Reviewed by Rachel Holmes
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The joint United Nations Program on HIV/Aids and the World Health Organisation estimate that global HIV infections have now topped 40 million. The infection rate has increased rapidly in Eastern Europe, Central and East Asia, particularly in China, Vietnam, Pakistan and Indonesia, where the focus is on combating prostitution and drugs to curb infection.
In The Wisdom of Whores,Elizabeth Pisani tackles the urgent need to communicate the hard data, scientific empiricism and complexity of the epidemic as a narrative journey, making it accessible as a human story.
Pisani's expertise is epidemiology, the study of how diseases spread in a population. In short, she is a card-carrying, intellectual number-crunching boffin nerd. But - and here's what makes the book a good read - Pisani is a charismatic, fun-loving, intellectual boffin nerd, full of joie de vivre and the ability to turn a rip-roaring good story. Critically, she is non-judgmental and passionate about how the scourge of stigma continues to kill people unnecessarily in a world where access to anti-retroviral drugs can keep people alive and living with HIV.
The wellspring of her journey is her lifelong addiction to Asia. “I was hooked on Asia, hooked on nightclubs and girlie bars, hooked on chatting to anyone who would chat”. Working for UNAids in Indonesia, she focused her epidemiological know-how on cutting the statistics for Aids. “Sex, drugs and plenty of squeamish politicians. Aids was the disease for me”.
Drawing on her decade of experience as an Aids technocrat working inside the corridors of international state-funded agencies, Pisani charts her adventure through the Asian sex trade and Aids industry, “a world where Byzantine international bureaucracies fight turf wars with one another, with pharmaceutical giants, with activist NGOs. A world where money eclipses truth”. She shows how hard it is to influence policy and get governments to do the right thing when they are presented with statistical facts.
This is an engaging, well- written and entertaining confessional- Pisani playfully highlights her “nice Catholic girl” credentials that drew her to the realities of the underworlds and the complexities of human behaviour. Weaving anecdotes drawn from a rich cast of drug addicts, hookers, dive bars and street corners, the book investigates how these human stories are - or are not - effectively translated into the flip charts, colourful graphs and budgetary funding models that should influence and define global health policies.
Pisani offers an intriguing conversation about how science intersects with state politics, and a beguilingly rigorous exposé of how contemporary political ideology manages and skews objective science by harnessing it to the aims and objectives of national states and the global capitalist superstate.
An engaging, compassionate libertarian, Pisani shows that while there are universal wisdoms to be learnt both in exotic subcultures and the corridors of political policy-making, there are no universals in data and the patterns of disease. Top-down policymakers want questionnaires, but “The truth is, real people don't have sex in boxes”.
Pisani is clear from the start that her story is about Asia, particularly Indonesia. Her research - characters, stories and data - are drawn from this region where, as she makes plain, there is no Aids tsunami on the scale of Africa: “Unlike many books about Aids it does not focus primarily on Africa, where two-thirds of HIV infections have been transmitted so far”.
As readers, we must be attentive to her point that HIV/Aids is an epidemic defined by combined and uneven development. Like global capitalism, there is no universal “normal development” model for Aids.
The Wisdom of Whores by Elizabeth Pisani
Granta, £17.99; 288pp Buy
the book here

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