Durban - More than 6.4 million South Africans are living with HIV - that’s the Moses Mabhida Stadium filled to capacity 100 times - with almost 400 000 new infections recorded last year, according to new statistics.
And as South Africa strives to conquer the pandemic, envisaging an HIV-free generation by 2030, male medical circumcision has been highlight- ed as key to reaching that goal.
The government, along with not-for-profit organisations, had set a goal of 4.3 million male medical circumcisions between 2011 and 2016. To date, 35 percent of that target - 1.6 million men circumcised - has been reached.
A total of 388 000 have been circumcised in KwaZulu-Natal, it was revealed at a press conference to promote a national government male medical circumcision project held in uMhlanga on Thursday.
Using scientific estimates, researchers claim that more than one million new HIV infections can be potentially averted if the targets are met.
Dr Harry Lake, chief executive of health NGO Care Works, said a third of South African women, aged between 30 and 39, are HIV positive.
It was worrying, he said, that only a quarter of infected men were making use of antiretroviral treatment, compared to a third of infected women.
Despite the Department of Health spending R12 billion on antiretroviral therapy, only 2.4 million infected people out of the total 6.4 million infected, were using it, Lake said.
“HIV costs us 2 percent of gross domestic product every year. If you count the past 10 years, our economy could have been 20 percent better off without the pandemic,” he said.
Lake said the male medical circumcision project was a high-return investment in South Africa, unlike for example the UK, where it would be a waste of money as prevalence there was low.
Dr Lisa Mulenga, clinical manager at the Society for Family Health, said 15 studies on male medical circumcision had shown that the procedure had reduced HIV risk by 58 percent.
Mulenga said the rate of HIV prevalence among women with circumcised sexual partners was 22.4 percent, while
it was significantly higher, at 36.6 percent, with a combination of circumcised and uncircumcised.
It was stressed that circumcision was not a substitution for condoms or other preventative measures, however.
Family physician Dr Don Pupuma recalled his first encounter with the virus as a doctor in a Johannesburg hospital in the 1990s.
He said that as a medical student at the time, the virus was only mentioned “probably once” during his studies, and said questions about it did not appear in exams.
HIV patients were treated in isolation and doctors used protective gear when consulting with them, he said, adding there was much fear of the virus by doctors at the time.
“We were certain it was a killer and that it was incurable,” he said.
“When I opened my practice in Soweto, that is where I saw the real impact of HIV. It swept through the township and terrorised the community.”
At the turn of the millennium, it was the most researched topic in the history of mankind, Pupuma said. “We continue to have frightening numbers of new infections, with 400 000 last year. South Africa is home to 6.4 million people living with HIV - that’s six times the population of our neighbour, Swaziland,” he said.
“We need to ask ourselves: how do we protect ourselves as a region, as a country? We need to take on board any measure that has passed rigorous scientific scrutiny.”
Pupuma said botched circumcisions and illegal circumcision schools were dangerous, although he was supportive of cultural circumcisions done by experienced men from registered circumcision schools.
The head of the Department of Health’s male circumcision programme, Dr Dayanund Loykissoonlal, said KZN’s target over the next three years was more than 460 000 procedures.
“Male medical circumcision has impacted on STIs (sexually transmitted diseases) like syphilis, because we have seen that go down in circumcised men and their partners,” he said. “We want to re-vitalise this programme to say ‘let’s get to the 4.3 million target’, because for every five circumcisions, there is one aversion (from HIV).”