Betrayal of Trust: The Collapse of Global Public Health

by Laurie Garrett

Book Overview

In this "meticulously researched" account (New York Times Book Review), a Pulitzer Prize-winning author examines the dangers of a failing public health system unequipped to handle large-scale global... This description may be from another edition of this product.

• Format: Paperback
• Language: English
• ISBN: 0786884401
• Release Date: August 2001
• Publisher: Hachette Books
• Length: 768 Pages
• Weight: 2.20 lbs.
• Dimensions: 9.1" x 1.4" x 6.1"

Customer Reviews

Not a quick read, but thought provoking

I love Laurie Garrett's work and have read both this book and _The Coming Plague_. And I am ready for her next treatise whenever she may print it. What reviewers say about the lengthiness and sometimes meandering style is true. When I read her first book, I was reminded of a joke I heard when attending an exhaustive, three day long training about HIV/AIDS counseling and testing. One of the presenters quipped that you might feel like you were dying of AIDS even though you never had it. Reading this book, you can feel wearied and overcome by the problems. But, if you go with her style, where she interweaves facts with stories of real pepole impacted by the very trends she cites, you get a greater sense of the dimensions of the problems and the reality of the issues. As we watch our president dismantle so many care systems, I think the chapters on what happened to Russia when they did the same have extreme relevance. The publish date of this fine book means that some of its data is aging but the representation of the problems and trend remain timely. Read it.

Prophetic Warning About Current State Of Public Health!

This is a truly prophetic warning from the acclaimed author of "The Coming Plague", which itself was an eloquent best-seller warning of the approaching debacle of increasing microbial threat based on human arrogance, rapid increases in virulence, multiple drug resistance (MDR), and the appearance of entirely new viral entities, comes this articulate, literate, and extremely well researched investigation into the woeful state of the world's public health organizations. Earlier she had warned of the disrepair and dangerous lack of preparedness of public health agencies, and here she writes with cutting clarity as to just how irretrievably damaged they now are. Many international authorities are now openly worried because these national and international public health organizations constitute the only potentially effective line of defense for quick public health countermeasures to intervene and combat both the initial appearance of microbial threats (through inoculation, maintenance of public sanitation systems, and rapid response to perceived threats) as well as continuing support for stemming the effects of such outbreaks once they occur. Without such agencies the public is left literally to the mercies of fate. This new work is an informative and fascinating decent into a terrifying world in crisis, and Ms. Garret quickly exposes the dark side of the highly vaunted globalization process. For even while Asian economies prosper under the new prosperity, dangerous new breakout of old microbial enemies such as pneumonic plague threaten the population with devastating new pandemics. Meanwhile, multiple drug resistant (MDR) forms of Tuberculosis have appeared in epidemic proportions in Russia, combining with the ravaging effects of drug addiction, alcoholism, and malnutrition (as well as the regional exposure to radiation poisoning connected to Chernobyl in the Ukraine) to exact a treble toll on life expectancy and quality of life in the struggling provinces. And this is just the most obvious tip of the iceberg.Domestically we face new emerging threats from MDR Tuberculosis, West Nile virus, and other new "superstrains" of microbial entities we were arrogant enough to believe we had permanently vanquished. This phenomenon, when combined with the rapid and increasingly popular modes of international travel now threaten us with a Pandora's box of so-called "Third world diseases" for which we have little of no natural immunity. As Garret reveals the results of her detailed investigation into the nature of the threat, the reader must take pause. We have, she suggests quite eloquently, suffered from a betrayal of trust from both our national leaders and the various local, state, and national public health agencies, which have deteriorated to such an alarming degree that they are now virtually unable to stem the tide now confronting us. This is serious albeit absorbing reading, and is not recommended for squeamish or immature readers. It is a quite accurate

Extremely Worthwhile Reading as is The Coming Plague

Yes, Laurie Garrett's books are lengthy, but what's does that have to do with the enormously valuable information she imparts to her readers. READ her books over time if you would rather. READ her books while you read another novel but READ them. I did enjoy The Coming Plague more but that was strictly due to my personal interest in that narrow topic. Betrayal of Trust covers Public Health and Medicine and its failings, setbacks, and the immediate future of our health. Betrayal of Trust is the result of her investigation of Public Health worldwide. Ms. Garrett utilizes fascinating examples and historical data to demonstrate among other things that we have a limited community of researchers, doctors, and other health related professionals around the world that try to contain and remedy extremely serious threats and potential threats to our health and well-being. Ms. Garrett sounds a major wake up call that the risk of a major epidemic or health crisis could strike at anytime and that we are absolutely not prepared to tackle the problem (for the many reasons she details throughout the book). We, Americans, go through our days feeling secure that the system is working when that is not reality. To merely say that the unavailability of financial support and treatment resources here and all over the world for containment and prevention of disease is an understatement of vast proportion. The spread of disease is a major problem that accompanies growing mobility of people and the unique illnesses they carry with them to other parts of the world. I wholeheartedly recommend Ms. Garrett's books now and anxiously await her next publication - regardless of the topic.

A "Must Read" book if you are interested in Public Health

Laurie Garrett does not write short books. But it's worth the effort ploughing through Betrayal of Trust if you care about Public Health and what its decline could mean for our children and grandchildren if due care and attention is not given to this important part of contemporary life. The frightening problems caused by the collapse of the Public Health system in Russia are a potential lesson to us all who live in the USA; Garrett chillingly portrays the grim situation now faced by the Russian people. If such problems can happen in a relatively sophisticated country, then we need to think of the problems of less well developed countries. And again Garrett brings the message home with her writing. Nowadays, infectious diseases know no borders, and their spread can occur with frightening rapidity. Garrett documents this with her own observations of Plague in India and Ebola in Zaire. Add in a chapter on bioterrorism and it becomes clear that this is a book that can have a real impact on one's thinking. Sure, there are probably some factual errors here and there, which is probably not surprising in a book of this length. But look at the big picture - which is what this book is very much about.

The unequal burden of public health

In this masterful work of reportage, Newsday Science correspondent Laurie Garrett accounts for the present disarray of public health and makes a convincing case for the interdependancy among the disease prevention and control infrastructures of both rich and poor nations. Using examples from the commomplace (HIV/AIDS, water borne bacterial infections) to the extreme (biological terrorism) Garrett copiously documents the centuary-long decline of public health systems, in the U.S. and among other countries (with special attention to Russia and the CIS). A worthy sequal to her previous work on emerging disease ecology ("The Comming Plague").