Windhoek — Minister of Health and Social Services, Dr Richard Kamwi, says Namibia has to mobilise resources and prepare the country's health facilities before scaling up male circumcision for HIV prevention.

The ministry, traditional circumcisers, donor partners and other stakeholders yesterday embarked on a two-day workshop that will highlight shortcomings before the rolling out of this exercise.

"At this stage, the health services are not yet ready," said the minister.

Scaling up safe male circumcision requires trained healthcare workers as well as equipment and supplies in place.

However, Kamwi told New Era that training of staff is not much of a concern because before nurses and doctors become qualified to practice, they undergo training, which includes surgery work.

Costs estimates for surgery (removal of the foreskin from the penis) per individual in neighbouring South Africa is N$55.75, revealed Dr Brian Pazvakavambwa, UN Agencies AIDS Team Leader for Inter-Country Support Team for Eastern and Southern Africa.

"Male circumcision requires resources, hence the need for a well calculated plan," the minister said.

A situation assessment found that in Namibia, only 21 percent of the male population is circumcised and with the World Health Organisation recommending that Sub-Saharan African countries consider scaling up male circumcision for HIV prevention, the country would have to include this in its intervention package.

Pazvakavambwa says in every three circumcised men, the nation would be able to prevent one new HIV infection. And for every HIV/AIDS positive person requires at least N$16877 (US$2411).

Namibia records 40 new infections on a daily basis.

Despite evidence being there that circumcision in men reduces their chances of contracting HIV by 60 percent, there is fear that people might abandon other preventative measures such as abstinence, being faithful to one partner and the proper use of condoms each time one engages in sexual intercourse.

According to the minister, there is need for effective communication as the danger stands that the circumcised few might get a false sense of security and abandon other preventative strategies that exist.

"This is not a magic bullet or a vaccine that is 100 percent safe," Pazvakavambwa said.

According to Pazvakavambwa, countries with high circumcision levels such as those in western Africa have low HIV prevalence rates.

Sub-Saharan Africa leads in HIV prevalence, with Zimbabwe and Botswana standing at about 25 percent and Namibia 19.9 percent.

Pazvakavambwa explained that the thinly keratinised mucosal layer of the inner foreskin is susceptible to minor trauma and abrasion during intercourse. That can facilitate entry of pathogens.

HIV mainly targets the Langerhans cells found on the foreskin and thus, "The study of foreskin and cervical biopsies showed that inner foreskin is more easily infected with HIV than external foreskin or cervical tissue," added Pazvakavambwa.