Governments should take ownership of VMMC programs says AVAC

By Michael Gwarisa

To ensure the sustainability of Voluntary Medical Male Circumcision (VMMC) programs in the face of dwindling donor support and donor fatigue, African governments have been urged to fund and promote VMMC programs.

Since VMMC was recommended by WHO and the UNAIDS in 2007 as key to HIV prevention in high prevalence settings, about 35 million men have accessed services across 15 VMMC priority countries in Eastern and Southern Africa.

However, since inception, VMMC programs have been largely financed by donors and Multilateral funding agencies amidst indications that funding from these organisations towards VMMC is standing at US$167 Million.

Speaking during a plenary session of Advancing Integrated Biomedical Prevention: Best Practices in Zimbabwe, Angelo Katumba, a Senior Program Manager at AVAC said they together with several partners came together to develop a Call to Action on VMMC where they highlighted key areas that need urgent attention to put VMMC back on track to pre-COVID-19 levels.

The Call to Action message includes Leadership and Governance, Finding and sustainability, Health Service Delivery, Global and Regional Advocacy, Partnership and Collaboration, Innovation and Commodities, communication and Demand Creation and Strategic Information and accountability.

We have come with eight Call to Action messages the key message here is that the job is not yet done and there is a need to accelerate VMMV for HIV prevention. For example for the ministries of health, we are calling on them to take ownership of the VMMC programs and absorb them into their domestic funding and funding mechanisms as a step toward sustainability,” said Katumba.

He also called on governments to monitor policy implementation, programmatic progress and financial commitments and report these on an annual VMMC leadership scorecard.

He also urged civil society to spearhead efforts culminating in a concrete social impact.

While Multilateral funding agencies are currently contributing US$167 Million toward VMMC, there Call to Action to have them increase support to at least US$250 Million per annum. An additional dedicated fund for innovation and research should be established to guide and promote novel approaches to VMMC for greater efficiency and effectiveness over the next five years.

“Ministers of finance and health must commit to an incremental increase in domestic funding for VMMC over the next two fiscal years, with a clear timeline and milestone for implementation. The private sector must actively participate as a significant partner in co-funding VMMC commodities and create mechanisms that tap private medical insurance as a means of sustainable funding.”

Meanwhile, Dr Brian Maponga, the Director of Health Systems Acceleration and Project Lead • Population Solutions for Health (PSH) in Zimbabwe said they were implementing a project dubbed integrate which is supporting HIV biomedical prevention.

“We are supporting the transition of the vertical VMMC program to a locally drive program. We are expecting outcomes of this project where we are looking at testing, demonstrating and communicating sustainability models which can maintain VMMC coverage and can be applied more broadly,” said Dr Maponga.

The UNAIDS underscored two main challenges faced by voluntary medical male circumcision (VMMC) programmes which include diminished funding and low coverage among men in their twenties and older. While there is good progress in VMMC, the Global AIDS update highlights that VMMC coverage remains far from reaching the 90 percent global coverage target for impact in many subnational areas of priority countries.

Additionally, funding has declined by almost half since 2020 from approximately US dollars 285 million to US dollars 147 million for the 15 countries funded by the United States President’s Emergency Plan for AIDS Relief (PEPFAR). However, questions have arisen about VMMC’s cost-effectiveness under growing coverage of other biomedical interventions, such as antiretroviral treatment.

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