What the Human Trafficking Movement Can Learn from the AIDS Movement Success

September 02, 2015 Caleb Benadum Opinion 
Policy Making, Awareness

The anti-human trafficking world loves its statistics. They sound so dramatic, don’t they? You can hear them passed around at dinner parties, anti-slavery trainings and you might even hear one on a C-SPAN senate hearing. Nothing gets people excited like cold, hard facts. Why should you care about human trafficking? Easy! Because there are 35.8 million people enslaved! Because the average age of entry into prostitution is 13. Because it is a 9.5 billion dollar business in the United States alone.

But there’s a problem with our statistics. I say this in full complicity, having used them myself. Our statistics are bad. Our numbers aren’t good. Many of you probably think you know what I want to say. Despite what you think, I’m actually not writing to criticize the statistics but instead to support them (with a few qualifications).

We live in a global world where human rights issues gain prominence through movements. But it is incredibly difficult to provide global estimates. At some point it all ends in guesswork. The human trafficking movement comes on the heels of one of the greatest human rights issues of yesterday (and today): AIDS. In the 30 years after HIV/AIDS was first discovered the world fought it into submission. Retroviral drugs are available to people in the developed and developing world alike. Despite the continued prevalence of AIDS, new HIV infections fell by over 40 percent between 2000 and 2013 according to a recent report.

The AIDS movement is more similar to our anti-slavery movement than you might think. AIDS was discovered in 1981. The primary victims were marginalized sections of society, namely homosexuals and intravenous drug users. A massive public awareness movement influenced congressional policy. Federal discretionary spending on AIDS shot up to 3.85 billion dollars in 1999, allocated to programs all over the world. Rock stars held benefit concerts. Talk show hosts dedicated episodes to the AIDS crisis.

Now, let’s turn to human trafficking. Modern slavery first became an issue in the 1990s. It’s primary victims are often marginalized sections of society, e.g. prostitutes and migrant workers. A concern for human trafficking grew out of the women’s movement in the 1980s. Public awareness influenced congressional policy. Legislators passed the TVPA, and the Palermo Protocol cleared the UN General Assembly. Congress allocated 112.1 million dollars to anti-human trafficking in 2014. Celebrities have held concerts, created documentaries and founded organizations. Top journalists dedicated books and documentaries to the issue. Do you see the similarities?

The AIDS movement has been successful. The anti-human trafficking movement is just getting started. What I want to handle in this post is the following: how did the AIDS movement provide global statistics? Were they good? What can we, as anti-human trafficking activists, learn from their incredible success?

© IES Ben al Jatib on Flickr

Measuring an Epidemic: AIDS, Africa and Epidemiology

If you’re like me, you’ve probably assumed that AIDS statistics have always been spot on. Post-scientific revolution we have a certain instinct to trust anything that is “scientific.” The thinking goes like this: because something is inherently measurable (e.g., a T-cell count), then any statistic MUST be inherently infallible. But that is wrong. Now, let me qualify what I want to say: AIDS statistics in 2015 are probably pretty accurate. But they weren’t for the first 20 years of the movement. They were off by hundreds of thousands of people locally, and globally by millions.

The United States has an incredible and accessible healthcare system. Yet our data for the prevalence of AIDS has been continually revised since the 1980s, showing vast discrepancies between estimates. In 1987, the celebrity Oprah Winfrey claimed on live TV that one in five heterosexuals would be dead from AIDS by 1990. The claim was wildly inaccurate even based on the estimates of the day. AIDS experts estimated that 1.5 million Americans had AIDS, a number that was later shown by back-calculation to be an overestimate of about 500,000 people. Arbitrarily, the City of Manhattan brought its estimate of people living with AIDS down from 400,000 to 200,000 in the late 1980s. When we turn to global estimates, the discrepancies are larger. In the 1980s, the United States was a developed economy with one of the most advanced healthcare systems in the world. But they could not accurately measure AIDS prevalence. The largest proportion of AIDS is in Africa. How was that measured?

Prevalence statistics are created by measuring the disease in a discrete population and extrapolating those numbers to the larger population (which comes with its own difficulties, since rural African communities often don’t have accurate census data). The method of extrapolation is based on epidemiological models which are used to design complex algorithms that are meant to predict prevalence. The best prevalence data comes from household or population-based studies, where a section of the population is surveyed. The first household studies in Africa, and in India, were not conducted until the early 2000s. Before that, epidemiological models were mostly based on prevalence studies conducted in antenatal clinics, i.e. by measuring pregnant mothers and generalizing the data to the population of a country. This was later shown to be fairly inaccurate and resulted in a skewed sample population. Oftentimes, antenatal clinics were in urban areas. But much of the population of any Sub-Saharan country lives in the countryside. The urban populations were also more likely to spread HIV via drug use or poor healthcare. UNAIDS now recommends that population surveys and antenatal surveys take place at regular intervals. See this WHO report for more information on antenatal surveillance data versus population based data.

The first computer-based epidemiological model was developed by James Chin and was called EPIMODEL. The program was shelved in some areas. Notably, South Africa came up with their own model, due to EPIMODEL’s inaccuracy in estimations. But the statistics continued to be based off of antenatal studies until the early 2000s, when population-based surveys began to be conducted in many major Sub-Saharan African countries (notably in Angola, Kenya, Mozambique, Nigeria, and Zimbabwe). The numbers didn’t match up. This led to the United Nations completely retooling its statistics in 2007. In 2002, the United Nations had estimated the worldwide prevalence of AIDS to be 42 million people. In 2006, that same number had been adjusted to about 40 million. In 2007, the United Nations admitted that both had been wrong. The numbers had, in fact, been much lower. The more accurate estimates, developed by back-calculation, were an estimate of approximately 30 million people in 2002 and about 33 million people in 2006. The United Nations estimate for AIDS prevalence, 21 years after AIDS was first discovered, was off by 12 million people!

The year of 2007 began a series of withdrawals and recalculations. Some came out and criticized AIDS organizations for using numbers that were vastly inaccurate. James Chin, the developer of EPIMODEL, published a book which claimed that the AIDS numbers may have been intentionally inflated by up to 30 percent. Typical to any nonprofit or charity field, bigger numbers mean bigger money. Anyone can, and anti-slavery activists often do, fall into the trap of using big numbers we know are not accurate because we want people to care.

Measuring Human Trafficking: Flawed Numbers and Four Pinocchios

The Washington Post “fact checker” has consistently given human trafficking claims and statistics “four pinocchios.” For those of you unfamiliar with his ranking system, this means that they are unreliable or inaccurate. Human trafficking activists usually respond to any criticisms with some statement that numbers are hard to calculate. But several have tried to calculate worldwide statistics, and it’s worth briefly examining the two major estimates.

First, the Global Slavery Index. The Index has been highly publicized and is the brainchild of the legendary Kevin Bales. They published their first estimate of 29.8 million people in 2013. The next year that number jumped to 35.8 million. Their methodology is more important than the actual numbers, and it is flawed. Several noted anti-slavery activists have pointed this out, including legal expert Anne Gallagher. She pointed out that the data was drawn from just 19 countries—then extrapolated all over the globe. Countries were assigned values based on their similarities to other countries, and the comparisons were sometimes absurd or useless. Thus, anti-slavery activists have been wary to use the new Global Slavery Index to estimate slavery, and the Index’s researchers have acknowledged these criticisms.

Second, the International Labour Organization estimated that there were 20.9 million people in slavery in 2012. Their methodology seems a little sounder, but their data pool is still fairly limited. They analyzed thousands of reports from various parts of the world and validated over 7,500 reports upon which they based their statistical analysis. They used a statistical model that seems fairly reliable but do estimate a significant portion of unreported cases. Most importantly, they are open about their methodology and admit its flaws. They estimate it could be off by about 1.4 million people either way, but that number changes if you required a higher probability of accuracy.

Neither is perfect, but the ILO study may be more accurate than the Global Slavery Index. The methodology is certainly more robust. What will be interesting to watch is when the movement begins to get good data. We may not be able to back-calculate, like we can with a disease, but it will give us a better idea of where our numbers are in proportion to the scope of this problem.

What We Can Learn from the AIDS movement: Lessons for Anti-Human Trafficking

1.Advocate Strongly, not Wrongly

Many anti-slavery activists get caught in the numbers trap because they care deeply about the issue. They want to replicate that in others. But bad data will produce bad results. Know when your numbers are poor or inaccurate, and know how you got them. Advocate on behalf of victims of human trafficking with other evidence. Tell the stories of freedom’s heroes. Tell the stories of those who have survived. We know that this is a global issue. We have reports from every country in the world. We don’t know the real prevalence. But we know that it is a crime against humanity and that it should not be tolerated.

The AIDS movement was successful because they focused on stories, not just on scary statistics. People cared about the emaciated victims they saw in documentaries, stumbling through African villages or the alleys of Manhattan. People witnessed others around them dying of AIDS. Congress didn’t allocate 3.58 billion dollars to AIDS prevention just because of a statistic—they did it because they had met, seen and known people who died of AIDS.

2.Remember that Slavery Doesn’t Happen in a Vacuum

HIV/AIDS organizations were criticized for their numbers because of the way that their numbers resulted in funding allocations. Billions of dollars were poured into HIV/AIDS and with great success. New HIV infections between 2000 and 2013 fell by 40 percent. Some healthcare experts have argued that the massive amount of funding poured into AIDS treatment and prevention takes funding away from other areas. A 2007 LA Times article, “The Unintended Victims of Gates Foundation Generosity,” illustrates this point. A mother who was living with AIDS received expensive retroviral drugs but gave birth to an infant who died for lack of a 35 dollar breathing tube. What use is it to pour money into AIDS programs when people are dying in droves of other, often easily-treated, diseases?

No one would deny that every dollar spent on AIDS is spent on a good cause. The point is merely that the nonprofit world has to be careful not to exaggerate or bolster one issue over others. Disproportionate funding results in unequal care. Imagine a world where millions are poured into anti-human trafficking efforts, yet other foundational issues continue to open people to being trafficked. We can rescue victims, but let us pray for a day when there are no more victims to rescue. When we advocate for funding for anti-human trafficking efforts, let’s be careful not to fall into the trap of believing that slavery happens in a vacuum. We need to work together with immigration attorneys, refugee protection officers, people involved in homeless care, anti-poverty workers and a host of others who aren’t directly anti-slavery activists. Advocate strongly for our cause, but advocate strongly for others as well.

3.Refocus the Issue: Help End Human Trafficking

Let us say to those who criticize our numbers: give us the benefit of the doubt, and we will continue to work on getting better estimates. Focus instead on the fact that this has been documented in every country in the world. Focus instead on the horrific nature of this crime and the world’s inability to stop it. We want what you want: effective anti-slavery programs that rely on solid data. We are trying hard with the data we have. It took the AIDS movement billions of dollars and over 25 years to come up with a good global estimate of AIDS prevalence. How much harder will it be for the anti-slavery movement? Not only are we dealing with a shadowy issue, poor reporting mechanisms (e.g., criminal justice systems) and poor enforcement, our movement has a relatively low rate of funding and is barely 15 years old.

Statistics are useful insofar as they help people to care about a cause and about the people affected. They will continue to be useful, and they will continue to get better. But a little bit of trouble is to be expected. What the anti-human trafficking world is going through right now is merely growing pains. The HIV/AIDS establishment faced the same crucible—and survived. The success the world has had against the horror of HIV/AIDS should be encouraging to anti-slavery activists around the world. The world’s fight against human trafficking, counting from the first international protocol forward, is only 15 years old. We have much to learn from the causes that have come before us and much to teach the human rights causes that will follow. Maybe we can’t agree on the numbers just yet, but let us agree to one thing:

One person enslaved is one person too many.

Topics: Policy Making, Awareness

About the Author

Caleb Benadum

Caleb Benadum is the Program Manager for the Trafficking in Persons Report Global Heroes Network, an upcoming web-based project planned for January 2015. He graduated from Capital University with a degree in Philosophy, and the University of Cincinnati Law School with a Juris Doctor degree. Having spent much of his life overseas, he is committed to modern-day abolitionism and the promotion of human rights around the world.