Few areas of medicine have undergone greater change during the past 50 years than infectious diseases. The optimism and clinical confidence associated with the development of antimicrobial agents from the 1940s onwards has been tempered by the emergence of new diseases, such as AIDS and infections associated with transplantation and cancer therapy, and by the widespread development of antibiotic resistance. Despite many advances, infectious diseases continue to account for about a quarter of all deaths worldwide1 (Box 1). Furthermore, a security dimension has emerged. A recent report on The global infectious disease threat and its implications for the United States from the US Central Intelligence Agency (CIA) analysed this "non-traditional threat": The dramatic increase in drug-resistant microbes, combined with the lag in development of new antibiotics, the rise of megacities with severe health care deficiencies, environmental degradation, and the growing ease and frequency of cross-border movements of people and produce have greatly facilitated the spread of infectious diseases.2
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