| Exemplifying resistance to those who would use HIV/AIDS to promote circumcision, Jeremy Proctor published an article today at the reproductive health blog RH Reality Check entitled "Gimmie Some Skin":
With American funding, thousands of adult African males have recently undergone circumcision to study their subsequent HIV infection rates compared with those of uncircumcised counterparts. HIV infection rates among uncircumcised control groups (often before studies had run their course) led researchers to conclude that the foreskin significantly contributes to seroconversion.
There is ample cause to question this conclusion.
Jeremy goes on to describe the weaknesses in the arguments for circumcision, illustrate the nature of what it removes by invoking the ubiquitous 3x5 index card, and cite examples of countries which have succeeded where others have failed:
Many developing countries, such as India, Thailand and Brazil, have successfully combated AIDS not through circumcision but through aggressive health- and condom-education programs. While hardly rid of HIV, these nations have dodged the devastating mortality rates of, say, Uganda or Botswana.
Surely there is as much to learn from intact Dutch and Thai men as there is from circumcised Ugandan men, but American medical/cultural bias has preempted this line of scientific inquiry. Indeed, the zeal to circumcise has eclipsed the study of whole categories of prophylaxis that may be as effective as circumcision-or even more so. Some of the most promising HIV preventives in development are microbicides administered topically-to the very type of mucosal tissue that circumcision destroys.
At the other end of the spectrum is Former U.N. Special Envoy for HIV/AIDS in Africa and Canadian Ambassador to U.N., Stephen Lewis. As reported at the blog circumcisionandhiv.com (focused on the intersection of these two issues), he recently had this to say on NPR's Worldview:
If I may draw a parallel, suddenly everybody is clamoring for circumcision for men, because that seems, a circumcised male, that seems to cut down the transmission from a woman to a man by something like 60% or better, so it's very beneficial to the men to be circumcised, and we've known for years that male circumcision was an important preventative intervention, and everybody speculated and spent endless time ruminating on whether or not it should be done, and then there were three studies in Uganda, Kenya, and South Africa showing unequivocally and categorically that it cut transmission to men by more than 60% in some cases, and I notice in the last 24 hours UNAIDS has now called for mass circumcision starting with young children. You know, 7 or 8 years ago there were people calling for that, and for whatever reason it has taken all this time to get around to it.
Ambassador Lewis's voice takes on a grave and frustrated tone towards those who did not, years ago, and do not today support a mission to circumcise males of all ages.
I remember, I have a very close collegue as a matter of fact, she's the co-director of AIDS-Free World who was working with UNICEF in East Africa back at the turn of the century, and she suggested, I thought with enormous inspiration, that all infants should be circumcised when we were doing immunization. I mean, it's perfect. You're doing measles immunization, you're doing polio immunization, you're doing it with infants, it would be a perfect way to combine circumcision, providing you were able to set up the procedure in safe circumstances. That's what UNAIDS is calling for today, exactly that, and at the time she suggested it 7 years ago, all the men in the office, you know, clutched their crotches and recoiled with horror..
Does Ambassador Lewis consider circumcising infants at whatever possible opportunity "perfect" exclusively because he believes that a dozen or more years in the future that boy's circumcision will help prevent the spread of HIV? Does he consider circumcision, at worst, a harmless surgery, whose implementation is free of ethical concerns?
If so, his view is not shared by Deo Agaba, who wrote recently in an opinion piece at AllAfrica.com:
[T]he right of children to be protected from any bodily harm and to make a choice regarding their physical being will undoubtedly be grossly violated by promoters of mass circumcision who are targeting babies and children.
There is a tendency to want to do something, anything, to win the fight against HIV/AIDS, and there are those who believe strongly that includes a fight against foreskins. Others favor proven methods and resist interventions which they say would violate the rights of infants, potentially backfire in adults, and be perceived as a colonial-style imposition.
The fight against HIV/AIDS is of the utmost importance. Let's find common ground, check our cultural biases at the door, respect the rights of those we want to help, and focus on strategies that really work. |
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