After Dipping in Recent Years, International Funding for African Condom Distribution May Increase
International funding for condoms, the "cheapest preventive measure" against HIV, "fell sharply" over the last two years, despite an emphasis by "rich governments" on HIV prevention, the Boston Globe reports. After peaking at $68.1 million in 1996, funding for condom distribution programs fell to about $40 million each year in 1999 and 2000, mostly due to cuts from European and Japanese donors, resulting in shortages in many sub-Saharan countries. Christian Saunders, who oversees condom purchases for the U.N. Population Fund, cited "donor fatigue" for the decrease in funding. But John Wilson, a health logistics specialist for global health firm John Snow Inc., said "more nuanced" factors may be to blame, explaining, "It's very hard for donors to keep up funding for things that work well. [Donors] are often attracted to try out new things, unproven things, things that are said to be innovative. What's the glory in buying billions of condoms?" However, a renewed emphasis on HIV prevention has "generat[ed] more enthusiasm" for condom distribution, the Globe reports. The United Nations said it plans to purchase $20 million worth of condoms this year, up from $8 million worth in 1999 and 2000, thanks in part to grants from the Dutch and British governments. And USAID, the "world leader in condom procurement," is aiming to improve on the $13.5 million it spent last year on 350 million condoms. The agency may seek to waive a "buy America" clause that requires it to purchase more expensive American-made condoms. USAID currently pays Custom Services International, an Alabama condom manufacturer, 6.3 cents per condom, but the agency could procure condoms from foreign manufacturers at 2.5 cents each. American and UN officials are also considering a "sharp increase" in the number of female condoms they provide.
Getting people in developing countries to use condoms has also been a challenge. Paul Delay, head of USAID's HIV/AIDS programs, said the agency is utilizing a "Coca-Cola model" for condom marketing and distribution, making condoms widely available at kiosks and other small "outlets" throughout rural areas. Packaging also impacts usage. Kate Roberts, a spokesperson for Population Services International, a not-for-profit health services group, said unmarked silver foil packages containing free government condoms are less popular than ones distributed at small stores with "flashy" names. She also explained how the condoms can be more effectively marketed, "There's Lovers Plus in Eastern Europe, Maximum for parts of Africa, or something that relates to the local people. In Angola, the condom name is Legal, which is slang for 'cool,' or 'acceptable.'" USAID is also set to undertake a multimillion-dollar project in conjunction with African mosques and churches, aimed at "overcoming religious obstacles to condom use." Delay added, "We may need to go on and have a condom summit and get a better estimate on needs and demand, and raise the resources" (Donnelly, Boston Globe, 6/18).