The Atlantic

What Bill Gates Fears Most

The threat of a flu pandemic clouds even his legendary optimism, so he's launching an initiative to prevent one.
Source: Yuri Gripas / Reuters

Bill Gates fancies himself an optimist. Global health, he feels, is on an upward trajectory. Childhood deaths are plummeting. Polio is on the verge of eradication.

But if there’s one issue that punctures his positivity, it’s the possibility that the world will face a serious pandemic—and the near certainty that we aren’t prepared for it.

“This is a rare case of me being the bearer of bad news,” he says. “My general narrative is: Hey, we’re making great progress and we just need to accelerate it. Here, I’m bringing more of: Hey, you thought this was bad? [You should] really feel bad.”

In 2015, that “if anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus.” Three years later, he stands by that assessment. “It would take a heck of a meteor or volcano or earthquake to get you to 10 million,” he tells me. “Even a nuclear weapon going off in New York City wouldn’t be 10 million.” By contrast, in 1918, when an H1N1 flu virus swept the world, it killed between 50 and 100 million people, and slashed U.S. life expectancy by 12 years.

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