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different problems at once. If you strengthen health systems, for example, you can expect to see improvements in malaria, child mortality, maternal health, and so on. The criticism is that vertical efforts come at the cost of horizontal ones, and that those horizontal efforts are, by their nature, the more effective way to save and improve people's lives with limited money and effort. I don't agree with the criticism, though. The vast majority of the resources goes to horizontal programs, including the global polio program's funding of routine immunization work. Targeted vertical programs such as house-to-house polio campaign vaccination or distributing drugs for tropical diseases are integrated into the horizontal system. The way polio campaigns have shifted to help with COVID shows that horizontal and vertical capabilities are not a zero-sum game. And COVID is not the only example: During the 2014 Ebola outbreak in West Africa, polio workers in Nigeria were able to step in and help with the Ebola response. Without them, the country's 180 million citizens would have been at far greater risk--and in fact, in countries without the polio-eradication infrastructure, the outbreak was much worse. Strengthening one muscle does not have to come at the expense of weakening another. As we build up the world's ability to detect and respond to outbreaks--the most dangerous of which will be respiratory diseases--the investments we make will benefit the entire health system. The opposite is also true: When health care workers are well trained and have the tools they need, and when everyone gets good care, health systems will be able to stop outbreaks before they spread far and wide. ***