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About the Author

Clare Herbert
Development Consultant (Kildare, Ireland)

I am a development consultant and educator, blogger and writer. My background is in communications, non-profit management and political work. My interest in international development bred from a period spent working in Zambia in 2007. Please take a look at my website, for more biographical information, or feel free to contact me for more information.


The Wisedom of Whores: A Review

Published 06th April 2010 - 2 comments - 3049 views -

The Wisedom of Whores.

First off, people are going to look at you funny if you read this in public. I’ve had fellow commuters peering over my shoulders trying to see just what is the ‘Wisedom of Whores’.

This was the best book I’ve read in a long time, and the best on development I’ve read (so far).


Witty and honesty, Pisani’s tell-it-like-it-is, conversational style takes us on a bizarre world tour of the HIV/AIDS landscape. From the red light districts of Asia to the dusty health clinics of Africa, to posh five star conferences and gay nightclubs at 4am in search of anal swabs, Pisani talks about the real world, about real people and about the devastating and preventable effects that HIV/AIDS has.

Pisani is an epidemiologist. She studies the spread of diseases through populations. As she describes it, she knows about sex and drugs.


Her prose is clear, accessible and informative with a few evocative gems thrown in for good measure. She’s also very funny.  She’s straight talking, while others tip toe around words like ‘erection’.  She thinks saving lives matters more than language and she’s right.

AIDS is a worthwhile topic. It raises lots of money and garners celebrity support. It’s the one primary disease affecting the developing world that’s still a problem in the west and there is a certain glamour associated with it. Compared with malaria or diarrhea, HIV/AIDS is sexy and fashionable.


She has some crosses to bear with the AIDS industry. (Isn’t that nuts? An AIDS industry.) She talks about government funds wasted on peer counseling and life skills classes where a few condemns or clean needles would have contained the problem and cost a lot less. One condemn or needle saves hundreds of thousands in anti-retroviral treatment (ARVs) and of course, stems the further spread of the disease. It works. It’s cheap. But, it’s not politically viable.

Politics operates on short cycles – if you do something cheap but unpopular now, you’ll get voted out of office. Your opponents will be in power to benefit from your forward planning.

She criticizes the “do as I say, not as you need” approach, in particular the ridiculous ‘Buy American’ policy which forced NGOs to buy only American made drugs, sucking up limited funding in order to boost pharmaceutical profits.

If Pisani needs a few doses of penicillin, she can easily get them locally for $1.50 a dose. But, because of the “Buy American” policy she’s forced to buy the same product at $71.15 a dose. It comes in fancy-schmancy packaging and is made in Tennessee. She has to get it from Tennessee to a clinic in the sweltering dust-bowl that is Dili, keeping it between 4 and 8 degrees centigrade. That’s insane.


She lets us see the sneaky side of statistics, exposing how they can be manipulated to suit any cause. I learned: look at the rates of change, not the absolute numbers.

Her aim was always to find how a disease could effect mothers and babies because that’s what politicians and voters care about. That’s how you can raise money.  No one gets elected being nice to hookers and junkies.


She encourages us to make friends with nuance because nuance is what matters. Broad strokes doesn’t cut it with something as complex and confusing as sex, drugs and disadvantage. “Sex is about the least likely thing to fit neatly into the blueprint of rational decision-making favoured by economists,” she writes.

She is human and she is honest. She is kind to people that most people shun (drug addicts, prostitutes, people who sleep around) realizing that their temporary risky behaviour should not be a death sentence. They grow up, move on from being reckless and deserve a full, healthy life. And, their future spouses and offspring certainly do not deserve punishment through HIV/AIDS. Pisani is kind and she is sensible.

That’s a word the development sector needs to see more of.  Sensible. She advocates policies based on science, logic and reason. Unfortunately, we live in “a world of money and votes, a world of media enquiry and lobbyists, of pharmaceutical manufacturing and religious and political ideologies. “ Solutions that work in the lab must also work at the ballot box, otherwise they will never see the light of day.

“The sheer volume of money now available washes away the need to use what we have well,” she writes. (This line kept me up nights.)

She bemoans the time NGOS spend on measuring and reporting things, “squabbling like jealous children in a family that’s grown too big” and calls for some free-market competition to shake off inefficiencies. (You can read more about it here under ‘Ants in the Sugar Bowl’.)

How daft is that. As I often say, charitable is great but SENSIBLE would be even better.


Always, she favours logic over dogma. Sure, abstinence and monogamy would be ideal but that ain’t never gonna happen. In a world where African leaders claim eating beetroot prevents AIDS, Pisani is a lone frustrated and logical voice.

If you’re interested in HIV/AIDS, development or the world we live in, read this book. If you want a great read and a rollicking trip around the world’s underbelly, read this book. If you want to get motivated, read this book. If you want people to look at you funny on the train, you should definitely read this book.

HIV/Aids is about “a great venn diagram of sex and drugs, desires and needs, hormones and money” and if you’re trying to understand it, this is a great place to start.

(P.S. Take a look at Elizabeth Pisiani at Ted here.)

Category: Health | Tags:


  • Aija Vanaga on 08th April 2010:

    This is a nice review, wondering that there is no comments under.

  • Clare Herbert on 09th April 2010:

    Thanks Aija. Glad you enjoyed it. It’s a great read - comes highly recommended.

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