Male medical circumcision reduces the risk of heterosexual men contracting HIV. It is highly likely that the widespread introduction and encouragement of voluntary male medical circumcision (VMMC) in countries with generalised heterosexual epidemics will reduce HIV incidence substantially. There is also evidence that VMMC reduces the risk of men contracting HPV, the virus that causes cervical cancer. Therefore, there is likely a lower risk of circumcised men passing on HPV to their female partners.
Yet a number of commentators have raised objections to the introduction of VMMC.
An article by Halperin et al. titled Male circumcision is an efficacious, lasting and cost-effective strategy for combating HIV in high-prevalence AIDS epidemics has been published in Future HIV Therapy (September 2008, Vol. 2, No. 5, Pages 399-405, doi:10.2217/17469600.2.5.399). It answers the objections raised to VMMC. Its authors include many distinguished scientists, clinicians and activists, including members of the TAC.
By Zackie Achmat, Mail & Guardian 27 September 2008
On September 20 2008, as South Africa’s newly acquired Gripen fighter jets took off from a local air show to parade across Cape Town skies, residents would awaken to one of the most remarkable days in the political history of the republic. The Mbeki-Pahad monolith had collapsed.
The decision by the ANC to recall President Thabo Mbeki represents the downfall of the most hubristic executive in contemporary South Africa, and one that has been characterised by the unrelenting denialism of the greatest threats facing our country -- the mounting failure of the criminal justice system to prosecute and convict criminals, the increasingly disturbing nature of violent crime, burgeoning inequality and unemployment, the HIV/Aids catastrophe and the culture of impunity for corrupt and incompetent public officials.
The Treatment Action Campaign (TAC) welcomes the appointments of Ms Barbara Hogan as the Minister of Health and Dr Molefi Sefularo as the Deputy Minister of Health. We congratulate President Motlanthe for making these excellent appointments.
We are confident that Hogan has the ability to improve the South African health system. She has been one of the few Members of Parliament to speak out against AIDS denialism and to offer support to the TAC, even during the worst period of AIDS denialism by former President Thabo Mbeki and former Health Minister Manto Tshabalala-Msimang. 0n 14 February 2003, she received the TAC memorandum to President Mbeki for a treatment plan. She was removed as Finance Portfolio Chairperson by Mbeki in part for her stand on HIV/AIDS. She has a reputation for being hard-working, competent and principled.
The combination of antiretroviral (ARV) and tuberculosis (TB) treatments could more than halve the mortality rate among patients coinfected with HIV and TB, according to a randomised open-label trial by the Centre for the AIDS Programme of Research in South Africa (CAPRISA).
The Treatment Action Campaign (TAC), the AIDS Law Project (ALP) and the AIDS and Rights Alliance for Southern Africa (ARASA) have issued a joint statement demanding improved social assistance for people living with TB, HIV and other chronic illnesses. In particular the statement addresses recent changes to social assistance regulations; the cancellation and withdrawral of social grants for drug-resistant TB patients; the proposed chronic disease grant; and, the failure of disability grants to adequately provide for people living with chronic illness.
On Friday 23 May 2008, the TAC began co-ordinating an emergency response to assist people displaced by xenophobic violence. TAC raised an unprecedented amount of money and goods and services donations from the public. In the interests of transparency, we provide here a draft income and expenditure statement for activities up to 3 September 2008. Our response continues, albeit that we are winding it down. The income and expenditure sheet below excludes the donations, many of them very large, and discounts we received. The reconciliation below is draft, subject to change and unaudited. TAC's audits are usually completed in September of each year and report up to the end of our financial year-end in February.
An easier-to-read PDF version of the table can be downloaded here.
It has been explained to TAC by some of South Africa's leading demographers that the provincial and national prevalence reported in the antenatal survey for 2007 appears to have been calculated using a different methodology to 2006. The apparent decline in provincial and national prevalence in 2007 may therefore be a consequence of this change in methodology. Provincial prevalence is calculated using district prevalence. A comparison of antenatal prevalence at district level between 2006 and 2007 indicates that, if anything, there has been no decrease in prevalence. It is not necessarily wrong for the Department of Health to change its calculation methodology if it has a reasonable basis for doing so but by failing to state that it has done so in the report, it has made a mistake or misled the public into thinking a real decline in prevalence has been measured. Furthermore, it appears that the methodology to measure prevalence in 2006 might also be different to 2005, possibly rendering comparisons over that period problematic too. The failure to adequately explain these methodology changes and why they were done is poor science and renders the antenatal survey a much less useful source of data than it could otherwise be.
Yanga Janet was released on bail for R500 last week. The case will be heard today (2 September 2008) outside the Khayelitsha Regional Court. TAC will be picketing outside the court to demand that justice is served.
In Cape Town Mayor Helen Zille's recent address to the full City Council (27 August 2008) she states that it is disingenuous for the TAC to withdraw its case in the High Court (demanding norms and standards from government for the sites housing displaced persons) on the basis that these have subsequently been provided because the TAC "was party to the formulation of these standards from the word go, and knew they were coming".
A key advocacy issue that TAC will focus on going forward is TB. TB has historically been one of South Africa's largest health problems, especially in the mines and poor communities. This has been further exacerbated by the HIV epidemic. HIV-related TB is the leading cause of death in South Africa. Recorded TB deaths have increased from 25,640 in 1997 to 73,903 in 2005. Of particular concern is drug-resistant TB.