More Money and Support Needed From Wealthy Nations To Broaden Access to Condoms in Developing World, Report Says

The developing countries that most urgently need to curb the spread of HIV/AIDS are "desperately" short of condoms, and international donors are not providing adequate funding to supply condoms to people in these nations, according to a report released on Sunday by Population Action International, the Toronto Globe and Mail reports (Nolen, Toronto Globe and Mail, 9/28). The report, titled "Condoms Count: Meeting the Need in the Era of HIV/AIDS," looks at the demand for condoms in countries with high rates of HIV infection and donor support for condom distribution and education initiatives. Although an estimated eight billion condoms would have been needed in 2000 to achieve "significant" reductions in HIV infection rates in developing nations, donors provided only 950 million condoms that year. Although many developing nations have implemented their own condom promotion and distribution campaigns, wealthier countries remain the main source of condoms for the poorest countries. Meanwhile, high proportions of young people in developing countries are sexually active, the report states, noting that 33% of unmarried young women and 40% of young men ages 15 to 19 in sub-Saharan Africa are sexually active. Condoms are "the only technology available for protection from sexually transmitted HIV," and condom use is especially important to curb HIV infection among young people, sex workers and others at high risk of HIV infection, the report states.

Providing the Goods
Although an accurate estimate of how many condoms are needed to keep up with demand in the developing world is difficult to calculate, it is clear that current rates of condom use are "too low to have an impact on the rate of increase" of HIV infection, the report states. According to the U.N. Population Fund, the cost of providing eight billion condoms worldwide in 2000 would have been $239 million. UNFPA estimates that 18.6 billion condoms will be needed in the developing world by 2015, at a cost of more than $557 million. But these cost estimates represent only the price of the condoms themselves -- which cost about three cents apiece -- and not the cost of distribution systems, education efforts and other initiatives related to expanding condom access, the report states. Factoring all of these criteria into cost estimates would boost the price to at least $2.8 billion by 2015. By contrast, donor support for condoms averaged only slightly over one billion condoms per year over the past decade. UNFPA and the U.S. Agency for International Development remain the two largest sources of condoms for the developing world, but these agencies are both facing restrictions imposed by the Bush administration that have curtailed their efforts to supply condoms. The private sector should also work to fill the distribution gap, the report states. "Significantly and rapidly expanding condom promotion and distribution in developing countries will require coordinated, concerted effort from governments, donors, international agencies and other organizations," the report concludes ("Condoms Count: Meeting the Need in the Era of HIV/AIDS," PAI, September 2002).

Political Commitment Needed
Officials at PAI stated that more political will is needed to increase condom use and access, noting that "too many politicians [in the United States] are reluctant to explicitly recognize the importance of condoms in HIV/AIDS prevention." Terri Bartlett, vice president for public policy at PAI, said that a Senate appropriations bill that provides funding for international HIV/AIDS programs only mentions condoms twice. PAI President Amy Coen said, "Condoms, not euphemisms, can protect people from AIDS. If condoms aren't explicitly mentioned in legislation, they cannot be explicitly funded." She concluded, "We have a simple message for everyone involved in the battle against AIDS. Money matters, political commitment counts and condoms save lives. And it's time to act, now" (PAI release, 9/29). The report, along with two fact sheets on condom use and HIV/AIDS, is available online.