Global Female Condom Conference 2015 Conference resume

Conference resume Durban, South Africa, 1-3 December 2015

Let’s take female condoms to the next level!

With pleasure!

Looking back to the Global Female Condom Conference 2015 fills me with pleasure and pride. The three day event proved to be vibrant and successful with delegates from well over 20 countries. It was absolutely inspiring to see so many people exchanging knowledge and experiences with the aim to learn, gather new insights and join forces in taking female condoms to a next level.

In over 40 plenaries and workshops many important aspects were addressed and discussed. Let me share some personal highlights.

Pleasure in sex We saw sessions in which it was clearly spelled out that female condoms bring pleasure. It is important to see the female condom not only in the area of disease and problems. We need to bring back the pleasure in sex to people. The first use of the female condom should be an amazing experience. That is what we should aim for.

Then people continue to use it and are willing to pay for it.

Good investment We also had a very clear session showing that female condom programming is a very good investment, because it will save a lot of costs in health. For governments investing in female condom programming it means a higher productivity, because you don’t lose years that people are ill. You don’t have to spend money on treatment. You can spend that money on other things.

Expanding the market One of the first things that has to happen as soon as new female condom models are prequalified at the international level: manufacturers, social marketing organisations and governments must make sure that the market for female condoms expands. If the volumes of sales are higher, prices will go down. That will make the product in the long run less dependent from donor funding.

Allies People can feel lonely sometimes advocating for female condoms. The fact that you all have been at the conference with so many allies, working on the same issue, gives strength for the next years to go ahead.

I want to thank everyone who was here for the tremendous work, the inspiring input and for joining forces to take female condoms to the next level. Let’s keep this energy going to ensure everyone in the world can have safe and pleasurable sex.

Mrs Greetje Lubbi Chair International Steering Group Universal Access to Female Condoms Joint Programme (UAFC)

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Table of contents The support of governments

page 4

Convincing the consumers

page 6

Meanwhile on Twitter

page 8

Innovating the product

page 11

Let’s turn words into deeds!

page 14

Call-to-actions

page 15

Conference credits

Participants take the floor

page 19 page 4, 5, 6, 7, 10, 12, 13

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#GFCC15 in a nutshell

The support of governments

A healthier population means less disease and death which also has major economic advantages for countries. Governments therefore want their citizens to have access to methods that prevent sexually transmitted infections and unplanned pregnancies. Female condoms should be one of these methods because as Lambert Grijns from the Dutch government emphasized in his speech - people have the right to choose.

However, most governments hardly invest in female condoms. Anny Peters, researcher for Rutgers in the Netherlands has discovered the reason why in her PhD thesis: most policy makers do not believe female condoms can be a success. They ignore studies on acceptability and rely on their own negative biases. Peters finds it odd that governments spend billions of dollars on the development of microbicides but pay little or no attention to female condoms.

Participants take the floor It is important to realise that every day a new generation becomes sexual active. We can not just let go. We can not talk about treatment as prevention to young people. We can not talk about long term family planning methods to young people. We need to talk about female condoms.

We owe it to that young generation. We owe it to all those people who are in need of dual protection methods at one moment in their lives.

Yvonne Bogaarts Rutgers, the Netherlands

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To convince policy makers of the importance of female condoms, advocacy towards them remains necessary. According to Yvonne Bogaarts, advocacy manager at Rutgers, the United Nations’ Sustainable Development Goals on health and gender equality present a new opportunity to attract the attention of governments, as female condoms address both issues. The Business Case for Female Condoms report of Global Health Visions, which shows the cost-effectiveness of investing in female condoms, can be a big help for advocates in their efforts.

We need to work together: governments, NGOs, the UN and the private sector. We need to be innovative, we need to find good marketing tools, we need to be convincing to people to make visible what is the advantage of female condoms and we need to work on registration and licenses.

Lambert Grijns Sexual and Reproductive Health and Rights & HIV/AIDS Ambassador of the Kingdom of the Netherlands

The conference also aimed to discover ways to ‘liberate’ female condoms from donor funding. Dependency on subsidies is not a sustainable existence for any product.

Social marketing organizations and manufacturers have to increase their (joint) efforts to create and expand a commercial market for female condoms. Nevertheless, funding of free distribution remains vital for low-income and vulnerable consumers.

Find the presentations and videos from all sessions of the conference on www.femalecondoms4all.org/conference2015.

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#GFCC15 in a nutshell

Convincing the consumers

If you either want higher-income consumers to buy female condoms or lower-income consumers to use the samples they get for free, promotion is key. People need to be convinced of the benefits as well as the nonsense of myths and misconceptions. Mags Beksinska, director of MatCH Research in South Africa, therefore stressed that it is crucial for female condom programmes to include the training of health workers to educate their clients.

Creating a market for female condoms is no different than for other products, according to PSI and the John Hopkins Center for Communication. For effective marketing it is necessary to put yourself in your audience’s shoes. What motivates consumers to buy your product? Audience segmentation is vital as different people have different needs and desires. Married women have other motivation factors than unmarried women, for example. Make sure the packaging attracts your specific audience.

Participants take the floor There is a high level of stigma around female condoms among policy and decision makers: they make sounds, they are painful and costly and women do not need them. Evidence has been generated over a decade that all of this is not true.

However, the perception continues. That is our main challenge.

Anasua Bagchi HLFPPT, India

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The public sector is not unfamiliar with effective campaigning. Josi Paz from the Brazilian government presented its strategy to educate people through the dating app Tinder. By asking for unsafe sex via fake profiles, it connects with people with high-risk behaviour and educates them on the use of protection methods. Another inspiring example comes from PSI that trains hairdressers and bar tenders to promote female condoms to their customers at night clubs.

One of the outcomes of the conference is the importance of targeting men in the promotion of female condoms. Men often make the final decision about which contraceptive to use and for a lot of women it proves difficult to suggest female condoms. The strong advice is: drive the empowerment of women but involve men in the drive.

Find the presentations and videos from all sessions of the conference on www.femalecondoms4all.org/conference2015.

The potential of female condoms is very important.

This contraception device is the only dual protection method women can administer which empowers them hugely. To get the female condom accessible for all, we need to get beyond the stigma that they are a product solely for key populations.

Renee Van de Weerdt UNFPA

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Meanwhile on Twitter Serra Sippel @SerraSippel | Dec 3 Larger need to address structural barriers to #femalecondoms: gender inequality, GBV, stigma, discrimination. Amelia Peltz @USAIDGH #GFCC15

Devan @devansiobhan | Dec 2 @SerraSippel: #Agenda2030 is opportunity for unified #femalecondom &empowerment agenda across gender, #SRHR, youth, LGBT movements #GFCC15

Minoshni Pillay @Minoshni | Dec 3 Calls for drop in price and better training of healthcare workers, to make female condoms widely accessible #GFCC15 #sabcnews

Rineke van Dam @rinekevandam | Dec 3 The first time you use a #femalecondom needs to be unforgettable, like your first time sex.

Raphael @DKTchangeslives #GFCC15

Zawadi Smartlove @ZawadiSmartlove | Dec 2 ‘Commitment worldleaders 2 #GlobalGoals health&gender equality=huge chance 4 femalecondoms’ Y.Bogaarts advocacymanager @RutgersWPF #GFCC15

Karl Hofmann @KarlHofmannPSI | Dec 3 #FemaleCondoms? Part of any effective broad based strategy for women’s health. #GFCC15 @PSIimpact

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Raziah Athman @RazAthman | Dec 2 Durban Young women using female condoms in South Africa have got the men at #GFCC15 craving try-outs with the sassy experiences they`ve shared

#GFCC15 Stephanie H @StephHaase | Dec 1 Female condoms empower women to take charge of their health, but also their sexuality and pleasure! #GFCC15

Lundi kaNcana @lundikancana | Dec 2 Reducing 90% of new HIV infection by 2020 through priorising and escalating #femalecondom use #GFCC15 #WAD2015

tianjohnson @tianjohnson | Dec 1 Dr. Anasua Bagchi from #HLFPPT #India talks #femalecondom programming & moving from #distribution to #use at #GFCC15

EVA Nigeria. @EVA_Nigeria | Dec 1 Nigeria There is a variety of female condom brands, you just have to choose the one which suits you best. #GFCC15 @ZawadiSmartlove @SaskiaHusken

Serra Sippel @SerraSippel | Dec 3 A rights-based approach is important for any SRH programming @KarlHofmannPSI @PSIimpact #GFCC15

kossy @sophyzundu | Dec 1 Commitments ranging from improving female condom brands to be more exciting and fun to use to improving access especially for yps #GFCC15

PATH @PATHtweets | Dec 3 Our #GFCC15 commitment? PATH and Dahua (http://bit.ly/1Q2OnEs) want to see a #femalecondom in everybody’s pocket. http://bit.ly/1jwmYMG

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Participants take the floor You should not look at female condoms only from a development perspective. Female condoms are a great product that provides you another choice to keep control over your body. That is not only important for developing countries, but for the whole world.

Jane Bruning Positive Women Inc., New Zealand

The challenge now for us is to distribute and promote the idea that female condoms are not just for a specific group, but for all women and men.

Josi Paz Department of Health, Brazil

We need to understand that female condoms are not in competition with male condoms. They just provide more options for saver sex. We need to invest as much in female condoms as we have done in male condoms to place them where they supposed to be.

Rowlands Kaotcha THP, Malawi

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#GFCC15 in a nutshell

Innovating the product

All studies on the acceptability of female condoms, for example carried out by MatCH Research, PSI and PATH, show that most users are positive about this protection method and want access to it. Nevertheless, the same studies also show that there are still negative factors that prevent people from using female condoms. Some think female condoms look weird, find the package too big or are afraid the condom might go into the vagina. An uncomfortable first experience is also a common barrier for a second try.

Product innovation is desirable in order to make female condoms even more attractive and to ensure the first experience is positive. Current female condom designs have an inner ring, an inner sponge or outer foam dots for keeping the condom in place and adding pleasure. Manufacturers are working on new designs, like the Panty Condom - a panty and female condom in one - and the Inner Condom for both vaginal and anal intercourse. They are also exploring the possibilities of producing female condoms with different flavours and textures.

New female condom products are also important for increasing the use of this protection method. People have preferences for different features of female condoms, so a ‘one size fits all’ approach is insufficient. Or, as a health worker said in the evaluation of South Africa’s programming of a variety of female condom products: “We all need shoes to protect our feet. But some like wearing heels and some like wearing sneakers.”

Innovating products is one thing, but getting them on the market is another.

Regulatory barriers and pre qualification by WHO/UNFPA can be challenging and time consuming. When governments, donors and NGOs aim to take female condoms to the next level, support to manufacturers and designers in entering the market is highly recommended.

Find the presentations and videos from all sessions of the conference on www.femalecondoms4all.org/conference2015.

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Participants take the floor The subsidies that are behind female condoms to date are going to reduce. Therefore the need to really put emphasize and pressure on social marketed and private female condoms is very clear.

Raphael da Silva DKT, Tanzania

It is a constitutional right for people to have access to HIV protection tools and the female condom is one of them.

Tian Johnson African Alliance for HIV Prevention, South Africa

We are working with female condoms on a daily basis. For us it is just normal to promote them.

Having donors and managing directors of big private and public organisations talking about female condoms in a positive way gives us a lot of confirmation and support that we are doing the right thing and that we can make the female condom accessible for all.

Lilly Claire Ekobika ACMS, Cameroon

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We need to build the capacity of those who are doing the advocacy, promotion and education of potential users.

Joachim Chijide UNFPA, Nigeria

It is exciting that the new condoms that are coming into the market are actually fast-tracking for prequalification. Which means that we will even have more choice. That is really good, because that will increase the quantities as well.

Thato Chidarikire Department of Health, South Africa

At the conference I have learned that it is important to improve the role of men in increasing the use of female condoms. Men are the ones who are buying the condoms, because they have been doing that ever since there were male condoms available. So they need to be convinced to purchase female condoms to support their partner.

Esther Agbarakwe ARFH, Nigeria

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Zawadi reflects

Let’s turn words into deeds!

Was that an exhilarating conference or what? Beforehand I said I hoped we can turn Female Condom Land into Female Condom Planet. But afterwards I feel like we’re heading towards a Female Condom Universe. In a couple of years even Martians will enjoy the protection of female condoms.

But seriously, this conference can turn out to be a game-changer in favor of the health and pleasure of millions of people around the globe. Government representatives, manufacturers, advocates, social marketers, researchers and other experts from all corners of the world exchanged information and experiences, discussed the chances and barriers of female condoms and even danced to celebrate these contraceptive life-savers. Most importantly, they committed themselves to take action to get female condoms to the next level.

The participants replied massively to my request to write one or more commitments or recommendations on a paper doll. I received almost 150 call-to-actions, ranging from promises to increase the availability of female condoms to ideas to make them more attractive. Here you only see a brief selection. All the other inspiring statements can be found on our website.

Words are nice, but now it’s time to turn them into deeds. The participants need to prove that their commitments are not as fictional as Martians. For everyone who could not attend the conference: get inspired by these call-to-actions and set your own goals. At the next Global Female Condom Conference we will reflect on the undertaken actions and results.

Go for it!

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Call-to-actions We remain committed to advocate for the inclusion of female condoms in family planning and HIV/AIDS prevention programmes. In doing so we particularly acknowledge the importance of addressing the needs of young people. We also remain committed to support the pre-qualification of female condoms and to ensure the procurement of quality female condoms, including through our AccessRH service.

Renee Van de Weerdt, Senior Technical Advisor Reproductive Health Commodities UNFPA

Currently we spend 15% of our condom budget on female condoms.

I pledge to advocate for an increase in the female condom budget.

This will assist in increasing access to female condoms.

Lundi Ncana, Department of Health of South Africa

Every woman around the world should have access to female condoms.

There should be more awareness and advocacy in all parts of the world.

Om Garg, Cupid Ltd.

We should no more crib and cry for support. We should no longer wait for funding. We should just start making female condoms accessible to the women out there, at small steps at the time. Even if it is one female condom for one woman we should do it from today, until we are done.

Anasua Bagchi, HLFPPT

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I commit to identify and engage with more opportunities to involve young people in advancing uptake and consistent and correct use of female condoms.

Joachim Chijide, UNFPA

We pledge to continue integrating female condoms into our various SRH, FP, HIV and youth projects to increase its universal access and with due time have an increased group of female condom users and advocates in Nigeria.

SFH Nigeria

In love with the female condom, just add flavour please.

Anita

I commit to introduce coloured female condoms in South Africa.

Leon Klugman, Focus Products

It is important to engage major donors not just as funders but also as partners and potential champions.

Kehinde Osinowo, ARFH

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We remain committed to champion and promote female condoms worldwide.

The Dutch Ministry of Foreign Affairs

We are committed to leading the global movement to make universal access to comprehensive family planning a reality. Working together as a global federation, we will intensify comprehensive programming for male and female condoms as the only multipurpose devices that simultaneously prevent sexually transmitted infections (STIs), including HIV, and unintended pregnancies. Between 2015 and 2020, IPPF will distribute 12 million female condoms.

Tewodros Melesse, Director-General IPPF

We commit to support the manufacturing, marketing and promotion of the female condoms as a pleasurable and safer way of making love.

SFH Zambia

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We will continue to be a global partner in the procurement, distribution and promotion of female condoms.

Amelia Peltz, USAID

We recognize the important role that female condoms play in both the prevention of unintended pregnancy and the prevention of sexually transmitted infections, including HIV. We will continue to promote female condoms in all countries and programs where we have active contraception programming, and to share the knowledge that we gain from our female condom programs with our partners throughout the field of sexual and reproductive health. We will also continue to work with UAFC, local partners and global partners such as the Female Health Company to promote and facilitate the use of female condoms in Mozambique, Nigeria, Kenya, Tanzania, Ethiopia and Senegal. As part of our work, we commit to: • generate demand for female condoms at the community level through grassroots advocacy and community education programs; • develop relationships with governments and other donors to increase investment and create new strategies to enhance distribution of female condoms; • involve men in female condom programming, both as advocates and recipients of SRH education, in order to promote female condoms as a contraceptive method that benefits both partners; • promote and celebrate Global Female Condom Day on September 16th Purnima Mane, President & CEO Pathfinder International

If the product will continue to play the role that it needs to, it will need greater advocacy with funders and governments and all actors involved.

We pledge to: • share our 20 years of experience in many condom brands, tens of millions consumer interactions; • continue to advocate within regards to female condoms; • continue to share experiences through our worldwide network of different country operations across country platforms.

Karl Hofmann, President & CEO PSI

Find all call-to-actions on www.femalecondoms4all.org/conference2015/call-to-action

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Conference credits Head of coordination: Marie Christine Siemerink (UAFC) Logistics and venue: Mags Beksinska and Raheel Mahomed (MatCH Research) Track session coordination: Programming, Evaluation & Implementation: Monique Demenint (UAFC/Oxfam Novib) and Beth Skorochod (PSI) Track session coordination: Advocacy, Campaigning & Communication: Rineke van Dam (UAFC/Rutgers) and Devan Shea (CHANGE) Track session coordination: Technical Developments & Science: Judit Barniol (UAFC/ i+solutions), Mags Beksinska and Jenni Smit (MatCH Research) Communications: Suzy Wong Chung and Tim Looten (UAFC/Rutgers) Conference identity: Dox in cooperation with UAFC/Rutgers Photography: Jethro Snyders Hostess: Zawadi Smartlove

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For all information on the global female condom conference 2015 please visit

www.femalecondoms4all.org/conference2015

MatCH Research Maternal, Adolescent and Child Health Research Department of Obstetrics and Gynaecology Faculty of Health Sciences University of the Witwatersrand