite different.There's a
group of handsome46
epidemiologists ready to go, they move in, they save the day, but that's just
pure Hollywood.
The failure to prepare could allow47 the next
epidemic to be dramatically more devastating than Ebola. Let's look at the
progression of Ebola over this year. About48
10,000 people died, and nearly49
all were in the three West African countries. There's three reasons why50 it
didn't spread more. The first is that there was a lot of heroic work by the
health workers. They found the people and they prevented51 more infections. The second is the
nature of the virus. Ebola does not spread through the air. And by the time52 you're
contagious, most people are so sick that they're bedridden53. Third, it didn't get into many urban
areas. And that was just luck. If it
had gotten into54 a lot more urban areas, the case numbers would have been much larger55.
So next time, we might not be so lucky. You can
have a virus where people feel well enough while they're infectious that they
get on a plane or they go to a market. The source56
of the virus could be a natural epidemic like Ebola, or it could be
bioterrorism. So there are things that would literally make things a thousand times worse57.
In fact, let's look at a model of a virus
spread through the air, like the Spanish
Flu58 back in 1918. So here's what would happen: It would
spread throughout59
the world very, very quickly. And you can see over 30 million people died from
that epidemic. So this is a serious problem. We should be concerned60.
But in fact, we can build a really good
response system. We have the benefits61
of all the science and technology that we talk about here. We've got cell
phones to get information from the public and get information out to them. We
have satellite maps where we can see where people are and where they're moving.
We have advances in biology that should dramatically change the turnaround time62 to
look at a pathogen63
and be able to make drugs and vaccines that fit for64 that pathogen. So we can have tools,
but those tools need to be put into an overall65
global health system. And we need preparedness66.
The best lessons, I think, on how to get prepared
are again, what we do for war. For soldiers, we have full-time, waiting to go.
We have reserves that can scale us up
to large numbers. NATO has a mobile unit that can deploy68 very rapidly. NATO does a lot of war
games to check, are people well trained? Do they understand about fuel and
logistics and the same radio frequencies? So they are absolutely ready to go. So
those are the kinds of things we need to deal
with69 an epidemic.
What are the key pieces? First, we need strong
health systems in poor countries. That's where mothers can give birth safely70, kids can get all their
vaccines. But, also where we'll see the outbreak71
very early on. We need a medical reserve corps: lots of people who've got the
training and background72
who are ready to go, with the expertise. And then we need to pair73 those medical
people with the military. taking
advantage of74 the military's ability to move fast, do
logistics and secure areas. We need to do simulations, germ games, not war
games, so that we see where the holes75
are.
The last time a germ game was done in the United States was back in 2001,
and it didn't go so well. So far76
the score is germs: 1, people: 0.Finally, we need lots of advanced R&D77 in areas of
vaccines and diagnostics. There are some big breakthroughs78, like the Adeno-associated virus,
that could work very, very quickly.
Now I don't have an exact budget79 for what this would cost, but I'm quite
sure it's very modest compared to the potential harm80. The World Bank estimates that if we have
a worldwide flu epidemic, global wealth81
will go down by over three trillion dollars and we'd have millions and millions
of deaths. These investments offer significant benefits beyond just being82 ready for the epidemic. The
primary healthcare, the R&D, those things would reduce global health equity
and make the world more just as well
as83 more safe. So I think this should absolutely be a
priority. There's no need to panic.
We don't have to hoard84 cans of spaghetti or go down into the
basement. But we need to get going85,
because time is not on our side. In fact, if there's one positive thing that
can come out of the Ebola epidemic, it's that it can serve as an early warning86, a wake-up call87, to
get ready. If we start now, we can be ready for the next epidemic. Thank
you.
Vocabulary
1.
worried
about = preocupar-se com
2.
That's
why = é porisso que
3.
like
this = como este
4.
basement
= porão
5.
filled
with = cheio com
6.
cans
= latas
7. we were supposed to go downstairs =
nós deveríamos ir para o andar de baixo
8. hunker down = abrigar-se
9. doesn't look like this = não se
parece com isso
10. Instead = ao invés disso
11. Anything = qualquer coisa
12. it's most likely to be = é mais
provável que seja
13. highly infectious = altamente
infeccioso
14. rather than = ao invés de
15. huge amount = imensa quantidade
16. deterrents = dissuadores,
impedimentos
17. actually = na verdade, realmente
18. ready for = pronto para
19. I'm sure all of you read about it =
tenho certeza que todos vocês leram sobre isso
20. lots of tough challenges = muitos
desafios dificeis
21. I followed it carefully = eu
acompanhei cuidadosamente
22. Through = através
23. Tools = ferramentas
24. what went on = o que aconteceu
25. there was = havia
26.
didn't work well enough = não funcionava bem o
suficiente
27.
at
all = absolutamente
28.
In
fact = na verdade
29.
key
missing pieces = peças chave faltando
30. how far it had spread = o quão ela
tinha se espalhado
31. delayed = atrasado
32. inaccurate = imprecise
33. orchestrating volunteers =
organizando voluntários
34. even so = mesmo assim
35. far slower than we should have been=
muito mais lento do que deveríamos ter sido
36. getting = conseguindo, obtendo
37.
would require us to have = teria exigido que nós
tivéssemos
38.
no
one = ninguém
39.
treatment
approaches = abordagens de tratamentos
40.
figure
out = descobrir
41. should be used = deveria ser usado
42.
could have taken = poderíamos ter tomado, tirado
43.
survivors
= sobreviventes
44.
missing
= faltando
45.
funded
= consolidado
46.
handsome
= bonito
47.
allow
= permitir
48.
About
= aproximadamente
49.
Nearly
= quase
50.
reasons
why = razões pelas quais
51.
prevented
= impediram
52.
by
the time = quando
53.
bedridden
= acamado
54. If it had gotten into = se tivesse
entrado em
55. would have been much larger = teria
sido muito maior
56. source = fonte
57. a thousand times worse = mil vezes
pior
58. Spanish Flu = gripe espanhola
59. Throughout = por todo o
60. Concerned = preocupados
61. Benefits = benefícios
62. turnaround time = tempo de resposta
63.
pathogen = patógeno (agente infeccioso
microscópico)
64.
fit for = são apropriados para
65.
overall
= geral, global
66.
preparedness
= prevenção
67.
scale
us up = ampliar-nos
68.
deploy
= posicionar-se
69.
deal
with = lidar com
70.
give birth safely = dar à luz com segurança
71.
outbreak
= surto
72.
background
= conhecimento, experiência
73.
pair = emparelhar, colocar lado a lado
74.
taking
advantage of = aproveitar, tirar proveito de
75.
holes
= buracos, brechas
76.
So
far = até agora
77.
R&D = “research and development” = pesquisa
e desenvolvimento
78.
Breakthroughs
= avanços
79.
Budget
= orçamento
80.
Harm
= dano
81.
Wealth
= riqueza
82.
beyond just being = além de apenas estar
83.
as
well as = assim como
84.
hoard
= fazer reservas, provisos
85. we need to get going = precisamos
nos mexer
86. early warning = aviso prévio
87.
wake-up call = chamado para despertar