Should It Really Take $100K to Create a Condom Men Will Actually Use?

Apr 3, 2013 | Anna Tomasulo | DD on Take Part

People generally like sex. A lot. With so many fans out there, and many of those folks needing to use contraception and stay safe from infections, the latest challenge issued by the powerhouse philanthropic organization, the Bill and Melinda Gates Foundation—to create a better condom—could get a huge response.

Simply put, the foundation has put out an open call for ideas for creating a condom that men will actually want to wear, thus dramatically reducing sexually transmitted diseases (STDs). Gates is asking for the granddaddy of all condoms.  

The “Grand Challenges in Global Health” program is a group of grants administered by the organization, with the goal of improving health worldwide through creative solutions to long-standing problems. The approach of Grand Challenges is inspired by mathematician David Hilbert, who famously identified 23 problems facing the mathematicians of his day. “The Problems of Mathematics” provided the foundation for mathematical research in the 20th century.

Similarly, Gates has identified 16 challenges in global health. These include creating vaccines that don’t require refrigeration; developing needle-free delivery systems; creating therapies that can cure so-called “latent infections” like HIV and, in some cases, tuberculosis, that have the potential to cause visible illness; and improving rates of healthy births and healthy kids. Clearly, the Gates Foundation thinks big.

If you think you’ve got a great idea for making condoms better (and getting more people to wear one during sex), you could be the winner of a $100,000 check.  And if a project continues to promise more successes after the first round of grants, the initial recipients are eligible to receive follow-up grants of $1 million.

This particular challenge is making headlines, but it isn’t actually that revolutionary. We have had basically the same condom for decades—still our best option for partners who want to use a barrier during sex to lower rates of transmission—and yet we still have soaring rates of STDs: According to the World Health Organization (WHO), there are 448 million new infections of curable, preventable STDs occurring every year. In 2011, the WHO reported approximately 34 million people living with HIV. What’s new, though, is that STDs are developing drug resistance, making some of them much harder to treat.

And if we have a simple, low-cost device that’s so effective at preventing STDs (a 2007 Cochrane review concluded that condoms, used properly, can lower the incidence of HIV by approximately 80 percent), yet we still have 448 million cases occurring annually, something is still not right, clearly.

And while, for now, most STDs are treatable, there is a big health impact on health, especially on women. These infections hurt the reproductive health of many women, as well as mothers and newborns. For example, untreated syphilis can increase the risk of stillbirth and newborn death. Further, untreated STDs significantly increase the risk of HIV infection and transmission, which should concern us all.

According to the HIV/AIDS charity, condoms have been around since ancient Egypt. The first published use of condoms was in Europe during the 1500s, as protection against syphilis, and the first latex male condoms were developed in 1919 by Frederick Killian. There haven’t been many significant changes to the structure of the condom; most have been only superficial changes to this long-standing design.

Perhaps the most common complaint about using a condom (and the top reason for not wanting to use one) is that sex doesn’t feel as good. And some men don’t like the rubbery smell and interrupting foreplay or sex to find and put on a condom. You’d think that with potential consequences like drug-resistant gonorrhea, HIV, or unwanted pregnancy, wearing a condom would be a no-brainer, no matter what it smells like. But that’s not the case; and getting people to change a behavior is not easy. The Gates Foundation recognizes this and is asking the very people who use condoms to design one that will overcome some of these pitfalls and complaints.

Clearly, ribbed, flavored, and glow-in-the-dark prophylactics aren’t enough to get us where we need to be in terms of ideal condom use. Two notable condom designs—far surpassing the quick fixes of color and scent change—are ORIGAMI’s condom and The Wingman. ORIGAMI has significantly changed the structure of the condom: This group has created a male condom, a female condom, and a condom specifically for anal-receptive intercourse. The male condom is a non-rolled, molded, silicone condom. It expands like an accordion, and is intended to enhance the sexual experience while being easy to put on (in just 2.8 seconds!), completely biocompatible (no allergic reactions!), and entirely viral-impermeable (no disease!). The ORIGAMI is not yet approved by the FDA or the WHO, but clinical trials have begun in California and the creators expect the condom to be available for sale in 2015. 

The Wingman focuses on application as well, This condom, created a few years ago by Dutch engineers, has a plastic ring with two “wings” around the opening of the condom. This simple plastic add-on means the condom is now super-easy to put on—the right way—in the dark and with just one hand; all a guy has to do is hold onto the ring and slide it down. Once the condom is on, you tilt the plastic ring back, causing it to detach from the latex. Done!

TEDMED, an off-shoot of the famous TED Talks, hosts a similar competition, called the “Great Challenges.” Instead of offering solutions, TEDMED gathers leaders of a given field and organizes multidisciplinary teams to engage in nationwide debate around these challenges. Twenty challenges have been identified, all focusing on health, and including promoting active lifestyles; reducing the impact of poverty on health; preparing for dementia; instituting whole-patient care; and improving medical communication. The goal is to achieve a richer understanding of these challenges. You can watch recordings of live TEDMED events ontheir site.

TEDMED and Gates should be applauded for fostering such creativity and innovation. Here’s hoping that these efforts will spawn the creation of some truly remarkable health solutions.



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