x Abu Dhabi, UAETuesday 25 July 2017

Circumcision should be covered by insurance: health experts

Experts would support a move to have insurance companies cover male circumcision because of the procedure's medical benefits, including reducing the spread of STDs and the incidence of cancer.

Experts would support a move to have insurance companies cover male circumcision because of the procedure's medical benefits.

Those include reduced incidence of urinary tract infections and decreased risk of penile cancer, said Dr Amin El Gohary, the professor of paediatric surgery at Al Noor Hospital and president of the UAE Paediatric Surgery Society.

"There is no doubt that the incidents of urinary tract infections is far lower in circumcised men," Dr El Gohary said. "There have also been studies where there were no reported cases of penile cancer in circumcised men."

Research also demonstrates a reduced likelihood of developing sexually transmitted diseases and HIV in circumcised men, he said.

"Those who oppose the procedure are looking at it from a purely sentimental point of view and not recognising the positive impact it has on health," Dr El Gohary said.

A series of three studies on 5,000 circumcised adults in Africa have proven the efficacy of the procedure in preventing the formation and spread of sexually transmitted diseased, mainly HIV and the human papillomavirus (HPV).

The studies were conducted by internationally acclaimed medical institutions, including Johns Hopkins and the Rakai Health Science Programme, and were carried out in Kenya, Uganda and South Africa.

The 2007 findings showed male circumcision can reduce the chances of contracting HIV by 60 per cent, HPV by 35 per cent and herpes by 30 per cent.

Results reported last year from the same trial group showed female partners of circumcised men also had a far lower chance of contracting diseases and infections.

Those women are about 30 per cent less likely to contract HPV, the main cause of cervical cancer, and up to 50 per cent less likely to contract bacterial infections.

Dr Aaron Tobian, an associate professor of pathology at Johns Hopkins University and a physician at its hospital, explained why circumcision reduced HIV risks.

"The foreskin contains a high number of T cells and dendritic cells [both involved in the immune system], which HIV targets," Dr Tobian said. "Therefore, by removing it we are significantly reducing the risk of infection."

The results of the study prompted the World Health Organisation to add circumcision to its list of recommendations as an important extra intervention method against HIV.

Despite the findings, medical insurance companies in the UAE and worldwide are reluctant to cover male circumcision unless the procedure is "medically necessary".

In the United States, the procedure is covered by Medicaid, the country's free public health insurance, in only 18 states.

Dr Nabil Mitry, a urologist at Manchester Clinic in Dubai, said some cases that warranted "medical necessity" were those in which the foreskin prevented the individual from passing urine, or where it was inflamed, tight and causing great discomfort.

"However, the procedure should not be taken lightly," Dr Mitry said. "It should be done by a professional doctor to avoid any complications including damaging any of the sensitive glands."

Dr Tobian said: "To come up with similar results across all trials is quite phenomenal. Insurance companies should provide coverage for parents who are educated about the risks and benefits and choose to circumcise their sons."

Given those benefits and the religious demands of the country, doctors in the UAE agree.

"I'm very disheartened by the fact the procedure is not covered by insurance companies, especially in a country where it is seen as a right," Dr El Gohary said.

"Before we look to others, we must value our own identity and the needs that come along with it."

mismail@thenational.ae