December 8, 2011
Dear Advocates,
Voluntary medical male circumcision (VMMC)
has been one of the biggest missed biomedical
HIV prevention opportunities of the last five
years. In many countries with high HIV
prevalence and low rates of male circumcision,
VMMC programs have been slow to scale up, even
though the intervention reduces men’s risk of
HIV via vaginal sex by at least 60 percent and
could have a profound impact on rates of new
infections at the population level if taken to
scale. In the past few weeks, however, there
has been a concerted effort to build momentum
and action around implementation at a scale
that could truly affect the course of the
epidemic. Released last week, AVAC
Report 2011 touches on some key
issues, and this update includes news on more
recent developments.
New Leadership at the International
Level
This week, VMMC was a focus of increased
advocacy and urgency at the 2011
International Conference on AIDS and Sexually
Transmitted Infections in Africa (ICASA),
held in Addis Ababa, Ethiopia. There was a
high-level meeting to galvanize support for the
intervention, with a strong emphasis on the
need for community and political leadership. On
December 5, UNAIDS and PEPFAR launched a five-year
action framework to accelerate the scale-up
of voluntary medical male circumcision (VMMC)
for HIV prevention. The framework was developed
by the World Health Organization (WHO), UNAIDS,
PEPFAR, the Bill & Melinda Gates Foundation
and the World Bank—in consultation with
national Ministries for Health. It calls for
the immediate rollout and expansion of VMMC
services in priority countries in eastern and
southern Africa.
New Evidence on Impact and
Implementation Lessons Learned
On November 30, PLoS Medicine
published a collection
of articles on voluntary medical male
circumcision, which make a compelling case
for the impact this strategy can have in
priority countries with high HIV prevalence and
low rates of VMMC. In one article by Hankins et
al, the authors calculate that, “An
investment of US$ 1.5 billion between 2011 and
2015 to achieve 80 percent coverage in 13
priority countries in southern and eastern
Africa will result in net savings of US $16.6
billion.”
The same article features a compelling
graphic that shows the number of infections
averted between 2011 and 2025 if VMMC targets
are met in key countries. In Zimbabwe, for
example, nearly 42 percent of anticipated
infections in women and men would be
averted by 2025.
Other articles focus on lessons learned in
scale-up in Tanzania, South Africa and
elsewhere; human resources and service delivery
innovations; and the challenges of putting a
price tag on activities to create demand for
the new service. All of the articles are open
access and available at PLoS
Medicine.
New Advocacy Resources
With re-energized international leadership and
new literature on the impact of VMMC, now is
the time for expanded advocacy from civil
society to take the intervention to scale.
- AVAC and its partners are working in
several countries, including Kenya, South
Africa, Uganda, Zambia and Zimbabwe, to develop
context-specific projects seeking to scale up
VMMC and ART as the two cornerstones of highly
effective combination prevention. If you are
working in those countries or others and would
like to learn more about these activities,
please email avac@avac.org
as we are looking for additional
partners.
- Later this month, the Medical
Male Circumcision Clearinghouse, a joint
project of WHO, UNAIDS, FHI 360 and AVAC, will
launch a newly expanded advocacy
resources section, including the first in a
series of interviews with “VMMC Champions”.
The series starts with Ugandan champion Dr.
Speciosa Wandira, the first-ever woman vice
president of an African nation, who has made
VMMC one of her focal issues as a champion
for an HIV-free generation.
- AVAC is developing a new series of
resources for implementation advocacy. Part of
this series will be a set of “talking
points”. These one-page tools will feature
key statistics and graphics designed to help
advocates in action. The first of these talking
points focuses on VMMC and can
be downloaded here.
In 2012, AVAC
will be intensifying its work on VMMC at the
local, national and international levels.
We hope these resources and updates encourage
further work from advocates—where ever you
are! Not sure where to start, or want to share
an exciting update? Please be in
touch.
Best,
AVAC
