Attempting to integrate VMMC into existing State and Public Health Circimcision programs only to achieve targets in Southern African countries is unobtainable. It is absolutely essential to also involve the Private Healthcare sector to reach targets.
gomcoThe re-usable Gomco Clamp consists of several parts that can be mis-matched, causing possible increase in complications.
Curnently, if every HIV-positive person in Southern Africa (around 22million) would be on ARV's at the cost of $100 per year with the new daily ARV Regime of $9 per month, this would ad about $2 billion per year to the current cost of the 32-year AIDS epidemic in Southern Africa.
ARV's, once started, need to be taken lifelong. Infra structucture needs to be established for Monitoring and Distribution.

If not taken regularly, therapy will fail, Resistence to Medication developed to Medication, and Pro-Viruses may become activated

According to the Framework for Clinical Evaluation of Devices for Adult Male Circumcision (WHO, 2011):

"WHO and other health authorities wish to identify one or more devices that

  • would make the VMMC safer, easier, and quicker
  • would have more rapid healing than current methods and/or might entail less risk of HIV transmission in the post-operative period
  • could be performed safely by health-care providers with a minimal level of training and
  • would be cost-effective compared to standard surgical methods for male circumcision scale up."
There is increasing pressure on the already overburdened Health Services, to commence HIV-positive patients earlier on ARV'S. ARV initiation, according to 2010 Treatment guidelines, is to commence ARV treatment at CD4 counts of 350 cells or lower. In June 2013, the WHO recommends raising the CD4 counts to 500 cells per microlitre of blood. This means, that treatment should start at a much earlier stage of infection.

Forceps Guided Surgical Circumcision

Surgical Circumcision requires high level of surgical skills, is time-consuming and costly. It has a high rate of minor complications, like Haematoma, bleeding, infection and delayed healing.