A call for voluntary medical male circumcision

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The joint United Nations Programme on HIV/AIDS (UNAIDS) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) launched a five-year action framework to accelerate the scale up of voluntary medical male circumcision (VMMC) for HIV prevention

 

. The framework-developed by the World Health Organization, UNAIDS, PEPFAR, the Bill & Melinda Gates Foundation and the World Bank in consultation with national Ministries of Health-calls for the immediate roll-out and expansion of VMMC services in 14 priority countries of eastern and southern Africa.

 

“Voluntary medical male circumcision is a high-impact and cost-effective prevention tool that will bring us one step closer to our goal of an HIV-free generation,” said UNAIDS Executive Director Michel Sidibe, who unveiled the action framework at the 16th International Conference on AIDS and STls in Africa (ICASA), together with partners. “Each HIV infection averted is money in the bank and fiscal space for the future,” he added. Joining Sidibe at the launch in connection with the ICASA conference, were the U.S. Global AIDS Coordinator Dr Eric Goosby and former President of Botswana, Festus Mogae.

According to UNAIDS there is evidence that VMMC, when provided by well-trained health professionals, reduces the risk of sexual transmission of HIV from women to men by approximately 60 percent. Since 2007, WHO and UNAIDS have urged countries with high HIV prevalence and low levels of male circumcision to expand access to safe VMMC services.

VMMC offers excellent value for money. Recent modeling commissioned by PEPFAR and UNAIDS found that reaching 80 percent coverage of adult VMMC in the 14 priority countries would entail performing approximately 20 million circumcisions on men aged 15-49 by the year 2015. Such a scale-up would cost a total of US$1.5 billion and would result in a net savings of US$16.5 billion by 2025 due to averted treatment and care costs. An estimated 3.4 million new HIV infections would be averted through 2025.

To date, the scale-up of VMMC has been modest in most countries. According to the joint framework, more than 550,000 men aged 15-49 had been circumcised in the 14 priority countries by the end of 2010. The greatest success in scaling up adult VMMC has occurred in Kenya, particularly in Nyanza Province. While progress in implementing VMMC programs has been more limited in the other priority countries, nearly all countries saw the pace of scale-up quicken in 2010.