Rating: 
Summary: Absolutely recommended reading
Review: This was an absolutely outstanding book. The chapter on the US should be required reading for anyone who lives and/or votes in this country!I learned more about public health-what it is, what it does and its importance-from reading this book than I did while obtaining my Master's Degree in Health Systems Administration. This book was worth every minute that I spent reading it.
Rating:
Summary: Fantastic
Review: This woman's intellect is unparallel. The writing style and discourse of information is well integrated, easy to read, and very informative. She turns what may be a difficult topic to read about into a narative that is intellectually stimulating, and appreciative. Get her other book, The Coming Plague, which one a Pulitzer in 1996. It is, as well, a feat to enjoy and appreciate. AMAZING!! My only regret is that I should have read about this topic years ago. Laurie Garrett is one person I would love to meet and have lunch with. AMAZING!!!
Rating: 
Summary: Globalization and the threat to global public health systems
Review: When THE COMING PLAGUE was a bestseller in 1995, readers convinced of the terrible crisis of newly emerging diseases, wanted more - especially solutions. The problem was that I could only reflect what scientists in the field were saying at the time: it was vague, even a bit desperate. That propelled me on a quest. I had to know why genuine solutions weren't at hand, and where they might be found. The result is BETRAYAL OF TRUST: THE COLLPASE OF GLOBAL PUBLIC HEALTH, due to be published this August by Hyperion. I hope that you will not only read this book, but spread the word. The issues are, quite literally, matters of life and death to us all. BETRAYAL OF TRUST is about globalization, not of the Web or of rock and roll, but of microbes and disease risks. The telltale stories are already there. A wedding banquet in wealthy Westchester County, New York sickens all in attendance, thanks to cyclospora parasites on the raspberries served atop the wedding cake: raspberries grown in Guatamala. Schools all over Japan are shut down because something the children are eating gives them deadly E. Coli infections: that "something" turns out to be daikon sprouts (a staple of the Japanese diet) grown in Idaho downstream from contaminated cattle. The entire world becoems hysterical over an Ebola virus outbreak in Zaire: an outbreak fueled by clinics so starved for medical supplies that doctors and nurses spread the disease to their patients because they lack protective gloves or sterile equipment. HIV and hepatitis viruses become epidemic throughout Siberia because alienated post-Communist youngsters drown their sorrows in opiate fogs, administered via contaminated syringes filled with virally infected heroin. Wherever the millions of people who cross an international border daily go, their microbial hitchhikers follow. Similarly, the globalized food production system means worldwide risks of bacterial and parasitic diseases. Global misuse of antibiotics signals emergence of completely drug-resistant, untreatable forms of tuberculosis, strep pneumonia, malaria and dozens of other diseases. A global marketplace for the 21st Century may look like Minneapolis' Mall of America; or, horribly, it may more closely resemble the outdoor produce marts of central Africa. My search led me to India in late 1994, during that country's pneumonic plague epidemic. And to Zaire in 1995, during the Ebola virus outbreak in Kikwit. In 1997 I spent several months traveling across the former Soviet Union nations, witnessing the complete collapse of their health systems, and the resulant epidemics and abysmal declines in life expectancies. Throughout 1998 and 1999 I dug through the history of public health in the United States, trying to understand what went wrong: why did the greatest public health system in the entire world lose its way? And I traveled all over Europe and the U.S. looking for ways to bridge the widening gap between what sorts of drugs and vaccines the world actually -- desperately -- needs, versus what is in the research and development pipeline at the largest pharmaceutical companies. The future is now, and it demands globalized public health that can match the new globalized threats. But the trend is in the opposite direction, as governments trim public health spending, medical care consumes precious remaining health dollars and profit drives all pharmaceutical innovations. Today the issue of emerging diseases has been elevated to official U.S. government status as a threat to National Security, and is receiving attention at the highest levels of the governments of the U.S., Canada, the European Community and within the United Nations system. That's all well and good, but it's hardly enough. No protective plans can be executed in the absence of a strong public health system in the United States and throughout the world. And, sadly, such a system no longer exists. BETRAYAL OF TRUST has consumed five years of my life, and exhausted me. If you read the book, however, all the pain and agony will have been well spent. Thanks for reading this, Laurie Garrett
Rating:
Summary: Extremely Worthwhile Reading as is The Coming Plague
Review: 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.
Rating:
Summary: Informative, an excellent read
Review: `Betrayal of Trust' is an interesting follow-up to Laurie Garrett's first book, `The Coming Plague.' This book brings a journalist's skills to what could otherwise be a somewhat boring topic. It consists of six chapters, each an in-depth examination of a different public health concern. The first chapter investigates the pneumonic plague panic of 1994 in India. The second scrutinizes the Congolese Ebola epidemic of 1995. The third chapter documents the collapse of Soviet/Russian public health, with particular attention to drug-resistant tuberculosis. The fourth (and most controversial) describes the decline of public health efforts in the US under its `managed care' and `medicine for profit' health system. The fifth chapter, titled `Biowar', is the most chilling (especially in light of recent events). And the last, and shortest, chapter is Garrett's epilogue. --- I found it unnerving to re-read the chapter about biological warfare. When I first read it many months ago it was documenting things almost no one (including me!) knew about. Today -- post Anthrax Scare -- most of the chapter is a summary of what `we' (the public) have learned from the experts just in the past few weeks... What makes this book worth reading is that `we' are still in our pre 9-11 stage of knowledge regarding the threats mapped out in her other chapters: drug resistance, virulent TB, tropical disease epidemics, the ever-widening impact of AIDS, the role of organized crime and corruption in the spread of lethal diseases, etc. Though these topics are not pleasant, they will be thrust onto public consciousness in the coming decades. Not without reason, Garrett's book has been compared to `Silent Spring'. Incidentally, be sure to read the hundreds and hundreds of footnotes; they are not as much about documenting sources (though they often do so), as they are about expanding on the text. One thing I will assure you: You can disregard the cover blurb from the Washington Post stating that this book `reads like a Robert Ludlum thriller'; `Betrayal of Trust' is much too full of facts, names, places, and detailed history to be a Ludlum novel - moreover, it is NOT fiction.
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