Male circumcision could reduce HIV, increase economic growth
Achieving the target of circumcising 80% of males between the ages of 15 to 49, which translates to 4.3 million medical male circumcision (MMC), by the end of 2016 could avert more than one million new HIV infections by 2025. This could save nearly R70 billion in averted HIV treatment costs; that is money that could be invested in education, infrastructure and improved care for people who are already living with HIV.
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Promoting MMC among South Africa's people and workforce not only saves lives and averts the loss that HIV/AIDS inflicts on society, but it can also provide a powerful boost to the country's economic competitiveness and buying power.
"The million lives saved obviously provides a major humanitarian benefit as families remain intact, but it also provides an economic advantage as the workforce is not depleted. The R70 billion from saved HIV treatment costs has impressive buying power - we could build nearly 700 000 Reconstruction and Development Programme (RDP) houses, or 40 hospitals, or 1 541 state-of-the-art schools, or even 281 Nkandlas," says Marina Rifkin, an epidemiologist working as the Public Health Specialist at CareWorks, an HIV management organisation.
She adds that while the National Department of Health's enormously successful ART programme has prevented AIDS deaths, it is just the start. "A comprehensive rollout of MMC would complement the success of the ART programme by drastically reducing the number of new infections; in the same way that the ART programme has lowered the number of HIV positive people who develop AIDS.
"ING Barings suggested in 2000 that HIV/AIDS would cut South Africa's annual growth rate by 0.3 and 0.4 percentage points during 2006 to 2010 and 2011 to 2015 respectively. MMC could help reduce the burden of new HIV infections enough to give the economy a real boost."
Rifkin notes that research by Boston University in 2008 suggested that South African business would lose around 15% of its profits. At this time, South Africa was also losing 5% of its workforce every year to HIV/AIDS.
South Africa has made excellent progress inasmuch as HIV can now be managed as a chronic condition through ART, but that comes at a massive cost. By reducing the number of new infections - and thus the number of people requiring ART- South Africa could free up billions for social development that addresses poverty, inequality and unemployment.
That is why it is important that workforce - the engine of economy growth - protect itself, its families and ultimately the economy from HIV. This is where MMC is crucial. A once-off, simple procedure, it reduces a man's risk of HIV infection by up to 60%.
MMC is the lynchpin of a combination prevention approach, including correct and consistent condom use, regular testing, treatment of STDs, reducing the number of sexual partners and delaying sexual debut.
"None of these measures offers 100% protection, but used in concert they offer the closest we have to an HIV vaccine. If enough men have MMC and follow the combination of prevention measures, South Africa could see a collapse in new infections in the next few years and an AIDS-free generation within decades."
MMC also helps prevent other STDs - such as syphilis in men and women - and reduces the risk of penile cancer and the risk of cervical cancer in circumcised males' partners. Therefore, MMC has a health dividend beyond HIV and as a result must be implemented energetically.
"MMC doesn't require chronic medication, so it is a very cost-effective measure. We must at all costs avoid the notion that 'I can relax about HIV prevention because if I'm infected I'll just take ART.' As successful as the ART programme has been, it's important to assist those who are HIV negative stay HIV negative, and MMC for you or your partner is an indispensable component of that," Rifkin concludes.
For more information, go to www.mmcinfo.co.za.
