March 28, 2022
Microsoft founder Gates (How to Avoid a Climate Disaster) delivers a thoughtful exploration of how lessons learned from Covid-19 can inform future global public health policies. In accessible prose, he spells out steps for preventing future pandemics, among them creating a global task force dedicated to doing so, a proposition he compares to fire prevention measures in the United States, noting that local governments spend $50 billion per year on that service. Gates’s proposed team (cheesily named GERM, for global epidemic response and mobilization) would be managed by the WHO and include about 3,000 staffers at an annual cost of around $1 billion, and the group would be responsible for “watching out for potential outbreaks, raising the alarm when they emerge, helping to contain them... and standardizing policy recommendations.” Other ideas floated include improved detection of viral outbreaks, greater funding of vaccine research, and closing the gap in access to healthcare between the first and third worlds. Gates is realistic about what he’s up against (“it will be hard to get the right... level of funding”), but he does a good job of making GERM’s $1 billion price tag seem reasonable, framing it as “less than one-one-thousandth of the world’s annual spending on defense.” The result is an intriguing proposal to blunt future pandemics.

May 1, 2022
The tech mogul recounts the health care-related dimensions of his foundation in what amounts to a long policy paper. "Outbreaks are inevitable, but pandemics are optional." Thus states the epidemiologist Larry Brilliant, a Gates adviser, who hits on a critically important point: Disease is a fact of nature, but a pandemic is a political creation of a kind. Therefore, there are political as well as medical solutions that can enlist governments as well as scientists to contain outbreaks and make sure they don't explode into global disasters. One critical element, Gates writes, is to alleviate the gap between high- and low-income countries, the latter of which suffer disproportionately from outbreaks. Another is to convince governments to ramp up production of vaccines that are "universal"--i.e., applicable to an existing range of disease agents, especially respiratory pathogens such as coronaviruses and flus--to prepare the world's populations for the inevitable. "Doing the right thing early pays huge dividends later," writes Gates. Even though doing the right thing is often expensive, the author urges that it's a wise investment and one that has never been attempted--e.g., developing a "global corps" of scientists and aid workers "whose job is to wake up every day thinking about diseases that could kill huge numbers of people." To those who object that such things are easier said than done, Gates counters that the development of the current range of Covid vaccines was improbably fast, taking a third of the time that would normally have been required. At the same time, the author examines some of the social changes that came about through the pandemic, including the "new normal" of distance working and learning--both of which, he urges, stand to be improved but need not be abandoned. Gates offers a persuasive, 30,000-foot view of a global problem that, he insists, can be prevented given will and money.

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May 1, 2022

Philanthropist Gates (How To Avoid a Climate Disaster) offers an insightful look into how the world can be better prepared, and possibly thwart, the next pandemic, whether natural or man-made. He synthesizes the lessons learned during the COVID pandemic to propose nearly step-by-step plans that governments, organizations, nonprofits, and individuals can take to prevent and prepare for future viral outbreaks. Gates's book is not a narrative of COVID; instead, its aims exclusively to propose global strategies for dealing with future pandemics. Utilizing his prodigious ability to analyze and synthesize data, Gates lays out a comprehensive, idealized plan to try and prepare every level of society to deal with widespread illness. VERDICT This book is a possible future blueprint for pandemic preparedness, which means that it's best audiences might be governments and NGOs, rather than individuals.--Laura Hiatt

Copyright 2022 Library Journal, LLC Used with permission.

Starred review from April 15, 2022
By now, most people are fluent in the parlance of pandemics--lockdowns, social distancing, masking, PCR tests, contact tracing, flattening the curve--but they are also understandably worried about where we go from here. In this concise and lucid book, global health activist Gates reflects on the current COVID-19 pandemic, considers future ones, and renders several sensible recommendations for prevention. Heed lessons on success and on failure from our response to COVID-19, Gates advises. Prioritize establishing a pandemic prevention team, (""the equivalent of a global fire department""). Enhance disease surveillance to identify outbreaks early, and protect folks quickly. Discover new remedies rapidly, expediting testing and approval of drugs. Have vaccine pipelines ready to roll (development, manufacturing in massive quantities, efficient delivery). Ramp up efforts at creating ""universal"" vaccines for coronaviruses and influenza viruses. Practice makes perfect: implement full-scale exercises to gauge the world's readiness to locate and react to outbreaks, strive for health equity, increase investment in public health infrastructure, design and financially support a sound pandemic prevention system. Gates emphasizes the importance of urgency; complacency itself is a threat. Passionate but never preachy, Gates delivers an expert, well-reasoned, and robust appeal for the world to unite in averting upcoming pandemics.

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