• Disease-X, A Sustainable And High-Return Business Strategy

    September 1, 2023
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    Joseph Alanen - Disease and Death
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    A business parable from Fearistan

    Fearistan, having done very well economically and provided its citizens a long lifespan, noticed that people were still occasionally dying in road accidents. Fearistanis were wealthy and really liked the freedom to travel. While road deaths were uncommon, any unnecessary death surely seemed worth avoiding.

    The road building industry, working closely with government, came up with the idea of building 6-lane highways between cities. Soon the big cities were all connected, and experts from the University of Transport proved that the new highways had a 7% lower accident rate than normal roads. University modelers predicted that if 6-lane highways were built between every town in Fearistan, they would save thousands of lives. Experts predicted that they would even save more lives than were actually dying on the existing roads.

    The country followed the experts (they were, after all, renowned for building roads) and invested in 6 lane highways everywhere. While the country exhausted itself and most people could not afford to drive their cars anymore, they were rightly grateful that the roadbuilders were saving them. The near empty roads were now almost completely accident-free, proving the experts right.

    Eventually, the roadbuilding industry faced a dilemma; they were running out of towns to which roads could be built. This was not what their investors needed. Then the road regulator and the roadbuilders met and identified an urgent need to build the new 6-lane highways to towns that did not yet exist. Fearistan had vast areas of empty desert that were completely open to town-building. When such towns were eventually built, experts predicted an inevitable and devastating tsunami of road accidents. This would return Fearistan to the total carnage from which they had so narrowly escaped years before. The new Town-X roads (as they termed them) were brilliant examples of high-tech road construction. And everyone could see how important this work was, to keep the public safe.

    In public health, we follow a similarly important business model. We call it ‘Disease-X’.

    Understanding pandemic risk from infectious disease

    Humans suffered for millennia from pandemics or ‘plagues’. These killed up to a third of some populations. While causes in some cases remain unclear, such as the Athenian plague of 430 BC, the major plagues since Medieval times were mostly bacterial; particularly bubonic plague, cholera and typhus.

    Bacterial pandemics ceased in late 19th century Europe with improved sanitation, and elsewhere after the addition of antibiotics. Most deaths from the pre-antibiotic Spanish flu outbreak in the early 20th century are also thought to be untreated secondary bacterial pneumonia. Cholera remains an intermittent marker of extreme poverty and social disruption, whilst most deaths from malaria, tuberculosis and HIV/AIDS are associated with poverty, which restricts access to effective treatment.

    When indigenous populations long separated from the bulk of humanity encountered carriers of smallpox and measles, the effects were also devastating. Having no inherited immunity, whole populations were decimated, particularly in the Americas, Pacific Islands and Australia.

    Now the world is connected, and such mass death events don’t occur. Connectedness can be a strong defense against pandemics, contrary to what Disease X proponents claim, through its role in supporting early-age immunity and frequent boosting.

    These realities reflect orthodox public health but are poorly compatible with current business models. They are, therefore, increasingly ignored.

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    A century of safety

    The past hundred years have seen two significant natural influenza pandemic events (in 1957-8 and 1968-9) and one major coronavirus outbreak (Covid-19) that appears to have arisen from gain-of-function research in a lab. The influenza outbreaks each killed less than currently die annually from tuberculosis, while the coronavirus outbreak was associated with mortality at average age above 75 years, with roughly 1.5 people per thousand dying globally.

    While the media fusses about other outbreaks, they have actually been relatively small events. SARS-1 in 2003 killed about 800 people worldwide, or less than half the number of children that die every single day from malaria. MERS killed about 850 people, and the West African Ebola outbreak killed about 11,300. Context here is important; tuberculosis kills over 1.5 million people every year while malaria kills over half a million children, and over 600,000 people die of cancer each year in the United States alone. SARS-1, MERS and Ebola may gain more media coverage than tuberculosis, but this is unrelated to actual risk.

    Why are we living longer?

    The reason behind increasing human lifespans is frequently forgotten, or ignored. As medical students were once taught, improvements came primarily through improved sanitation, better living conditions, better nutrition, and antibiotics; the same changes responsible for the reduction in pandemics. Vaccines came after most improvement had already occurred (with a few exceptions such as smallpox).

    While vaccines do remain an important addition, they are also of particular importance to pharmaceutical companies. They can be mandated, and together with the constant birth of children this provides a continuing, predictable and profitable market. This is not an anti-vaccine statement. It is just a statement of fact. Facts are what health policy should be based on.

    So, we can be confident that, barring an intentional or accidental release of a pathogen engineered by humans, it is highly unlikely that a Medieval-style outbreak will affect anyone currently living. While poverty will reduce life expectancy, it will remain relatively high in wealthier countries. However, we can also be very confident that those half million young children will die of malaria next year and that 1.5 million people, many of them children and young adults, will die of tuberculosis. Over 300,000 women in low-income countries will also die agonizing deaths from cervical cancer because they cannot access cheap screening. We know this, because it happens every year – it is what international public health, particularly the World Health Organization (WHO), was supposed to prioritize.

    The ability to monetize an illusion

    The Covid-19 response demonstrated how the sponsors of international public health institutions have found a way to monetize public health. This business model involves promoting abnormal responses to relatively normal viruses. It employs behavioral psychology and media campaigns to instill inappropriate fear into the public, then ‘locking them down’ – prison terminology before 2020. The public may then regain a degree of freedom (e.g., fly to visit a dying relative, or work) if they agree to take a vaccine, which in turn directly benefits the original sponsors of the scheme. The heavy public investment in Covid-19 mRNA vaccine development enabled pharmaceutical companies and their investors to reap unprecedented returns.

    The major public-private partnership for vaccine development for pandemics, CEPI (inaugurated at the World Economic Forum in 2017), states that “The threat of Disease-X infecting the human population, and spreading quickly around the world, is greater than ever before.” Health practitioners are quite susceptible to this propaganda (they are only human). Many also seek income from investments and patents from technologies that may help lock others down or make vaccine production quicker and cheaper. Basing their salaries and careers on loyalty to this pandemic industry, they join in vilifying and scapegoating those who speak against it. Shielded by their sponsors’ ‘greater threat than ever before’ claims, they can blind themselves to the major causes of ill health and act as if only pandemic risk matters.

    Why not rely on existing threats?

    Despite current efforts with yet another variant, Covid-19 is losing its ability to scare. Sustained fear is necessary for politicians in penetrated governments (as Kaus Schwab of the World Economic Forum notes) to provide this support. This business paradigm requires a continuing target.

    The overall aim is for the public to think that only a corporate authoritarian (fascist) nanny-state can save them from a continuing threat. Major natural outbreaks being rare, and lab escapes also infrequent, Disease-X fills this need. It provides the material for the media and politicians to work with between variant or monkeypox events.

    Where to from here?

    For the public, diversion of resources to fairyland diseases will increase mortality by diverting funding for real threats and productive areas of investment. Of course, if increasing lab leaks of engineered apthogens are expected from ongoing and future research, that would be different. But then this would have to be explained plainly and transparently, and prevention may be more effective than a very expensive cure.

    Disease-X is therefore a business strategy, dependent on a series of fallacies, dressed up as an altruistic concern for human welfare. Embraced by powerful people, the world they move in accepts amoral practice in public health as a legitimate path to their version of success.

    If our primary aim is to channel taxpayer funding to development of biotechnologies that the public can then be mandated to buy, to their own detriment but at great benefit to the developers, then Disease-X is the road forward. This market model ensures that a relative few can concentrate wealth gained from the many, at virtually no risk to themselves. The public must decide whether they want to keep their part of this highly abusive bargain.


    David Bell

    David Bell was formerly employed by the World Health Organization.
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