HIV/AIDS

WHO Progress Brief - Voluntary medical male circumcision for HIV prevention in priority countries of East and Southern Africa

July 2014

  • An impressive upturn in the number of male circumcisions performed occurred in 2013 with 2.7 million men in 14 priority countries of East and Southern Africa stepping forward for medical male circumcision, leading to a cumulative total of 5.82 million males circumcised since 2008. This is a noteworthy near-doubling from the cumulative 3.2 million males circumcised by the end of 2012 (see Figure). This positive trend signals a shift in pace and reduces the gap towards the ambitious target of 20.8 million males circumcised by 2016. The pace of scale-up varies across countries (see Table).
  • Voluntary medical male circumcision (VMMC) services add value by connecting men to health care and offering them, at a minimum, a package of services including education on safer sex, access to condoms and HIV testing and counselling services, with links to HIV care and treatment.
  • Success in rapid scaling up of VMMC emanates from:
    • commitment by ministers of health, policy-makers and programme managers, health care providers, global and regional stakeholders including donors such as PEPFAR and the Bill and Melinda Gates Foundation, and implementing agencies -- together putting in place and supporting programmes that deliver high quality services;
    • growing acceptance in communities, among men and their partners, adolescents and parents.

Figure: annual number of medical male circumcisions performed in 14 priority countries in East and Southern Africa, 2008 – 2013

Figure. Annual number of medical male circumcisions performed in 14 priority countries in East and Southern Africa, 2008 – 2013
(Source: Global AIDS Response Reporting, WHO/UNAIDS/UNICEF)

 

  • Maximizing the impact of VMMC on creating an HIV-free generation in East and Southern Africa requires further increases in scale-up. This ‘unfinished business’ to reach 20.8 million circumcisions by 2016 involves:
    • maintaining investments in and diversifying the funding base for VMMC programmes since there remain substantial resource gaps;
    • identifying innovative solutions to address supply and demand challenges; and
    • targeting resources based on age, risk and geography to improve efficiency and impact, thus requiring data that is disaggregated on these characteristics.

 

Table: annual numbers of male circumcisions in East and Southern Africa by country, 2008 – 2013, and progress towards goals


Country 2008 2009 2010 2011 2012 2013 Total Progress towards target of 80% coverage
Botswana 0 5,424 5,773 14,661 38,005 46,793 110,656 32.10%
Ethiopia, Gambella Province 0 769 2,689 7,542 11,961 16,393 39,354 98.40%
Kenya 11,663 80,719 139,905 159,196 151,517 190,580 733,580 85.3%*
Lesotho 0 0 0 0 10,835 37,655 48,490 12.90%
Malawi 589 1,234 1,296 11,881 21,250 40,835 77,085 3.70%
Mozambique 0 100 7,633 29,592 135,000 146,046 318,371 30.10%
Namibia 0 224 1,763 6,123 4,863 1,182 14,155 4.30%
Rwanda 0 0 1,694 25,000 138,711 116,029 281,434 16.10%
South Africa 5,190 9,168 131,117 296,726 422,009 514,991 1,379,201 31.80%
Swaziland 1,110 4,336 18,869 13,791 9,977 10,105 58,188 31.70%
Tanzania 0 1,033 18,026 120,261 183,480 329,729 652,529 47.50%
Uganda 0 0 21,072 77,756 368,490 801,678 1,268,996 29.90%
Zambia 2,758 17,180 61,911 85,151 173,992 294,466 635,458 32.60%
Zimbabwe 0 2,801 11,176 36,603 40,755 112,084 203,419 10.60%
Total 21,310 122,988 422,924 884,283 1,710,845 2,658,566 5,820,916 27.90%
* Kenya’s target is 94% coverage

(Source: Global AIDS Response Reporting, WHO/UNAIDS/UNICEF)

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