Betrayal Of Trust: The Collapse Of Global Public Health, By Laurie Garrett-Pulitzer Prize Winning, and New York Times Bestselling author of The Coming Plague.
Laurie Garrett takes on perhaps the most crucial global issue of our time in this eye-opening book. Garrett asks: is our collective health in a state of decline? If so, how dire is this crisis and has the public health system itself contributed to it? Using riveting detail and finely-honed storytelling, exploring outbreaks around the world, Garrett exposes the underbelly of the world’s globalization to find out if it can still be assumed that government can and will protect the people’s health, or if that trust has been irrevocably broken.
Importance Of Public Health-Worldwide
The importance of public health elsewhere in the world to our own society may not be at first obvious. Our grandparents grew up in an era when infectious diseases were a frightening reality; when to survive infancy was an accomplishment;when giving birth in and of itself was an invitation to death. At times, it seems we have forgotten all this. We now live in a comfortable ignorance about the health and well-being of people in faraway places. But in truth we are never very far away from the experiences of our forebears.
Relying On Effective Medical Science
We rely today on the effectiveness of medical science and our public health system to protect us. And yet, current medical science and public health practices, really because of their successes, have led to complacency and bureaucratic indifference and have helped to create the real biological peril in which we find ourselves.
We live in a world in which new human pathogens emerge and old infectious diseases once thought conquered can resurface with a vengeance. It is bravado to believe that we care now immune to these killers.
Advances In Public Health And Clinical Medicine
Advances in public health and clinical medicine have reduced infant mortality and raised average life expectancy dramatically-at least for the people of the affluent nations of the world-but history also provides examples of public health measures that had an unforeseen catastrophic impact.
In 1924, Albert Calmette and Camille Guerin developed a vaccine for tuberculosis that was widely distributed in developing countries. However, the vaccine was also associated with the death of seventy-seven infants in Lubeck, Germany, and vaccine recipients could no longer rely on the diagnostic tuberculin skin test for a diagnosis of tuberculosis infection.
By lowering childhood exposure to what had been background microbes, water filtration system and improvements in environmental sanitation actually left some people more vulnerable. The emergence of polio as an infectious epidemic disease occured because children did not acquire immunity early in life.
The resurgence and spread of drug-resistant strains of disease-causing microbes represents yet another ongoing threat to our health and well-being. Microbes have the extraordinary capacity for generating genetic variation and growing to immense population sizes at incredible rates; for microbes, minutes are tantamount to years.
Natural selections sorts out the best-adapted microbes, fueling an engine for rapid evolutionary change and improvement. Adaption to a new environment is a potential outcome of this process, and the reason why some disease-causing microbes have developed antibiotic resistance so rapidly.
Even now, continuously evolving microbes find their way comfortably into new hosts, and emerge triumphant after selective pressure is applied through drug therapies or vaccine-induced immunity, especially if these medical interventions are only partially effective.
The resurgence and spread of drug-resistant strains of disease-causing microbes one under control and now no longer curable demonstrates the power and productivity of microbial life. It also demonstrates the difficulty in deriving a durable defense against the microbial challenge.
Continuing Global Partnership
The future of public health is to continue to make a difference in conditions in the broader international community. The challenge is to adopt our public health strategy to control environments and modify behaviors in a constantly changing world.
Even with the experts of modern medicine people in the industrialized world may be surprised to find that they are woefully unprepared for the far-reaching challenges of an impending large-scale public health catastrophe.
We need to develop new and continuing global partnership with an ambitious, comprehensive agenda to readdress public health policies for the intervention and prevention of epidemic infectious disease. National healthcare policies should not languish and ultimately fail because politicians do not understand the difference between public health and curative medicine.
What is broken is fixable if the political will is there.
Laurie Garrett has written a provocative book on the global challenge for public health. In a world in which disparities in the health and well-being of population in industrialized and developing countries are widening and the benefits of public health and disease prevention on life expectancy are not shared, the potential for a global health catastrophe looms large.
The author takes us to the impoverished regions of the Indian subcontinent, where pneumonic plague ravages health and refuses to go away, despite readily available preventive measures and affordable curative medicines.
In Zaure, outbreaks of Ebola hemographic fever erupt upon disruption of local ecosystems. Curative medicine itself becomes a harbinger of public health calamity as outbreaks of Ebola hemographic fever cluster in the health care setting.
In the newly independent states of the former Soviet Union, economic and political instability, further deterioration of an already poor diet, increasing alcohol consumption, and the descent of a struggle medical system into chaos contribute to the resurgence of tuberculosis and a precipitous fall in life expectancy.
The poor and vulnerable become oppressed by the ruthless and powerful as the organization of the Russian State disintegrates into a Destoyevskian nightmare.
In America, the public health system struggle to cope with threats to the health and well-being of the population because of inadequate regulatory staff to properly inspect and protect food and drinking water. Garrett’s vision of this break-down is indelible.
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All The Best,