Scale-up of voluntary male circumcision cost-effective way to prevent HIV in S. and E. Africa

A collection of nine new articles to be published in PLoS Medicine and PLoS ONE, in conjunction with the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United States President's Emergency Plan for AIDS Relief (PEPFAR), highlights how scaling up voluntary medical male circumcision (VMMC) for HIV prevention in eastern and southern Africa can help prevent HIV not only at individual but also at community and population level as well as lead to substantial cost savings for countries due to averted treatment and care costs.

The first article by Catherine Hankins of UNAIDS, Steven Forsythe of The Futures Institute, and Emmanuel Njeuhmeli of PEPFAR/USAID, offers an introduction to the cost, impact and challenges of accelerated scaling up and lays out the rationale for the series. This article, as well as the one to follow, signposts the way forward to accelerate the scaling up of VMMC service delivery safely and efficiently to reap individual-and benefits.

The remaining 8 papers also focus on the various factors that go into effective program expansion of VMMC, including data for decision making, policy and programmatic frameworks, logistics, demand creation, human resources, and translating research into services.

The cost savings are clear: an initial investment of US$1.5 billion between 2011 and 2015 to achieve 80% coverage of VMMC services in 14 priority countries in southern and eastern Africa and thereafter US$0.5 billion between 2016 to 2025 to maintain that coverage of 80% would result in net savings of US$16.5 billion between 2011 and 2025. However, as the articles in the collection show, strong , country ownership, and stakeholder engagement, along with effective demand creation, community mobilisation, and human resource deployment, are essential in effectively expanding and maintaining VMMC programs.

The series publishes on 29th November 2011 in PLoS Medicine and PLoS ONE.

A question and answer Twitter expert session [#VMMC@USAIDGH] will be held on 19th December, 2011 from 1pm-2pm with Emmanuel Njeuhmeli, MD, MPH, MBA, Senior Biomedical Prevention Advisor of the Office of HIV/AIDS/USAID Washington, Co-Chair PEPFAR, Male Circumcision Technical Working Group, an author of the collection.

A Joint Strategic Action Framework to accelerate the scale-up of voluntary medical for in eastern and southern Africa, 2012 - 2016, will be launched on 5th December 2011 at the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) in Addis Ababa. The Framework has been developed with WHO, UNAIDS, PEPFAR, the Bill and Melinda Gates Foundation, the World Bank, and national programmes.

Citation: Scale-up of voluntary male circumcision cost-effective way to prevent HIV in S. and E. Africa (2011, November 30) retrieved 23 August 2019 from
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Nov 30, 2011
"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."

If circumcision really worked against AIDS, this just wouldn't happen.

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".

The one RCT into male-to-female transmission showed a 54% higher rate in the circumcised group:

ABC is the way forward. Promoting circumcision will cost African lives, not save them.

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