As alarming stories about new pathogens like the Ebola virus or Mad
Cow Disease fill today's headlines, scientists face a test of their
abilities to contain them. But public health officials face a
crisis of their own, because even when effective treatments become
available, efforts to control disease often fall short.
After the Cure was written to improve the prospects for
effective management of AIDS and other public health crises. Martin
Levin and Mary Bryna Sanger draw on cases of previous large-scale
public health initiatives to show how management effectiveness can
meet threats to public health.
Focusing on AIDS as the most compelling contemporary example of
the need for change, the authors advocate a commonsense approach
that seeks to minimize the chances of failure. They encourage
health officials to exercise "strategic skepticism" by developing
plans that anticipate potential problems-such as scientific
controversy over a vaccine's effectiveness or media
sensationalism-which could arise from flaws in program design and
implementation.
Case studies involving polio, swine flu, childhood immunization,
reemergent TB, and the early AIDS experiences demonstrate the
variety of managerial problems that can confront such initiatives.
By reviewing the lessons of these cases, the authors suggest how
their approach can be applied to the management of AIDS and future
public health threats. They then present both a critique of the
early mismanagement of the AIDS crisis and a scenario for "the day
after an AIDS vaccine is discovered."
Because epidemics are likely to increase, After the Cure clearly
demonstrates the importance of anticipating obstacles to their
management through skillful scenario writing. Combining careful
analysis with practical advice, it shows that in the public health
arena, management matters as much as medicine.
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