2011 - Written Evidence in response to Health Committee Public Health Inquiry

SUMMARY:

There has been a concerted effort in the professional literature, from a small cabal within the medical fraternity, to argue the case for reinstating non-therapeutic circumcision at the expense of the NHS, frequently using professed concern for the well-being of boys of certain ethnic or religious backgrounds receiving circumcision in non-medical settings, as a pretext.
Recently, there has been a string of mainstream media items favourable to male circumcision, which amount to nothing less than a marketing campaign to motivate parents to have their sons circumcised. Many of these articles draw upon established marketing concepts (in turn derived from insights of behavoiural science), most notably, the use of “experts”.  In the context of promoting circumcision to parents, such “experts” generally include medical practitioners who work at private circumcision clinics and religious officials.
Regardless of whether it is performed in a medical or non-medical setting, a significant number of boys subjected to the practice of circumcision will later fulfill the DSM-IV criteria for a diagnosis of Post-Traumatic Stress Disorder.
Circumcision removes the most sexually sensitive parts of a boy’s penis, including the foreskin, the frenulum, and the ridged band of nerves. The male foreskin is also designed to protect the glans of the penis throughout a man’s life, ensuring that the internal mucosal tissue remains moist and sensitive (much the same way that a woman’s clitoral hood protects the clitoris). In addition, the foreskin acts as a natural gliding mechanism to reduce chafing and dryness during intercourse.
The British Medical Association advises against routine male circumcision, and no national medical association in the world recommends that boys be forcefully circumcised for preventive health reasons.
There has been little incentive for the medical profession to investigate the long-term affects on men's sexual and psychological health and well-being, but the growth of groups such as NORM-UK (an organisation registered with the Charities Commissioners for England and Wales), suggests that a substantial number of men genuinely resent being circumcised.
It is imperative that Department of Health and Public Health England  mandate that all staff, contractors, agencies, facilities and departments under their auspices, including GPs and GP practices: Must not offer among their services the harmful male genital mutilation known as circumcision; Must not permit on their premises individuals or organisations promoting the harmful male genital mutilation known as circumcision; Must not be refer patients explicitly for the harmful male genital mutilation known as circumcision; Must not be employed or associated with any facility offering the harmful male genital mutilation known as circumcision; Must not allow their facilities to be used for the harmful male genital mutilation known as circumcision.; and Must not stock or allow on their premises literature or other material promoting the harmful male genital mutilation known as circumcision.
Given the dearth of research in this area, it would be appropriate for the Department of Health and Public Health England to partner with registered charities such as NORM-UK and to create incentives for medical researchers to investigate the long-term affects of circumcision on men's sexual and psychological health and well-being.

1.    There has been a concerted effort in the professional literature, from a small cabal within the medical fraternity, to argue the case for reinstating non-therapeutic circumcision at the expense of the NHS, frequently using professed concern for the well-being of boys of certain ethnic or religious backgrounds receiving circumcision in non-medical settings, as a pretext [1], a call loudly echoed in sections of the mainstream media [2]. Regardless of whether it is performed in a medical or non-medical setting, a significant number of boys subjected to the practice of circumcision will later fulfill the DSM-IV criteria for a diagnosis of Post-Traumatic Stress Disorder [3]. Further, circumcision removes the most sexually sensitive parts of a boy’s penis, including the foreskin, the frenulum, and the ridged band of nerves [4]. The male foreskin is also designed to protect the glans of the penis throughout a man’s life, ensuring that the internal mucosal tissue remains moist and sensitive (much the same way that a woman’s clitoral hood protects the clitoris). In addition, the foreskin acts as a natural gliding mechanism to reduce chafing and dryness during intercourse [5].

2.    Recently, there has been a string of mainstream media items favourable to male circumcision, which amount to nothing less than a marketing campaign to motivate parents to have their sons circumcised [2,6,7,8]. Many of these articles draw upon established marketing concepts (in turn derived from insights of behavoiural science), most notably, the use of “experts”. An “expert”, in a marketing context, is an individual who, because of their occupation, or perceived experience, is uniquely placed to lend credence to the product or service that an advertisement promotes [9]. In the context of promoting circumcision to parents, such “experts” generally include medical practitioners who work at private circumcision clinics [6,8] and religious officials [7]. Following complaints from the public, the Press Complaints Commission has reached resolutions noting the inappropriate implication in media items that religious officials are qualified to offer medical advice in regard to circumcision, the minimisation of the inherent risks of circumcision as a medical procedure, and the implication that circumcision is of minimal discomfort through the impression that it is legitimate practice to conduct the procedure without anaesthesia [10,11]. Both the hospital and doctor (who is also a Consultant Urological Surgeon at Royal Liverpool University Hospital NHS Trust) featured in a recent episode of the Channel 4 television series Embarrassing Bodies [8], linked to the video on the Channel 4 website from their respective web-pages [12,13], effectively by-passing the General Medical Council Guidelines about how medical practitioners should promote and publish information about their services [14]. It is unsurprising that such symbiotic relationships should form between private doctors seeking to promote their practice and mainstream media outlets who want to appease advertisers by keeping such a high-profile controversial social issue alive, since advertising is the force which has historically sustained all commercial media [15].

3.    The British Medical Association advises against routine male circumcision [16], and no national medical association in the world recommends that boys be forcefully circumcised for preventive health reasons. The Royal Dutch Medical Association's very up-to-date policy on circumcision states that "KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications", and that there is a good case for making it illegal [17]. Female genital mutilation has been illegal for a number of years now [18]. There has been little incentive for the medical profession to investigate the long-term affects on men's sexual and psychological health and well-being, but the growth of groups such as NORM-UK (an organisation registered with the Charities Commissioners for England and Wales), suggests that a substantial number of men genuinely resent being circumcised [19].

4.    A recent statement from the British Association of Paediatric Urologists on behalf of the British Association of Paediatric Surgeons and The Association of Paediatric Anaesthetists admitted that some doctor's under it's charge “have been willing to provide non therapeutic circumcision without charge rather than risk the procedure being carried out in unhygienic conditions.” [20]. In it's statement on the law and ethics of male circumcision, the British Medical Association has concluded that “it is for society to decide what limits should be imposed on parental choices.” [16].

5.    It is therefore imperative that Department of Health and Public Health England  mandate that all staff, contractors, agencies, facilities and departments under their auspices, including GPs and GP practices: Must not offer among their services the harmful male genital mutilation known as circumcision; Must not permit on their premises individuals or organisations promoting the harmful male genital mutilation known as circumcision; Must not be refer patients explicitly for the harmful male genital mutilation known as circumcision; Must not be employed or associated with any facility offering the harmful male genital mutilation known as circumcision; Must not allow their facilities to be used for the harmful male genital mutilation known as circumcision.; and Must not stock or allow on their premises literature or other material promoting the harmful male genital mutilation known as circumcision.

6.    To best develop and enhance the availability, accessibility and utility of public health information and intelligence regarding the harmful male genital mutilation known as circumcision, it is imperative that the Department of Health and Public Health England establish a central information store of the harm caused by male circumcision, which will form the basis for establishing a dictate that staff, contractors, agencies, facilities and departments under it's auspices, including GPs and GP practices, will not perform nor refer patients for circumcision; and to make use of the insights of behavioural science to research and implement strategies which discourage parents from subjecting their sons to the harmful male genital mutilation known as circumcision, without lending to it's prestige by implying that it is a practice worthy of it's own policy statement or the subject of a legitimate 'debate'.

7.    To counteract the mainstream media marketing of circumcision to parents, it is appropriate that the Department of Health and Public Health England mandate that staff, contractors, agencies, facilities and departments under it's auspices, including GPs and GP practices, will not perform nor refer patients for circumcision; and should use the insights of behavioural science to research and implement strategies which discourage parents from subjecting their sons to the harmful male genital mutilation known as circumcision, without lending to it's prestige by implying that it is a practice worthy of it's own policy statement or the subject of a legitimate 'debate'.

8.    It would be appropriate to invite appropriately registered charity organisations such as NORM-UK to partner with the Department of Health and Public Health England to contribute to compiling and improving the use of public health evidence to counteract the mainstream media marketing of circumcision to parents and discourage parents from subjecting their sons to the harmful male genital mutilation known as circumcision, without lending to it's prestige by implying that it is a practice worthy of it's own policy statement or the subject of a legitimate 'debate'.

9.    Given questions raised about the professional conduct of some medical practitioners with regard to the continuing practice of male circumcision, whatever system of voluntary regulation may be implemented, it is appropriate that the Department of Health and Public Health England mandate that staff, contractors, agencies, facilities and departments under their auspices, including GPs, GP practices and other public health specialists, will not perform nor refer patients for the harmful male genital mutilation known as circumcision.

10.    Given the dearth of research in this area, it would be appropriate for the Department of Health and Public Health England to create incentives for medical researchers to investigate the long-term affects of circumcision on men's sexual and psychological health and well-being.

11.    Links/References:
    1. Paranthaman K., Bagaria, J & O'Moore, E. (2010) The need for commissioning circumcision services for non-therapeutic indications in the NHS: lessons from an incident investigation in Oxford J Public Health first published online July 14, 2010 http://jpubhealth.oxfordjournals.org/content/early/2010/07/14/pubmed.fdq053.full
    2. Campbell, D. (2010) NHS urged to offer circumcisions to avoid botched operations in The Guardian Sunday 11 July 2010 http://www.guardian.co.uk/society/2010/jul/11/doctors-urge-circumcision-on-nhs

    3. Samuel Ramos and Gregory J. Boyle. Ritual and Medical Circumcision among Filipino boys: Evidence of Post-traumatic Stress Disorder Humanities & Social Sciences papers (2000). Available at: http://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1120&context=hss_pubs

    4. Morris L. Sorrells, James L. Snyder, Mark D. Reiss, Christopher Eden, Marilyn F. Milos, Norma Wilcox, Robert S. Van Howe Fine-touch pressure thresholds in the adult penis British Journal of Urology International, Volume 99 Issue 4 Page 864 – 869 April 2007 http://www.nocirc.org/touch-test/bju_6685.pdf

    5. Taylor, J.P., A.P. Lockwood and A.J.Taylor The prepuce: Specialized mucosa of the penis and its loss to circumcision Journal of Urology (1996), 77, 291-295 http://www.cirp.org/library/anatomy/taylor/

    6. Renton, A. (2010) It protects men (and women) against fatal diseases and sexual infections. So, should all boys be circumcised? in TheDaily Mail http://www.dailymail.co.uk/health/article-1199472/It-protects-men-women-fatal-diseases-sexual-infections-So-boys-circumcised.html

    7. Rich, B. (2010) To snip or not to snip? in The Guardian http://www.guardian.co.uk/lifeandstyle/2010/oct/30/circumcision-jewish-son-ben-rich

    8. Channel 4 (2011) Embarrassing Bodies Series 4 Episode 4 http://www.channel4.com/programmes/embarrassing-bodies/episode-guide/series-4/episode-4

    9. Schiffman, L Bednell, D O’Cass, A Paladino, A Kanuk, L (2005) Consumer Behaviour 3rd Edition Pearson Education Australia, Australia: Frenchs Forest

    10. Press Complaints Commission (2011) Parkes vs The Guardian http://www.pcc.org.uk/news/index.html?article=NjkxNg==

    11. Press Complaints Commission (2010) Warren vs Daily Mail http://www.pcc.org.uk/news/index.html?article=NjIyNA==

    12. http://www.spirehealthcare.com/Liverpool/Our-Facilities-Treatments-and-Consultants/Our-Treatments/Adult-circumcision/

    13. http://www.spirehealthcare.com/Liverpool/Our-Facilities-Treatments-and-Consultants/Our-Consultants/Mr-P-Cornford/

    14. General Medical Council (2011) Good Medical Practice: Providing and publishing information about your services http://www.gmc-uk.org/guidance/good_medical_practice/probity_information_about_services.asp

    15. Cunningham, S & Turner, G (2002) The Media & Communications in Australia Allen & Unwin, Australia

    16. British Medical Association. The law and ethics of male circumcision: guidance for doctors. London: BMA, 2006 http://www.bma.org.uk/ethics/consent_and_capacity/malecircumcision2006.jsp

    17. KNMG (2010) Non-theraputic circumcision of male minors http://knmg.artsennet.nl/web/file?uuid=579e836d-ea83-410f-9889-feb7eda87cd5&owner=a8a9ce0e-f42b-47a5-960e-be08025b7b04&contentid=77976

    18. LASSL (2004)4: Female Genital Mutilation Act 2003, DoH, published 27.2.2004

    19. http://www.norm-uk.org/

    20. British Association of Paediatric Urologists (2007) MANAGEMENT OF FORESKIN CONDITIONS Statement from the British Association of Paediatric Urologists on behalf of the British Association of Paediatric Surgeons and The Association of Paediatric Anaesthetists. http://www.apagbi.org.uk/sites/apagbi.org.uk/files/circumcision2007.pdf

2013 - Response to “PEPFAR Program Expenditures” [Form Number: DS-4213, OMB Control Number: 1405-0208]

Thank you for the opportunity to provide feedback to “PEPFAR Program Expenditures” [Form Number: DS-4213, OMB Control Number: 1405-0208]. This response document will briefly address concerns about the ethical, legal and methodological flaws with past research informing aspects of present PEPFAR program areas; concerns about adverse consequences of PEPFAR program areas; and concerns about the absence of oversight of the activities of PEPFAR funding recipients.

Ethical, Legal and Methodological Flaws with Past Research informing present PEPFAR Program Areas

In 2011 and 2012, the Department of Health and Human Services Office of Inspector General [OIG] published a series of audit reports revealing that throughout fiscal years 2000-2010, the National Institute of Allergy and Infections Diseases [NIAID], did not comply with the time and amount requirements specified in appropriations statutes, in awarding several federal contracts to commercial partners, committing the federal government to tens of millions of dollars of expenditure ahead of appropriation of funds from Congress (OIG 2011a; OIG 2011b; OIG 2011c; OIG 2011d; OIG 2012a; OIG 2012b). During this time, NIAID also funded and sponsored research conducted abroad, that would be unlikely to receive ethical approval to be conducted in the United States, incorporating the excision of healthy tissue from subjects in the absence of a clear and present immediate medical indication, specifically ClinicalTrials.gov registered trials NCT00059371 and NCT00425984 ['the African circumcision trials'] (NIH 2008; NIH 2007), the methodology, conclusions, ethics and legality of which have been questioned in the professional medical literature (Boyle & Hill 2011; Green et al 2010). In the years following publication of the African circumcision trials, regulatory agencies under the aegis of the Department of Health and Human Services have moved to strengthen protections afforded human research subjects and to increase the rigor with which trials conducted abroad are assessed as a basis for seeking approval of new drugs and medical devices in the U.S. market (FDA 2012; OHRP 2011), although concerns continue to be raised about the capability of National Institutes of Health [NIH] Data and Safety Monitoring Boards to ensure the safety of study subjects and validity and integrity of the data for clinical trials (OIG 2013a).

Adverse Consequences of PEPFAR Program Funding Areas

Despite the concerns identified above, the results of the African circumcision trials continue to be used to justify the en masse circumcision of men in Africa using PEPFAR funds and to justify the circumcision of boys and male infants - both in the United States and abroad - in the absence of clear and present immediate medical indications, and in the latter instance, with the tacit endorsement of U.S. government agencies in receipt of PEPFAR program funding (CDC 2011; Llewellyn 2012). In the wake of PEPFAR funding for mass circumcision programs in Africa, human rights organisations and local media in the region have reported coercion of men and boys to be circumcised (AFP 2012; Ahlberg & Njoroge 2013; Aluru 2013; Amnesty International 2013; Chibaya 2013a; Chibaya 2013b; Chirombo 2013; Dube 2012; Echwala 2013; Handable 2013; Hatyoka 2013; Langa 2012; Layoo 2013; Mbanje 2013; Mhlanga 2012; News24 2013; Ngwega 2012; Okwii 2013; Onyango 2012; Otieno 2013; Towindo 2012) and misdirection of limited medical resources from other priority areas to male circumcision (AHN 2012; Gonzalez 2012; ZimEye 2013).

Absence of Oversight

On the 15 June 2011, the OIG published a report critical of the Centers for Disease Control and Prevention's [CDC's] failure to oversee recipientss use of PEPFAR funds, concluding that the “lack of required documentation demonstrates that CDC has not exercised proper stewardship over Federal PEPFAR funds because it did not consistently follow departmental and other Federal requirements in monitoring PEPFAR recipients” (OIG 2011e). Further investigations by the OIG have also revealed specific failures of the CDC to monitor recipients use of PEPFAR funds in Namibia (OIG 2013c; OIG 2013d) and South Africa (OIG 2013b; OIG 2013e; OIG 2013f; OIG 2013g). In 2013, the OIG also published a report critical of the CDC's failure to oversee use of PEPFAR funds by the Vietnam Administration for HIV/AIDS Control (OIG 2013h), suggesting the possibility that more systemic problems may exist within the CDC, impacting the agency's ability to effectively oversee the activities of grantees in receipt of federal funds, and that this is not specific to difficulty with oversight of grantees in the African region.

Conclusion

Valid concerns exist about the ethical, legal and methodological flaws with past research informing aspects of present PEPFAR program areas; adverse consequences of PEPFAR program areas; and the absence of oversight of the activities of PEPFAR funding recipients. It is therefore imperative that full and complete disclosure and oversight in the proposed information collection activity take precedence over the CDC's and PEPFAR funding recipients' professed concerns for increased regulatory and administrative 'burden'.

References

AFP (2012) US urges circumcision for soldiers to fight HIV in Africa Yahoo! Health http://health.yahoo.net/news/s/afp/us-urges-circumcision-for-soldiers-to-fight-hiv-in-africa Accessed: 2012-06-17. Archived by WebCite at http://www.webcitation.org/68Trj7ABp

Ahlberg BM, Njoroge KM (2013) 'Not men enough to rule!': politicization of ethnicities and forcible circumcision of Luo men during the postelection violence in Kenya Ethn Health. 2013 Oct;18(5):454-68. doi: 10.1080/13557858.2013.772326. Epub 2013 Jun 11 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23758644

AHN (2012) HIV services in western refugee camps overwhelmed Gant Daily 29 March 2012 http://gantdaily.com/2012/03/29/hiv-services-in-western-refugee-camps-overwhelmed/

Aluru L (2013) Siaya County seeks forced male ‘cut’ law 2 October 2013 Standard Digital News http://www.standardmedia.co.ke/?articleID=2000094743&story_title=Kenya-county-seeks-forced-male-cut-law Accessed: 2013-12-15. Archived by WebCite at http://www.webcitation.org/6LtnVPjiW

Amnesty International (2013) Kenya’s ICC trials Amnesty International website 16 September 2013 Amnesty International website http://www.amnesty.org/en/news/kenya-s-icc-trials-2013-09-16 Accessed: 2013-12-15. Archived by WebCite at http://www.webcitation.org/6LtoCK3gQ

Boyle GJ, Hill G (2011) Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: methodological, ethical and legal concerns J Law Med. 2011 Dec;19(2):316-34 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22320006

CDC (2011) Trends in In-Hospital Newborn Male Circumcision - United States 1999-2010 Prepared by Xinjian Zhang, PhD, Sanjyot Shinde, PhD, Peter H Kilmarx, MD, Robert T Chen, MD, Div of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Shanna Cox, MSPH, Lee Warner, PhD, Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion; Maria Owings, PhD, Div of Healthcare Statistics, National Center for Health Statistics; Charbel El Bcheraoui, PhD, EIS Officer, CDC. Morbidity and Mortality Weekly Report (MMWR) Full-text available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a4.htm?s_cid=mm6034a4_w

Chibaya, M (2013a) Resistance hinders circumcision programme The Standard Full-text available at http://www.thestandard.co.zw/2013/05/19/resistance-hinders-circumcision-programme/ Archived by WebCite at http://www.webcitation.org/6Ltky3cRF

Chibaya, M (2013b) Winky D tackles circumcision controversy New Zimbabwe 21 October 2013 Accessed: 2013-12-15. Archived by WebCite at http://www.webcitation.org/6LtoaHGyi

Chirombo, S (2013) Malawi: Kasungu Registers Low Turnout for Male Circumcision allAfrica.com 5 July 2013 Accessed: 2013-07-08. Archived by WebCite at http://www.webcitation.org/6HxNQ2VYn

Dube, C (2012) F/town adult males spurn circumcision The Monitor 21 May 2012 http://www.mmegi.bw/index.php?sid=1&aid=370&dir=2012/May/Monday21 Accessed: 2012-06-17. Archived by WebCite at http://www.webcitation.org/68TqWHbxL

Echwala, E (2013) Zimbabwe's circumcision drive fails to take off IRIN News 9 July 2013 http://www.irinnews.org/report/98379/zimbabwe-s-circumcision-drive-fails-to-take-off Accessed: 2013-12-15. Archived by WebCite at http://www.webcitation.org/6Ltn5kJBC

FDA (2012) FDA's HSP/BIMO Initiative Accomplishments: Update May 2012 Food and Drug Administration Full-text available at http://www.fda.gov/ScienceResearch/SpecialTopics/RunningClinicalTrials/ucm305275.htm Accessed: 2012-06-10. Archived by WebCite at http://www.webcitation.org/68JLjWhEP

Gonzalez L L (2012) Africa: Less Global Funds, More Problems allAfrica 10 May 2012 Full-text available at http://allafrica.com/stories/201205110671.html

Green LW, Travis JW, McAllister RG, Peterson KW, Vardanyan AN, Craig A (2010) Male circumcision and HIV prevention insufficient evidence and neglected external validity Am J Prev Med. 2010 Nov;39(5):479-82 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20965388

Handable, N (2013) Zambia: Women Should Encourage Their Partners allAfrica.com http://allafrica.com/stories/201211201412.html Accessed: 2013-12-16. Archived by WebCite at http://www.webcitation.org/6LvIDW2pt

Hatyoka, B (2013) ‘Sensitise subjects on male circumcision’ Times of Zambia 22 May 2013 Accessed: 2013-12-15. Archived by WebCite at http://www.webcitation.org/6LtlPFBWm

Langa, V (2012) 175 MPs to be circumcised News Day 18 May 2012 http://www.newsday.co.zw/article/2012-05-18-175-mps-to-be-circumcised/ Accessed: 2012-06-17. Archived by WebCite at http://www.webcitation.org/68Tqz9L2u

Layoo, R (2013) Former inmates decry forced circumcision Daily Monitor http://www.monitor.co.ug/News/National/Former-inmates-decry--forced-circumcision/-/688334/2110502/-/1wm3ydz/-/index.html Accessed: 2013-12-16. Archived by WebCite at http://www.webcitation.org/6Ltvm2Hi9

Llewellyn, E (2012) Infant Circumcision: A Tipping Point for HIV Prevention USAID Frontlines May/June 2012 Full-text available at http://transition.usaid.gov/press/frontlines/fl_may12/FL_may12_U5_SWAZILAND.html Accessed: 2012-06-17. Archived by WebCite at http://www.webcitation.org/68U9lv9vt

Mbanje, P (2013) Zimbabwe government takes circumcision into the classroom The Standard http://www.thestandard.co.zw/2013/12/08/zimbabwe-government-takes-circumcision-classroom/ Accessed: 2013-12-16. Archived by WebCite at http://www.webcitation.org/6LtvSfy7N

Mhlanga, P (2012) Govt sharpens knives for forced circumcision NewsDay 1 December 2012 Full-text available at http://www.newsday.co.zw/2012/12/01/govt-sharpens-knives-for-forced-circumcision/

News24 (2013) Minister urges MPs to get circumcised News24 website http://www.news24.com/SouthAfrica/Politics/Minister-urges-MPs-to-get-circumcised-20131022 Archived by WebCite at http://www.webcitation.org/6Ltunawpb

NIH (2008) Male Circumcision and HIV Rates in Kenya ClinicalTrials.gov website 28 May 2008 Full-text available at http://www.clinicaltrials.gov/ct2/show/NCT00059371

NIH (2007) Male Circumcision for HIV Prevention in Rakai, Uganda ClinicalTrials.gov website 23 August 2007 Full-text available at http://www.clinicaltrials.gov/ct2/show/NCT00425984

Ngwega, N (2012) Tanzania: Handeni Promotes Male Circumcision to Curb HIV Spread allAfrica.com 11 February 2012 Full-text available at http://allafrica.com/stories/201302110873.html

OHRP (2011) Regulatory Changes in ANPRM Comparison of Existing Rules with Some of the Changes Being Considered Office of Human Research Protections website Full-text available at http://www.hhs.gov/ohrp/humansubjects/anprmchangetable.html Accessed: 2012-01-16. Archived by WebCite at http://www.webcitation.org/64jh4cWek

OIG (2011a) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract HHSN266-2006-00015C With NexBio, Inc. (A-03-10-03119) Health and Human Services Office of Inspector General website 21 September 2011 Full-text available at http://oig.hhs.gov/oas/reports/region3/31003119.pdf

OIG (2011b) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract HHSN272-2008-00013C with the EMMES Corporation (A-03-10-03115) Health and Human Services Office of Inspector General website 31 October 2011 Full-text available at http://oig.hhs.gov/oas/reports/region3/31003115.pdf

OIG (2011c) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract N01-AI-15416 With the University of California at San Francisco Audit (A-03-10-03120) on the Health and Human Services Office of Inspector General website 10 July 2011 Available at http://oig.hhs.gov/oas/reports/region3/31003120.pdf

OIG (2011d) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract N01-AI-3-0052 With Avecia Biologics Limited (A-03-10-03117) Health and Human Services Office of Inspector General website 21 September 2011 Full-text available at http://oig.hhs.gov/oas/reports/region3/31003117.pdf

OIG (2011e) Review of the Centers for Disease Control and Prevention’s Oversight of the President’s Emergency Plan for AIDS Relief Funds for Fiscal Years 2007 Through 2009 (A-04-10-04006) Health and Human Services Office of Inspector General website 15 June 2011 Full-text available at http://oig.hhs.gov/oas/reports/region4/41004006.pdf

OIG (2012a) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract HHSN266-2005-00022C With PPD Development, LP (Audit A-03-10-03118) Health and Human Services Office of Inspector General website 14 September 2012 Full-text available at https://oig.hhs.gov/oas/reports/region3/31003118.pdf

OIG (2012b) Appropriations Funding for National Institute of Allergy and Infectious Diseases Contract N01-AI-30068 With PPD Development, LP (Audit A-03-10-03116) Health and Human Services Office of Inspector General website 14 September 2012 Full-text available at https://oig.hhs.gov/oas/reports/region3/31003116.pdf

OIG (2013a) Data and Safety Monitoring Boards in NIH Clinical Trials: Meeting Guidance, But Facing Some Issues (Report OEI-12-11-00070) Health and Human Services Office of Inspector General website 28 June 2013 Full-text available at https://oig.hhs.gov/oei/reports/oei-12-11-00070.pdf

OIG (2013c) The Centers for Disease Control and Prevention's Namibia Office Did Not Always Properly Monitor Recipients' Use of the President's Emergency Plan for AIDS Relief Funds Audit (A-04-12-04020) Health and Human Services Office of Inspector General website 19 November 2012 Full-text available at https://oig.hhs.gov/oas/reports/region4/41204020.pdf

OIG (2013d) The Republic of Namibia, Ministry of Health and Social Services, Did Not Always Manage the President’s Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (Audit A-04-12-04019) Health and Human Services Office of Inspector General website 19 November 2012 Full-text available at https://oig.hhs.gov/oas/reports/region4/41204019.pdf

OIG (2013b) The Centers for Disease Control and Prevention's South Africa Office Did Not Always Properly Monitor Recipients' Use of the President's Emergency Plan for AIDS Relief Funds (Audit A-04-12-04022) Health and Human Services Office of Inspector General website 12 February 2013 Full-text available at https://oig.hhs.gov/oas/reports/region4/41204022.pdf

OIG (2013e) National Health Laboratory Service Did Not Always Manage President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (Audit A-05-12-00024) Health and Human Services Office of Inspector General website 15 August 2013 Full-text available at http://oig.hhs.gov/oas/reports/region5/51200024.pdf

OIG (2013f) The South African National Department of Health Did Not Always Manage President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (Audit A-05-12-00022) Health and Human Services Office of Inspector General website 23 August 2013 Full-text available at http://oig.hhs.gov/oas/reports/region5/51200022.pdf

OIG (2013g) Aurum Institute for Health Research Did Not Always Manage President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (Audit A-05-12-00021) Health and Human Services Office of Inspector General website 23 August 2013 Full-text available at http://oig.hhs.gov/oas/reports/region5/51200021.pdf

OIG (2013h) The Vietnam Administration for HIV/AIDS Control Did Not Always Manage the President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (Audit A-06-11-00057)  Health and Human Services Office of Inspector General website 10 June 2013 Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2013-06-10-hhs-oig-vietnam.html

Okwii, E (2013) Mbale Residents Flee Forceful Circumcision Uganda Picks 24 June 2013 Accessed: 2015-10-02. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2013-06-24-uganda-picks-mbale-residents.html

Onyango, H (2012) Kenya: The Cut for Boys to Tame HIV allAfrica Accessed: 2015-10-02. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2012-05-10-allafricacom-kenya-cut-for.html

Otieno, S (2013) Met to get cash, food prizes for circumcision The Star 22 July 2013 Accessed: 2015-10-02. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2013-07-22-star-kenya-met-to-get-cash.html

Towindo, L (2012) Were we fooled? The Sunday Mail 13 July 2012  Accessed: 2015-10-01. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2012-07-13-sunday-mail-zimbabwe-were-we.html

ZimEye (2013) Zimbabwe Buys Into Controversial Israeli Style Circumcision ZimEye Accessed: 2015-10-01. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/10/2013-11-10-zimeye-zimbabwe-buys-into.html

2015-09-27 Eyewitness News (South Africa) - "EC authorities meet to curb initiation deaths"

Excerpt:

CAPE TOWN - Authorities in the Eastern Cape will today start a two-day summit aimed at curbing initiation deaths.

Officials rescued 23 initiates, some as young as 13-years-old from illegal schools in several villages near Mthatha earlier this week.

It is off season and normally young people don't go for circumcision until the school holidays.

During the winter season more than 30 young boys died, most of them from the Eastern Cape while undergoing the rite of passage.
...
Two months ago 158 children were rescued from an illegal school near Tzaneen after community members reported suspicious activity.

Government said it is looking to clamp down on illegal schools by possibly introducing new legislation.

Archived URL: https://archive.is/7Wb8F

2015-09-25 Kisumu County News (Kenya) - Nascop to launch second national circumcision strategy in Kisumu

Excerpt:

The National Aids and STI Control Programme (Nascop) is set to launch the second edition of the National Voluntary Medical Male Circumcision (VMMC) strategy in Kisumu on Friday.

The second national VMMC Strategy which covers from 2014-2019 will be launched at the Tom Mboya Labour College.

The secretary of the Inter Counties Task Force on VMMC, Isaac Oguma said in a statement that the strategy will guide in the implementation of VMMC activities for a five-year period.
...
 As a result of this program, the national coverage of male circumcision has increased from 85 percent in 2007 to 91 percent in 2012 against a national target of 94%.

In Kisumu County alone, nearly 200,000 males are targeted during the second phase.

URL: http://www.hivisasa.com/kisumu/health/81591

2015-09-24 South African Broadcasting Corporation - "Initiation school leaders urged to meet health requirements"

Excerpt:

Deputy President Cyril Ramaphosa has called on initiation school members to be approved by community leaders. He was addressing hundreds of people at the National Heritage Day celebrations at the Ramokgopa Stadium, in Limpopo on Saturday.

He made the plea after the recent spate of deaths of young males due to botched circumcisions. Ramaphosa says that initiation school leaders must also meet health requirements.

URL: http://www.sabc.co.za/news/a/088e250049f72af49640dfa53d9712f0/Initiation-school-leaders-urged-to-meet-health-requirements-20150924

2015-09-21 PLoS One. - "Acceptability of Male Circumcision among College Students in Medical Universities in Western China: A Cross-Sectional Study"

Excerpt:

Author information

1 Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China.
2 Department of Microbiology, Biochemistry, and Immunology, Morehouse School of Medicine, Atlanta, Georgia, 30310, United States of America.
3 The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China.
4 School of Public Health, Xinjiang Medical University, Xinjiang, 830011, China.
5 School of Public Health, Chongqing Medical University, Chongqing, 400016, China.
6 National Center for STD Control, Chinese Center for Disease Control and Prevention, Nanjing, 210042, China.
7 State Key Laboratory for Infectious Disease Prevention and Control (SKLID), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, 102206, China.
8 Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, 530021, China; Guangxi Medical Research Center, Guangxi Medical University, Nanning, Guangxi, 530021, China

Abstract
Background

Male circumcision (MC) has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore MC’s acceptability and the factors associated with MC among college students in medical universities in western China.
Methods

A cross-sectional study was carried out in three provinces in western China (Guangxi, Chongqing and Xinjiang) to assess the acceptability of MC as well as to discover factors associated with the acceptability among college students in medical universities. A total of 1,790 uncircumcised male students from three medical universities were enrolled in this study. In addition, 150 students who had undergone MC were also enrolled in the survey, and they participated in in-depth interviews.
Results

Of all the uncircumcised participants (n = 1,790), 55.2% (n = 988) were willing to accept MC. Among those who accepted MC, 67.3% thought that MC could improve their sexual partners’ hygiene, 46.3% believed that HIV and sexually transmitted diseases (STDs) could be partially prevented by MC. The multivariable logistic regression indicates that MC’s acceptability was associated with three factors: the redundant foreskin (OR = 10.171, 95% CI = 7.629–13.559), knowing the hazard of having a redundant foreskin (OR = 1.597, 95% CI = 1.097–2.323), and enhancing sexual pleasure (OR = 1.628, 95% CI = 1.312–2.021). The in-depth interviews for subjects who had undergone MC showed that the major reason for having MC was the redundant foreskin (87.3%), followed by the benefits and the fewer complications of having MC done. In addition, most of these participants (65.3%) said that the MC could enhance sexual satisfaction.
Conclusions

MC’s acceptance among college students in medical universities is higher than it is among other populations in western China. An implementation of an MC programme among this population is feasible in the future.

PMID: 26390212

URL: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0135706

2015-09-15 Glob Health Sci Pract. - "Covering the Last Kilometer: Using GIS to Scale-Up Voluntary Medical Male Circumcision Services in Iringa and Njombe Regions, Tanzania"

Excerpt:

Author information

1 Jhpiego, Dar Es Salaam, Tanzania.
2 Jhpiego, Baltimore, MD, USA.
3 Jhpiego, Baltimore, MD, USA.
4 United States Agency for International Development (USAID), Dar Es Salaam, Tanzania.
5 USAID, Washington, DC, USA.
6 Tanzania Ministry of Health and Social Welfare, Dar Es Salaam, Tanzania.

Abstract

Background: Based on the established protective effect of voluntary medical male circumcision (VMMC) in reducing female-to-male HIV transmission, Tanzania's Ministry of Health and Social Welfare (MOHSW) embarked on the scale-up of VMMC services in 2009. The Maternal and Child Health Integrated Project (MCHIP) supported the MOHSW to roll out VMMC services in Iringa and Njombe, 2 regions of Tanzania with among the highest HIV and lowest circumcision prevalence. With ambitious targets of reaching 264,990 males aged 10–34 years with VMMC in 5 years, efficient and innovative program approaches were necessary.

Program Description: Outreach campaigns, in which mobile teams set up temporary services in facilities or non-facility settings, are used to reach lesser-served areas with VMMC. In 2012, MCHIP began using geographic information systems (GIS) to strategically plan the location of outreach campaigns. MCHIP gathered geocoded data on variables such as roads, road conditions, catchment population, staffing, and infrastructure for every health facility in Iringa and Njombe. These data were uploaded to a central database and overlaid with various demographic and service delivery data in order to identify the VMMC needs of the 2 regions.

Findings: MCHIP used the interactive digital maps as decision-making tools to extend mobile VMMC outreach to “the last kilometer.” As of September 2014, the MOHSW with MCHIP support provided VMMC to 267,917 men, 259,144 of whom were men were aged 10–34 years, an achievement of 98% of the target of eligible males in Iringa and Njombe. The project reached substantially more men through rural dispensaries and non-health care facilities each successive year after GIS was introduced in 2012, jumping from 48% of VMMCs performed in rural areas in fiscal year 2011 to 88% in fiscal year 2012 and to 93% by the end of the project in 2014.

Conclusion: GIS was an effective tool for making strategic decisions about where to prioritize VMMC service delivery, particularly for mobile and outreach services. Donors may want to consider funding mapping initiatives that support numerous interventions across implementing partners to spread initial start-up costs.

PMID: 26374807

URL: http://www.ghspjournal.org/content/3/3/503.long

2015-09-14 PLoS One. - A Clinical Trial to Introduce Voluntary Medical Male Circumcision for HIV Prevention in Areas of High Prevalence in the Dominican Republic

Excerpt:

Author information

1 University of Illinois at Chicago, Chicago, Illinois, United States of America.
2 Clinica de Familia, La Romana, Dominican Republic.
3 HIV Vaccine Trials Unit, Instituto Dermatologico y Cirugia De Piel, Santo Domingo, Dominican Republic.

Abstract
Background

Voluntary Medical Male Circumcision (VMMC) is an effective strategy to reduce the risk of HIV infection. Studies conducted in the Dominican Republic (DR) suggest that acceptability of VMMC among men may be as high as 67%. The goal of this clinical trial was to assess the acceptability, uptake and safety for VMMC services in two areas of high HIV prevalence in the country.
Methods

This was a single-arm, non-randomized, pragmatic clinical trial. Study personnel received background information about the risks and benefits of VMMC and practical training on the surgical technique. A native speaking research assistant administered a questionnaire of demographics, sexual practices and knowledge about VMMC. One week after the surgery, participants returned for wound inspection and to answer questions about their post-surgical experience.
Results

539 men consented for the study. Fifty seven were excluded from participation for medical or anatomical reasons and 28 decided not to have the procedure after providing consent. A total of 454 men were circumcised using the Forceps Guided Method Under Local Anesthesia. The rate of adverse events (AE) was 4.4% (20% moderate, 80% mild). There were no serious AEs and all complications resolved promptly with treatment. Eighty eight percent of clients reported being “very satisfied” and 12% were “somewhat satisfied” with the outcome at the one-week postoperative visit.
Conclusions

Recruitment and uptake were satisfactory. Client satisfaction with VMMC was high and the rate of AEs was low. Roll out of VMMC in targeted areas of the DR is feasible and should be considered.
Trial Registration

ClinicalTrials.gov NCT02337179
...
Funding: This project was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR000050.

URL: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137376

2015-09-08 AIDS Behav. - Circumcision Status and Time to Sexual Debut Among Youth in Sub-Saharan Africa: Evidence from Six Demographic and Health Surveys

Author information

    1 Department of Geography, Western University

Abstract

This paper examines the relationship between circumcision status and timing of sexual debut among unmarried youth in Sub-Saharan Africa using Demographic and Health Surveys. Results from survival analysis indicate that the association between circumcision and timing of first sex is place and context specific. Compared to uncircumcised, circumcised men in Rwanda, Uganda and Namibia hasten sexual initiation, whilst circumcised youth in Ethiopia and Mali delayed sex initiation. In Togo however, we found parity in timing to sexual debut. Our multivariate results reveal that, knowledge of HIV/AIDS risk and educational level also feed into the association between circumcision and timing of sex initiation- implying that efforts to prevent new HIV infection through circumcision could benefit from a proper understanding of how diverse set of factors interact in specific contexts to shape youth's decisions to initiate early sex.

PMID: 26350790

URL: http://www.ncbi.nlm.nih.gov/pubmed/26350790

2014-08-18 CDC - "Early Infant Male Circumcision: A Giant Leap toward an HIV-Free Generation in Botswana"

Excerpt:

Baby Tyrone was among the first infants in Botswana circumcised with one of two newly introduced medical devices for infants rolled out by the Ministry of Health earlier this year. Doctors and midwives were trained in January by experts from CDC. The new procedure is bloodless and requires no anesthesia or suturing.

Health officials say that not only will infant circumcision help protect boys from HIV when they become sexually active later in life, but that it also protects infants and boys from serious health complications such as urinary tract infections and paraphimosis, a condition that can lead to pain and swelling of the penis and may require surgery.
...
The rollout of Early Infant Male Circumcision in Botswana may be one of several indications that the Safe Male Circumcision (SMC) program has turned a corner in Botswana. Between April 2013 and February 2014, the national SMC program recorded 42,679 circumcisions, about 85% of its annual target and 10,000 more than the previous year.

More targeted demand creation campaigns and a fleet of new mobile outreach clinics may help explain the recent upsurge in voluntary circumcisions in Botswana. Or perhaps it’s the promise of new SMC devices that make the procedure easier and faster.

The U.S. government through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has supported Botswana’s SMC program from its inception in 2009 with nearly $25 million and technical assistance over the past five years. In 2013, PEPFAR restructured its support to a single-partner model and chose Jhpiego, a development organization affiliated with Johns Hopkins University, as the single implementing partner for all CDC-funded activities related to the SMC program.

The Ministry of Health also plans to roll out the PrePex male circumcision device following the completion last year of a six-month pilot study sponsored by PEPFAR.
...
“If we can integrate infant circumcision into the maternity wings and convince mothers that this is a good idea, this one can be a big win,” says Conrad Ntsuape, the national SMC Coordinator.

URL: http://www.cdc.gov/globalaids/success-stories/botswana_success.html

2015-09-24 eTurboNews - "Tourism clusters to be launched as part of this year’s World Tourism Day Celebrations"

Excerpt:

In a bid to strengthen service delivery,Uganda's Ministry of Tourism Wildlife & Antiquities (MTWA) is developing a framework under which regional clusters are to be formed.

In a communique from the Ministry inviting representatives from the different regions, to kick off this year’s World Tourism Day activities, a tourism cluster workshop has been scheduled for 25th and 26th of September 2015 at Gracious Palace Hotel in Lira district located in northern Uganda. The workshop is designed to develop capacity of the tourism clusters and to develop strategic work plans for implementation and in view of attracting funding.

Funded by (united Nations Development Programme) UNDP, the workshop shall also benchmark best practices from the South African experience and identify Unique Sales Propositions for each cluster .
...
So far the response has been positive with several clusters identifying unique selling products ranging from Bull fighting and Imbalu (male circumcision)

URL: http://www.eturbonews.com/64136/tourism-clusters-be-launched-part-year-s-world-tourism-day-celeb

2015-06-23 CDC reference circumcision-for-HIV/STI-prevention in health screening for migrants

Excerpt:

'Internationally, most countries do not track any of the three infections; however, the few publications and records available suggest case rates have declined worldwide over the past 50 years.
...
Additionally, HIV prevention strategies such as male circumcision may be playing a role, although definitive studies of this effect are still pending.'

URL: http://www.regulations.gov/#!documentDetail;D=CDC-2015-0045-0001

2015-09-23 Daily Monitor - Editorial: Check forced circumcision

Excerpt:

We reported last week about the forced circumcision of 25 pupils from Oderai Primary School in Soroti Sub-county, Soroti District in eastern Uganda. The exercise, which targeted pupils of 11 and 15 years, is said to have been facilitated by a non-governmental organisation.

The exercise was a traumatic one for the pupils some of whom had adverse reactions to the circumcision. According to their parents, one pupil disappeared while another refused to return to school.

The Ministry of Education should intervene in this matter to establish how the school administration managed to overstep their mandate to the extent of sanctioning such a life-changing medical procedure on underage individuals without their parents’ consent.

In fact, the entire district administration should be investigated because the school head claimed she released the pupils due to the involvement of district medical workers.
The official claim is that the district workers were merely doing their duty as per a government programme sanctioned by the district. However, if there are complications arising from this exercise, ultimately it is the parents who will bear the cost of medical bills and emotional trauma.
...
The hurried way in which the circumcision of the Soroti pupils was done raises questions about the objectives of those who carried it out. Is this a district wide exercise that they intended to carry out in other schools? Authorities in the ministries of Health and Education should come out and pronounce themselves clearly on this exercise.

URL: http://www.monitor.co.ug/OpEd/Editorial/Check-forced-circumcision/-/689360/2881298/-/rjd7hbz/-/index.html

2015-09-19 Daily Monitor (Uganda) - Parents protest forced circumcision of children

Cite as:  Onyango, J.E. (2015) Parents protest forced circumcision of children Daily Monitor 19 September 2015 Full-text available at http://www.monitor.co.ug/News/National/Parents-protest-forced-circumcision-of-children/-/688334/2876206/-/gvf444/-/index.html Accessed: 28 October 2015. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/09/2015-09-19-daily-monitor-uganda-parents.html

Excerpt:

Parents have protested the circumcision of their underage children studying at Oderai Primary School in Soroti sub-county, Soroti District.

At least 25 pupils were circumcised on Monday without consent of their parents and most of them have since not returned to school.

The exercise targeted children from Primary Three to Primary Seven aged between 11 to 15. They were circumcised at Soroti Health Centre III. The exercise was facilitated by Baylor Uganda, a non governmental organisation.

Parents said the circumcised children preferred to stay back at their respective homes because they are still feeling pain.

Archived URL: https://web.archive.org/web/20151028045624/http://www.monitor.co.ug/News/National/Parents-protest-forced-circumcision-of-children/-/688334/2876206/-/gvf444/-/index.html

2015-09-16 Daily Monitor (Uganda) - Baby loses penis during circumcision

Cite as: Basiime & Atuhaire (2015)  Baby loses penis during circumcision Daily Monitor 16 September 2015 Full-text available at http://www.monitor.co.ug/News/National/Baby-loses-penis-during-circumcision/-/688334/2871830/-/9w2t1t/-/index.html Accessed: 28 October 2015. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/09/2015-09-16-daily-monitor-uganda-baby.html
 
Excerpt:

Kabarole. A six-months-old baby in Fort Portal has lost his penis during circumcision, a procedure his mother claims she never authorised.
Ms Rosette Katushabe, a resident of Rwengoma village in Fort Portal municipality, says her baby was on September 2 circumcised by a sheikh without her consent.
...
Previous cases
In 2013, a 44-year-old lost his penis to a botched male medical circumcision procedure in a private clinic in Kawempe Division, Kampala. The man said the circumcision was free, but he had to pay shs20,000 for the drugs. He said he woke up three hours after the procedure to find his penis stiff and was removed days later at Mulago hospital when it darkened and began peeling off.

Archived URL: https://web.archive.org/web/20151028042614/http://www.monitor.co.ug/News/National/Baby-loses-penis-during-circumcision/-/688334/2871830/-/9w2t1t/-/index.html

2015-09-21 Global Fund - Results Report 2015

Cite as: Global Fund (2015) Results Report 2015 Global Fund 21 September 2015 Full-text available at http://www.theglobalfund.org/documents/publications/annual_reports/Corporate_2015ResultsReport_Report_en/ Accessed: 28 October 2015. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/09/httpwww.html

Except from the report:

Country Example – Kenya

With 1.6 million people living with HIV, Kenya has the fourthlargest number of people infected with the virus in the world. The number of new infections each year has dropped at a relatively slow pace. However, accelerated expansion of treatment has meant that many more people who contract HIV are staying alive.

About 700,000 people are now on HIV treatment in Kenya, and 53,000 women receive prevention of mother-to-child transmission services representing more than 70 percent coverage. Strong HIV testing campaigns have seen 75 percent of Kenyans test for the virus at least once. Fifty percent of people living with HIV in the country know their status. Also, expanded prevention efforts in providing voluntary medical male circumcision have led to 800,000 circumcisions.

Archived URL: https://web.archive.org/web/20151028041516/http://www.theglobalfund.org/documents/publications/annual_reports/Corporate_2015ResultsReport_Report_en/

2015-09-17 Zambia Daily Mail - "Zingeni Jere lauds benefits of male circumcision"

Cite as:  Zambia Daily Mail (2015) Zingeni Jere lauds benefits of male circumcision Zambia Daily Mail 17 September 2015 Full-text available at https://www.daily-mail.co.zm/?p=44014 Accessed: 28 October 2015. Archived by Bodily Autonomy Watch at http://bodilyautonomywatch.blogspot.com/2015/09/2015-09-17-zambia-daily-mail-zingeni.html

Excerpt:

Zingeni is among the 950,626 Zambian youths and men who have undergone the HIV prevention strategy across Zambia. The programme began in 2008.
According to research done by various organisations including the World Health Organisation (WHO), it has been revealed that male circumcision (MC) has helped reduce men’s risk of acquiring HIV by 60 percent.
...
The WHO 2015 Progress Brief on VMMC for HIV Prevention reports that nearly one million men have been medically circumcised since 2008 when VMMC started towards the end of 2014 as part of the massive scale-up of circumcision services in the country.
For the year 2014 alone, the report indicates that 315,168 men accessed the service.
From 2008 until 2014, a total number of 950,626 men have been circumcised, representing 49 percent of the country’s 2015 target of two million VMMCs.

URL: http://www.webcitation.org/6cbgqSCXf