At a bookstore reading, I learned that Elizabeth Pisani wrote The Wisdom of Whores — about doing HIV epidemiology among sex workers — because she wanted to have more of an effect on HIV prevention programs. Scientific papers didn’t have much effect unless a journalist wrote about them. Journalists, she found, tended to focus on the exceptions rather than the rules. The exceptions — e.g., sex trafficing — were a poor basis for policy, of course. So she did what drug dealers call “jump the connection”: She wrote a book about the rules, illustrating them with good stories. Speaking directly to the public. It seems to be working, she said.
Jane Jacobs (whom Pisani hadn’t heard of) said something enormously relevant to her enterprise. I think it was in an interview. “It’s a funny thing,” Jacobs told the interviewer. “You can’t change something unless you love it.” What a broad statement, huh? Could it be true? HIV prevention programs, in Pisani’s experience, have mostly failed. She was hopeful that private foundations could do what governments could not. The Gates Foundation, for example — could they crush HIV the way Microsoft crushed Netscape? Jacobs would have been skeptical: Is the usual attitude at the Gates Foundation to love, or at least respect, sex workers? Well, probably not. Indeed, the closer Pisani got to private foundations, the more skeptical she became. They were getting advice from former CDC bureaucrats and the like, full of the same ideas that had already failed.
Pisani held up one country as an example of how to do it right: Brazil. Why Brazil? I asked. Funny thing: In Brazil, they respect sex workers. Unlike everywhere else. In this case, at least, Jacobs was right.
More: Here‘s one version of Jacobs saying this: “I think people [who] give prescriptions, who have ideas for improving things, ought to concentrate on the things that they love and that they want to nurture.”
I think it is likely that there are people at the Gates Foundation who are motivated by a love of and compassion for women — who are mothers, daughters, and sisters — and who happen to also be in the sex trade. Although there are a variety of motivations for working in philanthropy, and the Gates Foundation pays better than other non-profits, those who work there are still on average driven by different motivations than most people. There is more money for people of comparable talent in other sectors, so those working in non-profits are likely doing so out of empathy and compassion for others and would be aware of the economic and social conditions that conspire to put women into the sex trade.
MT, I edited the post make it clear I was talking about the usual attitude of people who work at the Gates Foundation. The average attitude. You’re right, there may be exceptions.
“The Gates Foundation, for example — could they crush HIV the way Microsoft crushed Netscape?”
Yes, they could crush HIV exactly the same way they crushed Netscape – by flooding the market with thousands of HIV-free prostitutes who would give their services away at no charge.
This seems like a good argument for social freedom and harm reduction rather than criminalization, for things like prostitution, gambling, and drugs. If they are illegal, we tend to demonize them, and the people who do them are people willing to do illegal things, who tend to be sleazier. You get a feedback cycle of sleaziness. And then when there are problems (drugs that are bad for you, STDS among sex workers), they are hard to fix.
If instead you acknowledge that these things are going to happen anyway, make them legal and regulated, when problems come up it will be much easier to find smart, competent people who respect drug users, prostitutes, and Johns, and can provide good suggestions for fixing the problems.
that’s a great point, Patri. I’m going to write a post based on it.