Garrett vs. Farmer: Integrated Global Disease Control
This paper compares two prominent perspectives on global health priority-setting: Laurie Garrett's argument for sustained investment in communicable disease programs and surveillance, and Paul Farmer et al.'s proposal for a diagonal, integrated approach that addresses both communicable and non-communicable diseases simultaneously. The paper evaluates each position and ultimately argues that Farmer et al.'s framework is more compelling because it strengthens health systems holistically, exploits epidemiological and etiological links between disease types, targets shared risk factors, and promotes more efficient healthcare delivery through unified platforms for chronic and acute care.
- Overview of the Two Arguments: Summarizes Garrett and Farmer et al. positions
- The Case for Garrett's Communicable Disease Focus: Garrett's rationale for prioritizing infectious disease
- Why Farmer's Integrated Approach Is More Compelling: Farmer's diagonal model strengthens health systems
- Shared Risk Factors and Epidemiological Links: Common risk factors bridge communicable and non-communicable disease
- Efficiency and Healthcare Delivery: Integrated platforms improve cost and health outcomes
- Conclusion: Holistic approach to global public health endorsed
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What makes this paper effective
- The paper clearly frames the scholarly debate at the outset, naming both authors and summarizing their core positions before staking a clear thesis in favor of Farmer et al.
- Each supporting argument is anchored in a concrete mechanism — epidemiological linkage (HIV/AIDS and cancer risk), shared risk factors (poor nutrition, physical inactivity), and system-level efficiency — rather than relying on vague assertions.
- The conclusion synthesizes the argument by tying all threads back to the overarching principle of holism in public health, giving the paper a coherent intellectual throughline.
Key academic technique demonstrated
The paper models a comparative position essay: it presents two competing scholarly arguments fairly, then builds a reasoned case for preferring one. This technique requires the writer to steelman the opposing view (acknowledging Garrett's legitimate concerns) before offering point-by-point reasons why the favored framework is superior — a discipline central to academic argumentation at the undergraduate level.
Structure breakdown
The essay opens with paired summaries of Garrett and Farmer et al., then transitions into a multi-point argument for Farmer's integrated model. Each body paragraph develops one reason: system strengthening, epidemiological linkage, shared risk-factor reduction, and delivery efficiency. The conclusion restates the thesis in broader terms, emphasizing holism as a guiding principle for global health policy.
Overview of the Two Arguments
Laurie Garrett argues for continued global budgetary allocations for communicable disease programs and surveillance, emphasizing that investing in addressing non-communicable diseases at the expense of infectious disease control will have global repercussions if left unaddressed. She acknowledges that non-communicable diseases are a significant threat to public health, but she believes that communicable diseases should not be overlooked in the process.
In contrast, Farmer et al. propose addressing both communicable and non-communicable diseases together in an integrated, diagonal fashion, arguing that efforts to reduce the mortality and morbidity associated with either will be more effective if they are coordinated by building platforms that deliver both chronic and acute care.
The Case for Garrett's Communicable Disease Focus
Garrett's position rests on the concern that a reallocation of resources toward non-communicable diseases could weaken the surveillance infrastructure and programmatic capacity that has historically kept infectious disease outbreaks in check. She views the two agendas as competing priorities and cautions against allowing enthusiasm for chronic disease prevention to erode hard-won gains in communicable disease control.
Why Farmer's Integrated Approach Is More Compelling
While both arguments have merit, Farmer et al.'s proposal is more compelling for several reasons. First, addressing both communicable and non-communicable diseases in an integrated, diagonal fashion would strengthen health systems overall. Health systems designed primarily to address one type of disease may be ill-equipped to handle another. Addressing both types of disease together helps create a more holistic and comprehensive healthcare delivery system — one better equipped to handle the full spectrum of health challenges that populations face.
Second, Farmer's proposal would more effectively combat health problems because communicable and non-communicable diseases are often linked epidemiologically and etiologically. For example, people with compromised immune systems due to HIV/AIDS are more susceptible to non-communicable diseases such as cancer, cardiovascular disease, and diabetes. Addressing communicable diseases can therefore help prevent non-communicable diseases, and vice versa.
Conclusion
Both communicable and non-communicable diseases are significant threats to global health, and addressing them in a coordinated and integrated way is critical. While Garrett emphasizes the importance of continued investment in communicable disease programs and surveillance, Farmer et al. propose a more comprehensive approach that would strengthen health systems and enable more efficient and effective healthcare delivery. Farmer's argument is ultimately the more convincing one, as it approaches the problem of health from a holistic perspective — recognizing how health problems are interrelated at various levels and in different ways. The key to addressing public health is not to tackle it piecemeal, but rather to confront it holistically and as thoroughly as possible, with due attention to the interrelatedness of diseases.
References
Farmer et al. Chapter 11, Global Health Priorities for the Early 21st Century.
Garrett, L. (n.d.). Communicable before Non-communicable Diseases.
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