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Elizabeth Pisani: A raging dinosaur

ELIZABETH PISANI: (JP/Prodita Sabarini) In her blog, thewisdomofwhores

Prodita Sabarini (The Jakarta Post)
Ubud
Sun, November 23, 2008

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Elizabeth Pisani: A raging dinosaur

ELIZABETH PISANI: (JP/Prodita Sabarini)

In her blog, thewisdomofwhores.com, author and epidemiologist Elizabeth Pisani mourned the passage of the pornography bill late last month.

"I don't usually mind being wrong. Really I don't. But today it hurts. Indonesia has passed a bill that makes it illegal to bathe in rivers or wiggle your hips while dancing," she wrote in her blog last week.

"The news reached me at exactly the time I was on air on one of the country highest rated TV shows, talking about anal sex."

Pisani is a former foreign correspondent turned epidemiologist who has worked in the field of AIDS in developing countries, including Indonesia, for more than a decade. The author of The Wisdom of Whores, a book about AIDS, was in Indonesia last month for the Ubud Writers and Readers Festival.

The show referred to in her blog was Metro TV's talk show Kick Andy.

The British national talked to The Jakarta Post last month in Ubud, Bali. At the time of the interview, the bill had yet to be passed and she dismissed it as ridiculous.

"Tinggal ketawa aja kan (All you can do is laugh)," she said of the bill with a tinge of satire.

It is an issue close to her heart. Where the law defines pornography as any act or depiction that can incite sexual desire, the field where Pisani has been working in the past decade is, in her own words, "sex and drugs".

Fluent in Indonesian, as well as three other languages in addition to her native English, Pisani lived in Indonesia on two different occasions, first for three years in late 1980s to early 1990s as a reporter for news agency Reuters and then as an HIV surveillance expert for the Health Ministry from 2001 to 2005.

Her work for the ministry was to help the government improve its understanding of how and why HIV was spreading in Indonesia. But she wanted not only to collect information but also to persuade the government to carry out effective programs based on that information.

That means programs targeting the key populations vulnerable to HIV: sex workers, transvestites, gay men and injecting drug users.

But the trouble, she said, was that it was difficult to sell programs that ask governments, from the central level to the district level, to be nice to sex workers, transvestites, gay men and drug addicts.

"You have to start from scratch with every pemda (local administration) to say *Here's what we need to do' etc. It's already a hard sell at the central level. We're talking about sex. We're talking about drugs. Kemunafikan kita tinggi banget kan (Our hypocrisy is so great). When ... you see it exactly in the anti-pornography bill," she said.

She said that in Indonesia there was a lot of investment in or grants for programs that target teenagers and pregnant women.

"Those are not bad things. But they're not really where the HIV problem is in Indonesia."

In her book, which follows her along the corridors of the UN office in Geneva to Jakarta's seedy underbelly, she tells candidly an insider's story of the HIV prevention industry, which she dubs the "AIDS mafia", herself included.

When she started out as a consultant writer for UNAIDS in 1997, her main activity was "beating up" the story. That means exaggerating it.

"We weren't making anything up," she writes. "...once we got the numbers, we were certainly presenting them in their worst light. We did it consciously ... we were pretty certain that neither donors nor governments would care about HIV unless we could show it threatened the general population."

The beat up succeeded: Funding for AIDS in 1996 was around US$300 million, and in 2007, it was at $10 billion. However, she said, this lump of money was being spent badly in many parts of the world.

"In the field of prevention: Spending money badly is spending money on people and behaviors that are not really at risk," she said.

In her book she writes, "By 1998 it was clear that HIV wasn't going to rage through the billions in the 'general population', and we knew it".

But, she said, aiming propaganda at heterosexual teenagers is often an easier approach for politicians than doing something voters might not approve of, such as giving out condoms to sex workers and clean needles to drug users.

By 2005, she was tired of saying the same thing without seeing any change.

"I was like, I didn't need to do this job anymore because everyone knows what I'm going to say. Even though nothing changes, but everyone knows what we're going to say," she said.

"And somehow, people think that we only need more money, if we got more money, the problem will stop. The problem is not money. The problem is a political and community commitment to do what it needs to do."

She then set about writing the book, which she finished in three months. Getting it published required another 18 months.

She said she thought of herself as a "dinosaur" in this field, the older of two different generations in the field. The first generation are those who respond to HIV as if it is an emergency. The second is a new generation -- particularly in countries with strong health services -- that does not view the virus like that.

And the new generation needs to be left to figure out how to handle the epidemic in their own way, she said.

Despite being tired of it all, she still gets enraged when hearing there is no methadone in prisons or that a local government stopped funding free condoms. She views this anger as a healthy thing.

"As long as you still have the power to get furious you still have the power to care about the world."

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