Researchers from the Harvard University School of Public Health say that the significant investment that has been made in condom promotion, HIV testing and vaccine research has had limited success in Africa,

The researchers are advocating that male circumcision and reducing multiple sexual partners should become the "cornerstone" of prevention.

This article is the second that has been published in the British Medical Journal that has called for UNAids to be closed because it is distorting health financing.

Roger England is the chair of small Grenada-based think tank, Health Systems Workshop and he feels that too much is being spent on HIV compared with other diseases which kill more people.

Globally HIV causes 3.7% of mortality but received 25% of health aid and England argues that money would be better spent on improving health systems within countries.

More than 125 of the adult population in nine southern African countries are infected with HIV.

There has been widespread promotion about the importance of condom use but this promotion has not had a noticeable effect and no consistent reduction in risk of new infection associated with HIV testing.

Study leader Dr Daniel Halperin said many studies have shown that male circumcision significantly reduces the risk of heterosexual HIV infection.

There were three trials in Africa that were stopped early after showing at least a 60% reduction in HIV risk.

Programmes to promote fewer sexual partners appear to have played a primary role in reducing HIV rates in Uganda, Kenya, Zimbabwe, Cote d'Ivoire, and in urban Malawi and Ethiopia, he said.

"Despite relatively large investments in Aids prevention efforts for some years now, it's clear that we need to do a better job of reducing the rate of new HIV infections," said Dr Halperin who is a lecturer in International Health.

"We need a fairly dramatic shift in priorities, not just a minor tweaking."

Responding to the criticism of UNAids, Paul De Lay, director of the evidence, monitoring and policy department said HIV was and still is an emergency requiring an "unprecedented response".

"Even the best health services in the world cannot tackle AIDS alone.

"AIDS funding can and does bolster health systems more widely-providing wins for both AIDS and health in general."

Michael Carter, spokesperson for Aidsmap said: "There is undoubtedly a growing sense of frustration about HIV incidence figures and this inevitably leads to the search for methods of prevention that appear more effective."

"If we've learnt anything from the past quarter of a century it's to be pragmatic in our approach to HIV prevention."

He added: "Circumcision and partner reduction do have a role and will have greater success in some settings than others."

Lisa Power, head of policy at the Terrence Higgins Trust said: "Different strategies are needed for different countries and with the UK's concentration of HIV in specific populations, targeted work is essential."