It’s easy to overstate a case for this or that outcome when looking into the future. However, it is worth asking whether events could potentially overtake the fight against HIV/AIDS itself, in which case circumcision will have little meaningful effect anyway.
To most who read this blog, you may be wondering what on earth I am talking about.
First, let’s consider the most likely positive development that could overtake HIV/AIDS and the push for circumcision from the perspective of HIV/AIDS prevention. The obvious event that would render the debate moot is the development of a highly efficacious vaccine. Vaccines are far easier to deliver and roll out than circumcising vast numbers of men and boys. Moreover, a vaccine or vaccines are a universal response to the epidemic. Men, women, and children all benefit immediately from them.
The other positive and possible but in my opinion less likely event would be a sudden and committed effort to fund, encourage acceptance, and roll-out proven HIV/AIDS prevention technologies: universal access to condoms, testing, needle exchange, and treatment. This seems unlikely to me, as I have watched for 25 years, more than my entire adult life, while stated commitments have come and gone and the situation has worsened [edit: in the developing world. Great success has been achieved in the developed world with condoms, health education, testing, and treatment]. At least vaccine research continues apace and some major discoveries have occurred albeit without a breakthrough.
On the negative side, I believe there is one looming, slow motion catastrophic event that coupled with a couple of other major worldwide problems will moot much of the debate over HIV/AIDS.
Global warming is the obvious calamity that may come to mind. While the debate rages over the causes, nobody doubts that climate change is afoot. The predictions of habitability of parts of the earth range from mild to dire. But even this isn’t the issue I believe will most affect the world and especially places where HIV/AIDS, tuberculosis, malaria, and even cholera kill large numbers of people.
To get to the point, I direct you to an article that explains the effects of the end of the oil age that the world faces.
One word about the source. The Oil Drum [main site] is the effort of many very committed minds on the topic of Peak Oil [contributors]. Rather than provide my own synopsis, here [from EnergyBulletin.net] is a good overview of what this is all about and why it may matter more than the average person thinks:
Peak Oil is the simplest label for the problem of energy resource depletion, or more specifically, the peak in global oil production. Oil is a finite, non-renewable resource, one that has powered phenomenal economic and population growth over the last century and a half. The rate of oil ‘production,’ meaning extraction and refining (currently about 84 million barrels/day), has grown in most years over the last century, but once we go through the halfway point of all reserves, production becomes ever more likely to decline, hence ‘peak’. Peak Oil means not ‘running out of oil’, but ‘running out of cheap oil’. For societies leveraged on ever increasing amounts of cheap oil, the consequences may be dire. Without significant successful cultural reform, economic and social decline seems inevitable.