Addressing Condom Supply and Demand in PEPFAR Programs

Our Approach and Results

Condoms and personal lubricants play an important role within USAID’s HIV prevention, care, and treatment efforts, and their promotion and distribution are most effective when integrated with other services as part of an informed choice and client-centered approach to prevention.

USAID’s condom programming under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is strategically integrated into:

• HIV testing services

• VMMC

• Care and treatment

• PrEP

• DREAMS

• Programs to engage men

• Key population service delivery interventions, and

• Other community interventions

USAID assists countries in creating and implementing national condom strategies that address key supply and demand issues related to increasing condom use. It employs a total market approach to condom programming that engages the public sector for free condoms, the social marketing sector for subsidized condoms, and the commercial sector for regular priced condoms. This approach supports increased sustainability by reducing reliance on donor subsidies and increases host-country ownership of and oversight for condom programming.

Globally, USAID condom programming emphasizes key interventions related to strengthening condom supply, increasing demand, and improving use. These include:

• Procuring low-cost male and female condoms and lubricants for government and nongovernmental condom distribution programs in lower- and middle-income countries to ensure equitable access to products among key and priority populations and low-income groups;

• Providing individualized technical assistance to improve forecasting, supply planning, and distribution systems for condoms and lubricants through the USAID Global Health Supply Chain Procurement and Supply Management (GHSC-PSM) project;

• Providing support to governments for increased sustainability and greater stewardship, leadership, coordination, and management of condom programs, including through the development of national strategies and policies that create a supportive context for condom and lubricant distribution and promotion within the public and private sectors;

• Improving access to affordable and accessible male and female condoms and lubricants through condom social marketing projects;

• Creating demand for male and female condoms through evidence-based social and behavior change programs targeting specific populations; and,

• Coordinating with other global donors on condom supply and programming to ensure adequate and uninterrupted condom supplies in relevant countries, including the UNAIDS’ Global HIV Prevention Coalition, the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund), and the United Nations Population Fund.

In 2023, USAID provided the following commodities to 30 countries in Africa, Asia, and/or Latin America and the Caribbean using PEPFAR funds:

• 269.9 million male condoms

• 1.9 million female condoms

• 32.3 million sachets of lubricants

Central Condom Fund

USAID procures male and female condoms and/or lubricants for Africa, Asia, and/or Latin America and the Caribbean using PEPFAR and family planning funds. Since Fiscal Year (FY) 2020, PEPFAR has focused Central Condom Fund support to select countries with the intention of transitioning greater responsibility of procurement of condoms and lubricants to host-country governments and/or other donors. Condoms are provided at no cost, enabling countries to make condoms available to individuals for free or at highly subsidized prices. There is also limited funding available on a first-come, first-served basis to cover unexpected or emergency condom and/or lubricant requests from PEPFAR-supported countries. 

Starting in FY 26, the Central Condom Fund will be absorbed into bilateral PEPFAR budgets. All PEPFAR countries will be expected to incorporate procurement and distribution of no-cost and/or low-cost male and female condoms and personal lubricants into bilateral PEPFAR budgets, and/or work with country governments and other donors to address national needs.