Laurie Garrett's The Coming Plague

This paper is an overview of Laurie Garrett's The Coming Plague: Newly Emerging Diseases in a World Out of Balance, a study of the recent emergence of viruses, bacteria, and diseases and the responses they invoked in the international health community. Her account details the detective work required in recognizing and dealing with life-threatening diseases. She also shows clearly the effects of international politics, economics, psychology, and other factors significant to attempts to understand and contain health crises. Repeatedly, her stories chronicle scientific ignorance and scientific arrogance, as modern medicine's confidence in its ability to eventually conquer disease begins to falter in the face of poverty, insufficient resources, and the remarkable ability of microbes to adapt to new obstacles. She demonstrates the complexity of international health issues and outlines some of the issues world health groups must address in order to deal more effectively with new diseases.

By the 1950s and 1960s, doctors dealing with international medicine had begun to believe that the days of worldwide health crises were numbered. Between the discovery and implementation of antibiotics and the international increase in awareness of the importance of sanitary procedures, modern medicine appeared to be winning the battle against most of the major scourges that had once threatened populations. Malaria, typhoid, tuberculosis, scarlet fever, yellow fever, polio - diseases that

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freed from centuries of European colonialism" (p. 206). In every country with a per capita income far below that of the industrial nations, health care is a dramatic problem. Even simple sanitary measures, such as an uncontaminated water supply and insect control, are usually beyond the resources of most of the Third World. When international efforts provide funding for hospitals and training for medical personnel, they do not typically follow through with an ongoing supply of pharmaceuticals, syringes, and other daily necessities. Garrett provides numerous examples of Third World hospitals in which a single needle is sterilized at the end of the day, after having been used to give hundreds of contaminated injections, simply because no resources exist to provide a disposable supply of syringes. She notes, "Modernization [does not] necessarily bring twentieth-century European standards of living and health to the Third World" (p. 202). Politics also enters the picture, depending on who the victims are. When "less desirable" populations are the first to contract the disease, public interest tends toward apathy. When the victims are primarily poor, minorities, homosexuals, drug users, or citizens of another country (especia

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