00:00:17
When I was a kid,
00:00:19
the disaster we worried about most
was a nuclear war.
00:00:23
That's why we had a barrel like this
down in our basement,
00:00:27
filled with cans of food and water.
00:00:30
When the nuclear attack came,
00:00:31
we were supposed to go downstairs,
hunker down, and eat out of that barrel.
00:00:37
Today the greatest risk
of global catastrophe
00:00:41
doesn't look like this.
00:00:44
Instead, it looks like this.
00:00:48
If anything kills over 10 million people
in the next few decades,
00:00:53
it's most likely to be
a highly infectious virus
00:00:57
rather than a war.
00:00:59
Not missiles, but microbes.
00:01:03
Now, part of the reason for this is that
00:01:05
we've invested a huge amount
in nuclear deterrents.
00:01:10
But we've actually invested very little
in a system to stop an epidemic.
00:01:16
We're not ready for the next epidemic.
00:01:20
Let's look at Ebola.
00:01:21
I'm sure all of you read about it
in the newspaper,
00:01:25
lots of tough challenges.
00:01:27
I followed it carefully
through the case analysis tools
00:01:30
we use to track polio eradication.
00:01:35
And as you look at what went on,
00:01:37
the problem wasn't that there was a system
that didn't work well enough,
00:01:42
the problem was that we
didn't have a system at all.
00:01:46
In fact, there's some pretty obvious
key missing pieces.
00:01:51
We didn't have a group of epidemiologists
ready to go, who would have gone,
00:01:55
seen what the disease was,
seen how far it had spread.
00:01:59
The case reports came in on paper.
00:02:02
It was very delayed
before they were put online
00:02:04
and they were extremely inaccurate.
00:02:07
We didn't have a medical team ready to go.
00:02:09
We didn't have a way of preparing people.
00:02:12
Now, Médecins Sans Frontières
did a great job orchestrating volunteers.
00:02:17
But even so, we were far slower
than we should have been
00:02:20
getting the thousands of workers
into these countries.
00:02:24
And a large epidemic would require us
to have hundreds of thousands of workers.
00:02:32
There was no one there
to look at treatment approaches.
00:02:37
No one to look at the diagnostics.
00:02:38
No one to figure out
what tools should be used.
00:02:42
As an example, we could have
taken the blood of survivors,
00:02:45
processed it, and put that plasma
back in people to protect them.
00:02:51
But that was never tried.
00:02:53
So there was a lot that was missing.
00:02:55
And these things
are really a global failure.
00:03:00
The WHO is funded to monitor epidemics,
but not to do these things I talked about.
00:03:07
Now, in the movies it's quite different.
00:03:09
There's a group of handsome
epidemiologists ready to go,
00:03:14
they move in, they save the day,
but that's just pure Hollywood.
00:03:22
The failure to prepare
could allow the next epidemic
00:03:25
to be dramatically
more devastating than Ebola
00:03:30
Let's look at the progression
of Ebola over this year.
00:03:36
About 10,000 people died,
00:03:39
and nearly all were in the three
West African countries.
00:03:43
There's three reasons why
it didn't spread more.
00:03:46
The first is that there was a lot
of heroic work by the health workers.
00:03:50
They found the people and they
prevented more infections.
00:03:54
The second is the nature of the virus.
00:03:56
Ebola does not spread through the air.
00:03:59
And by the time you're contagious,
00:04:01
most people are so sick
that they're bedridden.
00:04:06
Third, it didn't get
into many urban areas.
00:04:10
And that was just luck.
00:04:12
If it had gotten into a lot
more urban areas,
00:04:14
the case numbers
would have been much larger.
00:04:17
So next time, we might not be so lucky.
00:04:21
You can have a virus where people
feel well enough while they're infectious
00:04:26
that they get on a plane
or they go to a market.
00:04:29
The source of the virus could be
a natural epidemic like Ebola,
00:04:32
or it could be bioterrorism.
00:04:34
So there are things that would literally
make things a thousand times worse.
00:04:39
In fact, let's look at a model
of a virus spread through the air,
00:04:45
like the Spanish Flu back in 1918.
00:04:49
So here's what would happen:
00:04:51
It would spread throughout the world
very, very quickly.
00:04:55
And you can see over 30 million people
died from that epidemic.
00:05:00
So this is a serious problem.
00:05:02
We should be concerned.
00:05:04
But in fact, we can build
a really good response system.
00:05:08
We have the benefits of all the science
and technology that we talk about here.
00:05:13
We've got cell phones
00:05:14
to get information from the public
and get information out to them.
00:05:18
We have satellite maps where we can see
where people are and where they're moving.
00:05:22
We have advances in biology
00:05:24
that should dramatically change
the turnaround time to look at a pathogen
00:05:28
and be able to make drugs and vaccines
that fit for that pathogen.
00:05:33
So we can have tools,
00:05:34
but those tools need to be put
into an overall global health system.
00:05:39
And we need preparedness.
00:05:41
The best lessons, I think,
on how to get prepared
00:05:44
are again, what we do for war.
00:05:46
For soldiers, we have full-time,
waiting to go.
00:05:51
We have reserves that can scale
us up to large numbers.
00:05:54
NATO has a mobile unit
that can deploy very rapidly.
00:05:58
NATO does a lot of war games
to check, are people well trained?
00:06:01
Do they understand
about fuel and logistics
00:06:03
and the same radio frequencies?
00:06:06
So they are absolutely ready to go.
00:06:08
So those are the kinds of things
we need to deal with an epidemic.
00:06:13
What are the key pieces?
00:06:15
First, we need strong health systems
in poor countries.
00:06:20
That's where mothers
can give birth safely,
00:06:23
kids can get all their vaccines.
00:06:25
But, also where we'll see
the outbreak very early on.
00:06:30
We need a medical reserve corps:
00:06:31
lots of people who've got
the training and background
00:06:34
who are ready to go, with the expertise.
00:06:37
And then we need to pair those
medical people with the military.
00:06:42
taking advantage of the military's ability
to move fast, do logistics
00:06:46
and secure areas.
00:06:48
We need to do simulations,
00:06:51
germ games, not war games,
so that we see where the holes are.
00:06:55
The last time a germ game
was done in the United States
00:06:58
was back in 2001,
and it didn't go so well.
00:07:02
So far the score is germs: 1, people: 0.
00:07:07
Finally, we need lots of advanced R&D
in areas of vaccines and diagnostics.
00:07:13
There are some big breakthroughs,
like the Adeno-associated virus,
00:07:17
that could work very, very quickly.
00:07:21
Now I don't have an exact budget
for what this would cost,
00:07:24
but I'm quite sure it's very modest
compared to the potential harm.
00:07:29
The World Bank estimates that
if we have a worldwide flu epidemic,
00:07:33
global wealth will go down
by over three trillion dollars
00:07:37
and we'd have millions
and millions of deaths.
00:07:41
These investments
offer significant benefits
00:07:44
beyond just being ready for the epidemic.
00:07:46
The primary healthcare, the R&D,
00:07:48
those things would reduce
global health equity
00:07:51
and make the world more just
as well as more safe.
00:07:55
So I think this should absolutely
be a priority.
00:07:59
There's no need to panic.
00:08:00
We don't have to hoard cans of spaghetti
or go down into the basement.
00:08:05
But we need to get going,
because time is not on our side.
00:08:09
In fact, if there's one positive thing
that can come out of the Ebola epidemic,
00:08:15
it's that it can serve as an early
warning, a wake-up call, to get ready.
00:08:21
If we start now, we can be ready
for the next epidemic.
00:08:26
Thank you.
00:08:28
(Applause)
![[2024] Pass the Shell Interview | Shell Video Interview](https://ruhnrawpgxrzdrgaohnf.supabase.co/storage/v1/object/public/images/video/nk7yZw4TLzs/thumbnail.jpg)
![[2023] Pass the Shell Interview | Shell Video Interview](https://ruhnrawpgxrzdrgaohnf.supabase.co/storage/v1/object/public/images/video/8cjmuGCLVng/thumbnail.jpg)
