Circumcision 'is the best weapon in fight against Aids'

The billions of dollars spent on Aids prevention programmes based on HIV vaccines, wide-scale testing and the promotion of condoms or sexual abstinence have turned out to be less effective than a simple surgical operation to remove the foreskin.

Some of the world's most distinguished scientists have warned that the "central pillars" of HIV prevention – from condom use to HIV vaccines – have crumbled in the worst-affected regions of sub-Saharan Africa.

On the 25th anniversary of discovery of the virus, the researchers warned that a quarter of a century of research into HIV vaccines and anti-viral creams, along with health programmes, have all failed to stem the Aids epidemic in Africa.

The scientists said there was an urgent need to reappraise existing strategies by looking at how to expand male circumcision in sub-Saharan Africa, where the heterosexual Aids epidemic has spilled into the general population, rather than being confined to high-risk groups, such as sex workers and their clients.

Daniel Halperin, of the Harvard School of Public Health, one of the co-authors of the study, said the time has come to look at male circumcision as the most important tool there is to limit the spread of HIV within the worst-affected regions of the world.

"Despite relatively large investments in Aids prevention efforts for some years now, including sizeable spending in some of the most heavily affected countries such as South Africa and Botswana, it's clear that we need to do a better job in reducing the rate of new HIV infections," said Dr Halperin. Less than 1 per cent of the funds spent by the UN programme has gone on male circumcision yet the other, more expensive strategies have failed to live up to expectations. "We need a fairly dramatic shift in priorities, not just a minor tweaking," added Dr Halperin.

Cutting off the foreskin has been shown in several studies to curb the spread of HIV through heterosexual contact by reducing the risk of infection. In men, the risk falls by 60 per cent, but even in women there is a knock-on effect with fewer infected men in the general population. "Over time, male circumcision, which has been called a 'surgical vaccine', would probably protect more women, albeit indirectly, than nearly any other achievable HIV prevention strategy," the scientists say in their study, published in the journal Science.

More than 45 studies over the past 20 years, including three large clinical trials in Africa, have shown the benefits of the operation in reducing the risk of infection among heterosexual couples. "Unlike most other interventions, male circumcision is a one-time procedure that confers lifelong protection. Modelling suggests that male circumcision could avert up to 5.7 million new HIV infections and three million deaths over the next 20 years in sub-Saharan Africa, many of these among women," said the scientists.

The use of condoms among heterosexual couples in Africa is not as high as in other countries such as Thailand, where the heterosexual HIV epidemic was largely confined to sex workers.

In western Africa, were male circumcision is high for cultural and religious reasons, the prevalence of HIV is low and controlled trials have shown that the operation can stem the rate of infection, said Professor Malcolm Potts, of the University of California, Berkeley. "It is tragic that we did not act on male circumcision in 2000, when the evidence was already very compelling," he said. "Large numbers of people will die as a result of this error."

Suggested Topics
Start your day with The Independent, sign up for daily news emails
Arts and Entertainment
Books should be for everyone, says Els, 8. Publisher Scholastic now agrees
booksAn eight-year-old saw a pirate book was ‘for boys’ and took on the publishers
Life and Style
Mary Beard received abuse after speaking positively on 'Question Time' about immigrant workers: 'When people say ridiculous, untrue and hurtful things, then I think you should call them out'
Life and Style
Most mail-order brides are thought to come from Thailand, the Philippines and Romania
Life and Style
Margaret Thatcher, with her director of publicity Sir Gordon Reece, who helped her and the Tory Party to victory in 1979
voicesThe subject is being celebrated by the V&A museum, triggering some happy memories for former PR man DJ Taylor
ebooksA special investigation by Andy McSmith
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Ashdown Group: Treasury Assistant - Accounts Assistant - London, Old Street

£24000 - £26000 per annum + benefits : Ashdown Group: A highly successful, glo...

Recruitment Genius: Installation and Service / Security Engineer

£22000 - £40000 per annum: Recruitment Genius: This company is part of a Group...

Recruitment Genius: Service Charge Accounts Assistant

£16000 - £18000 per annum: Recruitment Genius: Are you a a young, dynamic pers...

Cancer Research UK: Corporate Partnerships Volunteer Events Coordinator – London

Voluntary: Cancer Research UK: We’re looking for someone to support our award ...

Day In a Page

General Election 2015: Chuka Umunna on the benefits of immigration, humility – and his leader Ed Miliband

Chuka Umunna: A virus of racism runs through Ukip

The shadow business secretary on the benefits of immigration, humility – and his leader Ed Miliband
Yemen crisis: This exotic war will soon become Europe's problem

Yemen's exotic war will soon affect Europe

Terrorism and boatloads of desperate migrants will be the outcome of the Saudi air campaign, says Patrick Cockburn
Marginal Streets project aims to document voters in the run-up to the General Election

Marginal Streets project documents voters

Independent photographers Joseph Fox and Orlando Gili are uploading two portraits of constituents to their website for each day of the campaign
Game of Thrones: Visit the real-life kingdom of Westeros to see where violent history ends and telly tourism begins

The real-life kingdom of Westeros

Is there something a little uncomfortable about Game of Thrones shooting in Northern Ireland?
How to survive a social-media mauling, by the tough women of Twitter

How to survive a Twitter mauling

Mary Beard, Caroline Criado-Perez, Louise Mensch, Bunny La Roche and Courtney Barrasford reveal how to trounce the trolls
Gallipoli centenary: At dawn, the young remember the young who perished in one of the First World War's bloodiest battles

At dawn, the young remember the young

A century ago, soldiers of the Empire – many no more than boys – spilt on to Gallipoli’s beaches. On this 100th Anzac Day, there are personal, poetic tributes to their sacrifice
Dissent is slowly building against the billions spent on presidential campaigns – even among politicians themselves

Follow the money as never before

Dissent is slowly building against the billions spent on presidential campaigns – even among politicians themselves, reports Rupert Cornwell
Samuel West interview: The actor and director on austerity, unionisation, and not mentioning his famous parents

Samuel West interview

The actor and director on austerity, unionisation, and not mentioning his famous parents
General Election 2015: Imagine if the leading political parties were fashion labels

Imagine if the leading political parties were fashion labels

Fashion editor, Alexander Fury, on what the leaders' appearances tell us about them
Phumzile Mlambo-Ngcuka: Home can be the unsafest place for women

Phumzile Mlambo-Ngcuka: Home can be the unsafest place for women

The architect of the HeForShe movement and head of UN Women on the world's failure to combat domestic violence
Public relations as 'art'? Surely not

Confessions of a former PR man

The 'art' of public relations is being celebrated by the V&A museum, triggering some happy memories for DJ Taylor
Bill Granger recipes: Our chef succumbs to his sugar cravings with super-luxurious sweet treats

Bill Granger's luxurious sweet treats

Our chef loves to stop for 30 minutes to catch up on the day's gossip, while nibbling on something sweet
London Marathon 2015: Paula Radcliffe and the mother of all goodbyes

The mother of all goodbyes

Paula Radcliffe's farewell to the London Marathon will be a family affair
Everton vs Manchester United: Steven Naismith demands 'better' if Toffees are to upset the odds against United

Steven Naismith: 'We know we must do better'

The Everton forward explains the reasons behind club's decline this season
Arsenal vs Chelsea: Praise to Arsene Wenger for having the courage of his convictions

Michael Calvin's Last Word

Praise to Wenger for having the courage of his convictions