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officials who are the first people to see evidence of a pandemic in the making. Next, I'll explain some of the obstacles that make disease surveillance difficult for everyone--the fact that many births and deaths are never officially recorded, for example--and tell you about how some countries are overcoming these hurdles. Finally, I'll explore the cutting edge of disease surveillance--the new tests that will radically change the way doctors detect diseases in their patients, and a novel citywide approach to studying the flu that was pioneered in my hometown of Seattle. (The twists and turns and ethical dilemmas in that story are intense.) By the end of this chapter, I hope to persuade you that, with the right investments in people and technology, the world can have the tools it needs to see the next pandemic coming before it's too late. *** January 30, 2020, marked a major milestone in the COVID pandemic: The director-general of the WHO declared the disease a "Public Health Emergency of International Concern." That's an official designation under international law, and when the WHO invokes it, every country in the world is supposed to respond by taking various steps.* Although a few diseases, such as smallpox and new types of flu, are so alarming that they're supposed to be reported as soon they're detected, most of the time the system operates as it did with COVID. The WHO--trying to strike a delicate balance between protecting the public without setting off unnecessary panic--waits until it has enough data before setting a major international response into motion. * There isn't yet any mechanism for making sure they actually take these steps, though.