By 2040 the largest cities in the world will be located in Asia and Africa. Mumbai, Delhi, Kinshasa and Lagos will each be home to over 30,000,000 people. In these megacities, population density will have reached saturation point. Meanwhile, the overuse of generic antibiotics for over a century would have selected for multi-resistant strains of common pathogens. Traditional lastline antibiotics would have become largely inefficient.
While the upper classes will have access to state of the art facilities, revolutionary gene therapies and effective vaccination to fight diseases, sanitary conditions, access to healthcare and a balance diet will be extremely limited for the masses of poor city dwellers. Tuberculosis, SARS, pneumonia and diarrhoea will become deadly diseases again, wiping out entire families. Millions will die every single year from preventable infections. Containment measures will be the only solutions to prevent pandemics until new classes of antimicrobial agents are finally discovered and mass produced.