The PEPFAR ripple effect

Nov 14th, 2011 3:17 PM UTC
By ONE Partners

Heidi Wilson, VP of Programs at SAI and ONE member, writes about The Luke Commission, a PEPFAR-funded organization that helps prevent HIV through male circumcision and HIV/AIDS counseling and testing.

About a month ago, I went to Swaziland to provide consultation to a husband and wife team that provides mobile clinic services to rural Swazis. Their organization, The Luke Commission, is a faith-based program that employs more than 20 Swazi health educators. In addition to providing free comprehensive health care to rural Swazis with limited access to services, The Luke Commission, or TLC as they are also known, is working feverishly on HIV/AIDS prevention.

The Luke Commission holds 50 mobile outreach clinics per year, reaching an average of 500 patients per clinic. It’s a place where Swazis can receive testing, counseling and treatment initiation for HIV. This is huge. Swaziland has the highest prevalence of HIV in the world (42 percent among pregnant women, 25.9 percent of people overall). To support their work, The Luke Commission receives PEPFAR funding for male circumcision and HIV/AIDS counseling and testing.

According to the WHO, male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 percent. Because of this, WHO/UNAIDS recommends that male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence. Although not a silver bullet, it is part of a comprehensive approach that includes testing, counseling, treatment, and the promotion of safe sex practices.

Typically, USAID’s policy is to circumcise males between the ages of 15 to 49, as one part of a comprehensive HIV/AIDS program. However, with encouragement from PEPFAR, the Raleigh Fitkin Memorial Hospital in Manzini, has led the way on infant circumcision, circumcising all male children born at the hospital since 2009 unless the parents opt out. This is a health facility delivering 8,000 babies a year where half of the women are HIV-positive). Prevention of mother to child transmission is now complemented with infant circumcision.

This represents a huge cultural shift in Swaziland, instigated by PEPFAR support.

PEPFAR funding doesn’t just support individual programs, it’s altering the way communities practice prevention…for the better. A PEPFAR dollar spent ripples through a community. Cutting PEPFAR won’t just shrink programs, it will stop the ripples that are beginning to make real progress in the worst hit countries in the world.

For more information about male circumcision in Swaziland, click here.

Photo credit: The Luke Commission

TAGS: From Our Partners, HIV/AIDS, ONE