Global Leaders Meet to Address Threat of “Disease X” Pandemic

Experts warn of potential for deadly new pathogen to emerge

Global health and government leaders have convened this week at the World Economic Forum’s annual meeting in Davos, Switzerland to address concerns over the continued threat of new pandemics emerging in the coming years. High on the agenda is discussion of how to prepare for the possibility of “Disease X” – a hypothetical, currently unknown pathogen that experts warn could sweep across the globe and cause mass casualties potentially even exceeding those seen in the COVID-19 pandemic.

The concept of Disease X was first raised by the World Health Organization in 2018, referring to an unknown pathogen with pandemic potential that could emerge and quickly spread globally due to high population density and increased human mobility. With COVID-19 demonstrating just how disruptive such an event can be, health officials are urging political and business leaders to invest now in research, surveillance, and coordinated policy efforts to help prevent, detect, and contain future disease outbreaks before they become full-blown catastrophes.

“We cannot allow a myopic focus on national self-interest to undermine global solidarity in the battle against future pandemics,” said WHO Director General Dr. Tedros Adhanom Ghebreyesus in remarks at the Davos summit. “Disease X could be just around the corner, and we must learn the lessons from this pandemic to prevent an even worse crisis.”

Specifics on Disease X remain unclear

While experts agree on the need to plan for Disease X, specifics on what exactly it might entail remain unclear. Unlike previous pandemic preparations which focused on known viral families like influenza and coronaviruses, planners are grappling with the fact that Disease X could take almost any form.

“It’s really impossible to predict what Disease X will look like – whether it’s a virus, bacteria, parasite, or even a toxin or biological weapon,” said Dr. Maria Van Kerkhove, technical lead for COVID-19 response at WHO, in an interview this week. “So our strategy has to focus on building robust systems and tools for early detection and rapid response no matter the pathogen.”

Table 1: Potential Sources of Disease X

Efforts underway to prepare for Disease X include expanded viral sequencing and surveillance systems to detect novel pathogens, stockpiling of vaccines and therapeutics that may be effective against multiple diseases, and ensuring mechanisms are in place for rapid worldwide data sharing and coordinated decision making in response to outbreaks.

Additionally, further research into high risk pathogens and potential modes of transmission could prove invaluable. For example, so-called “viral spillover events” in which animal viruses evolve the ability to infect humans pose an ongoing threat, as demonstrated by SARS, MERS and COVID-19.

Conspiracy theories emerge

The Disease X concept has already attracted skepticism in some quarters, with radio host Alex Jones seizing on the discussions in Davos to repeat unfounded conspiracy theories alleging COVID-19 was intentionally created and released. Health experts have forcefully rejected such claims as dangerous misinformation.

“There is absolutely no evidence to suggest COVID-19 was the result of a laboratory leak or deliberate release,” said Columbia University virologist Dr. Angela Rasmussen. “Jones is cynically taking advantage of fears over future pandemics to peddle falsehoods and advance his own political agenda.”

Public health groups have warned conspiracy theories and disinformation could seriously hamper efforts to respond to Disease X or future outbreaks. “False narratives have already led to attacks targeting health workers and facilities during this pandemic,” noted the NGO Commonwealth Nurses Federation this week. “We cannot allow fiction to override scientific evidence at the expense of people’s health and safety.”

Impact on vulnerable populations a concern

While a pathogen as lethal as some worst-case Disease X scenarios may seem unlikely to experts, they emphasizeeven another moderately virulent pandemic could overwhelm unprepared health systems and have devastating impacts globally. The economic and social turmoil of COVID-19 serves to illustrate just how profoundly modern society can be disrupted by infectious disease threats.

There is particular concern over the effects Disease X could have on developing countries with underfunded health systems. “We cannot ignore the reality that any pandemic touches the most vulnerable populations first and hardest,” said UNICEF Executive Director Cynthia Barrow in a statement. “Children in poverty will be among the most defenseless against Disease X unless we prioritize equitable distribution of vaccines, treatments and resources now, before the next crisis begins.”

Table 2: Estimated Mortality Impact of Potential Pandemics

Preemptive investments today in pandemic preparedness make both moral and economic sense according to most experts. WHO estimates show that in a severe pandemic scenario the economic costs could run over $3 trillion annually – a price tag orders of magnitude higher than the estimated $50-100 billion needed to robustly equip global health systems.

The specific solutions discussed will also impact prospects for dealing successfully with Disease X. Experts largely agree that investments should focus on strengthening health resources in lower income regions worldwide. “If the COVAX initiative has taught us anything, it’s that we are only as protected as the most vulnerable among us,” said GAVI Alliance CEO Dimosthenis Bikos. “Hoarding resources can only breed instability when the next crisis comes.”

Possibility of engineered bioweapons also raises alarms

While natural zoonotic spillover remains the most likely source, the specter of intentionally engineered pathogens has also raised alarms among biosecurity experts. The rapid advance of technologies like synthetic biology and gene editing may be making it easier for rogue actors to produce bioweapons capable of targeting specific populations on a massive scale.

“We cannot ignore the increasing potential that state or non-state actors could manufacture novel biological weapons purposely designed to spread quickly and cause mass casualties,” warned Dr. Matthew Meselson, a molecular biologist with Harvard University. “The destructive power of these technologies is outpacing our ability to control them globally.”

Some researchers have begun modeling Disease X scenarios involving intentionally engineered pathogens in order to understand transmission patterns and test potential response strategies. But ethical questions have been raised about publishing details of these models that could aid would-be bioterrorists. There are also concerns that merely discussing engineered pathogens risks distracting focus from more likely natural spillover events or stigmatizing critical research.

“Sensational doomsday talk about bioweapons can generate panic and actually impede the open international cooperation needed to detect and mitigate these threats,” said Dutch researcher Dr. Marion Koopmans.

Ultimately experts agree balancing transparency, security and oversight will prove a major challenge for policymakers in the coming years. Global cooperation will be key not only to pandemic preparedness, but also to preventing catastrophic misuse of rapidly advancing biotechnologies.

Support urged for the WHO

A frequently echoed sentiment this week was the need to adequately fund WHO operations and empower the agency to take decisive action early against any Disease X or future pandemic threat. WHO remains constrained by the policy directives of its member states, many experts noted, limiting its ability to mount and coordinate responses without explicit international consensus.

“People look to WHO to lead on pandemics, but don’t appreciate the constraints placed upon the organization by governments Slow, bureaucratic coordination enables outbreaks to spin out of control,” said Devex managing editor Catherine Cheney.

A coalition of health advocates led by ONE Campaign executive director Gayle Smith called for the formalization of a Global Health Threats Council backed by guaranteed funding streams and able enact key measures like travel advisories and targeted economic sanctions in response to outbreaks.

“The lack of WHO mandate to directly intervene early in this pandemic worsened consequences globally,” Smith said. “China and other nations initially withheld vital information as COVID-19 spread unchecked. We need enforceable consequences for bad actors who risk triggering another disease X.”

Others have countered that adequately addressing gaps ability to detect and contain outbreaks early will negate need for punitive measures later. “Bolstering surveillance and health system capacity now could pay dividends 1000-fold if it prevents the next pandemic from emerging at all,” said Dr. Simon Ray, senior lecturer in applied statistics at Newcastle University.

The varied ideas emerging from Davos discussions will fuel debate over coming meetings and high-level forums. For now though, experts seem to universally agree the time to act is now.

“The question remains whether we have the collective vision to truly learn from recent history, and take the difficult steps needed to spare untold lives and disruption,” said economist Max Roser, quoting WHO chief Tedros’ concluding remarks in Davos. “There can be no excuse for allowing the same preventable losses to mount again when Disease X arrives.”

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