Tuesday, March 02, 2010

On circumcision & the "pulse" program...

Recently, I came upon this interesting article titled - Why circumcised men are less likely to get HIV. Here is a glimpse of what the article says:
Circumcision substantially lowers HIV risk among men by changing the bacterial communities of the penis, finds a new study. According to scientists at the Translational Genomics Research Institute (TGen) and Johns Hopkins University, the strongest evidence for a cause-and-effect relationship between circumcision and HIV risk reduction came from three randomized-control trials in sub-Saharan Africa, where the circumcision rate is relatively low and the HIV infection rate is relatively high. All the studies showed more than 40 percent reduction in HIV acquisition among circumcised men. The new study found that circumcision eliminates an area of mucous membrane and dramatically changes the penile bacterial ecosystem.
Why am I writing on this topic? Well, my interest in the topic is purely from the social standpoint. With HIV killing millions of people worldwide every year (mostly in the developing world), the toll of HIV related deaths expected to increase many folds globally in the coming years, & science still struggling to find a cure, it is not hard to imagine the daunting task ahead of us. It gets all the more serious when we realize that most of the deaths are among the economically backward communities. How do we address the issue, then?
The Government of India, in its by far largest mass health program in the world, has been successfully conducting the "pulse polio" program. The response & the results are there for all to see. The Ministry of Health & Family Welfare claims that between 1994 (when the program was launched) & 2004, the number of polio cases reported fell dramatically from 4791 cases to just about 135.
With India's population set to grow even further & exceed China in the next few decades, it should alarm policy makers, social activists, & the general public alike, on the potential time bomb we are sitting on. With the youth comprising the bulk of the population, & an increasing number of youngsters joining the mainstream, sexual practices & the associated health concerns should be of prime concern to the Government. Given such a scenario, we should proactively explore alternative avenues of prevention, even while science explores cure for the deadly disease.
It may be too early to start administering circumcision as one of the means to prevent HIV infections. Given the fact that circumcision also has religious significance to a section of the society, it should not be misconstrued as an initiative of the Government to appease only one section of the society. In this regard, it is necessary to disseminate the scientific conclusions among the masses, educate them on the what / why/ how / when of the subject, & make it voluntary to undergo circumcision. Also, because of the religious significance, it is important to seek the backing of religious heads of various communities on scientific grounds. Since the religious heads have better chances of educating the masses & motivate them to lead safe & healthy sexual life, their backing could bear intended results.
Sex being a taboo subject in the land of Kaamasootra, has to be addressed very delicately. Without being overtly sexist, the message should be sent across to the masses to lead safe & healthy sexual life. It is in our national interest that our policy makers come out with policies with the youth being the core beneficiaries of such policies. For this to happen, policy makers should break the walls of their parties & come out in support of such policies of national importance.
Could "voluntary pulse circumcision" program be an option in this direction to address the HIV menace?

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