Last week I had the opportunity to present as a panelist during Malawi’s Total Market Approach (TMA) Workshop on Condoms, presenting some of the findings coming out of a lengthy market landscape assessment I conducted earlier in 2015.
The workshop was well attended, including representatives from UNAIDS, CDC, UNFPA, USAID, PEPFAR, The Malawi Ministry of Health, The HIV Directorate General, District Health Officers and District Condom Coordinators, as well as other local NGOs that were enthusiastic to learn about the state of their current condom market.
The workshop was opened by HIV Directorate Director Dr. Frank Chibwandira, reminding attendees that the country was “far from achieving the ideal levels for condoms use in Malawi,” and that “the HIV Prevention Strategy has put in very ambitious plans to distribute over 250 million condoms in five years from 2015 to 2020.” He also underscored the Government’s commitment to “advancing condom service delivery in the prevention of HIV and other STI and unintended pregnancies.”
The workshop was an overwhelming success, with a round table discussion and working session that resulted in a ton of feedback and recommendations for the key stakeholders to consider moving forward. Sarah Gibson, Country Representative for PSI Malawi, was encouraged to see the energy in the workshop and the attentiveness and participation of all the attendees:
It is very exciting to hear and see how engaged stakeholders are about a total market approach for condoms in Malawi. It seems to speak both to a need to make the market work better and a desire to make this happen. Condoms are, and will always be, a vital component of the response to HIV and assisting the Government of Malawi to ensure robust condom supply through the public, social marketing and private sectors is critical in this effort.
As part of their HIV Prevention Strategy (2015-2020), and as part of the national condom strategy, Malawi has encouragingly embraced a Total Market Approach to help address gaps in the market that limit the health impact the current market can deliver. Total Market Approach, simply put, is a both a tool and methodology, ensuring that actors in a marketplace can determine where the market failures are and where to prioritize their efforts.
It assumes a few key principles, such as comparative advantage of different actors (the public sector offers something very different than the private sector), that consumer choice is critical for a health market, the respect of each sectors autonomy, and that all actions that happen in a market place should be based on a value for money calculation. It also assumes that the end goal is a healthy market – sustainable and diverse, with a variety of products at competitive prices to meet the needs of the people.
Above: PSI’s Chishango Condom
Malawi is currently in a nascent market stage, when you look at supply and demand factors, suggesting that it has a long road for improvement in the coming years. Free distribution is increasingly dominating the market share, there are very few private brands entering the market, and despite awareness of the benefits of using condoms, use remains very low during risky sex – around 25%! Clearly there is a lot to do to drive actual condom uptake, and to remove some of this burden that currently sits on the public sector (distributing over 70% of the market supply). Despite having two socially marketed brands that are incredibly popular, PSI’s Chishango and BLM’s Manyuchi, they are gradually making up less of the total market share as the free distribution of condoms has grown exponentially (30% between 2014 and 2015).
But the hope is that the output from this first of two Total Market Approach on Condoms workshops (the second will take place in August and cover a recent Need State Analysis Study) will result in some immediate actions to drive forward the equitable distribution of condoms, across the public, socially marketed, and private sectors, to ensure more sustainable HIV prevention impact in the future.