Cheaper Female Condoms
posted: 17/04/2009
A cheaper, more user-friendly female condom could have a vastly bigger impact in the global fight against HIV. Female condoms are important - at present they are the only woman-controlled means of protection against HIV. The first female condom was introduced in 1993.
Yet despite promotion by the United Nations and others, female condom use is still tiny, although women are more likely to become heterosexually infected than men.
The USA's Food and Drug Administration approved FC2, a new version of the female condom produced by the Chicago-based Female Health Co.
About 35 million female condoms were distributed worldwide last year, but that compares to more than 10 billion male condoms, which are far cheaper, familiar and a bit easier to use. However, many men refuse to use condoms, putting women at risk.
Made from cheaper material
Though the new female condom looks like the one we already have - a soft, transparent sheath with flexible inner and outer rings - the FC2 is made from synthetic rubber rather than polyurethane, making it cheaper to produce.
Quiet to use
Mary Ann Leeper, of Female Health Co. said the FC2 also is less noisy during use. People complained the original squeaked during use, which is embarrassing.
The developing world price for the current female condom is about $1 each and the cost of the FC2 is one-third less, and may fall if production rises, enabling health organizations to distribute many millions more than at present.
For now, the price will be about US$0.60c (mass-distributed male condoms cost very much less, $0.06c each. This price difference is still huge and a major issue in the developing world. If your income is $1 a day you are not able to buy these, but might conceivably manage to buy male condoms at 4 cents. However if demand rises FC2 production costs should fall and the price halve to about 25 cents.
The Female Health Co. distributed 14 million of the new FC2s last year along with 21 million of the original. The FDA announcement was welcomed by HIV prevention advocates because it means the U.S. Agency for International Development (USAID), one of the largest global providers of condoms, can now distribute them.
"If presented in the right way, many women do like it," Hoffman said. "To find these people and help them and train them, you need systematic programming, which costs money."
Resistance is less of a problem in some developing nations. The U.N. Population Fund, government agencies and nonprofits are aggressively promoting female condoms in places such as Brazil, Ghana, Zimbabwe and South Africa.
Zimbabwean and Ghanaian Women's Demands
Women's groups in Zimbabwe collected more than 30,000 signatures demanding access to the female condom. In Ghana, nonprofits say more than 10,000 people have attended training programs that teach women how to insert female condoms — they require careful instruction to be used properly — and how to negotiate with their male partners.
"The mindset is changing, but there are still a lot of challenges," said Bidia Deperthes, the Population Fund's HIV technical adviser for condoms. "Accessibility is still minimal. There's a huge demand, and we're not meeting it."
50 million target
Deperthes hopes that with FDA approval of the FC2, the number of female condoms distributed globally could climb to 50 million this year. If the numbers keep rising, she said, the cost to public-sector distributors for each FC2 could drop as low as 25 cents.
Women friendly
Another challenge is a stigma associated with the female condom in some places because prostitutes are among those deemed to benefit most from using it. On the other hand, advocates of the female condom say it has invaluable safe-sex potential for married women whose husbands are unfaithful and shun male condoms.
Serra Sippel, executive director of the Center for Health and Gender Equity in Washington, said FDA approval of the FC2 is a key step toward "putting the power of prevention in women's hands." But she bemoaned the product's limited over-the-counter availability.
"We'd love to see the profile raised, to have commercials about it and normalize it so people aren't embarrassed," she said.
The female condom's advocates stress that it will never be the "magic bullet" that by itself turns the tide in fighting AIDS. But, they say, it should be a bigger part of the arsenal.
"It's not going to be the one answer," Hoffman said. "But it's got a lot more to contribute than it has to date."
Other women's prevention
Efforts are being made to develope vaccines and microbicides that will also put women in a far better position to protect themselves, but results are disappointing and there have been many failures so far.
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