UNAIDS Inter Agency Task Team on Comprehensive Condom Programming

1. UNAIDS Inter Agency Task Team on Comprehensive Condom Programming Comprehensive Condom Programming- So much Potential, Yet so little Progress AIDS 2008 – 3-8 Aug. Mexico City Bidia Deperthes HIV/AIDS Technical Advisor on CCP United Nations Population Fund, New York, USA

2. Male and Female condoms- effective barriers against HIV • M/F condoms, when used consistently and correctly, are highly effective at preventing STIs/HIV. • Condoms are central to efforts to halt the spread of HIV as recognized at the ICPD in 1994 as well as by the UNGASS Political Declaration on HIV/AIDS, adapted unanimously by the UN members states on June 2006

3. CCP- so much potential… • When CCP is being coordinated with strong national leadership in a strategic partnership manner and supported by adequate human, financial and technical resources, the likelihood is …….it will work! • Examples. • Zimbabwe, Botswana, Mozambique, Thailand, South Africa, Brazil, etc… • 53 countries enrolled in the Global Condom Initiated to scale up CCP

4. CCP- Leadership/coordination • Successful scale-up of CCP depends upon strongleadership & coordination as well as great political will at global, national and community levels. • Removalof restrictive national policies limiting access to and education about condoms • Involvement of stakeholders in the process (strategic partnership) • Abolishment conditionality in donor financial support for HIV programs (development partners)

5. Multisectoral government response integrated with other services • Advocacy and policybriefs to support the integration of CCP with RH services and with all other HIV programs (all levels)

6. Condom supply

7. Funds for condoms • Donor support for condoms is channeled bilaterally (from one government to another), multilaterally (thru e.g. UN and WB) and thru the Global Fund. • Political support for condoms has been ambivalent and funding for condoms is only a little higher today than it was a decade ago.

8. Donor support for Male Condoms Condom supply has remained flat, since 2002 ! • USAID- average $23.4/yr over 1998-2007 (largest donor ) • UNFPA – average $12.6/yr over 1998-2007 (second donor) Donors: UNFPA, USAIDS, DfID, KfW, PSI, IPPF, DKT, UNDP, CDC, Hewlett Foundation, etc

9. Are male and female condoms on the Essential Drug List? Does the government impose taxes & tariffs on condoms? Is there a national budget line for condoms? Is supply of condoms a priority for national governments?

10. Condom supply is not a priority for many governments Only 56% of the countries have condoms on the Essential Drug List 26% of the countries impose taxes or tariffs on condoms Only 45% have a national budget line for condoms # of Countries (%)

11. Are Condoms a priority for the Global Fund ? • In 2007, the total contribution through Global Fund Resources was less than $700,000

12. In other words… • Gap in the supply of male condoms • In 2006, an estimated 18 billion MC were needed for HIV/P (13.5 B) & FP (4.4B). • The gap between the estimated number that were needed (18B) and the condoms that were used (11.5B) equal (6.5 B) translates into US$230 million in terms of cost.

13. Donor Support for Female condom programming Launch of the FCI

14. FC requirements to achieve Universal Access • Like with Male Condoms, there is a gap in Female Condom supply requirements. • Of the estimated requirement of 37 million only 20 million FCs were distributed in 2006. • Furthermore FC distribution represents less than one-half of 1% of all condoms distributed and their unit cost is more than 15 times that of male condoms

15. CCP: the neglected areas • Donor support figures reflect only the cost of the commodities • Costs associated with demand creation (raising awareness and improving use of condoms) and support (improving access, logistic and distribution capacity, staff salaries, training), are often not considered • These costs are estimated to be at least four times the commodity costs

16. CCP National Leadership with support from TSG Supply Demand Support Forecasting and Procurement Generating Demand Coordination And policy support Receiving, Warehousing /Storage Targeted distribution Integration Distribution Information, Education and Communication Capacity Building/Training Quality Assurance and Management Advocacy and Social Mobilization Standards and Regulations Logistics Management Information Systems Monitoring, Evaluation and Research

17. Whose role is it to scale up CCP? LEADERSHIP • Utilizing a “three ones” approach to programming, a national lead agency is identified as the coordinating body, there is one national CCP programme, and one national CCP M&E framework IMPLEMENTATION • National ministries/agencies, civil society/I/NGO partners and private sector can support implementation FUNDING and TECHNICAL SUPPORT • National Governments, Multilateral, bilateral donors I/NGOS and the private sector can provide funding and technical support

18. But ….Before scaling up, WE MUST HAVE A strong advocacy and demand from potential users to put pressure on their leaders to increase access to condoms Support from I/NGOs and civil society partners to carry the voice of communities and users, by participating in all relevant decision making processes

19. Questions for the audience Against this background, What is required to increase global, national and individual commitment to Comprehensive Condom Programming? And, How can we close the financial gap in male and female condom programming?