Director-General of Health Dr Sabelo Buthelezi has entered the legal argument over the award of a tender for a device to be used to circumcise boys between the ages of 10 to 14 in provincial health centres, writes Tania Broughton for GroundUp.
While the department has not formally opposed the application brought by a losing bidder, Unicirc, Buthelezi has submitted what he calls an “explanatory affidavit” wherein he supports Treaury’s decision to award the tender to CircumQ. “It is going to save millions of people’s lives through the prevention of the spread of HIV/Aids,” he said.
Unicirc claims 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 noted, however, that he would abide by the court’s decision.
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 to which Buthelezi refers “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 were 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, adding that 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 10 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 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.
See more from MedicalBrief archives:
Treasury defends tender for allegedly “untested” circumcision device
Court battle over ‘unsafe’ circumcision device
Penile rehab programme for botched circumcisions