The United Nations body tasked with combating the spread of HIV/AIDS and the United States scheme that funds global efforts against the pandemic today launched a five-year action framework to accelerate the scaling up of voluntary medical male circumcision as a prevention measure in Africa.
"Voluntary medical male circumcision is a high-impact and cost-effective prevention tool that will bring us one step closer to our goal of an HIV-free generation," said Michel Sidibé, the Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS), when he unveiled the action framework, a partnership with the US President's Emergency Plan for AIDS Relief (PEPFAR).
"Each HIV infection averted is money in the bank and fiscal space for the future," he said at the 16th International Conference on AIDS and STIs (sexually transmitted infections) in Africa (ICASA) in the Ethiopian capital, Addis Ababa, where the initiative was launched in the presence of the US Global AIDS Coordinator Eric Goosby and former President of Botswana, Festus Mogae.
The action framework - developed by the UN World Health Organization (WHO), UNAIDS, PEPFAR, the Bill & Melinda Gates Foundation and the World Bank in consultation with national health ministries - calls for the immediate roll-out and expansion of voluntary medical male circumcision (VMMC) services in 14 priority countries in Eastern and Southern Africa.
Voluntary medical male circumcision has been found to reduce the risk of sexual transmission of HIV from women to men by about 60 per cent when carried out by well-trained health professionals. Since 2007, WHO and UNAIDS have urged countries with high HIV prevalence and low levels of male circumcision to expand access to safe VMMC services.
Recent modelling commissioned by PEPFAR and UNAIDS found that reaching 80 per cent coverage of adult VMMC in the 14 priority countries would entail performing about 20 million circumcisions on men aged between 15 and 49 by 2015.
Such a scale-up would cost a total of $1.5 billion and would result in a net savings of $16.5 billion by 2025 due to averted treatment and care costs. An estimated 3.4 million new HIV infections would be averted through 2025.
Efforts to accelerate VMMC have, however, seen modest success in most of the priority countries. According to the joint framework, more than 550,000 men between the ages of 15 and 49 had been circumcised in the 14 priority countries by the end of last year.
The greatest success in scaling up adult VMMC occurred in Kenya, particularly in Nyanza province in the country's west.
While progress in implementing VMMC programmes has been more limited in the other priority countries, nearly all countries saw the pace of the scale-up quicken in 2010, UNAIDS points out.
"PEPFAR strongly supports heightened and immediate national ownership in all priority countries to implement safe, efficient voluntary medical male circumcision scale-up strategies," said Mr. Goosby.
"VMMC offers men an unprecedented opportunity to assume a proactive role in reducing their risk of contracting HIV, empowering them to protect their health and the health of their partners."
Mr. Mogae urged leaders in the 14 priority countries to support and scale up VMMC programmes.
"Strong collaboration between political, traditional and religious leadership will be critical to the safe and effective scale up of VMMC services," said Mr. Mogae, who is the chairman of Champions for an HIV-Free Generation, a non-governmental organization (NGO).
"The key role of religious and traditional leaders is to ensure that there is a working partnership with the communities so that while the circumcision is done medically as an add-on HIV prevention strategy, it still retains its religious or cultural significance to the communities," he added.
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From the USAID report "LEVELS AND SPREAD OF HIV SEROPREVALENCE AND ASSOCIATED FACTORS: EVIDENCE FROM NATIONAL HOUSEHOLD SURVEYS" "There appears no clear pattern of association between male circumcision and HIV prevalencein 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher." http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf
The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups "believe that circumcised men do not need to use condoms". http://www.info.gov.za/issues/hiv/survey_2009.htm
From the committee of the South African Medical Association Human Rights, Law & Ethics Committee : "the Committee expressed serious concern that not enough scientifically-based evidence was available to confirm that circumcisions prevented HIV contraction and that the public at large was influenced by incorrect and misrepresented information. The Committee reiterated its view that it did not support circumcision to prevent HIV transmission."
The one randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised btw: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/a bstract
ABC (Abstinence, Being faithful, and especially Condoms) is the way forward. Promoting genital surgery will cost African lives, not save them.
Circumcision to prevent HIV/AIDS does not make sense. Circumcised men still have to use a condom just like intact (uncircumcised) men. The best way to prevent HIV is through education about safe sex, not surgery. Don't let them fool you into getting circumcised - you'll still have to wear a condom every time.
And for women: don't let a circumcised man have sex with you without a condom. Don't let him fool you into thinking he's immune from HIV.
Why would the UN not recommend circumcision? Dr. David Tomlinson is chief expert to the World Health Organization on circumcision. He invented the "improved" Gomco, the "improved" Plastibell and the "improved" Accu-circ. Obviously, it is a conflict of interest for him to hold the position, when he stands to make money from each of these circumcision clamps sold.
Here Dr. Tomlinson is quoted in the advertising brochure for the Accu-circ. http://todayshospitalist.com/index.php?b=articles_read&cnt=647 and an ad: http://www.kentecmedical.com/media/document/AccuCircWorkshopBrochure.pdf
They make it seem so safe, comfortable, and marketable.
Having a foreskin, or not having a foreskin, makes little difference to the HIV virus. The point is that condoms work. Circumcision does not. New Zealanders have their foreskins, and one of the lowest HIV infection rates in the world. France and Denmark don't circumcise, and their infection rates are 1/10th those in the United States, where circumcision is very common.
Circumcision doesn't have any great prevention powers: http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102282676.html
http://journals.lww.com/stdjournal/Abstract/2011/11000/Circumcision_and_Acq uisition_of_Human.16.aspx
It's dangerous: http://www.quackdown.info/article/tara-klamp-story-update/ http://articles.latimes.com/2011/sep/26/health/la-he-circumcision-20110926 http://www.ajc.com/news/nation-world/atlanta-lawyer-wins-11-573890.html http://indiancountrynews.net/index.php?option=com_content&task=view&id=7526 &Itemid=131 http://www.nbrlawfirm.com/Medical-Malpractice/Blogs/toddler-dies-after-circ umcision-at-manhattan-hospital
In the US, we've buried nearly a million, mostly circumcised men, who died of AIDS.
My point is, you should stop pushing circumcision as a preventative measure for HIV. 1. It doesn't work 2. Those who tell you it does, are lying for their own reasons 3. Your people deserve the truth Condoms work. They protect both partners.
Many professionals have criticized the studies claiming that circumcision reduces HIV transmission. They have various flaws. Authorities that cite the studies have other agendas. Circumcision causes physical, sexual, and psychological harm. Other methods to prevent HIV transmission (e.g., condoms and sterilizing medical instruments) are much more effective, much cheaper, and much less invasive. Please see http://www.circumcision.org/hiv.htm for more information.
If anything this procedure called Circumcision will permanently sterilize all male babies. They are trying to decrease the numbers of babies being born to people of color and specifically the African male. Aids is not killing us off fast enough as they thought it would back in the early 1980's. So now they are coming up with something new.