peteg's blog

Elizabeth Pisani: The Wisdom of Whores

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Caroline from DRD lent me her copy of this personal memoir of the early days of the global AIDS intervention, covering a decade from roughly 1995. Pisani is at her strongest when she is telling anecdotes and presenting data, and at her weakest when she gets vague and non-constructive.

Like many experts, Pisani does not seem to realise that a lot of her experience is generic; for example, many data crankage (statistical) activities suffer from the problems she had, and would the collection process be so very different if the goal was to influence drink driving in the developing world, or efficiently saving cute furry creatures? Possibly less sexy, I grant you. Her bullshit bingo is age-old, and some themes get a Freakonomics-ish treatment, such as the idea that more people having sex is safer. Such coarse oversimplifications are rife in these types of books, but sometimes she is careful, for example in identifying that it is network effects that dominate in the spread of disease. The management of aid money struck me as largely an accounting issue, readily solved by finding a good accountant.

Stylistically Pisani sometimes gets tediously repetitious. The chapter The Naked Truth is twice as long as it should be, and that space could have been used to more fully explain infection vectors. Occasionally she is patronising and neo-colonial, partly because she wants to forment an iconoclastic lone-rider image, sometimes because that is how she thinks about some issues; arguing about whether prostitutes would prefer lipstick of nail polish as a reward for completing a survey is a trivial example. Her appeals to the crutch of rationality are tedious, especially when she robs it of any kind of universality. Some analogies have less than half an arse. For all her scientific training she is a journalist at heart.

Occasionally she touches on ethical issues, such as whether AIDS testing should always be voluntary, confidential, etc. These are interesting questions but she doesn't do much more than begin to explore them. I don't doubt there is a wealth of material out there on the morality of development, though as it is a mile from "the data", Pisani is likely unfamiliar with it. Her bibliography has the common problem of these polemics: it was designed to add heft and authority rather than serve as an entry point for the non-specialist who is the most likely reader. (One of her anecdotes is that by 2006 she had become so predictable that her colleagues knew what her criticisms would be; ergo I doubt they will critically read this text.)

Her TED 2010 talk gives a good sense of her tone and mode of discussion; the graph at approximately nine minutes in is the kind of rubbery thing I'm complaining about: is it only STIs that cause spikes in HIV load? What about pneumonia and suchlike?

For all that Pisani is not unnecessarily salacious, and her message is valuable, albeit not especially constructive; she offers no suggestions for getting the ants out of the sugar bowl, and indeed her solution was to become a queen ant (as far as I can tell). However unless we take her overly literally, there is little "wisdom of whores" in this book, which is more about nibbling at the hand that feeds.

Topical: Foreign Policy reports on drug rehab in Hải Phòng.