Bill Gates has warned for years that the world is not ready for a deadly pandemic.

Some of his ominous predictions are now playing out as the coronavirus spreads around the globe. The virus causes a disease known as COVID-19 and has killed almost 2,900 people and infected more than 83,000 others globally since December. The vast majority of cases and deaths have been in China.

"In the past week, COVID-19 has started behaving a lot like the once-in-a-century pathogen we've been worried about," Gates wrote in an op-ed for the New England Journal of Medicine. "I hope it's not that bad, but we should assume it will be until we know otherwise."

Gates referred to the outbreak as a pandemic, even though the World Health Organization has not yet made that declaration. The group has said instead that the virus has "pandemic potential."

"In any crisis, leaders have two equally important responsibilities: solve the immediate problem and keep it from happening again," Gates wrote. "The COVID-19 pandemic is a case in point. We need to save lives."

In the op-ed, Gates suggested the following solutions that could slow the virus' spread:

Wealthy countries should supply low- and middle-income countries in Africa and Southern Asia with trained healthcare workers to monitor the virus' spread and deliver vaccines.

Establish an international database where countries can share information.

Develop a system that screens for compounds that have already been safety-tested to use in a vaccine.

Governments and donors should fund manufacturing facilities that can pump out vaccines within weeks.

Gates compared COVID-19 to the 1957 flu pandemic, which killed more than 1 million people, and the 1918 flu pandemic, which killed 50 million people. The current outbreak, he wrote, is somewhere in between.

Gates said everyone should have access to an affordable vaccine

Gates predicted that large-scale trials for a coronavirus vaccine could happen as early as June. Anthony Fauci, the director of the National Institutes of Health's infectious-disease center, recently said that he hoped to start testing vaccine candidates in people by mid-April.

However, drug development is typically a multiyear process that can cost about $1 billion in the US. Gates said making vaccines affordable for everyone was the "right strategy" for containing the coronavirus outbreak.

"Given the economic pain that an epidemic can impose — we're already seeing how COVID-19 can disrupt supply chains and stock markets, not to mention people's lives — it will be a bargain," he wrote.

On Wednesday, Health and Human Services Secretary Alex Azar declined to promise that a future coronavirus vaccine would be affordable for all Americans. But he backtracked day later, saying that any vaccine developed in conjunction with the US government would need to be financially accessible to the public.

The Bill and Melinda Gates Foundation has already contributed $100 million toward the fight to contain the outbreak. In his op-ed, Gates said warding off a pandemic would require billions of dollars.

"There is no time to waste," he wrote.

Though China has seen a drop-off in its rate of new cases in recent days, the coronavirus has spread to at least 55 other countries. At least 72 people have died outside mainland China.

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