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“Beyond the cultural differences that must be bridged in any international effort, combined with factors of national politics, priorities, and values, we continue to grapple with the essential paradox of public health that began our discussion: when the system is working effectively, it is a silent venture and there are relatively few outbreaks of disease. These very successes lead most of us down a complacent path of false confidence, apathy, and assumptions that the endless dance is over. To complicate matters further, microbes themselves are hardly monolithic or permanently settled beings. For every attempt we make to destroy or weaken them, they respond with an equal and opposite force. The goal of both sides is to assume leadership of the evolutionary waltz ever in progress.” — Howard Markel