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From: PlusNews <[email protected]>
Date: Tue, Nov 6, 2012 at 3:56 PM
Subject: UGANDA: Mixed progress in male circumcision campaign
To: Elisabeth Janaina <[email protected]>


UGANDA: Mixed progress in male circumcision campaign

KAMPALA, 6 November 2012 (PLUSNEWS) - More than 380,000 Ugandan men
have been circumcised in the last two years as part the government's
HIV-prevention efforts, new statistics reveal.

Uganda's male circumcision programme was launched in September 2010,
targeting 80 percent of uncircumcised men - about 4.2 million men - by
2015. According to the Uganda AIDS Commission's (UAC) annual
performance review of the National HIV/AIDS Strategic Plan
(2011/2012), 380,000 men were circumcised by March 2012 under the
programme.

Just over one-quarter of Ugandan men are circumcised, but the US
President's Emergency Plan for AIDS Relief (PEPFAR) and UNAIDS
together project that circumcising 4.2 million Ugandan men could halve
the country's HIV incidence.

Recent statistics show that Uganda's HIV prevalence has risen [
http://www.irinnews.org/Report/95116/UGANDA-Higher-HIV-rate-cause-for-concern
] from 6.4 percent to 7.3 percent over the past five years.

Scaling-up

The government says it hopes to circumcise one million men each year
for the next three years.

"We are going to scale-up SMC [safe male circumcision] as a key
component in the core package of a combination of HIV prevention
services. I have given myself a target to circumcise one million
adults annually," SMC National Coordinator Barbara Nanteza told
IRIN/PlusNews. "I am working closely with the implementing partners to
roll out SMC services through surgical camps, outreach and mobile
teams."

"PEPFAR has given us funds to circumcise 750,000 men. We will mobilize
other funds from the government, UN agencies and partners," she added.

Nanteza said the government was considering lowering the target age to
12, hoping to reach boys and their parents during school holidays.

While the progress is impressive, outpacing neighbouring Kenya, where
477,000 men have been reached in four years, critics say it may be
difficult for the government to meet its targets unless it
significantly expands and speeds up the programme.

Major challenges

"The scale-up of medical male circumcision, a critical element of
combination HIV prevention, is slow and has been undermined by lack of
government support," HIV civil society organizations said in a 16
October 10-point plan to halt new infections and save lives.

The UAC acknowledges that, since the programme's launch in 2010, it
has not been formally scaled-up nationally, and effective linkages
between SMC and other HIV services have not been put in place.

"The coverage is still low because of a host of challenges. SMC was
adopted as a programme, but no budget has been allocated. Health
facilities were asked to start circumcision without additional
resources, including supplies," Richard Hasunira, HIV/AIDS adviser for
the health rights group Coalition for Health Promotion and Social
Development (HEPS)-Uganda, told IRIN/PlusNews. "The circumcision
effort that has so far been seen is driven by non-governmental
partners and donor agencies, and their effort is not effectively
coordinated."

The civil society activists said there was a need for the country's
political leaders [
http://www.irinnews.org/Report/94107/UGANDA-Lack-of-resources-political-will-slows-male-circumcision-progress
] to unify their messaging when it came to male circumcision,
otherwise they risk confusing the public about the government's
position. President Yoweri Museveni has himself been a frequent critic
of male circumcision as an HIV-prevention measure.

"Political leaders should show support for the evidence and stop
disparaging safe medical male circumcision with misleading comments,"
the organizations said in their plan. "SMC is a core part of
effective, evidence-based combination prevention, and the policymakers
who ignore that are exposing their own lack of commitment to ending
the epidemic and saving lives.

"Women must be involved at all levels of policy development and
implementation to ensure there is no misinformation or unintended
consequences for women, who are not directly protected by this
intervention," they added.

Convincing men in a largely non-circumcising country to accept the
procedure will be an uphill battle for the ministry; according to
Uganda's 2011 AIDS Indicator Survey, about 50 percent of men are
unwilling to undergo the procedure.

Scaling up the programme will also be difficult in a public health
system where just 63 percent of health worker positions are filled. In
the districts where the programme has been launched, stock-outs of SMC
kits are common. In addition, the health ministry has not developed a
framework for monitoring and evaluating the programme.

"Efforts should be made to rapidly scale-up SMC within the formal
health sector and in the context of the district health system. The
scramble for numbers should not overshadow the need to deliver quality
SMC services," a ministry official, who preferred anonymity, said.

so/kr/rz

[END]

This report online: http://www.plusnews.org/report.aspx?reportID=96723



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