By Rodney Muhumuza, Special to The Kansas City Star

After a study showed that circumcision reduces the incidence of HIV infection in men, circumcision providers in Uganda have been enjoying brisk business.

The drumbeat for circumcision has been so loud that by December, when a document detailing the official “circumcision policy” is made final, authorities may have no reliable estimate of how many Ugandans have heeded the call. What’s more, Uganda’s born-again attempts to curtail a resurgent AIDS crisis would have been done no favors.

How did we get there? It’s complicated.

Uganda was long hailed as a beacon of hope in the AIDs battle, for its success in bringing down the HIV prevalence rate from double digits in the early 1990s to as low as 5 percent by 2001. Such was Uganda’s reputation that it soon became a global exemplar of what it took to credibly fight AIDS.

The problem is that the figure didn’t keep going down, with prevalence rates in some parts of the country now much higher than the national average of about 6 percent. And by some accounts that figure is inaccurate, as the rate is said to be rising fast.

Today, the Kampala government’s willingness to embrace mass circumcision as a viable tool in the AIDS battle captures the desperation that has come to define Uganda’s AIDS outlook. In fact, the hysteria says less about what can be done to control the situation and more about what was not done but should have been. The missed opportunities are staggering.

Nearly all households in Uganda, including mine, have lost someone to AIDS. For the younger generation of Ugandans, however, the stories of the human losses may sound distant, in large part because fewer people die of AIDS today.

With more Ugandans accessing treatment, the debilitating effects of the disease are no longer as obvious, much less imagined. The tough message that AIDS kills, the prevention-rich mantra that was responsible for Uganda’s old success, has been lost at the altar of a policy that subtly emphasizes treatment.

Some critics allege that health authorities in Uganda sold their souls to the wallets of the pharmaceutical companies, but it may well be that they simply took a success story for granted. The authorities deny both accusations.

Ugandan health authorities previously fought AIDS with an attitude that proclaimed the fear of AIDS was the beginning of wisdom.

The evidence shows that it worked, with millions of Ugandans embracing the so-called ABC, a strategy that called for abstinence or fidelity or the use of condoms. But somehow that message stopped being mainstream. What happened to all the street posters that preached prevention? Though it’s hard to say that ABC has reached its tipping point, and even as it remains clear that the old prevention messages no longer are nearly as ubiquitous as they once were, the conversation has suddenly turned to circumcision.

The resulting crusade makes a mockery of a serious situation, a campaign whose ideas fly in the face of common sense.

In America, most babies are circumcised at birth; in Uganda and elsewhere in Africa where circumcision is catching on, old men are undergoing the procedure to avoid catching HIV. It’s ridiculous. As a strategy, circumcision doesn’t inspire changed behavior, the very essence of ABC.

It discounts the idea that a once-high prevalence rate dramatically went down because more Ugandans were compelled to revise their sexual behaviors. Beyond perverting ABC, a circumcision-based strategy ignores why the rate is rising again.

Until circumcision’s actual benefits and limits are made clear to everyone, illiterate or not, a circumcision drive that’s linked to HIV prevention is bound to be a spectacular failure. The comedians in Kampala know it when they claim that circumcision can cure AIDS. They measure the pulse of the country.

Rodney Muhumuza, a Ugandan journalist, is an Alfred Friendly Press Fellow at The Kansas City Star. To reach him, call 816-516-9707 or send e-mail to