Integrated Regional Information Networks - February 10, 2012
LILONGWE, 10 February 2012 (PlusNews) - Clement Zulu never
thought he would be circumcised. A Christian from the north of
Malawi, Zulu was among millions of Malawians who believed the
practice was a ritual for the southern Yao people, who are mostly
But after reading a newspaper article in October 2011 stating
that Malawi had adopted medical male circumcision as part of its
HIV prevention strategy and would begin providing the service,
the 34-year-old had a change of heart. Zulu is now one of the
many to have undergone the procedure free at state hospitals.
"Having lost my three relatives to HIV/AIDS I decided to take
some precautionary measures that would [help to] prevent me from
being infected," he told IRIN/PlusNews.
According to the Principal Secretary for HIV/AIDS in the Office
of the President and Cabinet, Mary Shawa, more than 5,000 men
have so far been circumcised - an "encouraging" figure given that
only 4 percent of the country's medical staff have been trained
to carry out the surgical procedure.
"Being a [member of the] medical [profession] does not mean that
one automatically knows how to [perform] circumcisions. So there
are special courses that [have to be] taken regarding the
circumcision," she told IRIN/PlusNews.
The campaign hopes to circumcise more than 250,000 men by 2015,
said National Sexually Transmitted Infections Programme Officer
in the Ministry of Health, Amon Nkhata.
As one of the countries hardest hit by HIV/AIDS, Malawi has been
criticized for moving too slowly in introducing free male
circumcision in state facilities. Results from three randomized
clinical trials released in 2005 and 2006 provided compelling
evidence that circumcision can reduce a man's risk of HIV
infection during heterosexual intercourse by as much as 60
The World Health Organization endorsed the procedure as an
HIV-prevention measure in 2007, but implementation of a
large-scale male circumcision programme in Malawi has been
controversial in the conservative country.
Southern Malawi, where most circumcisions take place, has a large
migrant labour population and an HIV prevalence rate of about 18
percent, accounting for almost 70 percent of the country's HIV
infections, according to government figures. Circumcision is
culturally less prominent in northern Malawi, where prevalence
rates are also lower.
The disparity between HIV prevalence and traditional circumcision
rates has raised doubts among some health officials, who argued
in local newspapers that they had not yet been presented with
enough clinical evidence, and the efficacy of male circumcision
was questionable given high HIV prevalence rates among
traditionally circumcising populations in the south.
But the government formally launched its voluntary medical male
circumcision programme last year in Mulanje district, which has
an estimated HIV prevalence of 17 percent. Mulanje is one of nine
pilot districts to offer the service.
"Malawi had also conducted its own study which also proved the
efficacy of male circumcision in reducing the spread of the virus
that causes AIDS," said Ministry of Health spokesman Henry
The government has embarked on an intense campaign to disseminate
accurate information about medical male circumcision. Malawi
registers 70,000 new infections a year, and people still had to
be reminded that male circumcision alone is "not 100 percent
safe", Chimbali cautioned.