the story So Far
The recent epidemic reported in the Democratic Republic of Congo in the first week of December 2024, which has killed more than 400 people and is still unclassified, has raised concerns that it may be an example of Disease This disturbing incident has reignited the discussion about “Disease X.” Disease It was coined by WHO to prepare for future outbreaks that could potentially lead to a devastating pandemic or outbreak that is difficult to predict or identify. Investigation continues for The outbreak underlines the importance of Disease
WHO’s priority list of pathogens?
Since WHO introduced the concept in 2018, COVID-19 has been widely viewed as a true disease representation – an unexpected, novel threat that requires rapid global response and adaptation. The concept of Disease Following the outbreak, WHO brought together scientists and public health experts to explore how outbreaks of a similar scale could be prevented in the future.
Swab samples are being taken for COVID-19 testing. file | Photo courtesy: The Hindu
WHO’s Priority List of Pathogens is a strategic tool published in 2018 designed to focus global attention and resources on the most serious infectious disease threats. This list identifies diseases that have epidemic or pandemic potential, for which medical measures such as vaccines or treatments are inadequate or nonexistent. The need for such a list arises from the urgency to direct research and development, allocate funds, and enhance preparedness. It helps policy makers, researchers, and health organizations prioritize efforts to control diseases. The current list (not exhaustive) includes Ebola virus disease, Marburg virus disease, Lassa fever, Nipah virus, Rift Valley fever, Crimean-Congo hemorrhagic fever, Zika virus, and Disease Each of these pathogens has been characterized by factors such as high mortality, the potential to spread rapidly, and the lack of adequate preventive or therapeutic options.
What is Disease X?
Disease WHO included it in its priority diseases blueprint in 2018 to focus on the risks of emerging diseases that science has not yet addressed. The term sits at the intersection of two categories (of four) popularized by Donald Rumsfeld’s matrix: “known unknowns” (threats we know about but cannot fully understand) and “unknown unknowns” (those Dangers we don’t know about and don’t understand). Disease
The potential culprits behind Disease X are diverse. It originates from Pathogen Is. Historical data supports this uncertainty. Since 1940 (where authentic records are available), researchers have identified more than 300 emerging infectious diseases, about 70% of which are zoonotic in origin, meaning they spread from animals to humans. This process, known as zoonotic spillover, is often associated with human encroachment on wildlife habitats, deforestation, and intensification of agriculture. Meanwhile, the growing risks of antimicrobial resistance, bioterrorism and accidental laboratory leaks add further layers of unpredictability.
Patterns in emerging diseases
While the exact nature of Disease X remains unknown, epidemiological patterns provide important insights into how new diseases emerge and spread. The emergence of viruses such as HIV, SARS, MERS and Ebola was closely linked to ecological disruptions caused by human activity. Deforestation, urbanization and climate change have brought humans and wildlife into closer contact, increasing the potential for pathogen transmission. Epidemiologists estimate that more than 1.7 million undiscovered viruses exist in wildlife, hundreds of thousands of which are potentially capable of infecting humans. The frequency of new outbreaks has also increased significantly since the mid-20th century, reflecting a combination of environmental, demographic, and global factors.
Areas with high biodiversity and inadequate health care systems, such as the Congo Basin, are particularly vulnerable. The interconnectedness of our world, with frequent international travel and trade, makes it easier for localized outbreaks to turn into pandemics, as seen with COVID-19. While epidemiology cannot predict the exact moment or source of Disease X, it can help identify high-risk areas and behaviors that increase the likelihood of its emergence.
Challenges of predicting Disease
It is difficult to predict the next Disease X, because its emergence depends on many unpredictable factors. Given their history of giving rise to major epidemics, zoonotic diseases are the most likely source. However, other scenarios, such as pathogens mutating to escape treatment, laboratory accidents, or deliberate biological attacks, cannot be ruled out. Climate change is also reshaping the dynamics of disease transmission, expanding the range of vector-borne diseases such as malaria and dengue fever, while driving pathogens to adapt to new hosts and environments.
The sheer number of potential pathogens adds to the complexity. Scientists estimate that only a fraction of the viruses capable of infecting humans have been identified, leaving a vast pool of unknown threats. Genomic sequencing and artificial intelligence are beginning to play an important role in narrowing down this vast field of possibilities, but even with these tools, predicting the exact origin, timing, and behavior of Disease X remains out of reach. However, what is certain is that the conditions that gave rise to pandemics like COVID-19 and SARS are still present, making the emergence of Disease X a question of when, not if.
Central to preparedness is the need for robust surveillance systems to quickly detect new outbreaks. Advances in genomic sequencing, artificial intelligence and real-time data sharing are essential tools for developing diagnostics, therapeutics and vaccines. It is also important to strengthen health care infrastructure, especially in low- and middle-income countries. Organizations such as the Coalition for Epidemic Preparedness Innovation (CEPI) are now investing in “prototype pathogen” platforms that can be adapted to target unknown diseases within 100 days of their identification.
need for global cooperation
Fighting Disease WHO’s ongoing efforts, such as its list of priority pathogens and the proposed Pandemic Treaty, aim to promote a unified global response to health emergencies. These initiatives recognize that pandemics do not respect borders and that fragmented efforts will be inadequate to combat an elusive threat like Disease X. Governments must work together to share data, pool resources and ensure equitable access to diagnostics, treatments and vaccines.
The outbreak in DRC is a sobering reminder of the risks facing the world. Disease By strengthening public health systems, investing in research and innovation, and promoting global solidarity, the world can prepare for the unexpected and protect future generations from the devastating consequences of the next pandemic. Frameworks such as the Nagoya Protocol, which ensure equitable sharing of benefits from genetic resources, can be expanded to include biological materials such as pathogens. This will promote global cooperation, ensuring fair access to research and medical measures during the outbreak. Any new disease anywhere is a threat to everyone.
(Dr. C. Aravinda is an academic and public health physician. Views expressed are personal. aravindaaiimsjr10@hotmail.com)
published – December 12, 2024 11:18 PM IST
