While defending ourselves against terrorism we may be missing the biggest threat - microbial outbreak. Bill Gates gave a TED talk in Spring 2015 on how we should prepare for danger.
What is the most dangerous animal in the world? Nope, it's not lion, it's a mosquito. We are much more scared of low probability, high risk than high probability, low risk. Gates predicts that an epidemic is over 50% more likely than atomic attacks, wars and other deadly disasters.
In the last 100 years the majority of deaths have been due to disease, particularly infectious disease, not lions, tiger, bears and terrorists.
20th Century vs. 21stCentury: Lessons Learned?
1900-2000: Infographic on a Century's Death Toll
Did you ever wonder why and how many people died in the last century? Here is an overview of the estimated death toll for the time-period 1900 - 2000, which could help to understand what people suffered from back in the days, and might support in drawing some conclusions for the future.
Want to see the full visualisation? Click here for full-view.
What we can see in the interactive visualisation is that disease as a cause of death is estimated to be the biggest "killer" in the 20th century (4,130,265,400 deaths). Health complications, accidents and murder rank far behind the disease category. Low in comparison of the other major causes ranks war with an estimation of 130,727,000 deaths "only". For the 21st century, atomic war technology could possibly cause a much worse war outcome. Regarding drugs, with tobacco leading the field and an estimation of around 100 Million tobacco related deaths (the majority of the 115 Million drug related deaths estimated) we maybe should consider to stop smoking within this century. To conclude: many of the causes that plagued us back then, we can control today. However, one of the biggest incalculable risk remains: Uncontrollable infectious diseases.
H1N1, SARS and ebola proved to us time and time again how ill prepared we are for an epidemic. When Medecin Sans Frontieres couldn't cope with containing ebola they called on the director of the World Health Organisation, Dr. Margaret Chan. An external review of the WHO ebola response showed us how ineffective we were at coping with a response. The WHO is funded to monitor disease but it does not have enough funding or preparation to respond to a global outbreak.
"The problem wasn't that the system did not work well enough, the problem was that there was not a system at all" says Bill Gates. We do not have a team of epidemiologists ready to go to monitor the spread of the disease, the case reports came in on paper and we didn't have a medical team ready to go.
Why Wasn't Ebola Worse?
10k people died of ebola, mostly in the three worst hit west African countries. There are three reasons that ebola was not worse. Firstly, the heroic actions of the health workers who risked their lives to contain the disease by carefully dealing with the ill and the bodies of the dead. Second, the very nature of the virus fortunately did not spread through the air and people were bed ridden by the time it was highly infectious. Lastly, by pure luck, ebola did not get into many densely population urban areas.
In 1918 the Spanish Flu killed 100 million people, but now we have a world of high speed transport with the largest population ever, not to mention the density of our ever growing cities. If the Spanish Flu hit today, it would be a very different state of affairs.
"Not Missiles, but Microbes"
The failure to prepare could be deadly. Gates proposes using military resources and strategies to get ready. We need stronger medical systems in the poorest countries, a medical corps, pairing of the medical people with the army, simulations of 'germ games' not 'war games' to practice our response. The cost of preparing is modest compared to the potential harm.
Infectious disease does not respect borders, making fighting in the interest of a single country totally redundant. As a globe we spent well over a trillion (10^9) on military in 2014, compared to 4.5 billion on the WHO. We are focusing on the risk of nuclear war and terrorism when the true threat is is closer to our biology.
Bill Gates being interviewed by Vox.com
The WHO and the UN are arguably institutionally corrupted by richer countries having a stronger voice. Because the richest have a bigger say, the decisions and actions do not represent the interests of the global good. This year Amnesty International called on the UN Security Council to relinquish their power to veto because they had abused it for national interest.
Aid is not necessarily the answer to development. Dr. Moyo's book 'Dead Aid' wonderfully summarises how development aid causes more harm than good by undermining local production resulting in a dependency culture. To truly improve the medical infrastructure of poorer nations we may have to consider trade, not aid. The redistribution of wealth and the importance of stopping exploitative economics is crucial to out global health. Yet again, ebola is a reminder of the disastrous outcomes of poverty and inequality.