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In a speech at the Munich Security Conference, the billionaire compared the dangers to nuclear war and climate change.
Mr Gates said: “The next epidemic could originate on the computer screen of a terrorist intent on using genetic engineering to create a synthetic version of the smallpox virus, or a super contagious and deadly strain of the flu.
“Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year – and they say there is a reasonable probability the world will experience such an outbreak in the next 10 to 15 years.”
Mr Gates argued the link between health security and international security is overlooked, and criticised governments for failing to pay attention to such threats.
He said: “We ignore the link between health security and international security at our own peril.”