I read through the article with the above title & the attached case study but was still not sure I could answer the question posed by the title of  a blog post from PSI Impact.

The title has been changed to "Can too many free and subsidized condoms actually harm markets?" Yes.

Jamie

++++++++++++++++++

Can Too Many Free and Subsidized Condoms Actually Reduce Access to Condoms?
Kim Longfield and Dana Sievers
PSI Impact
19 February 2015

In Myanmar, sexual encounters are the most common mode of HIV transmission, causing the epidemic to concentrate among key populations such as female sex workers (FSW) and their male clients (MC), as well as men who have sex with men (MSM). Since 1996, PSI/Myanmar has targeted its condom social marketing program to these groups in order to achieve the greatest impact by preventing the spread of infection.

PSI/Myanmar offers several varieties of Aphaw (“Trusted Partner”) branded condoms, which, through funding from PSI’s donors, are sold at subsidized prices. The attractive price is paired with mass media communications campaigns to promote use of the condoms among the FSW, MC, and MSM populations. Before Aphaw, there were few condom brands on the market, few advertising campaigns, and very little targeting of key populations at risk.

Since 1999, the National AIDS Programme and its NGO partners have distributed free, unbranded condoms to the poorest consumers, who cannot even afford subsidized Aphaw. The public sector distribution takes place in drop-in-centers, through peer educators, gatekeepers at brothels, and in massage parlors and karaoke venues. By 2009, these free condoms held a third of the market share.

Myanmar_2011-12_TalmarSoe_1358

In recent years, the Myanmar market has become more dynamic with more commercial businesses entering the market. Commercial condoms can cost three times more than Aphaw because they are targeted at well-off consumers who want (and can afford) brands that symbolize quality and luxury. Male clients of FSW, who are often wealthier, were poised to be a strong consumer base; however, the commercial sector had only reached about 5 percent market share by 2009 because many MC continued to buy the Aphaw brand that they knew and trusted.

In theory, the Myanmar market for condoms aspired to a total market approach (TMA). TMA segments the market so that the poorest consumers receive free products through the public sector; those with some resources buy subsidized products, usually through NGO-affiliated social marketers; and those with even greater resources purchase products through the commercial sector. By directing public finances to those who cannot afford products and services on their own, TMA can help governments achieve commitments and meet the health needs of the poorest and most vulnerable. Better use of donor funds for socially marketed products and opening up the commercial sector helps the market grow and become sustainable.

Central to successful TMA programs are partnerships that leverage each actor’s strengths and allow them to maximize their impact. The Myanmar experience, however, revealed that because the public, NGO, and commercial sectors’ work was not coordinated, the market for condoms was not functioning as efficiently as it could be.

There were two sources of inefficiency: 1) well-off consumers who could afford commercial brands were overcrowding the market for subsidized Aphaw condoms; and 2) public sector condoms, which were distributed for free, were not appropriately targeted to those in need and were being sold on the black market. Aphaw and public sector condoms thus held more than 90 percent of the market share—far more than their target population of low-income consumers—raising concerns about sustainability of the subsidized and commercial markets for condoms.

When it comes to markets, PSI aims to uphold a “do no harm” principle that compels it to work in a way that promotes equity and sustainability and protects individuals’ right to affordable health products. PSI/Myanmar recognized that it had to change its approach in order to avoid doing harm to the commercial market. Research suggested that better segmentation and coordination among the sectors would ensure that appropriately priced brands were reaching the right consumers.

In 2010, PSI/Myanmar started applying TMA concepts to improve the market’s efficiency. To learn how PSI’s role in the market changed, and how those adjustments brought a greater impact, read our case study in the most recent Cases in Public Health Communications and Marketing journal, published in collaboration with George Washington University’s Milken Institute School of Public Health, PATH, Abt Associates, United Nations Population Fund (UNFPA) and USAID.

http://publichealth.gwu.edu/departments/pch/phcm/casesjournal/volume8_suppl1/files/CasesVol8SupplLongfield_Final.pdf

http://psiimpact.com/2015/02/can-too-many-free-and-subsidized-condoms-actually-reduce-access-to-condoms/?utm_content=buffer044fc&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer