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Games and global health: an interview with Plague Inc. creator James Vaughan

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By Kailey Nolan, i-sense

James Vaughan is founder of Ndemic Creations, which, in 2012, launched the hugely popular strategic game Plague Inc. The app exploded onto the gaming scene, becoming the number 1 paid for app on i-phone and i-pad just two weeks after its US launch. As its popularity has grown, James has been able to successfully address real global health issues, raising $76,000 to fight Ebola last year through Plague Inc.’s 45 million players. i-sense’s Kailey Nolan caught up with James to discuss the inspiration behind Plague Inc. and future opportunities to contribute to the increasing challenge of infectious diseases.


What motivated you to create Plague Inc.?

I wanted to have a creative channel. I used to be a strategy consultant, which was enjoyable and taught me a lot, but I was never really able to create something new. I enjoyed playing games, so I thought making a game would be a good creative avenue for me. I started out part-time, working evening and weekends, alongside my work as a consultant and it was wonderful fun and very rewarding.

Why did you choose to centre your app around infectious diseases?

I was looking around for different game and app ideas and I had several in mind, but it was a 2008 flash game called Pandemic 2, that inspired me to focus on the idea of infection. I enjoyed playing Pandemic, but at the same time thought that it could be so much better.

All these thoughts started pouring out about how I could improve the game and once I started I couldn’t stop! I had my whole design document written out so I thought why don’t I just create a new, improved game for mobile devices. I was drawn to a topic that I found interesting, around the same time that I decided to make a game, and it all went from there. 

Did your interest in infectious diseases develop in the process of creating Plague?

Biology has always been a fascinating subject for me and developing this app was fun on so many different levels. Game design is great, but also being able to research and learn more about various different diseases was really interesting, albeit quite morbid.

Researching smallpox, for example, made me realise how much we take for granted and how, only very recently, there were situations where people would be dying from a horrific disease and there was nothing that could be done to help them- this was just how people lived. It seems like something that happened a thousand years ago, but it’s actually quite a recent pandemic.

You learn a lot and feel how vulnerable we are to disease, even now. So it’s nice to create an app that is both fun, but also educating people on how infectious diseases can spread.

The app has had phenomenal global success. Why do you think people are so drawn to this type of game?

I think there are a number of different reasons. Firstly, the theme of disease is something everyone can relate to. There are very few subjects that apply to all of humanity like disease does and it’s something that people are very aware, and genuinely afraid, of but maybe not as informed about as they would like to be. The game allows them to learn a little more about disease in an interactive way.

Also, playing the bad guy definitely helps. Becoming a deadly virus that has to infect and wipe out humanity sounds quite gruesome on the surface, but it’s different and it intrigues people. 

Plague is also quite a difficult game, it requires strategic thinking. People like to be challenged and a lot of mobile games are not challenging- they are designed to simply occupy your time. 

It’s a unique game about a worldwide topic and its grabbed people’s attention. That’s something I’m very proud of.

What kind of feedback have you had?

We have had mass amounts of feedback from people from all over the globe and I think this really demonstrates how much interest there is in infectious diseases as a topic.  There are so many ideas about how they would like the game to develop, features to add or change, because its something they can all relate to and want to see grow and expand.

Common feedback at the moment is people wanting to implement Ebola into the game. People have seen all the media commotion and they want to understand more about it. At its core, Plague Inc. is a model that lets you plug unto the variables and see what happens. Players want to be able to see how various different diseases would operate in that model.

There are scientific models, which have very accurate, interesting data, but lack an easy way to visualise this and see what that data really means. Plague is the opposite - the data is maybe not as accurate as it could be, but we are able to display it in a fun and accessible way. Plague Inc. simplifies and clarifies key concepts in order to help people learn the really important facts about diseases without bombarding them with too much information.

Do you plan to develop on the educational aspects of Plague Inc. by working more with education/research-focused institutions?

Plague Inc. currently provides a good understanding of how diseases spread; the game takes into account the various factors that can either inhibit or accelerate the spread of the disease, e.g. population size, hygiene, early detection, and evolving drug resistance to name a few.

Yet, there’s so much more cool stuff that could be done. I want to be giving players new content, whilst also working closely with educational and health organisations to incorporate new, real-life diseases into the game. So people will enjoy playing these different diseases, but are also learning about them at the same time. 

i-sense wants to identify potential outbreaks very early, even before people report symptoms to their doctor. Do you think there’s an opportunity for collaboration with Plague Inc.?

I definitely hope so. Plague Inc. has over 45 million players who are interested in how disease works and spreads and want to know more. So if we’re able to tell people that there’s a way that they can help identify and track the spread of infectious diseases and point them in the right direction to do this, there would be a lot of interest.

There is great synergy between what i-sense and Plague are trying to do and if we can leverage even a small part of the Plague Inc. community to help real world issues like that, it would be fantastic.

There’s also scope to add features to the game that reflect i-sense’s themes and objectives. For example, the disease could be contained in a specific country because more people reported their symptoms on social media, a key component of i-sense’s early detection techniques.  

Plague Inc. players have impressively raised over $76,000 to fight Ebola. How was this achieved and how can apps play a role in fundraising efforts?

Plague Inc. was in a uniquely powerful position to raise awareness of Ebola to well over 45 million people all over the world. From November -December 2014, we displayed a link to to everyone who opened the game. This link redirected players to an Ebola-specific donation page for a charity in their country, giving them more information about that charity and their work, along with the impact that their donation would have.

I am immensely proud of the Plague Inc. community for this and think it provides an interesting example about how you can use popular apps to help raise awareness of charitable causes; you already have a wide audience, geographically-linked information and donating is quick and easy.

The game has expanded significantly since its release in 2012. What’s the next big thing for Plague Inc.?

Now, you’re getting into top-secret territory. We launched Plague Inc. on PC back in February 2014 and we’re also working with Microsoft to bring it onto XBOX One to expand our coverage.

We have also released a scenario creator, which will let players create their own content for the game. This will still rely on fundamental Plague Inc. algorithms, but players can create their own symptoms and diseases and change country statistics so they have more control over how their disease adapts and spreads. I’m really interested to see where players’ imaginations will take them.

Plague Inc. has such a passionate and active community so there are always new ideas and requests we can draw upon. Hopefully will be able to link Plague to some educational and medical applications to help do some good in the world at the same time.

Finally, do you have any advice for other developers out there who want to break into the app market?

The key thing is to do something you feel passionate about and have realistic expectations. You need to really work out what you want to communicate to people and not try to cram every piece of information into one place!

If you want to create a fun gaming app, with an educational core, you need to accept that you are going to have to depart from reality in some places, in order to communicate the broader truth. There is a real urge to try and convey all your knowledge on a particular topic, but it’s much more effective to hook users first with an easy to use app and simple facts and go from there.

I would also look out for developers doing similar things and try to work together. It’s much easier to get people to download one app than several apps that do slightly different things.

Finally, having some kind of value proposition is key to any app. For a health app, this could be providing users with information that they can’t get anywhere else. For example, if a user reports on their health stats they could receive feedback on how many people in their area have also reported on this and if there are similar symptoms.

You will be getting enormous value from the data you receive, so be sure to give something back to the user. An app needs to be a two-way dialogue in order to be sustainable.


Can you infect the world? Plague Inc. is a unique mix of high strategy and terrifyingly realistic simulation with over 700 million games played!
 Your pathogen has just infected 'Patient Zero'. Now you must bring about the end of human history by evolving a deadly, global Plague whilst adapting against everything humanity can do to defend itself. Download here


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