Combating HIV – neonatal circumcision is effective and cost-effective too …

[3 September 2010 - 16h23]

A study carried out under the aegis of the Rwandan Ministry of Health recommends that boys should be circumcised as early as possible.

As it has been shown that circumcision is effective in helping to prevent infection with HIV – which can then lead to AIDS – some African states have been proposing that this procedure be applied to the entire male population. According to Dr Agnès Binagwaho of the Rwandan Ministry of Health, priority should be given to circumcising newborn male infants. For one thing, the risk of complications appears to be far lower among infants. Another argument is that early intervention results in substantial savings: circumcising a male infant costs €12 whereas circumcising a male adult costs €45.

In the long term, systematic circumcision of infants in developing countries would be a cost-effective strategy. Though inexpensive, the procedure could help to avoid numerous cases of infection with HIV… and hence avoid the need to provide far more costly treatments.

The problem, however, is that while preventive circumcision appears to be generally well accepted in Rwanda, in certain other countries, there are many reservations about it. In South Africa, where the prevalence of HIV is very high (close to 20% in some regions), certain ethnic groups refuse to agree to infant circumcision, considering it to be a “rite of passage” from childhood to adulthood. Carrying out this procedure for medical reasons is therefore unthinkable, particularly among male infants. However, we must remember that circumcision is only a supplementary way of preventing HIV: it is not enough in itself and using a condom remains essential.

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