Showing posts with label centers for disease control. Show all posts
Showing posts with label centers for disease control. Show all posts

Saturday, February 7, 2015

ATLANTA, GA: Most of 2000 responses to CDC proposal are anti


The Washington Times
January 15, 2015

Circumcision proposal by CDC drawing detractors

Nearly 2,000 postings against the practice
A federal proposal to encourage discussions about circumcision for baby boys and at-risk men of all ages has drawn nearly 2,000 mostly negative comments and a planned protest in front of a federal agency this month.

The proposal from the Centers for Disease Control and Prevention (CDC) doesn’t explicitly recommend circumcision, but it urges health care providers to proactively discuss the benefits and risks of circumcision with parents of baby boys and “uncircumcised at-risk heterosexual males” to allow people to make well-informed decisions about the procedure.

A public comment period on the proposal in the Federal Register ends Friday.

Circumcision, which cuts away a section of the tissue covering the head of the penis, is associated with a lower risk for acquiring HIV, genital herpes and human papillomavirus, as well as penile cancer and infant urinary tract infections in male infants, the CDC said in its draft recommendations.

The overall risk of adverse events is “low,” with minor bleeding and inflammation cited as the most common complications, the agency said.
“The scientific evidence is clear that the benefits outweigh the risks,” Dr. Jonathan Mermin, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, told The Associated Press when the proposal was unveiled in November.

But the vast majority of the 1,978 public comments on the CDC proposal opposed it — often furiously.

“Stop mutilating helpless babies,” wrote one commenter named Lucy Brenton. “There is no reason to cut healthy tissue of a normally functioning organ, especially without the permission of the owner,” she wrote.

Others decried the physical harm and deaths that have occurred with circumcision, as well as lifelong trauma associated with the loss. An online organization called foreskin-restoration.net said it had more than 5,000 members, some of whom “are so bothered by the imposed loss of their foreskin that they endure a tedious process of nonsurgical foreskin restoration to undo some of the sexual damage.”

Other critics noted that circumcision is unlikely to dent HIV transmission in the U.S. since most HIV cases are among men who have sex with men. The CDC proposal recognized this, saying that the studies showing circumcision as an effective HIV-prevention strategy only involved men who had sex with women.

U.S. health care providers “should inform men who exclusively have sex with men that male circumcision has not been proven to reduce the risk of HIV or [sexually transmitted infections] during anal sex,” the CDC said, adding that circumcision is still advised for bisexual men as well as men who have sex with HIV-infected women, commercial sex workers, injection-drug users and women who live in areas with a high HIV prevalence in the population.

The CDC proposal got a few supportive comments.

“Please don’t listen to the hysterical nay-sayers. Look at the evidence,” wrote one medical doctor, while a man writing as “Anonymous” said his bouts with balanitis, a swelling condition of the penis in uncircumcised men, “could have been prevented if I had been circumcised as an infant.”

Another circumcision supporter, Dr. Jeffrey Klausner, urged the CDC to recommend that the U.S. Preventive Services Task Force review the issue of newborn circumcision. If that task force would endorse newborn circumcision with “an A or B recommendation,” he wrote, it would require Medicaid and Medicare to pay for the procedures as a preventive intervention.

A peer review panel will also be assembled to examine the evidence for the proposal and offer expert opinion on whether the CDC recommendations are justified and appropriate for the intended audience. Final recommendations are likely to be published later this year in the Morbidity and Mortality Weekend Report, the CDC said.

The agency did not directly respond to a question about whether its expert-review panel would include anyone who is critical of circumcision. [Will even one of them have a foreskin?]  But it said its peer reviewers would be selected because of their expertise in such matters as urology, pediatrics, public health, infant circumcision and prevention of sexually transmitted diseases such as HIV/AIDS. [Foreskin anatomy and function, sexology, ethics?]

Anti-circumcision advocates in Atlanta said on their Facebook page that they are planning a rally Jan. 22 outside the CDC offices to protest the proposal.

“We all know that there are no benefits to the amputation of healthy body parts,” said organizers, including members of Bloodstained Men & Their Friends, who protest while wearing white pants with bright red circles at the crotch.

Monday, December 29, 2014

TARRYTOWN, NY: CDC "out of touch with the rest of the developed world"

Intact America
December 2, 2014

CDC "out of touch with the rest of the developed world"

TARRYTOWN, NY—Intact America, an organization that opposes the forced genital cutting of babies and children, sharply criticizes today’s Centers for Disease Control (CDC) proposed guidelines for circumcision.

The CDC is calling for doctors to tell the parents of male infants, children and adolescents that circumcision has been found to reduce the transmission to men of HIV and other sexually transmitted infections (STIs). The guidelines were released on December 2, 2014, opening a public comment period that will end on January 16, 2015.

“Beyond stating and restating its support for medically unnecessary circumcision, the Centers for Disease Control fails to provide any solid evidence to bolster the case for circumcision as a valid measure for disease prevention,” said Georganne Chapin, an attorney and executive director of Intact America. “The studies cited by the CDC purporting to show that circumcision reduces transmission of STIs were conducted in poor rural areas of sub-Saharan Africa over eight years ago. These studies have never been replicated elsewhere—let alone in the United States—and have no relevance to children or men in the developed world.”

“There have been no systematic studies conducted anywhere about the short-or long-term adverse consequences resulting from circumcision," says director Chapin. "Through thousands of personal stories from boys, men and their parents we know that circumcision causes myriad complications, some requiring surgical correction. Adult consequences include poor body image, painful sex, psychological problems, and erectile dysfunction. The CDC's continued persistence in recommending what they know to be an unnecessary surgery is questionable. It is happening in the face of increased public awareness about circumcision’s harms, declining U.S. circumcision rates, and the growing reluctance of states and insurers to pay for this medically unnecessary surgery.”

Intact America notes that the CDC’s proposed guidelines make no mention of the spontaneous and growing protests around the U.S. and Canada by men who are speaking out angrily about having been forced as children to undergo circumcision.

“As a public health organization, the CDC should be calling for a study of the true risks and complications from circumcision that occur over the lifetime of boys and men,” says Chapin, “before it promotes its evidence-free claim that the benefits of newborn circumcision outweigh its harms.”

The American Academy of Pediatrics released a statement in 2012 promoting the benefits of infant circumcision and calling for insurers and state Medicaid programs to pay for the surgery, performed in the U.S. often without anesthesia. This report is at sharp odds with the ethical and medical stance taken by physicians here and in Europe concerning the removal of healthy sexual tissue from children who cannot consent.

In early 2013 in the journal Pediatrics, a large group of physicians, medical organizations, and ethicists from European, Scandinavian, and Commonwealth countries issued a strongly-worded statement , calling American medicine’s support for infant circumcision “culturally biased,” and “different from [the conclusions] reached by physicians in other parts of the Western world, including Europe, Canada and Australia."

In October 2014, Britain’s National Health Service affirmed its previous position stating that, "…most healthcare professionals now agree that the risks associated with routine circumcision, such as infection and excessive bleeding, outweigh any potential benefits."

ATLANTA, GA: CDC taking submissions on male genital cutting

RollCall
December 1, 2014

To Cut or Not to Cut: CDC Poised to Offer Circumcision Guidance

by Paul Jenks
The Centers for Disease Control and Prevention on Tuesday will unveil new guidance on health outcomes relating to elective male circumcision. The agency has been developing counseling guidance for health care providers based upon recent clinical trials and reports that have demonstrated some effectiveness of circumcision in reducing the risk of HIV and several sexually transmitted diseases. The report will also address social, ethical and religious factors relating to circumcision. A notice opening up a 45-day comment period on the looming guidance text will be published on Tuesday.

A recent federal survey indicated 88 percent of non-Hispanic white men and 79 percent of non-Hispanic black men are circumcised but the rates are lower for other ethnicities. [Those are prevelance - proportion of males who are cut - figures, but the incidence - proportion of babies being cut today - is much lower.] However, the study also notes that many of those surveyed did not correctly identify whether they are circumcised.

Thursday, September 11, 2014

KENYA: Circumcision Secretariat Closes

The Star
August 25, 2014

Kenya: Circumcision Secretariat Closes

by John Muchangi
The secretariat that coordinated all voluntary medical male circumcision in Kenya the last six years has closed.

The Male Circumcision Consortium (MCC) started in 2007 in Kenya and has been key in promoting the male cut to prevent HIV in Kenya.

It was the body that reached out to the Luo Council and of Elders and Former Prime Minister Raila Odinga to popularise male circumsion Nyanza, where it is not traditionally practised.

Voluntary medical male circumcision has reached almost 700,000 men, up from 7,000 in 2008 when it was officially adopted in Kenya, according to the Ministry of Health.

MCC was the secretariat of the national taskforce on VMMC and linked the different groups carrying out medical male circumcision in Kenya.

It was funded by Bill and Melinda Gates Foundation and was initially planned to close in 2012 but was extended by two more years.
[Rather typical of Western interventions in Africa. Come in with a hiss and a roar - "We're going to save you!" - then leave with their tails between their legs, having achieved - what?]

"MCC was instrumental in forming the Nyanza Provincial VMMC Task Force that spearheaded the rollout of VMMC from the start, when the ground was shaky, to the present when we are firmly on solid ground," said Prof Kawango Agot, director of Impact Research and Development Organisation. "I believe that without MCC, Kenya would not have led the rest of Africa in VMMC rollout."

Officials said they sought other funding sources in vain and the closure of MCC was likely to slow down the momentum in Kenya.

Male circumcision has been proven to cut the risk of men acquiring HIV by about 60 per cent and remains a key prevention strategy in Kenya.
["Proven" - based on 73 circumcised men who didn't get HIV less than two years after 5,400 men were circumcised, while 64 did. And "a key prevention strategy" when condoms are known to be much more effective.]

At least 1.5 million Kenyans are living with HIV and 58,000 die every year after reaching the Aids stage.

The consortium brought together representatives from the ministry of health, FHI 360, EngenderHealth and Nyanza Reproductive Health Society, representing the University of Illinois at Chicago.

Dr Athanasius Ochieng', who sat on MCC as the VMMC programme manager at the National AIDS and STI Control Programme (Nascop), says. "The government provides policy direction and infrastructure. However, our partners help in implementation of services, and therefore there is need to have a coordinated approach. The MCC has helped to ensure this."

The MCC has convened the task forces regularly -- monthly at first and later quarterly -- since the programme began in 2008.

Dr Elijah June Odoyo, currently the technical lead for VMMC at the US Centers for Disease Control and Prevention (CDC) in Nairobi, says that through these studies and dissemination of their results, "the MCC has cultivated a culture where evidence guides programming."
[So without the MCC there will be no evidence? And then how will they know whether male genital cutting is causing HIV to fall, to rise, or having no effect?]

MCC Senior Manager Mathews Onyango said the task force approach championed by the MCC is now considered a "best practice." He adds that "it is now being applied in scaling up interventions to address other health issues, such as prevention of mother-to-child transmission of HIV, tuberculosis and leprosy, and HIV/AIDS care and treatment."

Thursday, September 27, 2012

ZIMBABWE: Men aren't buying circumcision

Zimeye
September 26, 2012

U.S center for disease control revises circumcision strategy

By Jack Jiri
Harare(ZimEye)-The US U.S. Center for Disease Control and Prevention in Zimbabwe says they are going back to the drawing board and map ways of convincing Zimbabwean males to get circumcised.
The development comes after only 75 000 people have been circumcised since the initiation of the program in 2009 as a measure of eradicating HIV.

The programme intends to circumcise 1.2 million by the year 2015.

Health experts say circumcision reduces HIV contraction by 60% but insist that it is not an effective way of preventing the pandemic. [There's many a true word....]
 
“There is some research going on on the second generation of understanding what motivates people, what their barriers are in accessing circumcision services and we will use that to address their concerns,” U.S. Centers for Disease Control and Prevention Country Director Peter Kilmarx, told Zimeye on the sidelines of the ongoing HIV/AIDS prevention monitoring & evaluation techniques workshop in Harare.
[Kilmarx and the CDC assume they know what is best for Zimbabwean men, better than the men themselves - though the men know better, first-hand, what it is like to be intact and what they would lose by getting circumcised.]
 
...

AIDS levy which is the only domestic source of the country’s AIDS programs is also in doubt owing to controversies surrounding its management by the National AIDS Council which administer the fund.

Wednesday, September 26, 2012

KENYA: Funds for circumcision misused, cut

Standard Media (Kenya)
September 25, 2012

Report decries misuse of funds meant for male cut

By Mangoa Mosota
A donor’s report on an NGO dealing with male circumcision has unearthed widespread misappropriation of funds.

As a result, the annual funding may be slashed from over Sh500 million [$US5,900,000] to less than Sh100 million [$US1,180,000].

Following the budget cut, Nyanza Reproductive Health Society (NRHS) has dismissed 250 workers.

...

The organisation’s director, Walter Obiero said the action has been taken due to cut in funding. He, however, declined to state annual funding to the body since its inception three years ago. But employees The Standard spoke to gave the figure of Sh595 million [$US7,021,000].

Technical support
The report dated August 21, 2012, of which The Standard has a copy, details massive financial impropriety. The assessment was done by the Centre for Disease Control (CDC) in Atlanta, US. They are Procurement and Grant Office (PGO), and Programme Budget and Extramural Management Branch. CDC offers technical support to NRHS, which is based in Kisumu, with operations spread across the country.

CDC has categoriosed NRHS as a ‘high-risk’ organisation, which means that other donors should be wary of it. “NRHS is required to work with CDC Kenya on revising their application to conform to the decreased scope of activities,” reads part of the report.

Among the impropriety is that NRHS went outside its approved CDC budget, and purchased 25 vehicles without CDC or NRHS Board of Directors consent.

“The organisation can spend Sh1 million [$US11,800] on imprest, in less than two weeks. Our assessment found gross mismanagement of the funds. HRHS does not have a limit on the amount of petty cash,” states part of the report that is signed by Shirley Wynn of PGO.

Furthermore, the report reveals contract salaries for workers differ from those they are paid. For instance, an employee’s salary is Sh35,280 [$US416.30], but the contract amount is Sh25,000 [$US295] although the report finding states that the difference can be accounted for.

...

Nyanza Reproductive Health Society ... is funded by President’s Emergency Plan for Aids Relief.

Thursday, July 5, 2012

NEW YORK: Metzitzah: Mohelim resist waiver

PIX11 News
July 2, 2012

Another Baby Gets Herpes After Controversial Circumcision

BROOKLYN, NY (PIX11)

Rabbis in the city’s ultra-Orthodox Jewish communities are resisting a possible change to the city and state health code, which would require parents to sign a consent form, before their infant boys undergo a controversial type of circumcision.

The ritual, known as metzizah b’peh, involves a mohel using his mouth to remove blood from the baby’s penis. The New York State Health Department has renewed concerns, after another infant recently was diagnosed with herpes, shortly after undergoing a metzizah b’peh.

The Orange County baby, who is one month old, was transferred to New York Presbyterian/Columbia University Medical Center for treatment.

Last September, a two-week old Brooklyn baby died from herpes at Maimonedes Medical Center, shortly after he underwent metzizah b’peh. The family refused to tell health officials the name of the mohel who performed the ritual.

A study released in June by the federal Centers for Disease Control showed 11 baby boys contracted herpes simplex between 2000 and 2011 in New York City, where there’s been a cluster of cases. Two of the infant boys died, and two suffered brain damage. The CDC noted that circumcisions “should be performed under sterile conditions.”

Yet observant Jews in some of the city’s most ultra-Orthodox neighborhoods continue to defend metzizah b’peh.

“You can’t change the tradition we have had for thousands and thousands of years,” said Pinchas Kohn, who told PIX 11 he has 50 grandchildren. “You have to check the mohel,” he said. When PIX 11 asked if mohels should be tested for herpes, he replied, “I think so. I think so.”

The ritual is not something most in Borough Park wanted to talk about. This is the community where the two week old baby died last September.

But at least one resident was concerned enough to supply Jewish Week—and then PIX 11—with “audio” tapes of phone calls made to some mohels earlier this year.

One mohel said he tries to kill infection this way. “What I do usually is, I pour wine on it. Wine is alcoholic. I use strong wine.”

The “undercover” caller was horrified when a mohel who was banned by New York State from performing metzizah b’peh indicated he was still doing the ritual in Rockland County, outside of New York City limits. Yitzchok Fischer was ordered to stop doing this type of circumcision back in 2007, not long after he was tied to herpes infections in 3 infants, including a boy twin who died. An infant’s immune system is usually not developed enough to fight off a herpes infection effectively.

Fischer was recorded by the caller saying of the ritual, “I can only do it in Rockland County.” When asked about some of the alarming stories, he said, “There’s nothing to worry about.”

Prosecutors have not had an easy time making cases against mohels who infect babies, because the families often protect the mohels’ identities.

The Orthodox community member who made the tapes said of the Brooklyn family who lost their infant son last September, “They’re covering up for a mohel who killed their child.”

Earlier story

Wednesday, June 13, 2012

NEW YORK: Parents to sign consent for metzitzah?

New York Times
June 12, 2012

City Urges Requiring Consent for Jewish Rite

By Sharon Otterman
New York City health officials proposed on Tuesday that Orthodox Jewish parents be required to sign a consent waiver before they can take part in a circumcision ritual that is believed to have led to the deaths of at least two babies in the city over the past decade.

The proposal, introduced at a Board of Health meeting, represents an escalation of the city’s efforts to curtail the ancient Jewish procedure of metzitzah b’peh, in which an adult male, usually the circumciser, places his mouth directly on the wound created by the removal of the infant’s foreskin to suck away the blood.
Last week, the federal Centers for Disease Control and Prevention published a report based on city information that said that from 2000 to 2011, 11 newborn babies in New York contracted the herpes simplex virus after the ritual. Ten of those babies were hospitalized; two suffered brain damage, and two died.

Based on those findings, the city’s health department issued a statement last week strongly urging that direct oral-genital suction not be performed during circumcision. It also announced that a number of hospitals had agreed to distribute a pamphlet to parents considering at-home circumcision, warning them of the risks.
On Tuesday, Dr. Jay K. Varma, deputy commissioner for disease control for the health department, announced the city’s next step, proposing that the Board of Health, which approves public health policies, require all parents who want direct oral suction to be used to sign a consent form indicating that they are aware of the risk of infection.

...

... In its study, the C.D.C. estimated that roughly 3,600 newborn boys a year in New York had circumcisions that included the procedure. Those infants, the agency said, had more than triple the normal risk of contracting herpes.

Over the past decade, as stories of babies sickened after such circumcisions have come to light, ultra-Orthodox authorities have strongly defended the practice as a religious right. [There is no such thing as "a religious right", only the rights of people to practise religion, which are subordinate to human rights.] Some rabbis argue that there is not enough evidence to show that the procedure causes infection, while others say the practice is important enough that it should be continued anyway.

Avi Shafran, spokesman for Agudath Israel, an umbrella group for many ultra-Orthodox organizations, said on Tuesday that the group wanted to study the proposed regulation before commenting on it. In March, the organization’s executive vice president, Rabbi David Zwiebel, warned that regulating the practice could drive it underground, making it more risky. [This objection is never used against regulating female genital cutting.]

In his presentation to the Board of Health, Dr. Varma said that two of the families whose babies got herpes after the ritual had told health authorities that they were unaware beforehand that it would be performed. He said distressed families had called, as recently as two weeks ago, saying they did not know their mohel would place his mouth on their infant’s wound, and wanting to know what could be done.

The health department is accepting public comments on the regulation until a public hearing on July 23, and will vote on it in September. Dr. Varma said the department was prepared for opposition.

“Since we are regulating how part of a religious procedure is done, this will be heavily scrutinized by legal experts, and it may be challenged at some point,” he said. “But we feel we are on very firm legal ground, because there is a compelling interest on behalf of the city in protecting the health of infants.” [How does allowing parentally consented metzitzah protect the health of infants?]

...

Earlier story