Gates Package — page 929

resources, and responsibility for detecting and responding to outbreaks and preventing them from becoming pandemics. Let's consider the sequence of events that are involved in an effective pandemic prevention response. Sick people have to go to a clinic, and the health workers there have to diagnose them properly. Those cases must get reported up the chain, and an analyst has to notice an unusual cluster of cases with similar suspicious symptoms or test results. A microbiologist must get samples of the pathogen and determine whether it's something we've seen before. A geneticist may need to map its genome. Epidemiologists have to understand how transmissible and severe the disease is. Community leaders need to get, and share, accurate information. Quarantines might need to be put in place and enforced. Scientists need to get cracking on diagnostic tests, treatments, and vaccines. And, just as firefighters run drills when they're not putting out a blaze, all of these groups need to practice, testing the system to find the weak spots and fix them. Bits and pieces of what you'd want in a monitor-and-respond system exist. I've met people who have dedicated their lives to this work, and many put their lives on the line for it. But COVID did not happen because there were too few smart, compassionate people trying to prevent it. COVID happened because the world hasn't created an environment in which these smart, passionate people can make the most of their skills as part of a strong, well-prepared system. At the country level, no Congress or Parliament ever told its top public health people: "Here's a proper budget for pandemic prevention. Stay vigilant. Make sure you're hiring the right people and preparing for these rare but massive outbreaks." Now we know they should have. The United States did some of this, but as we saw, the pieces didn't come together when