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Annotated list of resources on mass circumcision in Africa

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Advocates for mass circumcision in Africa

Considering the amount of foreign money committed to circumcise Africans, you have likely seen a lot of public messages promoting circumcision. If you want more information, these three websites are a good place to start: (a) WHO’s pro-circumcision site; (b) USAID’s pro-circumcision site; and (c)  The Clearinghouse on Male Circumcision for HIV Prevention, a website supported by a grant from the Bill and Melinda Gates Foundation.  

Overview of mass circumcision plans and achievements

A good introduction to current plans is UNAIDS 2011 publication: Joint Strategic Action Framework to Accelerate the Scale-Up of Voluntary Medical Male Circumcision for HIV Prevention in Eastern and Southern Africa. The document lists 8 non-African organizations supporting the scale-up (see page 9): 5 from the US (Department of Defense, USAID, Gates Foundation, CDC, and Office of the US Global AIDS Coordinator); and 3 international organizations (World Bank, WHO, and UNAIDS). Notably absent from this list are any other bilateral donors. The plan proposes that donors and governments spend $1.5 billion to circumcise a total of 20.3 million men in 13 countries by 2015, to achieve 80% circumcision among men aged 15-49 years. The 13 target countries are Botswana, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. Notably, circumcised men are more likely to be HIV-positive than intact men in Malawi, Rwanda, and Zimbabwe, and are almost equally likely to be HIV-positive in several other countries.

Compared to ambitious targets, achievements are falling short. According to the latest information from circumcision advocates, only 2.7% of the targeted 20.3 million men have been circumcised during 2008-10. In 7 of 13 countries, less than 1% of targeted men have been circumcised (see Table 2). Despite donors offering money, national buy-in has been limited (see Table 4).

Organizations and articles opposing circumcision for HIV prevention

 The French National AIDS Council opposes circumcision for HIV prevention.

Daniel Ncayiyana, editor of the South African Medical Journal, the most prestigious medical journal in Africa, argues in a hard-hitting editorial in the November 2011 that circumcision is “not the way to go for South Africa.” Ncayihana concludes that “correct and consistent condom use, not circumcision, is the most effective means of reducing female-to-male transmission, and vice versa.” Ncayiyana D. The illusive promise of circumcision to prevent female-to-male HIV infection – not the way to go for South Africa. S Afr Med J 2011; 101: 775-776.

Robert van Howe and Michelle Storm, in a 2011 article in the Journal of Public Health in Africa, summarize data and arguments, concluding that mass circumcision for HIV prevention “takes resources away from more effective, less expensive, less invasive alternatives,” including condom promotion. “By diverting attention away from more effective interventions, circumcision programs will likely increase the number of HIV infections.”

Intactivist (anti-circumcision) websites

The National Organization of Circumcision Information Resource Centers (NOCIRC) has for years campaigned against circumcision, raising many issues, including human rights of children, risks, sexual pleasure and function, and others. NOCIRC opposes mass circumcision for HIV prevention. NOCIRC began in the US. Subsequently, NOCIRC groups have been organized in many other countries.

South Africa’s National Organization of Circumcision Information Resource Centers (NOCIRC-SA) provides information and arguments against circumcision for HIV prevention.

Accessible and lively, the website circumstitions offers a lot of information and resources for public education and mobilization against circumcision for HIV prevention.

The International Coalition for Gender Integrity lists intactivist organization around the world, and provides links to their websites. ICGI provides information and arguments against circumcision for HIV prevention.

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