Malawi News Agency has put out a fatuous ‘article’ about a journalist who has been duped into being circumcised in an effort to persuade others to follow his ‘example’. This reminds me that about 6 months ago I blogged about a misinformation service called Internews, connected with the rather smug Gates Foundation and the BBC. Internews boasts about being able to ensure that only ‘positive’ coverage of the US Government’s mass male circumcision program in African countries with medium to high HIV prevalence appears on African news sources.
This Malawian journalist was, apparently, persuaded also by the fact that circumcision is said to protect against human papilloma virus (HPV), although the evidence for this is even slimmer than that relating to HIV. More importantly, many African countries are already receiving assistance to vaccinate millions of Africans against HPV (currently being piloted), so why promote mass male circumcision as well? Are they afraid the HPV vaccination will not give as much protection as their promotional literature claims?
However this journalist was either too innocent, or too well paid off, to check available figures for HIV prevalence among circumcised and uncircumcised men in Malawi. In 2010 HIV prevalence was 14% among circumcised men and only 10% among uncircumcised men. This makes it look as if not being circumcised is protective. But things get a lot worse if you look at the three regions of Malawi, where HIV prevalence and circumcision are very clearly correlated:
How much clearer could this be? It is even possible to view these figures for Malawi another way. A 2013 article entitled ‘Mapping HIV clustering: a strategy for identifying populations at high risk of HIV infection in sub-Saharan Africa‘, using the same data (from the 2010 Demographic and Health Survey) identified three major HIV ‘clusters’ in Malawi. The cluster in the North and the one in the center of the country were of relatively low HIV prevalence, where circumcision rates are low. The cluster in the South of the country was of high HIV prevalence, where circumcision rates are high.
Internews and their collaborators would not wish anyone to mention this in a national newspaper, as their express aim is to ensure that only positive coverage about mass male circumcision and HIV transmission sees the light of day; or at least that those who are being told these lies and deceptions don’t know that there are things about circumcision they would be well advised to research. Reading a newspaper that has been bought off by some misinformation service is not research.
The article is full of the usual anecdotal rubbish about mass male circumcision, including some deluded victim of Internews and Co. (also a journalist) who had a problem with penetrative intercourse before being circumcised, the old chestnut about circumcision making people “clean and free of bad odours” (despite making it clear that some of these people suffering from bad odors ‘wear the same underwear for several days), sex being better, etc.
Several times the official claim about mass male circumcision is repeated, that it only ‘gives 60% protection, that people still need to use condoms’ and the usual claptrap. The article even points out that circumcision rates are high in the South and low in the other two regions. But, and this is the clever Internews bit, they don’t bother mentioning that HIV prevalence in the country is highest where circumcision is more widely practiced and lowest where circumcision is less widely practiced.
One of the biggest worries about mass male circumcision is that being circumcised only sometimes appears to be correlated with lower HIV prevalence; just as frequently it appears to be correlated with higher HIV prevalence. Given that there is no known mechanism by which circumcision could protect against HIV infection (only a handful of vague protohypotheses), these differences make it clear that there is a lot more to HIV transmission than circumcision status.
The clear message about mass male circumcision and HIV being payrolled by Internews, Gates Foundation, UNAIDS, PEPFAR and the likes is that Africans are promiscuous, reckless, ignorant and unhygienic; this kind of neo-imperialist institutionalized racism is par for the course in the HIV industry (yes, it is an industry, just like development) and would be condemned as such in most western countries (aside from the US, and perhaps the UK, apparently). So why do we find it acceptable to allow people in high HIV prevalence countries to be systematically deceived?
People from different USA ports, dockworkers, say where the US gives healthcare, they also take your foreskin. Haiti being one of these places. This is a disgusting show of force, leverage of health against circumcision, to a desperate society whose culture to be intact is being lost.
Thank you Frank – the behavior of rich countries towards high HIV prevalence African countries is especially shocking and often seems like the Tukegee and Guatemala syphilis experiments all over again.
I bought today’s newspaper of The Standard,and the headline news was catchy:
Report: MEDICAL INJECTIONS LINKED TO NEW HIV INJECTIONS IN KENYA.
Reuse of needles by medical workers and especially traditional practitioners contributes to spread of HIV, according to the study.
NAIROBI, KENYA: A significant number of Kenyans are getting HIV infections from contaminated medical injections, according to a new insight into the Kenya Aids Indicator Survey.
In a rare public admission, a report for the May issue of the Journal of Acquired Immune Deficiency Syndromes says a number of new HIV infections in Kenya are from injections either self-administered or from health facilities and traditional healers.
“In 2008, it was estimated that 2.2 per cent of new HIV infections in Kenya were a result of unsafe injections received in health facilities,” says the special supplement of the detailed analysis of the Kenya Aids Indicator Survey, 2012.
Since then, the report says, more people, including those who are HIV-positive, are receiving injections in all types of health facilities, creating serious problems of coping for the medical systems.
An initiative of the Kenya Government and US agencies, this particular study was led by Dr Daniel Kimani of the Centre for Disease Control and Prevention, supported by a team from the Ministry of Health and the National Public Health Laboratory Services.
The study, carried out from October 2012 to February last year, says the problem is pegged on several factors such as a love among Kenyans for the needle against a pill, poor disposal of used medical waste and a high number of injections for people who are also HIV positive. The other problem is the possible reuse of needles by medical workers and especially traditional practitioners.
A total of 13,720 adults and adolescents aged 15–64 participated in the survey and one out of 15 reported having seen a used syringe or needle near their home or in their community in the past 12 months.
The authors demonstrate a high possibility that such a needle or syringe could be contaminated with the Aids-causing virus. They confirmed that more people who were injected in the last 12 months leading to the study period were more likely to have been HIV positive compared to people who never received an injection in the same period.
This follows the logic that most people with HIV are more likely to have more health problems than others and consequently most likely to visit a hospital.
“At the same time high HIV prevalence was noted among persons who had received injections from traditional practitioners,” reveals the report. Apart from the danger of the reuse of such an injection, the study concludes there is a real risk of poor disposal of needles particularly in urban estates. “This has led to increases in risk of injury to community members, especially children and domestic waste handlers.”
Hi Owino Qane – thank you, the article shows up the HIV industry in a poor light because if HIV can be spread by unsafe injections in Kenya it could be spread that way in other African countries, particularly those with far higher prevalence. Interestingly, very high prevalence countries often have much higher levels of access to healthcare, something the HIV industry has been studiously ignoring for years.
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Good work, Simon. Perhaps the NBA should recognise this for what it is and turn their attention to Gates and PEPFAR. Admire your research on USAID about population outcomes. Thanks.
Thank you Voxinfantorum. As long as institutions continue to insist that HIV is all about sex in African countries they will feel justified in concentrating on such unethical strategies as mass male circumcision. Human rights, even democracy, have been ignored.
Thank you, Simon, for your outstanding research into this deplorable state of affairs regarding promotion of mass circumcision in Africa to “prevent” HIV/AIDS.
Thank you very much, I hope opposition to these programs begins to have some effect soon. Not because they may do damage, though they may, but because mass circumcision is damage in itself.
As was pointed out by medical historian Frederick Hodges in the video ‘Whose Body, Whose Rights?’ (search YouTube or http://www.CircumcisionVideos.com), U.S. Army medical journals in the early to mid-20th Century published articles promoting circumcision of black soldiers – often under threat of court martial – based on racist ideas that black men ‘needed’ this because they were either promiscuous or lacked sufficient intelligence or motivation to practice proper genital hygiene. Sadly, this – like other excuses for prophylactic circumcision – are regurgitated with each new generation of circumcision advocates. Worse yet, introducing circumcision to a society begins an intergenerational cycle of abuse where circumcised fathers elect to impose this genital cutting on their male newborns, which of course violates the child’s fundamental right to physical integrity and an open future.
Thank you for your comment, yes, it seems there are people who simply like circumcision so much they want everyone to be circumcised and they will use, recycle, reuse, adjust, twist, misinterpret, cherrypick, improvise, lie, cajole, threaten, bluster (etc) anything to push their agenda. I wonder how much of public health ‘evolved’ from eugenics and how much was part of a more enlightened view of health.