Anti-AIDS Program To Fund Circumcision

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By Craig Timberg
Washington Post Foreign Service
Monday, August 20, 2007

JOHANNESBURG, Aug. 19 -- President Bush's $15 billion anti-AIDS program will begin investing significant money in making circumcision available to African men seeking to protect themselves from HIV, top U.S. health officials said Sunday.

Recent research showing that circumcision dramatically cuts the rate of HIV infection is highly convincing, a delegation of U.S. officials, led by Health and Human Services Secretary Mike Leavitt, told reporters in Johannesburg.

Countries taking part in the President's Emergency Program For AIDS Relief have been invited to seek money to expand access to the procedure.

Circumcision funding would be small at first, with budgets in the hundreds of thousands of dollars for individual countries. But it is likely to grow to be "an important part" of the program in coming months and years, said Kent R. Hill, an assistant administrator for the U.S. Agency for International Development.

The cells in the foreskin of a penis are especially vulnerable to HIV, and removing the foreskin makes a man about 60 percent less likely to contract the virus, studies in South Africa, Kenya and Uganda have shown. The research reinforces studies showing that regions with high circumcision rates generally have lower rates of HIV.

In Kenya, men from the Luo tribe, which does not circumcise its boys, have an HIV rate of 24 percent compared to a national rate of 7 percent. Kenya is among the nations preparing to expand circumcision services, Hill said.

Some other African nations have reacted warily to the studies. Most tribes in Africa once routinely circumcised boys in manhood rituals but the practice has declined in southern Africa, in part because of the influence of European missionaries who discouraged the practice as primitive.

Last year, before the recent studies, the Bush administration cut funding for a small program that was offering circumcision to men in Swaziland, where an estimated one in three adults is infected with HIV, the highest rate in the world. Swazis do not generally circumcise their boys.

The Bush administration had been reluctant to support circumcision services until there was broad international consensus on the issue, Hill said. But the recent studies made clear that "this is going to be one of the major interventions in the international arsenal" against AIDS, he added.

In the same meeting with reporters, Leavitt declined to comment on mounting criticism here of the personal behavior of South African Health Minister Manto Tshabalala-Msimang.

Sunday's editions of South Africa's Sunday Times newspaper reported that Tshabalala-Msimang, while working as a hospital administrator in Botswana in the 1970s, was convicted of stealing from a patient and was banned from the country for 10 years. The newspaper also reported that she had a history of alcohol-related liver problems and that, since receiving a liver transplant several months ago, she publicly drank wine or whisky on several occasions.

Tshabalala-Msimang has long been controversial because of her handling of AIDS, including her reluctance to embrace antiretroviral drugs and her repeated suggestions that diets high in lemons, beets and garlic could help control the disease.

President Thabo Mbeki has staunchly defended Tshabalala-Msimang, rebuffing calls from opposition parties, AIDS activists and scientists around the world that she be fired.


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