U.S. Ends Funding for Swaziland AIDS Program Providing Male Circumcision

The President's Emergency Plan for AIDS Relief no longer will fund an HIV/AIDS program in Swaziland that offers subsidized male circumcision in an effort to prevent the spread of the disease, USAID announced in a statement on Thursday, the Washington Post reports (Timberg, Washington Post, 10/13). According to a study conducted in South Africa and published in the November 2005 issue of PLoS Medicine, male circumcision might reduce the risk of men contracting HIV through sexual intercourse with women by about 60%. Two similar studies examining the effect of male circumcision on HIV transmission currently are underway in Kenya and Uganda (Kaiser Daily HIV/AIDS Report, 8/23). According to the Post, most major international health donors, including PEPFAR, have said they will not fund male circumcision programs until the results from the Kenya and Uganda studies are released (Washington Post, 10/13). The Swaziland program, conducted by the Family Life Association of Swaziland, has provided circumcisions for more than 325 men since the program launched in January (Phillips, Wall Street Journal, 10/12). The Family Life Association performed male circumcisions for roughly $40 per person, which is higher than the cost at public clinics but substantially less than the cost for the procedure at private clinics, according to the Post. USAID said it only recently found out about the program, which goes against U.S. policy supporting the study of male circumcision but not programs providing the procedure. USAID last year provided the program with $149,285 but did not renew funding for the next fiscal year, Dudu Simelane, deputy executive director for the Family Life Association, said. According to the USAID statement, the funding "should not have occurred, and there will be no further circumcision performed with U.S. government funds until the PEPFAR Scientific Steering Committee reviews data from ongoing clinical trials and considers any recommendations on male circumcision from the normative international agencies." Simelane said that the organization would like to continue the program but that no new donors have been identified (Washington Post, 10/13). "The demand [for circumcision] will not lose its momentum," Adam Groeneveld -- a urologist in Swaziland who performs circumcisions at the government hospital in the capital, Mbabane -- said, adding, "That's why FLAS will have to find some other source of money. There will be a temporary dip in the number of circumcisions and an increase in the waiting list" (Wall Street Journal, 10/12).