The Centers for Disease Control Need to Hear from You Today

UPDATE: At the end of this post is a list of key people to contact at the CDC and the AAP. Your voice is important. Please write the people speaking in your name.

I urge everyone who believes it is a mistake and a tragedy for the Centers for Disease Control to recommend neonatal circumcision to fight the spread of HIV/AIDS to write a letter to the director of that agency today. I also urge you to cc your Senate and Congressional representative.

Julie Louise Gerberding, M.D., M.P.H. [follow link for background on the director]
Director, Centers for Disease Control and Prevention
Office of the Director
Centers for Disease Control and Prevention
1600 Clifton Rd
Atlanta, GA 30333

[For those interested in where this is all coming from, there was a conference in the last few weeks that unfortunately I was not following that resulted in two very important presentations. The first was a study by Millett et al. [pdf document, link to abstract here] that confirmed the Sydney study that male circumcision has no value for gay men, who are the major risk group. Then there was this presentation that seems to recommend mass infant male circumcision anyway on a cost-effectiveness basis. No human rights issues were discussed or apparently even contemplated in recommending genital surgeries on children.]

This is my letter.

December 10, 2007

Julie Louise Gerberding, M.D., M.P.H.
Director, Centers for Disease Control and Prevention
Office of the Director
Centers for Disease Control and Prevention
1600 Clifton Rd Atlanta, GA 30333

RE: Recommendations viz neonatal male circumcision and HIV

Dear Dr. Gerberding:

I have learned with grave concern that you and the Centers for Disease Control are considering recommending neonatal circumcision as public health policy in the effort to stem the spread of HIV/AIDS in the United States. I oppose this recommendation in the strongest possible way.

Neonatal circumcision has run into national grassroots opposition from a sizable and highly active group of people for at least the last 25 years. This opposition on human rights grounds has resulted in the major medical organizations gradually moving away from support of a marginal procedure that damages sexual response and violates the individual human rights of the infants on the receiving end.

Whatever marginal gain individuals may receive from male circumcision must be in the context of informed consent and voluntariness. Infants can provide neither. The variables involved in the effectiveness of such a procedure over the longer term are many, including the changing dynamics of the disease, changes in provision of healthcare impacting cost-effectiveness, the possibility of new treatments, prevention technologies, and eventually a vaccine. Male circumcision has not served the United States well heretofore in comparison with non-circumcising countries and regions where the HIV/AIDS rate is much lower, e.g. Japan, most of Europe, and Latin America.

I urge you to reject neonatal male circumcision as public health policy in order to safe guard your credibility with the American people and throughout the world. The United States can ill-afford another dubious policy with scant input from American stakeholders.

Very truly yours,

/DWilton/

DAVID WILTON, Esq.
Editor
http://www.circumcisionandhiv.com/

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Below are addresses and emails for key people at the CDC and the AAP. Please both e-mail and snail mail letters to the addresses below.

Here are the emails:

julie.gerberding@cdc.hhs.gov
patrick.sullivan@cdc.hhs.gov
peter.kilmarx@cdc.hhs.gov
thomas.peterman@cdc.hhs.gov
allan.taylor@cdc.hhs.gov
allyn.nakashima@cdc.hhs.gov
mary.kamb@cdc.hhs.gov
lee.warner@cdc.hhs.gov
timothy.mastro@cdc.hhs.gov
stephanie.bailey@cdc.hhs.gov
stephen.blount@cdc.hhs.gov
kevin.fenton@cdc.hhs.gov

EAlden@aap.org
bioethics@aap.org
executivecommittee@aap.org
Jay.Berkelhamer@choa.org

Julie Louise Gerberding, M.D., M.P.H.
Director, Centers for Disease Control and Prevention
Office of the Director
Centers for Disease Control and Prevention
1600 Clifton Rd
Atlanta, GA 30333

Timothy Mastro, M.D.
Division of HIV/AIDS Prevention
CDC
Mail stop D21
Corporate Boulevard
Atlanta, GA 30329-1902

Renée Jenkins, M.D., President, AAP
Professor and Chair
Department of Pediatrics and Child Health
Howard University Hospital
2041 Georgia Ave, NW, Room 6B02
Washington, DC 20060
executivecommittee@aap.org

Jay Berkelhamer, MD, FAAP, Past-President, AAP
Children's Health Care of Atlanta
1600 Tullie Circle
Atlanta, GA  30329
Jay.Berkelhamer@choa.org

David T. Tayloe, Jr., MD, President-Elect, AAP
2706 Medical Office Pl
Goldsboro, NC 27534

Errol Alden, MD, Executive Director
American Academy of Pediatrics
141 Northwest Point Blvd,
Elk Grove Village, IL 60007
EAlden@aap.org

Comments

[Joe]

Where did you hear that the CDC are considering recommending neonatal circ?

[Gillian]

There was a presentation by CDC epidemiologist Peter Kilmarx on “Male Circumcision and HIV Infection” at last week's National HIV Prevention Conference in Atlanta.

You can see his slide presentation at the condensed link below. See especially Slides 29 and 30, in which the CDC states that the "benefits of neonatal circumcision outweigh [the] risks," and in which "coordinat[ion] with the AAP" is planned.

People at the AAP need to get letters too.

http://tinyurl.com/27a8zw

[IntactwhitemaleUSA]

Pardon me for saying this, but isn't it obivious? Big pharma wants a steady stream of infant prepuces for adult stem cell use. They'll probably get what they want. No better case could be made that the for-profit medical system here in the US is fatally flawed beyond repair: we need some form of medical reform that largely divorces medicine from profit.
Also, a parallel that I've been loath to make thus far: unfortunately, we have a vested interest here in the USA in keeping the drug war going. It's sad, and destroys so many communities from the inside-out, but we can't stop now!!! What are we going to say, "we're sorry" to the millions of addicts that the justice system has thrown in jail over the last 30+ years? We should have been more humane, or thought up a better system of treatment?
Sadly, we are truly becoming more like the wild west every day: everyone has to take responsibility for protecting themselves and their loved ones, because the authorities either can't or won't. Back in the days of the wild west, America was a no-wheres-ville on the world stage. And, it seems, that where we're headed back to.