Malawi Govt wants sexually active men to cut off their foreskins

Malawi Government says it wants 80 percent of sexually active men to undergo circumcision aimed at reducing the risk of contracting HIV and AIDS.

Deputy Health Minister Halima Daudi said  men aged between 15 and 49, should cut off their foreskins in clinics.

She was speaking in Lilongwe during the official launch of a National Policy on Voluntary Medical Male Circumcision.

“The World Health Organisation recommended voluntary medical male circumcision as an additional important strategy for HIV prevention, particularly in settings with high HIV prevalence and low levels of male circumcision, where the public health benefits will be maximized,” said Daudi.

Medical guidelines suggest circumcision can reduce the risk of urinary tract infections and cut the risk of penile cancer and sexually transmitted diseases. Photograph: David Levene

Daudi said male medical circumcision unlike traditional male circumcision, completely removes the areas which are most vulnerable to HIV infection.

She said medical male circumcision provides men life-long partial protection against HIV as well as other sexually transmitted infections.

“It should always be considered as part of a comprehensive HIV prevention package of services and be used in conjunction with other methods of prevention, such as female and male condoms,” she added.

Meanwhile, Voluntary Male Medical Circumcision programme will be rolled throughout the country.

It will be offered in almost all government and Christian Health Association of Malawi CHAM hospitals and clinics. Mobile clinics will also be set up across the district to ensure accessibility to the service.

The campaign hopes to circumcise more than 250,000 men by 2015, said National Sexually Transmitted Infections Programme Officer in the Ministry of Health, Amon Nkhata.

As one of the countries hardest hit by HIV/AIDS, Malawi has been criticized for moving too slowly in introducing free male circumcision in state facilities. Results from three randomized clinical trials released in 2005 and 2006 provided compelling evidence that circumcision can reduce a man’s risk of HIV infection during heterosexual intercourse by as much as 60 percent.

The World Health Organization endorsed the procedure as an HIV-prevention measure in 2007, but implementation of a large-scale male circumcision programme in Malawi has been controversial in the conservative country.

Southern Malawi, where most circumcisions take place, has a large migrant labour population and an HIV prevalence rate of about 18 percent, accounting for almost 70 percent of the country’s HIV infections, according to government figures. Circumcision is culturally less prominent in northern Malawi, where prevalence rates are also lower.

The disparity between HIV prevalence and traditional circumcision rates has raised doubts among some health officials, who argued in local newspapers that they had not yet been presented with enough clinical evidence, and the efficacy of male circumcision was questionable given high HIV prevalence rates among traditionally circumcising populations in the south.

But the government formally launched its voluntary medical male circumcision programme last year in Mulanje district, which has an estimated HIV prevalence of 17 percent. Mulanje is one of nine pilot districts to offer the service.

“Malawi had also conducted its own study which also proved the efficacy of male circumcision in reducing the spread of the virus that causes AIDS,” said Ministry of Health spokesman Henry Chimbali.

The government has embarked on an intense campaign to disseminate accurate information about medical male circumcision. Malawi registers 70,000 new infections a year, and people still had to be reminded that male circumcision alone is “not 100 percent safe”, Chimbali cautioned. –(Additional reporting by IRIN)

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