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Bill and Melinda Gates express ongoing concern about the current pandemic in their annual letter, while also looking ahead to preventing the next one.

“To prevent the hardship of this last year from happening again, pandemic preparedness must be taken as seriously as we take the threat of war,” Bill Gates writes in the letter, released Wednesday morning.

He calls for the creation of a global alert system, allowing health-care practitioners to flag unusual patterns among their patients and send test samples into a central lab for investigation. “Infectious disease first responders” would jump into action upon the emergence of some unknown or severely infectious pathogen.

Response to new infectious disease would be supported by new scientific tools and rapid testing. “By the next pandemic, I’m hopeful we’ll have what I call mega-diagnostic platforms, which could test as much as 20 percent of the global population every week,” Gates wrote.

It won’t come cheap. Gates acknowledged that this approach would require spending tens of billions of dollars per year, primarily by rich countries. He described it as an insurance policy, in effect, citing an estimate that COVID-19 will cost the world $28 trillion.

The Bill & Melinda Gates Foundation has pledged $1.75 billion toward fighting COVID-19. Recently, its efforts to fund the equitable distribution of COVID-19 vaccines in low-income parts of the world has been set back by a manufacturing glitch reported by AstraZeneca.

Melinda Gates wrote in the letter that they are concerned that COVID-19 will create a situation of “immunity inequality, a future where the wealthiest people have access to a COVID-19 vaccine, while the rest of the world doesn’t.” She said it’s critical to demand an inclusive approach.

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