Thursday, May 22, 2008

Uganda: Aids - High Time Men Got the Cut

The Monitor (Kampala)

18 May 2008

The campaign to have male circumcision as one of the major tools in the fight against the spread of HIV is gaining momentum by the day.

The latest call comes from policy analysts at two leading American universities. They propose that male circumcision coupled with reduction in number of sexual partners should become the focus of prevention efforts in countries such as Uganda with generalised HIV epidemics.

According to the researchers - from the University of California and Harvard University - male circumcision and reducing multiple sexual partnerships, two interventions currently getting less attention and resources, would have a greater impact in tackling the Aids pandemic.

When in 2006 initial findings of research into male circumcision in Uganda, Kenya and South Africa showed at least a 60 percent reduction in HIV risk, the trials were stopped early because it was not ethical to withhold the clearly proven benefits of this simple surgical procedure. Following the findings, a Monitor survey showed an increase in the number males seeking medical circumcision at various health units Kampala.

While it was anticipated that a policy would be put in place as per the recommendations of the researchers, nothing has happened. Even more strangely, President Museveni, a known lover of science, appears to be dithering or simply ignoring the evidence.

He was quoted last week saying he would not promote male circumcision as a means to prevent HIV transmission unless scientific evidence on its effectiveness was available. What more scientific proof do you want, Mr President?

And yet this President's blessing matters. Mr Museveni is credited internationally with leading the way in fighting HIV/Aids through the promotion of abstinence, faithfulness to one's partner, and condom use - the so-called ABC strategy.

And while we sleep, other countries are moving full-steam ahead and will soon overshadow Uganda on possibly the only front where our international credentials are not in dispute. In countries like Rwanda, where the research was not conducted, things are happening. President Paul Kagame is already promoting voluntary circumcision as his government works on a policy.

We all acknowledge the importance of ABC and treatment of sexually transmitted infections in controlling HIV infection, plus tackling related challenges such as domestic violence and poverty. Work should continue in all these areas.

But by no means should it end there. Let the government accept the science and promote male circumcision in Uganda where 135,000 people get infected with HIV every year.