COVID-19 has shown the world that with globalization and continuous improvement in transport and trade, the chance of an epidemic changing into a pandemic is now multiple times than ever before. Continents like Africa, that had very rare flu outbreaks in the past, also got badly affected by this contagious Virus. So, The fact that in the future we can see more contagious and deadly outbreaks cannot be denied or ignored.
Disease X: In 2015, WHO on the recommendation of its members constituted 'R&D Blueprint Scientific Advisory Group' to prepare a list of emerging infectious diseases that can cause serious medical emergencies and crises in the future. In its response, the committee prepared a list of 6 Diseases which are needed to be studied intensively to prevent future outbreaks. But in 2018, the list was updated and two new diseases were added to the list - Zika virus and Disease X.
According to WHO 'Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease. The R&D Blueprint explicitly seeks to enable early cross-cutting R&D preparedness that is also relevant for an unknown Disease X.
By creating this new terminology, WHO planned to boost the research on the pathogens (also called Pathogen X) that could most probably cause epidemics and in the worst case, a pandemic in future. This initiative mainly focuses on working on new ideas that can reduce the time interval between initiation of an outbreak and finding its cure. Hence, it would minimize losses incurred to the Human race. It would also encourage scientists to study the entire family of pathogens instead of just a particular strain, thus 'being prepared' if a new strain affects us in future.
The possible causes of the emergence of disease X mainly include but not limited to:
1) Biological mutations: Mutations naturally occur in most of the living organisms so as to adapt to a given environment but sometimes pathogens use mutations to bypass both active and passive immunity of an organism and to potentially harm them. All zoonotic pathogens use this pathway to gain the ability to infect humans e.g. Covid-19, SARS, Zika virus etc. As, biological mutations are unavoidable, we need to be always prepared for the deadly Pathogen X.
2) Antimicrobial Resistance: It is the ability by which microbe can resist the effects of medication that once could successfully treat the microbe. Most common example of AMR is antibiotic resistance. Due to uncontrolled and unnecessary use of antibiotics, many strains of harmful bacteria are gaining antibiotic resistance by mutation and natural selection. According to WHO, " Without harmonized and immediate action on a global scale, the world is heading towards a post-antibiotic era in which common infections could once again prove fatal and even some routine surgical operations and cancer chemotherapy will become less safe".
3) Bio-weapons or Bio-terrorism: With advancement in the field of gene engineering, we now have more options to diagnose and cure many diseases but it could also be used by some countries or organizations to create deadly genetically modified pathogens which could be spread in general public intentionally or by carelessness. It might be highly contagious as nobody will have resistance to it and inventing a cure for it would be equally challenging. e.g. Researchers at the University of Alberta recreated horsepox via lab synthesis to conduct research related to the an use of viruses to treat cancer. It was the modified strain of the same virus that killed millions of People in the 20th century and was completely eradicated in 1980 using effective vaccine.
Hence, promoting the research on unknown Disease X could prove to be a game-changer in future epidemics and pandemics.
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