Good news from Africa - congratulations to the World Bank

The World Bank has often been criticised for funding large-scale projects (such as hydropower schemes) which do not necessarily benefit the host community. However, for a recent project, whose report has just been published on their web site, the World Bank should be congratulated. Not a single reference to the word "circumcision" appears in it! The project, the Africa Multi-Country AIDS Program 2000-2006 (MAP), concentrated on tried-and-tested methods, such as prevention of mother-to-child transmission, voluntary counselling and testing, distribution of male and female condoms, provision of information and education about AIDS to the population, provision of antiretroviral (ARV) therapy, supporting vulnerable children, and supporting income-generating activities, for example, as alternatives to sex work.

The program certainly appears to have led to successful outcomes. The percentage of persons of age 15-49 with AIDS in sub-Saharan Africa has stopped increasing. In most countries surveyed. the number of people with a comprehensive knowledge about HIV has increased, as has the rate of condom use and the percentage of HIV-infected people on ARV therapy. For example, in Benin, the fraction of young women who reported using a condom in last sex with a nonregular partner increased from under 20 per cent in 2003 to over 50 per cent in 2005, and in Uganda, the percentage of people with advanced HIV infection who are being treated with antiretroviral drugs increased from 7 per cent in 2003 to over 55 per cent in 2005.

There is thus every reason to suppose that education, treatment, and poverty support measures will decrease AIDS incidence in all African countries. The encouragement of male genital mutilation in such countries as Swaziland, with its small population, and Botswana, with a democratic government and relatively well-educated populace, is therefore absolutely scandalous as well as being totally unnecessary. I congratulate the following Africans for standing up to the American-inspired mutilation bandwagon:
The WHO/UNAIDS support for male circumcision is setting the stage for a tragedy similar to the case of South Korea. Before the Korean War, circumcision was unheard of, but it appears to have been introduced under American military influence, and is now inflicted on about 90 per cent of boys.

For the sake of all of the world's male population, I therefore implore WHO/UNAIDS to change their stupid policy!

1 comment:

fa said...

Well the World Bank has also been responsible for some terrifying rubbish. The March 2006 report Male Circumcision: Evidence and Implications, by David Wilson and Joy de Beyer, encourages countries with low circumcision rates to introduce mass circumcision, citing as a positive example the dreadful case of South Korea, which started mutilating boy children
only after the Korean War under American military influence. (Figure 12 of the report shows that nearly 85 per cent of South Korean males in age cohorts 16-39 are circumcised).

In fact the paper they cite in support of the high South Korean circumcision rates (Kim DS, Lee JY, Pang MG. Male circumcision: A South Korean perspective. BJU Int 1999; 83 (Suppl 1): 28-33) has been taken entirely out of context. The Korean authors state in their abstract:
Conclusion: South Korea has an unusual history of circumcision. The mistaken and out-dated [my emphasis] notions about circumcision and lack of knowledge of phimosis by physicians seem to be a leading contributory factor to the extraordinarily high circumcision rate.

I conclude that it is worth while to study carefully the papers cited by any reports which purport to show that male genital mutilation has positive health effects. You may find that the authors contradict themselves!