“No one thanks the public health expert for a disease they did not get,” writes Bill Gates in his new book ‘How to Prevent the Next Pandemic’. This statement underscores the scepticism that experts face while doing preventive work. If a pandemic preventive strategy was truly effective, then the desired outcome is the absence of a pandemic. However, society might not perceive the absence of a problem as a tangible hallmark of success of a preventive programme.

For instance, if an undercover national security team were able to foil the 9/11 plot before it happened, chances are none of us today will remember their effort as history-altering. It is a lot easier to convince someone by fixing a problem that was already troubling them.

The book opens with an overview of infectious diseases that take a huge toll on human lives every year, but without receiving proportionate attention. Although known more as a technologist and business leader, the author is also a philanthropist who has meaningfully contributed to reducing the global impact of ailments like diarrhoeal diseases, malaria, HIV and tuberculosis. With that background, he recalls the dilemma he and others had in early 2020 about the eventual impact of the outbreak of Covid-19 that started in Wuhan, China. The book revolves around his vision that being fully prepared is the right strategy to tackle such an event if it were to happen again.

Passionate about vaccines and technology, Gates believes that it is possible to eradicate entire families of respiratory viruses such as influenza and corona viruses. The subsequent chapters discuss the contrasting approach that various countries took towards the Covid-19 pandemic. Harsh in his criticism of the early US policies, he singles out the confusing signals sent out to the US public about masks, even describing it on a timeline.

Gates also makes an effort to answer some of the criticism he has faced in the line of his work as a philanthropist with an interest in reducing the global burden of (predominantly) infectious disease. He is not afraid to talk about failures that occurred during the history of development of vaccines, including the early loss of human lives that occurred as a result. Referring indirectly to the pervasive subtype of vaccine hesitancy, he correctly observes “you can’t persuade uncertain people simply by throwing more facts at them”.

In spite of the world making great strides on the technology front, including the manufacture and rollout of effective vaccines, he observes that lack of good leadership within some countries and insufficient coordination between nations amplified the damage caused by the current pandemic. The biggest single flaw that cost lives was the failure to act early, which ironically was a lesson the world had learned over a hundred years ago during the Spanish flu.

He proposes that the world employ a special pandemic taskforce that he calls GERM, or Global Epidemic Response and Mobilisation Team. Like a fire-brigade that keeps the whole town safe but does not necessarily have to put out fires every day, GERM would stay alert in all corners of the world, looking for any sign of an outbreak. By acting early and decisively, the outbreak is stamped out before turning into a pandemic. He proposes that this group of professionals come under the purview of the WHO, so they get universal acceptance. He believes that such a task force can be maintained at a relatively small overall cost, which he emphasises will be a tiny fraction of the annual defence spending of some wealthy nations.

The book specifically avoids difficult and uncommonly used words that some writers tend to sprinkle in their text. Gates has a sense of humour which he is not afraid to bring out in the narrative; this makes reading lighter. Technical points are patiently explained in plain English. There are plenty of metaphors thrown in that help lay people understand complex concepts in immunology and public health. At the end of the main text comprising 250 pages, a short glossary of medical terms is provided. The clever cartoons deserve special mention, and their message is worth the squinting involved.

The book is evidently well-researched: the author has acknowledged a large number of experts who helped put it together. Importantly, the book presents the perspective of individual nations in a non-judgmental tone, and includes personal anecdotes of grassroots level healthcare workers who have done substantial work in less developed parts of the world.

In chapter 8, while discussing the disparity between countries on various health indices, Mr Gates explains why efforts to reduce child mortality will not lead to overpopulating the world. Replete with such discussions covering a range of topics from disruptive technology, innovation, drills, vaccine development and non-pharma interventions to computer modelling, “How to Prevent the Next Pandemic” will be a valuable addition to the book collection of anyone who has an interest in public health and policy making.

(Dr Rajeev Jayadevan is a specialist physician, public educator, author and is a member of the National Task Force of IMA for Coronavirus pandemic)

About the book

Title: How to Prevent the Next Pandemic

Author: Bill Gates

Publisher: Penguin Books

Price: ₹905 (288 pages)

Check out the book on Amazon

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