Trump says that "male circumcision in Mozambic" is a "scam". What is the program about?

In his common speech at Congress on Tuesday, President Trump took a jab to a number of external aid programs. “Listen to only some of the terrible waste,” he said and then shook a list of examples, including: “$ 10 million for male circumcision.”

It refers to a country, but USAID – the Agency for International Development of the United States – has funded male circumcision programs in a series of countries in southern and eastern Africa through the US President’s Emergency Plan for AIDS (Pepfar).

Public Health Experts and HIV prevention lawyers agree that Voluntary medical circumcisions for men – a procedure in which a medical provider eliminates the foreskin of a penis from a voluntary patient – is an extremely effective prevention for HIV. It has been shown that the procedure significantly reduces the risk of HIV transmission from women to men and is an intervention to prevent HIV profitable in countries with high infection rates.

The procedure is recommended for men after the onset of puberty, when they are more likely to be sexually active and differ from ceremonial circumcisions that are usually made by a non-medical supplier in a non-medical frame. “The benefits of the procedure are both for (the patient) and their future partners and, finally, in a big way, for the community and the country to reduce the spread of HIV,” says Anna BershteynAssociate Health Professor Population at Grossman School of Medicine in New York University.

A local anesthetic is used in the procedure.

A 60% prevention benefit

Voluntary medical circumcision has become a gold standard for HIV prevention in the early 2000s, after three innovative research studies from national health institutes and the French National Agency on AIDS research revealed that African countries with higher male circumcision rates lower rates of HIV infections.

“If a man is circumcised, he will reduce his chances of buying HIV by 60%,” says Mary MahyThe Director for Data for the impact on the common program of the United Nations on HIV/AIDS.

Scientists still do not know for sure how to remove the foreskin reduces the risk of HIV infection, but research suggests that the masculine foreskin has a number of more than a certain type of cells that HIV grabs. Bershteyn says that there is evidence that when the foreskin is removed during circumcision, the skin on the penis changes and the number of HIV vulnerable cells is reduced.

“But, apart from understanding the way, we have incredibly powerful evidence from several randomized studies that, regardless of mechanisms, greatly reduce the risk of HIV infection,” says Bershteyn.

In 2007, on the way of these research findings, the World Health Organization and the United Nations Program on HIV/AIDS began to recommend voluntary medical circumcisions in HIV high prevalence countries and low circumcision rates. Shortly after, Pepfar, which is mainly supervised by USAID, intensified efforts to Support male circumcision programs Worldwide, including in Mozambique.

“In the last 18 years, the governments of East and South Africa, where there are high risks among men who have vaginal sex, have started working with Pepfar, global funds and community groups and lawyers to start accessing circumcision,” says Mitchell WarrenExecutive Director of AVAC, a non-profit organization to prevent HIV.

Warren observes that Pepfar and other groups did not focus on the circumcision of men everywhere, but they used data based on data to target specific regions that have high HIV rates and small circumcision-including Mozambic rates. Since 2007, Pepfar has supported 32.5 million voluntary medical circumcisions for men in men and boys.

In Mozambic, the Ministry of Mozambican Health developed a national male circumcision strategy in 2009, with Pepfar support. Conformable Research from US Centers for Disease Control and PreventionBetween 2010-2023, over 2.5 million voluntary medical circumcisions were performed in the country, with 41% in boys younger than 15 years. And among those who received circumcisions, less than 2% were infected with HIV. This research has not yet been reviewed on a peer.

And as opposed to other prevention tools, such as oral pre-exposure prophylaxis (prep) and condoms, as the procedure must be done once, male circumcisions are profitable as HIV prevention. “The investment made in the male voluntary medical circumcision actually pays for itself relatively quickly,” says Bershteyn and can “ease the burden on governments and donor agencies that try to prevent HIV deaths”, because protected people do not require expensive treatments throughout their lives.

Warren says that male circumcision are “one of the best prevention investments (HIV) we have.”

The NPR addressed the State Department for Comments on Trump’s observations, but did not receive a timely response for publication.

Bec Roldan is an independent scientific journalist in Brooklyn, NY, covers topics for health and science and have previously served as Fellow Mass -AAAS Media at NPR.