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So the issue of circumcision in India today is more than a matter of public health—it taps into the diverse nature of Indian society itself, underscoring the deep religious and cultural differences dividing a country with a sometimes bloody history of coexistence. On top of this, the circumcision controversy also raises the issue of global sensitivity—in a society that, generally speaking, reveres modesty and shuns public expressions of sexuality, how do public health officials tackle the HIV epidemic that threatens to ravage India, while remaining respectful of cultural norms?

There are certainly no easy answers. If India avoids frankly discussing sex, heterosexual and homosexual, it will be allowing at-risk individuals to die in the name of cultural sensitivity. The Indian officials who allow cultural taboos to stand in the way of indisputable information on HIV are doing a great disservice to the 8.5 million seropositive Indians.

At the same time, non-Indian public health officials must understand that only continued dialogue with their South Asian counterparts will reveal appropriate ways of disseminating necessary information to a billion Indian citizens. Western public health organizations, which usually exceed their South Asian counterparts in terms of budget, resources, and manpower, often lack the local knowledge and training they need to effectively and appropriately communicate. As a glimmer of hope, we can point to the South Asian organizations that seem to understand the need to fuse solid information with cultural sensitivity. Home-grown, desi (Indian) groups working with sex workers in Mumbai and Kolkata have proved that it is possible to create an honest environment for discussing sex in a spirit of besharam, “without shame.”

As for the divisive foreskin, the Lancet article will have to be discussed frankly and openly among its authors and supporters, and among Indians themselves, both Hindu and Muslim. If current studies underway in Africa corroborate this link between foreskins and HIV, only an honest weighing of the benefits and drawbacks of circumcision will generate responsible policy.

Benjamin Siegel is a junior majoring in History at Yale University.