South Africa Slow to Encourage Circumcision to Curb HIV

Despite research last year in South Africa showing that male circumcision reduces HIV risk, there has been little public discussion there about using it in a prevention strategy. A law signed last month by President Thabo Mbeki actually prohibits the procedure for children under 16. Targeting the tribal circumcisions that sometimes injure or kill, the makes exceptions for religious and unspecified medical reasons. The law has not yet taken effect.

Articles describing the 60 percent reduction in HIV risk from male circumcisions performed in the Orange Farm township study were published in dozens of journals and newspapers throughout Africa and the world. But an online database search shows only two references to the South Africa study as having been published in South Africa. AIDS policy debates there have been tense since 2000, when Mbeki questioned the cause of AIDS and the safety and efficacy of antiretroviral therapies. The debate on the circumcision law did not include references to the study, said participants.

"They have made it more difficult to implement what may be our most important HIV-prevention strategy ever," said Francois Venter, president of the Southern African HIV Clinicians Society.

At a first-ever circumcision meeting last month at Soweto's Chris Hani Baragwanath Hospital, Martin G. Veller, medical school professor at the University of Witwatersrand, suggested routine circumcision for males ages 15-24 could reduce South African HIV infections by two-thirds. The one-time $32 million cost over several years, he said, would prevent 150,000 infections annually and $1 billion in annual medical costs.

"The research is ongoing," said Joel Netshitenzhe, senior policy advisor to Mbeki, referring to similar circumcision studies underway in Uganda and Kenya. "Once they've finalized it, there would have to be policy work based on the outcomes."

Back to other news for July 17, 2006