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

doi:10.1128/jmbe.v11i2.227

David R. Wessner , PhD
Department of Biology, Davidson College, Davidson, NC, E-mail:
dawessner@davidson.edu .

The Wisdom of Whores: Bureaucrats, Brothels and the Business of AID S; Elizabeth Pisani; (2008) . W. W. Norton & Co., New York. 372 pages.

As Elizabeth Pisani writes in The Wisdom of Whores , “HIV is a virus that doesn’t care what people think. It only cares what people do.” Yet, as she shows repeatedly in this informative, carefully researched, slightly irreverent look at HIV/AIDS, many of our decisions about the virus depend on what people think. She argues quite convincingly that ideology, not scientific evidence, often drives important decisions about everything from local prevention strategies to national and international funding decisions.

Pisani begins with a primer, of sorts, on epidemiology – but she does not provide the reader with the nuts and bolts of epidemiology. Instead, she provides important lessons learned from a career in the trenches. She notes, for instance, how important the wording of a question may be. She writes, “When things go wobbly in the data, it is often because we have asked the question incorrectly.” To illustrate this point, she uses as an example the drinking habits of an adult:

People have a hard time remembering details about very common events. Perhaps you, like me, regularly drink wine. Can you really remember exactly how many glasses of wine you drank in the last week, or the last month? And if you are asked how many of them were red wine and how many white, can you recall? Or do you shuffle through your mind and say, ‘I guess I drink wine about three times a week, usually about two glasses. There was that bender last Saturday, but that wasn’t typical, so I won’t count it.’

If people are asked how much they drank the previous day, she argues, they are more likely to remember. The same holds true for sex workers and injection drug users. If an epidemiologist asks them how many sexual partners they had or how many times they injected in the past month, the resulting answer will be “wobbly.” She then goes on to explain, that, in some instances, this type of “wobbly” data is sufficient. In other cases, more accurate data are needed and more specific questions must be asked.

Pisani also provides a very honest and, at times, disheartening look at the state of HIV/AIDS funding. In her opinion, money could and should be spent much more effectively. Many parties share the blame, she contends, for the inefficient use of funds – from international organizations to national governments to NGOs. “The sheer volume of money now available,” she writes, “washes away the need to use what we have well.” To defend her position, she discusses HIV/AIDS funding in East Timor. After becoming an independent nation, East Timor received $2 million from the US State Department and USAID for HIV programs. Pisani argues that this influx of money amounted to $285,700 per HIV infection; only seven people in East Timor had tested positive for HIV at that point in time.

In my class on HIV/AIDS, we spend most of our time discussing scientific articles about the virus and syndrome. These readings provide the students with a good factual background. But they don’t necessarily provide a nuanced context for the information. To provide this context, we will spend a week in the middle of the semester reading and discussing this book. In The Wisdom of Whores , Pisani causes the reader to rethink commonly held assumptions one may have about various groups of people, from researchers to government employees to sex workers. She allows the reader to think in new ways about collecting data and interpreting that data. Ultimately, she forces the reader to reevaluate his or her conceptions about global public health and our responses to the AIDS pandemic.

(Return to Top)

JMBE
ISSN: 1935-7885

Username
Password
Remember me

Journal of Microbiology & Biology Education

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