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I'm really confused right now. Over half of that money 18.5 billion, was donated to the "male circumcision consortium" so they can circumcise people in Africa. Is that really such an important issue that it became the recipient of one of the largest donations in the history of the world?

I'm certain that I must be missing something.




A quick Google search turns up this page[1] that lists the donation as "18.5 million to establish the [MCC]". That figure would make much more sense compared to the other figures.

[1] http://www.wellsphere.com/men-s-health-article/bill-gates-do...

Edit: Try this Google search. The real number is almost certainly 18.5 MILLION, which makes this table total up to about 18 billion dollars instead of 37 billion. It's amusing how people are jumping through hoops to force this 18.5 billion figure to make sense rather than looking for a citation. (But rest assured that lists assembled by Internet blogs are reliable sources of information.) I'm sure we'll start seeing this "fact" start turning up in research essays and other linkbait blogs.

https://www.google.com/search?q=bill+gates+donation+male+cir...


That makes more sense. For 18.5 billion, I wouldn't think there'd be a single person on the continent of Africa that wasn't circumsized.


For 18.5 billion, I'd be surprised if they had anything left.


I am also astonished by that number, but circumcision certainly seems to be an important way of fighting HIV.

"There is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60%."[1]

"Evidence among heterosexual men in sub-Saharan Africa shows a decreased risk of between 38 percent and 66 percent over two years"[2]

But Circumcision Rates in Africa are relatively high anyways, due to the population's religious background.[3]

Quote of New York Times Article: [4]

"Among those are 14 studies that provide what the experts characterize as “fair” evidence that circumcision in adulthood protects men from H.I.V. transmission from a female partner, cutting infection rates by 40 to 60 percent. Three of the studies were large randomized controlled trials of the kind considered the gold standard in medicine, but they were carried out in Africa, where H.I.V. — the virus the causes AIDS — is spread primarily among heterosexuals. "

"Other studies have linked male circumcision to lower rates of infection with human papillomavirus and herpes simplex Type 2."

" The procedure has long been recognized to lower urinary tract infections early in life and reduce the incidence of penile cancer."

So i guess it just all adds up in a way.

That being said, the number of over 18 billion Dollars (according to the article) being spent on this issue still astonishes me...

[1] http://www.who.int/hiv/topics/malecircumcision/en/

[2] https://en.wikipedia.org/wiki/Circumcision#Sexually_transmit...

[3] https://upload.wikimedia.org/wikipedia/commons/7/79/Global_M...

[4] https://www.nytimes.com/2012/08/27/science/benefits-of-circu...


> So i guess it just all adds up in a way.

It seems to "add up" only for experts from countries that do it traditionally (USA, Turkey, Israel) and recommend it, while basically no European country deems it medically necessary to recommend it, because there it is not traditionally practiced. In some European countries, like Sweden, Germany and Finaland, recently there were even attampts to legally consider circumcision as genital mutilation.

For me most of those 60% studies seem to be some sort of rationalisation based on a predetermined outcome: Let's find some strained statistical "evidence" that this stone age ritual that we are practicing, is somehow medically beneficial, so we can continue to cut our kids genitals to look like their father's without a bad conscience.

> There is compelling evidence that ... by approximately 60%

Did you ever read one of these 60%-papers yourselves and evaluated their reasoning, at how they arrive at their whopping 60%?

Their evidence is btw, even if published in medical journals, completely non-medical. All of those studies just claim that their strained stats show it, but they do not explain why. There is no established chain of causation and even the correlation is doubtful.

Here is a list of counter-arguments, basically claiming that the pro-arguments have been faked by circumcision proponents, many of them (like Prof Brian Morris who authored sevaral of these papers) being "circumfetishists", engaging in circumcisions for sexual pleasure, or having a Jewish background.

[1] http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf

[2] http://www.circleaks.org/index.php?title=Main_Page

[3] http://www.circumstitions.com/

[3.2] http://www.circumstitions.com/HIV-SA.html

[3.1] http://www.circumstitions.com/HIV.html

[3.3] http://www.circumstitions.com/HIV-SA-garenne.html


Is there a chance this is a case of correlation studies reported as causation by the media?

I find it unconvincing that it might protect against HIV. Personal incredulity and the endorsing of the WHO aside, how does that work?


The general theory is that circumcision causes a change in the membrane and "microbiomes" around that part of the penis.

I still struggle, however, to believe that a truly controlled study could ever be conducted and I wonder if the money wouldn't be better spent just providing condoms and sexual education to these at risk groups. We already know that condoms are very, very good a reducing HIV transmission rates, plus they work for both partners (circumcision studies only show reduced transmission to men from women), and also consistent use can reduce the risk of cervical cancers, HPV and unwanted pregnancies. In a way, studies and campaigns that focus on circumcision are unethical if they don't also provide access to this highly effective device.

But going back to the studies, the problem I have understanding them is that there is, as far as I'm aware, no way to perform a placebo circumcision. Any adult who has a circumcision is surely likely alter his behavior or perhaps take greater notice of the sexual education he received alongside the circumcision. Or, perhaps he may have the superhero effect, thinking he can have more unprotected sex? That's the part that makes it hard for me to believe that studies are controlled. And for those studies that look only at populations that perform infant circumcisions, it seems even more likely that differences in cultural, religious or social norms of each population would have just as much influence as the operation.

If anyone has details on how these studies control for confounding factors like that, I'd be interested to hear.


> how these studies control for confounding factors like that

The answer is: they simply do not at all.

[1] http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf

[2] http://www.circumstitions.com/HIV-SA.html


This should get you started: http://scholar.google.com/scholar?q=circumcision+aids

I'm not an expert on the field, but it does seem a bit controversial.


Some of these studies are contested http://samj.org.za/index.php/samj/article/view/5384/3655

Also, the fact that HIV rates in (mostly uncircumcized) Europe are lower than (mostly circumcized) US is confusing.


The coloring on the Wikipedia picture is horrible and is essentially the equivalent of this optical illusion.

http://en.wikipedia.org/wiki/File:Gray_square_illusion.png


It's a typo, and their supporting link is borked.

Try million instead of billion: http://www.wellsphere.com/men-s-health-article/bill-gates-do...


Easy win for reducing the spread of STDs (AIDS) in a place where contraception is taboo for a lot of the population.


Seems kind of crazy. How much would it cost to cure AIDS or develop affordable treatments? He is treating many of the symptoms from which people suffer in the world. However, accelerating the advancement of science and medicine might be a better goal. There's probably lots of redundant medical research for example. Take some of the money and help fund a new era of open medical research.


Pretty sure he does that too through the Bill and Melinda Gates Foundation.

Quick look at the wiki page says that among many global health issues, the Foundation hands out hundreds of millions in grants for AIDS research on condition that findings be public. It's notably also involved in the development of Malaria vaccines like RTS,S, the first anti-parasitic vaccine in history, I believe.


aids


Thanks. I Learned something new today. I had no idea that male circumcision reduces the chances of contracting HIV, but it does.

http://www.engenderhealth.org/our-work/major-projects/male-c...




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