If there were a new AIDS vaccine that could lower infections in women by 30% and in men by 2/3, we'd be hailing a global breakthrough. But there may be a more prosaic strategy that can achieve these reductions: circumcision.

According to the New York Times, circumcision has demonstrated, through admittedly incomplete tests, to be a powerful preventative measure. A 2002 USAID analysys reviewing 28 studies suggested a 50% reduction in infections among circumcised men. A French government study in South Africa suggested a two thirds reduction. A WHO study involving 8,000 people in Kenya and Uganda is currently underway, with preliminary results as early as June.

The fact that circumcision is unglamorous compared to vaccine or other interventions shouldn't stop us from moving the study of circumcision to the very top of the AIDS prevention research agenda.

The General Accounting Office yesterday issued a review of PEPFAR prevention programs. Titled "Spending Requirement Presents Challenges for Allocating Prevention Funding under the President’s Emergency Plan for AIDS Relief", the report reviews the PEPFAR requirement that 33% of prevention funding be spent on abstinence programs. The report highlights implementation problems this creates, and suggests additional reporting rules as well as limitations to the laws application.