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Circumcising millions: targets and outcomes

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Targets and reported numbers of men circumcised to end-2016

Not later than 2011, WHO and UNAIDS set targets to circumcise more than 20 million men aged 15-49 years in 14 countries in Africa through 2015; these goals were set to achieve 80% of sexually active men circumcised.[1,2] Against this target, WHO reports VMMC programs circumcised 14.54 million men by end-2016 — even one year late, only 71% of the target (see Table).[3] However, about 40% of these circumcisions were done to boys aged 10-14 years, who were outside the target population. Excluding these boys, the program circumcised 8.7 million men aged 15-49 years — only 43% of the target. 

Table: Reported targets and achieved circumcisions in VMMC programs, 2008-16

Country Target[1] Circumcisions 2008-16 (including boys aged <15 years)[2] Achievement as % of target (including boys aged <15 years)
14 countries 20.4 million 14.54 million 71%
Botswana 345,244 180,543 52%
Ethiopia 40,000 71,235 178%
Kenya 377,788 1,377,617 365%
Lesotho 376,795 144,858 38%
Malawi 2,101,566 396,151 19%
Mozambique 1,059,104 1,010,297 95%
Namibia 330,218 64,119 19%
Rwanda 1,746,052 730,059 42%
South Africa 4,333,134 2,844,413 66%
Swaziland 183,450 100,803 55%
Tanzania 1,373,271 2,210,026 161%
Uganda 4,245,184 3,115,110 73%
Zambia 1,949,292 1,484,899 76%
Zimbabwe 1,912,595 807,060 42%

Problems with data, new targets

Reported VMMC achievements in at least some countries might be exaggerated. With so many boys getting circumcised, VMMC programs may be circumcising boys who would get circumcised anyways, according to the custom of their group. In other words, data are unreliable…

Undaunted by lagging achievements and unreliable data, WHO and UNAIDS proposed in 2016 to circumcised an additional 27 million men by 2020.[4]

References

1. WHO, UNAIDS. Progress in scale up of male circumcision for HIV prevention in Eastern and Southern Africa: focus on service delivery, revised. Geneva: WHO, 2011. Available at: http://apps.who.int/iris/bitstream/handle/10665/44741/9789241502511_eng.pdf?sequence=1 (accessed 22 October 2018).

2. Currran K, Njeuhmeli E, Mirelman A, et al. Voluntary medical male circumcision: strategies for meeting the human resource needs of scale-up in southern and eastern Africa. PLoS 2011; 8: e1001129. Available at  http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001129 (accessed 10 April 2018).

3. WHO. Progress brief. 2017. Available at: http://apps.who.int/iris/bitstream/handle/10665/258691/WHO-HIV-2017.36-eng.pdf?sequence=1 (accessed 10 April 2018).

4. UNAIDS. On the fast track to end AIDS. Geneva: UNAIDS, 2016. Available at: http://www.unaids.org/sites/default/files/media_asset/20151027_UNAIDS_PCB37_15_18_EN_rev1.pdf (accessed 22 October 2018).

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