Lessons from the past to tackle Disease X
By: Prof. Dr. Mohammad Tariqur Rahman
In the year 2018, the WHO defined Disease X as blueprint priority diseases that include COVID-19, ebola virus disease, Lassa fever, MERS-CoV, SARS-CoV, Nipah viral diseases, and Zika viral diseases.
The ongoing legacy of COVID-19 mobilized us to expand our virtual empire into online meetings, lessons, consultations, shopping, social networking and whatnot. We also have learned to prepare ourselves to face a pandemic.
Amidst this new virtual empire, the alert for the arrival of another Disease X is loud and clear.
Deforestation, climate change, and urbanization are to be blamed for any plausible future epidemics of Disease X.
Health director-general Datuk Dr Muhammad Radzi Abu Hassan on 5 October 2023 conveyed his cautionary words to the nation: “Although the possibility of the occurrence of Disease X should be noted, excessive anxiety should be avoided. People are always advised to follow health guidelines, adopt good health practices, and always get the latest information about the development of this disease.”
Rightly so, the WHO emphasizes the importance of a transparent scientific process in researching the origin of the virus. Experts advocate for developing vaccines, early detection technology, and preparedness of health care systems.
So far so good! Right ideas and planning are all in place. Thanks but no thanks to COVId-19. Perhaps multiple vaccines are on the manufacturing belt as we speak.
As far as the vaccine is concerned, global marketing, mandatory administration policies, and planning for cross-border restrictions will be easier than ever before.
Yet, the very fundamental question that scientists, medical doctors, and policymakers must ask is: will the threat of Disease X end?
Not to be forgotten bacterial infectious diseases. The era of bacterial infectious diseases did not meet the postulated end with the discovery of antibiotics. After the momentary success of penicillin in controlling bacterial infections among World War II soldiers, penicillin resistance became a substantial clinical quandary in the 1950s.
In less than three decades, resistant bacteria against tetracycline, erythromycin, methicillin, gentamicin, and vancomycin emerged one after another. Albeit, the predatory paws of infectious bacteria did not perish.
Overuse or abuse of the antibiotics accelerated bacterial survival against antibiotics known as antibiotic resistance. No one had any clue of how antibiotic resistance would begin. Our enthusiasm to use antibiotics left the possible emergence of antibiotic resistance in the dark. Sadly, once we came to know about it, we found ourselves amidst a destitute war against resistant bacteria.
Taking a lesson from this, we must be aware of the overdose of vaccines too. Momentary success in controlling rapidly mutating viruses with multiple doses of vaccine should not elude us in another destitute war to fight Disease X. Here the enemies are the virus, more precarious than bacteria.
Epidemiological studies and the safety and efficacy of vaccine research for a few months or years might not be sufficient to prevent another deadly viral pathogen from emerging. In fact, emergence of new viral pathogens is an ongoing predicament.
Besides, policymakers and vaccine manufacturers must not forget about billions of doses of COVID-19 vaccines that expired in cold storage while millions from poor developing countries were ignored for the necessary vaccination in time. Keep it in mind, that people’s trust on vaccination practice is important for herd immunity.
If deforestation, climate change, i.e., CO2 emission due to industrialization, and urbanization are to be blamed for the emergence of Disease X, then what are we doing to reduce our share in damaging the ecosystem?
Instead, we feel proud of having mega structures or racing to build the world’s tallest buildings and towers at the expense of the natural ecosystem. Plenty of those structures are either underused or are meant for luxury rather than necessity. We have not stopped replacing natural forests with hybrid plantations.
En masse, industrialization and urbanization become synonymous to the progress of civilization at the cost of nature.
To add to this plight, even at an individual scale in academia or research institutes, we demand all our planning and research proposals must have potential industrial outputs.
Finally, we seem to ignore strengthening our natural immunity with a healthy lifestyle. Rather more physiological and psychological stress are imposed on individuals in racing the unhealthy competition of economic growth and prosperity.
Indeed with the advent of medical biotechnology we are capable of producing as many vaccines as we want. But that is not the ultimate solution to escape from the deadly paws of emerging pathogens.
While policymakers are emphasizing and implementing emerging disease control from a vaccine production and its business point of view, they need to commit to a sustainable balanced ecosystem for the next generations to live comfortably.
The burden of hyper-dependency on vaccines must be controlled – the way we are now controlling antibiotic usage. The sooner the better.
If we have to fight Disease X, let us fight it right. Let us stop any unintended invite to any unknown threats.
The author is the Associate Dean (Continuing Education), Faculty of Dentistry, and Associate Member, UM LEAD, Universiti Malaya. He may be reached at [email protected]