CHARLESTON, South Carolina — Since 2007, health organizations such as the WHO and UNAIDS have been advocating Voluntary Medical Male Circumcision (VMMC) as a tool to prevent the spread of HIV. The procedure, which involves the removal of the foreskin by a health professional, has been proven to reduce HIV transmission by 60 percent. Considering that Sub-Saharan Africa is home to approximately 70 percent of those infected with HIV, preventative measures in these areas can make a big difference in the global fight against HIV/AIDS.
Beginning in 2012, the WHO and UNAIDS established a five year strategic plan to increase circumcision rates in Eastern and Southern Africa. The plan is a call to action for countries to persuade uncircumcised men, especially those in the 15 to 49 year age group, to participate in VMMC. The program also aims to develop long term HIV health services.
UNAIDS states that VMMC is most effective as part of an all-inclusive HIV prevention package. The package should also include consistent use of condoms, a limited number of partners, HIV testing and early treatment methods for those in need.
Currently, 14 African countries with high HIV rates are working to carry out the UNAIDS plan and increase circumcision percentages. This includes Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe.
In order to promote VMMC, USAID has developed the Sankhani Moyenela, or Smart Choices, mission. The USAID funded mission is currently being implemented in various African countries by Jhpiego, a nonprofit health organization affiliated with Johns Hopkins University. In countries such as Malawi and Zimbabwe, citizens have taken the initiative to create local informative Sankhani Moyenela campaigns which encourage Voluntary Medical Male Circumcision.
A recent campaign in Zomba, Malawi took place from July 28 to September 6. The campaign proved to be highly successful with over 4,000 procedures in the first three weeks. Though traditionally, many Zomba residents regard circumcision with cultural and spiritual opposition, residents set these beliefs aside in order to reap the health benefits of VMMC.
Campaign members used creative techniques to encourage others to participate, and those that had undergone VMMC worked together to mobilize the community. The local Malawi Prison Service Brass Band also got involved as it took to the streets playing songs to promote the cause.
Similarly, in Zimbabwe campaigns have targeted national celebrities to join the cause and to encourage others to participate in VMMC. Celebrities that have contributed to the campaign include some of the nation’s best soccer players, musicians and popular DJs.
The PSI campaign began in October of 2013 and it was recently awarded Zimbabwe’s Advertising Campaign of the Year Award for its success. Judges stated that the campaign has been highly influential and a creative use of advertising. Over 20,000 men are now partaking in the procedure each month in Zimbabwe.
With the success of VMMC campaigns throughout these 14 primary countries, a few problems have occurred. As the number of men undergoing the procedure has increased rapidly in certain areas, doctors have struggled to meet the high demands. The standard setup for the procedure which employs just one bed, one assistant and one doctor only allows for eight to 10 procedures per day. Health facilities have been working to make this process more efficient, however, by using more beds and additional nurse assistants when available.
VMMC campaigns have also been affected by a lack of proper materials for the procedure. In order to combat this, Orange Farm has developed prepackaged and disposable VMMC kits, each containing all of the instruments needed for one circumcision. The kits have helped to meet VMMC demands and to save valuable time for health facilities.
Campaigners continue to promote the widespread cause for VMMC and the reduction of HIV/AIDS in these areas. Studies state that 80 percent coverage in the 14 primary African countries would cost $1.5 billion and would save approximately $16.5 billion in the long run. In addition, maintaining coverage through 2025 would prevent 3.4 million new cases of HIV.
– Meagan Douches
Sources: USAID, PLOS, PSI Impact, WHO, WHO