The Public Health Threat That Scares Bill Gates More Than Nuclear Weapons

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When it comes to the scary calamities that could befall humankind, Bill Gates isn’t too worried about earthquakes, nuclear war or even a life-ending asteroid. But, the philanthropist told Vox, there is one eventuality that especially concerns him: a widespread infectious disease that has the ability to wipe out millions around the globe.

“I rate the chance of a nuclear war in my lifetime as being fairly low,” said Gates in a recent video interview with Vox editor-in-chief Ezra Klein. “I rate the chance of a widespread epidemic far worse than Ebola in my lifetime as well over 50 percent.”

Travel is easier than ever before in our increasingly connected world, allowing more people to go to more places at a faster speed than any other point in history. It’s these global ties that could give the next serious disease the ability to spread quicker than any other epidemic in history. In fact, we’ve already seen the terrifying potential: while it took centuries for smallpox to cross the Atlantic, it only took weeks for SARS to spread to 30 countries on 5 continents when it emerged in 2003.

“We’ve created, in terms of spread, the most dangerous environment that we’ve ever had in the history of mankind,” Gates said.

In today’s world, a global outbreak of a highly pathogenic influenza strain — like the one that caused the Spanish Flu, killing an estimated 65 million people from 1918 to 1919 — could be catastrophic, Gates said, citing output from an algorithmic model of how disease spreads through the modern world. Given the convenience and speed of modern transportation, a disease like the Spanish flu could spread all around the world in just days, reaching “basically all urban centers around the entire globe” within 60 days, Gates told Vox. And within 250 days, a Spanish flu-like disease would kill more than 33 million people, the model predicted.

Gates calls the recent Ebola epidemic, which killed approximately 11,000 people, a warning sign that the world isn’t prepared to combat a deadly and fast-spreading disease like the Spanish flu. Indeed, the World Health Organization warned in March that the world is “highly vulnerable” to a severe pandemic flu. The good news, Gates pointed out, is that the solution to the problem is relatively cheap — at least compared to what the U.S. spends on military defense every year. It would take less than $1 billion a year to invest in research on antibodies, medical surveillance and military training, Gates said, and building basic public health infrastructure in countries where it’s lacking — considered the single-most effective disease-fighting tool — costs less than a dollar per person, per year.

“This can be done, and we may not get many more warnings like [Ebola] to say OK, it’s a pretty modest investment to avoid something that, really, in terms of the human condition, would be a gigantic setback.”

Watch the video above to see Gates explain the danger infectious disease poses, and check out Vox‘s in-depth piece on why we’re still not prepared to face the biggest threat to humankind.