Yet, the gap between the number of condoms needed and the number of condoms available is staggeringly high. In 2005, UNFPA estimated that at least 17.5 billion condoms were needed for HIV prevention and family planning. However, only 10.4 billion condoms were distributed that year – 22% of those through donor support (http://www.avert.org/condoms.htm). Male condoms make up the vast majority (99.6%) of globally distributed condoms. As a result, the condom gap for female condoms is even greater. In sub-Saharan Africa, for example, female condoms are only available at a rate of one for every 300 women per year.
Why is there a condom gap?
Donor support is a contributing factor. In low- and middle income countries, almost one in four people depend on donor-financed condoms to meet their HIV prevention and family planning needs. However, funding for condoms has stagnated in recent years – despite the fact that funding for the HIV response increased dramatically until 2008 (from $ 1.6 billion in 2001 to $15.6 billion in 2008). Donors appear to have lost interest in condoms and are shifting their resources and attention to newer and seemingly sexier issues.
In 2008, for example, donors spent $80 million on purchasing male and female condoms, while investments in research and development for an HIV vaccine and microbicides reached more than $1.1 billion (http://www.aidsmap.com/page/1435164). In their search for new methods, donors have overlooked condoms, which already exist as an effective prevention method and need to be scaled up. The choice to fund either new prevention research or condoms is a false dichotomy (often promoted by donors) and should not be the reason to neglect comprehensive and sustainable condom programming.
National governments often also fail to include commodities in their national budget, or reduce the money for condoms to fill gaps in other budget lines. IPPF Member Associations in Bangladesh, Tanzania, Uganda and Mexico took on this issue, and – through targeted advocacy – helped to increase government and state funding for reproductive health supplies by $11.5 million between 2008 and 2010. Such measures are all the more important as donors are now increasingly providing development aid through basket funding and budget support.
But there is more to the condom gap than funding for the commodity alone. Condom programmes need to be comprehensive in their approach to both supply and demand – ensuring quality, sound storage and distribution, and effective promotion. These components are often overlooked, or not carried out properly. This has resulted in inadequate supply and stubbornly low utilization figures.
With a growing population and the largest generation of young people in history becoming sexually active, the need for condoms is expected to increase significantly over the coming years. For the condom gap to be narrowed, efforts need to be exponentially expanded –by fully integrating condoms into existing HIV and sexual and reproductive health strategies and programmes.
As part of the UNAIDS Interagency Task-Team (IATT) on Comprehensive Condom Programming (CCP), SUPPORT and IPPF are working with UNFPA and other organizations to scale up global and national efforts. The IATT has developed a 10-step approach for CCP, and is finalizing guidance on strategic planning, training, demand generation and monitoring and evaluation. Moreover, SUPPORT offers pro-bono technical assistance to develop and implement programmes to increase the availability of - and access to - male and female condoms.
Useful Internet resource:
• UNFPA Comprehensive Condom Programming
Full article available from IPPF HIV Update newsletter - Issue 23: http://www.ippf.org/en/Resources/Newsletters/HIV+Update+Issue+23.htm
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