Healthy Dose: Kenya's Male Circumcision Drive Ramps Up

November 7, 2012

(We assume you’ve heard that President Barack Obama has won reelection).

Kenya is boosting its efforts to meet its goal of circumcising 1.1 million men.

Most efforts to increase voluntary male medical circumcision (VMMC) have been focused in the western province of Nyanza, which is dominated by the traditionally non-circumcising Luo community. The programme has also been rolled out in the capital, Nairobi, and the northwestern Turkana region, where circumcision levels are low.

“We have focused on other regions as well so that we can have as many people as possible getting medically circumcised,” Obiero said.

Kenya has carried out an estimated 477,000 circumcisions since the programme started in 2008, according to the government. “This figure does not include those in the private sector where voluntary medical male circumcision is also done,” said Obiero.

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 for HIV prevention is maintained for several years.

In 2011, UNAIDS and the US President’s Emergency Plan for AIDS Relief (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.

“To ensure that we achieve our target, the government will increase sensitization and mobilization efforts to ensure we can have more people embrace male circumcision as an HIV prevention method,” Athanasius Ochieng, VMMC programme manager at the National AIDS and Sexually Transmitted Infections Control Programme (NASCOP), told IRIN/PlusNews.

The role of women will also need to be increased. “It will also be critical to engage women in mobilization of their partners and to ensure that they play a bigger role in VMMC than is done currently,” Mark Okundi, a communication specialist with US-funded AIDS Population and Health Integrated Assistance, said.

The government is considering integrating male circumcision, currently offered as part of its HIV prevention package, into outpatient services in public hospitals, as well as starting infant male circumcision, which studies have found to be cost-effective. A recent study carried out among 1,200 infants in Nyanza Province concluded that infant male circumcision was safe, and an earlier study concluded that it was acceptable to most parents.

“We are carrying out studies on infant male circumcision, and once we have this, then we will find out the possibility of rolling out nationally,” Ochieng said.

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Global Health and Development Beat

Male Circumcision – A report from Uganda on the mixed results of the country’s male circumcision campaign in order to reduce the spread of HIV.

China – The Guardian reports that China’s slowly expanding welfare programs are making progress in the areas of healthcare, pensions and free lunches.

Measles – There are now 77 reported cases of measles in North Darfur.

Sanitation – Volunteers in India’s Rajasthan will use drums and whistles to shame people who defecate and urinate in public, an attempt to improve sanitation and hygiene in the state.

Malaria – It is taking longer to treat people with malaria in Western Kenya by using first-line drugs, say researchers.

HIV/AIDS – Researchers at Canada’s Western University completed the first phase of a HIV vaccine trial that they say showed promising results.

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The Players

CFRThomas J. Bollyky, Senior Fellow for Global Health, Economics, and Development at the Council on Foreign Relations, assesses President Obama’s record in promoting international science in the latest issue of Science. The President has made strides in integrating science into U.S. diplomacy and international development activities, but only modest progress on facilitating the day-to-day scientific exchanges that account for most international research.

OCHA – More humanitarian support is needed in the eastern DRC, said OCHA’s Director of Operations.

WFP – The World Food Programme will deliver food aid to southeast Cuba, launching a $20 million appeal.

Mali – The Ansar Dine rebels in northern Mali agreed to allow free passage to anyone who wants to deliver humanitarian aid to people in the region.

GAVI – The first ever pneumonia vaccine campaign was launched in Madagascar through the support of GAVI.

UNICEFAgreed to donate 36 vitamin A test kids to the Nigerian National Agency for Food and Drug Administration and Control

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Buzzing in the Blogs

Cholera does not need to be a part of what is normal life in Haiti, say Dr. Ralph Ternier and Cate Oswald in the Huffington Post.

The initial signs of cholera first showed their tell-tale symptoms on that fateful day in mid-October 2010 in Mirebalais, where our organization, Partners In Health/Zanmi Lasante has been working for over 25 years. Since then, our team of more than 4,000 Haitian colleagues has been dedicated to bringing an end to cholera. Community health workers have provided household chlorination and cholera prevention messaging, doctors, nurses and infection control specialists have provided treatment for over 100,000 people, our water and sanitation team has built chlorinated water systems and latrines, and out experts piloted the oral cholera vaccine in hard hit areas earlier this year. This multi-pronged approach has contributed to a steep drop in cases.

We’ve both witnessed the deeply personal impact that cholera has had on individuals, families and communities here in central Haiti. In the initial days and weeks of cholera, we had families abandoning loved ones at treatment centers for fear that they would return home and make everyone else sick. We had patients treated and cured of cholera attempting suicide as their employers refused to take them back to work or school. We had children orphaned because their parents got sick and weren’t able to get rehydrated quickly enough. As time has passed and more is known about the science of cholera transmission, much of this fear and social isolation has dissipated, but it took community-wide memorial services and psychosocial support groups to help patients and their family members come to terms with the fact that those with cholera did not deserve to be stigmatized.

We also witnessed incredible feats of solidarity: Community members helping to carry complete strangers for miles over mountains to treatment centers; signing up to help register and administer the oral cholera vaccine to every household in their neighborhood; leading education sessions in their churches, schools, and community centers.

We’re also very aware that our work is far from over. The sad reality is that even though we know that cholera is not going away, emergency funding for cholera is. We at Partners In Health/Zanmi Lasante treated more than 900 patients with cholera just in September. If we continue treating cases at the rate we are now, our dedicated cholera funding will be gone in a few short months, and we have no new funds on the horizon. And we’re one of a shrinking number of medical organizations partnering with the Haitian Ministry of Health to continue to provide prevention and treatment for cholera. Our friends at other organizations here in Haiti continue together with us in this struggle. They, too, are struggling to identify where ongoing funds for cholera prevention and treatment will come from as emergency cholera funding from incredible long-term partners such as the CDC and World Bank will no longer be available at the same rates in the new year.

We’ll be blunt: The loss of funding means that in months, thousands of patients — people we have the tools, skills, and expertise to save — will become sick, and hundreds more may needlessly die. This wouldn’t be accepted in a wealthy country. And we’re not willing to accept it in Haiti.

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Capital Events

Thursday

10:00 AM - Development Education in US Universities: What’s New and What’s Missing - CGD

1:10 PM - Book Discussion ‘The Last Hunger Season: A Year in an African Farm Community on the Brink of Change’ - CSIS

Friday

12:00 PM - The Origin of Gender Roles: Women and the Plough - CGD

12:30 PM - Wave II: Socializing Civil Rights and Women’s Health Issues - Georgetown Law

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By Mark Leon Goldberg and Tom Murphy

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