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Since 2007 the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended voluntary medical male circumcision (VMMC) as an important strategy for the prevention of heterosexually acquired HIV in men in settings where the prevalence of heterosexually transmitted HIV is high. Over 25 million men and adolescent boys in East and Southern Africa have been reached with VMMC services. These new guidelines update earlier WHO recommendations to maximize the HIV prevention impact of safe VMMC services and aim to guide the transition to the sustained provision of interventions with a focus on the health and well-being of both adolescent boys and men.
Throughout the world HIV prevalence is generally lower in populations that practice male circumcision than in populations where most men are uncircumcised. This has been observed over the years of the epidemic and has been confirmed by three randomized controlled trials concluded in 2005-2006. The results have led to the conclusion that male circumcision is an effective risk-reduction measure for men and should be used in addition to other known strategies for the prevention of heterosexually acquired infection. This book provides guidance to decision makers on human rights, ethical and legal considerations that need to be addressed before planning to provide male circumcision services within the response to HIV.
This document articulates a joint five-year framework for use among Ministries of Health (MoHs) and diverse country, regional and global stakeholders to accelerate the scale-up of voluntary medical male circumcision (VMMC) for HIV prevention in selected priority countries of eastern and southern Africa. It is intended to guide key stakeholders to collaborate and coordinate efforts for promoting country ownership, expanding coverage of this effective HIV prevention intervention, and contributing to “getting to zero” new infections.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
The book of Genesis tells us that God made a covenant with Abraham, promising him a glorious posterity on the condition that he and all his male descendents must be circumcised. For thousands of years thereafter, the distinctive practice of circumcision served to set the Jews apart from their neighbors. The apostle Paul rejected it as a worthless practice, emblematic of Judaism's fixation on physical matters. Christian theologians followed his lead, arguing that whereas Christians sought spiritual fulfillment, Jews remained mired in such pointless concerns as diet and circumcision. As time went on, Europeans developed folklore about malicious Jews who performed sacrificial murders of Christian children and delighted in genital mutilation. But Jews held unwaveringly to the belief that being a Jewish male meant being physically circumcised and to this day even most non-observant Jews continue to follow this practice. In this book, Leonard B. Glick offers a history of Jewish and Christian beliefs about circumcision from its ancient origins to the current controversy. By the turn of the century, more and more physicians in America and England--but not, interestingly, in continental Europe--were performing the procedure routinely. Glick shows that Jewish American physicians were and continue to be especially vocal and influential champions of the practice which, he notes, serves to erase the visible difference between Jewish and gentile males. Informed medical opinion is now unanimous that circumcision confers no benefit and the practice has declined. In Jewish circles it is virtually taboo to question circumcision, but Glick does not flinch from asking whether this procedure should continue to be the defining feature of modern Jewish identity.