

Project Director Prince Hillary Maloba’s landmark speech in Kimilili, Kenya. 2 February, 2016.

I do believe there is an element of cultural imperialism among members of circumcising groups who believe they have something important to share with “primitive” non-circumcising cultures.

—Tim Hammond

Human rights advocate

What is VMMC?

“Voluntary medical male circumcision” (VMMC) is the policy term for the world’s first mass surgical campaign, targeting Africans. It is based on three controversial clinical trials that were conducted and promulgated from 2002 to 2007. Its goal is to create and maintain an 80% male circumcision rate throughout the African continent.

Per WHO data, >25 million men and boys were circumcised in the VMMC campaign between 2008 and 2018. Because many men refuse circumcision, “early infant male circumcision” (EIMC) was added to the VMMC agenda in 2016. EIMC is administered by UNICEF.

The problem

It doesn’t help. It kills.

VMMC is often portrayed as a simple surgical solution to the African HIV/AIDS epidemic. Africans have found that this is not the reality. Many cite ethical and human rights issues within the campaign. Others observe that newly circumcised men and their partners are infected with HIV at a higher rate than those who were left alone.

Finding higher HIV prevalence among VMMC participants than uncircumcised men in the HAALSI cohort in South Africa in 2018, Harvard researchers concluded:

The impression given from circumcision policy and dissemination of prior trial findings that those who are circumcised are safer sex partners may be incorrect[.]

Also in 2018, President Yoweri Museveni broke his silence on the circumcision campaign as an HIV accelerator in Uganda, and became the first African politician to speak out against it.

Western public health agencies are endorsing VMMC to curb the spread of HIV by 50–60%. To that end, they are actively misinforming Africans that circumcision is protective against HIV (the “surgical condom” myth). This false security has substantially contributed to the HIV epidemic. In Malawi, the national HIV rate is reported to have doubled from 10% to 20% in the first year VMMC was implemented. In Uganda where we conducted our investigation, the downward trend in HIV rate was reversed over the early years of VMMC roll-out.

UNAIDS’ 2016 Prevention Gap Report states:

Declines in new HIV infections among adults have slowed, threatening further progress towards the end of the AIDS epidemic. Since 2010 [shortly after VMMC roll-out], the annual number of new infections among adults has remained static.

A Lancet article conveyed the tone of the 2016 International AIDS Conference:

[T]he mood was sombre as the goal of an end to AIDS receded.

Few have called out the probable cause of the unprecedented rise in new HIV infections that has plagued sub-Saharan Africa in recent years. The VMMC Experience Project is committed to presenting the view on the ground.

The Western public health community has yet to acknowledge the harm that VMMC is causing to its subjects, their partners whose HIV risk may be increased, and non-medically circumcised men exposed to the misinformation that circumcision provides protection against HIV. Many have become infected or died of AIDS believing they were protected by circumcision.

Background

VMMC was approved as a means of reducing HIV/AIDS in sub-Saharan Africa by a network of policymakers in the West. Critics have opposed the circumcision campaign due to weaknesses in the clinical trials that are used as its basis, and on ethical and practical grounds. However, the discourse on VMMC has been largely confined to the Western world where the body of VMMC-promoting literature only grows.

By 2014, six million men and children had been circumcised without follow-up, yet the global public had not heard a word from them. The VMMC Experience Project was established that year to give a voice to the people affected by the campaign. Our aim is to empower the most frequently overlooked contingent in the African circumcision regime: Africans.

Setting

We conducted interviews from 1–16 February, 2016 in Busia, Kumi, Pallisa, Tororo, and Soroti Districts.

Our focus was on three traditionally non-circumcising tribes targeted by VMMC: the Luo tribe in western Kenya (a predominately circumcising country), and the Bagwere and Iteso tribes in eastern Uganda. The Luo tribe faces ethnic discrimination for being uncircumcised, including barring from public office and forced circumcision attacks from the neighbouring Luhya tribe. The Bagwere and Iteso tribes have no cultural context for circumcision.

Interviews were conducted in English, Swahili, Dholuo, Teso, Lugwere, Luganda, and Samia languages.

What’s a mucous membrane anyway? Click here to see our analysis of VMMC science.