The World Health Organization is set to approve expanded use of an Israeli developed device that allows medical workers to perform “painless circumcisions.”
The PrePex device, created by Israel-based Circ MedTech, will be granted WHO prequalification on May 31 for use with males age 13 and above in 14 African countries.
Circumcision, the WHO says, is one of the most effective ways to prevent the spread of AIDS – which, despite a recent drop in numbers, still affects tens of millions in Africa. There are currently nearly 30 million people suffering from HIV, the root cause of AIDS, in sub-Saharan Africa – an area that accounts for almost 70% of the global total of new HIV infections.
Research and experience, says the WHO, shows that medical male circumcision, when safely provided by well-trained health professionals, reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. Thus, circumcision can play an important role in preventing the spread of HIV. But “selling” circumcision to adult men is, perhaps understandably, difficult.
Among the reasons, the organization has found, is because of the pain associated with circumcision. Although the procedure should generally be done in a hospital, there aren’t always proper facilities available; in the countryside, the operation may be done in a clinic, without sufficient anesthesia.
Enter PrePex – the first and so far only nonsurgical male circumcision device, according to Circ Medtech CEO Eddy Horowitz. The device requires “no injected anesthesia, no surgery, no sutures, no sterile settings,” he said.
The PrePex is actually a rather low-tech device, consisting of plastic and rubber rings that are placed on the penis and using pressure to separate the foreskin from the head of the penis. The elastic pressure ring is applied to the foreskin, cutting off distal blood flow. After a week, the foreskin falls off, and the wound is treated with a salve.
In studies conducted by the company in association with the WHO, the system has “confirmed that PrePex is safe and effective when performed by physicians and nurses, offering a virtually bloodless procedure that requires no needles (no injection of anesthesia), no knives, no sutures, a non sterile environment. The most recent study also confirmed that training for the procedure is simple and can be conducted by trained nurses in a fast and effective manner. In total, over 90% of the procedures conducted to date, were by nurses,” the company said of its WHO-approved study.
The results were sufficiently positive for the WHO to grant the device prequalification status for use on adults over the age of 18 in 2013, and now for adolescents. The qualification service is provided by WHO to assess the quality, safety and efficacy of medicinal products that makes it easier for nongovernmental organizations to use public money to buy the devices. To date, more than 125,000 PrePex procedures have been conducted in 12 countries: Botswana, Kenya, Lesotho, Malawi, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia, Zimbabwe and Indonesia. More than 11 national Training Centers are located across Africa, training local healthcare professionals, according to the company.