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Bill Gates on How the Ebola Outbreak Can Help Us Prepare for the Next Epidemic

And the next one could be far worse.

Asa Mathat

The Ebola outbreak was truly awful, killing 10,000 people and devastating the health systems and economies of three African nations. But the next outbreak could be a lot worse if we fail to learn some key lessons.

That was the message Wednesday from Bill Gates, whose nonprofit foundation was deeply involved in the response to the African health crisis.

Gates addressed the subject in a variety of venues, speaking at TED, publishing a paper in the New England Journal of Medicine and penning an op-ed piece for the New York Times.

“We’re not ready for the next epidemic,” Gates said.

With Ebola, he said, the world was far too slow to react. Not only didn’t it send enough health-care workers, but it wasn’t tracking outcomes or testing the blood of survivors to see what was keeping them alive. “There was a lot that was missing,” he said.

The outbreak is on the wane, Gates said, thanks to the work of health-care workers that did go, the fact that Ebola isn’t spread via the air and the fact that it didn’t find its way into many urban areas.

“Next time we might not be so lucky,” Gates said. The next outbreak, Gates said, could be far worse — a thousand times worse.

At TED, Gates set up a replica of an African field hospital, encouraging conference attendees to experience much of what it is like to go through the grueling and time-consuming processes health-care workers had to go through to avoid being contaminated with the virus. Doctors and nurses with experience in the region were on hand to walk people through the process and share their own stories.

“Right now the world isn’t ready to fight a highly infectious disease,” Gates said in a letter to those who visited the “Suiting Up for Ebola” experience. “In fact, of all the things that could kill more than 10 million people around the world in the years ahead, by far the most likely is an epidemic, from either natural causes or bioterrorism.”

Gates advocated both strong health systems in poor countries as well as a medical reserve corps ready to deploy on short notice. Armies have reserve corps and prepare for war with training missions; the same is needed for diseases.

And, he said, health workers should actually pair with military organizations, which are expert at deploying into regions quickly and efficiently.

Gates acknowledged he doesn’t know how much such an effort would cost.

“This should absolutely be a priority,” Gates said. “We need to get going because time is not on our side.”

Before Gates spoke, Seth Berkley, CEO of vaccine alliance organization Gabi, talked about the social and medical reasons why there is no effective treatment or vaccine for Ebola.

Berkley noted that, when it comes to Ebola, the fear is greater because of the lack of a treatment and the high fatality rate despite having known about it since 1976 and having vaccine candidates. In large part it is because market forces offered no incentive to create a vaccine, with those most likely to be impacted also being among those least able to pay for such a vaccine.

In fact, Berkley said, part of the reason there are even two vaccines in late-stage trials now is because of likely misguided fears after Sept. 11 that Ebola could be used as a weapon.

“We have to stop waiting until we see evidence of a disease becoming a global threat before we see it as one,” Berkley said.

This article originally appeared on

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