Saturday, July 2, 2022

Male Circumcision clinics closing down for lack of funding

Botswana’s HIV/AIDS is facing a crisis of its own as the American Centre for Disease Control funded Jhpiego announced to staff that it was closing down its Voluntary Safe Male Circumcision clinics due to lack of funding last Thursday.

Staff to be affected include doctors, nurses and support staff. At this point it is not clear how many health care workers will be affected, but a rough figure of about 18 has surfaced.

Sources told the Sunday Standard that they were scheduled to meet with the Jhpiego Country Director on Friday, but could not get details to the meeting before press time.

“We have just been told that there isn’t any funding to continue with the programmes and that Jhpiego is pulling out of the SMC programme. We have also been made to understand that our superiors are talking to the Ministry of Health to see if we cannot be absorbed back into the system,” said a health professional who requested anonymity.

Indications are that SMC sites in Mahalapye and Selibe-Phikwe will be the first causalities.

There are five US- funded VMMC clinics in the country. The Jhpiego clinics were part of the U.S. government’s assistance for Botswana to achieve its National Safe Male Circumcision Strategy to help prevent the spread of HIV/AIDS in Botswana. This strategy, which was mooted and enacted in 2007 was one of the ways the government hoped would realize goals of not having any new HIV Infections by the year 2016 by ensuring that 80 percent of HIV negative men would be circumcised by that year.

As recently as November 2012, the US Embassy in Botswana donated a Safe Male Circumcision (SMC) facility to the Mogoditshane Clinic. The P500,000 building was specially designed to cater for all aspects of the SMC program such as pre and post-operative care rooms, space for group education, counselling and HIV testing.

Jhpiego, which is a Non-governmental organization, began working in Botswana in 2006 where they conducted a Safe Male Circumcision facility readiness assessment. In the process, they assessed 58 clinical sites across the country to determine their ability to provide SMC services in accordance with good clinical practices and standard operating procedures.

According to information from organisation’s website, Jhpiego has been in the forefront of HIV/AIDS interventions war by carrying out several projects that included a situational analysis for the care and treatment needs of people living with HIV and AIDS and worked with the Ministry of Health (MOH) to implement a Training Information Monitoring System (TIMS) database that captures and reports training information. Currently, Jhpiego is implementing two CDC-funded programs in Botswana: 1) developing health worker capacity through high-quality pre-service education, and 2) expanding SMC services to prevent HIV transmission.

In May 2009, an online Journal on the International Aids Society which published an article on “The cost and impact of male circumcision on HIV/AIDS in Botswana” estimated that a total net cost of US$47 million would be needed to ensure that the SMC programme delivers results of reaching 80% coverage of adult and neonatal circumcision by 2012.

“This results in an average cost per HIV infection averted of US$689. Changing the target year to 2015 and the scale-up pattern to a linear pattern results in a more evenly-distributed number of MCs required, and averts approximately 60,000 new HIV infections through 2025,” read the article, in part.

This “add-on strategy” augmenting on-going government its efforts to reduce HIV prevalence, together with a significant increase in the provision of antiretroviral therapy (ART) in Botswana is expected to have impact on HIV prevalence levels.


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