- Email: [email protected]
Fiona Fox
Perspectives
On Reflection Certainty on circumcision?
Lunch with The Lancet Fiona Fox
Male circumcision may be one of the oldest and most common surgical procedures in the world, but longevity and frequency are no guarantee of acceptability. I visited Zambia recently to write about efforts being made to roll out adult male circumcision, after the landmark trials in South Africa, Kenya, and Uganda between 2005 and 2007 that showed it reduced transmission of HIV by 50–60%. My piece in The Independent sparked a flurry of negative responses from bloggers complaining the trials had been fixed and the surgery amounted to assault. Yet when the same piece was reprinted in the Times of Zambia, the response was positive—indeed, many African readers complained the operation was not being rolled out fast enough. Neonatal circumcision, done mostly for religious or cultural reasons, raises different concerns. In recent decades, most medical organisations in the west have deemed the practice not medically necessary, except in rare cases. But now arguments are being made for the protective effect of circumcision against other sexually transmitted infections, including human papillomavirus (HPV) and herpes simplex virus (HSV), as well as HIV. Indeed, The American Academy of Pediatrics has established a taskforce to examine its policy on circumcision and a similar investigation is underway in Australia. But in the UK no review is planned. Why? The procedure is much more popular in the USA than the UK—65% of US men are circumcised versus 16% in the UK. Although rates in both countries have been declining, if there are benefits from circumcision the UK would seem to have more to gain. But the Royal College of Paediatrics and Child Health says it does not intend to follow its US counterpart by establishing a working party to examine the issue, because heterosexual transmission of HIV is not a major problem in the UK (and there is no evidence circumcision protects men who have sex with men), a vaccine against HPV is currently being rolled out, and HSV is a smaller problem in the UK than in the USA. So no government is likely to reckon the cost of removing 300 000 foreskins a year worth the money. Although circumcision may be hard to justify at the population level, at the individual level there is now a clear medical benefit to the surgery, in addition to whatever religious or other function it fulfils. There remains, of course, the thorny issue of consent. The US and Australian reviews should make interesting reading.
Sitting in the offices of The UK’s Science Media Centre (SMC) in central London, awaiting my lunch date with its Director, Fiona Fox, I watch her busily negotiating with a UK national newspaper not to break an embargo on an upcoming story. Such is daily life at the SMC, which hosts near-daily press conferences on a wide range of science and health issues. Indeed, Fox and her team have hosted many of the biggest science stories of recent years. The SMC, an independent body funded by 80 different organisations, began work in 2002, 3 years after a UK parliamentary committee had concluded that scientists could not engage effectively with the media. Fox, who had no science background but had worked as a press officer in various organisations, applied to be the SMC’s founding director. After an interview grilling from eminent scientists including geneticist Robert Winston, she got the job. “There was a culture of scientists writing letters to editors, complaining after a story broke”, recalls Fox. “Our remit was to convince them the shouting from the sidelines wasn’t enough—they had to take responsibility for media coverage, not hide from it. And when scientists do this, they are usually pleased with the result.” The SMC offers media training for scientists, including meet the media days where they come face-to-face with UK national journalists in an informal setting. Fox and her colleagues also provide expert comment on just about any science or health subject. “There are far less journalists nowadays, but with much more space to fill. By providing them with expert comment, we are giving it to them on a plate—but what they are getting is fair, balanced, journalism”, says Fox. Raising the alarm over UK Government policy changes that could be detrimental to research is another of the SMC’s roles. Under Fox, the SMC has grown to a team of six and its success has led to the creation of SMCs based on the UK model in Australia, New Zealand, and soon, Canada. Fox is soon to face one of the biggest and most enjoyable challenges of her career—she is a key member of the team running the World Conference of Science Journalists, in London, UK, from June 30 to July 2. UK Minister of Science Paul Drayson and Lancet editor Richard Horton are among those who will take part. Fox describes the event as “a conference by science journalists, for science journalists and those interested in science journalism”. Fox concludes our lunch with a message to researchers nervous about engaging with the media: “Scientists engaging with the media inevitably makes a story better than it would be otherwise.”
For more on The UK’s Science Media Centre see http://www. sciencemediacentre.org/pages
For more on the World Conference of Science Journalists see http://www. wcsj2009.org/
Jeremy Laurance [email protected]
Tony Kirby [email protected]
www.thelancet.com Vol 373 June 13, 2009
2017
On Reflection Certainty on circumcision?
Lunch with The Lancet Fiona Fox
Male circumcision may be one of the oldest and most common surgical procedures in the world, but longevity and frequency are no guarantee of acceptability. I visited Zambia recently to write about efforts being made to roll out adult male circumcision, after the landmark trials in South Africa, Kenya, and Uganda between 2005 and 2007 that showed it reduced transmission of HIV by 50–60%. My piece in The Independent sparked a flurry of negative responses from bloggers complaining the trials had been fixed and the surgery amounted to assault. Yet when the same piece was reprinted in the Times of Zambia, the response was positive—indeed, many African readers complained the operation was not being rolled out fast enough. Neonatal circumcision, done mostly for religious or cultural reasons, raises different concerns. In recent decades, most medical organisations in the west have deemed the practice not medically necessary, except in rare cases. But now arguments are being made for the protective effect of circumcision against other sexually transmitted infections, including human papillomavirus (HPV) and herpes simplex virus (HSV), as well as HIV. Indeed, The American Academy of Pediatrics has established a taskforce to examine its policy on circumcision and a similar investigation is underway in Australia. But in the UK no review is planned. Why? The procedure is much more popular in the USA than the UK—65% of US men are circumcised versus 16% in the UK. Although rates in both countries have been declining, if there are benefits from circumcision the UK would seem to have more to gain. But the Royal College of Paediatrics and Child Health says it does not intend to follow its US counterpart by establishing a working party to examine the issue, because heterosexual transmission of HIV is not a major problem in the UK (and there is no evidence circumcision protects men who have sex with men), a vaccine against HPV is currently being rolled out, and HSV is a smaller problem in the UK than in the USA. So no government is likely to reckon the cost of removing 300 000 foreskins a year worth the money. Although circumcision may be hard to justify at the population level, at the individual level there is now a clear medical benefit to the surgery, in addition to whatever religious or other function it fulfils. There remains, of course, the thorny issue of consent. The US and Australian reviews should make interesting reading.
Sitting in the offices of The UK’s Science Media Centre (SMC) in central London, awaiting my lunch date with its Director, Fiona Fox, I watch her busily negotiating with a UK national newspaper not to break an embargo on an upcoming story. Such is daily life at the SMC, which hosts near-daily press conferences on a wide range of science and health issues. Indeed, Fox and her team have hosted many of the biggest science stories of recent years. The SMC, an independent body funded by 80 different organisations, began work in 2002, 3 years after a UK parliamentary committee had concluded that scientists could not engage effectively with the media. Fox, who had no science background but had worked as a press officer in various organisations, applied to be the SMC’s founding director. After an interview grilling from eminent scientists including geneticist Robert Winston, she got the job. “There was a culture of scientists writing letters to editors, complaining after a story broke”, recalls Fox. “Our remit was to convince them the shouting from the sidelines wasn’t enough—they had to take responsibility for media coverage, not hide from it. And when scientists do this, they are usually pleased with the result.” The SMC offers media training for scientists, including meet the media days where they come face-to-face with UK national journalists in an informal setting. Fox and her colleagues also provide expert comment on just about any science or health subject. “There are far less journalists nowadays, but with much more space to fill. By providing them with expert comment, we are giving it to them on a plate—but what they are getting is fair, balanced, journalism”, says Fox. Raising the alarm over UK Government policy changes that could be detrimental to research is another of the SMC’s roles. Under Fox, the SMC has grown to a team of six and its success has led to the creation of SMCs based on the UK model in Australia, New Zealand, and soon, Canada. Fox is soon to face one of the biggest and most enjoyable challenges of her career—she is a key member of the team running the World Conference of Science Journalists, in London, UK, from June 30 to July 2. UK Minister of Science Paul Drayson and Lancet editor Richard Horton are among those who will take part. Fox describes the event as “a conference by science journalists, for science journalists and those interested in science journalism”. Fox concludes our lunch with a message to researchers nervous about engaging with the media: “Scientists engaging with the media inevitably makes a story better than it would be otherwise.”
For more on The UK’s Science Media Centre see http://www. sciencemediacentre.org/pages
For more on the World Conference of Science Journalists see http://www. wcsj2009.org/
Jeremy Laurance [email protected]
Tony Kirby [email protected]
www.thelancet.com Vol 373 June 13, 2009
2017