From Bill Gates to the World Bank... Are we ready for the next pandemic?

In what looks like a futuristic prediction, famous businessman Bill Gates stood on a TED platform in 2015, more than a year after the outbreak of the Ebola epidemic, warning of changing sources of danger that should be vigilant For her the world, while nuclear war was the worst fear of his childhood and people at the time, the matter has become different in recent years, and he said: “If something kills ten million people during the next few decades, it is likely to be a highly contagious “virus” and not a war (1). ).

During his speech, Gates presents a simple and quick comparison between the preparedness of the developed world for any potential military conflict, or for any global medical challenge, and here the huge difference between a military preparation equipped with the latest technologies and the strongest human supplies, as opposed to fragile health systems, that can barely face health challenges At the time, Bill Gates used "Ebola" as a model to illustrate the ferocity of the expected danger, "Ebola" did not reach major cities, and it was not a respiratory virus that was easy to catch and spread, and African efforts succeeded in preventing its spread, but Gates also saw that luck was the reason. The main factor in the world's survival from this virus, and that the next most dangerous virus will infect people while they are on planes or stores, and they may not show symptoms of infection.

Bill Gates returned this year to stand on the same podium again, reminding of his speech, saying: “When I was on this podium in 2015, I was one of the many who said we were not ready for the pandemic and we had to prepare, but we did not, many watched my speech The previous one, but 90% of them saw it too late,” and this time he also used a realistic “Corona pandemic” guide, and reviewed several ideas for how to prepare for the upcoming epidemics and pandemics (2).

viral attack

Well, first of all, the method of transmission of viral infection from animals to humans should be clarified. It has been observed that the microorganism (that causes the disease) goes through several stages to transform from a microorganism of animal origin to one that infects humans and spreads among them. At first, this organism infects the animal under natural conditions, then The microorganism undergoes mutations or mutations that give it the ability to transmit to humans, that is, the infection is transmitted through the animal, and then the ability of the microorganism develops until its spread among humans becomes easier and faster and does not require the presence of the infected animal to cause infection between humans, but is transmitted from one person to another, and is considered This stage is the most dangerous, and it is the stage that causes pandemics and epidemics (3), and this confirms the importance of monitoring new pathogens and their stages of development, which will be an indicator of the type of medical response needed to deal with them.

There are also several factors that facilitate the spread of infectious diseases and their transformation into epidemics or pandemics, the most prominent of which is the new pattern of human life on Earth. Population communities are linked together, as nearly 12 million passengers travel daily around the world on 100,000 flights, and this has become the nature of the contemporary world, but it seems that no one could have imagined that the epidemic would travel in the same ways that capitals travel in a global economy. open (4).

West Nile virus is transmitted to humans by mosquitoes and some wild birds.

In addition, the severe overcrowding in our societies has prompted some of the human beings to live in close proximity to animals, and all of this facilitated the transmission of microorganisms that cause diseases of animal origin from animals to humans, and then between humans, such as the West Nile virus that is transmitted to humans By mosquitoes and some wild birds.

The change brought about by globalization in the age of technology has produced large cities that continue to expand, and commercial traffic and active travel trips do not stop, and this means the expansion of infection with any viral disease, while diseases previously affected a specific geographical spot, far from other population groups, and difficult to reach because The availability of means of transportation that facilitates the travel of the residents of the affected area. Diseases were limited to the residents of those spots, but this is currently impossible to happen.

necessary preparation

The Corona pandemic has so far killed more than six million people around the world (5), caused global losses that exceeded $20 trillion, and recorded a failure in the world’s health history, and in the context of global action to confront the pandemic, and search for ways to prepare for the upcoming epidemics or pandemics that Even deadlier, three researchers from the Resolve to Save Lives Foundation, founded by Dr.

Tom Frieden, former director of the Centers for Disease Control and Prevention in the United States, to participate in the global effort to address deadly health risks.

The study of the three researchers (6) concluded that the most important factors for pandemic preparedness are financing and governance, especially in low- or middle-income countries, and funding here is essential to building the capacity of health systems, specifically to build the facilities needed to respond to epidemic emergencies such as public health laboratories, and to cover the expenses necessary to provide Specialized medical staff and medical devices, in addition to the funding needed to feed and strengthen scientific research projects, and allocate part of the financial funding to strengthen primary care systems that are the first front line with diseases and epidemics. health, and provide the necessary vaccinations to stop any epidemic.

Another factor that researchers emphasize is its role in preparing to face epidemics and pandemics is building specialized skills and capabilities within health care systems. Providing financial support, if achieved, will not be sufficient, and here comes the role of health training programs to improve the quality and capabilities of workers in health sectors around the world.

But in this context, the three researchers also stress that this type of financial support is difficult to achieve or consolidate because it is affected by the political systems of countries around the world. The prevailing approach for these systems is to move to deal with the current immediate danger, not to prevent future risks, and even if these issues are raised, perhaps It takes years to deal with.

In addition, primary care systems do not receive support or funding that enhances their ability to play their role in dealing with diseases and epidemics in most countries of the world, and World Bank reports confirm in this context the role of governance in building legislation and legal systems to regulate the progress of existing efforts in accordance with laws International (7), we mention here human rights protection laws, and ethical frameworks for dealing with residents of war and conflict areas to ensure that their lives are not endangered in any way.

Control a small and terrifying creature

As we mentioned at the beginning, the possibility of new epidemics and pandemics will still exist, and it will even increase for the reasons mentioned previously, that is, we have to expect new epidemics and pandemics, but can we prevent new diseases from transmitting from animals to humans?

This question was posed by the "Horizon" magazine issued by the European Commission for Research and Innovation to Máire Connolly, Professor at the National University of Ireland School of Medicine (8), and she was of the opinion that reducing the risk of this is possible, but that it calls for Controlling the trade of wild animals, bush meat and wild game, especially in wet markets, which are those markets that sell agricultural products, meat and fresh fish, where live animals are offered for sale, also known as “wild animal markets” (9).

Connolly adds to this the importance of applying legal controls in poultry farms, rapid detection of diseases spread among birds, and monitoring wild birds. The risk of epidemics by urgently reporting disease cases in hospitals in areas at risk of epidemics, to speed up the application of safety, isolation and prevention measures.

The epidemic does not go away

The Wiley Online Library, which houses the highest quality scientific papers, has published an academic article in which Erica Charters and Kristin Heitman investigated the course of past epidemics (10), And how did these diseases come to an end, but the surprise here is that a large number of pandemics and epidemics do not end, but even the pandemics that most think were from the past, still live among us and kill humans to this day, and that what is happening in fact is the end of interest in the pandemic Or an epidemic, and turn this attention into a new epidemic or pandemic.

The two researchers noticed that there is a pattern similar to the novel in the history of epidemics in the past, you may be surprised to learn that, but evidence for this is what the famous Greek historian “Thocides” shed light on the death rates resulting from the plague that spread in 400 BC, and what resulted from This had an impact on social life, before the mention of the disease disappeared from his historical books, without the slightest indication that the disease had ended or the rates of infection had decreased, or even an explanation of how human life at that time would return to the normal situation before the disease.

A similar thing happened in America in the nineteenth century when “cholera” spread. Even the American historian “Charles Rosenberg” did not provide any information about the end of cholera in America compared to his extensive explanation about the beginning of cholera and its effects, and this was also noted with what was observed about The Spanish Flu pandemic in 1918, so the two researchers believe that the terms “epidemic” and “pandemic” were used with the aim of alerting societies to the seriousness of the disease, but their attention was directed after the low rates of disease infection towards another direction or towards more harmful problems.

Pandemics, then, partially end as soon as humans announce their end. Governments have known this since time immemorial, but Gates appears to have been right.

The two researchers also believe that we must define what we mean by the end of the epidemic or pandemic when we ask about this, that is, do we mean the disappearance of the disease or the end of the disaster resulting from it and the increase in the ability to confront it, and they give the Ebola epidemic as an example here, despite the rapid and wide spread of the epidemic in 2013, the The World Health Organization was late in declaring the disease as a health emergency that calls for international concern. Rather, it was quick to declare the end of the epidemic within a short period, but the analysis of the situation at the time confirmed that the organization’s statement about the end of the epidemic was not intended for the disappearance of the disease, but rather the decline of the resulting social, economic and political disasters. about him.

This is similar to declaring the end of cholera in England in the nineteenth century, as it is related to a decrease in cases and deaths compared to the beginning of the epidemic, and what is meant by the end of the epidemic or pandemic in most cases is the superiority of efforts to control the epidemic, success in limiting its spread, and mitigating its social and economic consequences. Likewise, the epidemic may turn into an endemic disease, as if it has settled in the place it reached, and its news will turn into routine news that people are accustomed to hearing, without causing panic similar to what happened at the beginning of the disease.

Pandemics therefore partially end once humans declare their end (11), this has been known to governments since ancient times, but it seems that Gates was right, and with the current global political turmoil, the effects of the Ukrainian war and other expected turmoil, the world that failed to monitor epidemics In previous decades, and in the face of the current pandemic that forced him to move to restore his natural order, he might fail again, just waiting for the opportunity to announce it!

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