New England Journal of Medicine
May 9, 2019 Vol. 380 No. 19
Stopping the Gaps in Epidemic Preparedness
Jeremy J. Farrar, M.D., Ph.D.
Several life-threatening viruses have been identified for the first time in the 21st century, including the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses. An association between Zika virus infection during pregnancy and microcephaly came to light only in 2015. Once seemingly confined by public health measures to sporadic episodes in rural areas, Ebola virus disease broke free in 2014, reaching urban centers and killing more than 11,000 people. Like all epidemics, it drew resources away from other critical health care needs and left a legacy of distrust and disconnection.
The World Health Organization (WHO), in conjunction with global experts, has drawn up a list of nine known infectious diseases and one unknown (Disease X) in a “Blueprint” for research and development (see box).1 These infections have the potential to cause public health emergencies, and we lack the tools to diagnose, treat, or prevent them. The world is therefore particularly vulnerable to these infections, and yet they’ve been neglected in research and development…