Making markets work for HIV prevention: The Total Market Approach for condom security in Vietnam

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Vietnam is at a crossroads in its response to HIV. Over the past decade, the Ministry of Health made significant progress preventing new HIV infections and scaling up harm reduction and treatment coverage. However, international donors currently resource nearly 80 percent of the national HIV program, and contributions are rapidly declining with the growth of the nation’s economy. 1 This is dramatically reducing the size and geographic scope of HIV-prevention efforts. Within this context, Vietnam is faced with the challenge of sustaining access to lifesaving HIV-prevention commodities, including condoms.

At the onset of the HIV response in Vietnam, donor-funded condoms and lubricant were made available for free or at subsidized cost to ensure access to key populations at risk of HIV. Key populations at risk of HIV in Vietnam include female sex workers (FSW), men who have sex with men (MSM), transgender women (TGW), people who inject drugs (PWID), and their sex partners. Although this was an important strategy to meet need, over time artificially low pricing hampered the development of a local commercial condom market. Local condom manufacturers and distributers were unable to compete with a market dominated by high-quality subsidized imports, even when an increasing number of consumers, including those affected by HIV, could afford and preferred commercial condoms. Meanwhile, cheap and low-quality imported condoms and lubricant flooded the unregulated commercial market. A 2014 inspection revealed that 26 percent of commercial condoms sampled in two cities of Vietnam were of substandard quality.2