South Africa's Brief History of Free Condoms
Against the backdrop of reports that condom distribution has dropped, we look at how safe sex became the state's responsibility in South Africa.
South Africa faces a concerning trend—a drop in the distribution of free condoms, as recently reported by news outlets in the country.
This decline raises questions about a flagship State’s program that has been instrumental in tackling HIV/AIDS, a one-time national health crisis in South Africa.
Drastic
According to a public policy document—the Health System Trust’s District Health Barometer that provides a snapshot for understanding health service delivery across South Africa—the drop in condom distribution has been drastic over the last five years.
It shows that in 2022, the government distributed 45% fewer male condoms as compared to 2018, which represents a drop from 728 million to just 403 million, with a difference of more than 300 million.
The decline also affected the distribution of female condoms, but at lesser scale.
Speaking to a radio newscast, Bongiwe Ndlovu who is a Project Manager for a national youth health advocacy organisation said bureaucracy is mainly to blame for the situation.
She said condoms suppliers are facing delays as they await approval from the South African Bureau of Standards (SABS).
The implications of this decline are severe. South Africa has one of the highest HIV prevalence rates globally, with an estimated 7.5 million people living with the virus.
Condoms remain the most effective way to prevent HIV transmission during sexual intercourse. A decrease in their accessibility could lead to a resurgence of new infections.
But how did condoms come to be free in the Rainbow Nation, with the State assuming responsibility for the promotion of safe sex?
A History of Free Condoms
“HIV/AIDS does not discriminate by race, gender, or sexual orientation, and neither should our response.”
—Nelson Mandela, 14 July 2000
South Africa's free condom programme is a relatively new initiative born out of what’s been described as a national health crisis.
The early 1990s saw a rapid rise in HIV/Aids cases, prompting the government to take decisive action.
In 1994, with the end of the apartheid regime, the newly elected ANC government made public health a priority.
One of the key strategies was the National Aids Prevention Program (NAPP), which kicked off in 1997.
The NAPP placed emphasis on public education about HIV/Aids and safe sex practices. This included the free distribution of condoms at government clinics and public health facilities.
Nelson Mandela’s 2000 speech at the XIII International AIDS Conference highlighted the government's commitment at the time to combat the pandemic.
“HIV/Aids does not discriminate by race, gender, or sexual orientation, and neither should our response,” Mandela had famously declared in what was a watershed moment that marked a shift in the global commitment to the fight against HIV/Aids.
South Africa’s free condom programme has undoubtedly played a crucial role in curbing HIV transmission in the country.
Studies by the Medical Research Council show a significant increase in condom use following the programme's implementation.
This, coupled with access to antiretroviral treatment (ART), has contributed to a decline in new HIV infections and Aids-related deaths.
But clearly, the programme now faces challenges. The recent drop in distribution highlights the need for better supply chain management and outreach efforts.
And beyond distribution, there are other resistance factors to safe sex. Social stigma, particularly amongst young people, remains a hurdle. And conservative religious groups frown upon the programme, which they view as an encouragement to premarital sex.