Abstract
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-profit sector (including social marketing), or the for-profit commercial sector. The focus of this assessment is on sustainability, equity and impact using the market development approach. The objective is to provide recommendations for building and sustaining condom programs, 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.
Zimbabwe was one of the countries selected for analysis, as it has historically been one of the strongest condom programs in the region. Zimbabwe is one of only five countries to meet or exceed UNFPA’s regional benchmark of 30 male condoms/man/year.1,2 Significant investments have been made in the public sector and the condom social marketing program that have resulted in increasing condom distribution, coupled with high levels of awareness, access and condom use. Zimbabwe provides an archetype of a strong condom program that is currently at risk due to economic challenges and decreasing funding levels. The main question for the country condom program is whether the gains made in the past can continue, given an over reliance on a highly subsidized social marketing program and a large public sector free distribution program.
