But as Bill Gates said to us when Mark and I met with him in his Seattle-area office, “People invest in high-probability scenarios: the markets that are there. And these low-probability things that maybe you should buy an insurance policy for by investing in capacity up front, don’t get done. Society allocates resources primarily in this capitalistic way. The irony is that there’s really no reward for being the one who anticipates the challenge.” Every time there is a new, serious viral outbreak, such as Ebola in 2012 and Zika in 2016, there is a public outcry, a demand to know why a vaccine wasn’t available to combat this latest threat. Next a public health official predicts a vaccine will be available in x number of months. These predictions almost always turn out to be wrong. And even if they’re right, there are problems in getting the vaccine production scaled up to meet the size and location of the threat, or the virus has receded to where it came from and there is no longer a demand for prevention or treatment. Here is Bill Gates again: Unfortunately, the message from the private sector has been quite negative, like H1N1 [the 2009 epidemic influenza strain]: A lot of vaccine was procured because people thought it would spread. Then, after it was all over, they sort of persecuted the WHO people and claimed GSK [GlaxoSmithKline] sold this stuff and they should have known the thing would end and it was a waste of money. That was bad. Even with Ebola, these guys—Merck, GSK, and J & J [Johnson & Johnson]—all spent a bunch of money and it’s not clear they won’t have wasted their money. They’re not break-even at this stage for the things they went and did, even though at the time everyone was saying, “Of course you’ll get paid. Just go and do all this stuff.” So it does attenuate the responsiveness. This model will never work or serve our worldwide needs. Yet if we don’t change the model, the outcome will not change, either.
Michael T. Osterholm (Deadliest Enemy: Our War Against Killer Germs)