Preparing for the Next Infectious Disease Threat: Ronald Nahass on Antimicrobial Resistance, Global Cooperation and Pandemic Preparedness

As Infectious Diseases become increasingly complex, the medical community faces a combination of emerging infections, antimicrobial resistance, an ageing population and growing pressure on the infectious disease workforce. In an interview ahead of IDWeek 2026, Ronald Nahass, Clinical Professor of Medicine at Rutgers Robert Wood Johnson Medical School, discusses the evolving challenges facing the specialty and why international collaboration will be essential for preparing for the next infectious disease threat.

Nahass, whose career has included work in HIV, hepatitis B and hepatitis C, also highlights developments in antiviral research, the search for a hepatitis B cure, HIV prevention and emerging approaches to antimicrobial resistance. He also expresses concern about whether the global community is doing enough to prepare for another pandemic.

How Ronald Nahass Became Interested in Infectious Diseases

Nahass’s interest in infectious diseases began surprisingly early. As a young person, he was fascinated by mould growing on fruit, vegetables and bread and wondered what was responsible for it. That curiosity eventually developed into an interest in microbiology.

His decision to pursue infectious diseases as a medical specialty was strengthened during college. As part of the experience leading into medical school, he volunteered at a hospital and spent a summer working with a nationally recognised infectious disease physician.

That experience left a lasting impression on him. Nahass recalled being struck by the physician’s broad medical knowledge, the respect he commanded and the apparent trust patients placed in him.

For Nahass, the encounter demonstrated that infectious disease medicine was not simply about identifying microorganisms. It involved complex medical decision-making, close relationships with patients and a deep understanding of how infections interact with the wider health of an individual.

Taking Infectious Disease Expertise Beyond Major Medical Centres

More than two decades ago, Nahass founded ID Care in New Jersey, a physician-run and physician-led infectious disease practice that has grown into one of the largest practices of its kind in the United States.

He explained that the motivation behind the model was the belief that infectious disease expertise should extend beyond major academic and medical centres.

The approach was based on bringing specialist knowledge into the community so that more patients could benefit from infectious disease clinicians. According to Nahass, the needs of patients and the potential contribution of the specialty extended well beyond traditional hospital settings.

This model reflects a broader question facing specialist medicine: how can limited expertise be made accessible to a larger population as the demand for complex care increases?

Antimicrobial Resistance Is Increasing the Complexity of Care

One of the biggest challenges identified by Nahass is the growing complexity of infectious diseases. Antimicrobial resistance is a major part of that problem, but it is not the only factor.

Modern medicine allows patients with increasingly complicated health conditions to survive and receive treatments that can also make them more vulnerable to difficult infections. Opportunistic infections, for example, can occur in people whose immune systems are compromised, including some transplant recipients and patients receiving advanced cancer therapies or other intensive treatments.

These circumstances can make infections more difficult to diagnose and treat. Clinicians may need to consider unusual organisms, resistance patterns, interactions with other treatments and the patient’s underlying medical condition at the same time.

Nahass also points to demographic changes. As populations age, more people may become susceptible to infections that require complex management, adding to the demand for specialist expertise.

The Infectious Disease Workforce Faces Growing Pressure

The increasing burden of complex infections is occurring alongside a workforce challenge. Nahass described a situation in which the need for infectious disease expertise is expanding while the workforce has difficulty keeping pace.

This creates a difficult balance for healthcare systems. Antimicrobial resistance, opportunistic infections and increasingly complex patients all require specialist input, but specialist capacity is not unlimited.

The challenge therefore goes beyond developing new medicines. Healthcare systems also need sufficient numbers of trained professionals who can diagnose infections, interpret microbiological information, select appropriate treatments and help manage complicated cases.

Expanding access to infectious disease expertise into community settings is one potential component of addressing that gap, while research, education and collaboration remain important to the specialty as a whole.

Why Infectious Disease Threats Require International Cooperation

Infectious diseases do not remain confined within national borders. This makes cooperation between countries, health agencies and medical organisations an important part of responding to emerging threats.

Nahass describes infectious disease as an international effort, noting that pathogens do not recognise political or geographic boundaries. Outbreaks can affect multiple countries, while information about a developing health threat can spread around the world within minutes.

He highlighted the difficulties involved in coordinating information and public messaging across different levels of government and between countries. In the United States, state health departments and federal agencies may have different responsibilities, while international health organisations and governments must coordinate when an outbreak crosses borders.

Misinformation Adds Another Layer to Outbreak Response

Another challenge discussed by Nahass is the modern information environment.

During an infectious disease emergency, the public needs clear, accurate and timely information. At the same time, social media and online platforms allow unverified information and misinformation to circulate rapidly.

This can complicate public health communication. Health authorities and medical organisations must not only provide accurate information but also communicate it in a way that people can understand and trust.

The experience of COVID-19 demonstrated how difficult pandemic communication can become. Nahass also referred to other international infectious disease events, including Ebola and a hantavirus episode on a cruise ship, as examples of why cross-border cooperation and effective communication remain important.

Hepatitis B Cure Research Among Key Areas of Interest at IDWeek 2026

Looking ahead to IDWeek 2026, Nahass highlighted several areas of research that he is particularly interested in seeing discussed.

One of the most significant for him is hepatitis B. He has spent much of his career working in antiviral medicine, including HIV, hepatitis C and hepatitis B. He is particularly interested in research being presented at IDWeek around the possibility of a hepatitis B cure.

Hepatitis B remains a major global health concern, and efforts to reduce its long-term burden include prevention, diagnosis, treatment and strategies aimed at elimination. Research into curative approaches could represent another direction in that broader effort.

Nahass also expects discussion around hepatitis C and continuing efforts towards its elimination.

New HIV Therapies and Prevention Strategies

HIV remains another important area of innovation. According to Nahass, recent research has included novel and extended therapies as well as preventive approaches designed to reduce HIV transmission.

He also pointed to early research into an HIV cure. Although cure research remains an area of investigation rather than an established clinical solution, Nahass sees the scientific direction as particularly interesting because of parallels with approaches being explored in hepatitis B.

The development of longer-acting therapies and prevention strategies has the potential to change how HIV is managed and how transmission is prevented. However, translating promising research into widespread clinical practice requires evidence from rigorous studies, appropriate regulatory assessment and effective access to care.

Antimicrobial Resistance and New Antibiotics Remain a Priority

Another major focus at IDWeek 2026 is expected to be antimicrobial resistance and the development of new antimicrobial agents.

Drug-resistant infections can limit the effectiveness of established treatments, making infections more difficult to manage. The problem can become particularly challenging when patients are older, medically vulnerable or receiving treatments that compromise immune function.

Developing new antimicrobial drugs is therefore an important part of the response. However, new medicines alone cannot solve antimicrobial resistance. Appropriate prescribing, infection prevention, surveillance and responsible use of existing antimicrobial agents are also important components of the broader response.

Are We Prepared for the Next Pandemic?

One of Nahass’s strongest concerns is Pandemic Preparedness. He expects IDWeek 2026 to include discussions about whether healthcare systems and governments have adequately prepared for another major infectious disease emergency.

The question is particularly relevant after the global experience of COVID-19. Pandemic preparedness involves much more than having medicines available. It includes surveillance systems, laboratory capacity, healthcare infrastructure, supply chains, research capabilities, trained personnel and effective public communication.

International coordination is equally important because an emerging pathogen can spread across borders before individual countries have fully understood the threat.

Nahass believes there is an opportunity to learn from previous experiences, including understanding what worked and where responses fell short. He wants the infectious disease community to examine those lessons and consider how they can be incorporated into future preparedness plans.

What Could Better Pandemic Preparedness Look Like?

Although the interview does not prescribe a single preparedness model, the issues raised point to several areas that require sustained attention.

• Stronger surveillance: Early identification of unusual infections can provide more time to investigate and respond.
• Laboratory capacity: Rapid and accurate testing is essential for identifying pathogens and tracking outbreaks.
• Antimicrobial readiness: New treatments and effective antimicrobial stewardship can help address resistant infections.
• Healthcare workforce capacity: Adequate numbers of infectious disease specialists and other healthcare professionals are essential during complex outbreaks.
• Clear communication: Public health messaging needs to be accurate, understandable and responsive to changing evidence.
• International collaboration: Infectious disease threats require cooperation across countries and health systems.
• Learning from previous outbreaks: Reviewing past responses can help identify gaps before the next emergency occurs.

The Future of Infectious Disease Medicine

The issues raised by Nahass illustrate how infectious disease medicine is changing. The specialty is dealing with organisms that can become resistant to treatment, patients with increasingly complex medical needs and emerging threats that can spread internationally.

At the same time, scientific advances are opening new possibilities. Research into hepatitis B cures, HIV therapies and prevention, new antimicrobial agents and other antiviral strategies could reshape aspects of infectious disease care.

But scientific progress must be matched by healthcare capacity. New therapies have limited impact if patients cannot access them, while even the most sophisticated surveillance system requires trained professionals to interpret the information and act on it.

Conclusion

Ronald Nahass’s reflections ahead of IDWeek 2026 highlight a central challenge for modern infectious disease medicine: the threats are becoming more complex while the demand for specialist expertise continues to grow.

Antimicrobial resistance, opportunistic infections, an ageing population and workforce limitations are putting pressure on healthcare systems. Meanwhile, global outbreaks and the rapid spread of information and misinformation demonstrate why infectious disease preparedness cannot be treated as a purely national issue.

Research into hepatitis B cures, HIV treatment and prevention, antimicrobial resistance and pandemic preparedness will be among the areas attracting attention at IDWeek 2026. For Nahass, the larger lesson is that preparing for future infectious disease threats requires sustained scientific investment, adequate clinical expertise, accurate communication and collaboration across borders.

Source: Interview with Ronald Nahass, Clinical Professor of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA, published in Microbiology & Infectious Diseases AMJ, 1 October 2026. DOI: 10.33590/microbiolinfectdisamj/5094U02A.

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