International Herald Tribune Editorial - Rare good news about AIDS

International Herald Tribune Editorial - Rare good news about AIDS
Copyright by The International Herald Tribune
Published: December 14, 2006


The announcement Wednesday about the results in two African studies of male circumcision may be the most important development in AIDS research since the debut of antiretroviral drugs more than a decade ago. The National Institutes of Health halted studies in Uganda and Kenya when it became overwhelmingly clear that circumcision significantly reduces men's chances of catching HIV.

The studies recruited men willing to be circumcised and randomly assigned them to immediate surgery or to a control group. In both studies, the circumcised men acquired half the number of HIV infections that their uncircumcised counterparts did. The studies confirm the results of a trial that ended last year in South Africa, in which circumcision prevented 60 to 70 percent of new AIDS infections.

Until now, efforts at AIDS prevention have largely failed. Little wonder. It requires people to resolve — every day — either not to have sex or to use condoms. Circumcision, by contrast, is a one-time procedure. It is familiar and widely accepted all over the world, even by groups who do not practice it. And safe circumcision does not require a doctor. Community workers and traditional healers can be trained to do the operation safely and given the correct tools. Based on the South African results, groups like the United Nations AIDS program and the World Health Organization were already discussing how they might promote circumcision in countries around the world. They should now move as quickly as possible.

Governments and international donors should also work urgently to provide new financing to help high- risk countries train community workers to do safe circumcision. News of the South African results has already led to a surge in demand for the procedure across Africa, and clinics that now offer it have long waiting lists.

Any campaign will have to be coupled with warnings that circumcision offers only partial protection against HIV and should not become a license for risky sex. Governments must continue to promote condoms and partner reduction.

For years, the holy grail of AIDS prevention has been a vaccine, even one that is only 50 to 60 percent effective. A real vaccine is years away. But now we know its near equivalent exists. International donors and governments should join together to spread the good news about circumcision and make the procedure available everywhere.