ABSTRACT
This chapter compares responses to the global voluntary male medical circumcision (VMMC) initiative in two small southern African countries Lesotho and Swaziland. These two countries are particularly instructive, as their realities contradict the evidence upon which global VMMC policy was established both countries have heavy HIV burdens but contrasting male circumcision (MC) practices. In the US and the UK, MC fell out of favor given limited scientific evidence of its value. Despite a strong opposition movement in the 1960s, MC was re-medicalized in the US as a common procedure in neonates. An initial rapid assessment and cost-effectiveness analysis was conducted in 2007 in Lesotho, following the World Health Organization (WHO) endorsement of VMMC, with a full situational analysis completed in 2008. The case of VMMC as a new HIV prevention strategy presents itself as a global endeavor an interconnectedness of ideas, interpretations, and reflexivity across national borders and geographical and ideological boundaries.
