Valley of Life or Death

At the heart of the AIDS epidemic in Africa, there is a deadly mystery that has puzzled scientists for years. There are groups of people who are four times less likely to get HIV than other people, sometimes living just yards away, across a single valley - people with apparently similar behaviour and lifestyle. Scientists realised that if they could understand why these people are so much less vulnerable to the HIV virus, it might lead to an answer that could save millions of lives. And after 15 years of detective work it turns out there may be a remarkably simple answer: the high risk areas for HIV coincide with tribes who are uncircumcised. In Africa, it seems a man is much more likely to get HIV if he is uncircumcised. In Kaoma, Western Zambia, a young boy is on his way to the sacred Mukondaa - the tribal circumcision ground. Around him the tribal elders are gathered, dressed in their ceremonial garb, and vivid masks. But the young boy himself is an outsider, not from this tribe, and none of his relatives or ancestors have ever been circumcised. In fact, his parents are only prepared to break the taboo of their own tribe because they believe that circumcision could save his life by protecting him from AIDS. At first sight this belief seems like the kind of superstition to which desperate people often turn in times of plague. But now there is scientific evidence that suggests these people could well be right. There have now been twenty seven statistical studies that show a big difference in HIV infection between circumcised and uncircumcised men. For example, among the uncircumcised people of Kisumu in Western Kenya, a man is three times as likely to get AIDS than his circumcised neighbours. Among truck drivers in Mombasa the difference is four-fold. Horizon travels across Africa, tracing the work of scientists who have unearthed the statistical data behind this correlation. At the same time microbiologists have been battling to understand the complex and insidious virus, and their work indicates that the foreskin may be a key entry point for HIV. The logical conclusion for these scientists is that if you remove the foreskin, you begin to protect the man. No-one believes that circumcision can protect completely - the evidence so far only indicates that it reduces the risk of infection by HIV, and then only during heterosexual sex. Unquestionably, condoms are still the best protection. But in the many countries where the use of condoms is minimal, it seems that circumcision might help to reduce the spread of AIDS. In the absence of a vaccine for AIDS, and the lack of condom use in the developing world, should governments think the unthinkable and encourage the circumcision of young boys in non-circumcising tribes as a public policy? Opposing this idea are the voices of tribal elders who are loath to change tribal traditions that have existed for generations, and a fierce Western anti-circumcision lobby which believes that circumcision is a form of mutilation and violates basic human rights.

Other episodes for this season

Breath of Life
Episode 1 - Breath of Life
The Lost City of Nasca
Episode 2 - The Lost City of Nasca
The Diamond Makers
Episode 3 - The Diamond Makers
Supervolcanoes
Episode 4 - Supervolcanoes
Miracle In Orbit
Episode 5 - Miracle In Orbit
Complete Obsession - Body Dysmorphia
Episode 6 - Complete Obsession - Body...
Is GM Safe?
Episode 7 - Is GM Safe?
Planet Hunters
Episode 8 - Planet Hunters
Moon Children
Episode 9 - Moon Children
Mega-tsunami: Wave of Destruction
Episode 10 - Mega-tsunami: Wave of Des...
Conjoined Twins
Episode 11 - Conjoined Twins
The Lost World of Lake Vostok
Episode 12 - The Lost World of Lake Vo...
Vanished: The Plane that Disappeared
Episode 13 - Vanished: The Plane that...
The Secret Treasures of Zeugma
Episode 14 - The Secret Treasures of Z...
Valley of Life or Death
Episode 15 - Valley of Life or Death
Extreme Dinosaurs
Episode 16 - Extreme Dinosaurs
Supermassive Black Holes
Episode 17 - Supermassive Black Holes
The Boy who was Turned into a Girl
Episode 18 - The Boy who was Turned in...
Atlantis Reborn Again
Episode 19 - Atlantis Reborn Again