Michael Osterholm describes his book as "part history, part current affairs, and part blueprint for the future".[1] Top of his concerns are influenza pandemics, antibiotic resistance and bioterrorism, combined with "no clear international governance structure for how we are going to deal with these issues".[1] Focusing on major infectious diseases, he highlights the world's vulnerability to their emerging threats.[2][3] His concerns include the effects of major outbreaks on medicine and vaccine production, should countries where these are produced be affected.[4]
Content includes a chapter on coronaviruses titled, "SARS and MERS: Harbingers of Things to Come".[5] Other chapters are on the HIV/AIDS, toxic shock syndrome, the 2015–16 Zika virus epidemic, and Ebola outbreaks, covering all the main outbreaks over the previous 30 years,[2] including influenza bioterrorism,[1] Gain-of-function research, influenza research, the antivaccine movement, and antimicrobial resistance.[2] The concept of "game-changing influenza vaccines" is introduced in the chapter "Taking influenza off the table". This provides reasoning and mechanisms for developing vaccines.[2] Solutions to antimicrobial drug resistance are suggested in the chapter titled "Fighting the resistance".[2]
The authors divide infectious diseases into four classes: pathogens that have the potential to cause pandemics; pathogens important to particular regions; endemic diseases; and bioterrorism, dual-use research of concern, and concerns over gain-of-function research, where modifying pathogens in the laboratory might potentially be misused.[2][6]
The book contains personal experiences, including Osterholm's La Crosse encephalitis,[2] and it uses medical history to assess the threat of pandemics and anti-microbial resistance, while also discussing political responses.[7] The authors propose a nine-point "Battle Plan for Survival" to fight emerging threats, with the aim of informing and inspiring people into public health work.[1]
