Small Global Health Investments can Lead to Big Results

By Amy Lieberman

Zambian public health clinics performing adult male circumcisions.

It was a bold move, says Doug Call, Senior Regional Director of Southern Africa at PSI, despite support from local government and evidence from recent randomized controlled trials that showed a 60 percent reduced chance of HIV transmission for HIV-negative circumcised men.

“It was risky on a number of fronts,” Call remembers. “The randomized controlled trials were published but there was and continues to be a backlash against male circumcision. We didn’t know whether or not the donor environment in the U.S. would really get behind the idea to fund this.”

PSI also did not want to make an investment and have it fall apart, Call says, over a project that was culturally loaded.

By the end of 2008, PSI, through its partnership with the Zambian government, performed nearly 2,500 circumcisions. The next year, the program expanded to Zimbabwe – with more than $1 million in private funding for the start-up initiative – and by 2011, the project received its first funding award from the U.S. Agency for International Development and then by the Bill & Melinda Gates Foundation in 2010.

Now, PSI’s voluntary medical male circumcision program has performed the surgical operation on more than 400,000 teenage boys and adult men in Southern Africa. The United Nations Children’s Fund, the Gates Foundation, USAID and the U.K. Department for International Development are backing is Zimbabwe project with an approximate collective $57 million, and the Zambia initiative is receiving roughly $39 million from USAID, the Gates Foundation and the U.S. Department of Defense.

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Remembering US Needle-Exchange Pioneer David Purchase

The needle-exchange movement has been an important development in the effort to reduce the spread of infectious diseases, especially HIV/AIDS, among drug users. A good amount of credit for the growth of the movement in the United States can be attributed to David Purchase.  In fact, there are unconfirmed reports that Mr. Purchase’s needle exchange work in Tacoma, Washington beginning in 1988 was the first such offering in the United States.

A drug counselor, Mr Purchase used the $3,000 he won in a settlement after being struck by a drunk driver while on his motorcycle to begin to provide clean syringes to his clients. Sadly, Mr Purchase passed away from pneumonia on January 21  at the age of 73. His Point Defiance AIDS Project and the North American Syringe Exchange Network are responsible for keeping 15 million potentially harmful syringes off the streets each year.

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