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Can You Change Something If You Don’t Love It?


Posted by Seth Roberts .. Doctor of Philosophy

At a bookstore reading, I learned that Elizabeth Pisani wroteThe 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 said something enormously relevant to Pisani’s enterprise. I think it was in an interview. “You know, 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: Does anyone at the Gates Foundation 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.

 
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