The relationship of casual, commercial sex to an extremely infective infectious disease like Covid-19 cannot be underestimated.
New Delhi: Leading epidemiologists, medical scientists and researchers from the public health institutions of two leading US universities, Yale and Harvard, recently put out a mathematically modelled study that highlights the critical importance of the continuing closure of Red Light Areas (RLAs) in India to contain Covid-19 cases, limit hospital load and reduce deaths. The study predicts “a significant increase in the surge in Covid-19 cases, hospitalizations and deaths in India if RLAs are not closed post lockdown, which could overwhelm the medical system, economy and country.” Comparing reopening and an extended closure of RLAs, they project reduction by 32-60% of cumulative Covid-19 case load and 44-67% of Covid-19 related deaths at the peak of the epidemic. Extended closure could also serve to delay the peak by 8-23 days.
While the projections may be overly dramatic, for mathematical models cannot be the best predictors of human reality, the acute causal relationship of casual, commercial sex to an extremely infective infectious disease like Covid-19 cannot be underestimated.
The study rightly argues that operational RLAS would rapidly become hot spots—not punning but in Covid zoning terms—because while social distancing is an essential tenet of Covid-19 prevention sexual activity by its very nature precludes it. RLAs have concentrations of “sex workers”, “vulnerable to high rates of infectious disease transmission, experience particularly high rates of asymptomatic transmission of infection, a notable component of Covid-19, because of the high number of daily contacts. (Japan has just placed “sex workers” in the highest risk category for contracting the virus—the only other “profession” on par with medical workers’ risks.) Additionally, as commercial sex buyers include truck drivers and migrant labour as known major user categories, the potential for widespread Covid-19 transmission into other geographical areas is axiomatic. The study points the way forward with structured financial support and alternative employment to reintegrate the displaced. Unexceptional logic with empathy. The damaging potential of operating RLAs is sheer common sense.
But interestingly, the study has stirred a hornets’ nest among a clutch of former bureaucrats and activists who have written to the US universities demanding a withdrawal of the study. They have queried its estimates and assumptions; protested its release without prior peer review (authors’ self declaration); accused non transparency of research methodology; non response to multiple requests to see findings and decried their direct reach to policymakers and media bypassing civil society organisations. They have raised considerable hue and cry in the media.
Why there must be intermediaries to process information to political leaders and public is a question worth asking these protestors who, unfortunately, do have enough clout with the US universities to have elicited a prompt assurance to review the study. Whatever the outcome of that review, it is also necessary that the public knows that this protest is being shepherded by a lobby far from unbiased. The lead signatories/spokespersons are ex bureaucrats who arrived at some eminence only because of their very ready acceptance of very flawed mathematically modelled projections based on arbitrary estimates and assumptions—then also backed by huge donor funds—for the HIV/AIDS pandemic hysterically unfolding 20-25 years ago.
The lead signatories helmed the very organization—NACO (some others grew from HIV/AIDS projects)—that created a knee jerk reaction across the range of the political spectrum in India. Efforts to legalise brothels did not take off but widespread legitimization of RLAs and the commercial sex phenomenon was secured; the euphemism “sex work” for commercial sex exploitation popularized and the formulation “sex worker rights” championed as human rights instead of human rights violations. Strident, coordinated effort by Western donors for an “enabling environment” for commercial sex and a condom and STD drug protected “safe sex” national strategy for HIV/AIDS prevention ensured multimillion dollars poured into projects that built the profile of “sex as work” and “workers’ rights”; the cookie cut creation at Sonagachi in Kolkata hailed as a global icon.
HIV/AIDs prevention strategies destroyed such public health systems as still existed then by the creation of NACO and its state subsidiaries as silos of great influence, diverting health officials time and resources to this one disease at the cost of all else. Considerable funds were also placed outside public accountability systems to richly fund newly created affiliations comprised solely of those with high risk sex behaviour, seeding socially destructive change unthinkable till then in socially conservative India.
Those of us who worked on these issues then and opposed such mindless strategies tooth and nail were marginalised. Prostitution increased by leaps and bounds and brothels flared up along the highways of the country as truck drivers got special projects to facilitate “safe” sexual activity and petrol pumps and roadside dhabas lost their embarrassment to become condom depot holders. (Articles, research documents and TV programmes still exist to bear out the veracity of what is said here.)
The widespread official legitimisation of prostitution and deliberate ambiguity created about the laws of the land greatly accelerated the numbers of those selling sex. Efforts for India to emulate the excellent Swedish model that penalized the buyer but rehabilitated the exploited seller (rapidly adopted by many other countries) was debunked here, while the Dutch, German, Australian and Thai models that legalized/or otherwise encouraged commercial sex were touted as the great success stories. The Covid-19 pandemic that has cleared the skies of pollution has also reversed this other seemingly irreversible phenomenon.
As the Yale/Harvard study now documents, Netherlands, once the leader of the legalised sex trade movement, has opened Amsterdam but not reopened its brothels; nor have its co followers Germany and Australia; the latter has now also banned strip clubs and sole sex operators. Covid-19 has brought in its wake a chance to reassess and rectify havoc created by that other media stormed global pandemic.
What are these RLAs in India? Nothing but a colonial legacy created by the British by chalking off areas in towns for their Tommies to be able to enjoy medically checked “safe” native women. Independent India should have long closed these cesspools of female sexual exploitation with adequate funding to provide alternatives to the poverty stricken exploited women—the vast majority there after sexual assaults, broken and ravaged, the majority as minors. Instead the HIV/AIDs pandemic solidified and “dignified” this despicable colonial legacy, increasing numbers, decreasing age at entry with the aged discarded after use like refuse. Today as Covid-19 brings the issue full circle it is ironic to see the HIV/AIDS band rising up to cry foul.
The sex industry ranks with arms and drugs as a huge multi-billion dollar enterprise with its tentacles in many businesses. Huge vested interests will not allow sex slavery and pornography to be eliminated even in civilised modern existence. Unfortunately, the HIV/AIDS pandemic served as a convenient respectable vehicle that could co-opt large sections of civil society, academia, media and of course politicians into another way of thinking, conflating these anti social activities with personal freedoms, freedom of expression and human rights. Whatever its other mal-consequences, Covid-19 offers a second chance to put right the damage of that HIV/AIDS legacy.
Finally, contrary to what former heads of Naco publicise about lack of transparency/accessibility of the present Yale/Harvard study it is in the public domain, readily accessible, including all data generated from the study with its code available on a link openly given of the GitHub repository. By contrast I accessed the voluminous HIV/AIDS research conducted at the Indian taxpayers’ expense only through one of the first Right to Information applications filed under the Act. That’s another whole story—suffice here to say that the mathematical models on which the entire edifice of HIV/AIDS prevention was constructed was so false that the actual numbers were less than half the HIV prevalence touted to corner huge funds that denied other health priorities, just to bring down its incidence from a non-existent high level. So much for a biased lobby’s militant demand for “due procedures” and “credible report”.
But ignore the maths; common sense arguments are sufficient so that Covid-19 numbers don’t become more monstrous and some good yet flows from having gone through this havoc.
Rami Chhabra is a media veteran, who pioneered the first feminist columns in the national press. She has served the country in various capacities, including in GoI and as Member, National Population Commission.