Betrayal of Trust
The Collapse of Global Public Health

Publisher:  Hyperion, New York, USA
Year Published:  2000  
Pages:  754pp   Price:  $42.95   ISBN:  0-7868-6522-9
Library of Congress Number:  RA441.G37 2000   Dewey:  362.1--dc21
Laurie Garrett narrates the story of recent failings of public health systems across the globe. This book is a warning that humanity must begin, once again, to take seriously the idea that the health of each individual depends upon the health of the community. If community health is not prioritized, Garrett advises, the bulk of the human race may suffer grave consequences.

Betrayal of Trust offers detailed case studies of the mid-90s outbreaks of pneumonic plague in India and Ebola in Zaire, the disintegration of public health in former Soviet nations, the growing crisis in American managed health care, and the threat of biological warfare. Garrett takes the reader deeper and deeper into the heart of the crisis as she tells of the failures of public officials, from the local government level to international leadership. She writes that, "a sound public health system, it seems, is vital to societal stability and, conversely, may topple in the face of political or social instability or whim", emphasizing the interconnected nature of political, economic, cultural, and health realities.

The mutual dependence of many aspects of human life (along with the complex health challenges that result) is the principal theme of the book. Increased trade, the movement of peoples, and the pressure of 24-hour media coverage have contributed to the globalization of health - for good or for ill. An outbreak in an African village can kindle the fears of the world and lead to economic or social quarantine of an entire nation. The use of biological weapons threatens every corner of the globe. Garrett's book indirectly proposes solutions, such as ensuring global access to low-tech basic necessities (clean water, safe food, sanitation), but chiefly reveals the inadequate efforts of the late twentieth-century.

[Abstract by Tara McElroy]


Table of Contents:

Acknowledgments
Preface - By Dr. Steven Wolinsky, Northwestern University School of Medicine
Introduction

ONE
Filth and decay
Pneumonic plague hits India and the World ill responds

TWO
Landa-Landa
An Ebola virus epidemic in Zaire proves public health is imperiled by corruption

THREE
Bourgeois Physiology
The collapse of all semblances of public health in the former Soviet Socialist Republics

Four
Preferring anarchy and class disparity
The American public health infrastructure in an age of antigovernmentalism

FIVE
Biowar
Threatening biological terrorism and public health

SIX
Epilogue
The changing face of public health and future global prophylaxis

NOTES
INDEX

Subject Headings

• Addiction
• African Health
• AIDS (Acquired Immune Deficiency Syndrome)
• AIDS/Developing Countries
• Alcohol Use/Abuse
• Biological & Chemical Warfare
• Biological Weapons
• Censorship
• Disease Control
• Disease Prevention
• Disease Surveillance
• Drug Abuse/Addiction
• Gabon
• Immunization
• India
• Infection Control
• Infectious Diseases
• Ivory Coast
• Life Expectancy
• Preventive Health Care
• Preventive Health Care/Developing Countries
• Public Education
• Public Health
• Russia
• Soviet Union
• Tuberculosis
• Vaccines
• World Health Organization
• Zaire