(The South African Medical Association sent a letter response last week to NOCIRC-SA—the South African chapter of the National Organization of Circumcision Information Resource Centers— denouncing male infant circumcision as “unethical”and “illegal.” The letter was signed by Ms. Ulundia Berhtel, head of the Human Rights, Law & Ethics unit, and Obo Chairperson of the Human Rights, Law & Ethics Committee.

The South Africa Medical Association (SAMA) letter was in response to a February letter sent from NOCIRC-SA to the Kwa-Zulu Natal Health Department to try and stop the new mass infant circumcision programs. The NOCIRC-SA letter pointed out the legal and ethical consequences of rolling out mass infant circumcision programs for HIV prevention. According to the Children’s Act, children can only be circumcised for “medical reasons” directly related to problems with the foreskin. Circumcision is a serious surgery that is traumatic for the infant, irreversible, and results in a significant loss of sexual sensation and capability. A healthy foreskin is important for normal sexual functioning when the child becomes an adult. Circumcising children for HIV prevention is therefore illegal under the Children’s Act, and children could sue their doctors as adults for the violation of their right to a complete body.

In their February letter to SAMA, NOCIRC-SA highlighted the fact that while there are studies on HIV prevention for circumcised adult males, there are currently no studies in existence on HIV prevention for circumcised infants. NOCIRC-SA holds that it is “unreasonable” and “inhumane” to perform a radical genital surgery on infants 12-14 years before they will become sexually active. These children can be educated on condom use—which provide the best protection against HIV for each time of use, over 99% if used correctly—and in 12-14 years a vaccine for HIV might exist. Any circumcised man having regular unprotected sex over time will ultimately carry the same risk of HIV exposure and increase the risk of his partner, especially if he falls prey to the belief that he is protected from HIV. Already, throughout Africa, men are beginning to believe that they do not need to wear a condom because they are circumcised.

The response letter from the South African Medical Association:
CIRCUMCISION OF BABIES FOR PROPOSED HIV PREVENTION

We refer to the above matter and your email correspondence of 16 February 2011.

The matter was discussed by the members of the Human Rights, Law & Ethics Committee at their previous meeting and they agreed with the content of the letter by NOCIRC SA. The Committee stated that it was unethical and illegal to perform circumcision on infant boys in this instance. In particular, the Committee expressed serious concern that not enough scientifically-based evidence was available to confirm that circumcisions prevented HIV contraction and that the public at large was influenced by incorrect and misrepresented information. The Committee reiterated its view that it did not support circumcision to prevent HIV transmission.