Njeuhmeli, E., Forsythe, S., Reed, J., et al. PLOS Medicine (November 2011), 8(11), doi.org/10.1371/journal.pmed.1001132.
This study used the Male Circumcision Decision- Makers’ Program Planning Tool to predict the cost and impact of scaling up voluntary male medical circumcision (VMMC) in 13 countries in eastern and southern Africa where VMMC is considered a priority (Botswana, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia, Zimbabwe, and Nyanza province in Kenya). The calculations were based on epidemiologic and demographic data from each of the countries, and the cost of each procedure, which ranged from USD$65 to $95, was calculated according to World Health Organization supply-side models for optimal volume and efficiency. To attain 80 percent coverage in these countries would require over 20 million circumcisions between 2011 and 2015, and 8.4 million more in the subsequent decade to maintain coverage at that level. Modeling showed that if coverage at this level could be achieved, it would avert more than 3.3 million new HIV infections, with USD$16.5 billion in cost savings on care and treatment.