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

4.13 of 5 stars 4.13  ·  rating details  ·  625 ratings  ·  44 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, 768 pages
Published August 15th 2001 by Hyperion (first published 2000)
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Sep 25, 2007 Manderson rated it 4 of 5 stars
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
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...more
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
Kevin J. Rogers
Feb 04, 2008 Kevin J. Rogers rated it 5 of 5 stars
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 4 of 5 stars
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.
I'm basically the perfect reader for this book - I am really interested in global health, and already felt going in that Garrett had probably performed an important public service in writing this, as it helped to bring issues of public health into the foreground when it was published. I am also already really alarmed by most of the the things that Garrett points out in the book are alarming.

But this book is long, rambling, and kind of painful to read. I get that the point is to make the reader u...more
This book was horrifying to me precisely because I had been to several of the locations depicted in the book, albeit at an earlier time than the author or her researchers were there. However, this provides independent confirmation for me that she's accurate, because it was bad enough when I was there. This was vividly demonstrated by her examination of the Russian health system, which I experienced myself in various parts of the former Soviet Union from 1995 to about 2000. I SAW and walked thro...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...more
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
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
Well-researched with a strong narrative structure. The scope is somewhat limited to five subjects, each given it's own lengthy chapter.
Robin Winter
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
Tish Newmyer
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
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...more
Luc Blazejewski
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
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
Paula K Breeze
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
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.
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
Sweetman Sweetman
Nov 16, 2009 Sweetman Sweetman rated it 5 of 5 stars
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.
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.
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.
Oct 06, 2007 Bridget rated it 4 of 5 stars
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.
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.
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.
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.
This was one of the first books I read about public health. I was totally hooked. A real page turner. The chapter about tracing ebola back to patient one was fascinating.
Kate Jongbloed
Laurie Garrett is amazing. If you have even a remote interest in health issues, read this and The Coming Plague. She puts things in great context, with a lot of detail.
Rich Greene
Fast paced and scary... a little dated, but I don't think much has changed in the public health sector. Sure makes you think twice about world and national priorities
One of my favourite subjects, and everyone should read, but long and meandering. One reviewer on this site: "for public health nerds." Guess that's me.
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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.” 6 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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