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AFRO-NETS> Kaiser Daily HIV/AIDS Report






Kaiser Daily HIV/AIDS Report
----------------------------

HIV TRANSMISSION: BENEFITS OF MALE CIRCUMCISION WIDELY IGNORED 

Male circumcision could reduce the spread of HIV/AIDS in developing 
countries, saving millions of lives, but the international health com-
munity remains "reluctant to publicize this fact," according to an edi-
torial in The Lancet. In his Salon.com column, Hank Hyena notes that 
the editorial, written by Daniel Halperin and Robert Bailey, refers to 
a decade-old study that found uncircumcised Kenyan men who frequently 
visited prostitutes were eight times more likely to contract an infec-
tion than circumcised men. 

In addition, Halperin and Bailey point to 27 studies that show a simi-
lar association between infection rates and circumcision. They theorize 
that the foreskin "provides a vulnerable portal of entry to HIV and 
other pathogens ... such as chancroid, syphilis and herpes, that are 
known cofactors for HIV infection." In developing countries like Zambia 
and India, Halperin and Bailey assert that circumcision "could provide 
a huge barrier" to the AIDS epidemic. However, they charge that the in-
ternational health community has "disregarded information about the 
probable link between circumcision and HIV/AIDS transmission." They 
point to the Johns Hopkins Media/Materials Clearinghouse; none of its 
30,000 AIDS- related listings discusses circumcision and transmission 
rates. 

Although they acknowledge that circumcision would be "counterproductive 
if men believe that the procedure [alone] will protect them" from HIV, 
Halperin and Bailey note that the procedure is gaining favor in eastern 
and southern Africa. There, traditional healers are recommending the 
procedure as "a way to alleviate chronic STD infection and AIDS." They 
conclude The Lancet editorial with "a plea to the international health 
community to assist the public with education, training and circumci-
sion services," while asking their colleagues "to assist them in this 
mission" (Hyena, Salon.com, 2/28).


UNITED NATIONS: DEVOTES ECONOMIC AND SOCIAL COMMITTEE MEETING TO AIDS

The U.N. Economic and Social Committee devoted an entire session Tues-
day to the AIDS pandemic, marking the second time that the United Na-
tions has devoted a meeting to the topic, Newsday reports. U.S. Ambas-
sador to the United Nations Richard Holbrooke, who has argued that de-
ploying U.S. soldiers to areas such as Rwanda or the Congo without in-
forming them about the risks of HIV endangers their lives, said, 
"Clearly and flatly, the U.S. will not support any peacekeeping mission 
anywhere ... that does not support action on the issue." Accordingly, 
the U.S. State Department Tuesday declared a "proclamation of war" 
against AIDS in a memorandum distributed to its missions and embassies. 

UNAIDS Director Dr. Peter Piot said, "Finally, finally we are seeing 
changing gears in the international community ... Let's agree that 
here, today, we put aside all the doom and gloom talk of AIDS in Af-
rica. Today we've got to go beyond that. We must spread a message of 
hope." Other participants debated whether to focus on treating AIDS pa-
tients or preventing AIDS from spreading. Traditionally, the global em-
phasis has been on prevention rather than treatment of the disease, but 
treatment has become the "most divisive issue" since the U.N. Security 
Council's Jan. 10 declaration of war on AIDS. But activists have 
charged that a war on AIDS that fails to address the needs of those who 
are already infected means "that millions of people with HIV in Africa 
are only good for the role of bugbears of the world contagion." 

Failing to mention treatment for her nation's 2 million citizens esti-
mated to be infected with the virus, South African First Lady Zanele 
Mbeki called for prevention programs. She said yesterday that the only 
way to slow the spread of HIV in South Africa is to create economic 
programs that give women control over their lives (Garrett, Newsday, 
2/29). Disagreeing with Holbrooke, Indian representative Satyabrata Pal 
turned the conversation to the economic toll of the disease. Arguing 
that AIDS is not a security issue but a development problem, Pal called 
for the council to commission an analysis on the full economic and so-
cial costs of AIDS and asked that the council "consider that discover-
ing a vaccine was less profitable than discovering a cure" (Presswire, 
2/29).


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