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The Israeli innovations leading the global fight against AIDS

Young men in Rwanda holding the PrePex device
With ‘making the impossible possible’ attitude, Israelis are changing how world deals with this health crisis

The thousands of new immigrants who arrived in Israel from the Former Soviet Union in the 1990s may not be aware of it, but they have helped play a big role in the global fight against HIV/AIDS.

While this may seem a little farfetched, there is a perfectly good explanation behind it. Due to the influx of immigrants from the Former Soviet Union, Israeli scientists and researchers gained a wealth of experience in adult male circumcision because of the need to carry out the procedure on many men who were considered Jewish under Israel’s Law of Return but did not necessarily have a circumcision as babies as is customary according to Judaism.

To meet the high demand, Israeli hospitals at the time set up special circumcision clinics in five hospitals throughout the country.

The combination of practical needs on the ground and Israeli determination has since led to a number of Israeli innovations being influential in helping to prevent the spread of HIV/AIDS across the world.

In 2007, the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) began advocating male circumcision as a means of preventing HIV transmission after studies had found that circumcision reduces the risk of heterosexually-acquired HIV/AIDS infection by up to 70%. It was decided that if 20 million men could be circumcised by 2015, 3.4 million cases of HIV would be prevented and 16.5 billion dollars saved in reduced health care costs.

Due to the experience Israeli medical experts gained in carrying out circumcision procedures on adult males in the 1990s, a delegation was sent from Israel to Africa in order to address the issue.

Despite the huge challenges such as poor facilities in Africa, there not being enough physicians on the ground and the reluctance of adult males to go through this painful procedure, a group of Israelis decided to take on the challenge and help make a real difference.

Five urologists and entrepreneurs joined forces and came up with PrePex, a non-surgical device that is safer, faster and less expensive than any surgical male circumcision methods or devices. The technology behind this simple yet extremely effective device was developed by Circ MedTech Ltd., a global social enterprise combining innovation and technology into healthcare solutions. While surgical circumcision procedures are generally costly, painful and time consuming, the PrePex device is safer, faster and cheaper than surgery. It allows male circumcision to be conducted with no bleeding, no cutting of live tissue, no stitching, no injected anesthesia and no need for physicians or surgery rooms.

PrePex has become so popular that it is now used in 12 countries around the world and last year PrePex's CEO Eddy Horowitz and his team accepted a prestigious prize for the device's contribution to humanity, at the 2015 Tech Awards - “the Oscars of Silicon Valley."

“The reaction to PrePex in Africa has been overwhelmingly positive, Adi Kadussi, marketing director at Circ MedTech Ltd, tells i24news. “PrePex is proof that it’s possible to change the perception of the ancient practice of male circumcision. “Innovation, creativity and thinking outside the box have led us to developing a solution to one of the greatest global healthcare challenges - preventing HIV," she adds. “As we develop smaller sizes for infants and children, PrePex has the potential to improve lives all over the world.”

When explaining why Israelis have played such a big part in the development of such technologies, Kadussi says that they are a very motivated people. “Nothing can stand in their way,” she says. “Israelis have this attitude of turning the impossible into the possible thanks to their willpower. They are not afraid of challenges - every difficulty is a challenge to them.”

Enabling men to continue with their daily life while going through the procedure has made PrePex highly popular among men. “There are plenty of men who talk about how it changed their lives,” Kadussi says. “Even celebrities have used it, including one famous musician in Zimbabwe who went up on stage while wearing the device under his clothes.” He was able to this because the device is discreet, causing no bulges under the man’s clothing. Following application, an Inner Ring surrounded by an Elastic Ring is worn by the man for seven days. During this time, radial elastic pressure gently compresses the foreskin, inhibiting blood supply and causing the foreskin to die and then the device together with the necrotic foreskin tissue is safely removed.

The team behind PrePex are not the only Israelis helping to lead the fight against HIV/AIDS.

Last month two Israeli scientists said they had reached a breakthrough in destroying cells infected with the HIV virus. Prof. Abraham Loyter and Prof. Assaf Friedler of the Hebrew University in Jerusalem claimed to have found a method that will kill cells infected with the virus without harming the entire body, thereby curing the HIV carrier.

The research was so successful that the Zyon Pharmaceutical Company signed an exclusive agreement with Hebrew University to develop the life-changing medication.

The scientists were able to develop peptides, which cause many copies of the HIV virus' DNA to enter the cell, instead of the usual one copy. This process leads to an activation of the cell's self-destruction mechanisms, thereby killing the cell and preventing a spread of the virus in the carrier's body.

A couple of months prior to that, Israeli scientists from Ben-Gurion University made a revolutionary breakthrough in researching HIV when they discovered similarities between HIV and leukemia.

Dr. Ran Taube of the department of microbiology, immunology and genetics at the university in the southern Israeli city of Beersheba said the discovery would lead to a "revolutionary diagnosis and the key to the clinical solution that will prevent infection with HIV and will destroy the deadly virus."

Working with Dr. Uri Rubio of Soroka University Medical Center, Taube has explained that the research aims to stamp out AIDS and slow the progress of a rare mixed-lineage leukemia (MLL) that mostly occurs in children.

With Israelis having already played such a massive part in the global fight against HIV/AIDS, it will be interesting to see what other developments and innovations come out of the country in the near future.

Yonathan Cohen is an i24news web editor



Circumcision is a dangerous distraction in the fight against AIDS. From a USAID report: "There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher." http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf (this will include men who were circumcised tribally rather than medically, but they and their partners may also believe themselves to be protected, and the whole rationale for the RCT's into female-to-male transmission was a purported correlation between high rates of male circumcision and low rates of HIV) It seems highly unrealistic to expect that there will be no risk compensation. The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups "believe that circumcised men do not need to use condoms". This figure seems to have been unchanged in 2012. http://www.info.gov.za/issues/hiv/survey_2009.htm http://www.hst.org.za/sites/default/files/ZANationalHIVCommunicationSurvey2012.pdf http://jhhesa.org/sites/default/files/hiv_survey.pdf It is unclear if circumcised men are more likely to infect women. The only ever randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract ABC (Abstinence, Being faithful, and especially Condoms) is the way forward. Promoting genital surgery seems likely to cost African lives rather than save them. Recent news from Botswana: "There is an upsurge of cases of people who got infected with HIV following circumcision." http://www.gabzfm.com/circumcised-men-still-run-risk-hiv-infection and from Zimbabwe: "SOME circumcised men are contracting HIV and Aids after ditching the use of condoms, under a misguided belief that male circumcision (MC) would prevent them from getting infected" http://www.thestandard.co.zw/2013/11/10/circumcised-men-indulge-risky-sexual-behaviour/ and from Kenya: "Push for male circumcision in Nyanza fails to reduce infections" http://www.standardmedia.co.ke/?articleID=2000093293&story_title=push-for-male-circumcision-in-nyanza-fails-to-reduce-infections from Uganda: "A new study of 314 female sex workers (FSWs) in Makindye division found that more than half of respondents falsely believe that once a man is circumcised, protection is not necessary during sex." http://www.observer.ug/index.php?option=com_content&view=article&id=33658 and from Malawi: "According to the report, HIV rates have doubled in Malawi moving from 10% to 20% in 1 year. Strangely, this has been the same period that Malawians have been manipulatively forced to go through circumcision in masses with the promise that it reduces the contraction of HIV." http://malawi24.com/2015/08/04/circumcision-disaster-malawi-hiv-infection-rate-doubles/

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