Gates Package — page 928

24--a show I really staffed and equipped, pregnant women get pre- and post-natal care, and children get their routine vaccines; health care workers are well trained in public health and pandemic prevention; and reporting systems make it easy to identify suspicious clusters of cases and raise the red flag. When that kind of infrastructure is in place--as it is in most wealthy nations and some low- and middle-income ones--you're much more likely to notice the early stage of a new disease emerging. Without that infrastructure, you don't notice the new disease until it has spread to tens of thousands of people and probably gotten into multiple countries. But what's most unrealistic about what you see in the movies is that it suggests there's some agency that pulls together all these different capabilities, acting swiftly and decisively to prevent a pandemic. My favorite example is an episode of the TV show 24--a show I really liked--where a terrorist intentionally releases a pathogen in Los Angeles. Word gets to practically every government entity in no time. The hotel where the release took place is immediately sealed off. A computer modeling genius figures out not only how the disease will spread, but how quickly news of the disease will get around, and (the best part) how bad traffic will get as people flee the city. I remember watching that episode and thinking, "Wow, that government sure knew how to prepare." It made for great TV, and of course we could all sleep better at night if things really worked that way. But they don't. Although there are many organizations that work hard to respond to a major outbreak, their efforts largely depend on volunteers. (The best known is the Global Outbreak Alert and Response Network.) Regional and national response teams are understaffed and underfunded, and none of them has a mandate from the international community to work globally. The only organization that sort of has that mandate, the WHO, has very little funding and almost no personnel. There is no organization with the size, scope,