In Fiscal Year 2016 alone, PEPFAR spent over $15 million on VMMC services in Kenya.17 This
architecture drove rapid scale-up but created three perverse incentives: volume targets
disconnected from real demand; per-circumcision mobilizer payments that incentivized
aggressive recruitment regardless of appropriateness; and structural pressure toward data
inflation.
VMMC stakeholders documented how high volume targets and per-
circumcision payments produced pressure to recruit primary school students and employ peer-
pressure mobilization tactics. In 2017, 60% of circumcisions in Kenya were performed on boys
aged 10–14.
Glasklare Genitalverstümmelung von Unmündigen. "Voluntary", freiwillig ist da der Hohn.
Eine widerliche Sauerei ist das. 
USAID OIG quarterly disclosures in June, September, and December 202518 identify an active
investigation of "wide-scale fraud involving the voluntary medical male circumcision program
funded by PEPFAR." According to OIG, this investigation has led to termination of a $105 million
implementing-partner contract (with approximately $52 million unspent at termination) and
separation of one USAID mission employee. The implementing partner has not been publicly
named and the investigation remains active.
All das Geld fehlt bei den tatsächlich wirksamen, sogar hochwirksamen HIV-Bekämpfungsmaßnahmen.
A legitimate question in the era of antiretroviral-driven epidemic control is whether VMMC is still
needed as ART coverage approaches the UNAIDS 95-95-95 targets and long-acting PrEP (pre-
exposure prophylaxis) agents (cabotegravir, lenacapavir) enter the portfolio.
Ja scho, aber es lässt sich doch so schön Geld verdienen mit der Verstümmelei! Was soll denn aus all den Koberern werden?