Managing adult male circumcision for HIV/AIDS prevention in Africa: A model for international health workforce collaboration in an urgent public health crisis

Issues: Managing large-scale adult male circumcision (MC) services is required in mastering this promising intervention and reversing AIDS in Africa. Few countries have meaningful experience with hospital-based MC for adults. A model we developed in Israel, offers a road-map for policy makers in establishing international collaboration in MC and HIV/AIDS.

Description: Male Circumcision is now a proven HIV prevention intervention. Three controlled trials (in South Africa, Kenya and Uganda) provided evidence that MC reduces the probability of transmission from infected women to men by up to 60%. Countries most affected by HIV/AIDS need now to develop evidence-based policies, programs and training; and be guided by the international community how to either scale-up or role-out male circumcision services.

Lessons Learned: With over 20,000 documented circumcisions of adults in Israel, we have developed a model for MC technology transfer to Africa, supporting scaling up or rolling out MC services for HIV prevention.

We demonstrate that recruitment, training and deployment of international surgeons to perform MC in countries of need is: doable, could be cost-effective, efficient, safe and brings out a spirit of collaboration between healthcare workers.

Recommendations: Utilizing knowledge, skills and good will of experienced, qualified and well trained surgeons we shall describe, analyze and discuss the travel to Africa of medical teams in support of local health organizations facing shortage in human resources for MC, and as a vehicle to enhance international collaboration in global health