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US extends funding ban on circumcision of babies in Kenya

Circumcision of babies; US government has maintained its money should not fund the circumcision of babies in Kenya.

Although the US President’s Emergency Plan for Aids Relief (Pepfar) has refused to finance early infant male circumcision for the third year in a row, uptake has been encouraging.

Kenya has received Sh39.17 billion ($345 million) from Pepfar for HIV prevention efforts.

The funds will be spent in 2023, with Sh489 million going toward voluntary medical male circumcision.

Pepfar explained its decision by claiming that unfavorable injuries to neonates following circumcision were five times higher than in boys aged ten and up, and twice in teenagers aged 15 and up, according to data.

This data, on the other hand, is compiled from all 50 Pepfar-supported countries, all of which are affected by the embargo.

Past studies on infant circumcision in Kenya show such adverse effects are extremely low and within the acceptable range.

“Safety is the primary consideration in VMMC programmes. The minimum age of eligibility for VMMC remains 15 years old,” Pepfar said in its current guidance for countries planning to utilise the current grants.

The letter adds: “However, not all 15-year-olds will have reached physical maturity and any client with immature genitalia should not be circumcised.”

Male circumcision prevents the risk of men contracting HIV by about 60 per cent.

Pepfar added that boys should also be able to give informed consent.

“Health care providers should strive to postpone non-emergency invasive and irreversible interventions like VMMC until the adolescent is sufficiently mature to provide informed consent,” Pepfar said.

Kenya introduced early infant male circumcision in 2014 after it was endorsed by the United Nations Children’s Fund and World Health Organization (WHO) for long term HIV prevention.

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The long-term aspiration of Kenya was to ensure circumcision of babies is available in all Maternal-Newborn-Child Health (MNCH) facilities especially in non-circumcising counties.

Recent assessments indicated that adverse events remained at around 0.3% EIMC, well below the planned cut-off of 2%.

By 2019, the EIMC program in Kenya aimed to circumcise at least 40% of all early male infants who came into contact with EIMC facilities within 60 days of birth.

However, in 2021, one survey found that just 17.4 percent of babies were circumcised, significantly less than the 40% target.

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