By Kevin Kelley and Mike Mwaniki
Washington/Nairobi
The Nation (Nairobi)
22 August 2007
American foreign aid will soon shift to an unlikely aspect of Kenyan culture
- male circumcision.
Nearly Sh350 million out of the Sh25 billion which the United States gives Kenya to fight Aids will now be used to make circumcision more widely available to men.
The dramatic twist in the Bush administration's financial support is driven by recent studies in Kenya and elsewhere which show that circumcised men are far less likely to contract the virus that causes Aids.
A senior official with the US Agency for International Development told the Washington Post that funding for the male cut will amount at first to only a few hundred thousand dollars a year, but will become "an important part" of the American anti-Aids programme in Africa in the coming years.
Diverting support
But the decision is bound to attract criticism from Kenyan Aids experts as it will be diverting Aids support from the Kenyan region most affected by Aids, Nyanza province, where the majority of the population, as a custom, do not practice circumcision.
According to recently released figures, Nyanza province, where male circumcision is not widely practised, has 183,000 HIV/Aids infections while Coast province, where male circumcision is more widespread has 93,000 cases. The figure for Nairobi is 197,000 and Central province has only 96,000 cases. Part of the research on male circumcision was conducted in Kisumu and South Africa.
The research showed that circumcision can more than halve men's vulnerability to the virus causing Aids from having sex with HIV-infected women.
Experts believe cells on the inside of foreskin, the part of the penis cut off in circumcision, are particularly susceptible to HIV infection.
The foreskin also suffers small tears during intercourse.
If male circumcision results in an overall decrease in HIV infections then women would eventually benefit, they said.
The decision to encourage circumcision marks a shift in Bush administration policy.
USaid official Kent Hill said the White House had been reluctant to promote the male cut until recent studies showed that Kenya and other countries receiving assistance through the President's Emergency Programme for Aids Relief were being urged to use Pepfar funds to expand access to circumcision..
The Washington Post claims that nearly 25 percent of Luo men are infected with the virus, compared to a national adult rate in Kenya of seven percent and notes that Luos do not practice male circumcision.
Removing the foreskin of the penis makes a man about 60 percent less likely to become infected, according to the results of studies in Kenya, Uganda and South Africa.
The Chairman of the National Aids Control Council, Prof Miriam Were, supported the move saying male circumcision was one of the best methods of preventing the spread of the disease in Kenya.
Prof Were said research had proved that the practice was between 60 to 65 percent effective.
Best method
"I insist that this practice, however, traditional, is one of the best methods of preventing the spread of the disease. We in the government should really encourage people to undergo this right of passage because evidence has showed us the way," she said.
In May, US ambassador to Kenya, Mr Michael Ranneberger, said Sh350 million would be used in a campaign for male circumcision to prevent HIV infection.
Mr Ranneberger's sentiments came shortly after the UN endorsed male circumcision as a way of preventing HIV infections in heterosexual men.
The World Health Organisation and UNAids also recommended that circumcision be made more easily available in Africa.
The WHO and UNAids said increasing male circumcisions could prevent 5.7 million sub-Saharan African men from contracting HIV over the next two decades, and save three million lives.
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