It should be possible to make diagnostic tests, drugs, and vaccine platforms that could be adapted for use against various pathogens. Today, with the possible exception of influenza vaccines, we do not have nearly enough capacity for developing adaptable platforms, partly because there are opportunity costs for private-sector organizations in shifting resources away from more commercially viable projects to work on tools for epidemics that may not happen. We may need an international funding system that factors in these opportunity costs.

Other than watching for symptoms, the diagnostic approach used during the Ebola epidemic has involved sending blood samples for quantitative polymerase-chain-reaction (qPCR) analysis. But qPCR machines are expensive and not widely available, so on average it has taken 1 to 3 days to get test results. For the next epidemic, an adequate number of qPCR machines should be made available while novel diagnostic methods are rapidly developed. We also need a clear process for developing and manufacturing accurate diagnostic tests rapidly. A focused effort to accelerate this process and establish a rapid approval and procurement process would be worthwhile.

On the therapeutics front, there are drugs that work against viruses similar to Ebola, and some of them have been shown in test assays to have an effect against Ebola. Unfortunately, they were not tested in patients with Ebola until after the epidemic had peaked — in part because there was no clear process for approving a novel trial format or for providing indemnity against legal liability. We will need to develop a clear set of guidelines (and testing and regulatory pathways) for determining whether existing drugs could be repurposed to help stop a particular epidemic.

We also need to invest in more research on antiviral drugs, antibody treatments, and RNA-based constructs. We should have either stockpiles or manufacturing capacity for therapies that might be effective in an epidemic.

Plasmapheresis should have been used in the Ebola epidemic, but its application wasn't approved and scaled up until it was too late for this intervention to have a large impact. Plasmapheresis is quite effective for a number of diseases (including smallpox and viral hemorrhagic fevers such as Lassa fever) and has a reasonable chance of working for Ebola as well. The Gates Foundation started working to establish plasmapheresis units in early September 2014 and quickly found partners ready to take them into the affected countries. Unfortunately, the effort was hampered by the lack of a clear process for approving new approaches. We should develop rules now to expedite drug approvals in future epidemics and establish clear guidelines for approving studies and treatments, including experimental ones. A global epidemic-drug–approval process could avert long delays by indemnifying companies working on new approaches.

Three different Ebola vaccine constructs were being developed in the summer of 2014. Although all were in early stages, this work made us more prepared for Ebola than we would be for an entirely new pathogen, for which vaccine development could take 2 or more years. Moreover, it is not clear how quickly vaccine developers could or would move or who should finance the final research and manufacturing of a new vaccine.

Among known pathogens, influenza is the one most likely to cause a large epidemic; even seasonal influenza variants probably cause several hundred thousand excess deaths each year. So it's disappointing that we don't have a vaccine for all influenza strains. There is work being done toward this goal, but it has garnered nowhere near the resources that it deserves.

Ideally, vaccine research would be funded in such a way that during an outbreak, a vaccine could be designed, tested for safety, and ready for manufacture at scale within a few months. There is no guarantee of success, but I believe that given enough time and resources, such efforts could produce an invaluable contribution for epidemics and overall health.

Given Ebola's limited infectiousness in the early stages of the disease, most of the quarantine policies that were proposed would have been counterproductive. But when a far more infectious agent comes along, quarantine may be one of the few tactics that can reduce its spread in the early stages of disease. Because democratic countries try to avoid abridging individuals' rights to travel and free assembly, they might be too slow to restrict activities that help spread disease.

Part of the process should include a plan for effective public communications, including coordination of the messages conveyed by all the different voices people will hear, from governments, to United Nations agencies, to news media, to bloggers. Digital communication can be used to great advantage, but unless a plan is in place, it will only spread confusion and panic faster.