MEDICAL male circumcision now forms part of government's policy to reduce HIV infections.

MEDICAL male circumcision now forms part of government's policy to reduce HIV infections.

"By 2011, medical male circumcision must be practised all over South Africa," Health Minister Aaron Motsoaledi said recently when detailing new protocols for TB and Aids treatment which came into effect on April 1.

Making medical male circumcision part of HIV-prevention measures has been a contested field for a few years. It's one of the issues that bedevilled the reign of the late former minister of health Manto Tshabalala-Msimang.

On the other hand, circumcision is a traditional rite of passage into manhood that has been practised in South Africa and on the continent for many years. Convincing traditional leaders of the benefits of medical male circumcision was not easy. After much consultation, policy now exists.

"The evidence is clear that this is an intervention that is useful, that is scientific, that is evidence-based, that is an addition to the prevention package. The approach that has been taken is that there is no debate about the impact of male circumcision," said head of the South African National Aids Council Nono Simelela.

The issues were around working with the sensitivities of traditional practices - against whether or not went against what other cultures do in terms of circumcision.

"But now with the main issue around cultural sensitivities having been resolved, it's now something that has been totally embraced and accepted as a key component of our prevention strategy in South Africa."

"We want to undertake massive male circumcision. We believe that by 2011, male circumcision will be practiced all over," said Motsoaledi.

Three provinces have been targeted to introduce the service. KwaZulu-Natal is taking the lead in implementing the policy. Ironically, circumcision used to be a traditional practice among Zulu men about 200 years ago. Late last year, King Goodwill Zwelithini called upon Zulu men to go back to the practice of circumcision to protect themselves against HIV infection. Some district hospitals are already offering the service.

"King Zwelithini announced that the tradition which the Zulu nation has been practising for more than 200 years is going to come to an end - in terms of not practicing circumcision traditionally. They are going to do it medically," the health minister said.

"By 2015, the KwaZulu-Natal premier, the MEC and the king have pledged they will have conducted 2,5 million circumcisions. The Northern Cape has said it is ready to do it. Mpumalanga has been quiet and I want to pledge for them. They must do it."

Policy towards medical male circumcision followed a number of scientific studies that showed that it can reduce HIV infection in men by up to 60percent. However, it's important to note that circumcised men must continue using condoms as the addition of the latex sheath offers extra protection.

All sexually active men are encouraged to get circumcised for HIV prevention.

The policy is yet to decide on infant circumcision.

Provincial health departments will release details of their plans to roll out the service in the foreseeable future. - Health-e news