Betrayal of Trust: The Collapse of Global Public Health

Rating:
Summary: A very good but hastily published book
Review: I won't bother to repeat what other reviewers have made clear: this is a valuable and necessary book. What bothered me is the apparent haste and carelessness with which it was put into print. The book needs a thorough copyediting to clean up numerous misspellings and grammatical errors. It's a disservice to the author and the subject matter to have such a large number of obvious errors propagated into print. I hope this publishing house uses some of the profits from this book to hire a few good editors.

Rating:
Summary: Another compelling, worthwhile read
Review: I'll start with the bad - yes, there are areas of this book that I think an editor never saw. That said, I'm not sure it detracts so much from the quality - the point comes through, and to discuss the minutia of politicking and health plans would have drowned the reader in prose outside the point of the book.

Now - to the story. Like The Coming Plague, this book does a wonderful job of pointing out the science of disease, how diseases emerge and re-emerge, and why everyone needs to care, whether it's in your country or not. I think this gives detail unavailable due to the mass of diseases covered in her first book; as a result, this one can do a more thorough job in getting the reader to understand the universal repurcussions of the decisions made on all levels about health care. It will also make you start to care about those countries you usually ignore.

Again, I think everyone would benefit from reading this book. It reads like a set of thrilling short stories, with the most compelling hook of all - they're true.

Rating:
Summary: Another compelling, worthwhile read
Review: I'll start with the bad - yes, there are areas of this book that I think an editor never saw. That said, I'm not sure it detracts so much from the quality - the point comes through, and to discuss the minutia of politicking and health plans would have drowned the reader in prose outside the point of the book.

Now - to the story. Like The Coming Plague, this book does a wonderful job of pointing out the science of disease, how diseases emerge and re-emerge, and why everyone needs to care, whether it's in your country or not. I think this gives detail unavailable due to the mass of diseases covered in her first book; as a result, this one can do a more thorough job in getting the reader to understand the universal repurcussions of the decisions made on all levels about health care. It will also make you start to care about those countries you usually ignore.

Again, I think everyone would benefit from reading this book. It reads like a set of thrilling short stories, with the most compelling hook of all - they're true.

Rating:
Summary: The decline in public health
Review: In my view, public health is not in good shape. There are exceptions: CDC in the United States, the British Public Health Service and the Pan American Health Organization. However,on a global level there are many disaster areas and the World Health Organization is dysfunctional. The introduction of West Nile virus into the US is an example of why Americans should be concerned, but there are many other examples threatening the health of people throughout the world. Garrett does a great job of illustrating the deficiencies in global public health. The fact is, because of modern transportation, the desuetude of public health organizations, and the decline in quarantine measures, we are in more danger than before. I'm not sure every single fact in the book is correct, but I am sure her main thesis is correct.

Rating:
Summary: How nicely written but not entirely true.
Review: In the book "Betrayal of Trust: The Collapse of Global Public Health" the author managed to convey the past and the present public health problems in a very unique form that "attracts readers eye". Laurie Garret succeeded to highlight the issues of poverty, social disparities, political unrest and their relation to health in a number of countries. On the other hand, the content of information was biased due to its selective nature of presentation (at least in chapter on the Former Soviet Union). Nevertheless, overall the book is a standalone powerful tool that is targeted on a general public in order to raise its awareness of the problems of the global public health.

Rating:
Summary: The unequal burden of public health
Review: 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").

Rating:
Summary: A well-written book for amateurs
Review: It is a well-written book. It could be interesting for amateures and non-professionals. But I would not recommend the book for professionals working in the areas of infectious diseses and epidemiology. I do not belive it is going to help them understand the problem. It is a good book for frightening youself before going to bed.

Rating:
Summary: Controversial Critique of US Public Health Infrastructure
Review: It should come as no surprise that the most controversialchapter in Laurie Garrett's awesome book is her critique of theAmerican public health infrastructure. The chapter title itself,"Prefering Anarchy and Class Disparity", throws down thegauntlet. It is easier to understand, fear, and despair over theappalling conditions which Garrett reports on in India, the states ofthe former USSR, and the African continent, than it is to focusunblinking eyes on the chronic crisis in public health in the UnitedStates. After all, the situation here is something which we ascitizens of a democracy should, theoretically, be able to change. Wecan influence policy, priorities, and budget allocations. In writingthis chapter Garrett challenges us to motivate ourselves to analyze,organize and act, rather than merely to absorb her observations andtruth-telling.

Garrett brings her skills as a Pulitzer Prize winningreporter to the chapter on American public health in the same way thatshe brings them to the sections on Zaire and the Ukraine. Much of theAmerican chapter is based on her original reporting for Newsday, NPR,and others, on Tuberculosis, AIDS, and numerous other subjects. Thehistorical information and analysis are presented, not to compete inthe refined academic atmosphere of scholarly discourse, but rather togive the reader the background and context necessary to understand thestory of public health in this country. Using a journalistic approachto research, the original, contemporary sources were used wheneverpossible to provide a snapshot of the evolution of public health inAmerica. These include: government reports; state, county, and citystatistics; contemporary medical and scholarly journals; contemporarypopular periodicals and circulars; propaganda and political pamphlets;historic textbooks; and other sources. In addition, active workers inpublic health, policy makers, and scholars of public health wereconsulted and interviewed.

Yes, there are many footnotes. Theirpurpose is to disclose to the reader the process by which Ms. Garrettmade her conclusions, and invite the reader to follow the same, or adifferent path. They also serve to alert the reader to thelimitations,difficulties, and contradictions in the historic andmodern sources.

Some Amazon customer / reviewers have commented onorganizational problems and omissions in the American chapter. Theseare largely due to the fact that the chapter was drastically cut inthe final edit. Certainly many readers are grateful, since the bookis hefty as it is...Regarding specific points of regretableerror-in-fact (for example, the acutal dates of Hermann Biggs tenureat the NYC Board of Health pointed out by Anonymous Expert PAReviewer) such corrections are warmly welcomed. Please sendcorrections, with explanation and citations, to: [e-mail]

As to disputes of interpretation. Let's create a venue fordiscussion. This is a subject of social significance which shouldsurpass personal pride, etc. What can we do to make this a prominenttopic of public discussion?

NOTE: Responder, Adi Gevins, researcher,Betrayal of Trust

Rating:
Summary: Paperback Primer Invaluable to the Public
Review: It took me over a month to do justice to this book, and I have taken into account the thoughts of other reviewers. A book of this importance would indeed have benefited from an international advisory board of public health, medical, insurance, and policy experts; it would certainly have benefited from greater structure, firmer editing, and a foreword by someone like a former Surgeon General of the United States. As it is, it appears to have overcome these deficiencies with hyped-up marketing and sweetheart reviews, and this in some ways counterproductive because this book could have, should have, become a mainstream topic in the Presidential campaign. It failed to do so for several reasons, not least of which is the propensity of both candidates and their advisors to avoid serious thinking, but also because the book is not helpful to a popular understanding of the very real global and domestic threats to the health of our children today and in future generations. Having said all this, I commend the book for its content and do not recommend it as avocational reading. There are some very important points that the book brings out, and I will itemize these in order of importance: 1) Public health is about detection and prevention, medicine is about remediation. In the long run, investments in public health are vastly cheaper and more effective than after-the-fact medical intervention; 2) The insurance industry in the developing world has failed to support public health investments, and in a remarkable collusion with the pharmaceutical, hospital and managed health care industries, has created a very expensive and increasingly ineffective system focused on drugs (to which diseases are increasingly resistant) and hospitals; 3) Hospitals are no longer reliable in terms of protecting patients from both error and secondary infection from other patients. People are coming out of hospitals, in many cases, with more diseases than when they went in; 4) The health of our nation depends on the health of all other nations-not only does a collapse of public health in Africa lead to failed states and forced migrations, but it also is but an airline flight away from infecting Kansas; 5) Clean drinking water, uninfected food, and good environmental and occupational health conditions are at risk in many parts of the United States and Europe, not only in Russia and the rest of the world; 6) The United Nations, and the World Health Organization in particular, are in disarray and ineffective-in large part because of a lack of support from member nations-at dealing with the public health commons. There is no question but that the author has hit a "home run" in terms of describing the harsh reality of epidemics in India and Africa, the collapse of public health in Russia, the rapid migration of many diseases from Russia through Germany to the rest of Europe and the U.S., and the severe costs in the U.S. of a retreat from the collective good with respect to public health. Unfortunately, it is a home run hit in isolation, not a game-winning home run, because it fails to drive home, to the only audience that matters-the U.S. voter-exactly what political and economic initiatives are required to achieve three simple objectives: 1) re-establish the public health infrastructure in the U.S.; 2) redirect the entire health care industry toward preventive measures-including water and food quality controls-instead of remedial prescriptions; and 3) provide compelling incentives to the rest of the world for cleaning their own house (this presumes that we are able to clean our own first, a very questionable assumption at this point in time). This is a valuable book, a five in terms of intent, a three in terms of execution, and I am glad that I took the time to read it. It provides a wonderful foundation for enjoying, at an intellectual and policy level, the medical and public health novels by Robin Cook.

Rating:
Summary: Perfidy in High and Low Places
Review: Laurie Garret's writing is bigger than life but sometimes just as flawed. This dynamic superwoman occasionaly outruns her facts (penicillin is NOT a sulfa drug) but she has produced a classic that ranks with Zinsser, DeKruif and Sinclair Lewis in understanding the obligation that governments have to preserving the public's health. Unfortunately, when the US Constitution and Bill of Rights were written health was up to God so the right to health was never recognized. Consequently public health has been left to the police powers of the state, and of whatever state is involved. Garett chronicles the failure of politicians to respond to their responsibilities and the lip of the precipice where we all stand. It is a wonderful book and a synoptic view of the failure of public responsibility and governmental bundling that puts us all in jeapordy.