Infectious diseases are global and local. They impact health and disease in every country, but protean factors— cultural, geographical, and political— determine their particular local distribution. Every single patient is globally colonized by microorganisms, but singular behaviours, genetics and co- morbidities significantly determine what organisms cause disease in any individual. The practice of infectious diseases medicine necessarily demands an understanding of the person and the world in which they live. This chapter will emphasize the importance of context in assessing patients for infectious diseases. In terms of global mortality, communicable diseases remain the leading causes of mortality. Despite the evocative epithet of ‘infectious diseases’, these are not all caused by creatures that creep and crawl. Cosmopolitan diseases (i.e. universally distributed infections such as influenza or bacterial pneumonia) represent a huge burden wherever medicine is practised. However, it is important to note that in high- resource settings, infection imported by travel and migration is increasing. In particular, the international traffic of emerging infections, such as Zika virus, and anti-microbial resistance (AMR) are already major healthcare problems. As the world shrinks and the climate changes, the distribution of infectious diseases will continue to change. The threat of AMR no longer looms— it is a present and real danger. In the time it will take for disciples of this text to reach the end of their specialty training, AMR will account annually for more deaths than cancer. The delivery of almost all interventional, surgical, and immunomodulatory therapies depends on our ability to provide effective anti- microbial prophylaxis and rescue. The ability of organisms to adapt rapidly to novel iatrogenic selection pressures means that the treatment of human immunodeficiency virus (HIV), tuberculosis (TB), malaria, and manifold other pathogens will be compromised, not simply anti- bacterial agents. The future of modern medicine depends on the global healthcare community sharing both concern and responsibility. This chapter will include cases pertaining to the management of AMR.