October 5 is International Day of No Prostitution.
There is a growing effort to frame commercial sex as merely “sex work”—an economic choice and a matter of labor rights. Proponents argue that paid sex provides an income stream, enabling individuals to support their families in an increasingly harsh economic landscape. But this framing masks a deeper structural truth. When we analyze prostitution through a Primary Health Care lens and measure it against genuine social rights, the claim that commercial sex is an empowering opportunity quickly collapses.
A true right functions as an “equalizing opportunity”. Rights such as quality education, comprehensive healthcare, social welfare, and secure shelter expand human capability, protect bodily integrity, and foster genuine equity. They level the playing field so that every person can thrive regardless of socioeconomic status. Viewed through the social determinants of health, these rights are not luxuries—they are the conditions that keep entire communities well.
Prostitution stands in direct opposition to this definition. It does not equalize; it reflects and deepens existing vulnerabilities. It is not an alternative created by choice but a default mechanism driven by poverty, unemployment, and the absence of basic safety nets. From a Primary Health Care perspective, commercial sex is not a livelihood—it is a vector of violence, trauma, and disease that concentrates harm among those already least protected.
Neoliberalism and the deprivation of social services
To understand why commercial sex is framed as a “survival choice,” we must examine the macroeconomic forces shaping our communities. Under neoliberal policy, the state systematically retreats from its obligation to guarantee social welfare. Public spending on health, housing, and education is slashed, privatized, or commodified.
When social services are gutted, three things follow:
– Essential needs become market goods. Healthcare and education are transformed from fundamental rights into costly commodities that must be purchased.
– Safety nets vanish. Families facing catastrophic illness, joblessness, or displacement are left without state support.
– Survival is individualized.The burden of structural failure falls entirely on the individual, forcing marginalized people—predominantly women—into high-risk survival strategies to secure food, shelter, and medicine.
In this climate, governance favors corporations and commercial elites, prioritizing profit margins and deregulated markets over human well-being. The expansion and normalization of the commercial sex industry fits seamlessly into this paradigm.
Who truly profits?
The argument that legalizing prostitution empowers marginalized women ignores the realities of political economy. In practice, full legal recognition of sex establishments primarily benefits third-party exploiters: brothel owners, agency operators, “casa” managers, and traffickers who capitalize on women’s bodies for commercial gain.
When commercial sex is absorbed into the market as standard enterprise, the state abdicates its responsibility to provide real economic alternatives. It effectively tells marginalized women that instead of social protection, education, or decent work, their primary economic asset is commercial access to their own bodies.
The path forward: Decriminalizing women, penalizing exploitation
If our goal is human rights and health equity, policy must rest on two uncompromising principles:
1. Decriminalize the individual. Women and marginalized people in commercial sex must be free from police harassment, arrest, and prosecution—and must be offered real options: comprehensive healthcare, housing, educational pathways, and social welfare support.
2. Penalize third parties and buyers. The financial incentives for exploitation must be dismantled. Pimps, establishment owners, buyers, and traffickers who profit from economic vulnerability must face civil and criminal accountability.
This approach—the Equality or Nordic Model—treats commercial sex not as a legitimate substitute for state welfare, but as a symptom of structural inequality.
We cannot allow neoliberal policy to redefine survival under poverty as a human right. A just society does not ask vulnerable people to compromise their bodily integrity to survive; it restructures its economy to guarantee education, health, shelter, and dignity for all. (davaotoday.com)
