Laurie Garrett

The influx of AIDS money into global health carries risks, but well-designed programs can improve health care overall; Garrett responds.

Thanks to a recent extraordinary rise in public and private giving, today more money is being directed toward the world's poor and sick than ever before. But unless these efforts start tackling public health in general instead of narrow, disease-specific problems -- and unless the brain drain from the developing world can be stopped -- poor countries could be pushed even further into trouble, in yet another tale of well-intended foreign meddling gone awry.

To get a sense of the broader damage a new pandemic might do, it helps to consider the one the world is currently enduring: HIV/AIDS. Because this deadly scourge moves slowly, many of its social, political, and economic effects have yet to be understood. But the impact is hard to overstate. And it is growing.

Biological terrorism is now a greater menace than ever, yet the world remains woefully unprepared to protect itself. Public health systems must stockpile vaccines and develop response strategies -- but they risk losing legitimacy if governments continue to rely on the military and the police for defense against bioterrorism. It is time to seriously rethink the U.S. approach to this deadly threat.

After wiping out smallpox and winning other battles against the microbes, modern medicine ran into the aids virus. With urbanization and jet travel bringing people together in greater concentrations and more rapidly, infectious diseases are enjoying new opportunities to spread--and to evolve drug-resistant and more lethal strains. Advances in genetics make the threat of biological warfare even more threatening. It is time to write a better prescription for public health.