DISEASE X: THE IMPENDING PESTILENCE

PRIORITY EQUITABLE CANDIDATES AND AFFLICTION

1.      Zoonotic viruses

2.      Synthetic viruses/bioweapons

3.      Bacterial infections

4.      Crimean-Congo hemorrhagic fever

5.      Ebola virus disease and Marburg virus disease

6.      Lassa fever

7.      Middle East respiratory syndrome corona virus(MERS-CoV) and Severe Acute Respiratory Syndrome(SARS)

8.      Nipah and henipaviral diseases

9.      Rift valley fever

10.  Zika

11.  “Disease X”(MAJOR PANDEMIC)

Disease X is implicit to be a major outbreak. This is a placeholder name that was adopted by the World Health Organization (WHO) in February 2018 on their shortlist of blueprint priority disease given to the very grave threat that unknown viruses the pretense to human health. Each year the WHO updates the list with guidance from experts in all fields of the scientific study of which pathogens pose the most the threat of causing the next global pandemic.

WHY THIS NAME?

WHO adopted this name to guarantee that their planning was sufficiently flexible to adapt to an unknown pathogen (eg.broader vaccines and manufacturing facilities). Disease X is caused by Pathogen X, an infectious agent that is not currently known to cause human disease, but an etiologic agent of a future outbreak with epidemic or pandemic potential.Director of the National Institute of Allergy  and Infectious Diseases Anthony Fauci stated that the concept of Disease X would encourage WHO projects to focus their research efforts on entire classes of viruses(eg.flaviviruses) instead of just individual strains (Zika virus), thus improving WHO capability to respond to unforeseen strains. In 2020, it was speculated, including among some of the WHO’s own expert advisors, that COVID -19, caused by SARS Co –V-2 Virus strain, Met the necessities to be the first  Disease X.

X SPOTLIGHT ON VIRUSES

It is a big query that why X focus is on viruses and why all these viruses appear new. The theory o “new” is very implicit. The viruses included in the Blueprint list are called emerging because they were identified only recently, after having caused diseases in humans. However, these viruses existed in nature for a very long time, in animal reservoirs. The Nature journal estimated that, if all viruses present on the planet were aligned, they would cover a distance of 100 million light-years. A rough estimation based on a study in bats suggests that at least 3,20,000 viruses can infect mammals and that all species of vertebrates together could host at least 3 million and a half different viruses.

SUMMONS VS ADVANCES IN DRUG DEVELOPMENT

The product development cycle remains lengthy for de novo medical counter measures: diagnostic tests normally take 2-5 yrs to develop and 5-10 years of their completion before procurement can be initiated. The timeline for vaccines development is even longer since it requires human Safety and efficacy data.

Technological opportunities speed up discovery and translation of new products. This lead to the discovery of effective antiviral drugs which extend to papillomavirus, enteroviruses, Hepatitis C virus over the next 5-10 years. Currently,18 specific antiviral drugs (excluding interferon)are licensed in the UK, with more in phase 3 clinical trials or available on expended access. Cloning and sequencing have provided tools to identify viral enzymes and have brought the day of the “designer drug” nearer to reality. At the other end of the spectrum of drug discovery, huge numbers of compounds for screening can now be generated by combinatorial chemistry. The thrust to find drugs effective against HIV has also stimulated research into novel treatments for other virus infections including herpes virus, respiratory infections, and Hepatitis B and C viruses.

Is the apocalypse really upon us? Well maybe…but our greatest good and what we least can spare is hope itself.

Miss. Anitta Thomas, IIIrd B.pharm