The Bill and Melinda Gates Foundation hired Mann Global Health to conduct an analysis of the state of condom programming for HIV prevention in five countries in sub-Saharan Africa. Concerned that funding for condoms has declined, the Foundation sought greater insight into condom total markets – meaning the larger context of all condoms distributed in each country, whether via the public sector, the private non-pro t sector (including social marketing), or private commercial actors. The focus of this assessment is on sustainability and impact using the market development approach. The objective is to provide recommendations for building and sustaining equitable condom programs at scale, based on a clear understanding of how and why existing markets are failing, and how programs can be strengthened along with the future investments needed to ensure a healthy total market that aims for equity, sustainability, and scale.
Tanzania’s condom program provides a unique archetype representing a mature condom market that had a successful condom social marketing program in the past and now is facing sustainability challenges as funding has dropped significantly and is likely to drop further. Tanzania presents an opportunity to study whether the gains made in condom programming in the past can continue in a country with an over reliance on highly subsidized condom social marketing. It also allows us to understand how to grow condom markets sustainably while addressing equity and health impact objectives. As a country archetype, Tanzania provides a window into issues that are common across other countries, as well as possible strategies for improvements.