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When will the next pandemic hit? How will we monitor it and contain its spread? Will epidemics become more frequent and less deadly—or less frequent and more deadly?

Bacteria Fight Back


[The greatest risk] to human health comes in the form of antibiotic-resistant bacteria. We live in a bacterial world where we will never be able to stay ahead of the mutation curve. A test of our resilience is how far behind the curve we allow ourselves to fall.

World Economic Forum


Up to one-third of the world lives with latent tuberculosis infection.

Tuberculosis (TB) is responsible for 1.8 million deaths per year, and both multi-drug resistant (MDR) and extensively drug resistant (XTR) TB are on the rise.

India has the highest burden of TB, a ticking time bomb. Any number of relatively likely immunological challenges—a new HIV-like virus, a low-level radiation event on the Pakistan border—could cause a reoccurrence of TB and multiplicative effect of MDR and XTR TB, which could then spread from India.


Antibiotic resistance is projected by some to kill 50 million per year by 2050—about the same as the total number of deaths in 2016 from all causes combined.

This could come at a total economic cost of $100 trillion.

Despite this, there is an almost total collapse of the antibacterial R&D pipeline.

In response to major crises, many dozens of novel antibiotic technologies will be developed, like designer bacteriophages or nano-spike surface coatings.

As of 2016, 40 new antibiotics were in clinical development. However, novel antibiotic development is poorly incentivized—only one in five drugs admitted to Phase 1 trials make it to patients, and in some cases the drugs can be obsolete by the time they finish trials. As market incentives decrease even further for the development of antibiotic drugs, a federal agency will be put in charge of antibiotic technology, stockpiling and development.

pandemic arms race tuberculosis

Gentlemen, it is the microbes who will have the last word.

Louis Pasteur

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