![]() What has gone wrong on the testing front? It was hard to supervise in developing countries as the disease burden shifted. That takes a mix of academia and the private sector to build those up. The only disease we’ve done a good job on with antivirals is HIV and that’s kind of an amazing thing. Why is that and how do we fix the problem? While we’ve had a few recent advances in COVID-19 treatments, they’ve taken a long time. Then they’re ready to work on any pandemic when there’s ever a hint of it. The thing we need to do better next time is the surveillance piece, the dedicated pandemic preparedness team, say several thousand people, that does germ games, modeling, ongoing respiratory surveillance and who keep their skills fresh by working on things like malaria and measles all the time. I don’t think we would do it the same way again. COVAX was created partly because of that lack of U.S. Typically on world problems, the U.S., both in terms of funding and expertise, plays a leading role. Should something like it stick around after this pandemic? The Bill & Melinda Gates Foundation has worked with COVAX, the effort to equitably supply vaccines throughout the world that has not fully lived up to its promise. We want rich countries to invest in new pandemic tools partly because of, of course, these millions of deaths and trillions of dollars, but also because we see the investment in good surveillance and in any of these tools-diagnostics, therapeutics but particularly vaccines-as incredibly helpful even before the next pandemic comes along. We got lucky that with mRNA technology … the very first successful vaccine was a pandemic vaccine. Other than funding the Coalition for Epidemic Preparedness Innovations, very little was done. there were people, including myself, who were very specific about things that should be done. Most other really bad things, there are small forms of them that remind you there can be a big one. ![]() It’s very hard for governments to maintain capacity for things that don’t happen very often. What has been the single-greatest lesson learned from the COVID-19 pandemic? ![]()
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