Disease X

[4][5] The WHO adopted the placeholder name to ensure that their planning was sufficiently flexible to adapt to an unknown pathogen (e.g., broader vaccines and manufacturing facilities).

[4][6][14] The Disease X placeholder acknowledged the potential for a future epidemic that could be caused by an unknown pathogen, and by its inclusion, challenged the WHO to ensure their planning and capabilities were flexible enough to adapt to such an event.

[5][6][17] John-Arne Røttingen, of the R&D Blueprint Special Advisory Group,[9] said: "History tells us that it is likely the next big outbreak will be something we have not seen before", and "It may seem strange to be adding an 'X' but the point is to make sure we prepare and plan flexibly in terms of vaccines and diagnostic tests.

[18] Women's Health wrote that the establishment of the term "might seem like an uncool move designed to incite panic" but that the whole purpose of including it on the list was to "get it on people's radars".

[21] Parallels were drawn with the efforts by the United States Agency for International Development (USAID) and their PREDICT program, which was designed to act as an early warning pandemic system, by sourcing and researching animal viruses in particular "hot spots" of animal-human interaction.

[26] In April 2020, The Daily Telegraph described remdesivir, a drug being trialed to combat COVID-19, as an anti-viral that Gilead Sciences started working on a decade previously to treat a future Disease X.

[6][11] WHO special advisor Professor Marion Koopmans, also noted that the rate at which zoonotic diseases were appearing was accelerating, saying: "The intensity of animal and human contact is becoming much greater as the world develops.

[3] Later that month, Marion Koopmans, Head of Viroscience at Erasmus University Medical Center in Rotterdam, and a member of the WHO's R&D Blueprint Special Advisory Group,[9][35] wrote in the scientific journal Cell, "Whether it will be contained or not, this outbreak is rapidly becoming the first true pandemic challenge that fits the disease X category".

[38] In 2018, WHO R&D Blueprint Special Advisor Group member Røttingen was questioned about the potential of Disease X to come from the ability of gene-editing technology to produce synthetic viruses (e.g., the 2017 synthesis of Orthopoxvirus in Canada was cited), which could be released through an accident or even an act of terror.