In-vivo Banner, Vol 3 No12, Nov/Dec 2004 co branded with the Columbia University Medical Center logo

Global Health
Research Briefs
Around & About
Point of View


Journalist Calls World's Health Care Outlook Dire
A shift in political will is necessary, she says, to tackle enormous public health problems

Laurie Garrett, an author and Newsday medical and science writer
Laurie Garrett

Laurie Garrett, an author and Newsday medical and science writer who spoke on campus in November as part of the Global Health Seminar Series, said she was deeply concerned about the global health situation, which is losing ground against AIDS, tuberculosis, and increasing urbanization.

"The pre-9/11, Cold War model of national security in which public health, if considered part of national security at all, is only considered for one's own country, is no longer a workable model," said Ms. Garrett, author of the recently published "Betrayal of Trust: The Collapse of Global Public Health."

HIV/AIDS, one of the world's most pressing health problems, is not being adequately addressed, according to Garrett. "Less than 2 percent of the $15 billion President Bush pledged to fight AIDS has been spent," she said, "and the rest may never be allocated because of the mounting deficit in the United States, spending on the conflicts in Iraq and Afghanistan, and more tax cuts."

Drawing a comparison between AIDS and the "Black Death," which wiped out one-third of Europe's population in the 1340s and 1350s, Ms. Garrett said that by shrinking the adult population of sub-Saharan Africa, this disease is becoming a national security problem. "These missing adults are the parents, the policemen and women, the laborers, the doctors and nurses," she said. "The changing demographics may bring economic chaos, the rise of demagogues, social disaster, and regional instability. Many of these conditions already exist in some pockets of Africa."

Ms. Garrett cited one small fishing village in Uganda where almost everyone is an AIDS orphan. "It's a 'Lord of the Flies,' lawless place," she said. "This could be the future of all of Africa."

In addition to the havoc wrought by pandemics such as HIV/AIDS, Ms. Garrett said that the explosive growth of cities and the rise of new cities where none existed also present public health challenges by putting added stress on infrastructure – especially water supplies – as both people and animals use the water for drinking and as toilets. Such conditions are ripe for giving rise to infectious diseases that can quickly spread around the world.

In a world with so many potential hotspots, however, the World Health Organization's global surveillance and response team responsible for monitoring pandemics currently numbers less than 10 staff members.

Ms. Garrett believes one way to tackle pressing global health care issues is to uphold the values implied by President Bush in a statement he made during his first inaugural address: "When we see a wounded traveler on the road to Jericho, we will not pass to the other side." This sentiment will benefit everyone, not only those in the countries currently most affected, Ms. Garrett said. "We can build up 'fortress' America, but microbes will not present passports," she said. "We are globalizing opportunities for microbes, so we need to globalize the solutions."

—Susan Conova