The next deadly disease that will cause a global pandemic is coming, Bill Gates said at a discussion of epidemics on Friday.

We're not ready.

A flu like the 1918 influenza pandemic could kill 30 million within six months, Gates said, and the next disease might not even be a flu, it might be something we've never seen.

The world should prepare like it does for war, according to Gates.



If there's one thing that we know from history, a deadly new disease will arise that will spread around the globe.

That could happen easily within the next decade. And as Bill Gates reminded listeners while speaking at a discussion about epidemics hosted by the Massachusetts Medical Society and the New England Journal of Medicine on Friday, we're not ready.

As Gates said, he's usually the optimist in the room, reminding people that we're lifting children out of poverty around the globe and getting better at eliminating diseases like polio and malaria.

But "there's one area though where the world isn't making much progress," said Gates. "And that's pandemic preparedness."

The likelihood that such a disease appears continues to rise. New pathogens emerge all the time as the world gets more populous and humanity encroaches on wild environments. It's becoming easier and easier for individuals or small groups to create weaponized diseases that could spread like wildfire around the globe. According to Gates, a small non-state actor could rebuild an even deadlier form of smallpox in a lab. And in our interconnected world, people constantly hop on planes, crossing from megacities on one continent to megacities on another in a matter of hours.

According to one simulation by the Institute for Disease Modeling presented by Gates, a new flu like the one that killed 50 million in the 1918 pandemic would most likely kill 30 million within just six months now. And the disease that next takes us by surprise will most likely be one that we see for the first time when the outbreak starts, like happened recently with SARS and MERS viruses.

If you were to tell the world's governments that weapons were under construction right now that could kill 30 million people, there'd be a sense of urgency about preparing for the threat, said Gates.

"In the case of biological threats, that sense of urgency is lacking," he said. "The world needs to prepare for pandemics in the same serious way it prepares for war."

Stopping the next pandemic

The one time the military tried a sort of simulated wargame against a smallpox pandemic, the final score was "smallpox one, humanity zero," according to Gates.

But as he said, he's an optimist, and he thinks we could better prepare for the next viral or bacterial threat.

In some ways, we're clearly better prepared now than we were for previous pandemics. We have antiviral drugs that can at least do something to improve survival rates in many cases. We have antibiotics that can treat secondary infections, like pneumonia associated with the flu.

We're getting closer to a universal flu vaccine. During his talk, Gates announced that the Bill and Melinda Gates Foundation would be offering $12 million in grants to encourage the development of such a vaccine.

And we're getting better at rapid diagnosis, too, something essential since the first step against a new disease is quarantine. Just yesterday, a new research paper in the journal Science announced the development of a way to use the gene-editing technology CRISPR to rapidly detect diseases and to identify them using the same sort of paper strip used in a home pregnancy test.

Yet we're not good enough yet at rapidly identifying the threat from a disease and coordinating a response, as the recent global reaction to the last Ebola epidemic showed.

There needs to be better coordination and communication between military and government to help coordinate responses. And Gates thinks that government needs ways to quickly enlist the help of the private sector when it comes to developing technology and tools to fight against emerging deadly disease.

As Melinda Gates said recently, the threat from a global pandemic - whether one that emerges naturally or one that's engineered - is perhaps the biggest risk humanity faces right now.

"Think of the number of people who leave New York City every day and go all over the world - we're an interconnected world," she said. Those connections make us all vulnerable.