Ministry targets 700,000 men after new circumcision method becomes popular

The Ministry of Health has said it is targeting about 700,000 men to undergo non-surgical male circumcision by 2016. The ministry yesterday rolled out the non-surgical male circumcision, medically referred to as PrePex.
Dr Binagwaho (L) and Fuerst and Col. Dr. Ben Karenzi, the head of Rwanda Military Hospital, Kanombe, at rollout of the PrePex circumcision method yesterday. The New Times/ T. Kisambira.
Dr Binagwaho (L) and Fuerst and Col. Dr. Ben Karenzi, the head of Rwanda Military Hospital, Kanombe, at rollout of the PrePex circumcision method yesterday. The New Times/ T. Kisambira.

The Ministry of Health has said it is targeting about 700,000 men to undergo non-surgical male circumcision by 2016.

The ministry yesterday rolled out the non-surgical male circumcision, medically referred to as PrePex.

The new method, which has been under clinical trials in the country, was unveiled at Rwanda Military Hospital, Kanombe, during a function attended by officials from UN agencies, including the World Health Organisation.

Rwanda is the first country to roll out PrePex on a nationwide scale.

The Minister for Health, Dr Agnes Binagwaho, said to attain the set target, the scaling up process will be combined with training of healthcare providers from district hospitals and health centres.

She added that during the clinical trials, the number of people who showed up for non-surgical circumcision was overwhelmingly big, which informed their set target.

Circumcision has been proven to lower the risk of HIV transmission and infection by a rate of 60 per cent.

PrePex is in form of a ring. It enables circumcision to be performed without surgery or any blood loss, by nurses, who don’t need extensive training to use the apparatus.

The PrePex device is made of three components.  The first is the rigid inner ring that is applied inside the foreskin while the elastic ring is applied on top of the foreskin to cut off the blood flow to the foreskin.

The third item is used to cover the forehead of a male organ not to be contaminated. Medics say the dead foreskin and the device are removed after seven days.

“Since this system doesn’t require someone to be in hospital, nurses can conduct it from anywhere, including classroom during weekends. This kind of circumcision is suitable for only adolescents and adults and it is free,” said Dr Binagwaho.

She described the roll-out as a milestone not only for Rwanda, but for Africa as a whole.

“No known drug could reduce the HIV infection rates by 60 per cent apart from circumcision and it’s an honour that Rwanda now leads the world in this new effort,” the minister said.

WHO-Certified

PrePex was pre-qualified by WHO in May this year, after a rigorous three year clinical and regulatory evaluation process, which began in Rwanda.

It has also been cleared by the US Food and Drug Administration.

Speaking at the same event, Tzameret Fuerst, the co-founder and president of Circ MedTech, the developer of PrePex, said worldwide, a person contracts HIV infection every 12 seconds, while every 16 seconds someone dies of HIV/Aids.

“We need to reverse the trend. Now that we have the tool, it’s time to make a historic change,” Fuerst said.

She added that in six years, sub-Saharan Africa has met 10 per cent of the target to reach 20 million men by 2015.

“We have roughly two years to reach the remaining 90 per cent. We are at a tipping point in history where the traditional methods and the status quo are just not good enough. To have an Aids-free generation, the world needs ground-breaking innovation, deployed at record speed, with a technique that will drive men into the clinics. PrePex is the solution,” she said.

Dr Leon Ngeruka, a surgeon, said the new device does not necessitate injecting anesthesia or sutures, and can be conducted by nurses in a clean, non-sterile setting.

Gilbert Gatsibagye, who was circumcised during the clinical trials, told The New Times that the procedure was not painful and he never missed work unlike what he expected from the conventional method.

“From the day a ring was put on the penis to the sixth day, I never felt any pain. I only felt some pain on the seventh day, the day the ring was supposed to be removed. Apart from feeling a bit uncomfortable, it is a friendly procedure,” said Gatsibagye.

During the clinical trials, about 8,000 people underwent PrePex circumcision.

In 2007, international health authorities announced a programme to circumcise 80 per cent of adult males (20 million men) in 14 countries in sub-Saharan Africa, which as the highest number of HIV infections. 

According to WHO, and the Joint United Nations Programme on HIV/Aids, this mass adult male circumcision effort would prevent an estimated 3.4 million new HIV infections and would result in a net savings of $16.5 billion in treatment and healthcare costs. 

In Rwanda, HIV prevalence rate stands at 3 per cent among adults aged 15 to 49. The rate has remained relatively stable, with an overall decline since the 1990s, partly due to improved HIV surveillance.

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