[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:05.77,0:00:09.30,Default,,0000,0000,0000,,When I was a kid, the disaster\Nwe worried about most
Dialogue: 0,0:00:09.30,0:00:12.03,Default,,0000,0000,0000,,was a nuclear war.
Dialogue: 0,0:00:12.03,0:00:15.08,Default,,0000,0000,0000,,That's why we had a barrel like this\Ndown in our basement,
Dialogue: 0,0:00:15.08,0:00:18.46,Default,,0000,0000,0000,,filled with cans of food and water.
Dialogue: 0,0:00:18.46,0:00:19.90,Default,,0000,0000,0000,,When the nuclear attack came,
Dialogue: 0,0:00:19.90,0:00:21.75,Default,,0000,0000,0000,,we were supposed to go downstairs,
Dialogue: 0,0:00:21.75,0:00:25.88,Default,,0000,0000,0000,,hunker down, and eat out of that barrel.
Dialogue: 0,0:00:25.88,0:00:29.92,Default,,0000,0000,0000,,Today the greatest risk \Nof global catastrophe
Dialogue: 0,0:00:29.92,0:00:32.30,Default,,0000,0000,0000,,doesn't look like this.
Dialogue: 0,0:00:32.30,0:00:36.44,Default,,0000,0000,0000,,Instead, it looks like this.
Dialogue: 0,0:00:36.44,0:00:41.93,Default,,0000,0000,0000,,If anything kills over 10 million people\Nin the next few decades,
Dialogue: 0,0:00:41.93,0:00:45.50,Default,,0000,0000,0000,,it's most likely to be \Na highly infectious virus
Dialogue: 0,0:00:45.50,0:00:47.79,Default,,0000,0000,0000,,rather than a war.
Dialogue: 0,0:00:47.79,0:00:51.68,Default,,0000,0000,0000,,Not missles, but microbes.
Dialogue: 0,0:00:51.68,0:00:53.88,Default,,0000,0000,0000,,Now part of the reason for this is that\N
Dialogue: 0,0:00:53.88,0:00:58.08,Default,,0000,0000,0000,,we've invested a huge amount\Nin nuclear deterrants.
Dialogue: 0,0:00:58.08,0:01:04.13,Default,,0000,0000,0000,,But we've actually invested very little \Nin a system to stop an epidemic.
Dialogue: 0,0:01:04.13,0:01:07.87,Default,,0000,0000,0000,,We're not ready for the next epidemic.
Dialogue: 0,0:01:07.87,0:01:09.76,Default,,0000,0000,0000,,Let's look at Ebola.
Dialogue: 0,0:01:09.76,0:01:13.86,Default,,0000,0000,0000,,I'm sure all of you read about \Nit in the newspaper,
Dialogue: 0,0:01:13.86,0:01:15.40,Default,,0000,0000,0000,,lots of tough challenges.
Dialogue: 0,0:01:15.40,0:01:19.68,Default,,0000,0000,0000,,I followed it carefully through \Nthe case analysis tools we use
Dialogue: 0,0:01:19.68,0:01:23.72,Default,,0000,0000,0000,,to track polio eradication.
Dialogue: 0,0:01:23.72,0:01:25.57,Default,,0000,0000,0000,,And as you look at what went on,
Dialogue: 0,0:01:25.57,0:01:30.33,Default,,0000,0000,0000,,the problem wasn't that there was\Na system that didn't work well enough,
Dialogue: 0,0:01:30.33,0:01:34.59,Default,,0000,0000,0000,,the problem was that we didn't have\Na system at all.
Dialogue: 0,0:01:34.59,0:01:39.03,Default,,0000,0000,0000,,In fact, there's some pretty obvious\Nkey missing pieces.
Dialogue: 0,0:01:39.03,0:01:43.44,Default,,0000,0000,0000,,We didn't have a group of epidemiologists\Nready to go who would have gone,
Dialogue: 0,0:01:43.44,0:01:47.70,Default,,0000,0000,0000,,seen what the disease was,\Nseen how far it had spread.
Dialogue: 0,0:01:47.70,0:01:50.45,Default,,0000,0000,0000,,The case reports came in on paper.
Dialogue: 0,0:01:50.45,0:01:52.81,Default,,0000,0000,0000,,It was very delayed before\Nthey were put online
Dialogue: 0,0:01:52.81,0:01:55.59,Default,,0000,0000,0000,,and they were extremely inaccurate.
Dialogue: 0,0:01:55.59,0:01:57.86,Default,,0000,0000,0000,,We didn't have a medical team ready to go.
Dialogue: 0,0:01:57.86,0:02:00.45,Default,,0000,0000,0000,,We didn't have a way of preparing people.
Dialogue: 0,0:02:00.45,0:02:05.78,Default,,0000,0000,0000,,Now, Médecins Sans Frontières did a \Ngreat job orchestrating volunteers.
Dialogue: 0,0:02:05.78,0:02:08.88,Default,,0000,0000,0000,,But even so, we were far slower\Nthan we should have been
Dialogue: 0,0:02:08.88,0:02:12.36,Default,,0000,0000,0000,,getting the thousands of workers\Ninto these countries.
Dialogue: 0,0:02:12.36,0:02:14.34,Default,,0000,0000,0000,,And a large epidemic would require us\N
Dialogue: 0,0:02:14.34,0:02:19.29,Default,,0000,0000,0000,,to have hundreds of thousands of workers.
Dialogue: 0,0:02:20.75,0:02:25.16,Default,,0000,0000,0000,,There was noone there to look\Nat treatment approaches.
Dialogue: 0,0:02:25.16,0:02:26.95,Default,,0000,0000,0000,,No one to look at the diagnostics.
Dialogue: 0,0:02:26.95,0:02:30.24,Default,,0000,0000,0000,,No one to figure out what tools\Nshould be used.
Dialogue: 0,0:02:30.24,0:02:33.99,Default,,0000,0000,0000,,As an example, we could have taken\Nthe blood of survivors,
Dialogue: 0,0:02:33.99,0:02:39.16,Default,,0000,0000,0000,,processed it, and put that plasma\Nback in people to protect them.
Dialogue: 0,0:02:39.16,0:02:41.76,Default,,0000,0000,0000,,But that was never tried.
Dialogue: 0,0:02:41.76,0:02:43.52,Default,,0000,0000,0000,,So there was a lot that was missing.
Dialogue: 0,0:02:43.52,0:02:48.30,Default,,0000,0000,0000,,And these things are really \Na global failure.
Dialogue: 0,0:02:48.30,0:02:51.30,Default,,0000,0000,0000,,The WHO is funded to monitor epidemics,
Dialogue: 0,0:02:51.30,0:02:55.05,Default,,0000,0000,0000,,but not to do these things I talked about.
Dialogue: 0,0:02:55.05,0:02:57.84,Default,,0000,0000,0000,,Now in the movies, it's quiet different.
Dialogue: 0,0:02:57.84,0:03:01.67,Default,,0000,0000,0000,,There's a group of \Nhandsome epidemiologists
Dialogue: 0,0:03:01.67,0:03:06.04,Default,,0000,0000,0000,,ready to go, they move in, \Nthey save the day.
Dialogue: 0,0:03:06.04,0:03:10.18,Default,,0000,0000,0000,,But that's just pure Hollywood.
Dialogue: 0,0:03:10.18,0:03:13.89,Default,,0000,0000,0000,,The failure to prepare could allow\Nthe next epidemic
Dialogue: 0,0:03:13.89,0:03:18.74,Default,,0000,0000,0000,,to be dramatically \Nmore devastating than Ebola
Dialogue: 0,0:03:18.74,0:03:24.31,Default,,0000,0000,0000,,Let's look at the progression \Nof Ebola over this year.
Dialogue: 0,0:03:24.31,0:03:27.15,Default,,0000,0000,0000,,About 10,000 people died, \N
Dialogue: 0,0:03:27.15,0:03:31.85,Default,,0000,0000,0000,,and nearly all were in the three\NWest African countries.
Dialogue: 0,0:03:31.85,0:03:34.43,Default,,0000,0000,0000,,There's three reasons why\Nit didn't spread more.
Dialogue: 0,0:03:34.43,0:03:37.27,Default,,0000,0000,0000,,The first is that there was \Na lot of heroic work
Dialogue: 0,0:03:37.27,0:03:38.81,Default,,0000,0000,0000,,by the health workers.
Dialogue: 0,0:03:38.81,0:03:42.14,Default,,0000,0000,0000,,They found the people and they \Nprevented more infections.
Dialogue: 0,0:03:42.14,0:03:44.76,Default,,0000,0000,0000,,The second is the nature of the virus.
Dialogue: 0,0:03:44.76,0:03:47.70,Default,,0000,0000,0000,,Ebola does not spread through the air.
Dialogue: 0,0:03:47.70,0:03:51.24,Default,,0000,0000,0000,,And by the time you're contagious,\Nmost people are so sick
Dialogue: 0,0:03:51.24,0:03:54.82,Default,,0000,0000,0000,,that they're bedridden.
Dialogue: 0,0:03:54.82,0:03:58.41,Default,,0000,0000,0000,,Third, it didn't get into \Nmany urban areas.
Dialogue: 0,0:03:58.41,0:03:59.92,Default,,0000,0000,0000,,And that was just luck.
Dialogue: 0,0:03:59.92,0:04:02.10,Default,,0000,0000,0000,,If it had gotten into a lot \Nmore urban areas,
Dialogue: 0,0:04:02.10,0:04:06.16,Default,,0000,0000,0000,,the case numbers would have \Nbeen much larger.
Dialogue: 0,0:04:06.16,0:04:09.47,Default,,0000,0000,0000,,So next time, we might not be so lucky.
Dialogue: 0,0:04:09.47,0:04:14.53,Default,,0000,0000,0000,,You can have a virus where people \Nfeel well enough while they're infectious,
Dialogue: 0,0:04:14.53,0:04:17.84,Default,,0000,0000,0000,,that they get on a plane\Nor they go to a market.
Dialogue: 0,0:04:17.84,0:04:20.85,Default,,0000,0000,0000,,The source of the virus could be \Na natural epidemic like Ebola,
Dialogue: 0,0:04:20.85,0:04:22.83,Default,,0000,0000,0000,,or it could be bioterrorism.
Dialogue: 0,0:04:22.83,0:04:25.94,Default,,0000,0000,0000,,And so there are things that would \Nliterally make things
Dialogue: 0,0:04:25.94,0:04:27.90,Default,,0000,0000,0000,,a thousand times worse.
Dialogue: 0,0:04:27.90,0:04:33.48,Default,,0000,0000,0000,,In fact, let's look at a model\Nof a virus spread through the air,
Dialogue: 0,0:04:33.48,0:04:37.95,Default,,0000,0000,0000,,like the Spanish Flu back in 1918.
Dialogue: 0,0:04:37.95,0:04:39.56,Default,,0000,0000,0000,,So here's what would happen:
Dialogue: 0,0:04:39.56,0:04:43.56,Default,,0000,0000,0000,,it would spread throughout the world\Nvery, very quickly.
Dialogue: 0,0:04:43.56,0:04:48.68,Default,,0000,0000,0000,,And you can see, over 30 million people\Ndied from that epidemic.
Dialogue: 0,0:04:48.68,0:04:50.50,Default,,0000,0000,0000,,So this is a seriousl problem.
Dialogue: 0,0:04:50.50,0:04:52.26,Default,,0000,0000,0000,,We should be concerned.
Dialogue: 0,0:04:52.26,0:04:56.98,Default,,0000,0000,0000,,But in fact, we can build\Na really good response system.
Dialogue: 0,0:04:56.98,0:05:01.84,Default,,0000,0000,0000,,We have the benefits of all the science\Nand technology that we talk about here.
Dialogue: 0,0:05:01.84,0:05:04.56,Default,,0000,0000,0000,,We've got cell phones to get \Ninformation from the public
Dialogue: 0,0:05:04.56,0:05:06.14,Default,,0000,0000,0000,,and get information out to them.
Dialogue: 0,0:05:06.14,0:05:08.84,Default,,0000,0000,0000,,We have satellite maps where \Nwe can see where people are
Dialogue: 0,0:05:08.84,0:05:10.22,Default,,0000,0000,0000,,and where they're moving.
Dialogue: 0,0:05:10.22,0:05:13.86,Default,,0000,0000,0000,,We have advances in biology\Nthat should dramatically change
Dialogue: 0,0:05:13.86,0:05:16.45,Default,,0000,0000,0000,,the turnaround time to look at a pathogen
Dialogue: 0,0:05:16.45,0:05:21.79,Default,,0000,0000,0000,,and be able to make drugs and vaccines\Nthat fit for that pathogen.
Dialogue: 0,0:05:21.79,0:05:23.65,Default,,0000,0000,0000,,So we can have tools, but those tools\N
Dialogue: 0,0:05:23.65,0:05:27.50,Default,,0000,0000,0000,,need to be put into an overall\Nglobal health system.
Dialogue: 0,0:05:27.50,0:05:29.79,Default,,0000,0000,0000,,And we need preparedness.
Dialogue: 0,0:05:29.79,0:05:32.26,Default,,0000,0000,0000,,The best lessons, I think, on how \Nto get prepared
Dialogue: 0,0:05:32.26,0:05:35.11,Default,,0000,0000,0000,,are, again, what we do for war.
Dialogue: 0,0:05:35.11,0:05:39.00,Default,,0000,0000,0000,,For soldiers, we have full-time,\Nwaiting to go.
Dialogue: 0,0:05:39.00,0:05:42.32,Default,,0000,0000,0000,,We have reserves that can scale \Nus up to large numbers.
Dialogue: 0,0:05:42.32,0:05:46.00,Default,,0000,0000,0000,,NATO has a mobile unit \Nthat can deploy very rapidly.
Dialogue: 0,0:05:46.00,0:05:49.16,Default,,0000,0000,0000,,NATO does a lot of war games to check, \N"Are people well trained?
Dialogue: 0,0:05:49.16,0:05:52.26,Default,,0000,0000,0000,,Do they understand about\Nfuel and logistics
Dialogue: 0,0:05:52.26,0:05:54.24,Default,,0000,0000,0000,,and the same radio frequencies?"
Dialogue: 0,0:05:54.24,0:05:56.78,Default,,0000,0000,0000,,So they are absolutely ready to go.
Dialogue: 0,0:05:56.78,0:06:01.47,Default,,0000,0000,0000,,So those are the kinds of things\Nwe need to deal with an epidemic.
Dialogue: 0,0:06:01.47,0:06:03.30,Default,,0000,0000,0000,,What are the key pieces?
Dialogue: 0,0:06:03.30,0:06:08.59,Default,,0000,0000,0000,,First, we need strong health systems\Nin poor countries.
Dialogue: 0,0:06:08.59,0:06:11.25,Default,,0000,0000,0000,,That's where mothers \Ncan give birth safely,
Dialogue: 0,0:06:11.25,0:06:13.18,Default,,0000,0000,0000,,kids can get all their vaccines.
Dialogue: 0,0:06:13.18,0:06:18.15,Default,,0000,0000,0000,,But, also where we'll see\Nthe outbreak very early on.
Dialogue: 0,0:06:18.15,0:06:19.94,Default,,0000,0000,0000,,We need a medical reserve corps:
Dialogue: 0,0:06:19.94,0:06:22.50,Default,,0000,0000,0000,,lots of people who've got \Nthe training and background
Dialogue: 0,0:06:22.50,0:06:25.85,Default,,0000,0000,0000,,who are ready to go, with the expertise.
Dialogue: 0,0:06:25.85,0:06:30.56,Default,,0000,0000,0000,,And then we need to pair those\Nmedical people with the military.
Dialogue: 0,0:06:30.56,0:06:34.42,Default,,0000,0000,0000,,taking advantage of the military's ability\Nto move fast, do logistics
Dialogue: 0,0:06:34.42,0:06:36.45,Default,,0000,0000,0000,,and secure areas.
Dialogue: 0,0:06:36.45,0:06:39.13,Default,,0000,0000,0000,,We need to do simulations,
Dialogue: 0,0:06:39.13,0:06:41.81,Default,,0000,0000,0000,,germ games, not war games,
Dialogue: 0,0:06:41.81,0:06:44.49,Default,,0000,0000,0000,,so that we see where the holes are.
Dialogue: 0,0:06:44.49,0:06:48.47,Default,,0000,0000,0000,,The last time a germ game \Nwas done in the United States
Dialogue: 0,0:06:48.47,0:06:50.71,Default,,0000,0000,0000,,was back in 2001, \Nand it didn't go so well.
Dialogue: 0,0:06:50.71,0:06:55.49,Default,,0000,0000,0000,,So far the score is germs: 1, people: 0.
Dialogue: 0,0:06:55.49,0:07:01.88,Default,,0000,0000,0000,,Finally, we need lots of advanced R&D\Nin areas of vaccines and diagnostics.
Dialogue: 0,0:07:01.88,0:07:05.25,Default,,0000,0000,0000,,There are some big breakthroughs, \Nlike the Adeno-associated virus,
Dialogue: 0,0:07:05.25,0:07:09.23,Default,,0000,0000,0000,,that could work very, very quickly.
Dialogue: 0,0:07:09.23,0:07:12.60,Default,,0000,0000,0000,,Now I don't have an exact budget\Nfor what this would cost,
Dialogue: 0,0:07:12.60,0:07:17.68,Default,,0000,0000,0000,,but I'm quite sure it's very modest\Ncompared to the potential harm.
Dialogue: 0,0:07:17.68,0:07:21.74,Default,,0000,0000,0000,,The World Bank estimates that \Nif we have a worldwide flu epidemic,
Dialogue: 0,0:07:21.74,0:07:25.46,Default,,0000,0000,0000,,global wealth would go down\Nby over 3 trillion dollars
Dialogue: 0,0:07:25.46,0:07:29.80,Default,,0000,0000,0000,,and we'd have millions\Nand millions of deaths.
Dialogue: 0,0:07:29.80,0:07:32.81,Default,,0000,0000,0000,,These investments offer \Nsignificant benefits beyond just
Dialogue: 0,0:07:32.81,0:07:34.52,Default,,0000,0000,0000,,being ready for the epidemic.
Dialogue: 0,0:07:34.52,0:07:36.89,Default,,0000,0000,0000,,The primary healthcare, the R&D,\Nthose things would reduce
Dialogue: 0,0:07:36.89,0:07:41.17,Default,,0000,0000,0000,,global health equity\Nand make the world more just
Dialogue: 0,0:07:41.17,0:07:43.26,Default,,0000,0000,0000,,as well as more safe.
Dialogue: 0,0:07:43.26,0:07:47.51,Default,,0000,0000,0000,,So I think this should absolutely\Nbe a priority.
Dialogue: 0,0:07:47.51,0:07:48.98,Default,,0000,0000,0000,,There's no need to panic.
Dialogue: 0,0:07:48.98,0:07:53.47,Default,,0000,0000,0000,,We don't have to horde cans of spaghetti\Nor go down into the basement.
Dialogue: 0,0:07:53.47,0:07:55.17,Default,,0000,0000,0000,,But we need to get going,
Dialogue: 0,0:07:55.17,0:07:58.02,Default,,0000,0000,0000,,because time is not on our side.
Dialogue: 0,0:07:58.02,0:08:03.52,Default,,0000,0000,0000,,In fact, if there's one positive thing\Nthat can come out of the Ebola epidemic,
Dialogue: 0,0:08:03.52,0:08:09.88,Default,,0000,0000,0000,,it's that can serve as an early warning,\Na wake-up call, to get ready.
Dialogue: 0,0:08:09.88,0:08:14.76,Default,,0000,0000,0000,,If we start now, we can be ready \Nfor the next epidemic.
Dialogue: 0,0:08:14.76,0:08:16.11,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:08:16.11,0:08:19.87,Default,,0000,0000,0000,,(Applause)