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A review by now_booking
The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS by Elizabeth Pisani
4.0
Fascinating take on the global AIDS epidemic!
I am not huge into non-fiction but as someone working in public health who saw this listed as the first book of the APHA (American Public Health Association)’s new book club, I decided to check this out. It’s the kind of book I read in grad school but wouldn’t have necessary have selected if not for the book club. Or so I thought.
The “Wisdom of Whores” is a fascinating take on the global AIDS epidemic that was written about a decade ago, but which is sadly still very relevant in talking about the way we address not just AIDS policy and programming, but health policy and programming in general. The author focuses on talking about all the missed opportunity, wasted funds, things we’ve done wrong over decades of programming. Her thesis looks a lot at the dichotomy between science and evidence and ideology and self-interest, between epidemiology and politics and between plain-speaking and political correctness. In short, Elizabeth Pisani is not shy to list EVERYTHING wrong with AIDS programming and believe me, the list according to her, is long. She is not interested in prevarication or sensitivity and will step on any toes required to get her point across and she is intentional in this- from the start of the book, she tells you of her fatigue with all the pussyfooting that goes on in the AIDS discourse, in her opinion, getting in the way of the plainspeaking that might bring about useful discussions and actual change. She, like everyone who works in the field, is very convinced of her own ideologies and as a scientist (specifically an epidemiologist), she puts out her data to convince you that she is right, and in fairness, she is very convincing.
As a reader of this book, and as someone from a developing country, it needs to be said that this book is not for “us.” By us, I mean readers from the countries that would be defined as “most affected.” Pisani‘s writing about developing countries is what I imagine colonialist’s who first arrived African shores sounded like in their clinical anthropological descriptions of “the natives and their ways.” Whilst Pisani is equally scathing about Western leaders, there is certainly a degree of condescension when she’s writing about certain regions (Africa being one). Even her beloved Indonesia doesn’t escape her patronizing tone at times. Once I recognized that this was not a book that was afraid of sounding racist or bigoted or condescending (she warns you early on) and once I realized that I was not the target audience for this book, which seems more aimed at whistleblowing funders to their constituents (tax-payers), I was pretty much unoffended.
The book title is pretty accurate. This is not one of those pop science book that promises you one thing but delivers dry textbook biscuits that no one is interested in reading. If anything, the title is underselling just how “red light district” this book is. She might have called it “Sex, Drugs and HIV” and that would have been an accurate summary because basically, all the science is viewed through the lens of the human pursuit of pleasure above all things even common sense. I learned a lot more about sub-cultures and sexual and injected drug use networking in developing countries than I’d ever known before- from proper sex workers to warias (transsexual sometimes prostitutes) to rent boys, to men sleeping with men who don’t identify as gay, to “faithful” couples who occasionally sell sex, to injected drug users who know better than to share needles or inject drugs but do it anyway... the list is endless- the high risk subcultures numerous and if anyone is treated with compassion by the author in this book, it is these very high risk populations who according to her get the least focus and the least programming even though they have the highest need. And because of the compassion with which Pisani treats these populations, you’ll find your compassion towards them increase.
My takeaway from this book is that Elizabeth Pisani comes across as a lover of pleasure, an asked of questions, a shaker of tables, a master of data, a know it all, a condescending so-and-so, a compassionate supporter of the underrepresented and many other things along those lines. However, she’s not wrong in her call for interventions to be more evidence-supported and less based on feelings, ideologies and self-interest. I highly recommend reading this book if you’re even vaguely interested in sex, drug use and HIV programming.
I am not huge into non-fiction but as someone working in public health who saw this listed as the first book of the APHA (American Public Health Association)’s new book club, I decided to check this out. It’s the kind of book I read in grad school but wouldn’t have necessary have selected if not for the book club. Or so I thought.
The “Wisdom of Whores” is a fascinating take on the global AIDS epidemic that was written about a decade ago, but which is sadly still very relevant in talking about the way we address not just AIDS policy and programming, but health policy and programming in general. The author focuses on talking about all the missed opportunity, wasted funds, things we’ve done wrong over decades of programming. Her thesis looks a lot at the dichotomy between science and evidence and ideology and self-interest, between epidemiology and politics and between plain-speaking and political correctness. In short, Elizabeth Pisani is not shy to list EVERYTHING wrong with AIDS programming and believe me, the list according to her, is long. She is not interested in prevarication or sensitivity and will step on any toes required to get her point across and she is intentional in this- from the start of the book, she tells you of her fatigue with all the pussyfooting that goes on in the AIDS discourse, in her opinion, getting in the way of the plainspeaking that might bring about useful discussions and actual change. She, like everyone who works in the field, is very convinced of her own ideologies and as a scientist (specifically an epidemiologist), she puts out her data to convince you that she is right, and in fairness, she is very convincing.
As a reader of this book, and as someone from a developing country, it needs to be said that this book is not for “us.” By us, I mean readers from the countries that would be defined as “most affected.” Pisani‘s writing about developing countries is what I imagine colonialist’s who first arrived African shores sounded like in their clinical anthropological descriptions of “the natives and their ways.” Whilst Pisani is equally scathing about Western leaders, there is certainly a degree of condescension when she’s writing about certain regions (Africa being one). Even her beloved Indonesia doesn’t escape her patronizing tone at times. Once I recognized that this was not a book that was afraid of sounding racist or bigoted or condescending (she warns you early on) and once I realized that I was not the target audience for this book, which seems more aimed at whistleblowing funders to their constituents (tax-payers), I was pretty much unoffended.
The book title is pretty accurate. This is not one of those pop science book that promises you one thing but delivers dry textbook biscuits that no one is interested in reading. If anything, the title is underselling just how “red light district” this book is. She might have called it “Sex, Drugs and HIV” and that would have been an accurate summary because basically, all the science is viewed through the lens of the human pursuit of pleasure above all things even common sense. I learned a lot more about sub-cultures and sexual and injected drug use networking in developing countries than I’d ever known before- from proper sex workers to warias (transsexual sometimes prostitutes) to rent boys, to men sleeping with men who don’t identify as gay, to “faithful” couples who occasionally sell sex, to injected drug users who know better than to share needles or inject drugs but do it anyway... the list is endless- the high risk subcultures numerous and if anyone is treated with compassion by the author in this book, it is these very high risk populations who according to her get the least focus and the least programming even though they have the highest need. And because of the compassion with which Pisani treats these populations, you’ll find your compassion towards them increase.
My takeaway from this book is that Elizabeth Pisani comes across as a lover of pleasure, an asked of questions, a shaker of tables, a master of data, a know it all, a condescending so-and-so, a compassionate supporter of the underrepresented and many other things along those lines. However, she’s not wrong in her call for interventions to be more evidence-supported and less based on feelings, ideologies and self-interest. I highly recommend reading this book if you’re even vaguely interested in sex, drug use and HIV programming.