2 August 2012

MCHIP staff in Lesotho were excited to host Ambassador Eric Goosby, the U.S. Global AIDS Coordinator, at a Program-supported Voluntary Medical Male Circumcision (VMMC) service site at a hospital near Maseru, Lesotho on 4 August. MCHIP/Lesotho has been working in close collaboration with the Lesotho Ministry of Health (MOH) to integrate VMMC services at health facilities throughout the country. Ambassador Goosby met with doctors, nurses, counselors and clients who are coming together to reduce the transmission of HIV from women to men, thereby decreasing the incidence of HIV in Lesotho nationally – currently with an estimated 23% prevalence rate.

[Photo below, from left: U.S. Ambassador Michele Thoren Bond, MCHIP VMMC Technical Advisor Dr. Virgile Kikaya, USAID HIV AIDS Program Director Macarena Garcia, Ambassador Eric Goosby, and VMMC counselors. (Photo courtesy of Jhpiego.)]



In Lesotho, the determination of young men to access these newly available circumcision services is exceptional. The services are being rolled out and provided to clients at no cost in district hospitals. The trend of high demand in Lesotho has been observed since the VMMC program was launched, an effort funded by the United States President’s Emergency Plan for AIDS Relief (PEFPAR) through USAID and implemented by MCHIP.

In contrast to other countries, where rapid scale up of circumcision services has encountered problems due to lack of demand, cultural sensitivities, or insufficient integration with existing health systems, the Lesotho MOH and MCHIP Lesotho’s step-by-step approach is already reaping rewards.

Initiated just six months ago in March of 2012, the program has already passed the 5,000 mark for numbers of circumcisions completed, and providers are seeing no drop in the demand for the services. Such achievements are possible through the strong leadership from the Lesotho MOH, respecting cultural sensitivities around traditional rites of initiation to adulthood (a ritual that includes a form of circumcision), and working with – rather than apart from – the existing health system.

This trend of VMMC uptake in Lesotho has the ability to change the course of the epidemic. Modeling shows that the 5,000 circumcisions just completed in Lesotho will avert 1,000 infections in the future, saving lives as well as millions of dollars in care and treatment.