Sometimes it just takes a little common sense to do what is right. But it never hurts to have an academic study back up your point of view. Common sense dictates that circumcising baby boys is the most cost-effective way to achieve the benefits of circumcision even if that boy is not likely to engage in sexually risky behavior until later in life. The anti-circ fanatics often rail against newborn circumcision, saying "baby boys don't have sex, don't circumcise them until later in life." Now comes still another study that establishes the obvious -- newborn circumcision is cheaper and safer and less complicated than adult circumcision. So let's do the obvious -- every baby boy should leave that foreskin behind when he comes home with mommy!
Check out this story below, and share your comments.
ScienceDaily (Jan. 21, 2010) — Circumcising newborn boys as a way to prevent HIV infection in later life is more cost-effective than circumcising adult males, finds a new Rwandan study in PLoS Medicine.
It has already been conclusively shown, from three randomized clinical trials in Uganda, Kenya, and South Africa, that adult male circumcision (MC) roughly halves the HIV transmission rate from women to men. Many African countries hit hard by HIV are therefore offering men the procedure as way to control the epidemic. Rwanda is one such country -- about 3% of adults in Rwanda are infected with HIV but only 15% of men are currently circumcised.
But performing the operation in adolescents and adults is linked with a higher risk of complications than circumcising newborns. And the operation is quicker and simpler to perform in newborns. The new study, by Agnes Binagwaho (Rwanda Ministry of Health) and colleagues, therefore set out to compare three different strategies as applied to Rwanda: circumcising newborns (neonates), adolescents, or adults.
The researchers used a technique called "cost-effective analysis," which looks at the balance between the costs of a medical intervention and its benefits. They estimated that each neonatal MC would cost just US$15 whereas each adolescent or adult MC would cost US$59. They found that neonatal MC would in fact save more money than it costs, because the operation is cheap to perform and would prevent HIV infections that are expensive to treat.
The study findings, say the authors, "suggest that Rwanda should be simultaneously scaling up circumcision across a broad range of age groups, with high priority to the very young."
In an expert commentary on the new study, Seth Kalichman (University of Connecticut) says: "The cost-savings of neonatal MC are compelling and suggest that implementation is economically feasible in developing countries hit hardest by HIV/AIDS. Neonatal MC should therefore be considered a priority in comprehensive HIV prevention plans for southern Africa."
Showing posts with label anti-circumcision. Show all posts
Showing posts with label anti-circumcision. Show all posts
Saturday, January 23, 2010
Thursday, December 10, 2009
2009 Turning Point: Momentum to Circumcise Grows Worldwide
As the year 2009 draws to a close, history may judge this year as the "turning point" in the movement to achieve universal circumcision -- a world in which the foreskin no longer poses a health threat to a male, his partners, or society as a whole.
Aided by one medical study after another this year, more governments than ever have embraced the goal of 100% male circumcision, knowing that this simple health procedure can reduce the risk of HIV by 60% and dramatically curb the spread of STDs, HPVs, cancers, and other ailments that afflict society.
When the data is finally collected for the year 2009, it will show that more males world-wide are circumcised now than ever before in world history. To be circumcised is not only the "norm" in the USA, it has become the desired norm across the world simply because "the cut" is healthy.
Even in those countries where governments have been reluctant to embrace circumcision (i.e., many European countries), the populace as a whole is joining the circumcision movement. Men are opting for the cut, and parents are wisely choosing to circumcise their sons at birth, knowing this is the safest, most reliable, and inexpensive way to protect their boy for life.
We have also seen a growing appreciation of the value of circumcision in Asia and the Indian subcontinent. I would bet, once the data is in, that more Japanese, more Indians, more Chinese are circumcised than ever before -- joining their counterparts in Korea, Philippines, and Indonesia who are already clean-cut. The best news on that front this year have been reports that Chinese health officials may encourage universal circumcision in the near future. The world's largest country could set a powerful example if it would promote newborn circumcision as an important health measure.
The year 2009 also saw the growing hysteria of the anti-circumcision fanatics, as they try to pressure governments to ignore the medical science and to scare parents against this life-preserving procedure. In my view, the fanaticism of these groups only marginalizes them among the mainstream. That is certainly true in the USA where, despite millions of anti-circ dollars spent on lies and mischaracterizations, I have no doubt that more baby boys were circumcised this year than last year.
Just ask the normal person on the street here in the Midwest about circumcision and the answer is always the same. "Of course. It's the healthy thing to do." -- a statement usually coupled with "Yeah, it prevents AIDs." The latter is not quite accurate -- it reduces the risk of AIDs -- but the public is getting the basic message.
Even those who may be confused on the issue because of anti-circ propaganda usually return to the basics. "It's cleaner. It's easier." -- with the variation "If it was so bad, why does everyone do it?" They do it because, deep down, nobody really wants a filthy foreskin that can cause so much medical havoc.
If 2009 becomes the turning point in the medical goal of achieving universal circumcision, there is still one disappointment which can be remedied in the remaining weeks of this year. Where is the American Academy of Pediatrics? Where is the CDC, Centers for Disease Control? We began the year with hope that -- based on medical science alone -- the AAP and CDC would declare that every male should be circumcised. While insiders say they want to do this because they know it is medically right, pressure from the anti-circs have delayed action. Nothing would complete 2009 more as the "Year of Circumcision" than a strong backbone at the AAP and CDC and a year-end statement encouraging ("voluntarily") the circumcision of males!
So what do you think? Do you agree that, in general, this has been a terrific year for circumcision? I welcome your thoughts.
Aided by one medical study after another this year, more governments than ever have embraced the goal of 100% male circumcision, knowing that this simple health procedure can reduce the risk of HIV by 60% and dramatically curb the spread of STDs, HPVs, cancers, and other ailments that afflict society.
When the data is finally collected for the year 2009, it will show that more males world-wide are circumcised now than ever before in world history. To be circumcised is not only the "norm" in the USA, it has become the desired norm across the world simply because "the cut" is healthy.
Even in those countries where governments have been reluctant to embrace circumcision (i.e., many European countries), the populace as a whole is joining the circumcision movement. Men are opting for the cut, and parents are wisely choosing to circumcise their sons at birth, knowing this is the safest, most reliable, and inexpensive way to protect their boy for life.
We have also seen a growing appreciation of the value of circumcision in Asia and the Indian subcontinent. I would bet, once the data is in, that more Japanese, more Indians, more Chinese are circumcised than ever before -- joining their counterparts in Korea, Philippines, and Indonesia who are already clean-cut. The best news on that front this year have been reports that Chinese health officials may encourage universal circumcision in the near future. The world's largest country could set a powerful example if it would promote newborn circumcision as an important health measure.
The year 2009 also saw the growing hysteria of the anti-circumcision fanatics, as they try to pressure governments to ignore the medical science and to scare parents against this life-preserving procedure. In my view, the fanaticism of these groups only marginalizes them among the mainstream. That is certainly true in the USA where, despite millions of anti-circ dollars spent on lies and mischaracterizations, I have no doubt that more baby boys were circumcised this year than last year.
Just ask the normal person on the street here in the Midwest about circumcision and the answer is always the same. "Of course. It's the healthy thing to do." -- a statement usually coupled with "Yeah, it prevents AIDs." The latter is not quite accurate -- it reduces the risk of AIDs -- but the public is getting the basic message.
Even those who may be confused on the issue because of anti-circ propaganda usually return to the basics. "It's cleaner. It's easier." -- with the variation "If it was so bad, why does everyone do it?" They do it because, deep down, nobody really wants a filthy foreskin that can cause so much medical havoc.
If 2009 becomes the turning point in the medical goal of achieving universal circumcision, there is still one disappointment which can be remedied in the remaining weeks of this year. Where is the American Academy of Pediatrics? Where is the CDC, Centers for Disease Control? We began the year with hope that -- based on medical science alone -- the AAP and CDC would declare that every male should be circumcised. While insiders say they want to do this because they know it is medically right, pressure from the anti-circs have delayed action. Nothing would complete 2009 more as the "Year of Circumcision" than a strong backbone at the AAP and CDC and a year-end statement encouraging ("voluntarily") the circumcision of males!
So what do you think? Do you agree that, in general, this has been a terrific year for circumcision? I welcome your thoughts.
Friday, September 11, 2009
UN Reaffirms Value of Universal Circumcision
Maybe, just maybe, we are beginning to see government agencies (outside of Africa) embrace the goal of universal circumcision, a society where the foreskin can no longer pose a threat to a male and his partners. Experts from the World Health Organization, UNAIDS, and the South African Centre for Epidemiological Modeling applied mathematical modeling to a number of studies showing the benefits of circumcision.
Here are some of their conclusions:
* "Using a 10-y time horizon, one new HIV infection would be averted for every five to 15 men newly circumcised. For the most successful interventions, where almost all men are circumcised, HIV incidence could be reduced by ~30%–50% over the same period."
* "Women, even if not directly protected, would benefit indirectly from the introduction or expansion of male circumcision services because their probability of encountering an HIV-infected male sexual partner gradually declines with programme scale-up."
* "Circumcising men who have not started sexual activity leads to the greatest population-level benefit in the long term. . . . Of course, circumcising both adult males and neonates would maximise the short- and long-term impact of circumcision on HIV incidence."
* "The estimated costs per adult male circumcision are between $30 and $60 depending on the programme setting, with neonatal circumcision costing about one-third this amount. . . . By comparison, estimates of discounted lifetime treatment costs typically exceed $7,000 per HIV infection if only first-line treatment is provided, and twice as much if second-line treatment is available."
Put simply, universal circumcision at birth provides the best health protection at the lowest cost. Circumcising before sexual activity is best, and one HIV case can be prevented for every five males circumcised. Isn't that worth it?
Now let's hope our friends at the Centers for Disease Control (CDC) are able to read this report through the fog of crap being tossed up by the anti-circ fanatics.
Here are some of their conclusions:
* "Using a 10-y time horizon, one new HIV infection would be averted for every five to 15 men newly circumcised. For the most successful interventions, where almost all men are circumcised, HIV incidence could be reduced by ~30%–50% over the same period."
* "Women, even if not directly protected, would benefit indirectly from the introduction or expansion of male circumcision services because their probability of encountering an HIV-infected male sexual partner gradually declines with programme scale-up."
* "Circumcising men who have not started sexual activity leads to the greatest population-level benefit in the long term. . . . Of course, circumcising both adult males and neonates would maximise the short- and long-term impact of circumcision on HIV incidence."
* "The estimated costs per adult male circumcision are between $30 and $60 depending on the programme setting, with neonatal circumcision costing about one-third this amount. . . . By comparison, estimates of discounted lifetime treatment costs typically exceed $7,000 per HIV infection if only first-line treatment is provided, and twice as much if second-line treatment is available."
Put simply, universal circumcision at birth provides the best health protection at the lowest cost. Circumcising before sexual activity is best, and one HIV case can be prevented for every five males circumcised. Isn't that worth it?
Now let's hope our friends at the Centers for Disease Control (CDC) are able to read this report through the fog of crap being tossed up by the anti-circ fanatics.
Tuesday, June 9, 2009
Aussie/NZ Doctors Cave to Anti-Circumcision Fanatics
According to The Age, a Melbourne newspaper, the Australia/New Zealand college of physicians is not yet ready to do the obvious -- recommend the circumcision of all baby boys. Anti-circumcision fanatics have been more successful on that continent than in the USA, dropping the number of healthy, clean-cut boys over the last twenty years.
Here's the article from its June 6 paper with my comments in boldface:
"THE Royal Australasian College of Physicians has flagged it will not change its policy against circumcision despite evidence the procedure can prevent the spread of HIV and other sexual diseases." [How much medical evidence do these docs need?]
"The college, which represents physicians and pediatricians in Australia and New Zealand, has adopted the position that "there is no medical indication for routine neonatal circumcision" since 2004." [A bad decision in 2004, but much worse in 2009.]
"But it has been reviewing this stance in part following recent scientific research suggesting that the risk of HIV infection could be dramatically reduced by the practice. Three trials conducted in South Africa, Kenya and Uganda between 2005 and 2007 showed conclusively, according to the World Health Organisation, "that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 per cent". [Repeat, docs, circumcision cuts the risk of HIV by 60% -- what are you waiting for? 100%?].
"Further research, published this year in the New England Journal of Medicine, has found that circumcision can reduce the transfer of human papillomavirus — the chief cause of cervical cancer in women — by 35 per cent, and herpes simplex virus — the chief cause of herpes — by 25 per cent." [So, on top of the HIV reduction, it cuts cervical cancer in women by 35% and herpes by 25%, and you Aussie/NZ docs still won't acknowledge the obvious?]
"The journal said the findings underscored "the potential public health benefits of the procedure". The college, which began its review in 2006 and was supposed to come out with a revised policy at the end of 2007, will not do so until the end of this year, as it considers the new evidence." [Better late than never, but what are you waiting for?]
"It is estimated that 10 to 20 per cent of male infants are circumcised in Australia." [Ewww, the thought of so many filthy foreskins in Australia should make us all sick, especially their future female partners].
"The chairman of the college's panel considering the issue, David Forbes, of the University of Western Australia's school of pediatrics, said the African studies had delayed the new recommendation, but so too had the fact "it is a contentious and non-clear-cut issue". [It's only contentious for the foreskin lovers who won't recognize medical evidence.]
"It's quite clear that there's evidence that circumcision in adult males helps prevent HIV in Africa," said Professor Forbes. "It's not so clear that circumcision in Australia in infants is of benefit to the infants or the community. Policy is about getting the right message to health planners so that we have safe but cost-effective expenditure." [The best time to circumcise is at birth, folks. Safer, cheaper, faster, pain-free, cleaner. Everyone knows that.]
New concerns about the practice of circumcision in Australia were raised last week after the Tasmanian Law Reform Institute found that parental consent might not be enough to protect the circumcisers of baby boys from later legal action. [Another distraction by the foreskin lovers. Since when can parents not consent to life-saving medical procedures for their children?]
No specific laws regulate the removal of the foreskin. [The biggest improvement would be a law to require circumcision before entering school, as a public safety measure like vaccinations.]
Professor Forbes said he wanted to have the college's position "finalised by the end of this year, hopefully before". [Again, better late than never].
"He said the benefit of reducing human papillomavirus "appears not to be such an issue in Australia" because a vaccine was being produced. And there were important differences between the HIV situation in Africa and Australia: HIV rates in Australia were far lower and condom use was much higher." [HIV rates are lower in Australia because the previous generation, now sexually active, were circumcised at birth. With so many young boys now afflicted with a foreskin, those rates will change by 2020].
"He said while there was clear evidence that circumcision reduced the rate of urinary tract infection, this alone did not justify routine use of the procedure as the infection rate was so small.
He said the 10-strong panel consisted of pediatricians, surgeons and policy and public health experts. "There are extremely strong views at both ends of the spectrum for those who promote circumcision and those who oppose it," he said." [Yes, another benefit of circumcision, the reduction of UTI. The list of benefits goes on and on and on, but Aussie docs ignore them].
"Undertaking elective surgery of minors who are not able to consent is for many pediatricians an even bigger issue, especially when there are examples of (Muslim) societies who elect to have it at puberty when people can choose." [This 'consent' issue is another red herring raised by the anti-circ fanatics. What about parental rights and responsibilities to keep their children healthy?]
"Dr Forbes declined to preview what the college's recommendation would be. "Policy change tends to be evolutionary, not revolutionary, and given that there are no trials of neonatal circumcision for prevention of HIV, I wouldn't expect revolutionary change. I would expect evolutionary change." [Just follow the science, dudes].
"Roger Short, from Melbourne University's department of obstetrics and gynaecology, hopes the college will view circumcision in a more favourable light. "It would be exciting to see the Royal College come forward with a slightly more progressive attitude than its previous pronouncements," he said. "The evidence is coming in, and it is irrefutable, that there are major benefits." [Thank you, Dr. Short. You're a doc who speaks the truth on the science].
"Professor Short said there were no grounds for making circumcision mandatory." [Well, I disagree about this. Circumcision should be required for all boys, with exceptions for the obvious conscientious religious objection].
Instead, the college should change its recommendation. "I think we should go from saying 'when in doubt, don't circumcise' to 'when in doubt, do'." [Absolutely. So Aussie/NZ docs, just do it].
Here's the article from its June 6 paper with my comments in boldface:
"THE Royal Australasian College of Physicians has flagged it will not change its policy against circumcision despite evidence the procedure can prevent the spread of HIV and other sexual diseases." [How much medical evidence do these docs need?]
"The college, which represents physicians and pediatricians in Australia and New Zealand, has adopted the position that "there is no medical indication for routine neonatal circumcision" since 2004." [A bad decision in 2004, but much worse in 2009.]
"But it has been reviewing this stance in part following recent scientific research suggesting that the risk of HIV infection could be dramatically reduced by the practice. Three trials conducted in South Africa, Kenya and Uganda between 2005 and 2007 showed conclusively, according to the World Health Organisation, "that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 per cent". [Repeat, docs, circumcision cuts the risk of HIV by 60% -- what are you waiting for? 100%?].
"Further research, published this year in the New England Journal of Medicine, has found that circumcision can reduce the transfer of human papillomavirus — the chief cause of cervical cancer in women — by 35 per cent, and herpes simplex virus — the chief cause of herpes — by 25 per cent." [So, on top of the HIV reduction, it cuts cervical cancer in women by 35% and herpes by 25%, and you Aussie/NZ docs still won't acknowledge the obvious?]
"The journal said the findings underscored "the potential public health benefits of the procedure". The college, which began its review in 2006 and was supposed to come out with a revised policy at the end of 2007, will not do so until the end of this year, as it considers the new evidence." [Better late than never, but what are you waiting for?]
"It is estimated that 10 to 20 per cent of male infants are circumcised in Australia." [Ewww, the thought of so many filthy foreskins in Australia should make us all sick, especially their future female partners].
"The chairman of the college's panel considering the issue, David Forbes, of the University of Western Australia's school of pediatrics, said the African studies had delayed the new recommendation, but so too had the fact "it is a contentious and non-clear-cut issue". [It's only contentious for the foreskin lovers who won't recognize medical evidence.]
"It's quite clear that there's evidence that circumcision in adult males helps prevent HIV in Africa," said Professor Forbes. "It's not so clear that circumcision in Australia in infants is of benefit to the infants or the community. Policy is about getting the right message to health planners so that we have safe but cost-effective expenditure." [The best time to circumcise is at birth, folks. Safer, cheaper, faster, pain-free, cleaner. Everyone knows that.]
New concerns about the practice of circumcision in Australia were raised last week after the Tasmanian Law Reform Institute found that parental consent might not be enough to protect the circumcisers of baby boys from later legal action. [Another distraction by the foreskin lovers. Since when can parents not consent to life-saving medical procedures for their children?]
No specific laws regulate the removal of the foreskin. [The biggest improvement would be a law to require circumcision before entering school, as a public safety measure like vaccinations.]
Professor Forbes said he wanted to have the college's position "finalised by the end of this year, hopefully before". [Again, better late than never].
"He said the benefit of reducing human papillomavirus "appears not to be such an issue in Australia" because a vaccine was being produced. And there were important differences between the HIV situation in Africa and Australia: HIV rates in Australia were far lower and condom use was much higher." [HIV rates are lower in Australia because the previous generation, now sexually active, were circumcised at birth. With so many young boys now afflicted with a foreskin, those rates will change by 2020].
"He said while there was clear evidence that circumcision reduced the rate of urinary tract infection, this alone did not justify routine use of the procedure as the infection rate was so small.
He said the 10-strong panel consisted of pediatricians, surgeons and policy and public health experts. "There are extremely strong views at both ends of the spectrum for those who promote circumcision and those who oppose it," he said." [Yes, another benefit of circumcision, the reduction of UTI. The list of benefits goes on and on and on, but Aussie docs ignore them].
"Undertaking elective surgery of minors who are not able to consent is for many pediatricians an even bigger issue, especially when there are examples of (Muslim) societies who elect to have it at puberty when people can choose." [This 'consent' issue is another red herring raised by the anti-circ fanatics. What about parental rights and responsibilities to keep their children healthy?]
"Dr Forbes declined to preview what the college's recommendation would be. "Policy change tends to be evolutionary, not revolutionary, and given that there are no trials of neonatal circumcision for prevention of HIV, I wouldn't expect revolutionary change. I would expect evolutionary change." [Just follow the science, dudes].
"Roger Short, from Melbourne University's department of obstetrics and gynaecology, hopes the college will view circumcision in a more favourable light. "It would be exciting to see the Royal College come forward with a slightly more progressive attitude than its previous pronouncements," he said. "The evidence is coming in, and it is irrefutable, that there are major benefits." [Thank you, Dr. Short. You're a doc who speaks the truth on the science].
"Professor Short said there were no grounds for making circumcision mandatory." [Well, I disagree about this. Circumcision should be required for all boys, with exceptions for the obvious conscientious religious objection].
Instead, the college should change its recommendation. "I think we should go from saying 'when in doubt, don't circumcise' to 'when in doubt, do'." [Absolutely. So Aussie/NZ docs, just do it].
Monday, May 25, 2009
TSA Full Body Scanners Can See Circumcisions
We all know the stories about uncircumcised males being embarrassed about their foreskins, at least in circumcised countries like America. Turns out the new full body imaging scanners being put in place by the TSA at airports across the country are so detailed that TSA will soon know the circumcision status of every dude who gets scanned. I haven't yet heard if the anti-circumcision groups are up-in-foreskins, oops, I mean up-in-arms about this, but it wouldn't surprise me. Keeping track of the nation's uncircumcised males is one way to know who is the most likely threat to public health, I suppose. The TSA is obviously looking for objects and devices that can blow up planes, but I dare say that more people have died from foreskins infecting a male or his partners (especially female) with HIV, HPV, STDs, and other ailments than from a bomb on board an American plane.
Anybody think the day will come when the TSA will haul aside uncircumcised dudes and send them off to a doctor? I admit, that's extreme. But you do wonder whether knowledge that a man's circumcision status will be checked every time he goes through an airport has any impact on circumcision rates in the USA.
Anybody think the day will come when the TSA will haul aside uncircumcised dudes and send them off to a doctor? I admit, that's extreme. But you do wonder whether knowledge that a man's circumcision status will be checked every time he goes through an airport has any impact on circumcision rates in the USA.
Wednesday, May 6, 2009
Listen to the Medical Doctors: Circumcise Now!
Below are just a couple of quotations from some noted medical doctors that I think we all should respect. Of course, the FLs ("foreskin lovers") will disparage these docs in the misguided, ongoing anti-circ effort to protect their beloved foreskin. But with a respected doctor like Anthony Fauci says, "Circumcise!" maybe the American Academy of Pediatrics will listen.
“Medically supervised adult male circumcision is a scientifically proven method for reducing a man’s risk of acquiring HIV infection through heterosexual intercourse,” says NIAID Director Anthony S. Fauci, M.D. “This new research provides compelling evidence that circumcision can provide some protection against genital herpes and human papillomavirus infections as well.”
“The cumulative scientific evidence supporting the public health value of medically supervised male circumcision is now overwhelming,” says Thomas C. Quinn, M.D., study co-investigator, chief of the International HIV/STD Section in NIAID’s Laboratory of Immunoregulation and co-author of the study. “This new research confirms the substantial health benefits of male circumcision, including reduced acquisition of HIV, genital herpes, HPV and genital ulcer disease.”
"These findings have significant public health implications for the control of HIV, genital herpes and HPV in areas of high prevalence, such as Africa, and further suggest that efforts to scale-up male circumcision could have tremendous benefit,” said Dr. David Serwadda, co-principal investigator and dean of Makerere University’s School of Public Health.
In the eyes of the anti-circumcision fanatics, these doctors must just be looney.
“Medically supervised adult male circumcision is a scientifically proven method for reducing a man’s risk of acquiring HIV infection through heterosexual intercourse,” says NIAID Director Anthony S. Fauci, M.D. “This new research provides compelling evidence that circumcision can provide some protection against genital herpes and human papillomavirus infections as well.”
“The cumulative scientific evidence supporting the public health value of medically supervised male circumcision is now overwhelming,” says Thomas C. Quinn, M.D., study co-investigator, chief of the International HIV/STD Section in NIAID’s Laboratory of Immunoregulation and co-author of the study. “This new research confirms the substantial health benefits of male circumcision, including reduced acquisition of HIV, genital herpes, HPV and genital ulcer disease.”
"These findings have significant public health implications for the control of HIV, genital herpes and HPV in areas of high prevalence, such as Africa, and further suggest that efforts to scale-up male circumcision could have tremendous benefit,” said Dr. David Serwadda, co-principal investigator and dean of Makerere University’s School of Public Health.
In the eyes of the anti-circumcision fanatics, these doctors must just be looney.
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