AsiaOne: Sex, drugs and the hard facts (Nov 9)

Sex, drugs and the hard facts

In town last month to promote her work, Elizabeth Pisani, the London-based 44-year-old epidemiologist, is as unflinchingly honest in real life as she is in the book.
Tan Hui Yee

Tue, Nov 11, 2008
The Sunday Times

The speaker takes the microphone to address the handful of people at the corner of Page One bookstore. Please, he asks those milling around, take your seats for a session with the author.

No one stirs until a small, pixie-faced woman leans over the mike and announces: 'Sex and drugs in the corner! Sex and drugs in the corner!'

Peals of laughter break out. The seats fill up. The woman is Elizabeth Pisani. Her newly released book, The Wisdom Of Whores, gives an insider's view of the bloated Aids industry and it literally has a lot to do with sex and drugs.

In town last month to promote her work, the London-based 44-year-old epidemiologist is as unflinchingly honest in real life as she is in the book. The former Economist journalist, who spent more than 10 years tracking and fighting the spread of the disease in organisations such as the World Bank, UNAIDS and the World Health Organisation takes no prisoners as she attempts to pin down exactly what is wrong with the system.

Acquired immune deficiency syndrome (Aids), she says, is 'completely preventable' with a condom and a clean needle. The HIV virus, which causes it, is spread mainly through sex, and drug addicts using infected needles.

But bureaucrats, religious leaders and politicians are squeamish about providing or promoting the use of the two relatively cheap items. Some even insist on making abstinence central to HIV prevention programmes.

'But discouraging sex is never a winning game. Sex is a lot of fun and people will go a long way to get it,' she says.

'Abstinence has no effect on preventing the spread of HIV. It sometimes delays the spread of HIV by about a year and a half, but it doesn't seem to have any effect at all on the overall levels of HIV.'

She also pokes fun at unrealistic pro-abstinence groups, one of which suggests on its website that people 'visit a nursing home' instead of having sex.

'Hmmm, visit a nursing home or have an orgasm? Now let me see...If we base our prevention programme around things which are so obviously absurd, we're going to get nowhere,' she declares.

'Absurd' is also the word she uses for the Singapore Government's move earlier this year to criminalise anyone who has reason to believe that he may be infected with the HIV virus and yet has sex with another person without first informing that person of the risk.

She says: 'I can't imagine a situation when you're in Batam for the weekend with your golf buddy and you're in the brothel, and you think: Oh, you know what, actually I won't have sex with this girl because otherwise if I don't tell my partner I might get into trouble. Or I will use a condom because otherwise...People don't think like that. It's impossible to regulate your way out of this problem.'

'Nothing,' she declares, 'gets in the way of common sense like erections and addiction.'

In her book, she suggests instead that the enforcement of condom use be put in the hands of those in power. The Thai government, for example, registered great success when it threatened to put out of business brothel owners who were lax in enforcing the use of condoms.

The scientist in her will not let political correctness get in the way of plain facts.

While she is derisive of religious zealots who try to paint Aids as a gay disease, she is equally critical of gay men who are lax in their use of condoms.

She writes in her book: 'HIV is not divine retribution for unprotected anal sex with lots of other people. It is simply a consequence of unprotected anal sex with lots of other people, in the same way that lung cancer is a consequence of smoking, and obesity is a consequence of eating fast food, drinking supersized Cokes, and getting in your truck to drive the 800 yards to church instead of walking.'

In Singapore, where heterosexual sex is the main source of HIV infection but gay sex accounts for the fastest-rising source of reported cases, 'the gay community should be very worried', she tells The Sunday Times.

'To say 'Oh, this isn't a gay problem' doesn't help reduce the stigma because in the end what you get is more disease.'

However, she notes that Section 377A of Singapore's penal code, which criminalises sex between men, makes it more difficult for gay men to seek the information they need to protect themselves.

Globally, the budget for Aids in developing countries has grown from a mere US$300 million (S$449 million) a year in 1996 to US$10 billion last year, but vast amounts of money are wasted because governments, for ideological or political reasons, are not focusing enough attention on the groups which need them most - gay men, sex workers and drug injectors.

For example, the United States, which budgeted US$4.2 billion for HIV in developing countries this year, does not allow federal funds to be used on clean needles for drug injectors.

Wastage also stems from the fact that many countries prioritise Aids treatment over other equally or more pressing health threats.

'Why should someone with HIV get free treatment when someone with lung cancer doesn't? The reason that distortion exists is because there is a massive international lobby for free HIV treatment. So developing countries, where a big proportion of the health budget comes from donors - and Indonesia is a classic case - very often spend a big proportion of their health budget on HIV.'

Asked about the provocative title of her book, she paid tribute to the transgender sex workers on the streets of Jakarta who provided her with the greatest insights after she went there seven years ago to work on HIV prevention.

She mentions in particular Ms Ines Angela, a sex worker in Jakarta who pointed out that surveys on sex workers were skewed because researchers were interviewing the least active individuals.

Ms Pisani relates, with a chuckle: 'She said, 'Any sex worker who is on the street talking to a research team is a sex worker who is not with a client... I'm never on a street corner, I'm with a client.'

'And I was like...she's right. Oh dear.'

After that, surveys on the sex workers were conducted through their internal hierarchies, with each district's leader gathering interviewees at her home in the daytime, when they were not working.

The other reason for Ms Pisani's choice of title is somewhat more grim. The budget to fight HIV/Aids worldwide has ballooned almost disproportionately in relation to the number of people suffering from the infection. The number of people living with HIV rose by 38 per cent between 1996 and 2006, but spending on HIV in developing countries surged 2,900 per cent over the same period.

This money, in turn, has attracted groups - some not entirely relevant to the cause - into vying for a piece of the pie.

She reflects: 'After nearly 15 years in this ever-better funded industry, more and more money is sloshing around, and more non-governmental organisations, United Nations organisations and international organisations are jumping into the cause. You see people bending over backwards to get HIV money. In the Aids industry these days, we're all whores.'

» Go to www.straitstimes.com for more on Ms Elizabeth Pisani.

The Wisdom Of Whores. Bureaucrats, Brothels And The Business Of Aids, published by Granta, by Elizabeth Pisani, is on sale at $40.66 (with GST) at major bookstores

This article was first published in The Sunday Times on Nov 9, 2008.

TodayOnline: There is a reason for the law, Homosexuality is anti-social (Sept 10)

There is a reason for the law

Homosexuality is anti-social

Wednesday • September 10, 2008

Letter from Heikel Bafana

I REFER to "Stop making a mockery of Rule of Law: Let's accept gays"
(Sept 8). I must disagree with the assertions of Mr Ho Kwon Ping.

Mr Ho calls for homosexual behaviour to be decriminalised. Whatever
perception he has gleaned from the official attitude, the views of
large segments of our society against the homosexual lifestyle are
neither ambiguous, ambivalent nor schizophrenic.

Whether due to religious belief or personal family values,
homosexuality is widely seen in Singapore society as aberrant
behaviour. I concede, of course, that this view is not shared by
members of the gay community.

Mr Ho's assertion that only "the most fervently fundamentalist
Christians or Muslims" in Singapore care about making gay sex a
criminal act is baseless, and indeed, false.

The Penal Code provision represents the manner in which the law
expresses our society's commonality of understanding as to what is to
be allowed and what is not.

Encouraging a family unit that is able to procreate and rear children
who will contribute to the future of this country is the prime
imperative of our society, and legislating against any behaviour —
including accepting widespread homosexual behaviour, which attacks the
sacrosanct nature of the family unit — is perfectly acceptable.

The Rule of Law constitutes the sum total of the social contract which
we, as citizens, agree to live by. In a multi-racial and multi-faith
society like Singapore, the Rule of Law is a delicate alchemy of
competing racial, cultural and religious demands. It cannot be subject
to change merely because of the high-pitched calls of a small segment
of our society.

I concede that in the context of the prevailing practice of the
criminal justice system here, the belief may arise that homosexual
acts are not subject to criminal prosecution. However, this belief is
not entirely accurate.

Similar non-prosecutions by the authorities are also the norm, for
example, in cases of mischief or of assault involving simple hurt.

However — and this is the critical distinction — the victim still has
the right to lodge a Magistrate's Complaint and undertake a
prosecution himself. From this perspective, why should a person who
feels aggrieved as a victim of homosexual behaviour be deprived of
such a right to prosecute an assailant?

To achieve acceptance, tolerance or respect, perhaps it is more
effective for the gay community to address in substance the issues
which lead society to frown upon homosexuality. Such engagement would
be more effective than getting tied up in knots about the law.

Mr Ho calls for an act of boldness to allow gays to "realise their
dreams". To believe that changing a piece of legislation will attain
this result is misconceived.

TodayOnline: There is simply no need for anti-gay law (Sept 10)

There is simply no need for anti-gay law

Wednesday • September 10, 2008

Letter from Tang Li

I REFER to Mr Ho Kwon Ping's "Stop making a mockery of Rule of Law:
Let's accept gays" (Sept 8), and I would like to applaud him.

Like Mr Ho, I have to ask myself if there is any justification for
keeping a private act between consenting adults, criminal.

During last year's debate on the repealing of Section 377A, Nominated
Member of Parliament Thio Li-Ann argued passionately that repealing
the act was bad for public morality. In her address, she noted that
"Diversity is not license for perversity".

The majority of Parliament agreed with this and the result was the
retention of 377A, but with a promise from the Government that the law
would not be enforced.

Mr Ho rightly pointed out that the idea of having a law that the
Government has no intention of enforcing makes a mockery of the Rule
of Law, something which is central to the heart of Singapore's
rules-based society. The proponents of the ban on homosexual
intercourse spoke passionately about the need to defend public
morality, but they failed to provide a logically-sound reason for
their case.

At best, Professor Thio argued that private acts would have public
repercussions as in the area of public health. She pointed out that
HIV/Aids was spread most efficiently by anal sex.

What she failed to prove was how anal sex between two consenting men
was more conducive to the spread of HIV/Aids than anal sex between
heterosexuals.

The Ministry of Health's statistics on HIV found that in 2007 there
were 255 heterosexuals infected, versus 145 homosexual and bisexual
infections, something that nobody seemed to have taken note of.

Furthermore, the defenders of public morality didn't seem too troubled
by the fact that the greatest rise in HIV among women was from
loyally-married women who were infected by their husbands.

So, where is the premise for having a law against consensual
homosexualactivity? Singapore is socially-conservative, but does that
mean it is necessary to have laws — albeit non-enforced ones — that
discriminate against one group without protecting another?

Ministry of Health statistics on HIV show that anal sex between
consenting adult men is no less of a threat to public health than sex
between heterosexuals. So, why then do we need laws if there is no
threat to public health or security? Is it because the majority of
people disapprove of it? Surely, the people who disapprove of such
acts would continue to disapprove of them regardless of whether laws
against them exist or not?

There is no rational premise for laws against homosexuality, so why do
we need them? More importantly, why do we have such laws if we have no
intention of enforcing them? Is it because we know that such laws have
no benefit to society? I may not like homosexuals or homosexuality,
but I can see no reason for laws against what consenting adults do in
the privacy of their bedroom.

I salute Mr Ho for taking a stand against the current mockery of the
Rule of Law.

TodayOnline: Sexual orientation not a 'right'

Sexual orientation not a `right':

Just because the rest of the world allows it, doesn't mean Singapore
should

Wednesday • September 10, 2008

Letter from Koo Xun Zhao

I REFER to "Stop making a mockery of Rule of Law: Let's accept gays"
(Sept 8) and would like to point out several fallacies in Mr Ho Kwon
Ping's reasoning.

First, contrary to what he says, the Government has not said it would
not prosecute those who breach the law — just that it would not pursue
those who breach it.

This is a fundamental difference which does not result in what he
calls "a mockery of the Rule of Law". It can be just as easily argued
that we can avoid what Mr Ho calls our current "schizophrenic"
situation by actually enforcing the law on gay sex.

After all, it was the Rule of Law before the Government decided to be
more open to gays.

Mr Ho also compares the so-called "persecution" of gays with racial
discrimination. Sexual orientation or preferences, however, are not
"rights".

Hence the question of discrimination does not arise. Mr Ho also cites
proponents of the Rule of Law advocating the decriminalisation of gay
sex, "something which the rest of the world has long decriminalised".

Using what the rest of the world does as the basis for establishing or
repealing a law has no grounds in law-making.

The same goes for the argument that Victorian laws be removed as there
are important laws in our books today that exist from those times that
are still relevant: For example, the law against incest.

Mr Ho claims that it is only "the most feverishly fundamentalist
Christians or Muslims" and the "homophobic" who care about whether the
law against gay sex is kept. In this, he is misinformed since there
are even gays who feel that the statute should be kept.

Moreover, The Straits Times reported on Sept 20 last year that a
survey by Nanyang Technological University found that seven in 10
Singaporeans frown on homosexuality.

I urge Mr Ho to speak to non-gays who are also knowledgeable, if not
experts, in the law and who are for criminalising gay sex to get their
perpectives on the issue.

TodayOnline: Don't send mixed signals (Sept 9)

Don't send mixed signals

Tuesday • September 9, 2008

Letter from Felicia Tan Ying Yi

I REFER to the commentary "Stop making a mockery of rule of law: Let's
accept gays" (Sept 8). I fully agree with Mr Ho Kwon Ping.

The Government's stand on homosexuality in Singapore seems to pander
to religious fundamentalists who are vocal.

Such an attempt to pacify those who believe that it is their place to
impose their value system on others should not happen in a country
that prides itself on openness, secularism and pluralism.

It is all too convenient for the Government to "appease" the gay
community by not taking action against them, while at the same time
continue to pacify the conservatives by keeping the law in name.

However, this merely cheapens what the rule of law means. Laws should
not be made or retained to reflect the views of a vocal minority; in
fact, their purpose should not even be to reflect the views of the
majority.

Instead, they are there to protect the rights of the citizens. In this
way, section 377A of the Penal Code achieves nothing.

I feel that the Government should be courageous enough to finally
decide that everyone, regardless of gender, sexual orientation, race
or religion, has an equal right to privacy, and this right should
never be superseded by the moral posturing of any group, regardless of
how vocal or influential.

Or, if the Government should still choose to retain this archaic law,
then it should enforce it instead of sending mixed signals.

But it should also be ready to expect the exodus of not only the gay
community, but also of liberal, tolerant people like me, who refuse to
settle down and start families in such a country.

TodayOnline: What's next? Same sex marriages? (Sept 9)

What's next? Same sex marriages?

Tuesday • September 9, 2008

Letter from Anton Chan

MR HO Kwon Ping is wrong to propose the acceptance of gays into
Singapore society because accepting a gay lifestyle would have a
tremendous impact on society as a whole in terms of religious beliefs,
social well-being and families.

As a Christian, I oppose legalising a gay lifestyle in Singapore
because it's against my beliefs. As a father of three teenagers, I
care because I don't want my children to be affected by such a lifestyle.

Imagine if we allow the acceptance of such a lifestyle in Singapore.
What next? Legalise same sex marriages? Legalise adoption of children
for gays?

Where are we as a socially-conservative society heading towards?

Soon gays will claim the right for social acceptance in all areas
including education, welfare et cetera. What effect will this have on
the next generation of children and parents who wish that their
children will grow up normally and produce children in the normal
course of their being?

The only strong contention in Mr Ho's proposal is the so-called gay
leading edge in the "creative class". Doesn't our society have many
other people to develop and nurture? Why are we so eager to promote
creative class talent in Singapore? So that we can become a more
tolerant society to accept whatever lifestyle these bring? Definitely no.

I would like to borrow a similar argument by Attorney-General Walter
Woon regarding the Human Organ Transplant Act (Hota). In "None above
the law" (Sept 8), he said: "If Dr Lee (Wei Ling) disagrees with Hota,
she is at perfect liberty to campaign to have it amended ... But until
Parliament amends or repeals the Hota and the Oaths and Declarations
Act, they remain the law of Singapore."

If anyone disagrees with the law for gays as enacted by Parliament,
he/she is at perfect liberty to campaign to have it amended ... But
until Parliament amends or repeals the law of Singapore for gays, it
remains the law of Singapore.

TodayOnline: Stop making a mockery of rule of law: Let's accept gays (Sept 8)

Stop making A mockery of rule of law: Let's accept gays

Why keep such an archaic statute when there's no intention to prosecute?
http://www.todayonline.com/articles/274653.asp

Monday • September 8, 2008

HO KWON PING

news@newstoday.com.sg

SINGAPORE is known to be economically liberal, but socially
conservative. It is a rules-governed society with clear parameters for
behaviour, whether political, economic, or social. And within the "OB
markers" (out-of-bounds markers) of these do's and don'ts, it is a
transparent and fair social order, with no favouritism for anyone
operating outside the parameters.

This state of affairs governed the issue of homosexuality in Singapore
for many years. Not only was gay sex illegal, but every manifestation
was openly discouraged — some would say suppressed — and
discrimination against gays in the public domain (the civil service,
the military, the police, schools, and so on) was commonly accepted.
Indeed, because it was public policy to promote heterosexual family
life as the only norm, any other lifestyle was considered deviant and
handled accordingly. Repressive though it certainly was to gays, it
was at least very predictable.

Today, official attitudes towards homosexuality in Singapore are quite
different. They are certainly ambivalent and ambiguous — some would
even say, schizophrenic. On the one hand, many gay Singaporeans are
feted and lauded for their creative contributions to Singapore, and
warmly accepted by even senior figures of the establishment. On the
other hand, gay sex remains a criminal activity, even after much
public debate on the issue, and any kind of activity which is seen to
promote a gay lifestyle remains off-limits.

To those who believe that the non-persecution of gays is already
something to be grateful for, one could argue that allowing a black
person to sit in the front of the bus while legally forbidding it, is
something to be grateful for. Or, in an analogy closer to home for the
supposedly homophobic heartlanders, should a Chinese person be
grateful if the edict forbidding Chinese and dogs to enter parks in
Shanghai in the '20s were relaxed in reality, but maintained in the
law?

At another level, my gay friends argue cogently that non-prosecution
(or non-persecution, for that matter) signals, at the most, simple
tolerance of them, and nothing more. There is a difference between
being tolerated because gays are seen to be at the leading edge of the
"creative class" — which Singapore is trying to develop as part of its
new knowledge-based, creativity-oriented economy — and being accepted
because of the recognition that fundamental human rights and the
dignity of the individual extends to gays as much as to anyone else.

The somewhat schizophrenic decision to not prosecute an illegal
activity has ramifications beyond the gay community, and has disturbed
some sections of the larger community, which is not particularly
interested in gay issues.

To many thoughtful citizens, Singapore has always openly claimed that
the Rule of Law, possibly even more than the formal mechanisms of
democracy, is a vital component of good governance. Yet, to
criminalise gay sex and, in the same breath, state that anyone
breaching this law will not be prosecuted, makes a mockery of the Rule
of Law.

Minor though this violation of the principle may be, the proponents of
the concept that the Rule of Law is a sacrosanct pillar of the
Singapore ethos lament that the Government did not take the bold step
to simply decriminalise something which the rest of the developed
world has long decriminalised; which most Singaporeans (except,
perhaps, the most fervently fundamentalist Christians or Muslims)
don't care that much about one way or the other; which the police,
courts, and legal community would welcome simply to remove an archaic,
Victorian-era statute; and finally, which the gay community would
embrace as an important signal that their right to privacy — a
fundamental human right — is considered to be more important than the
right of anti-gay groups to proselytise about morality.

Optimists hope that the decriminalisation of gay sex — a yawn to
anyone except the homophobic and the gays themselves — will eventually
occur. In reality, rather than in law, gays in Singapore today have
never had it so good, and should within a short time, become
fully-accepted — not just tolerated — members of an increasingly
diverse, and therefore vibrant, Singapore community.

But if we pat ourselves on the back for being so "bold" as to accept
casinos and Formula 1 events into staid Singapore, why can't the
boldness extend to a simple act to enable gays to realise their dream
— indeed, their simple right — to be normal Singaporeans like anyone
else, no more and no less.

The writer is chairman ofSingapore Management University,executive
chairman of Banyan Tree Holdings and chairman of MediaCorp.