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The Wisdom of Whores: Bureaucrats, Brothels and the Business of AIDS Paperback – 6 Jul 2009

4.8 out of 5 stars 20 customer reviews

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Review

'[A] rollicking, eye-opening, hilarious account of the underbelly of international AIDS research ... Forget everything you've ever gleaned from boilerplate stories about AIDS research: The Wisdom of Whores vibrates with "I've been there" authenticity' Philadelphia Enquirer 'An absorbing read - Her book has freshness, charm and innocence, reminding us of the core elements that remain at the heart of this epidemic' Independent '[A] wonderful book on the salamagundi of money, politics, hypocrisy and obduracy (or possibly just plain stupidity) in what she calls the business of AidsA"' Telegraph 'A beguilingly rigorous expose - engaging, well written and entertaining' Times 'A major book' Daily Telegraph 'Pisani packs quite a punch. Her book - ignited a mini-firestorm of controversy - It exploded several prevalent myths about the diseases' Irish Sunday Independent

About the Author

Elizabeth Pisani studied Chinese at Oxford before working as a foreign correspondent for Reuters, the Economist and the Asia Times. She has an MSc in Medical Demography and a PHD in Infectious Disease Epidemiology. She has worked in the field of HIV prevention for a decade, for organisations including UNAIDS, WHO and Family Health International.


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Format: Paperback Verified Purchase
I met Elizabeth Pisani in one of her earlier lives when she was a business journalist. She was pretty impressive at that, but she would end an email with "got to get back to sexual networking now". She was already a medical demographer moonlighting as journalist. Now she has written a remarkable book about her life and work. It's partly a hard-nosed statistical account of why so much of what we are told about AIDS is wrong, backed up by 40 pages of footnotes and references and a website. In particular how little AIDS actually spreads among heterosexuals outside southern and eastern Africa; but telling people that everyone was at risk was the way to mobilise public attention. It's also the story of the author's nights doing "qualitative research" in dodgy bars and street corners in the sleaziest parts of Asia, which is often very funny as well as shocking. And the politics of the AIDS Industry. The book was written while the Bush administration was pushing its "faith-based" programmes while insisting that drugs available at $1.50 a dose be bought from US suppliers at $71. Meanwhile funding was rolling in on massive scale, but very often, Pisani tells us, for spending on the wrong things. East Timor had a big AIDS budget and plenty of other public health problems, but no AIDS. Despite the grim theme it's actually a very funny book with a lot of sympathy for the people she meets. There are positive messages. There are some very dedicated people in health ministries across Asia; and there are programmes that do seem to work. The UK DfID and the Chinese government also come out of the story better than many other players. One is left with great admiration for the author. She has done a very tough job and has written a marvellous book about it, with many lessons for the world.
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Format: Paperback
I've just finished reading The Wisdom of Whores by Elizabeth Pisani and it is a wonderful book. Ok, a wonderful book especially if you find yourself compulsively turning the pages of popular science books more than novel, but still - a book written by a real expert who also happens to have been a journalist before becoming an epidemiologist, and can write vividly, entertainingly and with passion about fairly obscure statistical points. Most of all, I loved the sense of fun, and genuine liking for people, that came across from the book: despite the fact that it deals with a disease that has killed millions and will kill more, it's a book that celebrates the lives of the people it destroys, gay guys, whores and junkies to use Pisani's definition: not with a funeral but with endless descriptions of wit, spirit, dinner parties and shared meals, cigarettes and drinks.

It makes quite a number of vibrant points, that boil down to "to stop HIV spread you need to do nice things for whores, junkies, and gay guys, and lots of people don't want to." And there are wonderful anecdotes, like the erotic Chinese classic novel she appropriated for a lesson in relationship networks and reality check for a Chinese apparatchnik, or how she rescued a night's worth of samples from a couple of Indonesian policemen...

I'll just say, go out and buy this book, it will entertain you and outrage you and leave you with a faint sense of hope in the human race.
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Pisani's book doesn't get off to the strongest start - I had the impression that she was trying to get across an image of herself and her colleagues at UNAIDS as a bunch of bright young things rushing around and being idealistic - but it gains momentum impressively.

She talks about her experience in Indonesia putting surveillance of HIV into practice (and all the problems associated with this, including the very different sexual identities and risk groups which she came across in Asia), her work with African companies and NGO/government funding and organisation hypocrisies. She leaves discussing the infectious mechanisms of HIV a bit late in the book, but this doesn't undermine the message that The Wisdom of Whores is trying to get across (that we can and should tackle the spread of HIV in a different way, that we have the tools and need to use them).

A note on the title - ignore it, because it makes this sound like a pile of pop-science crap, which it is not. I feel that this was chosen as an eye-catching cover rather than one which appeals to the target market of interested, not-necessarily-scientist individuals with some focus on health. Before I bought this I read a review which claimed there was no actual wisdom from whores in the book, which I found hilarious having read it - there are very good anecdotes and plenty of personal stories from those in the sex industry, and wisdom too.

I found this book hard to put down, which is something I haven't found since I read Goldacre's Bad Science book. The writing style is almost on a par with his, and Pisani is occasionally very funny on top of being insightful. The tone is sometimes forced but overall it's not detrimental to the ease of the read. If you want to know anything about HIV, epidemiology, politics, the sex industry or even Asia in general, this is a fascinating book.
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This is a really interesting book about the whole subject of public health, based on a decade's work on HIV in south-east Asia (particularly Indonesia). You learn how difficult it is to pin down the problem, how everything effects everything else, the frustration of finding that the things donors are willing to fund are not the things that would actually help, and the ways in which being perceived as a mad Westerner can let you solve problems.
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