TITLE: Contraceptive procurement

ACTIVITIES: By 2009, the Government of Tanzania (GOT) estimates the overall demand for condoms will

be over 150 million per year. In 2007, condoms were distributed in Tanzania through a combination of

social marketing programs, the public sector, and commercial sector sales.

Public sector condoms have been procured through the World Bank and the Global Fund for the prevention

of HIV transmission, other sexually transmitted diseases, and for contraceptive purposes. For the first two

years of the Global Fund Round 4 award, roughly 100 million condoms will be procured and sent through

the public central distribution system. The GOT has proposed that PSI assist the MOH with the distribution

of condoms procured. There have been significant issues with overstocking at the central warehouse, with

very little stock being pushed to the regions or districts, in addition to a lack of deliveries to the lower level

facilities from the district sites. This is expected to improve as the roll-out of the integration logistics

systems occurs and several PEPFAR and non-PEPFAR funded partners continue to work with the public

distribution system.

The funds requested in FY 2008 are to supply approximately 8.5 million male condoms and 800,000 female

condoms to be distributed by the social marketing program Tanzania Marketing and Communications (T-

MARC). Social marketing in Tanzania has evolved from programs that used to target the general public, to

programs that are focusing specifically on most at risk populations (MARPS). These condoms will be

distributed in high HIV transmission areas such as communities surrounding mines, agricultural estates, and

truck stops and will be made available at places where high risk sex takes place such as bars and

guesthouses. AED's program has benefited from the 2006 launch of DUME condoms, a branded male

condom designed to appeal to MARPS. Lady Papeta, T-MARC's female condom was launched in 2005

and has been surprisingly popular, particularly among commercial sex work (CSW) populations. These

condoms will be distributed through an elaborate and extensive network of traditional (pharmacy) and non-

traditional (bars, nightclubs, and hotels) points of sale. Emergency Plan partners will also distribute

condoms targeting MARPS including PharmAccess targeting the military, a new Uniformed Services

prevention intervention targeting police, prison guards and immigration officials, and through the transport

corridor initiative ROADS targeting truckers, CSWs and other at risk populations living and working in the

project areas of operation. All distribution activities have been and will continue to be discussed and

negotiated with the National AIDS Control Programme.

Historically, condom procurement and distribution to public sector sites has been problematic, often due to

the unpredictability of donor support and the long lead times in planning for condom procurements in

Tanzania. The USG team believes there is an opportunity to plan carefully for future procurements for the

PEPFAR-supported programs to secure an even supply of condoms. The proposed funding covers the

identified need for condoms socially marketed by PEPFAR partners through the first part of 2010. While

this 2010 falls outside the normal programming period for the 2008 Country Operational Plan, this funding

must be secured and obligated in early 2009, in order to avoid supply chain disruptions. The long lead-time

for investing in new condoms for distribution in 2010 is largely due to the national forecast for condoms

being done on a schedule that does not coincide with COP planning.

LINKAGES: Any Other Prevention narratives for T-MARC, PharmAccess, ROADS, JSI, NACP and any

other social marketing programs.