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The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS

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About the Author

Elizabeth Pisani has lived in Indonesia at various times over the past twenty-five years, originally as a journalist and later as an HIV epidemiologist. The author of The Wisdom of Whores and Indonesia Etc., she is based in London.

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Product details

Hardcover: 400 pages

Publisher: W. W. Norton & Company; 1 edition (June 17, 2008)

Language: English

ISBN-10: 0393066622

ISBN-13: 978-0393066623

Product Dimensions:

6.5 x 1.3 x 9.5 inches

Shipping Weight: 1.6 pounds (View shipping rates and policies)

Average Customer Review:

4.5 out of 5 stars

58 customer reviews

Amazon Best Sellers Rank:

#1,283,787 in Books (See Top 100 in Books)

…is what Elizabeth Pisani says she does for a living. She says that it is a lot easier than trying to explain that she is an epidemiologist working in HIV/AIDS prevention and treatment. She is feisty, irreverent, provocative, knowledgeable, and deeply caring; a human who can be brought to tears simply by looking at numbers – and knowing what they truly represent. Her outlook is admirably captured by the title to her book. She does not specifically cite Thomas Pynchon’s “Proverbs for Paranoids”, the one that posits: “If you have them asking the wrong questions, you don’t have to worry about the right answers,” but she sure did act upon those truths. In the preface, she relates what the professor at the London School of Hygiene and Tropical Medicine asked at the end of the first lecture: “Why was there a fourteen-year gap between the first case-controlled study showing a strong association between smoking and lung cancer, and the first US Surgeon General’s report on the dangers of smoking?” She reports that there was only stony silence in the classroom, so she dared to break the ice with: “You’re asking the wrong question…Surely the key question is: how much money did British American Tobacco and Philip Morris give to US Senate campaigns in that fourteen-year interval? As with Big Tobacco, time and time again Pisani will reinforce the eternal truth that “follow the money” will provide the answer to a given action in the field of HIV / AIDS.Before getting into “sex and drugs,” Pisani was a reporter for Reuters. Her media background, her ability to speak Chinese, and her medical scientific training has provided a strong background for being able to explain both the HIV / AIDS epidemic as well as the political and medical establishments’ responses. Admittedly I had never heard of the phrase “beating it up,” which is journalist-speak for “making a mountain out of a molehill,” as Pisani explains. How does one successfully “cook up” an epidemic – in the sense of getting serious money allocated to treat people who are engaged in “deliberate, disgusting and revolting conduct,” to use the description of Senator Jesse Helms? Market the “innocents”! The stay-at-home wives and their to-be-born children infected by their philandering husbands. A small element of truth that was “beat up” into very large appropriations spearheaded by Helms and the religious right (bless ‘em).Down and dirty. The author can do spreadsheets, and sit in the back row at the international conferences playing *** Bingo while also asking provocative questions with the best of them. But she also does “HIV surveillance,” a nice neutral term that means she is out in the upscale gay clubs of Jakarta as well as along the railway tracks talking (and gaining the confidence!) of waria. Waria? Pisani says that it is a “smush-up” of a term, deriving its letters from the Indonesian words for “woman” and “man.” She develops an understanding for their lives, and what they truly do, and conveys it all to the reader in straightforward, “plain speaking” prose? “Bottoms.” A term of the trade along the railroad tracks, and Pisani discovers the percentage of times they become “Tops,” thus learning how HIV is so readily transmitted through the “community,” a term she proves is often not operative. In terms of “plain speaking,” the author’s chapter “The Naked Truth” is truly excellent on describing how HIV is actually transmitted.Another truly excellent chapter is entitled “The Honesty Box.” It explains the many difficulties involved in epidemiological work in trying to obtain accurate numbers that truly depict an epidemic. There is simple miscoding of the survey forms. There are dispositive survey differences brought about via decentralization (everyone “doing their own thing.”) There is “survey bias,” i.e., receiving different answers depending on who is asking the questions. And on and on, including, of course, asking the wrong questions, or ones inappropriately formulated, in months, instead of yesterday.Equally informative are chapters on the dominance of ideology over science (and how the scientists quietly try to circumvent this), particularly with American funding for HIV / AIDS, as well as the many intergovernmental and inter-NGO squabbles over the distribution of the now ample “sugar” of funding that is now in the pot. And then there is her own assessment why she herself, might not always undertake the appropriate protective measures (he is a “nice boy” through the second bottle of wine). Equally powerful is her discussion of her (apparently one-time) husband’s drug addiction problem and how she did not want to talk about it… but wanted strangers to talk about theirs. Yes, the ironies.With an estimated 40 million dead from HIV /AIDs, and the fact that almost all of them would be alive today if they had used either a simple piece of latex and/or a clean needle, I felt it would have been useful if Pisani could have devoted a chapter to why people don’t, which would have expanded on her own reasons. In terms of inaccuracies, I was stunned with her description (and calculations!!) of Muslim religious beliefs concerning sex and Ramadan. First, it is only during the DAYLIGHT hours that Muslims must refrain from food, drink, sex. And during my 1979 visit to Indonesia, during Ramadan, I asked the rickshaw driver about the fast: “That is only something rich people do.” And then there is the “survey bias” that she did not seem to account for (p. 91-96).Still, an excellent book that should be a required part of any course in Public Health… or for the “general” public who wants to know more about the epidemic of our times. 5-stars.

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, 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 ordered this booked after watching Elizabeth Pisani's TED talk and wanting to know more about HIV/AIDS and her research. I just finished it and I thoroughly enjoyed every page. I rarely read any non-fiction and I did not expect to enjoy it nearly as much as it did but it keep my interest the whole way through. Everything from Pisani's stories about her time in China and Indonesia to the vast amount of information she offers about HIV/AIDS kept me wanting to learn more. I recommend this to anyone who's even remotely interested in learning more about the HIV/AIDS crisis and how it is handled around the globe, even if this type of book isn't your usual cup of tea.

I really enjoyed reading this book. While some of its details might make some people uncomfortable (HIV spread and taboo topics go hand in hand) the author's honesty and frankness is refreshing. The book itself is a little short for my taste but not everyone likes to read tomes. The iconoclastic nature of the book and its challenges of several truisms added to the appearance of honesty. As I continue to study the subject the accuracy of these claims may be questioned in which case I will revisit the review but her statements are well documented in the text.

A fascinating read about the realities of how governments and institutions really dealt with the HIV/AIDS crisis; and how they should've. Very clearly written and from someone who was on the inside all the way

Wanted to love it...had a really hard time getting into it...I still haven't breached the 3rd chapter and I'm a MPH student so I feel like the subject matter is generally intriguing to me. I'm sure it's a great book---I'll get around to it someday

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