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Modelling the potential impact and cost of scaling-up male circumcision in resource poor settings: A case of Uganda

Nazarius M Tumwesigye
Fred Wabwire-Mangen
Danstan Bagenda
Freddie Ssengooba
Alex Opio
Christine K Nalwadda
Lori Bollinger
John Stover


This study modelled estimates of the cost and impact of male circumcision (MC) under different scenarios using the Decision Maker’s Program Planning Tool on data from Uganda. Results showed that the number of new adult HIV infections could be reduced by 23 000 if MC could be increased from the current 25% to 80% by 2015. The incidence of HIV could be reduced by 0.2 percentage points over the same period. If a scale up programme is to meet a target of 80% by 2015 then the annual number of MCs performed should be over twice as many as those performed in 2011. The discounted net cost per infection averted would be US$559 for the period 2011–2015 and the country would save US$6 841 per infection. A scale up of MC will reduce HIV prevalence and incidence substantially and it would be highly cost effective. The government should mobilise funding to meet high MC targets that would deliver the desired reduction in prevalence and incidence in a short period of time.

Keywords: Health economics, male circumcision, Decision Maker’s Program Planning Tool, adult HIV infection

African Journal of AIDS Research 2013, 12(1): 63–71

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eISSN: 1608-5906
print ISSN: 1727-9445