What is ‘Disease X’ and how is the world preparing for it?

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While “Disease X” may sound like a “science fiction film,” one expert said, it’s something we all need to be prepared for. But what is it?

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Some social media users have falsely claimed this week that “Disease X” is a virus that might be deliberately released or is even already spreading in the world.

These claims are inaccurate, emerging as the term was set to be discussed by an expert panel at the 2024 World Economic Forum meeting in Davos.

While “Disease X” is rather a hypothetical scenario to prepare for the next pandemic, experts discussing this concept said it still needs to be taken seriously.

What is ‘Disease X’?

“Disease X” is a name that the World Health Organization (WHO) has given to an unknown future pathogen with the potential to start a severe global epidemic.

“There are things that are unknown, that may happen and anything happening is a matter of when, not if,” Dr Tedros Adhanom Ghebreyesus, the World Health Organization’s (WHO) director-general, said during an expert panel in Davos this past week.

“So we need to have a placeholder for that, for the diseases we don’t know that may come, and that was when we gave the name “Disease X,'” he said, explaining that the concept was first discussed in 2017 and has recently gotten “attention” online.

The UN agency added it to a list of priority diseases that require accelerated research and development due to their potential to cause a public health emergency in 2018.

COVID-19, for Ghebreyesus, was the first “Disease X” – ie the first unknown pathogen since the term was coined that emerged and caused a pandemic.

He said that the goal was not for this idea to create panic, but rather to better prepare for the possibility of new emerging diseases.

Preetha Reddy, a vice-chair of a private sector healthcare group in India, told the same Davos panel that while the name Disease X “seems like a science fiction film,” everyone needs to be aware of it as “it’s definitely a clear and present danger”.

Reddy said that just as militaries prepare for war, healthcare systems need to prepare as well.

How should countries prepare for ‘Disease X’?

Preparedness should start with strong primary healthcare and preparations at the community-level, said the WHO director-general.

“High-income countries were surprised because their investments in the last many decades were on high technology, cutting edge technology in tertiary services, even robotic surgery, but their investment in primary health care was not there,” he said.

“Even some countries couldn’t do contact tracing. So to prepare countries, I think renewed commitment to strengthen primary health care is very important”.

The WHO, the World Bank, and other partners set up a pandemic fund in 2022 to help low and middle-income countries with preparedness for emerging pathogens.

“COVID-19 has highlighted the pressing need for action to build stronger health systems,” said World Bank Group President David Malpass in a statement that year. “Investing now will save lives and resources for the years to come”.

Countries are also currently negotiating an international pandemic treaty with the outcome expected to be submitted at the 77th World Health Assembly in May 2024.

The EU Council agreed on the bloc starting negotiations for this treaty in 2022, adding that this type of instrument would help with better early detection of threats, more equitable access to medicines and vaccines, and better international cooperation.

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Addressing problems that emerged from COVID

One of the ways in which experts want to prepare for future unknown pathogens is to determine what could have gone better during the most recent pandemic.

Michel Demaré, chair of the board of pharmaceutical company AstraZeneca that was behind one of the early COVID-19 vaccines, said there is now more emphasis on “sustainability and resilience of health systems”.

“We have seen that health systems were not prepared for that last time, not only to handle the sheer volume of COVID cases,” but also cancer diagnoses and other health issues concurrently, he pointed out.

Demaré recommended that countries consider health as a strategic asset such as energy, that health spending be “smarter,” such as focusing on prevention efforts, and that countries should build on technology, data management, and artificial intelligence (AI).

Experts also pointed out that one of the big issues during the COVID-19 crisis was global inequalities.

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“High-income countries were hoarding vaccines and low-income countries were not getting vaccines,” said Ghebreyesus.

“Access was a problem, and to address the equity problem, we have established the mRNA technology transfer hub in South Africa to increase local production,” he said. It is meant to build capacity in low- and middle-income countries to produce mRNA vaccines.

Surveillance and sharing of data across the globe are also important initiatives for countries to keep up with despite COVID-19 no longer being a global emergency.

“We are as strong as the weakest link,” Ghebreyesus said, adding that preparation needs to be at the country level but also include investment in global initiatives.

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