I am reviewing books again! As always, I planned to catch up on a year’s worth of accumulated and unread books over the holidays, but I failed, as I am only finishing this commentary halfway through 2026. Here are my impressions of a stack purchased in 2025 (and with a late addition), several written by notable figures in public health. With publication dates throughout last year, they largely miss the happenings of the current presidential administration, but those books are coming, for sure. 

Learning From Success and Failure

Tom Frieden’s book, The Formula for Better Health. How to Save Millions of Lives—Including Your Own, is well described by its title. Based on his extensive experience with tuberculosis control in New York City and India, as New York City Health Commissioner under Mayor Bloomberg, and as Director of the Centers for Disease Control and Prevention (CDC) under President Obama, Dr. Frieden distills public health action to three words: see, believe, and create. See refers to finding the patterns that describe emerging and persistent problems and that point towards solution; believe involves showing that progress can be achieved and that advances have been made; and create involves finding new approaches to solve problems. His illustrations draw from his long career’s successes and failures: control of tuberculosis and smoking; banning of trans fats and the implementation of soda taxes in New York City; treatment of hypertension globally; and the Ebola epidemic in Africa. For soda taxes, he summarizes his paradigm as follows: See—sugar-sweetened beverages are a major source of consumption of calories; believe—alcohol and tobacco taxes reduce consumption; and create—develop a broad strategy for negotiating politics and opposition, for gaining support, and for communications. Of course, during his years as New York City Health Commissioner, Frieden had the backing of Mayor Bloomberg with his exceptionally strong support of public health. 

Frieden has had an impactful, action-oriented career. I worked with him almost two decades ago on the Bloomberg Initiative to Reduce Tobacco Use, a global program that was evidence-driven and innovative in its approaches. It has made a difference. In distilling his public health approach to see, believe, create, he oversimplifies the complexities of public health, but he does summarize one approach to taking evidence-based action. The book is not a guide for public health professionals, nor an introduction to public health for the public. Rather, it should be read to learn about how a public health leader has made a difference in New York City, the United States, and the world.  

Preparing for the Next Pandemic

For decades, Michael Osterholm served as an epidemiologist in the Minnesota Department of Health and as an advisor to the federal government on biosecurity and other issues. More recently, he directs the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, which addresses emerging infections and preparedness. With journalist Mark Olshaker, he wrote The Big One: How We Must Prepare for Future Deadly Pandemics, published in September 2025. “The big one” is a hypothetical pandemic even more deadly than COVID-19 that strains resilience in an unprepared world. The book is structured around the artifice of the emergence of a coronavirus pandemic (SARS-3) that unfolds across the book. Each chapter begins with an update on the happenings of this pandemic and ends with “takeaways”, sandwiched around discussion of the chapter’s topic, e.g., mandates and effective communication. However, the approach may tire readers with its many characters, listed in a four-page appendix, and organizations.

The Big One’s overall message is clear: the world is not prepared for “the big one.” Didn’t we know that already from SARS-CoV-2 and COVID-19? And, as I write this, yet another Ebola outbreak is unchecked in Sub-Saharan Africa. The unsolved challenge lies in the book’s subtitle—How we must prepare for future deadly pandemics. Once again, COVID-19 showed that “we” is a fragmented and disconnected group of entities at levels ranging from local to global. “We” does include all of us because achieving herd immunity through vaccination is essential to end pandemics caused by an emerging infectious agent. Osterholm and Olshaker offer guidance on what needs to be done to enhance preparedness for the seemingly inevitable “big one.” The range of recommendations and the entities involved speak to the futility of getting ready. Turning to respiratory protection as an example, the book reasonably proclaims that N95 respirators should be available when needed. I chaired a committee of the National Academies of Sciences, Engineering and Medicine that set out a framework to ensure that respiratory protection would be available for all if needed. Doing so would require action by Congress and the Executive Branch, and collaboration with public health, medical, and industry partners. My committee’s report, released in 2022, was ignored. 

The book is critical of the various mandates implemented as the pandemic surged, claiming that “all these measures were hurriedly put into place, reactively without any deep thinking or discussions among public health professionals and policymakers as to what the metrics would be to require such actions, or how and when to end them.” This and other retrospective commentary ignore the uncertainties about the rapidly spreading virus and its consequences and the attendant need for protective action. Osterholm and Olshaker invoke the need for applying the Precautionary Principle on other topics, but not on mandates. Read in the context of 2026, the chapter, "Politics and Policy", can seem out-of-touch. However, its first takeaway is still correct: “Honest, evidence-based political leadership is often the only defense against mis- and dis-information in a pandemic and therefore can have life-and-death consequences.” Now, we are learning what happens when we don’t have “honest, evidence-based political leadership.”

The Rise of Anti-Science

Michael Mann, a climate scientist, and Peter Hotez, a vaccinologist, are leading figures in their fields and outspoken in combatting anti-science and misinformation. In Science Under Siege: How To Fight the Five Most Powerful Forces That Threaten Our World, they team up to describe the drivers of anti-science activities and steps that can be taken to combat them. They are among the most vocal scientists who have engaged in the fray over science and evidence-based decision-making. Mann became known for his “hockey stick” description of the abrupt rise of global temperature in recent decades. In the so-called “Climategate” episode involving stolen emails from the University of East Anglia, he was targeted, accused of misconduct, and investigated. Hotez has been repeatedly attacked for his advocacy of vaccines and their safety and his unrelenting stand that vaccines do not cause autism, a position motivated in part by being the father of a daughter with autism. Both have been viciously attacked in right-leaning media, and their safety threatened. Written in their two voices, they bring personal stories and passion to the book. 

Science Under Siege lists five actors pushing anti-science: the plutocrats, i.e., very rich individuals with undue societal power; the petrostates, i.e., states or nations with economies dependent on fossil fuel extraction; the pros, i.e., seemingly legitimate credentialed individuals undermining science; the propagandists, i.e., those spreading anti-science misinformation and disinformation, including bots; and the press, i.e., the conservative outlets that disseminate anti-science messaging and the mainstream outlets that have moved towards “neutral” stances and look to “both sides” on issues like vaccination for which the evidence is hardly uncertain. They trace the connections among the five and the driving influence of the ideologies and funds of the plutocrats. Mann and Hotez are direct in listing examples and names, often drawing on their own experiences. Their widely ranging account is informative for the general reader seeking to learn about the rise of anti-science.

The final chapter, "The Path Forward", describes their plan, based on their five drivers of anti-science. Elements include “Penalize the Pros, Propagandists, and Petrostates”, “Pressure the Plutocrats”, “Mend the Media”, “Be the Change”. Their plan describes actions that can be taken at multiple levels, from individuals to organizations to governments. As a researcher and academician, I have struggled with what I can do that will make a difference. Mann and Hotez emphasize communication by scientists, for which they are exemplars. They call for training science communicators, not a new proposal, and not yet a required education standard. Some organizations, e.g., the National Academies of Sciences, Engineering, and Medicine, have taken strong and public positions on science and society while universities have been generally wary. As their book documents, anti-science is not purely the result of “a failure to communicate”. Political change is needed to restore the role of science in society. The book ends with an analogy to Tolkien’s Lord of the Rings, and the struggle between lightness and darkness. While a somewhat forced analogy, they are correct in stating, “And, the stakes simply couldn’t be greater.”

Global Health Aid Under Siege

Are you perplexed by the dismantling of our major global health agency? Read Into the Wood Chipper by Nicholas Enrich, which provides (literally) a day-by-day account of the destruction of the US Agency for International Development (USAID). USAID was targeted from the first day of the second Trump Administration with the signing of Executive Order 14169, “Reevaluating and Realigning United States Foreign Aid.” At the time, USAID had an annual average budget of $23 billion and 10,000 employees worldwide. It operated critical global health initiatives delivering medications for tuberculosis, malaria, and HIV/AIDS, and supported programs to advance maternal child health and much more. Enrich was a senior official in the Bureau of Global Health as the Department of Government Efficiency (DOGE) demolished USAID with no understanding of the consequences of its actions. The termination of USAID needed to be documented, and Enrich has successfully done so.

In describing the daily details, he shares stories of interactions with DOGE and political appointees assigned to USAID, involving bullying, deception, and disrespect for the agency’s staff and purpose. Its history, dating to 1961 when it was founded by President Kennedy, and accomplishments, including the highly successful President’s Emergency Plan for AIDS Relief (PEPFAR), were ignored as it was fed “into the wood chipper” by DOGE,  abetted by political appointees. The consequences of the termination of USAID were real and immediate. My collaborators in Eastern Africa told me about trials being terminated, and staff let go. Using modeling, researchers have quantified the benefits of USAID funding as 91 million premature deaths averted from 2001-2021; as to harms, they estimated that 14 million premature deaths would occur through 2030 because of stoppage of USAID programs. 

The Debate Over COVID-19 Continues

I finish with In Covid’s Wake: How Our Politics Failed Us, by Stephen Macedo and Frances Lee, both Princeton faculty members. The authors retell the story of the COVID-19 pandemic with two messages: first, public health steps taken to limit the pandemic were not grounded in a holistic assessment of their consequences; and second, the public health and scientific communities were not forthright about uncertainties and slapped down dissent. Reading this book left me frustrated because I found the retrospective analyses offered by the authors to be one-sided and posed in a sterilized context not reflective of the enormity and rapidity of the threat posed by the pandemic at the time.

The book uses an artifice — labeling public health and other experts as “the elite” — that quickly set me off. I have no doubt that the authors would place me in that group, an academic who led the epidemic modeling effort for Colorado working collaboratively with the Governor and state agencies. In the authors’ account, such modeling exaggerated the potential toll of the pandemic and led to the non-pharmaceutical interventions they criticize ferociously. They argue (correctly) that modeling in 2020 did not consider the potential harms of lockdowns, both on the economy and on the education of schoolchildren. They neglect to acknowledge the urgency of decision-making at the time, as an infectious agent of unknown virulence spread rapidly and real-time decisions were needed day-by-day about expanding capacity to care for the critically ill. Such modeling to compare potential benefits and harms of interventions was not practicable nor would results have changed the imperative of assuring that health care needs would be met.  Should we learn retrospectively about the consequences of what was done during the frightening first months of the pandemic? The answer is: of course.

The book also turns to other controversies of the pandemic: the origins of SARC-CoV-2 (lab leak or natural origin), respiratory protection, dissent among scientists, and the handling of mis- and disinformation. A central theme is that the “elites” were caught in “group think” and quashed debate and dissension.  In a chapter titled “Noble Lies,” Macedo and Lee opine as follows:

“Public health experts and elite scientists in most cases no doubt sincerely believed that they were operating in the public interest. The evidence that we present here also suggests that their actions — like those of most people in responsible positions in difficult circumstances — were mixed with conflicts of interest and the desire to avoid blame, protect reputations, and preserve personal privilege and institutional power.”

This is a harsh indictment that does not fit with the tireless efforts of my public health colleagues in Colorado and elsewhere to limit the pandemic’s impact. While my views on the analyses presented by Macedo and Lee In Covid’s Wake are clear, I welcome retrospective assessments of what happened. We do need to learn much more about what we can do to be ready for the next “big one.” 

This article is part of a column, The Jon Samet Report, on the biggest issues facing us today in public health, written by the former dean of the Colorado School of Public Health, Jon Samet, a pulmonary physician and epidemiologist, and Professor of Epidemiology and Occupational and Environmental Health. Dr. Samet is a global health leader, shaping the science and conversation on issues ranging from tobacco control to air pollution to chronic disease prevention and more. Each month he shares expert insights on public health issues from local to global.