Advocacy Message at International Platform 2009

Female condoms can reduce HIV infection and unwanted pregnancy
The urgent need for access to female condoms is evident in the feminization of the HIV pandemic, the large unmet need for contraception, and the pitiful progress towards meeting Millennium Development Goals 3, 5 and 6 on gender equity, maternal health and haltering and reversing the spread of HIV. The female condom is the only female-initiated prevention method that provides protection against both pregnancy and sexually transmitted diseases, including HIV. Yet, the female condom is not widely available. It could provide a life saving choice for women in Africa and elsewhere who are at risk of HIV and whose partners refuse to use male condoms or whose partners like to use female condoms. Providing female condoms would help to meet the need of 200 million women who have no access to contraceptives, and to reduce unintended pregnancies and unsafe abortion.

Reducing the barriers to female condoms.
Four main barriers to increased access must be addressed.

1. Lack of information and misconceptions about the female condom'
2. Weak supply chain and stock-outs;
3. Lack of variety in existing female condoms;
4. Current price of the female condom.

First, the public knows little about female condoms, but studies have shown that the female condom is highly acceptable to people once they have used it. Acceptance levels range from 41% to 95%.12 The rapid expansion of sales and free distribution in the few countries at the forefront of female programming demonstrates the massive unmet demand for female condoms. Decision makers, especially Ministries of Health and other policy makers, donor agencies, and the retail sector need to know this and to understand the female condom’s strong potential for the empowerment of women, prevention of HIV infection and unintended pregnancy. Investments and funding are needed to invest in demand creation of the female condom.

Second, an increased and steady supply of female condoms is needed. In 2007 donors purchased only 1 female condom for every 200 male condoms. Supply chains must function more effectively and efficiently. To date, female condom programs have often run out of stock quickly. If women cannot access the product when it is needed, they will lose confidence in the method.

Third, the market for the female condom is currently dominated by a single product. More variety promises to increase demand and that, in turn, would help reduce price.

To achieve variety, greater efforts are needed to:

• Put in place international standards to assure quality
• Bring to market new models that will meet international standards
• Document commercial viability of and demand for female condoms

Fourth, the current price discourages large-scale procurement and programming. In addition to investing in new models of the female condom, donors and government should invest in large scale programming in selected countries. Increasing demand in this way will have direct benefits and also contribute to economies of scale and potential price reductions.

Make Female Condoms Available, Accessible and Affordable
We know from decades of family planning programs, that adding even one method to the contraceptive mix raises contraceptive use and the number of safer sex acts. Providing female condoms, with their dual protection quality, thus has enormous potential. The International Platform Meeting call upon ourselves, our NGO colleagues, and policy makers at all levels to:

• Advocate for comprehensive female condom programming with governments and international organizations. By 2015, every female condom program must be comprehensive, including solid supply-chain management, large scale demand creation for all ages, and introduction strategies to encourage and support correct and sustained use.
• Advocate for 15 million Euros - for further research and development to generate a variety of female condoms by 2015.
• Work to reduce the price to 0,20 US$ per piece by 2011;
• Share information and best practices on the female condom and female condom programming with many audiences, including donor agencies, policy makers, and potential users.

For more information, please contact:
Nienke Blauw
Advocacy Officer UAFC Joint Programme World Population Foundation