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For four thousand years, the size and vitality of cities, economies, and empires were heavily determined by infection. Striking humanity in waves, the cycle of plagues set the tempo of civilizational growth and decline, since common response to the threat was exclusion—quarantining the sick or keeping them out. But the unprecedented hygiene and medical revolutions of the past two centuries have allowed humanity to free itself from the hold of epidemic cycles—resulting in an urbanized, globalized, and unimaginably wealthy world.   However, our development has lately become precarious. Climate and population fluctuations and aspects of our prosperity such as global trade have left us more vulnerable than ever to newly emerging plagues. Greater global cooperation toward sustainable health is urgently required—such as the international efforts to harvest a Covid-19 vaccine—with millions of lives and trillions of dollars at stake.   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