KENYA, UGANDA: Men regret being cut, denounce campaign

BlackNews.com
November 30, 2016

Africans Speak Out Against the Mass Circumcision Campaign

by Max Fish
“We respect science honestly, but we do not support what science brings to finish us, to defile our cultures, defile our rights.” — Prince Hillary Maloba

— Since 2008, western public health giants* have been circumcising Africans by the millions to slow the spread of HIV/AIDS. American taxpayers are funding the effort through the President’s Emergency Plan for AIDS Relief (PEPFAR). An estimated 12 million men and boys have been circumcised to date. The world has not heard a word from them until now. —
 
Nationwide — The VMMC Experience Project recently sent cameras into Uganda and Kenya to document the realities of the mass circumcision program. Local investigators conducted interviews with 90 affected men and women and found:
1. Africans are told circumcision conveys immunity from HIV. 2. Condom use is at an all-time low, and AIDS is on the rise.
3. The program is killing the very people it is supposed to help.
4. No follow-up post circumcision (cut-and-release approach).
5. Resentment and outrage among Africans.
The “Voluntary Medical Male Circumcision” (VMMC) public health program is the first mass surgical campaign in human history. It targets Africans exclusively, leading some to question whether there are underlying racial motives. For centuries, western stereotypes have held that African men are lascivious or hypersexed, unable to control their sexual urges. Compulsory African-American male circumcision campaigns were proposed as early as the nineteenth century.

Prince Hillary Maloba is a native Kenyan, director of the VMMC Experience Project, and the driving force behind the investigation. “Male circumcision,” he explains, “as a project that has been applied for we [sic] Africans, has failed to reduce HIV the way we were told. Two, we view it as a violation of human rights. How target only one race in the entire world?”

Bishop Cleophas Matete, another native Kenyan, agrees: “I believe the entire process of trying to test it in Africa was wrong from the beginning.”

The mass circumcision campaign was introduced to reduce the incidence of HIV in fourteen sub-Saharan African countries that did not initially practice genital cutting. However, UNAIDS data indicate that the African HIV epidemic has only worsened since 2010—shortly after VMMC was implemented. For the first time since the war on AIDS began, HIV is back on the rise.

The World Health Organization claims that male circumcision curbs female-to-male HIV transmission by up to 60 percent and provides lifelong partial protection against HIV and other sexually transmitted infections. Their conclusions derive from a process of contentious surgical experimentation on Africans.

Opponents allege that the targeting of impoverished Africans constitutes a racial and human rights issue. Comparisons are made to the Tuskegee syphilis study. Others argue that the program results in a dangerous false security. The present investigation confirms that men, women, and teens are abandoning condoms out of a belief that they are already protected by circumcision. This in turn increases the spread of HIV.

Prior to the VMMC Experience Project investigation, none have consulted or followed up with the men and women who have been directly affected. Many are living in rural poverty, invisible to the developed world. They have had no platform or voice in the circumcision agenda. Maloba’s investigation is the first to shed light on the African side of the story.

African men and women say the campaign is violating their rights, confusing their cultural identity, and profoundly worsening the AIDS epidemic. They implicate the program in the spike in HIV cases we have seen in recent years. Seven respondents in Maloba’s investigation said that they had acquired HIV because of misinformation around circumcision.
 
“I blame those who told me that if I get circumcised I won’t get HIV,” said one respondent, “and I got HIV already!”

Others mourned the loss of friends, brothers, relatives, and neighbors to AIDS following the procedure they believed would protect them.

“These people are dying of HIV due to ignorance,” a respondent explained.

“If we don’t stop this thing,” Maloba warns, “this community will not have a generation that will take care of the old people.”

Instead of mass circumcision, Africans want funding for sustainable medical facilities, anti-retroviral medications (ARVs), more durable condoms, HIV education, and poverty reduction initiatives.

Many cite AIDS-related tragedies from the VMMC program. They seek an end to the circumcision campaign as a public health disaster and a form of cultural imperialism from the West. “It is something that has been imposed on us,” a reverend explained in his interview. “If I could get a forum to fight it, I could fight it very hard.”

*VMMC-promoting institutions include the Bill & Melinda Gates Foundation, the World Health Organization, UNAIDS, USAID, PEPFAR, Jhpiego (Johns Hopkins University), and numerous NGOs.

About the VMMC Experience Project The VMMC Experience Project is a 501(c)(3) nonprofit effort to document the effects and aftermath of the world’s first mass surgical campaign. Its aim is to empower the most frequently overlooked contingent in the African circumcision regime: Africans.

ZIMBABWE: Mass circumcised stalled by lack of funds

Newsday (Zimbabwe)
June 17, 2014

Lack of funding stalls circumcision programme

by Veneranda Langa
THE United Nations Programme on HIV and Aids (UNAids) says lack of funding and medical personnel has stalled expansion of the Voluntary Medical Male Circumcision (VMMC) programme to rural areas.

This was disclosed in a 2013 UNAids report titled Matching Supply with Demand: Scaling Up Voluntary Medical Male Circumcision in Tanzania and Zimbabwe.

The report said the shortage of doctors had caused the programme to miss its targets to circumcise some 1,3 million males aged between 13-29 years by 2015.

... The UN body also recommended intensive awareness campaigns to dispel existing misconceptions about the benefits of circumcision. [...such as the myth that there is any benefit...]

“Zimbabwe is a non-circumcising country and local norms around VMMC, such as a strong preference for VMMC during pre-adolescence, are not a hindrance to reaching the target population. Over 76% of the VMMCs in Zimbabwe are performed on males aged 15 to 49 years.

“Zimbabwe plans to dispel myths about circumcision through scaling up demand creation activities, particularly best practices such as partnerships with public figures and community organisations and leaders and through engaging women as both partners and mothers.” ["Demand creation" = propaganda, brainwashing]

ZIMBABWE: Men not accepting circumcision

The Standard (Zimbabwe)
May 19, 2013

Resistance hinders circumcision programme

by Moses Chibaya

The government set an ambitious target to circumcise three million men by the end of 2015, in its bid to reduce HIV infections in the country.

But to date, only 8% of the target population has been reached, less than two years before the deadline.

United Nations Joint Programme on HIV and Aids (UNAids) country director, Tatiana Shomiliana, said there was need to re-strategise so that more young people can be mobilised for the circumcision programme.

She said while resources had been availed to circumcise over 100 000 males in 2012 alone, far less than half the target was achieved.

“An analysis is going on. We are trying to understand why. Do we target wrong people? Do we message wrongly?” Shomiliana said.

She said wrong packaging of messages was contributing to the poor response to the programme. Shomiliana cited the message “Be a winner, get circumcised” which she said does not clearly bring out what it is that one would be winning by getting circumcised.

...

SWAZILAND: Circumcision plans go awry

IRIN News
May 13, 2013

Circumcision plans go awry in Swaziland

MBABANE, 13 May 2013 (IRIN) - It was an ambitious plan to circumcise the majority of men in Swaziland, an effort to reduce the risk of HIV transmission in a country with the world's highest HIV prevalence. How could it have gone wrong?

“First they told me that circumcision will not really protect me against HIV. Then they tell me that I cannot have sex for some weeks or months after circumcision. I told them ‘fusaki’ [get out]!” Eric Dlamini, a 22-year-old law student, told IRIN.

These views are at the heart of the failure of the Accelerated Saturation Initiative (ASI) to achieve more than a fraction of its targeted goal, the circumcision of 80 percent of Swazi males between ages 15 and 49 within a year.

The programme, a partnership between the Ministry of Health and Social Welfare and the US-based Futures Group, was launched in 2010, and extended to 30 March 2012 when initial efforts showed a failure to achieve targeted results. But only about 20 percent - or 32,000 - of the targeted demographic were circumcised through the programme.

US$15.5 million was spent on the programme, or $484 per circumcised male.

“We do not believe [ASI] was a failure but an additional prevention measure that is contributing to the overall combination efforts to end the HIV/AIDS pandemic in the country,” US Embassy in Swaziland spokesperson Molly Sanchez Crowe told the local press.

Imposed from outside?
Male circumcision has been scientifically proven to reduce a man's risk of contracting HIV through vaginal intercourse by as much as 60 percent. Follow-up studies have found that the effectiveness of male circumcision in HIV prevention is maintained for several years.

Government health officials, like Minister of Health Benedict Xaba and Khanya Mabuza, the acting director of the National Emergency Council on HIV and AIDS (NERCHA), have noted that ASI taught the country important lessons and left behind several clinics and other health infrastructure.

But a year after the programme ended, Swazi health officials are still trying to figure out what went wrong. Health workers, who spoke to IRIN on the condition of anonymity, pointed out that the programme was hastily implemented. They wondered why the short implementation time was not extended. Ending the programme, they fear, may suggest to international donors that the country is a hopeless cause.

“We have been struggling with HIV for 20 years, and we see programmes come and go. Some are fads... and some are not well thought out. The Swaziland programme came from the outside. The health ministry was willing to go along because there was money there. But it was imposed,” said Thandi Mduli, an HIV testing officer in Manzini.

Officials with health-oriented NGOs admitted to IRIN they are “terrified” of criticizing an initiative funded by the “mighty” US President’s Emergency Plan for AIDS Relief (PEPFAR) and involving the global population control NGO Population Services International (PSI).

The ASI programme was an attempt to duplicate in Swaziland the circumcision successes seen in Kenya and other countries, without apparently doing the pre-campaign ground work. Kenya has carried out an estimated 477,000 circumcisions since its programme started in 2008, according to the government.

In 2011, UNAIDS and PEPFAR launched a five-year plan to have more than 20 million men in 14 eastern and southern African countries undergo medical male circumcision by 2015.

Reasons for failure
“There were a lot of issues involving male circumcision that were not properly explained to Swazi men, so they rejected it and they talked to their friends, and word of mouth was negative instead of positive. This is the opposite of what a campaign like this needs to work,” said NERCHA's Mabuza.

Other issues included unfamiliarity of the procedure. “When I heard I would still have to wear a condom, I said, ‘What is the point?’” said Samkelo Mduli, a university student.

A survey commissioned by the Futures Group in 2011 found that although there was a 91 percent awareness of circumcision, nationally, the largest barrier to circumcision was fear of pain. Other barriers included fear of something going wrong, and a general lack of understanding of the procedure.

Another reason for the rejection of circumcision was not anticipated by ASI promoters: belief in witchcraft, which is widespread in Swaziland. Criminals are known to seek “strengthening” potions made with human body parts. Killings associated with “ritual murder” routinely correspond with national elections. Victims, usually children or older people, are found with body parts missing. One attack made headlines in the Swazi press recently.

“That’s also what I wanted to know, and they wouldn’t tell me - what happens to my foreskin once it is cut off?” said Mduli.

Health Minister Xaba alluded to this when he told the Times of Swaziland, “Some men feared that the foreskin could end up in wrong hands, being used by some unscrupulous people for their ulterior motives.”

“This is embarrassing and nobody wants to talk about it,” said the programme director of a faith-based HIV/AIDS initiative in Manzini. “The circumcision initiative failed because of this arrogance on the part of its promoters. It would have been easy to be honest and explain to the Swazi men that their foreskins would be incinerated like all surgical refuse. But the promoters said, ‘Oh, no, we can’t talk about witchcraft. What will the donors say?’”

Swaziland
HIV Rates:	Circumcised men	21.8%
	Intact men	19.5%
Source: www.measuredhs.com (p235, pdf p256)

UGANDA: Museveni still opposes circumcision

Africa Review
January 2, 2013

Museveni sticks to position on circumcision

by Agatha Ayebazibwe
Uganda's President Museveni has reaffirmed his earlier stand against safe male circumcision in eliminating HIV, saying the campaigns in favour of the method are misleading Ugandans into unchecked sexual behaviour. [He's right.]

In his end of year message to the nation on Sunday, the President said there was need to revisit the earlier strategy of Abstinence, Being faithful and Condom use (ABC) strategy if the current trend of HIV is to be reversed.

The 2011 Uganda Aids Indicator Survey figures show that the prevalence of HIV among adults has increased from 6.4 per cent in 2005 to 7.3 per cent in 2011. Ministry of Health figures also indicate that new infections increased by 11.5 per cent between 2007/8 and 2010/11.

The President said Ugandans should return to morality and sexual discipline if HIV\Aids is to be fought effectively, adding that HIV/Aids is not a medical but a moral problem that should be treated as such.

Mr Museveni had made the same call in Rakai during the World Aids Day celebrations on December 1, 2012.

The President’s call is in disagreement with that of [some] scientists who advocate for safe male circumcision as another preventive measure which offers [only men] up to 60 per cent protection from the HIV virus that is yet to have a cure.

Mother-to-child
Officials of the Aids Control Programme (ACP) at the Ministry of Health received the news with criticism, saying HIV is a big problem in Uganda that cannot be tackled with a single strategy but rather a combination of all scientifically-proven preventive measures, including circumcision.

“Currently, the scourge is on the rise despite the fact that the ABC campaign has existed for several years now,” said Dr Alex Ario, the ACP programme manager. Dr Ario added: “Other methods cannot be excluded at a time when we have to ensure that the rate of infection is brought down.”

He, however, said the government should acknowledge that there is a problem so it can adopt all the available preventive measures. “We are not telling people to go on rampage because they are circumcised. [They can do that without being told.] We will continue to use a combination of preventive measures until that time when we will get one method that offers 100 per cent protection against HIV.”

The UNAIDS Country Representative, Mr Musa Bungundu, said the ABC strategy is not enough to reduce the increasing HIV infection rate and therefore should be used alongside other measures.

He said if the President thinks that circumcision is not effective, the government should ensure that policies against mother-to-child transmission of HIV are implemented beyond paper to check the more than 15,000 children who are born infected every year.

UNITED NATIONS: Circumcision not important in preventing HIV

November 20, 2012

New H.I.V. Cases Falling in Some Poor Nations, but Treatment Still Lags

By Donald G. McNeil

New infections with H.I.V. have dropped by half in the past decade in 25 poor and middle-income countries, many of them in Africa, the continent hardest hit by AIDS, the United Nations said Tuesday.

The greatest success has been in preventing mothers from infecting their babies, but focusing testing and treatment on high-risk groups like gay men, prostitutes and drug addicts has also paid dividends, said Michel Sidibé, the executive director of the agency U.N.AIDS.

“We are moving from despair to hope,” he said.

Despite the good news from those countries, the agency’s annual report showed that globally, progress is steady but slow. By the usual measure of whether the fight against AIDS is being won, it is still being lost: 2.5 million people became infected last year, while only 1.4 million received lifesaving treatment for the first time.

“There has been tremendous progress over the last decade, but we’re still not at the tipping point,” said Mitchell Warren, the executive director of AVAC, an advocacy group for AIDS prevention. “And the big issue, sadly, is money.”

Some regions, like Southern Africa and the Caribbean, are doing particularly well, while others, like Eastern Europe, Central Asia and the Middle East, are not. Globally, new infections are down 22 percent from 2001, when there were 3.2 million. Among newborns, they fell 40 percent, to 330,000 from 550,000.

The two most important financial forces in the fight, the multinational Global Fund for AIDS, Tuberculosis and Malaria and the domestic President’s Emergency Plan for AIDS Relief, were both created in the early 2000s and last year provided most of the $16.8 billion spent on the disease. But the need will soon be $24 billion a year, the groups said.

“Where is that money going to come from?” Mr. Warren asked.

The number of people living with H.I.V. rose to a new high of 34 million in 2011, while the number of deaths from AIDS was 1.7 million, down from a peak of 2.3 million in 2005. As more people get life-sustaining antiretroviral treatment, the number of people living with H.I.V. grows.

Globally, the number of people on antiretroviral drugs reached 8 million, up from 6.6 million in 2010. However, an additional 7 million are sick enough to need them. The situation is worse for children; 72 percent of those needing pediatric antiretrovirals do not get them.

New infections fell most drastically since 2001 in Southern Africa — by 71 percent in Botswana, 58 percent in Zambia and 41 percent in South Africa, which has the world’s biggest epidemic.

But countries with drops greater than 50 percent were as geographically diverse as Barbados, Cambodia, the Dominican Republic, Ethiopia, India and Papua New Guinea. [...where circumcision is not prevalent.]

The most important factor, Mr. Sidibé said, was not nationwide billboard campaigns to get people to use condoms or abstain from sex. Nor was it male circumcision, a practice becoming more common in Africa.

Rather, it was focusing treatment on high-risk groups. While saving babies is always politically popular, saving gay men, drug addicts and prostitutes is not, so presidents and religious leaders often had to be persuaded to help them. Much of Mr. Sidibé’s nearly four years in his post has been spent doing just that.

Many leaders are now taking “a more targeted, pragmatic approach,” he said, and are “not blocking people from services because of their status.”

Fast-growing epidemics are often found in countries that criminalize behavior. For example, homosexuality is illegal in many Muslim countries in the Middle East and North Africa, so gay and bisexual men, who get many of the new infections, cannot admit being at risk. The epidemics in Eastern Europe and Central Asia are driven by heroin, and in those countries, methadone treatment is sometimes illegal.

Getting people on antiretroviral drugs makes them 96 percent less likely to infect others, studies have found, so treating growing numbers of people with AIDS has also helped prevent new infections.

Ethiopia’s recruitment of 35,000 community health workers, who teach young people how to protect themselves, has also aided in prevention.

...

Mr. Warren’s organization said in a report on Tuesday that the arsenal of prevention methods had expanded greatly since the days when the choice was abstain from sex, be faithful or use condoms. Male circumcision, which cuts infection risk by about 60 percent [They can never resist saying that, with ever increasing certainty, can they? Or failing to mention it is only from women to men?], a daily prophylactic pill for the uninfected and vaginal microbicides for women are in use or on the horizon, and countries need to use the ones suited to their epidemics, the report concluded.