Health DG enters the legal fight over circumcision device

Health Director-General Dr Sabelo Buthelezi has filed an affidavit supporting the National Treasury’s decision to award a circumcision device tender to CircumQ. Illustration: Lisa Nelson

• Health Director-General Dr Sabelo Buthelezi has filed an “explanatory” affidavit supporting the National Treasury’s decision to award a circumcision device tender to CircumQ.
• Rival bidder Unicirc has gone to court to challenge the award, disputing claims that the device is safe.
• Buthelezi claims the device has been used for over a year in five Gauteng health districts with only “mild adverse effects”.

Director-General of Health Dr Sabelo Buthelezi has entered the legal fray over the award of a tender for a circumcision device to be used to circumcise boys between the ages of 10 to 14 in provincial health centres.

While the department has not formally opposed the application brought by a losing bidder, Unicirc, Buthelezi has put up what he says is an “explanatory affidavit” in which he supports the decision by the treasury to award the tender to CircumQ. He says it “is going to save millions of people’s lives” through the prevention of the spread of HIV/Aids.

Unicirc claims that the CircumQ device is untested and unsafe, and wants the court to order that the tender process begin afresh. But Buthelezi says the device has been used for more than a year in five health districts in Gauteng with only “mild adverse affects”.

“I consider this a success,” he said. “Any disruptions will have a detrimental impact on the smooth running of the programme and will result in many young men not being able to acquire these essential services. I can only state that the rule of law must prevail,” he said, noting however, that he would abide by the decision of the court.

In a further affidavit filed by Unicirc, its director Dr Cyril Parker accused Buthelezi of “actively opposing” the application when no notice of opposition or other papers had been filed.

He said the Gauteng report Buthelezi refers to “runs to just eight slides including front and back covers” and provides very little information.

“We are not told, for example, anything about the manner in which the data was collected, what definitions of mild and severe adverse affects were used, how many clients were circumcised in total, including those circumcised using other methods,” Parker said.

He said there was also a “complete lack of detail” regarding the ages of clients. In Unicirc’s application, it had raised specific concerns about the use of the CircumQ device on boys aged ten to 14.

He said the claimed 3,560 circumcisions accounted for a mere 6.76% of the total number of circumcisions completed in one year, “strongly suggesting that the take-up of the device has been particularly slow”.

The report put up by Buthelezi was of “little use to the court”, Parker said, noting that it had been produced long after the tender had been awarded.

Parker claimed that one of the key differences between the two devices was that CircumQ still required suturing which posed significant health risks while the Unicirc device did not, and it could be used safely by a trained nurse in about 20 minutes.

Unicirc was also much further along the pre-qualification process for World Health Organisation approval.

“The DG is taking sides,” Parker said. “For a party claiming to be non-partisan, the DG appears to go to great lengths in defence of both CircumQ and its device.

“National Treasury ought to have taken the following facts into account in awarding the tender: the lack of reliable data establishing that the device is fit for purpose and the risk of harm, both to boys and the Voluntary Male Circumcision Programme (VMCC) as a whole, associated with using an unproven surgical aid.

“Should our application result in any disruption, it would be for good cause,” Parker said.

He said he agreed that the matter needed to be resolved urgently and his lawyers intended to apply for a preferential date for a hearing in the Pretoria High Court.

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