When it comes to global health policy, Bill Gates has never been known for subtlety. So it’s hardly surprising that his charitable foundation’s latest report on the greatest challenges facing mankind might make some readers want to lock themselves in an indefinite quarantine.

Readers familiar with Gates’ previous warnings about the rising risk of a global pandemicwill recognize the top three risks: antibiotic resistance, governmental reluctance to fund health-care solutions and the next global contagion. The latter risk factor has become so universally feared by health professionals that the World Health Organization already has a name for it: “Disease X”. The likelihood of an explosive global pandemic breaking out in the relatively near future increases along with the population in the world’s poorest countries, which are presently experiencing explosive population growth even as birth rates in the developed world plummet. And if the world’s wealthiest countries don’t invest resources to combat these issues in Africa, South America and Asia now, it will be infinitely more expensive grappling with the consequences on the back-end, as Gates explained in an interview with the Telegraph.

“We are not fully prepared for the next global pandemic,” he says. “The threat of the unknown pathogen – highly-contagious, lethal, fast-moving – is real. It could be a mutated flu strain or something else entirely. The Swine Flu and 2014 Ebola outbreaks underscored the threat.”

The risks associated with the population boom in the poorest countries in Africa has long been treated as “the elephant in the room” by global policy makers. Even if one sets aside the risk of disease, the developing world must step up to monitor the economic impacts of rapidly increasing populations, confronting issues like political instability to ensure that the expansion will yield unbridled growth like similar periods in China and India.

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