Bill Gates has probably spent more time thinking about public health—not just in the developing world—than almost anyone who isn’t a medical epidemiologist. In a 2015 TED talk, he warned about the likelihood of a pandemic and his bottom-line was, “We’re not ready.”

Being right isn’t always gratifying. Yet, in the current issue of WIRED, Gates doesn’t cast blame on the skeptics. “We can do the postmortem at some point. We still have a pandemic going on, and we should focus on that.”

His message is for public officials and private industry alike. A particularly urgent need is for a rapid self-test for Covid 19. Most tests today, which require people to wait days for results, are essentially useless, Gates says, and a big barrier to quicker test results is the insurance reimbursement system. Tardy tests are reimbursed at the same rate as timely ones. Why not build in a financial incentive for speedy response and a penalty—including no reimbursement at all—for delayed results?

Another shortfall is that the US should help the vaccine companies build extra factories for the billions of doses that will be needed around the world if the pandemic is to be effectively stopped. Although this would be expensive, he says it’s a fraction of the money that will be lost in a tanking worldwide economy. “In terms of saving lives and getting us back to normal,” that expenditure is a smart and essential investment. Interesting.