The Wisdom of Whores

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Elizabeth Pisani's The Wisdom of Whores - Bureaucrats, Brothels and the Business of AIDS is a great book (along with a great website). Elizabeth Pisani is an epidemiologist with years of experience working on HIV/AIDS (or sex and drugs, as she puts, which sounds a lot, well, sexier) at a variety of agencies, including UNAIDS. The book is the story of her frustrations at the way the international community, national governments, NGOS and AIDS activists have dealt with the epidemics, as well as her hopes in some of the progress made. To me, precisely because the book is data-driven, it was not controversial. My reaction was more, "well, if that's what the data show, so be it." But also, I think, the book was billed as controversial because Pisani calls things what they are: penises, receptive or insertive anal sex, etc. and she does spend a lot of time describing her study in red light districts of Jakarta and other (mostly Asian) place. She discusses the brothels, the warias (transgendered male prostitutes) and rent boys, the drug injectors. She does spend a lot of time describing that world that a lot of people would rather never hear of: the stigmatized, the marginalized, those we can safely ignore and those that don't get politicians votes come election time. Doing nice things for whores and junkies carries no political rewards. Doing things for innocent wives and children does. So, that's what has been done with HIV/AIDS and this has been a tragic mistake. But these descriptions are unvaluable and fascinating because we never read about them. If you read about HIV/AIDS, you will read a lot about Africa (which does make sense since the high rates of infection in the general population are to be found in Eastern and Southern Africa). The problem is that the African patterns of infection have been assume to apply everywhere, especially Asia, where that is just not the case. So, the solutions and programs suggested are inadapted. The programs needed in Eastern and Southern Africa are not those that are needed in Asia. In these parts of Africa, AIDS does affect the larger population (Zambia, which I visited a couple of years ago, the infection rate is at an appalling 16% of adult population) but that's just not the case in Asia where most of the solutions described by Pisani involve programs to distribute condoms, lubricants and clean needles. It is also one of Pisani's other frustrations: we know how HIV is transmitted (biologically, that is), we know the types of behavior most likely to facilitate this transmission, so, we know what kind of prevention is needed. And yet, there is too much focus placed on treatment, rather than preventing people from getting infected in the first place. Early in her career as an epidemiologist, author Elizabeth Pisani was employed as a foreign correspondent in Asia for Reuters, The Economist and the Asia Times. While on a trip to further research the HIV/AIDS epidemic, she developed a strong interest in the epidemiology field and later pursued a career resulting in her PhD in Epidemiology. The author refers to this field of expertise as, 'sex and drugs' for a living. Pisani has also worked as a consultant in various governments as well as the World Health Organization. When Pisani makes the reference “beating it up,” she is referring to exaggerating a relatively small issue, or creating an immensely, impressive story from something that may in reality be rather mundane. In the first chapter, Pisani clearly owns up to “beating up” data with the intention of suggesting an impending leap from the group most at-risk to the general population, which would allow more money to be used for the prevention of HIV and for the people with below-orthodox social standing.  Bearing in mind that the writer and her colleagues were intending to raise money to fund HIV/AIDS prevention and research, she “beat up” her statistics because accurate data was scarce. This is, unethical...
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