He predicts that within the next three decades there will be either a major war or another pandemic.

Infectious disease experts share his fears, if not more so, saying it’s no longer a question of if there will be another pandemic, but only of when.

The Bill & Melinda Gates Foundation did not respond to Fortune’s request for comment on the entrepreneur’s expectations regarding the next pandemic.

But while the Gates Foundation’s work focuses on eradicating polio and other diseases caused by unclean water, scientists fear that a host of other diseases will pose a significant threat in the future.

This ranges from more aggressive fungal infections and even a new flu virus to an outbreak of potentially sexually transmitted diseases.

The good news is that the global health community could take some relatively simple steps to prevent an outbreak as massive as the COVID-19 pandemic.

The bad news is that they don’t.

What kind of disease will the next pandemic be?

Professor Paul Hunter of the University of East Anglia emphasises that around 75% of emerging infectious diseases arise from accidental transmission of pathogens from animals to humans.

Decades before the COVID pandemic, Professor Hunter wrote articles outlining the need for stronger action to combat illegal wildlife trade.

Some health authorities blame animal-human interactions in the trade chain for the outbreaks of Ebola, SARS and COVID.

Therefore, the next pandemic could have a similar origin, he added.

Dr Brian Ferguson of the University of Cambridge agreed with Professor Hunter’s view.

“To make a general prediction, it will probably be a respiratory disease, simply because those are the easiest to spread,” Dr. Ferguson explained.

“The hardest disease to stop is respiratory disease. We’ve gotten very good at purifying water. We haven’t gotten very good at purifying air.

“It’s very difficult to predict what type of … respiratory infection it is. There are many possibilities. There’s the flu, there are coronaviruses, there are other viruses that are spread through the respiratory tract (and) could come from anywhere, just like SARS-CoV-2 did.”

30 years or earlier?

The general consensus among pathologists, epidemiologistsand health experts is that Gates’ prophecy is likely to be true and in fact prove to be optimistic.

If Gates is referring to a major pandemic involving zoonotic pathogens – on a scale like Covid – Professor Hunter said it is impossible to predict a timeframe given the random nature of disease transmission between animals and humans.

“We could have another (pandemic) next week,” says Professor Hunter Assets“Or we might not have one for the next 50 years. It’s nonsense to try to predict when random events might occur.”

Professor Joseph Allen of Harvard University also stresses that a 30-year benchmark may delay a problem that could occur sooner: “It is not almost certain, it is certain.”

“It’s not necessarily wrong to say it could happen in the next 30 years, but I don’t think we should think it will take another 30 years… To set a horizon, in the next 30 years? Absolutely. But we should make it clear to people and governments that that doesn’t mean it’s a problem that will only arise in 30 years.”

Are we prepared for another pandemic?

“For most of my life, I considered myself an optimist,” says Professor Hunter. “I’ve outgrown that now.”

He is not alone – many medical professionals are concerned that important lessons have not been learned from the COVID pandemic.

The experts’ concerns Assets The issues we addressed ranged from inadequate collaboration among global health organizations, to inadequate vaccine sharing with poorer countries, to a lack of investment when global health is not high on the political agenda, to a lack of data on the origins of emerging diseases.

However, the scientists raised another point: both the public and governments are simply exhausted by the possibility of another pandemic.

“I think what Bill Gates was saying … he was talking about things that are probably going to happen faster than we’re ready for,” Dr. Ferguson said. “That’s something a lot of people don’t really want to acknowledge because they’re fed up with COVID.”

Likewise, the psychological damage Covid has inflicted on healthcare professionals worldwide is “profound,” said Professor David Denning of the University of Manchester.

He told Assets: “If you could imagine being a nurse or a doctor and being told in a year or two that another pandemic was coming, you would just want to run away. It’s just awful.”

It will be “really, really difficult” to support an already exhausted medical workforce physically and mentally during another pandemic, he added.

Professor Allen tells Fortune that another simple – and little-known – prevention method adapts society’s built environment to better prevent respiratory diseases.

“If we design buildings with health in mind, they can, without exaggeration, become one of the most important public health interventions of this century,” he explained.

“COVID has shown how short-sighted that was. You had a virus that spread almost exclusively indoors. Our building stock is intentionally designed to be poorly ventilated and poorly filtered. Is it any wonder we experienced this disaster?”

border controls

A key difference between an epidemic and a pandemic is that the latter can spread violently across multiple regions, each of which may respond differently to the threat.

Professor Denning says some diseases – such as the Zika virus – are stopped by host species such as mosquitoes not being able to travel long distances.

One welcome improvement Professor Denning has observed is more thorough testing of imported animals, reducing the risk of cross-border transmission of infections.

Explaining that surveillance has improved since COVID, he said, “I spoke to my colleague who works in Canada, and now there is avian influenza in dairy cows in the U.S. So far they have managed to prevent the disease from entering Canada, despite the massive trafficking of cattle across the border. So that’s a very positive thing.”

“It is a mix of surveillance and appropriate measures by veterinarians and health authorities to prevent transmission.”

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