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Gates Package, p.921 · gates:exh:00331
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cases, its benefits vastly outweighed the risk. But someone needed to take the blame, and Sencer
was the fall guy.8
Sencer, who died in 2011, remains highly regarded in the world of public health. The
consensus is that pushing for mass immunizations was worth the risk; if he had been right about
a pandemic, the cost of inaction would have been enormous. But critics focused more on the risk
of a rare autoimmune disease--which was real--than on the possibility that tens of millions
could die.
In public health, you have to be careful about sending a message that says, "act early and
you'll be fired if you get it wrong." Of course, if someone makes a truly wretched decision,
firing may be in order. But officials need the leeway to make tough calls, because there will
always be false alarms, and distinguishing them from the real thing is not an easy task.
What if Sencer had done nothing, and his fears had turned out to be valid? Tens of
millions of people would have died of a virus that had started in the United States, which had a
chance to stop it but chose not to. When people like Sencer act in good faith and with the best
data they have available to them, they should not be attacked for possibly having made the
wrong call purely because we have the benefit of hindsight. It creates a perverse incentive to be
overly cautious--to protect their careers by holding back. And when it comes to public health,
holding back can lead to disaster.
6. It pays to invest in innovation.
It's tempting to assume that invention occurs practically overnight. If in January you wouldn't
know what messenger RNA was if it walked up to you on the street, and by July you've read all
about it and are getting a vaccine that uses it, you might think it went from idea to reality in just