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Betrayal of Trust: The Collapse of Global Public Health
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Betrayal of Trust: The Collapse of Global Public Health

4.09  ·  Rating Details ·  1,006 Ratings  ·  50 Reviews
In this meticulously researched and ultimately explosive new book by the Pulitzer Prize-winning author of the New York Times bestseller The Coming Plague, Laurie Garrett takes readers across the globe to reveal how a series of potential and present public health catastrophes form a terrifying portrait of real global disaster in the making.
Paperback, 800 pages
Published August 15th 2001 by Hachette Books (first published 2000)
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Sep 25, 2007 Manderson rated it really liked it
Recommends it for: anyone interested in public health
Shelves: non-fiction
This is the book that shifted my political views from anarchy into the recognition that centralized forms of governance are essential for such services as public health. This book is somewhat of a frightening read in that it suddenly makes you realize that mankind is not only being threatened environmentally and by terrorism and warfare, but much more imminently through disease and the surge of new anti-biotic resistant microbes. An eye-opener, for sure, and definitely worth working through this ...more
Feb 17, 2012 Gwenyth rated it liked it
Shelves: global-health
I'm basically the perfect reader for this book, as I'm really interested in global health, and already felt going in that Garrett had performed an important public service in writing this book (as it helped to bring issues of public health into the foreground when it was published). I am also already truly alarmed by many of the issues that Garrett tackles.

But this book is long, rambling, and kind of painful to read. I get that the point is to make the reader understand that she's not talking ab
Sep 13, 2008 Rebecca rated it really liked it
I have a great deal of respect for Laurie Garrett's work. She is an incredibly talented journalist who has sounded the alarm on numerous public health crises. This book helped to raise awareness about a number of emerging public health issues and is generally very readable. That being said, it needed a good editor. The editing is, generally, incredibly sloppy. Quotes are repeated, large sections of paragraphs are repeated, and sections do not always flow. I was really psyched to read this book a ...more
Roswitha Muntiyarso
This book really give an understanding about real life case of epidemic diseases. Epidemic diseases usually happens in the third world countries or a country that has several problem politically and economically. I only read first two chapter of the book and several pages from the third chapter but it really gives me many sight about epidemic diseases.

In the first chapter about Yersinia pestis and how people in Surat, India try to manage about it. It was really surprising when the bulbonic plaqu
Jun 25, 2007 Crystal marked it as to-read
Borrowed a copy from the Upper Hudson Library System, but it had been read so much it fell apart. Later this year I'd like to borrow a copy or buy one.

I heard Laurie Garrett on the radio talking about how a simulation of a flu epidemic in NYC would overwhelm every bed in every hospital all the way upstate, necessitating treating people at home. She said it would be like a Hurricane Katrina hitting every major city at once.

At the time I heard her on the radio, I was a few days from delivering my
Kevin J. Rogers
Feb 04, 2008 Kevin J. Rogers rated it it was amazing
Recommends it for: Anyone concerned with the course of humanity.
A chilling account of the collapse of public health throughout the world, and the potential ramifications for the future of the human race. Garrett is a first-rate journalist, and this book reads like a detective story--fast-paced, dramatic, full of action and suspense--while at the same time sticking closely to the facts and conclusions rendered by the best professionals in the field. A moving book and a call to action; I've been a card-carrying member of Medecins sans Frontieres since the day ...more
Dec 15, 2007 Molly rated it really liked it
Recommends it for: public health nerds
A compelling and rather depressing series of articles on the state of global public health. Not a pretty picture. But Laurie Garrett is an insightful and engaging writer, so it's fascinating, if disheartening.
LInda L
Nov 07, 2016 LInda L rated it really liked it
This book will scare you to death -- it is SO frightening. Biowarfare, and so many others are coming and apparently no one cares enough to put money into Public Health. I did not read Garrett's previous book, The Coming Plague, but I'm sure it's as well-researched as this one. The editing could have been better, and it was so so long, but the subject is one of which we should all be aware. And now we have Zika!!
Feb 08, 2015 Elena rated it liked it
Shelves: meds
This is not a good divulgative work; it's too dense, it tells no narrative, it is in need of a good editing, the chronological approach is a bad idea, the subject matter is too wide for it, it forces her to jump themes. Who is it addressed to, anyway? Not the general public and certainly not the unamerican one, domestic issues are both too detailed and not explained enough. It quotes what should be referenced and references what ought to be quoted. It post-produces the data not at all. Divulgati ...more
Feb 07, 2009 Rosemary rated it it was amazing
This book was extremely difficult to read in that the crisis she describes seems almost hopeless. I had read her book, The Coming Plague and it was scary in point out our lack of preparation and the dwindling supply of money and support given by our then Republican government.

I am hopeful that now that we have chosen Barack Obama that the greatness of our country will rise and we, as a people, will decide to again subscribe to the notion that a nation is only as great as the way it treats its m
Dec 31, 2010 Ahmar rated it really liked it
I'll admit, didn't read this mammoth of a work from front-to-back. It makes up for being a bit sensational by being well-researched. The chapter "Preferring anarchy and class disparity" makes the book worthwhile. However, I think Garrett falls on the wrong side of the argument in the chapter "Biowar." The natural ecology of infectious diseases--take influenza, for example--warrant preparedness that can be backed by demonstrated, scientific evidence. Therefore, there is no need for scaremongering ...more
Feb 08, 2016 Doug rated it really liked it
Very disturbing book and frightening in some respects. The section on biowarfare could keep you a wake at nights. The extent to which politics and corporate greed determine the delivery of health care is infuriating. Doctors, hospitals, drug companies are out to drive up revenues and profit margins while insurance companies are out to maximize profits by keeping costs down, often by denying essential medical services. In the middle is the health care consumer, the patient, who is getting screwed ...more
May 30, 2010 Ashley rated it liked it
The book feels a bit dated. I wish they'd come out wig a second edition that revisits global public health in a post-9/11, post-2004 tsunami world.

The author clearly did her research, and as a catalogue of public health failings in the last 20-30 years it is useful. However, her suggested fixes at times felt shallow and I thought she didn't pay quite enough attention to the political and national-identity aspects of the issue.

That said, it is a solid introduction to the various kinds of problem
Tish Newmyer
Mar 08, 2009 Tish Newmyer rated it it was amazing
It is a wake up call to read this book. When you look at the global picture of health-- really the leading indicator of successful societies-- there are many interconnected themes. And America is not a leader anymore in global health let alone national health. As Ms. Garrett had outline in The Coming Plague, don't think that you can hide away and avoid what is happening around the globe. Any disease is a plane ride away. And, with all the changes to ecosystems, poor public health management, pas ...more
Robin Winter
Nov 10, 2013 Robin Winter rated it really liked it
A fascinating read but frustrating. There's too much incitement here without rigorous comparison of data. I hate reading a book like this when the author compares data without translating it into the same base. Thus, giving percents to compare against absolute numbers stalls me out, kicks me right out of the text while I do the math to see if what she asserts tallies. Yet I give four stars because the information is vital, the issues overdue for discussion and attention. Her previous book, The C ...more
Paula K Breeze
Apr 03, 2007 Paula K Breeze rated it it was amazing
Garrett discusses how non-potable water, environmental pollutants, preventable infections and diseases, and other ills of mankind which effective public health practices can prevent are factors in economic collapse. Sounds very dull. It ain't. It's frustrating, heartbreaking to the point of madness. Clean air, clean water and enough food, facilities for personal hygiene and treatment of disease--this is not complicated stuff to provide. Yet thousands of people die every day from lack of these s ...more
Sep 24, 2007 Jessica rated it liked it
I read this book while in grad school, partially for a project on the public health system in post-communism Russia. It is fascinating, and extremely well written. My only complaint is that I found some inaccuracies (or at least statements which differed from other sources I read) in the section about the former USSR. That being said, this is still a very worthwhile and eye-opening read for those interested in International Health Matters. I hope Ms. Garrett writes more on this topic, because th ...more
Luc Blazejewski
Jan 05, 2014 Luc Blazejewski rated it really liked it
Without a doubt this is the most comprehensive account of history and current status of public health around the world. The author's thorough research is truly remarkable, making her points extremely clear. I feel anyone who has the slightest interest in health care or health care policy should read this book. My one critique was the amount of information delivered was overwhelming. I read this book slowly over 2 years in 20-30 page increments because my brain struggled to process all the inform ...more
Sep 26, 2007 Sara rated it really liked it
This took me a loooong time to read because it's very information dense and it's quite long. While it's not as fantastic as _The Coming Plague_, it's informative and offers a look at the importance of public health infrastructure - and what happens when the infrastructure isn't adequate. In particular I thought the look at what happened in the former Soviet states after the collapse of the USSR was fascinating.
Kim Moyer
While I found the content of this book to be interesting, I also found the book to be very repetitive and felt it was much longer than it really needed to be. Sometimes it even felt like Garrett was rambling and it took forever for her to get to her point.

That said, it is somewhat frightening to think about how truly unprepared we are to handle a true epidemic (either naturally occurring or via biological weapons). The book is very well researched too.
Feb 07, 2010 Russ rated it really liked it
Interesting read on how public health care concerns us all, and what the government's responsibility should be and why. It changed my views on the whole subject of Universal Public health care, I now understand some important reasons it needs to be seriously considered. Well written, though she takes a lot of small text on big pages to relay her message. Good read, just don't expect to finish it in one go
Jun 18, 2008 Rachel rated it liked it
This is a great read for those interested in public health, international health, and biosecurity. Although painfully long - and long winded at times - the series of articles ranging from the plague in India to ebola in the Congo and from TB in Russia to health security in the USA are very interesting and thought provoking.
E Sweetman
Nov 16, 2009 E Sweetman rated it it was amazing
Recommends it for: those who are interested in global health and microbiologists
Shelves: influential
I read this book while I was waiting for "The Coming Plague" to be returned to the library and it was worth it. Her research is in-depth and informative. This, in retrospect, was more informative and interesting than the book I was looking for. This is why I love libraries, I would have simply bought my intended book and not found this.
Apr 20, 2012 Natalie rated it it was amazing
Best book ever. Dense, very dense. It took me lots of months to soak it in bit by bit. I bet I could read it again and still be just as engrossed. It reads like a thriller, but it's history, science, health care, and world politics all in one --and relevant today, even though it's an old book! I wish more people would read it.
May 10, 2009 Mark rated it really liked it
Although 50% longer than it needed to be, this book is a fascinating and chilling overview of the increasing public health risks facing the world -- many of which are side effects of current medical practices.
Mar 08, 2009 Max rated it really liked it
Well-written, good overview of some of the world's recent public health crises. Good reporting, but doesn't really propose solutions other than saying that we need to spend more money on global public health.
Jan 10, 2010 Stacy rated it liked it
Exhaustive report on the threats to our collective well-being, by the journalist who also wrote The Coming Plague. Not as good as The Coming Plague, but still worth the time, particularly if interested in international public health.
Oct 02, 2007 Bridget rated it really liked it
Recommends it for: everyone
Shelves: socialscience
This book is huge, but well written and researched. It talks about how challenges facing our public health systems have changed, highlighting recent threats. Scary stuff. If you read it, set aside some time, it's long and very detailed.
Aug 11, 2014 Will rated it really liked it
Well-researched with a strong narrative structure. The scope is somewhat limited to five subjects, each given it's own lengthy chapter.
Karen Skoog
Jan 11, 2016 Karen Skoog rated it it was amazing
Very interesting but dubious fact-checking. A good starting point for learning the history of various epidemics.
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“In all, 86 per cent of the increased life expectancy was due to decreases in infectious diseases. And the bulk of the decline in infectious disease deaths occurred prior to the age of antibiotics. Less than 4 per cent of the total improvement in life expectancy since 1700s can be credited to twentieth-century advances in medical care.” 5 likes
“Ebola haunted Zaire because of corruption and political repression. The virus had no secret powers, nor was it unusually contagious. For centuries Ebola had lurked in the jungles of central Africa. Its emergence into human populations required the special assistance of humanity's greatest vices : greed, corruption, arrogance, tyranny, and callousness.” 5 likes
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