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December 04, 2011

Male Circumcision a Forgotten Key in AIDS Prevention

Leaders of the global fight against AIDS say male circumcision is among the most overlooked keys to reducing the incidence of sexually transmitted infections.  At the international conference on AIDS in Africa, major funders are urging nations to take greater responsibility for education, treatment and prevention campaigns.

The United Nations AIDS organization and the U.S. President's Emergency Plan For AIDS Relief (PEPFAR) announced a five-year campaign to persuade men in 14 African countries to voluntarily submit to circumcision.  Recent studies suggest that circumcision reduces the risk of female-to-male sexual transmission of HIV infections by roughly 60 percent.

UNAIDS Director Michel Sidibe says adding voluntary male circumcision to the mix of prevention strategies could lead to a dramatic drop in overall infections.

"If we have 60-percent reduction, if you combine that to the other prevention measures we have, we can start reducing sexual transmission numbers of new infections even more than 50 percent," he said.

The 14 targeted countries are Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Uganda, Tanzania, Zambia and Zimbabwe.

Sidibe says his experience working with Kenya's Luo community has convinced him that men will voluntarily submit to circumcision once they understand the consequences.

"Once in Kenya when I was coming from Luo areas, when they were resisting completely to male circumcision, because for hundreds of years they never had male circumcision," he said.  "When we managed to bring the elders and managed to mobilize them, and make them understand it is a matter of survival of their community, the change was amazing.  People who were resisting circumcision, today they are just asking, and they [authorities] don't know even how to deliver on it."  

Sidibe says another key to a successful sustained campaign to defeat AIDS will be persuading African governments to take the lead role, rather than depending on funding from donors like the United Nations and the United States.

"My expectation is to engage African leaders and to make them understand that we cannot put people on treatment for life just counting on resources coming from outside," he said.  "It is important that their responsibility in terms of looking on domestic funding and trying to look at innovation in terms of funding on the continent."

U.S. Global AIDS Coordinator Eric Goosby says in this era of tight budgets, donor countries will demand greater local involvement.

"The number one goal is that they understand the sustained commitment the United States has had to the HIV/AIDS issue historically for 30 years, but that the relationship with countries is moving from a traditional donor relationship to one more of a partnership, where we expect there to be a contribution from the country to match and amplify our contributions in country," he said.

Goosby, Sidibe and Botswana's former president, Festus Mogae, are among the top officials attending ICASA, the International Conference on AIDS and Sexually-Transmitted Infections in Africa.  The five-day gathering in Addis Ababa has attracted some of the world's top experts, officials and activists to discuss the latest trends and scientific findings in the battle against AIDS.