The wisdom of whores. Bureaucrats, brothels, and the business of AIDS. Elizabeth Pisani. Sydney: Granta, 2008 (xvii + 372 pp). ISBN 978 1 84708 024 0.

Given the provocative cover, I approached this book with reservations. And irritatingly, the author scatters the terms “AIDS mafia” and “AIDS industry” throughout the book. She never defines the terms, but she would probably class me as a member of both! Yet after two careful readings, I am totally disarmed. While I disagree on some points, Elizabeth Pisani tells the truth about AIDS clearly and unequivocally.

Only global warming is more topical than HIV/AIDS. Any thinking person, lay or professional, must have serious questions. Why is the epidemic in sub-Saharan Africa so different from everywhere else? Why has the long-awaited Grim Reaper scenario (spreading throughout the general community) never eventuated? Why, with a virus which is “not actually all that infectious” but which has nonetheless caused 70 million infections world-wide, are we no nearer to controlling the epidemic? Pisani answers these questions with devastating clarity. She is eminently qualified to do so, with a PhD in epidemiology and more than 10 years’ field experience. She retains, too, the sharpness and ruthlessness of the investigative journalist she once was.

There are ribald stories and humour here, but throughout runs a barely repressed strain of anger. Bucket-loads of money are being wasted, good science is often ignored, truth has been replaced by lies and, as the author reminds us, prevention “programs based on lies don’t work”.

There is a softer side to this author. She is a friend of harlots and sinners. It is people considered the dregs of society who are most at risk. She says, “Getting HIV prevention services for people who needed them most has begun to seem like a debt I owe”. By her forthright analysis and outline of what needs to be done, she has gone some way towards paying her debt.