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Of dreams and nightmares: implementing medical male circumcision in eSwatini (Swaziland)

Abstract This article uses the accelerated saturation initiative (ASI) Soka Uncobe, which took place in the kingdom of eSwatini in 2011 and 2012, to comment on HIV humanitarian health interventions in Africa. Soka Uncobe, the first ASI on voluntary medical male circumcision, aimed to circumcise 80 per cent of all HIV-negative men aged fifteen to forty-nine years over a twelve-month period. Using written and verbal accounts, I draw attention to the dreams and hopes behind the design of the initiative. I also highlight the dynamics of the implementation of Soka Uncobe, and, in doing so, I chart the path to its ultimate failure by showing the reluctance of the implementation partners (based mainly in the global North) to take seriously what have now become well-known critiques of why humanitarian interventions fail. Ultimately, I suggest that, despite having the potential to produce some critical results, Soka Uncobe was no different from previous transnational humanitarian health interventions. Thus, an exposé of why it failed is pivotal to this article about the dreams that underpinned the first ever ASI related to medical male circumcision.