||"Makona, Edgar Dearn" [ profile ]
Rwanda: Male Circumcision scale-up with new technology
May 3rd, 2011 - 08:31:00
The Government of Rwanda recently announced plans to scale-up its
voluntary male circumcision program using the PrePex system, a new
device for rapid adult male circumcision deployment in
According to a press release, PrePex is the only male circumcision
method available today in the public health arena to offer the unique
combination of the following: no anesthesia, no sutures, no blood and
no sterile settings requirement.
In 2010, the Government of Rwanda initiated a nationally sponsored
study to test the safety and efficacy of the system. Results showed
its potential to revolutionize male circumcision as an HIV prevention
method, says Dr. Agnes Binagwaho, an international HIV expert and
currently the Permanent Secretary in the Ministry of Health of Rwanda,
asking colleagues to share their experience.
A new study is currently under way to compare it to surgical
circumcision for rapid scale-up of male circumcision in resource
limited setting, especially its cost-effectiveness. Co-investigator
Professor Steven Kaplan, a leading urologist from Weill Cornell
Medical College of Cornell University in New York, and a member of the
International Male Circumcision Advisory Committee of Rwanda, says
that so far the evidence is very compelling for PrePex, a
non-surgical technique with no local anesthesia will make this
technology accessible and scalable.
In the past few years, male circumcision studies have shown strong
evidence in reducing the risk of heterosexually acquired HIV infection
in men, and new technologies that make it more accessible in areas
where there is a gap in surgical and anesthesia services can only be
welcome. But, as experts note and as recommended by the WHO and
UNAIDS, behavior change must remain the core of prevention efforts and
safe, voluntary male circumcision for adult male is only one component
of a comprehensive strategy. Lessons from the decline in HIV
prevalence and incidence in Zimbabwe from 29% in 1997 to 16% in 2007
are being drawn by health implementers and policy makers.
Rwanda has a national goal to decrease its HIV incidence rate by 50%
by circumcising two million adults in two years as part of a
comprehensive HIV prevention strategy. With the PrePex device, this
can be a reality and we finally have the potential to achieve our
The procedure is quick, simple, bloodless and safe, says Dr. Agnes
Binagwaho, an international HIV expert and currently the Permanent
Secretary in the Ministry of Health of Rwanda.
Speaking to IRIN PlusNews, Binagwaho noted that although no adult male
circumcision device is approved by the World Health Organization,
PrePex is approved by the European Union.
Sophie Beauvais, Global Health, HIV/AIDS