The possibility of a pandemic is a challenge Donald Trump is unqualified to handle as president. I remember how Trump sought to stoke fear and stigma during the 2014 Ebola epidemic. He called President Barack Obama a “dope” and “incompetent” and railed against the evidence-based response our administration put in place — which quelled the crisis and saved hundreds of thousands of lives — in favor of reactionary travel bans that would only have made things worse. He advocated abandoning exposed and infected American citizens rather than bringing them home for treatment.

Trump’s demonstrated failures of judgment and his repeated rejection of science make him the worst possible person to lead our country through a global health challenge.

The outbreak of a new coronavirus, which has already infected more than 2,700 people and killed over 80 in China, will get worse before it gets better. Cases have been confirmed in a dozen countries, with at least five in the United States. There will likely be more.

Though scientists have been able to create vaccines for other viruses, developing a vaccine for HIV has been especially challenging. (In lieu of one, doctors mostly use preventative drugs like Truvada to help prevent contraction of the virus in uninfected people who are at high risk.)

But a vaccine could significantly taper infections worldwide. “Even a moderately effective vaccine would significantly decrease the burden of HIV disease over time,” said Fauci in a statement.

So why are HIV vaccines so elusive?

HIV behaves unlike most other viruses in some important ways. Usually, when a person is infected with a virus, their immune system creates antibodies that target the bug. That’s usually the starting point for researchers, who work to develop drugs that can imitate that process (but without causing the recipient to develop a full blown reaction to the virus). What’s tricky about HIV, however, is that when a person is infected with the virus, that same process of developing antibodies isn’t triggered.

There surely will be, though. At some point, a new virus will emerge to test Trump’s mettle. What happens then? He has no background in science or health, and has surrounded himself with little such expertise. The President’s Council of Advisers on Science and Technology, a group of leading scientists who consult on policy matters, is dormant. The Office of Science and Technology Policy, which has advised presidents on everything from epidemics to nuclear disasters since 1976, is diminished. The head of that office typically acts as the president’s chief scientific consigliere, but to date no one has been appointed.

Other parts of Trump’s administration that will prove crucial during an epidemic have operated like an Etch A Sketch. During the nine months I spent working on this story, Tom Price resigned as secretary of health and human services after using taxpayer money to fund charter flights (although his replacement, Alex Azar, is arguably better prepared, having dealt with anthrax, flu, and sars during the Bush years). Brenda Fitzgerald stepped down as CDC director after it became known that she had bought stock in tobacco companies; her replacement, Robert Redfield, has a long track record studying HIV, but relatively little public-health experience.

Rear Admiral Tim Ziemer, a veteran malaria fighter, was appointed to the National Security Council, in part to oversee the development of the White House’s forthcoming biosecurity strategy. When I met Ziemer at the White House in February, he hadn’t spoken with the president, but said pandemic preparedness was a priority for the administration. He left in May.

Organizing a federal response to an emerging pandemic is harder than one might think. The largely successful U.S. response to Ebola in 2014 benefited from the special appointment of an “Ebola czar”—Klain—to help coordinate the many agencies that face unclear responsibilities. In 2016, when Obama asked for $1.9 billion to fight Zika, Congress devolved into partisan squabbling. Republicans wanted to keep the funds away from clinics that worked with Planned Parenthood, and Democrats opposed the restriction. It took more than seven months to appropriate $1.1 billion; by then, the CDC and NIH had been forced to divert funds meant to deal with flu, HIV, and the next Ebola.