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There are a lot of people, Bill Gates included, who could have said “I told you so” at the start of the COVID-19 pandemic. In 2015, Gates warned a pandemic could happen and that the world was unprepared.

In How to Prevent the Next Pandemic, published seven years later, two years into a pandemic, Gates says, “Outbreaks are inevitable, but pandemics are optional.” At first glance, this seems optimistic, if not impossible: In a world this interconnected and interdependent, how can we reasonably and ethically contain outbreaks?

But the experts agree with Gates.

The World Health Organization’s Independent Panel for Pandemic Preparedness and Response says the COVID-19 pandemic was a sign of how vulnerable our world is:

“Our careful scrutiny of the evidence has revealed failures and gaps in international and national responses that must be corrected,” the panel writes in a 2021 report. “Current institutions, public and private, failed to protect people from a devastating pandemic. Without change, they will not prevent a future one. That is why the panel is recommending a fundamental transformation to a new system of complete pandemic preparedness. If we fail to take this goal seriously, we will condemn the world to successive catastrophes.”

Current institutions, public and private, failed to protect people from a devastating pandemic. Without change, they will not prevent a future one.

WHO’s Independent Panel for Pandemic Preparedness and Response

“No one wants to live through this again ¬— and we don’t have to,” Gates writes. “If we make key investments that benefit everyone, COVID-19 could be the last pandemic ever.”

These key investments? Make and deliver better tools, including vaccines; improve disease monitoring; and strengthen health systems. Gates also advocates for a cross-disciplinary Global Epidemic Response and Mobilization (GERM) team that could contain outbreaks with speed and efficiency.

Some of these investments are already in the making: wastewater monitoring could keep an eye on infections in a community; mRNA vaccine technology has proved its efficacy; telehealth and health wearables changed the way we interact with health-care systems.

Others need more work. Gates calls for data to be available in real time, but data-protection laws and systems lag, and ethical concerns should not be ignored. Plus, changes need to be implemented worldwide, not just in countries that can afford it.

Gates’ calls for monitoring and responding to outbreaks are admirable, but a global coordinated effort is not realistic right now. Pandemics cross borders; they need countries to work together. They need collective investment and effective communication strategies. The COVID-19 pandemic proved some places are not ready, for socioeconomic and political reasons.

Dr. Eeshani Kandpal, senior economist in the Development Research Group of the World Bank, says pandemic-preparedness efforts should focus on the relationship between health inequity and broader social and economic vulnerability.

“The COVID-19 pandemic demonstrates that pandemic preparedness planning cannot be divorced from the fight against inequality,” Dr. Kandpal writes in a 2022 editorial for the British Medical Journal. “Addressing these dual challenges will require investment and political will. Gaps in countries’ capacity to finance health were large before the pandemic and have further widened in its wake, creating a fault line that threatens health security for all. Centering health equity in pandemic preparedness planning is not just the right thing to do, but also the smart thing.”

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