Background: Male and female condoms are the only devices that reduce the transmission of HIV and other sexually transmitted infections and prevent unintended pregnancy. Donor funding for condom procurement has been reduced in recent years. In 2013, about 10 condoms were made available to every man aged 15-64, and on average only one female condom per eight women in sub-Saharan Africa. To date very few condom manufacturers are present in the African market. In 2015, several condom manufacturers joined donor agencies to form a coalition whose main goal is to provide 20 billion condoms by 2020 in low- and middle-income countries. In furtherance of this goal, the authors conducted from August to October 2017 a survey to assess the barriers that prevent condom manufacturers from entering the African market.
Methods: A self-administered semi-structured questionnaire and in-depth interview were used to collect information on barriers to entering the African market among condom manufacturers.
Results: Nineteen manufacturers (out of 52 invited) from 12 countries, including the biggest male condom manufacturer in the world and all three female condom producing companies, completed the questionnaire. Biggest barriers to entering the African condom market were the high risk of insufficient return on investment (74%), inefficient distribution channels (74%), lack of purchasing power of targeted market segments (69%), lengthy and costly registration processes (68%), free and subsidized condoms (58%), and lack of partners and difficulty to vet financially strong local partners. Other barriers were macroeconomic and market-specific challenges related to government, currency stability, and trade policies.
Conclusions: The survey identified several critical barriers preventing entry to the African condom market. African governments could create an enabling environment for market entry by harmonizing regulatory standards, providing tax exemptions/incentives, reducing registration processing time and fees, facilitating adequate financing of local condom distributors, and establishing a public-private partnership for a healthy condom market. Donor agencies and governments should limit distribution of free and subsidized condoms to the right populations (key and poor populations) and dedicate funds for demand generation and promotion activities to grow the commercial condom market and make it more attractive.

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