Post-Apocalypse
The world was heavily nuked, with few survivors.
While you can choose any disease to infect the world with, the world has changed heavily, some examples:
1. Most seaports and airports have been closed due to the lack of government.
2. Most countries genuinely don’t exist: that means they cannot close borders or try to cure your disease.
3. New countries, empires, or territories have been formed, with their own economies: who they send boats and planes to.
And there’s many more!
Good luck!