We’ve seen and read this once and again in Science Fiction. The outbreak of an unknown infectious disease which spreads across a large region or even worldwide. Since the Florentines fleeing from the Black Death in Giovanni Boccaccio’s Decameron, pandemic has become a literary genre itself. Disease X is now formally recognised as one of the top threats by the World Health Organization.

In February 2018, the WHO released details of its infectious disease Research and Development (R&D) Blueprint. The WHO’s R&D Blueprint was started as a response to the Ebola crisis in 2014. The Ebola outbreak in West Africa showed us that research and development for medical products needs to be an integral part of any response to epidemics and public health emergencies. Experts recognise the need to develop platform technologies to expedite the development and production of medical products during an epidemic.

Given their potential to cause a public health emergency and the absence of efficacious drugs and/or vaccines, WHO experts think there is an urgent need for accelerated research and development for:

• Crimean-Congo haemorrhagic fever (CCHF)
• Ebola virus disease and Marburg virus disease
• Lassa fever
• Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS)
• Nipah and henipaviral diseases
• Rift Valley fever (RVF)
• Zika
• Disease X

Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease, and so the R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown “Disease X” as far as possible.

I am glad to see that our organisations are able to look forward into the unknown trying to anticipate dangers lurking around, but seeing Disease X in the list is, well, like going to the cinema and hearing a fasten-your-seat-belt announcement…