WHO, UNAIDS and PSI call for scale up of male circumcision in Eastern, Southern Africa

WHO, US Global AIDS Coordinator, and noted academic highlight ways to maximize impact of the life-saving intervention at the International AIDS Conference in Vienna

The U.S. Global AIDS Coordinator Ambassador Eric Goosby and the World Health Organization's Director of HIV, TB, and Malaria, Africa Regional Office, Dr. David Okello, joined PSI (Population Services International) today in calling for greater efforts to rapidly and efficiently scale up male circumcision service delivery in Eastern and Southern Africa.  

In March 2007, WHO and UNAIDS recommended adult male circumcision as an effective HIV prevention intervention, able to reduce the risk of HIV infection among men by up to 60 percent. Male circumcision is the only intervention to show consistent efficacy in clinical trials. Scaling up male circumcision to reach 80 percent of adult and newborn males in Eastern and Southern Africa by 2015 could avert more than 4 million new HIV infections between 2009 and 2025 and could yield a total net savings of US$20.2 billion during the same time period.

Speaking at an afternoon press conference at the 18th International AIDS Conference in Vienna, Dr. Krishna Jafa, PSI Director of HIV, TB and Reproductive Health, said, "With global resources spread thin, we must focus on expanding proven and cost-effective methods like male circumcision to prevent HIV transmission." Those comments echoed similar remarks made yesterday by former President Bill Clinton and philanthropist Bill Gates, who both called for rapid and efficient scale up of male circumcision as a proven, cost-effective method of HIV prevention.

Despite the understanding of the need for scale-up, barriers still remain in many countries where the epidemic has hit hardest. Shortages of trained health care providers and inefficiencies in traditional delivery methods have prevented many countries from reaching their target goals for numbers of men circumcised.  

PSI – which provides male circumcision services in four countries across Southern Africa and communications support in six – today released its ground-breaking study from Zimbabwe, where researchers customized and implemented the MOVE model for male circumcision.  MOVE (Models of Optimizing Volumes and Efficiency) optimizes the use of staff and facility space to allow task shifting and task sharing. It also prioritizes clinical techniques and surgical methods to help scale up male circumcision services. The study shows that the quality of the procedure was not compromised by the model and there were no increases in the percentage of clients reporting adverse events following the procedure.

"The MOVE model was successful in Zimbabwe due in large part to the strong support of the Zimbabwean government, which made MOVE a part of its nationwide expansion of male circumcision services," said PSI President and CEO Karl Hofmann, who moderated the press conference. "In order to replicate this success elsewhere, we must engage all sectors – public, private and non-governmental organizations alike – in expanding access to high-quality male circumcision services through efficient service delivery and supply chain management systems."

PSI will host a satellite session on strategies for scaling up male circumcision services on Wednesday July 21 at the International AIDS Conference.  Frances Cowan of the University College of London, who also spoke at today's press conference, will join representatives from USAID, the Centers of Disease Control, Family Health International and the Nyanza Reproductive Health Society in Kenya to discuss issues such as cost-effectiveness, informed demand and integrating neonatal male circumcision services in the session.