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What natural disaster is most likely to kill more than 10 million human beings in the next 20 years?

Terrorism? Famine? An asteroid?

Actually it’s probably a pandemic: a deadly new disease that spreads out of control. We’ve recently seen the risks with Ebola and swine flu, but they pale in comparison to the Spanish flu which killed 3% of the world’s population in 1918 to 1920. If a pandemic of that scale happened again today, 200 million would die.

Looking back further, the Black Death killed 30 to 60% of Europe’s population, which would today be two to four billion globally.

The world is woefully unprepared to deal with new diseases. Many countries have weak or non-existent health services. Diseases can spread worldwide in days due to air travel. And international efforts to limit the spread of new diseases are slow, if they happen at all.

Even more worryingly, scientific advances are making it easier to create diseases much worse than anything nature could throw at us – whether by accident or deliberately.

In this in-depth interview I speak to Howie Lempel, who spent years studying pandemic preparedness for Open Philanthropy. We spend the first 20 minutes covering his work as a foundation grant-maker, then discuss how bad the pandemic problem is, why it’s probably getting worse, and what can be done about it. In the second half of the interview we go through what you personally could study and where you could work to tackle one of the worst threats facing humanity.


Tens of millions could die in a pandemic during our lifetimes, perhaps even billions in a worst case scenario. This presents a serious risk to social stability.

Recent and historical pandemics show that we are not reliably good at controlling new diseases, and that they can often kill a large fraction of infected people.

Advances in biology makes it much easier to create highly dangerous diseases that could be even worse. Biosafety regulations reduce the risk of dangerous pathogens escaping the lab, but not to zero.

Local and international institutions for tackling new pandemics leave a lot to be desired. Fast response is essential to stop the spread – but it can take a long time to haggle over who is going to pitch in. Coordination between the many bodies meant to play a role is poor. Furthermore, it’s hard to transport qualified people and equipment to a disaster zone.

There are many opportunities to reduce the risk, in the government, private sector or charities. Many groups have proposed sensible ways we could better prepare ourselves for a pandemic but the suggestions are largely not being applied.

People can work to tackle pandemics with an unusually wide range of specialties – medicine, biomedical research, social science, security studies, and entrepreneurship. We suggest a number of places to study and work.

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About the show

The 80,000 Hours Podcast features unusually in-depth conversations about the world's most pressing problems and how you can use your career to solve them. We invite guests pursuing a wide range of career paths — from academics and activists to entrepreneurs and policymakers — to analyse the case for and against working on different issues and which approaches are best for solving them.

The 80,000 Hours Podcast is produced and edited by Keiran Harris. Get in touch with feedback or guest suggestions by emailing [email protected].

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