Circumcision device made in China gains approval of WHO

The World Health Organization authorized the prequalification to a male circumcision device made in China, which is expected to contribute to the global fight against HIV/AIDS.

The WHO announced on Wednesday that the ShangRing - named after its Chinese inventor, Shang Jianzhong - meets acceptable standards of quality, safety and efficacy for male circumcision.

"The prequalification of ShangRing is highly exciting. It's a great example of Chinese innovation. The prequalification by the WHO is another example of the increasing role China is taking in global health," said Bernhard Schwartlander, the WHO Representative in China.

According to Schwartlander, the ShangRing is the first Chinese-manufactured device of its kind to have been WHO-prequalified, and only the second such device to be WHO-prequalified globally.

The ShangRing is a disposable device that consists of two concentric rings that clamp together and expose the natural foreskin of the penis in such a way that it can be removed surgically, but with minimal bleeding.

The ring is removed seven days after the surgery when the wound has healed. Different from the conventional surgery, the procedure doesn't require stitches, and the patient is allowed to bathe and only requires oral antibiotics.

The use of the ring also cuts the procedure time to about three to five minutes from about 30 before.

"This new device will be especially valuable and helpful in low resource settings given that it does not require the use of hospital facilities for surgery. It's a highly practical solution," Schwartlander said.

WHO's list of prequalified medicinal products is used by international procurement agencies and increasingly by countries to guide bulk purchasing of medicines.

"The significance of circumcision has already shown in some African countries since the surgery has been widely promoted in the region gradually in the past decade," said Philip S. Li, associate research professor of urology at Weill Cornell Medical College of Cornell University.

Li and his colleagues have conducted clinical trials and researches on the ShangRing for years in Africa since 2009.

Clinical trials, many done in sub-Saharan Africa, have demonstrated that circumcision reduces HIV/AIDS infection risk by 50 to 60 percent in the population at risk.

Infection rates have plummeted in recent years because of public education campaigns by governments that emphasize condom use and the arrival of new antiviral drugs, African health authorities say.

No data are available on the circumcision rate in China, but anecdotal evidence from the medical community suggests that less than 5 percent of males are circumcised. Most suffer no problems from diseases.

But the new circumcision ring could help some people.

"With the WHO's prequalification, the ShangRing will rapidly spread its benefits worldwide and provide a cheaper and effective solution to the global HIV/AIDS control," said Cheng Feng, program director of Research Center for Public Health at Tsinghua University.

Contact the writers through yangwanli@chinadaily.com.cn