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While the human race battles itself ... the advantage moves to the microbes' court. They are our predators and they will be victorious if we, Homo sapiens, do not learn how to live in a rational global village that affords the microbes few opportunities.
Her picture is not entirely bleak. Epidemics grow when a disease outbreak is amplified--by contaminated water supplies, by shared needles, by recirculated air, by prostitution. And controlling the amplifiers of disease is within our power; it's a matter of money, people, and will. --Mary Ellen Curtin
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Laurie Garrett has done a masterful job of chronicling the spread of infectious diseases over the last 50 years. The book is divided into sections that give the history of the rise (and in one or two cases- the fall) of the major pandemics of this century. The chapter on AIDS is worth the price of the book alone and should be required reading for political science students. It's the perfect case study on how apathy, intolerance, ignorance and political infighting foster the spread of infectious diseases.
The underlying message of The Coming Plague is that we are at war with oodles and oodles of really small things whose survival instincts are much better than ours. In short- we're losing! These pernicious little buggers seem to be able to adapt much quicker than we can find new ways to kill them.
The Coming Plague reads like a detective story. And Garrett does a fine job of making it human and personal by giving us a peek into the lives of the scientists who are heading up the fight to solve the mysteries -and the victims who suffer from them.
Ms Garrett's highly detailed and exhaustively documented thesis, written while on a graduate fellowship at Harvard, is both frightening and hard to ignore. She posits that through our environmental arrogance and stupidity, the general medical strategies of the western societies, and our consistent overuse of antibiotics, we are quickly losing the continuing fight to keep the general public of both the postindustrial nations and the less developed world safe from the wild panoply of microbiological agents that are out there in the environment, and we are, through our encroachment on wilderness areas never before populated by humans, unnecessarily introducing segments of the population to new microbiological agents who then find a vector or path into human habitation and resultant infection. Moreover, the increasing levels of world commerce and concomitant travel among the nations of the world mean that someone infected in the jungles of South America or equatorial Africa can be in a restaurant in New York City or at the beach on Martha's Vineyard several days later as the agent starts its formidable and often highly contagious microbiological attack. This is truly scary stuff.
One becomes increasingly concerned about the safety of the general public and for our relative lack of public health preparedness as one winds through the pages of this long book. The approach is one of individual story telling, and while this makes the book much more readable and entertaining, it also tends to repeat a lot of information that one could otherwise avoid. Yet this is truly a minor quibble with a facintaing and fact-packed book that often made me feel like I was taking a graduate seminar in "Current Issues in Infectious Epidemiology". It's tone is both approachable and yet scholarly, a rare treat to enjoy, and Ms Garrett's obvious intelligence and ability to communicate shines here, as she makes complex environmental, infectious disease, and human issues converge in an understandable and compelling way.
Finally, she makes an excellent case for increased public awareness as well as immediate political action to restore and reinvigorate the vitality and capability of our local, state, and national public health agencies, and certainly has increased my own awareness and concern for the ongoing scientific effort to battle the microbes. If her argument that many of the gains of the 20th century in public health (and the healthy longevity we enjoy as a result) are increasingly at risk is correct, we must take action to combat the wide range of problems she discusses to avoid a serious long-term breakdown in our public health system. This is an important book that has sparked a serious national and international public debate about some critically important issues that could literally potentially affect billions of people across the globe. I recommend it, hope it will be even more widely read, and hope you read it, too.
Even if you live in the middle of the Canadian tundra and have sworn off eating mollusks for the rest of your life, this book hammers home the fact that you're still not safe from what used to be called 'Third World diseases'. Even as I write this review, there is a woman in an isolation chamber of a hospital in Hampton, Ontario who is gravely ill with an unknown hemorrhagic fever. The doctors don't think its Ebola Fever, but they're not sure what it is, or whether any of the other passengers on the plane from Nigeria to Canada could also have been infected.
You can conclude (as I did) from "The Coming Plague" that many of us who expected to die from age-related conditions such as heart failure or cancer, may now well perish from infection. This book manages to combine the heroics of "Men against Death", the grim prophecy of "Silent Spring", and descriptions of several hair-raising, near-tragedies akin to the "Hot Zone". I highly recommend it.
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