Betrayal of Trust: The Collapse of Global Public Health by Laurie Garrett

Betrayal of Trust: The Collapse of Global Public Health Reviews

• 
  Gwenyth

  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 about one disaster, but rather a global failure of which each disaster is mounting evidence. Even so I wonder if it would have been better split into a few better edited volumes: one about the American health care system, one about the crumbling public health structure in the USSR, and maybe a third focusing on developing world outbreaks including the Ebola and plague incidents she begins with. This would also have given her more room to get into some of the nuances of each case.
  
  By taking on so much, Garrett ends up giving short shrift to all: at a certain point it just read like a never-ending string of variations on the sentence, "frazzled/harried/depressed leading expert says situation is tragic/deeply frightening/far worse than people realize/about to get even more terrible etc". The various experts and patients are introduced and dropped again so rapidly that I eventually gave up on trying to feel a human connection to them, which perhaps also made her writing hard to engage with.
  
  Even though I agree with about 98% of what she's written and believe the subject matter is important, I couldn't get excited about this book.
• 
  Kevin J. Rogers

  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 I finished reading it.
• 
  SamuraiKitty

  I purchased this book years ago, but didn't read it until now. When Garrett's book "The Coming Plague" was first published in the early 1990's, I checked it out of the library, and I was fascinated by her re-telling of how the CDC "cowboy" scientists of the 1950's, 1960's and on up decades were sent all over the world to determine what was causing outbreaks of epidemics that had no names but were killing hundreds if not thousands of people: The what, the why, the how. I don't read a lot of non-fiction, and even less scientific based non-fiction, but "The Coming Plague" just fascinated me. One of the things that really stuck in my mind was her statement (paraphrasing) that we are not Island Nations any longer - that travel not only works for people but for viruses, and bacteria, insects, etc. That something that affects one continent/area of the world could easily travel to another area of the world. I bought "Betrayal of Trust" years ago, but I just never got around to reading it. Other things to read.... so fast forward to COVID19/March 16th when I am working remotely from home, and yes, this book on it's dusty shelf .... it just seemed appropriate to start reading it now. In this book, Garrett goes beyond the actual outbreaks of epidemics and talks about how the public health care systems respond to them. And how the lack of funds, and lack of supplies, the corruption of governments/ignorance of governments tie into how a community and or country respond when an epidemic rears its ugly head. All the issues that have been currently happening in regards to lack of supplies, medicines, hospital preparedness (ie - ICU beds to handle a situation) have been issues that have come up before. But governments didn't listen to the warnings of scientists, and spent money elsewhere, because countries that could and should have spent money on public health care ignored the warnings, corrupt countries have never spent on their people, and the rest of the countries just didn't have the funds to put towards public health. The book does not read as well as "The Coming Plague", in my opinion. Other reviewers have stated that the editing of the book is to blame for this and I agree. However, I still think it is an important book, as is "The Coming Plague" and I highly recommend it.
• 
  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 plaque or the black death really re-occurred in India and become epidemic. All people start to be crazy about the pest and try to kill all the pest without eventually know about what exactly the main cause of the epidemic, the bacteria who reside inside the gut of the rat flea and obviously not only the rat itself.
  
  In the second chapter, the books describes even more tragic epidemic in Zaire. The Ebola virus or what local people called as 'landa-landa'. The actual main causes about the epidemic is not because of the highly contagiousness of the virus but mostly due to lack of medical facility in the entire community. If we trace back it really due to bad government and corruption everywhere that let the money for medical facility gone to the white-collar pocket. The second chapter also describes how actually WHO deals with the new emerge disease. It needed coordination with different country which has high-technology facility (Laboratory with BSL4) so that the research about the main cause of the disease still can be held without harming the nearby community and also the researcher itself.
  
  This book is highly recommended for people who wants to know about epidemiology of disease and how to control it. It gives you a broad idea that epidemiology is not only try to solve the problem by curing the disease but more importantly is to halt the spread of the disease and how to build herd immunity in the community.
• 
  K.B. Pellegrino

  Visionary and important to read today.
• 
  Casey

  After reading Garrett's "The Coming Plague" (one of my favorite books), this one was a long slog through a thick tome. But worth it. Conclusion? We're toast!
• 
  Rosemary

  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 most vulnerable citizens, not its CEOs. That's a paraphrase and I don't quite remember who said it, but I believe in it.
  
  Back to the book, it is very factual and I hope many people read it and and that we do not fail the test of will. We must support health of all people everywhere for moral reasons and to protect us as well.
• 
  E Sweetman

  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.
• 
  Natalie

  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.
• 
  Molly

  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.
• 
  enna

  This book will change your life.
• 
  Shelley

  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.
• 
  Maureen Flatley

  Though this book is almost ten years old it remains a compelling story of how public health is compromised and why we should care.
• 
  Kate

  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.
• 
  Jessica

  Pretty much never going to a hospital again.
  
  Terrifyingly good.
• 
  Mauri

  A rough read between what is a hell of a lot of summarizing of upsetting information, parsing out what has improved/worsened since this was published 20 years ago, skimming whole sections covered in books I've already read, and Garrett's blind spot with regards to race. The Indian Reorganization Act (you might know it as the Wheeler-Howard Act or the Indian New Deal)? Not actually a great thing for Native American Indian health. The fact that some of the doctors and nurses who worked on the Tuskegee Study were African American? Pretty damn irrelevant and does not magically make the Tuskegee Study not a racist massacre. Garrett mentions racially driven gaps in health indicators often enough, but the moments she actually digs beyond the numbers are...uh, telling.
• 
  Yao

  It is a very good book to read in the context of the spread of COVID-19. The stories from each country are representative, delivered clear conclusions on the issues of public health. Something in this book also happened recently on COVID-19, such as suspecting US army spread the virus and the decayed public health infrastructure. It gives a fresh new view on public health, which was equivalent to medical in my old knowledge.