PSI- Condom Social Marketing in Southern Africa 2012-2014

Summary Through expanding the total condom market, PSI reported that more people have access to condoms and are motivated to use them. According to PSI, the project averted 15,036,364 million Disability-adjusted Life Years (DALYs) through the sale and distribution of 1,019,528,136 male and female condoms in Botswana, Lesotho, South Africa and Eswatini and reached over 15 countries and approximately 2,000 participants with its regional capacity building initiatives. Output 1: Strengthen Capacity of regional HIV prevention organizations operating across Southern & Eastern Africa. Activities broadly focused on supporting scale up and dissemination of PSI’s tools, innovations and best practice, both internally and externally, with the goal of strengthened abilities of numerous regional stakeholders to better prevent HIV. Due to a multiplicity of confounding factors, PSI stated it was challenging to assess the impact of these efforts on improving safer sexual behaviours associated with condom use.  PSI used marketing experience and best-practice expertise for transferable tools internally to increase the quality and consistency of social marketing programming across the global organization. PSI also developed minimum quality standards. Externally, PSI deepened dialogue with partners about the total market approach, such as UNAIDS, UNFPA and RHSC, and contributed to global focus on contraceptive security. Partnerships developed into deeper collaboration on innovations for reaching key populations and moving towards a total market approach. Specifically, PSI improved the capacity of 35 organisations in the region through training/technical assistance, disseminating research results and sharing best practices with academic institutions, civil society, government and private sector partners. Output 2: Establish an efficient and financially sustainable condom social marketing model PSI transformed a previous project approach from an NGO model to a self-sustainable regional social enterprise model operating in South Africa, Botswana, Lesotho and Swaziland. PSI South Africa was established with the mission of achieving sustainability by applying commercial principles to condom programmes and by operating as a private sector entity.  At the end of the programme, the regional enterprise was selling two condom brands, Trust and Lovers+, as well as lubricant, and was, according to PSI, the number one provider of sold condoms in the region with 75% of the commercial market share. PSI adopted a low-margin, high volume pricing strategy in order to continue to reach lower income consumers while generating revenue to help sustain the social enterprise. Moreover, a portion of condom sales revenues was used to help distribute a larger share of public free condoms.   While remaining cognizant of PSI's global mission as a not for profit organization, PSI also embraced private sector approaches in the PSI SA management, organisational and operational structures and processes. For example, 36 health staff spread across the region were replaced with 9 commercially oriented operations staff with specific expertise in finance, marketing and logistics at PSI SA. While management and operational structures increased operational efficiencies, reduced costly stock-outs and created streamlined decision making to respond quickly to opportunities and threats in the marketplace. The introduction of a more effective supply chain was key to ensuring sustained access to condoms by decreasing the number of stores that reported stock-outs from 76 in 2011 to 0 within the first year of the programme and sustaining that throughout the programme. 

According to the original programme proposal, PSI’s vision with the intervention was to serve the total market for condoms by increasing demand for socially marketed condoms across Southern Africa through a financially sustainable condom social marketing enterprise operating at a regional scale. Project Goal: To contribute to a 50% reduction in HIV incidence in Southern Africa by 2016 The project had two main objectives (labelled outputs by PSI): Output 1: Strengthen Capacity of regional HIV prevention organizations operating across Southern & Eastern Africa. 1.1. Strengthen regional capacity building efforts so that by 2015 regional HIV prevention partners will be able to plan, implement, monitor and evaluate their prevention effortswith little assistance from donors and PSI. Output 2: Establish an efficient and financially sustainable condom social marketing model2.1 Increase gains from Phases I and II in condom social marketing so that condoms remain available and accessible to those most in need across Southern Africa, while evolving toa point where condom sales revenue will cover a greater percentage of operating costs.The project will aim to leave in place an efficient and fully sustainable regional condomdistribution model by 2015.2.2. Expand the sustainable condom distribution model to also social market and distribute female condoms and lubricant to targeted groups and gradually remove the subsidy forboth products to levels near sustainability. The project aimed to distribute over 550 million male condoms across four countriesin Southern Africa (Botswana, Lesotho, Swaziland and South Africa) as well as 2 millionfemale condoms and 500,000 120ml tubes of lubricant and will achieve increases in consistent condom use with regular and non-regular partners among target populations.