Contrary to its name, Disease X is not a disease but rather a placeholder concept for a future illness that could pose a serious threat to humans. It is a possible infectious agent that is not yet determined, but it is crucial to be ready for it since it might cause a new infectious disease to which people are not immune. (Lodhi, 2024).
Disease X was added to the World Health Organization’s (WHO) list of diseases with the highest research priority in 2018. The list contained the following pathogens: COVID-19, Lassa virus disease, Ebola virus and Marburg virus disease, Nipah and henipaviral illnesses, Rift Valley fever, Middle East respiratory syndrome coronavirus (MERS-CoV), and Zika (Sams et al., 2022). Unlike the other eight diseases on the list, Disease X was not a recognised pathogen. It instead reflects the awareness that a significant global pandemic may be triggered by a pathogen that is currently unknown to cause human illness. Since then, this hypothetical disease has been the primary focus of global pandemic preparedness initiatives.
Africa Could Be a Key Frontier for Disease X
The 2014 Ebola epidemic in West Africa caused a humanitarian crisis, which influenced the initial conception of Disease X. Despite decades of research, no interventions were ready to be deployed in time to save over 11,000 lives (Gale & Bloomberg, 2024). The Ebola epidemic took two years to contain after starting in Guinea and swiftly spreading to Europe and the USA (Zaman et al., 2024). In response, the World Health Organisation created a research and development plan to hasten the development of different tools for priority diseases.
Nobody is certain where Disease X will originate, but experts predict that it will happen in either China or Africa, causing a pandemic estimated to kill 80 million people (Sams et al., 2022). Nonetheless, a lot of conspiracy theories about the origins of Disease X have been floated throughout the years. Bats were frequently cited as the most likely source, backed up by data from previous outbreaks. Zoonotic diseases, which spread from animals to people, have been a continuous menace throughout history; this notion represents the imminent threat that comes from them (Fei & Huang, 2024). Other early cause narratives also suggested military intervention and abuse of antibiotics (Davies, 2022).
Potential Emergence, transmission and Control Channels for Disease X (Fei & Huang, 2024)
In Ethiopia and Sudan, there was speculation that the alleged bleeding eye sickness or Crimean-Congo hemorrhagic fever might be the next Disease X. This fever, which left individuals bleeding from their eyes, mouth, and anus, was a terrible disease with a greater fatality rate than a plague and had perplexed medical authorities for many years (Bateman, 2020).
Monkey pox (Mpox) is a zoonotic disease that is endemic to Central and West Africa, with a global outbreak beginning in 2022. Although the primary animal reservoir for mpox is still unknown, the virus that causes the disease has been detected in small rodents, monkeys, and other mammals that reside in these areas (Hakim & Widyaningsih, 2023). After the SARS-CoV-2 virus that causes COVID-19, this is the most recent instance of Disease X to appear. However, years of research have produced safer and more modern smallpox vaccinations, which may also be effective against mpox. Three mpox vaccines are currently being recommended by some countries for vaccination of individuals who are at risk, despite their limited availability (World Health Organization, 2024).
People frequently perceive Africa, where there is significant human-animal contact, as a hotspot for diseases; however, the 2009 H1N1 pandemic, which preceded COVID-19, started in Mexico which was not considered a hotspot (Coulson, 2024). We must be open to the possibility that Disease X might originate anywhere there are humans or animals, which is practically the entire world.
Staying ahead: Disease X incidence in Africa
WHO has warned that Disease X is probably going to be the next major outbreak that we haven’t witnessed before, following COVID-19. Globally, COVID-19 has claimed the lives of almost 7 million persons. Healthcare experts issued a warning in 2023 that any future pandemic may be considerably deadlier, killing an estimated 50 million people globally (Lodhi, 2024).
The pandemics of the past have taught us some lessons, and there may be many more challenges ahead. Anticipating the possible advent of an as-yet-undiscovered infectious disease may enable the public health system to respond more quickly and effectively, producing the drugs, vaccinations, and diagnostic tools required to save lives. Through this idea of “anticipatory imagination,” professionals and non-experts alike may proactively work on those viral families and start thinking about how they are transmitted, how they influence the human body, and what sorts of immune responses are relevant (Coulson, 2024).
There are already conversations, according to Turkish Radio and Television Corporation Afrika (2024), to use platform technologies to identify vaccinations for X. These technologies include scientists creating tailored vaccine formulas. So much so that when an epidemic occurs, researchers may use the platform to input the right sequence and sequence the specific genetics of the pathogen to produce a new vaccine.
In Africa, WHO has begun to put measures in place to prepare for another epidemic. This includes a pandemic fund and a technology transfer hub in South Africa, which would allow for local vaccine manufacture and assist in addressing concerns of vaccine disparity between high- and low-income nations. Such efforts are also predicted to significantly lower the expenses associated with a pandemic if one occurs. While COVID-19 cost the world over $16 trillion, worldwide spending of just $124 billion over five years might considerably improve the world’s preparedness for large epidemics in the future, according to research funded by the Gates Foundation (Lodhi, 2024).
Furthermore, the Africa Centres for Disease Control and Prevention (Africa CDC) has signed a Memorandum of Understanding (MoU) with the Coalition for Epidemic Preparedness Innovations (CEPI) to enhance prevention, preparedness, and response in Africa (Edwin, 2024). This collaboration in research, clinical trials, and local manufacturing of medical countermeasures will significantly improve regional vaccine research in Africa, allowing for a faster and more equitable response to emerging infectious diseases, outbreaks, epidemics, and pandemics.
Conclusion
The concept of Disease X is not new and has been around since at least 2018. It has already accomplished a few things; as a result of work done in response to the MERS pandemic, BioNTech and Moderna were able to have a SARS-CoV-2 vaccine candidate ready in a matter of hours to days (Coulson, 2024).
However, people interpret scientific concepts in different ways, as seen by the numerous conspiracy theories that persist about the imminent Disease X. The awareness that this strategy raises is ultimately crucial for enhancing resistance to potential epidemic threats and unidentified diseases in the future by drawing on past experiences and knowledge.
References
Bateman, S. (2020, February 29). “Disease X” feared to have hit ethiopia as dying villagers “bleed from eyes.” Daily Star. https://www.dailystar.co.uk/news/world-news/disease-x-feared-hit-ethiopia-21601531
Coulson, M. (2024, February 15). What is disease X | johns hopkins | bloomberg school of public health. Publichealth.jhu.edu. https://publichealth.jhu.edu/2024/what-is-disease-x
Davies, N. (2022, June 13). Disease X and africa: The creation of disease narratives – institute of development studies. Institute of Development Studies. https://www.ids.ac.uk/opinions/disease-x-and-africa-the-creation-of-disease-narratives/
Edwin, M. (2024). Africa CDC and CEPI deepen partnership to fortify african preparedness against disease outbreaks | CEPI. Cepi.net. https://cepi.net/africa-cdc-and-cepi-deepen-partnership-fortify-african-preparedness-against-disease-outbreaks
Fei, Y., & Huang, J. (2024). Unveiling disease X: Strategies for tackling the new frontier of infectious diseases. Zoonoses, 4(1). https://doi.org/10.15212/zoonoses-2024-0013
Gale, J., & Bloomberg. (2024, January 16). NDTV. NDTV.com. https://www.ndtv.com/world-news/what-is-disease-x-how-scientists-are-preparing-for-the-next-pandemic-4872347
Hakim, M. S., & Widyaningsih, S. A. (2023). The recent re-emergence of human monkeypox: Would it become endemic beyond africa? Journal of Infection and Public Health, 16(3), 332–340. https://doi.org/10.1016/j.jiph.2023.01.011
Lodhi, A. (2024, January 18). What is disease X and how will pandemic preparations help the world? Al Jazeera. https://www.aljazeera.com/news/2024/1/18/what-is-disease-x-and-how-will-pandemic-preparations-help-the-world
Sams, K., Grant, C., Desclaux, A., & Sow, K. (2022). Disease X and africa: How a scientific metaphor entered popular imaginaries of the online public during the COVID-19 pandemic. Medicine Anthropology Theory, 9(2), 1–28. https://doi.org/10.17157/mat.9.2.5611
Turkish Radio and Television Corporation Afrika. (2024, January 18). Why is the world concerned about “disease X”? Trtafrika.com; TRT Afrika. https://trtafrika.com/africa/why-is-the-world-concerned-about-disease-x-16693228
World Health Organization. (2024). Monkeypox. Www.who.int. https://www.who.int/health-topics/monkeypox#tab=tab_3
Zaman, M. H., Ali, N., & Ilyas, M. (2024). “Disease X” and prevention policies. Frontiers in Public Health, 12, 1303584. https://doi.org/10.3389/fpubh.2024.1303584
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