What is Disease X?

In 2022, the World Health Organization (WHO) convened 300 scientists to look at 25 virus families and bacteria to develop a list of pathogens they believe have the potential to wreak havoc and are deserving of more research.

Disease X, first recognized by WHO in 2018, is included on that list, and according to WHO, it "represents the knowledge that a serious international epidemic could be caused by [an unknown] pathogen."

WHO Director General Tedros Adhanom Ghebreyesus said at the meeting in Davos that COVID-19 may have been the first Disease X, and that experts are learning from that experience. Studying Disease X enables "early cross-cutting R&D preparedness that is also relevant" for an unknown disease, WHO said.

According to Amesh Adalja, from the Johns Hopkins Center for Health Security, a deadly disease, which would likely be a respiratory virus, could already be circulating among animals but is not yet able to be transmitted to humans.

"There are strains of viruses that have very high mortality rates that could develop the ability to transmit efficiently from human to human," he said.

These viruses could be circulating in "bats like COVID-19, it could be in birds like bird flu, or it could be some other type of animal species, swine for example," Adalja added. "It's really about that interface between humans and animals, where interactions are occurring, that these types of viruses get a foothold."

How experts are preparing for Disease X

According to WHO, if we're unprepared for Disease X, it's likely the disease could cause even more damage than COVID-19 did, which has killed more than 7 million people.

"If we did so poorly with something like COVID-19, you can imagine how poorly we would do with something like a 1918-level event," Adalja said, referencing the influenza pandemic of 1918 that killed an estimated 50 million people worldwide, according to the Cleveland Clinic.

In order to be better prepared for a future pandemic, Tedros said an early-warning system and a plan for health infrastructure, which was overburdened during the COVID-19 pandemic, could help.

"Whether it's in health systems or even the private sector, by the way — research and development — you can prepare for it," he said.

Adalja added that another big lesson from COVID-19 was the importance of transparency.

"I think what we see now is this distrust between infectious disease physicians, public health practitioners and the general public, because what happened is politicians injected themselves into this," he said. "People may not actually be receptive to the protective actions that are being recommended by public health officials."

Michel Demaré, chair of the board of AstraZeneca, noted that many countries are not spending enough money on preparing their health systems for the next pandemic.

"It's not just about spending more, it's also about spending smarter," he said, noting that OECD countries spend just 3% of their health systems' budget on prevention on average.

"Obviously if you spend so little on prevention, you end up spending the majority of your budget on hospitalization and only treatments," Demaré said.

According to Tedros, WHO has partnered with other global organizations to put initiatives in place to prepare for the next major pandemic or epidemic, including the pandemic fund to help nations with resources, the mRNA vaccine technology transfer hub to ensure vaccine equity among low-income nations, and the pandemic and epidemic intelligence hub to improve collaborative surveillance between countries.

These types of measures are "essential for a fast and effective epidemic and pandemic response," said Michael Ryan, executive director of WHO's Health Emergencies Programme, adding that such preparedness is what allowed COVID-19 vaccines to be developed "in record time." (Singh, CBS News, 1/17; Saric, Axios, 1/19; Lagatta, USA Today, 1/17; Gale, Bloomberg, 1/15)

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