During the Reagan administration, Garrett says, budget cuts dramatically weakened public health while also denying poor Americans access to medical care. Even the U.S., historically a pioneer in public health (this commitment was demonstrated by New York City's quick and successful response to an 1888 cholera epidemic, as well as the tenement reform movement of the early 1900s that helped eliminate diphtheria), is lagging today. With no funding left for health care, Russia was overwhelmed by a tuberculosis epidemic. After the U.S.S.R.'s breakup, the Russian economy collapsed. The former Soviet Union, for all its flaws, according to Garrett, assured every citizen access to health care. In India in 1994, neglect of public health for the poor led to an outbreak of pneumonic plague the once-dreaded disease is now easily treatable with antibiotics, but the failure of Indian authorities to quickly reach a diagnosis and provide accurate information resulted in a worldwide panic. Researched analysis of disaster in the making in a world with no functioning public health infrastructure.
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