Two articles by Garenne (2023a,b) argue that voluntary medical male circumcision does not reduce human immunodeficiency virus transmission in Africa. Here we point out key evidence and analytical flaws that call into question this conclusion.

Even though antiretroviral therapy (ART) access for human immunodeficiency virus (HIV)-infected children increased dramatically, anaemia has continued as a challenge regardless of a cluster of differentiation (CD4) count and viral load. Hence, the present study aimed to assess the determinants of iron deficiency anaemia among children living with HIV after the initiation of ART. An institution-based unmatched case–control study was conducted among consecutively selected 712 children on HIV care from 1 September to 30 October 2022 in the Metekel zone. A pre-tested and structured data extraction checklist was used to collect the data. Data were analysed using STATA version 16 software. Binary logistic regression was used to find the association between independent variables and anaemia. The level of statistical significance was declared at a value of P < 0⋅05. A total of 712 HIV-positive children (178 cases and 534 controls) were included in this study, with a completeness rate of 98⋅8 %. In multivariable analysis, variables that have a statistically significant association with anaemia were as follows: CD4 count <350 (Adjusted Odds Ratio [AOR] 2⋅76; 95 % CI 1⋅76, 4⋅34), World Health Organization (WHO) clinical stage III (AOR 7⋅9; 95 % CI 3⋅5, 17⋅91) and stage IV (AOR 7⋅8; 95 % CI 3⋅37, 18⋅1), cotrimoxazole prophylaxis therapy (AOR 0⋅5; 95 % CI 0⋅31, 0⋅8) and mid-upper arm circumference (MUAC) ≤11⋅5 mm (AOR 2⋅1; 95 % CI 1⋅34, 3⋅28). The present study found that CD4 count, WHO clinical stage, cotrimoxazole prophylaxis therapy and MUAC were significantly associated with anaemia in children on ART. Therefore, continuous screening of anaemia and nutritional treatment is essential in these patients.

Engaging communities is a key factor in efficient response to public health emergencies (PHE). Previous and recent outbreaks have shown that civil society organizations (CSOs) can mobilize the communities to better prepare and respond to a PHE. Consequently, the World Health Organization (WHO) Regional Office for Africa (AFRO) implemented an initiative to partner with community leaders by engaging CSOs. The Civil Society Organization Initiative (CSO Initiative) aims to work directly with well-established community-based organizations to accelerate whole-of-society preparation and response. Twenty-three CSOs from 12 WHO African Region Member States have been supported financially and technically to implement effective community-based interventions to respond to the coronavirus disease (COVID-19) pandemic. After 1 year of implementation (2021), the successes, challenges, and recommendations for maximizing future engagements with CSOs are outlined. As the COVID-19 outbreak is again underlining, partnering with established CSOs to engage diverse social groups from various communities can help provide a timely and efficient response to a PHE.