World Health Organization

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In July 2012, the WHO (World Health Organization) published a study[1] (just in time for the just then started Circumcision Debate in Germany) which recommended to perform circumcisions as a prevention against HIV/AIDS. This study supposedly promises a 60% protection against AIDS.

Circumcision proponents use this study[2] for justifying even circumcisions on male toddlers and infants in Germany, Europe and Northern America. But the study only referred to Africa (Kenya, Uganda, and South Africa) and only to adults.

In fact, the study is scientifically vulnerable and has since been sharply criticized by experts.

Guideline Development Group (GDG)

In May 2018, the WHO announced to develop new guidelines on male circumcision, focussing on doing even more male circumcisions as a HIV/AIS prevention action.[3] They named the following GDG members:

At least 16 members of the GDG are biased in favor of circumcision, while only 7 members have unclear points of view. Chances are that they are also strongly involved in this topic and take a position in favor of circumcision. The WHO will certainly have deliberately selected and named these experts on circumcision. One can therefore accuse the WHO of bias on this topic.



The following sections are from IntactWiki:

WHO.jpg
Chief Circumcision Expert:
David R. Tomlinson
Related Organizations:
UNAIDS

The World Health Organization endorses male circumcision as an HIV prevention method based on the three RCTs in Kenya, South Africa, and Uganda.[4]

“ WHO Endorses Circumcision as HIV Prevention
...male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence. (World Health Organization)[5]

On their website[5], they acknowledge that, even if the latest "studies" were correct, "[m]ale circumcision provides only partial protection," and that it should be part of a "comprehensive HIV prevention package" that includes HIV testing and counseling services, treatment for STD infections, the promotion of safer sex practices and the provision of condoms and the promotion of their correct and consistent use.

Note: Even if the recent trials were accurate (and their credibility is highly questionable), circumcision could only reduce the relative risk of acquiring HIV between circumcised and uncircumcised men by 60% over a period of about one year. Condoms have an absolute reduction risk of acquiring HIV that's over 95% (closer to 100% when used properly), making circumcision a moot point.

Chief expert on infant circumcision

David R. Tomlinson is the inventor of the AccuCirc device for infant circumcision.[6] He also wrote a manual on infant circumcision for the World Health Organization.[7]

Initiatives Since 2006

The Department of Reproductive Health and Research (RHR), together with the WHO Department of HIV/AIDS and the Joint United Nations Programme on HIV/AIDS (UNAIDS), launched a number of new initiatives in 2006–2007.[8]

Circumcision Manual

Infant boys are born with a healthy penis and foreskin. Treatment is not required. Infant boys do not engage in sexual intercourse so they cannot contract HIV infection by sexual intercourse. Infant boys cannot grant consent for this irreversible body altering surgery which violate several significant United Nations human rights instruments.

Nevertheless, in partnership with other WHO departments, UNAIDS, and the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO), the Department of Reproductive Health and Research (RHR) has developed a Manual for male infant circumcision under local anaesthesia.[9][8] JHPIEGO addresses female gynecological health and is out of its field in addressing male health.

The manual is intended for use by clinical officers, who can be trained to perform uncomplicated circumcision, and to refer more complex cases. The manual is expected to be published in 2011. The manual itself is supported by training guides and a certification framework, to facilitate the upgrading of skills of officers who are not otherwise authorized to perform surgery.

As justification for circumcision, the Manual alleges that circumcision would reduce the incidence of urinary tract infection (UTI) in the first six months of life, however this is not a valid justification because UTI, if it should occur, is easily treated medically instead of with body-altering surgery.[10]

Moreover, the foreskin protects the penis from infection, so the amputation of the foreskin makes UTI more likely. In infant boys, UTIs originate from the external environment, strongly suggesting that these infections are iatrogenically caused.[11] Two interventions that put the male infant at immediate risk for UTIs are circumcision, and forced retraction of the foreskin. These interventions tear away the synechia which binds the foreskin to the glans in male infants, thereby creating entry points for E. coli bacteria,[12] which binds to the glans penis of the infant.[13] Urinary tract infections (UTI) are a complication of circumcision.[14][15][16][17]

Promotion of infant circumcision by publishing a manual has the effect of increasing demand for circumcision devices such as those manufactured by David R. Tomlinson.

Assessment Toolkit

RHR is also supporting the development of a toolkit that will allow countries to assess their preparedness for introducing or expanding male circumcision services. RHR contributed to a number of other documents dealing with various aspects of male circumcision, including a review of global trends and determinants of prevalence, safety and acceptability, and a guide to enhancing the quality of male circumcision services.

See also

CircWatch

References

  1. ↑ http://www.who.int/hiv/topics/malecircumcision/en/
  2. ↑ http://www.who.int/hiv/topics/malecircumcision/fact_sheet/en/
  3. ↑ REFweb (May 2018). WHO to develop new guidelines on male circumcision. Retrieved 26 March 2020.
  4. ↑ REFweb (2011). Male circumcision for HIV prevention, World Health Organization. Retrieved 6 May 2011.
  5. ↑ a b REFweb (2011). Male circumcision for HIV prevention, World Health Organization.
  6. ↑ REFnews Katz, Paula S. (September 2008)."Night work without burnout", Today's Hospitalist. Retrieved 26 September 2011.
    Quote: ...an invention: a circumcision tool to help prevent HIV that has recently been cleared by the FDA.
  7. ↑ REFnews Hennessy-Fiske, Molly (26 September 2011)."Injuries linked to circumcision clamps", Los Angeles Times. Retrieved 25 September 2011.
    Quote: Dr. David Tomlinson, who teaches family medicine at Brown University in Providence, R.I., wrote a manual on infant circumcision for the World Health Organization.
  8. ↑ a b REFweb (2011). Male circumcision for HIV control, World Health Organization. Retrieved 6 May 2011.
  9. ↑ REFbook World Health Organization, JHPIEGO (2010): Manual for early infant male circumcision under local anaesthesia. Geneva, Switzerland: WHO Document Production Services. ISBN 9789241500753. Retrieved 1 June 2011.
  10. ↑ REFjournal McCracken, G.H.. Options in antimicrobial management of urinary tract infections in infants and children. Pediatr Infect Dis J. August 1989; 8(8): 552-555.
  11. ↑ REFjournal Maskell, R., et al. Urinary Pathogens in the Male. British Journal of Urology. 1975; 47
  12. ↑ REFjournal Winberg, J., et al. The Prepuce: A Mistake of Nature?. Lancet. 1989; : 598-599.
  13. ↑ REFjournal Cunningham, N.. Circumcision and urinary tract infections (letter). Pediatrics. 1986; 77(2): 267.
  14. ↑ REFjournal Smith, R.M.. Recent contributions to the study of pyelitis in infancy. Am J Dis Child. 1916; XII: 235.243.
  15. ↑ REFjournal Cohen, H., et al. Postcircumcision Urinary Tract Infection. Clinical Pediatrics. 1992; : 322-324.
  16. ↑ REFjournal Goldman, M., Barr, J., Bistritzer, T., Aladjem, M.. Urinary tract infection following ritual jewish circumcision. Israel Journal of Medical Sciences. 1996; 32(11): 1098-1102.
  17. ↑ REFjournal Prais, D., Shoov-Furman, R., Amir, J.. Is circumcision a risk factor for neonatal urinary tract infections?. Arch Dis Child. 6 October 2008; DOI.
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