Needles in haystacks: finding new approaches to combat infectious diseases Multidrug resistance in human pathogens is a growing problem worldwide, with some strains acquiring resistance to all commonly-used antibiotics. Traditional antimicrobials target essential bacterial functions, such as replication and cell wall synthesis, and this can select for resistant microorganisms. Novel therapeutics that do not rely on these approaches are urgently needed to address this trend. Interestingly, a recent study found that samples of bacteria from the gut flora of members of an isolated Amazonian tribe that had never been exposed to antibioticscarried antibiotic resistance genes(http://news.sciencemag.org/biology/2015/04/resistance-antibiotics-found-isolated-amazonian-tribe). These findings support the notion that resistance genes exist in the environment and can protect bacteria during clinical therapy. This burgeoning threat affects all countries; one has only to consider the burden of multidrug-resistant tuberculosis (a bacterial infection with Mycobacterium tuberculosis) as well as drug-resistant malaria (a protozoal infection with Plasmodium spp.) on global human health, particularly in developing countries. To specifically address this problem, in September 2014 the U.S. administration released a report outlining their national strategy to combat antibiotic-resistant bacteria (https://www.whitehouse.gov/sites/default/files/docs/carb_national_strategy.pdf). This document outlines 5 interrelated goals to improve human health. Another important health issue is the existence of infectious diseases with little or no effective treatment. One has only to consider the recent Ebola outbreak to understand the ramifications of ignoring diseases that are not currently a First World problem. How can we anticipate the most pressing issues that will affect public health in the future?