Condom TWG progress report

National Condom Strategy Launching Workshop

June 12, 2020

 Outline
 Introduction

 National Condom Technical Working Group

 Major Activities of condom TWG

 Observed challenges and Interventions

 Way forward
 Introduction

 Condom is easily available and user friendly method which effectively

reduce the risk of HIV transmission and an efficient contraceptive with
correct and consistent use.

 Comprehensive condom program is one of the six pillars of national HIV

prevention roadmap

 The roadmap outlined the need to strengthen national condom programs,

including adequate male and female condom procurement, demand
creation and distribution
 Introduction ctd…

The main interventions indicated in the roadmap:

 Finalize the national condom strategy and monitor its implementation

 Establish condom program coordination mechanisms at national and regional level

 Improve accessibility and use of male and female condoms (expand and diversify
condom distribution outlets targeting KPPG)

 Improve condom quantification and procurement mechanisms

 Strengthen condom stock tracking and redistribution mechanisms

Inline with this National Condom Technical Working Group is established

 Nation Condom Technical Working Group

Established with objectives:

 To support effective strategy and guideline development of condom

programming in the country

 Support FHAPCO/MOH technically in areas on the condom supply chain

and quality assurance

 Serve as a national platform to enhance condom program coordination

among stakeholders engaged in condom services provision
 TWG ctd…

Membership

 The technical working groups has 15 members composed of

 FMOH (3 persons)
 FHAPCO(3 persons)
 Ethiopian Pharmaceutical supply agency 1 person)
 Ethiopia Public Health institute (1 person)
 Ethiopian Food and Drug Administration (1 person)
 UNFPA, UNAIDS, WHO, PSI, DKT, AIDS Health care Foundation(AHF)
(1 person each)
 One private organization representative
Major Activities of the condom TWG
1. Conducted ongoing discussions and desk reviews to identify problems underlying

condom availability, accessibility and sustainable supply and identified

 Lack of clear information on organizations engaged in importing condoms

 Poor coordination among the different condom programs (family planning and
STI/HIV)

 Weak quantification, procurement, distribution and tracking of condoms

2. Two sub-teams were organized within the condom TWG to conduct assessment

and look into challenges related to supply chain and quality of condoms
Observed challenges and Interventions

Supply Chain related Challenges

 Quantification was not aligned among the different programs even though the
beneficiaries in most cases are overlapping e.g. Family Planning and HIV/STI

 Service based forecast was considered to estimate family planning condom

requirement

 There are limitations in the data used (close to 11 million condom forecasted
annually)

 The HIV/STI Prevention program forecast is relatively better but there were
inconsistencies in some figures (number of FSW, number of sex acts per week)
 Observed challenges ctd…

Supply Chain interventions by TWG

 The team revisited the assumptions and quantified the universe of condom need

 The universe of condom need of the country will be the sum of the requirement
for the two programs

 The team also proposed a target (90% of the universe of need) to be fulfilled in
2020/21 and reaching 100% in year three.

 The resources and supply chain activities need to be aligned end-to-end

 The contributions of the different sources, in the total market approach, is also
analyzed and future direction proposed
 % of
Quantity in Source of % share
Year 90% Share TMA
Pcs Fund proposed
current

TGF 20.1 30 free

UNFPA 6 6 free

PSI-Ethiopia 6.4 6.4 free

2019/20 199,341,370 179,407,233 Social

DKT-Ethiopia 35.1 40
Marketing

Private Sector 0 5 commercial

AHF 0 2.5 Free

Total available supply in % 67.6 89.9  
Supply gap in % 32.4 10.1  

The contributions of bilateral/multilateral need to be increased and the contribution of private (commercial condom)
be realized to fill the anticipated gap
 Observed challenges ctd…

Quality related Challenges

The sub-team visited GHSC-PSM and EFDA offices to assess the process
undergone to assure the Quality of Condoms

 GHSC-PSM imports condoms for DKT, PSI and other projects supported
by USAIDS

 USAIDS has specifications and list of suppliers for condom

 Before importing condom, testing is done by the suppliers and FHI-360

 Once condoms arrive in-country, EFDA conducts post shipment inspection

and quality test
 Observed challenges ctd…

Quality related Challenges

 When condoms arrive in county;

 poor handling at ports (air and sea) and

 human error in post shipment testing

are causing variations in test results between pre-shipment (FHI-360) and post (EFDA)

 Out of 126 million condoms imported by GHSC-PSM the year prior to this visit, 2.6
million failed quality assurance test done by EFDA though the condoms passed
quality assurance test of FHI-360

 Lack of a recognized or accredited laboratories for checking variability in test

results
 Observed challenges ctd…
EFDA conduct quality test for:
 Registering/market authorization

 New consignment of condom/Post shipment testing

 Post market surveillance

 Suspected condom report from public, government or none government offices

 EFDA laboratory uses ISO 4074 of 2014 version minimum standard criteria

However:

 Trainings given for laboratory workers are not comprehensive that includes
maintenance of equipment (service interruption and error occurs)

 “Budget limitation to improve and excel quality management system”

 Way Forward

 It is recommended by the team to look for an external laboratory that will conduct
pre-shipment quality testing to minimize cost incurred due to rejection

 Strengthen the capacity of the EFDA to conduct QA test

 Review and upgrade condom quantification tool

 The teams strongly believe that coordination of condom programs and aligning the
supply end-to-end will improve the quality of condoms by pulling together all the
expertise and efforts

 The condom TWG will continue to technically support implementation of the

strategy

 Regional condom TWG need to be establishment and strengthening

Thank you