LONDON: When I was a child, my family would often go on hikes across Dartmoor, that glorious hilly wilderness in southwest England.
One of my favourite pastimes on these trips was spotting the ruins of old villages.
These, I was told, were settlements abandoned in the 14th century when the Black Death swept through Europe, killing between 30 per cent and 60 per cent of the population.
It was a haunting memory; so much so, that when I recently took one of my daughters riding in the same hills, I pointed out the stones, and explained they were a small monument to the horrors of pandemics.
“Could it happen again?” my daughter asked solemnly, looking at the ruins.
I carefully proffered the same reassuring answer that my parents had once given me: Unlike the 14th century, we now have powerful medicines and a much more advanced understanding of infection and how to control it.
This, in theory, should easily prevent another Black Death. But as I uttered the words, part of my mind was asking: “Really?” After all, if you talk to the medics or philanthropists involved in the fight to prevent contagious diseases, there is a clear — and rising — note of anxiety.
Take Bill Gates, the tech billionaire. In recent years, he and his wife Melinda have battled to improve global public health and say they are very optimistic about the stunning possibilities offered by 21st-century science. But there is one area where they are pessimistic: Pandemics.
EMERGENCE OF NEW PATHOGENS
The Gates Foundation recently modelled what might happen if a flu pandemic like the one in 1918 (in which between 50 million and 100 million people died) erupted today. The research suggests that if a comparable airborne respiratory pandemic hit now, about 33 million people would die within six months. And, as Bill Gates observed in a speech last month:
Given the continual emergence of new pathogens, the increasing risk of a bioterror attack, and how connected our world is through air travel, there is a significant probability of a large and lethal modern-day pandemic occurring in our lifetimes.
Our globalised world and love of travel makes it easy for pathogens to spread. But another significant problem is a dire lack of coordinated action.
In theory, the US has plenty of cutting-edge science and money to fight disease. However, the Trump administration has shown little interest in tackling this issue.
Last week the White House global health security lead, Rear Admiral Timothy Ziemer, abruptly resigned from the National Security Council (NSC).
John Bolton, head of the NSC, does not have plans to replace him, even though — in a ghastly irony — Ziemer left on the very same day that Democratic Republic of Congo reported a new outbreak of Ebola.
Some Trump officials argue that the private sector should take the lead. But pharmaceutical companies do not have much incentive to develop speculative drugs unless there are government subsidies.
While it would ideally make sense for international bodies such as the United Nation to take charge — since pandemics move across national borders at lightning speed — much of the time the United Nation is depressingly slow-moving, bureaucratic and underfunded.
IS THERE ANY OTHER SOLUTION?
Gates, for his part, is now frantically assembling philanthropic coalitions to develop a universal flu vaccine. He is also begging the US government to stockpile “antiviral drugs and antibody therapies that can be … rapidly manufactured to stop the spread of pandemic diseases or treat people who have been exposed”.
Separately, in a welcome flash of proactive innovation, the UN is exploring ways to improve its own cross-border initiatives: Last year, for example, it floated a plan to issue so-called pandemic bonds to give it more pre-emptive funding to fight pandemic risk.
Entrepreneurs are responding too. Take Nathan Wolfe, a well-known epidemiologist who has spent most of his career working with public sector groups to combat disease.
Today, though, Wolfe runs a California company, Metabiota, that harnesses big data to model disease, helping to create pandemic insurance for companies and governments.
This might seem like a sideshow, given that what we really need to do is prevent another pandemic, not just protect against financial hits.
Yet, after a lifetime of frustration working with the public sector, Wolfe told me that one of the best catalysts for government change might be getting the private sector to model the risk of pandemics; after all, there is nothing like paying for protection to concentrate the mind.
Let us all hope so. But the next time I hear about a new Ebola, Zika, bird flu — or “normal” flu — scare, those images of the Dartmoor ruins will pop into my mind.
Yes, the miracle of technology is what separates us from the 14th century, as I cheerfully told my daughter; but technology only works if we use our brains and collaborative spirit.
And in that respect, we are not always so different from medieval Europe.
© 2018 The Financial Times Ltd. All rights reserved. Please do not copy and paste FT articles and redistribute by email or post to the web.