In the waning days of the cold war when the Berlin Wall was about to fall and the “velvet revolutions” of eastern Europe were confounding Western predictions of a continued multi-generational standoff between the communist block and the Western world, defense contractors were in a panic. Talk about a “peace dividend” was beginning to percolate up in the public discourse. The idea bouncing around the dizzy heads of academics, politicians, and the punditry of the day, was that massive defense budgets and far-flung outposts and the fear that another Vietnam could be foisted upon us at a time or place not of our choosing could all fall by the wayside and make way for investments in neglected inner city schools, health care, and infrastructure of all types.
The defense contractors may have been in a panic, but they were not back on their heels for long. They came up with an argument. The argument depended on an old idea, dating from the age of rapid technological innovation of the 1950s and before. The nutshell version of the argument went like this: a billion dollars spent on weapons research will produce untold and as-yet-unimagined gadgets and technologies for civilian use, and thereby justifies otherwise unjustifiable expenditures. Basically, they said to the US government, “You must fund weapons systems because they advance research and development that would not otherwise advance.” In essence, their argument was a pitch for socialism. Private industry won’t do the research. “So we must. And along the way, we’ll come up with some pretty fantastic new guns and aircraft, too.”
In a system where conflicts of interest are rife and making guns pays better than making butter, the counter-argument never had a chance: whatever civilian gadget the military spun off would cost a fraction of that billion dollars to develop alone.
Circumcision is just like that. This article, which I will not reproduce here, tries to convince that circumcision is a good thing, not solely because it will allegedly save people from HIV infection, but also because it will drive development of infrastructure. And said infrastructure will yield dividends in strengthening health systems and disseminating education on the epidemic. In essence, the greater the demand for circumcisions, the more clinics and trained personnel there will be. And hence, the myriad other services clinics and trained personnel can provide, will be provided. Circumcision is the vehicle for development.
The disturbing part of all this is that the new infrastructure will be used to provide prevention strategies that actually work, raising the general healthfulness of all. But the circumcision campaign will get all the credit and perpetuate on cultural grounds. And here’s the problem: there is no way that once the cultural meme for circumcision gets rooted in society that any discussion of ethical issues will be able to control it. Ethical violations in the form of uninformed consent, enforced conformity, and social pressure to submit, will beget further ethical violations.
And so it goes, long into the future without regard to the trend of HIV/AIDS. The end of the epidemic will leave this destruction in its wake as well.