African Opposition to UNICEF’s Mass Infant Circumcision Campaign: UNICEF responds. So do Africans.

  KAMPALA, UGANDA - 08/01/2017 (PRESS RELEASE JET)

An African empowerment organization issued an open letter to UNICEF regarding its "early infant male circumcision" (EIMC) program aimed at reducing HIV infections in Africa. The program, according to the letter, has failed to consider African viewpoints on the matter.

The VMMC Experience Project is a non-for-profit organization to empower African men and women to raise their voices on the issue of mass circumcision as provided by Western health organizations. Last year, its investigation into the "voluntary medical male circumcision" (VMMC) campaign in rural East Africa revealed less-than-voluntary recruitment methods for circumcision, including $3 vouchers to impoverished men and the targeting of schoolboys without their parents’ consent. Vulnerable populations such as orphaned children and prison inmates become frequent targets, as the recruiters — called "mobilizers" — are compensated per head. Some of these boys and men later regret undergoing the procedure. Others report they never consented at all.

According to the investigation, the mass circumcision campaign also results in confusion around HIV immunity. At least seven respondents attributed their own infections to misinformation derived from the campaign. Others mourned the loss of loved ones to HIV/AIDS following circumcision undergone for HIV/AIDS prevention.

Prince Hillary Maloba, a native of Kenya and Uganda, is the Director of the Project. His uncles are members of the Bagisu, a circumcising tribe with one of the highest HIV rates in Uganda. "Millions of circumcised men are living with HIV," he reports. "Millions of children [with circumcised parents] are left AIDS orphans. Now traditionally non-circumcising tribes are being forced to accept circumcision based on blatant lies." His conclusion is resolute: "We demand the banning of mass circumcision in Africa."

In a letter to The VMMC Experience Project, UNICEF responded that the opinions around its African infant circumcision program are "mixed," but that the procedure will ultimately reduce the risk of HIV infection when the boys become sexually active. The World Health Organization recommends male circumcision as a vital tool to reduce the HIV burden in sub-Saharan Africa.

Clinical trials in South Africa, Uganda, and Kenya found that the procedure reduced men’s HIV risk by 51%–60%, while a trial in Uganda found that it increased women partners’ risk by 54%. (The latter trial was stopped early "for futility.")

Yet the African circumcision trials are not without criticism. At a Berlin press conference against UNICEF’s infant circumcision program in May, Dr. Ulrich Fegeler, representing the German Pediatric Society, described these studies as "scientifically as holey as Swiss cheese."

In Europe, there is growing condemnation of the practice of infant circumcision, as the Ombudsmen for Children in Norway, Sweden, Finland, Denmark, Iceland, and Greenland have called for a ban on medically unnecessary circumcisions performed on underage boys. The Danish Medical Association’s 2016 Policy on male infant circumcision describes the practice as "ethically unacceptable," while the Royal Dutch Medical Society urges "a powerful policy of deterrence."

In 2013, the Council of Europe adopted a Resolution which classifies medically unnecessary circumcisions as a violation of children’s right to physical integrity. As to its potential benefits, the Council cites "clear evidence to the contrary."

The European policies stand in stark contrast to that of the American Academy of Pediatrics, which states that while the true incidence of complications is unknown, the benefits of infant circumcision outweigh the risks.

UNICEF's African infant circumcision initiative is backed by the American agencies USAID and PEPFAR. To some Africans, the exercise conjures images of American colonialism, even cultural assault. "Circumcision has failed to respect a vast array of cultures that had been fighting HIV effectively," says Maloba. "We totally reject this."

Last month, The VMMC Experience Project partnered with international medical professionals — including the former President of the Polish Association of Pediatric Surgeons, Dr. Piotr Czauderna, and the beloved American physician-broadcaster and media personality, Dr. Dean Edell — to issue a joint response to UNICEF.

The new letter urges UNICEF to re-examine the Project’s investigation into negative experiences with the African circumcision campaign, and calls on the children’s rights organization for "a plan of action or retraction" from the program.

The letter will be addressed in the General Assembly meeting of the European Network of Ombudspersons for Children in September, where the latter will adopt a joint Statement on medically unnecessary circumcisions performed on male minors.

The VMMC Project awaits a response from UNICEF.