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Observation: Male circumcision may reduce HIV/Aids infection
2006-12-23 08:35:58
By Judica Tarimo
Global advocacy programmes in combating HIV/Aids focuses mainly on abstinence, being faithful to a single sexual partner, and condom use (ABC) as the best effective approach to war against the disease.
In many countries, the ABC system has worked successfully, and in fact, helped to reduce the infection rate.
Seriously affected countries in Africa are now considered as real models in HIV/Aids because of effective application of ABC.
One of these countries is Uganda, which, some years back, earned international credit from developed and developing countries, for reducing the infection rate in communities by using the ABC strategy.
Besides international praise, Uganda attracted huge funding from different international organizations and rich nations, particularly the US and some European countries, to finance its domestic HIV/Aids programmes.
There had been constant international pressure with massive support from international bodies and a handful of rich countries, calling upon global governments to adopt Uganda’s ABC success as a role model.
The US government, for one, had been on the frontline, asking countries to take Uganda’s successful story on ABC.
In the course of time, ABC has reached many African countries, where the majority of Aids victims live.
Most of African nations had incorporated ABC strategy in their local HIV/Aids frameworks.
Advocacy programmes in schools, work place, business centres, shopping malls, mining sites, in most of African countries, now focus directly or indirectly, on ABC strategy.
Non-governmental organizations, sensitize and mobilize the youth and general public on the correct use of condoms, down to the villagers. Government leaders and local HIV/Aids control programmes and institutions are busy organizing national meetings, workshops, seminars, to educate professionals, academics, government officials, private sector members, and related segments of the population, on ABC.
But the impact of these interventions is still negligible, as HIV/Aids infection rate exhibits an upward trend day in day out.
Millions of people are being infected in the face of ABC strategy.
An estimated 2 millions are living with the HIV virus in Tanzania, with new infections accounting for a greater percentage.
The situation is almost the same or worse in other African countries.
The disease has a negative impact on vulnerable social groups – children, women, the elders etc.
In fact, control mechanisms have proved a failure to yield the anticipated results.
That is not caused by poor designing of the formulated strategies and interventions, but altitudes and characteristics of human beings; hey cannot be controlled easily.
Several efforts were made towards distributing condoms in bus terminals and other public places, but many people still prefer unprotected sex under the prefix of satisfying their sexual pleasure.
However, there is no enough scientific literature and evidence to prove the truth of such perceptions.
Researchers are coming up with findings to mitigate the impact of the disease on societies.
Emerging findings suggest massive male circumcision as an alternative strategy to slow down HIV/Aids infections rate.
Thanks to the United Nations for backing up the idea and aggressively advocating for mass male circumcision in HIV/Aids stricken southern African nations.
Recently, the head of the United Nations anti-Aids agency, Dr Peter Piot, appealed to world governments to develop a policy of mass male circumcision in fighting the disease.
It is said that several recent medical studies have confirmed that circumcision cuts the risk of HIV infection among men by 50-60 per cent, and the findings have been backed by UNAIDS.
”These (African) countries should now prepare how to introduce circumcision on a large scale,” the UNAIDS chief said, adding, ”the science is clear.”
”Baby boys should be targeted first but then attention should switch to adolescent boys and adult men,” said Piot.
Male circumcision has been proved to be an effective tool in HIV/Aids prevention in some African countries — South Africa, Botswana and Nambia, the most hit countries in the southern Africa.
A US/Uganda study had found that male circumcision can also reduce infections in female partners by 30 percent.
But experts said more research was needed to establish the possible benefits of circumcision before it could be promoted as part of national HIV programmes.
These views contradict with the UN official who says given the grim HIV/Aids situation in southern Africa, it was important to promote the idea of widespread circumcision.
”We are faced with an absolute crisis where you have 20-40 per cent of adults being HIV-positive ... You need to use every scientifically proven method to bring down the new infections,” says Piot.
He adds: ”Even if large-scale circumcision was introduced, countries should continue to promote condom use as well as abstinence.”
In Tanzania, medical experts are busy testing their findings which support male circumcision as a means to reduce infection rates.
Some studies conducted in certain coast and central regions have proved that HIV/Aids prevalence rate has drastically gone down because of male circumcision practice.
Prof. Fred Mhau, Chairman of the Tanzania Aids Association, said at a recent HIV/Aids forum that, there is a possibility of reducing infections by half if male circumcision was incorporated in the national interventions.
”Areas where circumcision was normally practiced, HIV/Aids infections are low compared to areas that do not practice it,” noted Mhau.
There is local pressure exerted by experts that male circumcision should be a mandatory requirement for all male persons in Tanzania.
”I appeal to the government to introduce a system whereby circumcision is made mandatory to all males, regardless of their traditions or religious affiliation,” said Prof. Mhau.
But the government is hesitant in adopting the idea holistically.
The Health and Social Welfare Minister, Prof. David Mwakyusa, said the government is scrutinizing new research findings on the relevance of male circumcision in reducing HIV/Aids infection rates before adopting the idea in the local interventions against the disease.
”We cannot rush to the idea. We want to conduct thorough study on the suggestions and get clear evidence before incorporating the idea in our HIV/Aids policy frameworks,” said the minister.
The government admitted that HIV/Aids infection rate in countries that practices male circumcision has been reduced.
Prevalence rate in certain coast and central areas in Tanzania is low due to male circumcision.
”There is some truth in the new research findings, but we cannot adopt it just like that.
There are lot of things that must be looked into. We need to get prepared,” said the minister.
Mwakyusa said local experts were working on the new findings and their relevance in the local context and later on forward recommendations to the government.
”As I am talking, experts are meeting in Arusha to discuss the same issue. I hope they would come up with sound suggestions and advise the government accordingly,” he said.
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